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Aim: This study aimed to evaluate the effects of uncoated paper on skin moisture, pressure injury risk and pressure injury incidence in neurological intensive care unit patients. Methods: A randomized controlled design was used. The experimental group (n = 68) received usual care (repositioning every 2 h and use of an air mattress) and application of uncoated paper on the sacral area for 5 days, whereas the control group (n = 67) received only usual care. A repeated measures analysis of variance was used to determine changes in the skin moisture and risk of pressure injury between the groups. A chi‐squared test was used to determine the change in the incidence of pressure injuries for sacral area. Data were collected from 20 October 2017 to 6 March 2018. Results: There were statistically significant differences in the skin moisture and risk of pressure injuries between the experimental and control groups. However, a significant difference was not observed in the incidence of pressure injuries between the groups. Conclusion: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients. SUMMARY STATEMENT: What is already known about this topic? The neurological intensive care unit patients with motor deficits, loss or deterioration of sensory function and decreased consciousness have high risk of pressure injuries.Although various guidelines consider excessive skin moisture as an important cause of pressure injuries, few targeted interventions exist to manage excessive skin moisture. What this paper adds? The uncoated paper application was effective in reducing skin moisture in neurologic intensive care unit patients.In addition, application of uncoated paper application has an effect on risk of pressure injury in neurologic intensive care unit patients. The implications of this paper: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients.Nurses should recognize that pressure injuries are potentially preventable adverse events and use various preventive interventions including skin moisture management. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aims of this study were to measure skin moisture and transepidermal water loss after application of uncoated paper and to compare skin moisture and transepidermal water loss after use of uncoated paper and disposable underpads. Study design. The study was a cross-over, prospective, open-labeled, randomized trial. Sample and setting. Bedridden patients aged ≥18 years at a medical center in Korea were included. Treatment order was randomly assigned using block randomization, with a block size of 4 and an assignment rate of one-by-one. Methods. Skin moisture was measured using a Corneometer 825 and transepidermal water loss was measured using a Tewameter 300. Results. Skin moisture after application of an uncoated paper was significantly lower than observed after application of a disposable underpad (mean 40·6 and SD 13·1 vs. mean 64·6 and SD 23·7, p < 0·001). Transepidermal water loss also showed greater health scores after using uncoated paper (mean 11·1 and SD 5·7 g/m2/hour) than after applying a disposable underpad (mean 23·2 and SD 11·1 g/m2/hour, p < 0·001). There were no statistical between-group differences in room temperature, relative humidity, and body temperature. Conclusion. We found that uncoated paper was helpful in avoiding excessive moisture without adverse effects. Relevance to clinical practice. As indicated by the results of this study, uncoated paper can be applied to bed-ridden patients who required incontinence care. Nurses may consider using uncoated paper as one of nursing methods in the routine care of bed-ridden patients for moisture control. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the effect of the Roy adaptation model‐based strengthening program (RAMBSP) applied to nursing students on social media addiction, healthy lifestyle behaviours and self‐esteem. Methods: One hundred five nursing students studying at a nursing faculty of a university were included in this prospective, two‐armed (1:1), randomized controlled study. The study group (n:54) had 12 weeks of RAMBSP online group sessions. No intervention was made to the control group (n:51). The social media addiction level, which was the primary outcome of the study, was evaluated with the Bergen Social Media Addiction Scale (BSMAS) and healthy lifestyle behaviours and self‐esteem, which were secondary outcomes, were evaluated with the Healthy Lifestyle Behaviours Scale II (HLBS‐II) and the Rosenberg Self‐Esteem Inventory (REI). Students filled out BSMAS, HLBS‐II, and REI online via Google Forms before and after RAMBSP. Findings: At the end of the programme, there was no significant difference between the groups in terms of BSMAS scores of the students in the study group (p > 0.05); however, the difference was significant in terms of HLBS‐II and REI scores (p < 0.05). It was determined that the empowerment programme increased students' awareness of social media addiction. Conclusion: It is recommended to implement programmes that will increase students' awareness of social media addiction and its effects and to conduct new research that will cover large and different sample groups. Trial registration: It was registered at ClinicalTrials.gov in March 2021 (NCT04820517). Summary statement: What is already known about this topic? With the development of technology, social media addiction is widely seen in nursing students, who are a fragile group.Biopsychosocial approaches should be presented together in practices aimed at reducing or controlling the use of social media.It is not known whether an empowerment programme based on the nursing model (Roy adaptation model) to reduce social media addiction in nursing students is effective. What this paper adds? This programme constitutes an example of how to combine Roy adaptation model, one of the nursing models related to reducing social media addiction and providing controlled social media use, with the empowerment programme.The strengthening programme based on Roy adaptation model helped student nurses to acquire and maintain healthy lifestyle behaviours by increasing their awareness of social media addiction and improving their self‐esteem. The implications of this paper Roy adaptation model‐based psychoeducation should be conducted to enable nursing students to gain awareness of social media addiction and its consequences.Roy adaptation model‐based activities should be planned and implemented to intervene in students with social media addiction and to lead them to healthy social media use.Course contents should be added to the nursing curriculum to encourage the use of social media in a way that is effective, safe and contributes to personal development. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

Background: High cognitive load in nurses is a common problem in the intensive care unit (ICU). However, it remains unclear what different types of cognitive load the ICU nurses have experienced during the implementation of delirium interventions. Aim: To describe the characteristics and explore the effect of implementing a delirium intervention on the cognitive load of nurses working in the ICU. Methods: A cluster‐randomized controlled clinical trial was conducted. Six ICUs were randomized in a 1:1 ratio, and eligible nurses from these units provided either a delirium bundle intervention in addition to usual care (27 nurses) or usual care alone. An instrument was used to measure different types of cognitive load (MDT‐CL), assessing intrinsic, extraneous and germane cognitive load. The repeated measures analysis of variance was used to detect between‐group differences. Results: Among these nurses, significant between‐group differences were identified in terms of their overall (P < 0.001), intrinsic (P < 0.001) and extraneous (P < 0.001) cognitive load. There was no significant change observed in the germane cognitive load (P = 0.489) in the delirium intervention group. Conclusion: It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses, in order that tailored strategies can be applied to reduce cognitive load in ICU nurses. Summary statement: What is already known about the topic? ABCDEF bundle interventions are effective to reduce ICU delirium incidence and improve clinical outcomes.Nursing care in the intensive care units is characterized by elevated demand on workloads and increased cognitive load.Cognitive load has been identified to include three different types: intrinsic cognitive load, extraneous cognitive load and germane cognitive load. What this paper adds? The application of a delirium intervention in ICU nurses can increase the intrinsic, extraneous and overall cognitive load but had no effect on the germane cognitive load in ICU nurses.It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses so that tailored strategies can be applied to reduce cognitive load in ICU nurses. The implications of this paper: Evaluating different types of cognitive load in ICU nurse is helpful to support appropriate allocation of nursing resources and improvement of patient safety.This study highlights the necessity of improving efforts focusing on reduction of the intrinsic and extraneous cognitive load related to nursing care for delirium in ICUs. [ABSTRACT FROM AUTHOR]

Aim: This study compared the effects of web‐based and face‐to‐face education given to office workers on health beliefs and physical activity levels towards obesity. Methods: The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846. Results: A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05). Conclusion: It was determined that web‐based and face‐to‐face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level. Summary statement: What is already known about this topic? Beliefs about obesity and physical activity are changed by face‐to‐face education methods.Along with the changing and developing technology, web‐based education has gained importance as well as face‐to‐face education.Studies on the effect of web‐based education compared with face‐to‐face education are limited. What this paper adds? This study determined that face‐to‐face education and web‐based education had an effect on beliefs about effecting change in obesity and the duration of physical activity.Web‐based education can be as effective as face‐to‐face education for this. The implications of this paper: Individuals' beliefs about reducing obesity can change with face‐to‐face education and also with web‐based education, which can be accessed more easily in desired time periods.Web‐based education can be used to improve obesity in cases where face‐to‐face education cannot be applied. [ABSTRACT FROM AUTHOR]

Aim: This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia. Methods: A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes. Results: Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention. Conclusion: A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes. Summary statement: What is already known about this topic? Family‐supported diabetes self‐management education intervention produced inconclusive effects on self‐management behaviour and quality of life. What this paper adds? A social‐cognitive theory‐guided, culture‐tailored, and community‐based diabetes self‐management education and support programme resulted in a preliminary effect on improving self‐management behaviour and quality of life.A nurse‐led diabetes self‐management education and support programme intervention, including the families of patients, may be an option to boost the self‐management practise and quality of life of people with diabetes. The implications of this paper: Culturally tailored diabetes self‐management education and support programme could be an option to improve self‐management behaviour and enhance quality of life.Community‐based nurse‐delivered diabetes self‐management education and support can improve self‐management behaviours and enhance quality of life in 2 months duration. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (i) evaluate the effectiveness of mindfulness‐based interventions in improving self‐efficacy, reducing stress and anxiety among peritoneal dialysis patients, and (ii) compare the most effective method of mindfulness based interventions. Methods: This randomized three‐arm controlled trial recruited first‐time peritoneal dialysis patients from the peritoneal dialysis outpatient clinic in Singapore. Patients were randomly allocated to either video‐assisted mindfulness training, therapist‐assisted mindfulness training or treatment‐as‐usual. All groups received 4.5 days of structured peritoneal dialysis training at the peritoneal dialysis centre, while video‐assisted mindfulness training and therapist‐assisted mindfulness training groups were taught additional mindfulness‐based techniques. The perceived stress scale, self‐efficacy, and anxiety (State and Trait Anxiety Inventory) were measured at baseline, 4‐ and 12 weeks post‐randomization, using reliable and valid instruments. Results: Thirty‐nine patients were recruited (13 in each group). All the therapies showed a significant time trend in anxiety. Only therapist‐ and video‐assisted mindfulness training showed a significant trend in perceived stress scale scores but not treatment‐as‐usual. All Intervention X Time interactions were not significant. Patients in therapist‐ and video‐assisted mindfulness training groups had reduced perceived stress scale scores compared to treatment‐as‐usual at week 12. Conclusion: This study demonstrated the potential of mindfulness‐based interventions in reducing stress among first‐time PD patients. Summary Statement: What is already known about this topic? Mindfulness‐based interventions have been recommended to mediate stressful events.Mindfulness‐based interventions as complementary therapy can be taught to patients who are starting peritoneal dialysis for the first time; however, the best method to guide mindfulness‐based interventions is unknown. What this paper adds? The findings showed that mindfulness‐based interventions can potentially reduce stress and anxiety but have no statistically significant effect on self‐efficacy for patients undergoing peritoneal dialysis for the first time.Video‐ or therapist‐guided mindfulness training is just as effective in teaching mindfulness‐based interventions. The implications of this paper: Nurses hold an essential role in improving the experience of patients undergoing peritoneal dialysis by advocating and facilitating the use of MBI during dialysis, especially those who display high levels of stress and anxiety, as well as signs of coping issues. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the effects of a web‐based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self‐efficacy and the labour process in primigravida women. Methods: The study was conducted in a single‐blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A‐B, the Childbirth Self‐efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education. Results: Fear of birth was lower, and the birth self‐efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery. Conclusion: Health Belief Model‐based web‐based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self‐efficacy and positively affect the birth process in primigravida women. Summary statement: What is already known about this topic? Caesarean delivery is an important health problem that is common all over the world.Fear of childbirth and low self‐efficacy are two important reasons for the increase in the frequency of caesarean section rates.Nurses can make important contributions to the prevention of optional caesarean birth by providing women with health education.What this paper adds? The web‐based birth preparation programme based on the Health Belief Model and motivational interview decreased fear of birth and improved attitudes and behaviours towards vaginal delivery by increasing health beliefs and birth self‐efficacy.The implications of this paper: This study brings a new perspective, indicating that a birth preparation programme based on the Health Belief Model and supported by motivational interviews with primigravida women is an effective method of preventing elective caesarean delivery.It is recommended that nurses use web‐based training tools and conduct cognitive behavioural strategies in antenatal classes. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to explore the effects of a guided self‐help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. Background: Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face‐to‐face delivery of mindfulness interventions may be inconvenient for individuals. Guided self‐help interventions may be more accessible. Methods: This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8‐week guided self‐help mindfulness intervention, while the individuals in the control group received a psycho‐educational brochure. The Five Facet Mindfulness Questionnaire, the Connor‐Davidson Resilience Scale and the Maslach Burnout Inventory‐Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. Results: After an 8‐week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. Conclusions: The guided self‐help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses. Summary statement: What is already known about the topic? Mindfulness‐based interventions can improve psychological resilience and reduce job burnout of nurses.A growing body of studies has begun incorporating self‐help strategies with mindfulness‐based interventions.There are few studies exploring the use of the guided self‐help mindfulness interventions for Chinese psychiatric nurses and the associated effects on psychological resilience and job burnout. What this paper adds? The guided self‐help mindfulness intervention reduced job burnout and improved psychological resilience compared with psycho‐education intervention. Implications of this research Self‐guided mindfulness interventions can be used to improve psychological resilience and reduce job burnout among psychiatric nurses.In the future, the impact of self‐help mindfulness interventions on the mental health of nurses in other specialties can be trialled. [ABSTRACT FROM AUTHOR]

Aim: The study aimed at evaluating the effect of posture correction and stretching movements on lordosis and lumbar pain in pregnant women. Background: An increased lumbar lordosis during pregnancy is considered one of the most common causes of lumbar pain. Methods: This quasi‐experimental study was performed on 66 pregnant women referred to health centers in Tabriz, Iran, from November 2020 to June 2021. The participants were randomly assigned to the intervention and control groups. The intervention group received training of posture correction movements and stretching exercises during pregnancy from 16 to 18 to 35–37 weeks of pregnancy in six sessions for 45–60 min. The data were collected using a flexible ruler and a visual analog scale. Independent t‐tests, repeated measures ANOVA, and ANCOVA tests were used. Results: The mean (standard deviation: SD) of lumbar lordosis increased from 45.12 (2.07) to 54.97 (2.20) in the intervention group at 35–37 weeks and changed from 44.28 (2.03) to 55.54 (3.39) in the control group at 35–37 weeks (adjusted mean difference: −1.24, 95% confidence interval: −2.48 to −0.005, P = 0.04). The mean (SD) of lumbar pain at 28–30 weeks was 2.80 (1.72) in the intervention group and 3.74 (2.23) in the control group (P = 0.09). However, the mean (SD) of lumbar pain at 35–37 weeks in the intervention group 4.38 (2.45) was significantly lower than that in the control group 5.83 (2.96) (P = 0.04). Conclusion: This study provides evidence for the potential health benefits of training posture correction and stretching movements on controlling lumbar lordosis and reducing lumbar pain during pregnancy. Summary statement: What is already known about this topic? One of the most common causes of low back pain refers to the enhancement of lumbar lordosis.The standard corrective movements and stretching exercises approved during pregnancy increase muscular strength and reduce the severity of lordosis if they are done regularly. What this paper adds? This is the first study that investigates the impact of a childbirth preparation program including posture correction and stretching movements on lordosis and lumbar pain in pregnant women.The findings indicate that the posture correction movements and stretching exercises delivered in childbirth preparation classes are effective in controlling the enhancement of lumbar lordosis during pregnancy and reducing lumbar pain. The implications of this paper: Training of posture correction and stretching movements during pregnancy is recommended for all pregnant women with no contraindication to exercise during pregnancy and even for women with a history of caesarean section who may decline to participate in the preparation classes for physiological birth.Evidence‐based posture correction/exercise guidelines during pregnancy should be developed and embedded in prenatal care. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Background: Pain and anxiety management in patients undergoing medical and surgical procedures is an important competence area for nurses. Aim: This study aimed to determine and compare the effects of virtual reality and acupressure interventions on pain, anxiety, vital signs and comfort levels in the process of femoral catheter extraction for patients undergoing coronary angiography. Methods: The study was a single‐blind, three‐group, randomized controlled trial conducted in the cardiology clinics of a university hospital in 2021. A total of 153 patients (51 virtual reality, 51 acupressure, 51 control) participated in the study. Data were collected using a Visual Analogue Scale, the State–Trait Anxiety Inventory, a vital signs follow‐up form and the Perianesthesia Comfort Scale. Results: Both intervention groups had significantly lower pain and anxiety scores, as well as higher comfort scores, compared to the control group (p < 0.001). The virtual reality group had lower systolic blood pressure, respiratory rate and pulse rate than the control group (p < 0.05). The acupressure group had lower systolic and diastolic blood pressure and respiratory rate than the control group (p < 0.05). Conclusions: While neither intervention group was found to be superior to the other, both interventions improved vital signs and comfort levels by reducing pain and anxiety. Summary statement: What is already known about this topic? Uncontrolled pain and anxiety during medical and surgical procedures may increase the risk of complications and have negative effects on the pulmonary and cardiovascular systems, leading to changes in vital signs and compromising patients' hemodynamics.Virtual reality has demonstrated its potential to restore cognitive attention capacities, enabling patients to remain engaged and mentally focused during procedures, and thus reducing pain and anxiety.Acupressure, as a non‐pharmacological intervention, involves applying pressure to specific points on the body to alleviate pain and anxiety. It constitutes a safe, side‐effect‐free and cost‐effective option for improving patient outcomes.What this paper adds? This paper contributes to the knowledge of virtual reality and acupressure interventions as non‐pharmacological approaches that nurses can safely incorporate within their independent professional roles.The study evaluates the effects of traditional acupressure and technological virtual reality interventions on patients, comparing the two interventions for the first time to the best of our knowledge. Furthermore, to the best of our knowledge, these procedures were applied for the first time in femoral catheter extraction after coronary angiography.The implications of this paper: This study emphasizes the positive impacts of virtual reality and acupressure interventions administered by nurses for patients undergoing medical procedures.Overall, the findings suggest that non‐pharmacological techniques such as virtual reality and acupressure can contribute to a similar degree in improving patient outcomes during medical procedures. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test the effect of Otago exercises on fear of falling, balance, empowerment and functional mobility in older people living in nursing homes. Methods: This study is a parallel‐group randomized controlled trial. In total, 56 individuals were stratified randomized according to age‐gender. Participants were recruited from September 2021 to August 2022. Data were collected at baseline, in the 8th and 12th weeks. The researcher gave Otago exercise training to the intervention group three times per week for the first 4 weeks and applied it to the individuals, and in the next 8 weeks, the researcher visited the institution to ensure the continuity of the exercises and contacted the individuals by phone. Friedman test and generalized linear model were used in the analysis of data. Results: In the study, group and time interaction were found to be significant in terms of the Berg balance scale, 30‐second sit‐and‐stand test, elderly empowerment scale and timed up‐and‐go test. It was determined that the intervention did not improve fear of falling, upper extremity strength and 6‐min walk test results. Conclusion: Health personnel and administrators should have increased awareness about Otago exercises and can recommend implementation of the programme. Summary statement: What is already known about this topic? Otago exercises are an evidence‐based, home‐based programme for improving balance.What this paper adds? Otago exercises can improve the balance, lower‐extremity strength, elderly empowerment score and timed up‐go test score of older people living in nursing homes.The Otago exercise programme did not improve the fear of falling, the strength of the upper extremities and the 6‐min walk test results for older people living in nursing homes.The implications of this paper: Health personnel and administrators should be aware of the potential benefits of Otago exercises and can recommend implementation of the programme.Nurses working in nursing homes can be taught how to deliver the programme and to plan training to roll out the programme. [ABSTRACT FROM AUTHOR]

Background: Breathing exercises, such as diaphragmatic breathing and positive expiratory pressure (PEP), relieve breathlessness in people with chronic obstructive pulmonary disease (COPD). Aim: This study aimed to investigate the effects of breathing exercises with PEP and reading aloud on vital signs, fatigue level, severity of dyspnoea and respiratory function parameters in patients with COPD. Design: The study followed a randomized controlled trial of COPD patients from a single hospital in eastern Turkey. Methods: The study included 103 patients who were randomly assigned to receive pre‐reading exercises, breathing exercises with a PEP device or no intervention for 8 weeks. Results: The use of a PEP device improved oxygen saturation, forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) values and reduced fatigue and dyspnoea severity. Reading aloud lowered the mean arterial pressure and reduced fatigue and dyspnoea severity. Conclusion: The study concludes that PEP devices and reading aloud can improve respiratory function in patients with COPD. Additionally, reading aloud is an accessible, easy‐to‐implement and economically feasible method for treating COPD symptoms. Summary statement: What is already known about this topic? Chronic obstructive pulmonary disease (COPD) causes cough, shortness of breath, fatigue and impaired exercise capacity. The most common symptoms are dyspnoea and fatigue.The treatment and prognosis of COPD require skilled nursing care. Breathing exercises guided by nurses relieved the symptoms.Information technologies are increasingly used for COPD monitoring and therapy. Remote patient monitoring, especially the use of wearables, can improve patient outcomes and reduce healthcare expenditures.What this paper adds? Reading aloud and positive expiratory pressure (PEP) breathing exercises can improve vital signs and lung function in patients with COPD, with the latter being more effective.Wearable technologies for remote patient monitoring can help manage COPD and improve patient outcomes.The implications of this paper: Wearable technologies for remote patient monitoring can support COPD management and improve patient outcomes.Pulmonary exercise devices improve oxygen saturation, forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) in COPD patients while reducing fatigue and dyspnoea. These devices help patients with COPD breathe easily.Reading aloud reduces fatigue, dyspnoea and mean arterial pressure. COPD patients can benefit from reading newspapers, magazines and novels aloud. [ABSTRACT FROM AUTHOR]

Aims: To assess the effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease (COPD). Background: A few recent studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with COPD. More studies are needed to prove its benefits. Design: This study used a quasi‐experimental design. Methods: Seventy‐two admitted COPD patients were assigned to experimental group or control group through purposeful sampling. Data were collected from March 2016 to November 2017 in the Thoracic Intensive Care Unit of a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale and the Clinical COPD Questionnaire were measured before education and at the first, second and third months after discharge. Results: The Medical Research Council dyspnea scale and COPD Self‐Efficacy Scale results in the experimental group were significantly improved compared with the control group in the third month after discharge. The Clinical COPD Questionnaire score continued to improve in both groups in the third month after discharge, and there was no difference between the two groups. Conclusion: A short‐term unsupervised home‐based pulmonary rehabilitation with self‐ management program had significant benefits for patients with COPD. The long‐term effects need to be confirmed. Summary statement: What is already known about this topic? The literature emphasizes the importance of alternative supervision of home‐based pulmonary rehabilitation rather than center‐based pulmonary rehabilitation for patients who find this inconvenient to access.Few studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with chronic obstructive pulmonary disease (COPD). What this paper adds? This study demonstrates that a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program can improve dyspnea during physical activity, self‐care efficacy in certain activities and quality of life after discharge in patients with COPD. The implications of this paper: The findings of this study can be used as the basis for providing a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program for patients with COPD after discharge.We recommend that patients with COPD undergo unsupervised home‐based pulmonary rehabilitation with self‐management for 3 months after discharge, especially if regular hospital visits for this are not convenient.The effect of longer‐term unsupervised home‐based pulmonary rehabilitation can be further studied in the future. [ABSTRACT FROM AUTHOR]

Background: Occupational stress is generally acknowledged as a major issue in the health sector that may have a detrimental impact on nurses' psychological and physical health, particularly during the COVID‐19 epidemic. Aim: This study evaluated the effectiveness of a psychoeducational interventional programme in decreasing occupational stress and improving coping methods among nurses during the COVID‐19 pandemic. Methods: This study used a cluster‐randomized approach. Data were collected from 80 nurses working in two public health‐care centres from May to August 2020 in Jordan. Two centres were assigned randomly to the intervention and control groups. The psychoeducational programme was delivered to the intervention group in six sessions over 6 days for 2 weeks. The collected data were analysed using SPSS through descriptive and inferential statistics. Occupational stress and coping strategies were measured. Results: Repeated‐measures analysis of variance (ANOVA) indicated that the degrees of occupational stress and coping strategies significantly differed between study groups over the three points of data collection. Conclusion: This psychoeducational interventional programme is a valuable noninvasive method that can improve individual coping strategies to manage stress in practice during the COVID‐19 pandemic. Summary statement: What is already known about this topic?: Nurses face high degrees of occupational stress throughout the COVID‐19 pandemic.Nurses are vulnerable to mental and physical health problems because of the high degrees of stress.Current evidence of the effectiveness of psychoeducational programmes on occupational stress and coping strategies is limited due to a lack of well‐designed randomized trials. What this paper adds?: This psychoeducational interventional programme can effectively reduce occupational stress and improve coping strategies among nurses in clinical settings during the COVID‐19 pandemic.The results of this study are expected to serve as a guide for nursing leaders and policymakers to modify plans, procedures and protocols to utilize effective stress‐preventive strategies for nurses and occupational stress management during the COVID‐19 pandemic.The study can help nursing educators develop an efficient clinical education plan that addresses the needs of nurses and students to manage future occupational stress appropriately. The implications of this paper: This study can help nurses improve individual coping strategies to manage occupational stress in clinical practice during the COVID‐19 pandemic.This research can inform future researchers who would like to study the same issue in another context and use a qualitative approach for in‐depth analysis.This study offers nursing educators, including clinical nursing instructors, lecturers and other academic faculty staff, a better understanding regarding occupational stress among nursing staff in clinical practice and their coping strategies. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to test the effects of a novel diabetes self‐management education (DSME) programme focused on multilevel social resources utilization on improving self‐management behaviour, social resources utilization and haemoglobin Alc (HbA1c) in patients with type 2 diabetes mellitus (T2DM). Methods: A randomized controlled design was used. A total of 118 participants with T2DM from two communities were recruited through randomized sampling, and randomly assigned to the novel DSME group or the traditional DSME group. DSME focusing on multilevel social resources utilization was implemented in the novel DSME group. Data were collected at baseline (T0), at the end of the intervention (T1) and 3 months after the end of intervention (T2) from 3 March to 16 November 2014. Results: Comparing these two groups, the participants in the novel DSME group reported significantly better improvement in self‐management behaviour and social resources utilization at T1 and T2 (all p < 0.01). A significant difference was found in the mean improvement of HbA1c level between the two groups at T2 (p < 0.05). Conclusions: The novel DSME programme focused on multilevel social resources utilization can effectively enhance T2DM patients' self‐management behaviour and social resource utilization and lower HbA1c levels. More importantly, the effects could last longer. Summary statement: What is already known about this topic? Traditional diabetes self‐management education does not guarantee lifelong effective diabetes self‐management behaviour.The utilization of multilevel social resources has been found to be positively associated with self‐management behaviour and health outcomes of patients with chronic diseases. What this paper adds? The novel diabetes self‐management education programme is beneficial to community patients with type 2 diabetes mellitus as it shows significantly better effects in improving diabetes self‐management behaviour, social resources utilization and HbA1c level, and the effects last longer.Due to the large diabetes patient population and the relative shortage of medical resources in China, focusing on inspiring patients' initiative to actively tap and utilize existing and potential social resources for self‐management is indicated when developing education protocols for diabetes patients. The implications of this paper In addition to traditional self‐management education, community health‐care professionals should pay attention to the education of social resources utilization to further improve and solidify diabetes patients' self‐management behaviour.Especially in places with large population and limited medical resources, it is economical and effective to inspire patients to actively tap and utilize existing and potential social resources for self‐management. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effect of web‐based patient education on anxiety in patients scheduled for thyroid surgery. A secondary aim was to evaluate the patients' postoperative recovery outcomes. Design: This study is a randomized controlled trial. Method: The study was conducted at a university hospital in Turkey between September 2018 and May 2019 with 76 patients scheduled for thyroidectomy surgery and randomly assigned into two groups. Patients in the intervention group received web‐based education, while those in the control group were given only routine care. Measurements were performed before surgery, on the day of surgery, and 1 week after discharge. Results: On the day of surgery, intervention group anxiety levels were lower than those of the control group, and the majority of early recovery parameters were significantly better in the intervention group than in the control group. One week after discharge, the intervention group patients' anxiety levels were significantly lower. Web‐based education had no impact on pain, time in the operating room, readmission to the hospital after discharge, or length of hospitalization. Conclusions: Nurse‐led web‐based education reduced patients' anxiety regarding surgery. The results also show that it may improve postoperative early recovery. Summary statement: What is already known about this topic? Preoperative anxiety can be associated with numerous symptoms, and recovery time may be prolonged but preoperative information is effective in reducing patient anxiety and hastening early recovery.Nurses have active roles in patient education and the information given by the nurse during preparation for surgery process can positively impact patient health outcomes.As technology has advanced, methods used by patients for acquiring information have changed, and written materials have been replaced by online platforms. What this paper adds? Nurse‐led patient education can exert positive effects on surgical patients.Web‐based education reduces patients' anxiety about surgery compared with the traditional approach. The implications of this paper: Nurse‐led web‐based patient education can be a useful method for reducing patients' anxiety and improving early recovery.Nurses can use this research to develop innovative approaches to the education of perioperative patients. [ABSTRACT FROM AUTHOR]

Aim: This trial aimed to evaluate the effects of instrumental reminiscence therapy based on Roy's adaptation model on adaptation, life satisfaction and happiness in older people. Background: Reminiscence therapy is one of the nursing interventions that facilitates the adaptation of older people to the process of ageing. Design: The study utilized a pretest–posttest randomized controlled trial design. Methods: This study was conducted at two nursing homes in Northern Cyprus between April and June 2021. The trial comprised 34 participants. A descriptive information form, the Assessment Scale of Adaptation Difficulty for the Elderly, Life Satisfaction Index A and Oxford Happiness Questionnaire—Short Form were used for data collection. Results: Mean posttest scores obtained by the intervention group from the Assessment Scale of Adaptation Difficulty for the Elderly, Life Satisfaction Index A and Oxford Happiness Questionnaire—Short Form were significantly higher than their pretest scores (P < 0.05). There was a significant difference between the mean scores obtained by the intervention and control groups from the Assessment Scale of Adaptation Difficulty for the Elderly, Life Satisfaction Index A and Oxford Happiness Questionnaire—Short Form (P < 0.05). Conclusion: Instrumental reminiscence therapy based on Roy's adaptation model increased the levels of adaptation, life satisfaction and happiness in older people. Therefore, instrumental reminiscence therapy might be applied, integrated with the Roy's adaptation model. Summary statement: What is already known about this topic? Reminiscence therapy is generally applied to older adults with cognitive impairment, such as Alzheimer's dementia.Studies have investigated whether there was a change in life satisfaction after receiving reminiscence therapy.Reminiscence therapy is mostly applied in 8–12 sessions. What this paper adds? This study shows that instrumental reminiscence therapy can be applied to healthy older adults without any cognitive health problems.Roy's adaptation model may be a guide to systematically categorize the instrumental reminiscence therapy sessions and the group activities.Enrichment of reminiscence therapy sessions with various group activities positively affected the adaptation, life satisfaction and happiness levels of older adults. The implications of this paper: This study reveals the importance of popularizing the use of instrumental reminiscence therapy and making it a routine nursing practice by nurses serving older people individuals. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to examine the effectiveness of a psychoeducational intervention on self‐efficacy (primary outcome), anxiety, depression, treatment adherence, and health‐related quality of life (HRQoL) of patients undergoing haemodialysis. Methods: A two‐group randomized controlled trial of 124 patients (65 and 59 patients in the intervention and control groups, respectively) recruited from a tertiary hospital in Singapore was conducted. Data were collected from January 2015 to June 2016. Outcomes were measured at baseline and 1, 3, and 6 months after the intervention. General linear model was used to analyse data. Results: Our findings showed significant group effect on HRQoL (effects of kidney disease on daily life; p = 0.041), time effect on all outcomes (p < 0.05; except for treatment adherence behaviours and HRQoL [burden of kidney disease]), and group * time interaction effect on anxiety (p = 0.040) and depression (p = 0.003), with the intervention group reporting better outcomes. Conclusions: The positive effects of our intervention on patients' self‐efficacy, psychological well‐being, treatment adherence attitudes, and HRQoL implied its potential use in dialysis/renal centres to improve patients' self‐care and health outcomes. Summary statement: What is already known about this topic? Patients undergoing haemodialysis commonly encounter physical and psychological health challenges due to the complexity of the disease and long‐term treatment regimens.Improving self‐efficacy in self‐care could improve patients' psychological well‐being, treatment adherence, and health‐related quality of life among these patients.Limited literature is available on how psychoeducational intervention can improve health outcomes of patients undergoing haemodialysis. What this paper adds? The psychoeducational intervention positively reduced haemodialysis patients' anxiety and depression and improved treatment adherence attitude and health‐related quality of life. The implications of this paper: The psychoeducational programme could be integrated into routine care in renal or dialysis centres to enhance the health outcomes of patients undergoing haemodialysis.Future studies should incorporate technology in the delivery of psychoeducational interventions to improve their accessibility and sustainability. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate the effects of progressive muscle relaxation on sleep quality and fatigue in patients with rheumatoid arthritis. Methods: This randomized controlled study was conducted with 72 patients with rheumatoid arthritis who applied to the rheumatology outpatient clinic of a university hospital between January and May 2018. The data were collected using the Patient Information Form, Pittsburgh Sleep Quality Index and Fatigue Severity Scale. After the patients in the intervention group completed the forms, patients were given training with regard to the application of progressive muscle relaxation which they subsequently performed, and the Pittsburgh Sleep Quality Index and Fatigue Severity Scale forms were repeated after 6 weeks. Results: After performing progressive muscle relaxation for 6 weeks, the total score of the Pittsburgh Sleep Quality Index and the fatigue score decreased among patients in the intervention group; no change was observed among the patients in the control group. A statistical difference was found between the two groups in terms of the Pittsburgh Sleep Quality Index's and Fatigue Severity Scale's mean scores. Conclusion: Progressive muscle relaxation can be recommended to enhanced sleep quality and reduce fatigue in patients with rheumatoid arthritis. Summary statement: What is already known about this topic? Sleep disturbances and fatigue are among the most common symptoms in patients with rheumatoid arthritis.Many individuals with rheumatoid arthritis are turning to complementary and alternative medicine for relief of their symptoms.Studies on the efficacy of progressive muscle relaxation on reducing fatigue and improving sleep quality in patients with rheumatoid arthritis are limited. What this paper adds? This randomized controlled trial showed that the progressive muscle relaxation used in the intervention was effective in terms of reducing fatigue and improving sleep quality in patients with rheumatoid arthritis.There was no change in sleep quality or fatigue intensity in the control group, where progressive muscle relaxation was not applied. The implications of this paper: Progressive muscle relaxation can contribute to reducing fatigue and improving sleep quality in patients with rheumatoid arthritis.Nurses can educate patients with rheumatoid arthritis in progressive muscle relaxation and encourage them to continue this action because of its ease of administration and economic effectiveness. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to determine the effects of milking and suction methods on maintaining drain patency following cardiac surgery in paediatric patients. Methods: This was a randomized controlled trial. The patients were assigned to three groups (suction method, milking method, and control group) between July 2018 and December 2019. Results: The most frequent medical diagnoses were tetralogy of Fallot (34.4%, n = 31) and ventricular septal defect (14.4%, n = 13). Heart rate may increase unless a method was chosen to maintain drain patency (F: 4.450, p = 0.003); suction (F: 0.528 p = 0.781) and milking (F: 2.281 p = 0.070) methods did not significantly increase the heart rate. The use of a manipulation method for maintaining drain patency maintained stability of the blood pressure values and did not affect haemodynamic stability, oxygen saturation, and body temperature. There was no statistically significant difference within and among the groups (p > 0.05) in relation to the volume of bleeding between admission until the sixth hour, although there was greater bleeding with the milking method (2.67 ± 15.30 ml) and less bleeding (−5.00 ± 23.30) with the suction method. Conclusion: The milking and suction methods used to maintain drain patency can be employed and will assist with maintaining the stability of the patient within the first critical 6 h. Further studies need to be conducted in order to clarify that the recommendations can be generalized to all children with congenital heart disease. Summary statement: What is already known about this topic? Manipulation methods are employed to prevent drain blockage after cardiac surgery.Milking and suction methods are frequently used.There is a limited amount of research‐based evidence to support nursing management for these methods of preventing blockage in chest and mediastinal drains. What this paper adds? Manipulation methods could be used, especially for patients to maintain stability in the first critical six hours after surgery, and they do not harm the hemodynamic process.The milking method used to maintain drain patency in paediatric patients after cardiac surgery can be considered less preferred because it causes an increase in the amount of bleedingThe suction method can be preferred because it reduces the amount of bleeding in the critical early post‐operative period. The implication of this paper: Findings can support decision‐making over the method to be used to maintain drain patency, decided by the treating team in a multidisciplinary manner. [ABSTRACT FROM AUTHOR]

Background: Despite pervasive need for peripheral intravenous catheters, insertion is often difficult, and approximately two thirds fail prematurely. Midline catheters are an alternative long peripheral catheter, inserted in the upper arm, ideal for patients with difficult access. Aim: The aim of this study is to test feasibility of the protocol and compare the efficacy and safety of midline catheters to peripheral intravenous catheters. Design: A parallel‐group, pilot randomized controlled trial of adult medical/surgical hospitalized patients, from a single Australian referral hospital. Methods: Participants with difficult vascular access (≤2 palpable veins) and/or anticipated ≥5 days of peripherally compatible intravenous therapy were recruited between May 2019 and March 2020. Participants were randomized to (1) peripheral intravenous catheter or (2) midline catheter. Primary feasibility outcome measured eligibility, recruitment, protocol adherence, retention and attrition. Primary clinical outcomes measured device insertion failure and post‐insertion failure. Results: In total, n = 143 participants (71 peripheral intravenous catheters and 72 midline catheters) were recruited; n = 139 were analysed. Most feasibility criteria were met. Peripheral intravenous catheters had shorter functional dwell time, with higher incidence of post‐insertion failure compared to midline catheters. Conclusion: Midline catheters appear to be superior for patients with difficult vascular access or receiving prolonged intravenous therapy; a large, multi‐centre trial to confirm findings is feasible. Summary statement: What is already known about this topic? Peripheral intravenous catheters have endemically high incidence of complications.Midline catheters have been proposed as an alternative peripheral intravenous device, following recent advancements in catheter material and design.Few studies have compared safety and efficacy of contemporary midline catheters with peripheral intravenous catheters. What this paper adds: Midline catheters had a longer functional dwell time and lower incidence of post insertion‐failure, compared to peripheral intravenous catheters.Midline catheters appear safe; however, inserter skill appears to have critical influence on insertion success. The implications of this paper: This study established the feasibility and importance of a large, multicentre, randomized controlled trial to confirm findings.Future research should also focus on financial impacts, including cost‐efficiency.Policy makers should consider training specialist inserters to place midline catheters. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effectiveness of prenatal breast‐feeding education provided to pregnant women who experience fear of breast‐feeding in the COVID‐19 pandemic period. Methods: A prospective randomized controlled trial study was conducted with 128 pregnant women (64 in the experimental group and 64 in the control group) between November 2021 and February 2022. The data were collected via the Numeric Pain Rating Scale, the Breastfeeding Motivation Scale and the Iowa Infant Feeding Attitude Scale to assess fear, motivation and attitudes regarding breast‐feeding. The pregnant women in the experimental group were provided with and education programme on 'safe breastfeeding in the COVID‐19 pandemic'. The breast‐feeding education included in standard care was given to the control group after pre‐test data collection was completed. Results: The significant differences in the mean Numeric Pain Rating Scale, Breastfeeding Motivation Scale and Iowa Infant Feeding Attitude Scale scores of the groups were in favour of the experimental group (P < 0.05). It was determined that in the first postnatal month, in the experimental group, the numbers of women who believed that their breast‐feeding was not affected by COVID‐19 and the numbers of infants solely breastmilk‐fed were higher compared to the control group (P < 0.05). Conclusion: Prenatal breast‐feeding education about safe breast‐feeding in the COVID‐19 pandemic period can reduce fears of breast‐feeding and increase motivation and approving attitudes regarding breast‐feeding. Summary statement: What is already known about this topic? The COVID‐19 pandemic dramatically reduced access for new mothers to their immediate family, health‐care providers and support systems, which are social support providers.The COVID‐19 pandemic also caused mothers to experience intense fear, anxiety and uncertainty about whether to continue breast‐feeding.Although published guidelines emphasize that the advantages of breast‐feeding outweigh the risk of transmission, fears of transmission of COVID‐19 have caused mothers to avoid breast‐feeding. What this paper adds? During the COVID‐19 pandemic period, the breast‐feeding motivation of expectant mothers who received midwife support for breast‐feeding increased, and their fear of breast‐feeding decreased. The implications of this paper: To ensure well‐being in postpartum mothers, a special breast‐feeding education plan should be developed for the conditions during the pregnancy and postpartum periods.In the COVID‐19 pandemic period, breast‐feeding education can be beneficial for this vulnerable group. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery. Methods: This randomized controlled study was conducted with 132 participants at a public hospital between June 2017 and 2018. The Kinesio taping method was applied once, immediately after the surgery during the hospital stay and breathing exercises were performed three times a day for 30 min on the first, second and third post‐operative days. Results: The median age of the women was 47 years. The mean body mass index was 27.6 ± 5.0 kg/m2. When the intervention and control groups were compared, the level of women's pain in the Kinesio taping group was significantly reduced. There was also a statistically significant difference in terms of the passage of gas and defecation time and wound healing in groups with Kinesio taping. Conclusions: Kinesio taping has been shown to be an effective intervention in the management of acute pain after surgery. The results of this study suggest that future studies may be indicated to study taping in other surgical conditions. Summary statement: What is already known about this topic? Standard surgical procedures performed in gynaecology and obstetrics can be associated with severe post‐operative pain.Post‐operative pain following gynaecological abdominal surgery is a common symptom, and nurses play a key role in ensuring that it is properly and adequately managed. What this paper adds? Kinesio taping is a more effective method than the standard analgesia control group and for the groups with combined or sole application of breathing exercises.This randomized controlled trial showed that Kinesio taping used in the intervention was more effective in pain management, reduction of time to passage of gas and defecation and wound healing after gynaecological abdominal surgery. The implications of this paper Kinesio taping can contribute to reducing pain, reduction of time to passage of gas and defecation and wound healing after gynaecological abdominal surgery.Nurses can be trained on Kinesio taping after gynaecological abdominal surgery and encouraged to use this method because of its effectiveness. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to investigate the effect of health belief model‐based short interviews on preventive behaviours for osteoporosis in postmenopausal women. Design and methods: A randomized pretest, posttest and follow‐up design was used. The study was conducted between June 2016 and June 2017 with an intervention (n = 41) and a control group (n = 41). The intervention group applied the Short Interviews Model for 12 weeks as a short interview programme that was created based on the health belief model. The study data were collected by the researcher using a descriptive information form, the Osteoporosis Health Belief Scale, the Osteoporosis Self‐efficacy Scale and the Osteoporosis Knowledge Test. Results: In the posttest and follow‐up measurements, the mean scores of the intervention group on the total Osteoporosis Health Belief Scale and its self‐efficacy and exercise sub‐dimensions and the total Osteoporosis Knowledge Test and its sub‐dimensions were significantly higher than those of the control group. Conclusion: The short interviews held in this study provided evidence to guide women and nurses in the prevention of osteoporosis in postmenopausal women. It is recommended that the prevention of osteoporosis should be integrated into women's health programmes at the primary health‐care level. Summary statement: What is already known about this topic? Osteoporosis is a critical public health problem that is common among women all over the world. It causes deaths, different disabilities and economic losses every year.Nurses can make important contributions to the prevention of osteoporosis through the health education that they will provide for women. What this paper adds? Sending short messages to women to protect them against the risks of osteoporosis, holding short interviews to improve bone health, sending motivating messages to their phones and teaching them appropriate exercises increased their health beliefs, self‐efficacy and knowledge in preventing osteoporosis. The implications of this paper: This article brings a new perspective that holding health belief model‐based short interviews with postmenopausal women is an effective method of preventing osteoporosis.It is recommended that nurses should conduct interventions to maintain and develop bone health by holding short interviews with women for whom they will provide health‐care services and by using social media tools (giving booklets and sending text messages and videos about strengthening bones via WhatsApp) in the provision of primary health‐care services. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [ABSTRACT FROM AUTHOR]

Background: Case management has been regarded as the front line of necessary change for fragmented healthcare system. Aim: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12‐month follow‐up. Methods: A quasi‐experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. Results: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. Conclusion: Nurse‐led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized. Summary statement: What is already known about this topic?: Current evidence of the effectiveness of case management is limited due to mixed results and single settings.Case management is rarely tested in single‐type cancer patients and in countries with underdeveloped primary care. What this paper adds?: Nurse‐led hospital‐based case management can effectively improve quality of life, anxiety, depression, symptom distress, treatment adherence and unplanned readmission rates.In countries with underdeveloped primary care, case management is a feasible way to provide continuous care to cancer patients and to improve healthcare utilization. The implications of this paper: Nurse case managers can serve as a pivot in multidisciplinary management of cancer patients to promote interdisciplinary cooperation and resource integration.A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized.Future studies and nursing practice should develop an online case management platform and set up posts for full‐time case managers. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare the effects of breastfeeding, breast milk odour and mother's heartbeat sounds on perceived pain during heel lance procedures in term newborns. Design: This was a randomized three‐group experimental study. Methods: The sample of the study consisted of 90 newborns. The data were collected using pulse oximeter, fetal hand doppler, voice recorder, loudspeaker, a data collection form and the ALPS‐Neo Pain and Stress Assessment Scale for Newborn Infants. Results: During the procedure, newborns in the breast milk odour group had high levels of pain and stress, those in the mother's heartbeat sounds group had mild pain and stress, and those in the breastfeeding group had no pain and stress. Additionally, a statistically significant difference was found between their crying times. This difference was the highest for newborns in the breast milk odour group, followed by the mother's heartbeat sounds and breastfeeding groups, respectively. Conclusion: Breastfeeding and mother's heartbeat sounds, which are non‐pharmacological pain relief methods, are effective in neonatal pain management. However, breast milk odour is not effective for pain control in newborns. Further studies should examine the efficacy combinations of these methods. Summary statement: What is already known about this topic? The presence of pain is a major stress factor for newborns.The American Academy of Pediatrics (AAP) recommends the use of non‐pharmacological pain control methods to relieve the pain caused by routine medical procedures in newborns. What this paper adds? This randomized controlled experimental study showed breastfeeding is a very effective method for pain control in newborns during heel lance procedures.The sound of the mother's heartbeat was found to be moderately effective.Breast milk odour was not effective for pain control in newborns. The implications of this paper: The use of non‐pharmacological pain management methods such as maternal heart sounds in combination with methods with high evidence level (breast milk, breastfeeding, etc.) may increase the effectiveness of pain management in newborns.In order to determine the effect of sense of smell on pain management in newborns, new studies should be planned comparing newborns of different postnatal ages. [ABSTRACT FROM AUTHOR]

Aims: Effective methods for relieving pain in inserting a needle for chemotherapy in cancer patients have been studied. This study examined the pain relief effects during needle insertion into the implanted venous access chemoport by comparing three methods. Methods: This randomized controlled trial included 120 cancer patients who were randomly assigned. The experimental groups received applications of lidocaine cream (n = 30), cryotherapy (n = 30) and cutaneous stimulation therapy (n = 30); the control group (n = 30) received routine care. Premeasurements and postmeasurements were evaluated using a visual analogue pain scale and nurses' careful observations of patients' pain behaviour checklists during needle insertion. Results: Pain levels were reduced by all three interventions, with the level of relief depending on the type of application. All experimental groups showed significant reduction in pain compared with the control group. Lidocaine cream had the strongest effect, followed by cryotherapy and then cutaneous stimulation. Conclusion: Lidocaine cream, cryotherapy and cutaneous stimulation therapy all reduced cancer patients' pain levels during insertion of an implanted central venous access chemoport needle. Nurses can apply cryotherapy and cutaneous stimulation therapy independently to reduce the pain associated with this procedure. Future studies should consider using these methods to control for any individual differences that may exist. Summary statement: What is already known about this topic? Implanted venous access chemoport needle insertion is a frequently performed procedure in clinical oncology, often causing pain in patients.Nurses should be aware of the pain patients experience during these invasive procedures and understand the pharmacological and nonpharmacological methods that can minimize pain. What this paper adds? This study identified pharmacological and nonpharmacological methods used to relieve pain associated with implanted venous access chemoport needle insertion.This study indicates that using one of the three interventions (lidocaine cream, cryotherapy and cutaneous stimulation) prior to inserting implanted venous access chemoport needle reduces pain scores experienced by cancer patients. The implications of this paper: Application of lidocaine cream, cryotherapy or cutaneous stimulation therapy can contribute to the effective management of pain during implanted venous access chemoport needle insertion in clinical settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to evaluate the efficacy of narrative therapy in relieving stigma in oral cancer patients who underwent major surgical treatment. Background: Health‐related stigma compromises mental health and life quality in people with physical or mental abnormalities. Narrative therapy has been implemented to overcome stigma among populations in a diversity of disease states. However, the effectiveness of narrative therapy in relieving stigma among patients with oral cancer is not known. Design This study was a randomized controlled trial, in which 100 oral cancer patients were selected and randomly assigned to the 'narrative therapy' group, who received narrative therapy treatment in addition to standard care, and the 'control' group, who was provided standard care only. Methods: This research combined measurement of several questionnaires to evaluate stigma. Analysis of variance and paired t tests were employed for data analysis. Results: Findings in this study demonstrated that narrative therapy treatment effectively relieved oral cancer patients' sense of shame, reducing overall stigma and significantly improving self‐esteem and social relationships. Conclusions: Narrative therapy was demonstrated to be a promising therapeutic intervention for stigma relief in oral cancer patients. Summary statement: What is already known about this topic? Stigma is common among oral cancer patients, especially those who undergo major surgical resection. Psychological intervention is highly recommended in addition to postsurgical care.Narrative therapy might help relieve stigma among oral cancer patients. What this paper adds? Conventional postsurgical care did not improve oral cancer patients' psychological situation.A 7‐week intervention of narrative therapy treatment significantly reduced stigma and enhanced sense of self‐worth and social support among oral cancer patients. The implications of this paper: Narrative therapy can be clinically accepted as a therapeutic approach to assist oral cancer patients with stigma after major surgery.Tailored approaches, including patient‐customized methods, should be encouraged in conducting narrative therapy. [ABSTRACT FROM AUTHOR]

Aim: To design a protocol based on the experiences of long‐term survivors to facilitate resilience for oesophageal cancer patients in rural China. Background: According to the latest Global Cancer Statistics Report, 604,000 new cases of oesophageal cancer were reported, of which over 60% of the disease burden is distributed in China. The incidence of oesophageal cancer in rural China (15.95/100,000) is twice as high as those in urban areas (7.59/100,000). To be sure, resilience can help patients better adapt to post‐cancer life. But universal interventions involving improving the resilience of oesophageal cancer patients have much less been explored, especially for rural patients. Methods: The two‐arm, parallel design, non‐blinded, randomised controlled trial will be implemented in 86 adults diagnosed with oesophageal cancer and will be randomly assigned to the control group or the intervention group via the blocked randomisation. The intervention group will undergo an intervention with one‐on‐one guidance from a nurse while viewing a CD of the experiences of long‐term survivors with oesophageal cancer in rural areas. Every 2 weeks, a theme session will be introduced, and the entire intervention will continue for 12 weeks. Psychosocial variables (resilience, self‐efficacy, coping mode and family support) will be surveyed at baseline, post‐intervention and 3 months after the intervention. The paper complies with the Standard Protocol Items: Recommendations for Intervention Trials 2013 and Consolidated Standards of Reporting Trials guidelines for study protocols adapted for designing and reporting parallel group randomised trials. Conclusion: The intervention programme transitions from hospitalisation to discharge, which includes one‐on‐one interventions by medical personnel and a portable CD describing the experiences of long‐term survivors with rural oesophageal cancer. Once the intervention's effectiveness is proven, this protocol will provide psychological support for massive oesophageal cancer patients. Relevance to clinical practice: The intervention programme may be used as an auxiliary therapy to promote patients' postoperative psychological rehabilitation. This programme has the advantages of being cost‐effective, flexible, accessible, and convenient and can be implemented without the limitation of time, place and clinical medical staff. Trial registration: The Chinese Clinical Trial Registration number is ChiCTR2100050047. Registered on 16 August 2021. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of telephone monitoring, in combination with texts, on medication adherence and blood pressure (BP) control in primary hypertension. Method: Data were collected from August to December 2016. Seventy‐seven adults were randomized to the intervention and control groups. A 12‐week intervention consisted of regular text messages and phone calls. The control group received usual hypertension care. The outcomes were evaluated with blood pressure measurement and medication adherence self‐efficacy scale short form. Results: Medication adherence in Week 12 was found to be significantly higher in the intervention group than in the control group. Mean systolic and diastolic BP levels in Weeks 4, 8 and 12 were statistically significantly lower in the intervention group than in the control group (p < 0.05). Conclusion: Using text messaging and nurse‐led telephone monitoring improved adherence and BP control in adults with hypertensive in primary care. Summary statement: What is already known about this topic? Despite advances in the treatment of hypertension, blood pressure (BP) control and medication adherence in hypertensive patients is not at the desired level.There is need to alternative approaches to improve BP control and medication adherence.Few researchers have examined the effect of telephone monitoring in combination with text messaging on medication adherence and BP control in adults with hypertension. What this paper adds? We provided nurse‐led telephone monitoring and sent SMS with one‐way text messaging and individualized, patient‐tailored content, resulting in improved adherence to drug treatment and reduced blood pressure at the end of the three‐month study period.At the end of the 3‐month study period, the rates of blood pressure control in the intervention group were statistically significantly higher than those of the control group. The implications of this paper Nurses should integrate SMS combined with telephone monitoring into public health for hypertension management.Telephone monitoring, in combination with SMS, may be helpful hypertension care during a disaster or pandemic. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of computerized cognitive training on the cognitive functions of stroke patients. Background: With increased publications on computerized cognitive training, a meta‐analysis is essential to determine the effects of computerized cognitive training among stroke patients. Design A systematic review and meta‐analysis of randomized controlled studies. Data Sources: Cochrane Library, Pubmed, EBSCO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc and Wanfang Database were explored to search for research studies from inception to January 2020. Review Methods: Six outcomes indicators were considered to determine the effects of computerized cognitive training. Two reviewers were selected to search and independently appraise the available articles from various databases. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 622 patients with 17 studies were included. Computerized cognitive training significantly improves global cognition, working memory, attention and executive function of stroke patients. However, there was inadequate evidence to demonstrate any effects of computerized cognitive training on activities of daily living and depression. Conclusion: Computerized cognitive training improves the cognitive functions of stroke patients. However, further research studies are needed to confirm its efficacy in activities of daily living as well as on alleviating depression. Summary statement: What is already known about this topic? Stroke commonly results in health impairments, particularly on cognitive functions, activities of daily living and depression, which may have a negative impact on a patient's quality of life.Previous studies indicated that computerized cognitive training is a safe and efficacious intervention for improving the cognition of older patients with dementia.Little is known about the efficacy of computerized cognitive training on improving cognitive functions, activities of daily living and depression among stroke patients. What this paper adds? Computerized cognitive training significantly improves global cognition, working memory, attention and executive function among stroke patients compared with control groups.No statistically significant effects were found on activities of daily living and depression.Subgroup analysis indicated that 4 and 12 weeks of medium‐high intensity computerized cognitive training showed significant improvement on global cognition for stroke patients. The implications of this paper: Healthcare providers should recognize the efficacy of computerized cognitive training on the cognitive rehabilitation of stroke patients.Cognitive outcome measurements vary between studies and further appraisal of reliability and validity is essential to avoid reporting bias and to validate research trials with uniform neuropsychological measurements.Further clinical trials are required with large samples and long‐term follow‐up of interventions and reporting adverse events. [ABSTRACT FROM AUTHOR]

Aims: This pilot study aimed to evaluate the effects of motor imagery training on lower limb motor function of stroke patients. Background: Motor imagery training has played an important role in rehabilitation outcomes of stroke patients. Methods: In this pilot randomized controlled trial 32 stroke patients were randomly divided into experimental and control groups from January to June 2017. Patients in both groups received conventional neuro‐rehabilitation five times a week in 3‐h segments for 6 weeks. Patients in the experimental group underwent an additional 20 min of motor imagery training. Measures were evaluated by motor function of the lower extremity, activities of daily living and balance ability. Results: The outcomes significantly improved by motor imagery training were the Fugl‐Meyer Assessment of the lower extremity, the Functional Independence Measure dealing with transfers and locomotion, and the Berg Balance Scale. Conclusion: Motor imagery training could be used as a complement to physical rehabilitation of stroke patients. Our findings may be helpful to develop nursing strategies aimed at improving functional ability of stroke patients and thus enhancing their quality of life. Summary statement: What is already known about this topic? Lower extremity dyskinesia is among the most common complications that significantly limit the patient's activities of daily living. Motor imagery training, a safe and cost‐efficient technique, may be used as a complement to physical rehabilitation of stroke patients.Evidence suggests that motor imagery training is effective in upper limb recovery after stroke.There is limited evidence of the effectiveness of motor imagery training on lower limb motor functions of patients with chronic stroke. What this paper adds? Motor imagery training can be incorporated into conventional therapy among individuals by rehabilitation specialist nurses with sufficient experience of motor imagery training, but substantial resources are needed.Six‐week motor imagery training resulted in a significant improvement in the motor performance of lower limbs in patients with stroke.Further study is needed to modify and optimize the present programme and should be focused on enabling more stroke patients to benefit from motor imagery training. The implications of this paper: The addition of motor imagery training to the conventional neuro‐rehabilitation can significantly promote the recovery of motor performance of lower limbs in stroke patients, thus reducing long‐term disability and associated socio‐economic burden.The findings of this pilot study may be helpful to develop nursing strategies aimed at improving functional ability and consequently the quality of life of stroke patients.Nurses can learn the motor imagery training as a technique for practising psychomotor nursing skills. [ABSTRACT FROM AUTHOR]

Aim: Study aims were to determine the most effective chlorhexidine concentration to be used in reducing microbial colonization in patients under mechanical ventilation and to examine the effect of oral care using different concentrations on the integrity of the oral mucous membranes. Design This research was a randomized controlled double‐blinded experimental study. Method: The sample of study consisted of the 116 adult patients who remained intubated. Oral care was given to patients 4 times/day as per nurse protocol. Every morning during for 4 days, the intraoral mucosa of all groups of patients was assessed. Microbial colonization samples from oral mucosa were taken in the morning before oral care. A determination of the species of microorganisms in these samples was made. Results: A statistically significant difference was found with regard to the reproduction of microorganisms between the oral mucosa samples taken from patients using 2% and 1% chlorhexidine solutions (P < 0.001). In the cultures taken from patients on the first and fourth days of intubation, a total of 36 different microorganisms were seen to be reproducing. Conclusion: It was concluded that the most effective oral solution for the prevention of microbial colonization in patients under mechanical ventilation was chlorhexidine 1%. Summary statement: What is already known about this topic? Oral hygiene with solutions scientifically proven to be effective in patient care can reduce bacterial colonization in the oral mucosa in patients under mechanical ventilation.Chlorhexidine gluconate is an oral antiseptic solution that is preferred for the reduction of microbial colonization, particularly in patients under mechanical ventilation. However, a concentration of chlorhexidine gluconate solution has not been standardized in the oral care of these patients. What this paper adds? This randomized controlled study will serve as guide to the use of the most suitable and effective solution of chlorhexidine in the oral care of patients under mechanical ventilation.Chlorhexidine 1% was effective to reduce bacterial load in oral mucosa. The implications of this paper: With patients on mechanical ventilation support, correct, effective and regular oral care by nurses is of the utmost importance.Nurses can play an active role in ensuring the integrity of the oral mucosa and increasing comfort with the oral care in patients under mechanical ventilation. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to evaluate the effects of an intervention involving earplug placement during nocturnal sleep in non‐ventilated intensive care unit patients. Methods: A randomized controlled trial was conducted in 107 adult patients between January 2017 and December 2018. Participants in the intervention group (n = 55) slept with earplugs between 10 pm and 7 am on the second night of their intensive care unit stay. In the control group, participants slept with no earplugs. Outcome parameters included sleep, urinary 6‐sulfatoxymelatonin levels, relaxation responses measured using the Richards–Campbell Sleep Questionnaire, liquid chromatography‐mass spectrometry results and vital signs. Urine was collected between 10 pm and 7 am. Results: Overall, 28.03% of participants showed virtually no 6‐sulfatoxymelatonin excretion in the collected urine. Outcome parameters were not significantly different between the groups, indicating that wearing earplugs alone did not affect sleep quality, urinary 6‐sulfatoxymelatonin and vital signs. Conclusions: The effects of using earplugs alone on sleep quality, urinary 6‐sulfatoxymelatonin and relaxation responses in patients admitted to the intensive care unit were inconclusive. Additional research is required before earplugs alone can be widely used to improve sleep quality. Summary statement: What is already known about this topic? Excessive noise exposure causes numerous adverse health outcomes, which not only contributes to noise‐induced stress and hearing loss but also affect patients' sleep.Wearing earplugs might be a practical nonpharmacological strategy used by nurses to improve ICU patients' quality of sleep. What this paper adds? Wearing earplugs alone did not affect patients' urinary 6‐sulfatoxymelatonin level in the ICU.Wearing earplugs alone did not increase patients' subjective sleep quality in the ICU. The implications of this paper: The findings of the present study on the effects of using earplugs alone on sleep quality, urinary MT6s level and vital signs in ICU patients extend the literature, particularly with respect to the limited research on using earplugs alone.Prolonged effect of earplug intervention on sleep quality is unknown. A longer intervention may help elicit any difference in sleep quality. [ABSTRACT FROM AUTHOR]

Aims: To investigate the efficacy of pre‐emptive remifentanil in alleviating pain during tracheal suctioning in patients under mechanical ventilation. Background: Goal‐directed sedation is recommended for patients under mechanical ventilation by the current guidelines. Whether goal‐directed sedation can prevent pain during tracheal suctioning in these patients is unknown. Design: This was a two‐centre, randomized, crossover, single‐blind trial conducted between August and October 2019. Methods: Patients under mechanical ventilation received low‐dose remifentanil, high‐dose remifentanil or placebo prior to each tracheal suctioning in a random order. The primary outcomes were evaluated using the critical‐care pain observation tool and Richmond agitation–sedation scale after tracheal suctioning. Adverse events were also documented. Results: A total of 39 patients who underwent 117 tracheal suctions were enrolled. After the tracheal suction, changes in the critical‐care pain observation tool and Richmond agitation–sedation scale scores were significantly lower in the low‐dose and high‐dose groups than in the placebo group (P < 0.001). A non‐significant increase in the absence of spontaneous breathing was observed in the high‐dose group compared to that in the placebo group. Conclusion: A pre‐emptive remifentanil bolus of 0.5 μg/kg can mitigate the pain associated with tracheal suctioning. SUMMARY STATEMENT: What is already known about this topic? Pre‐emptive analgesia is recommended by several guidelines to alleviate the pain associated with invasive and potentially painful procedures in ICU patients.Goal‐directed sedation can shorten the length of hospital stay and is recommended for patients in the ICU by several clinical practice guidelines.Literature regarding whether goal‐directed sedation management or pre‐emptive remifentanil can prevent the pain associated with tracheal suctioning in patients under mechanical ventilation is scarce. What this paper adds? A pre‐emptive remifentanil bolus of 0.5 μg/kg can mitigate the pain associated with tracheal suctioning. The implications of this paper: Normal opioid doses administered for goal‐directed sedation management might be insufficient to prevent the pain associated with tracheal suctioningPre‐emptive analgesia can alleviate the pain without increasing the risk of opioid‐related adverse events in ICU patients under mechanical ventilation. [ABSTRACT FROM AUTHOR]

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Aim: The aim of this study is to evaluate the effect of education and counselling on prenatal screening and diagnostic tests on pregnant women's decisional conflict, anxiety levels and attitudes towards the tests. Background: Clinical practice guidelines recommend prenatal genetic counselling for pregnant women before participation in the tests. Methods: A total of 210 pregnant women participated in the study by completing the State–Trait Anxiety Inventory‐I, Decisional Conflict Scale, SURE Scale, Knowledge Assessment Forms, Decision Satisfaction Form and Attitudes Scale between June 2017 and March 2018. In the first stage, pregnant women were evaluated who had only prenatal genetic screening tests and in the second stage, pregnant women who had been recommended to receive diagnostic tests. The intervention group received face‐to‐face individual education and counselling about prenatal genetic tests. Independent samples t test, t tests and Pearson correlation tests were used. Results: Education and counselling for prenatal screening tests and diagnostic tests from the first weeks of pregnancy were effective in decreasing anxiety, decisional conflict, increasing attitudes towards tests and had positive effects on pregnant women's knowledge level and decision satisfaction (P < 0.005). Conclusion: Prenatal genetic counselling and education are more effective if provided from the first weeks of pregnancy. Decreasing anxiety, decisional conflict and increasing knowledge levels of pregnant women are important to make informed decisions. Summary statement: What is already known about this topic? Prenatal genetic screening and diagnostic tests have been done for many years.ACOG and clinical practice guidelines recommend prenatal genetic counselling for pregnant women before participation in the tests. What this paper adds? This study is the first randomized controlled trial to assess the effect of prenatal genetic education and counselling from the first gestational weeks of pregnant women.Our results show that prenatal genetic education and counselling is more effective if provided from the first weeks of pregnancy.Prenatal genetic screening and diagnostic test education and counselling provided to pregnant women decrease their anxiety and decisional conflict, increase their decision satisfaction on prenatal tests and lead to more positive attitudes. The implications of this paper: This study provides an evaluation of education and counselling for both prenatal screening and diagnostic testing.Education and counselling programme that we used in this study can be successfully implemented into nursing and midwifery practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effect of health literacy education given to nursing students on health literacy level. Background: Health literacy has become an important issue in the field of health. Health literacy is an issue of interest to health professionals as well as individuals. Methods: The study was conducted as a randomized controlled trial. A total of 206 nursing students, 103 in the intervention and 103 in the control group, were included in the study. The intervention group received four weekly training sessions of health literacy education. The research was registered at ClinicalTrials.gov with the registration number NCT04868487. Results: On the baseline assessment, there were no statistically significant differences between the intervention and control group in terms of health literacy level (p > 0.05). In the 1st‐ week and 12th‐week measurements, the health literacy level of the intervention group was significantly higher than control group (p < 0.05). Conclusion: Health literacy education was effective in increasing the health literacy level of the students. Therefore, the concept of health literacy should be added to the nursing education curriculum. Summary statement: What is already known about this topic? Health literacy is important for nursing care.Health literacy of nursing students is not at the desired level.There is no special intervention to improve the health literacy level of nursing students. What this paper adds? This study provides evidence on how the health literacy level of nursing students can be improved.It also emphasizes the importance of nursing students to gain health literacy proficiency before graduation.Without intervention to improve health literacy, the health literacy level of students cannot reach a sufficient level with nursing education alone. The implications of this paper: The current study indicates that health literacy education remarkably increased the level of health literacy of nursing students.Nurses or nursing students with a high level of health literacy can improve the quality of care by communicating more effectively with patients. [ABSTRACT FROM AUTHOR]

Aims: This study aims to investigate the effects of semi‐elevated right lateral and semi‐elevated supine positions on feeding tolerance, stress severity and pain levels among premature infants during tube feeding. Methods: This was a randomized cross‐over clinical trial. A total of 34 premature infants who were fed via orogastric tube were included in this study. Feeding tolerance was assessed by abdominal circumference measurements and checking gastric residuals; this assessment was single blinded. Physiological values were evaluated before, during and after tube feeding. The stress severity and pain levels of the infants were also evaluated independently by the researchers before, during and after tube feeding. A significance level of.05 was accepted for all statistical analyses. Results: There were no difference between infants' vital signs, stress and pain scores according to feeding positions before tube feeding (p >.05). By feeding positions, a statistically significant difference was found between infants' vital signs, abdominal circumference and gastric residuals of infants during tube feeding. Pain and stress levels of infants were found to be significantly higher in the semi‐elevated supine position during tube feeding (p <.05). Conclusions: Use of the semi‐elevated right lateral position during tube feeding was found to have a more helpful effect in reducing stress and pain among premature infants when compared with the use of the semi‐elevated supine position. SUMMARY STATEMENT: What is already known about this topic? Tube feeding, one of the ways of giving the nutrients that premature infants need, is a stressful and painful nursing intervention.One of the complications with tube feeding of premature infants is feeding intolerance, which is an important and serious problem. What this paper adds? The result of this randomized cross‐over clinical trial provides evidence that semi‐elevated right lateral position is effective in reducing pain and stress levels of premature infants during tube feeding.Semi‐elevated right lateral position during tube feeding is effective to increase the feeding tolerance of premature infants. The implications of this paper: This study contributes to the literature on positioning methods to manage stress and pain associated with tube feeding and increase feeding tolerance in premature infants.Nurses should be aware that tube feeding is a stressful practice for infants and should take interventions to reduce stress. During tube feeding, semi‐elevated right lateral position is an effective nursing intervention to reduce stress and pain and increase feeding tolerance. [ABSTRACT FROM AUTHOR]

Background: Child hospitalization is a stressful experience for both children and their parents. Parents should establish effective communication with healthcare professionals to be able to participate in the care of their children in the hospital environment. Aims and Objectives: The purpose of the study was to determine the effect of parental participation in the care of hospitalized children on parent satisfaction and parent and child anxiety. Design The design used for this study was randomized controlled trial. Methods: The study data were collected between 1 February and 31 May 2016. Frequency, percentage, paired t test, Mann–Whitney U and Wilcoxon were used to analyse the data. Results: The study compared the parents' pretest and posttest scores on the anxiety and found that there was a statistically significant difference between the posttest scores of intervention and control groups. There was also a statistically significant difference parental participation and overall satisfaction subscales of the parent satisfaction as well as their total scores and mean scores. Comparison of the children's posttest scores on the anxiety inventory also found a statistically significant difference. Conclusion: The study concluded that parental participation in the care of hospitalized children increases parent satisfaction with healthcare, and reduces anxiety of both parents and children. SUMMARY STATEMENT: What is already known about this topic? Child hospitalization is a stressful experience for both children and their families.Physical impairment, invasive interventions, surgery, death, pain and experiencing loss of control are among the reasons that children feel anxious in the hospital environment.Parental participation is an essential element of quality of care for children in hospital. However, there is often confusion in role perception between parents and nurses which may be affected by nurses' attitudes, their ability to provide information, their communication and interpersonal skills and willingness to relinquish control. What this paper adds? Parental participation in the care of hospitalized children increases parent satisfaction with healthcare, and reduces anxiety of both parents and children.Nurses confirmed the belief that parents' participation in the child's care is an important part of nursing in paediatric care and suggested that the nurses should play the role of being the communicator with the parents.The study indicates that there is a need for hospital management to develop clinical routines and staff guidelines for parental involvement in paediatric care. The implications of this paper: Nurses need to be aware of the impact their communication has on parents and help them to clarify their role as parents in hospital.For clinical practice, checklists and staff guidelines could be useful tools in arriving at an understanding of how to work with children's parents. One of the biggest challenges that lies ahead is to get hospital staff to strive toward a better understanding and attitude toward parental participation.Parents' participation is very important for nurses, children and families in adapting to hospitalization, but still, parents' participation is not at the desired level. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of use of virtual reality headsets on mothers' anxiety, by distracting their attention, during their child's circumcision procedure. Design This was a randomized controlled intervention study. Methods: The study used a pretest and posttest design and was carried out between April 15, 2019, and June 30, 2019, with 60 participants (n = 30 intervention and n = 30 control group). The data were collected using a personal information form, the State Anxiety Inventory and Faces Anxiety Scales. In the study, the participants in the intervention group watched videos through a virtual reality headset. Results: The socio‐demographic characteristics of the intervention group and control group were similar in the pretest, except for the educational level. After the intervention, the intervention group's mean scores on the Faces Anxiety Scale, heart rate and respiration rates were significantly lower than those of the control group, but the difference between the mean State Anxiety Inventory scores was insignificant. Conclusion: Distraction using videos produced by virtual reality headsets is effective in reducing mothers' moderate level anxiety. It is recommended that further studies should be conducted in different ambulatory surgery procedures. SUMMARY STATEMENT: What is already known about this topic? Circumcision is the most common surgical procedure.Although it is frequently performed as an outpatient surgical procedure and is considered to be simple, it causes anxiety for parents.There is a need for low‐cost and easy‐to‐implement applications that are capable of reducing parents' anxiety during the procedure. What this paper adds? Watching a video through a virtual reality headset resulted in a significant change in the mean Facial Anxiety Scale score.The difference in heart rate and respiration rate was statistically significant between the intervention and control groups.Distraction by watching a video through virtual reality headset did not affect the mean State Anxiety Inventory scores. The implications of this paper: This cutting‐edge new technology might be an efficient, low cost and easy‐to‐apply distraction intervention for nurses.The intervention can be integrated into nursing care for managing parents' anxiety.Future studies should assess the effectiveness of the intervention using VR technologies in an effort to reduce parents' anxiety. [ABSTRACT FROM AUTHOR]

Aim: This study examined the effect of an individualized educational intervention on the knowledge, attitudes and self‐management ability after 12 weeks for outpatients with atrial fibrillation. Methods: A randomized control‐group pretest‐post‐test experimental design was used. Elderly outpatients with atrial fibrillation aged over 65 years were recruited from a university hospital in Korea. The experimental group received a 50‐min individualized education on self‐management, one telephone counselling after 8 weeks and maintenance of a self‐management diary for 12 weeks. Data were collected from November 2017 to April 2018 and analysed using SPSS 22.0 for descriptive statistics and hypothesis testing. Results: The participants' mean age was 71.9 (4.6) years. Compared to the control group (n = 29), the experimental group (n = 31) showed a significantly greater improvement in knowledge regarding atrial fibrillation and stroke prevention (t = −2.27, p =.027) and self‐management behaviours (t = −8.02, p <.001). There were no significant group differences in attitudes towards atrial fibrillation. Conclusion: The findings suggest that education for elderly people with atrial fibrillation should be individualized, focusing on self‐management in daily life to prevent cardiovascular complications. Future research is needed to confirm the long‐term effects of such education programmes. SUMMARY STATEMENT: What is already known about this topic? Older adults with AF tend to lack the knowledge and have inadequate self‐management skills regarding their illness. Their awareness of AF should be raised, especially regarding cardiovascular complications, such as stroke and heart failure, and prevention of complications.Patients with AF, mostly older people and those with comorbid conditions, need to be educated on the different approaches apart from the usual education to prevent developing strokes. What this paper adds? Individualized education focused on self‐management to prevent cardiovascular complications was more effective in increasing the knowledge and self‐management behaviour among Korean older adults with AF compared with those patients receiving routine medical education.Education for patients with AF should be tailored to meet the needs of older adults and those with comorbidities and focus on self‐management to prevent cardiovascular complications in daily life. The implications of this paper: Individualized education and telephone counselling can help improve knowledge of complications and self‐management among elderly people with AF.Health care professionals need to provide periodical counselling and education to elderly people with AF to enhance their self‐management behaviour in daily life to prevent cardiovascular complications. [ABSTRACT FROM AUTHOR]

Background: University students are faced with several stress factors affecting their mental health. Therefore, the first year at university is a period that calls for careful attention and research. Aim: The aim of this study is to evaluate the effect of laughter yoga on mental symptoms and cortisol levels in nursing students. Methods: This study is a randomized controlled study employing a pre‐/post‐test design with a control group. A total of 75 healthy university students were assigned to the intervention group and control group. The Brief Symptom Inventory was applied to both groups before Session 1 and after Session 8. Saliva samples were taken from the students to measure their cortisol levels before and after each session. Results: Evaluation of the mean scores obtained from the Brief Symptom Inventory before and after the intervention showed a significant decrease in the scores between groups (P < 0.05). In three out of the eight sessions, there was a significant decrease in the intervention group compared with the control group regarding the mean values of pre‐test and post‐test salivary cortisol levels (P < 0.05). Conclusion: Laughter yoga can provide an effective means to help first‐year nursing students cope with stress and reduce mental symptoms. SUMMARY STATEMENT: What is already known about this topic? Laughter yoga is a non‐pharmacological and non‐invasive method of complementary therapy.An ever‐increasing interest in laughter yoga is observed among nurse researchers.There is little research on laughter yoga in nursing students and randomized controlled studies are limited. What this paper adds? This study showed that laughter yoga reduced levels of anxiety, depression, negative self, somatization and hostility.Salivary cortisol levels significantly decreased in the intervention group in sessions after the fourth laughter yoga session. The implications of this paper: Laughter yoga can provide an effective means to help first‐year nursing students cope with stress and reduce mental symptoms.It is recommended to integrate laughter yoga into the first‐year nursing education curriculum in order to alleviate the mental symptoms of students.Laughter clubs can be set up in nursing faculties, and laughter yoga sessions can be organized for students. [ABSTRACT FROM AUTHOR]