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Aim: The aim of this study is to describe and evaluate how nurses caring for COVID and non‐COVID patients assess changes in their work and in nursing activities during the two waves of the COVID‐19 pandemic. Methods: Two cross‐sectional surveys were conducted for Estonian nurses working during the first and second waves of the COVID‐19 pandemic, using The impact of COVID‐19 emergency on nursing care questionnaire. Based on convenience sampling, the data were collected among the members of professional organizations, unions and associations. Responses from the first (n = 162) and second wave (n = 284) were analysed using descriptive statistics, Fisher's exact test and McNemar's test. Results: The COVID‐19 pandemic changed the working context during both waves for nurses caring for COVID and non‐COVID patients. Changes were considered to a greater extent during the second wave, when Estonia was severely affected, and by nurses caring for COVID patients. During the second wave, the number and complexity of patients increased, and nurses caring for COVID patients performed fundamental care, nursing techniques and symptom control significantly more frequently compared to nurses caring for non‐COVID patients. Conclusion: Taking care of COVID patients is demanding, requiring nurses to perform more direct patient care. However, the pandemic also increased the frequency of activities not related with direct patient care. Summary statement: What is already known about this topic? The COVID‐19 pandemic has influenced the context of care and all dimensions of nurses' work.Despite increasing research on the impact of the COVID‐19 pandemic on nursing care, little attention has been given to differences between caring for COVID and non‐COVID patients during the different waves of the COVID‐19 pandemic. What this paper adds? Nursing care for COVID patients requires from nurses more direct patient care through fundamental care activities, nursing techniques and symptom control compared to non‐COVID patients.The impact of the COVID‐19 pandemic on nurses' work reflects the severity and progress of different waves of the pandemic, which needs to be considered in preparing for future pandemics.Nursing care during a pandemic may also lead to an extensive workload due to tasks not related to direct patient care as nurses contribute to the management of the pandemic on all levels of health care. The implications of this paper: The COVID‐19 pandemic has had a significant impact on nursing, where the mitigation of long‐term effects of the pandemic is still ongoing, and thus, knowledge about the details of the resulting changes is required.Study findings enable us to mitigate the impact of the pandemic on nurses and to highlight aspects that need to be taken into account when preparing for future pandemics. [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]

Aims: This study intended to explore the workplace bullying, self‐efficacy and emotional distress of the nursing staff and determine the predictors of nursing staff's emotional distress. Methods: Cross‐sectional and correlation designs were used, collecting data including socio‐demographic data, workplace bullying, self‐efficacy and emotional distress scales. Results: Results showed that the frequency of poor sleep quality in the recent 2 weeks, working in the intensive care centre or emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress in nursing staff. Conclusion: Nursing supervisors are advised to design suitable shift schemes to allow adequate time for nurses to maintain proper rest and develop a safety notification system to give bullied victims the assurance of safety. The design and implementation of the programs are encouraged to improve self‐efficacy among nurses by strengthening the training of social skills, improving employees' communication skills and their relationships with other employees. Summary statement: What is already known about this topic? Nursing workplace bullying can lead to health problems and patient safety problems.What this paper adds? This study provides information about workplace bullying, self‐efficacy and emotional distress in nurses.Poor sleep quality in the recent 2 weeks, working in the intensive care centre or the emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress among nurses.The implications of this paper for policy/practice/research/education Hospital managers should arrange education programs to improve nurses' self‐efficacy to avoid emotional distress.Suitable shift schemes should be designed for the nurses to maintain proper rest, and a safety notification system should be provided to the bullied victims for the assurance of safety. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this systematic review was to determine the levels and influencing factors of mental workload in intensive care unit nurses. Background: Intensive care unit nurses have a high mental workload level. To our knowledge, no meta‐analytic research investigating the levels of mental workload in intensive care unit nurses and related factors has yet been performed. Design: This article is a systematic review and meta‐analysis. Methods: Eleven electronic databases were searched from the database setup dates until 31 December 2022. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The PRISMA guideline was used to guide reportage of the systematic review and meta‐analysis. Results: Seventeen studies were included. In these studies, the pooled mean score of mental workload was 68.07 (95%CI:64.39–71.75). Furthermore, subgroup analyses indicated that intensive care unit nurses' mental workload differed significantly by countries, sample size and publication year. The mental workload influential factors considered were demographic, work‐related and psychological factors. Conclusion: Hospital administrators should develop interventions to reduce mental workload to enhance the mental health of intensive care unit nurses and nursing care quality. Hospital managers should pay attention to the mental health of nurses and guide them to correctly relieve occupational stress and reduce mental workload. Summary statement: What is already known about this topic? The prevalence of mental workload among ICU nurses is higher than in other departments in hospital.There are no published systematic review and meta‐analysis studies that synthesize the current evidence. What this paper adds? This review estimated overall mental workload scores, which indicated that ICU nurses have a high level of mental workload.The levels of mental workload among ICU nurses may be influenced by multiple factors, classified for this review in terms of demographic, work‐related and psychological factors. The implications of this paper: Demographic, work‐related and psychological variables should be taken into account in developing comprehensive interventions to reduce nurses' mental workload.Similar meta‐analyses in the future can evaluate other healthcare workers and those in other regions to determine in what departments the level of mental workload is high. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [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]

Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexually transmitted diseases (STDs) remains high worldwide in today's society, especially among young people. Youth education on STDs could help to reduce the prevalence of the condition in society and prevent new cases. Aim: The aim of this study is to assess the effectiveness of peer‐based short‐form educational videos on youths' knowledge of STDs. Methods: This quasi‐experimental study was conducted in Turkey. The sample consisted of 121 students divided into experimental and control groups. Pre‐ and post‐test control group quasi‐experimental research design was employed in this study during the spring semester of the academic year 2021–2022. Peer‐based short‐form educational videos created by nursing students were used as an intervention. The survey form and Sexually Transmitted Disease Knowledge Questionnaire were used to collect data. Results: Participants with parental responsibilities and had previous STD experience had higher knowledge score than the other subgroups. There was a significant main effect of peer‐based short‐form educational video on participants overall knowledge score of STDs. Additionally, the effect of intervention continued at 12‐week follow‐up measurement. Conclusion: Peer‐based short‐form educational videos increase young people's knowledge of STD, and the impact of the intervention continued at 12‐week follow up. Summary statement: What is already known about this topic? Sexually transmitted diseases continue to be prevalent in society, particularly among young people.Sexually transmitted diseases can lead to serious health conditions and have a significant impact on sexual and reproductive health.The effectiveness of internet‐based education and lectures on sexually transmitted diseases has already been investigated.Little research has been addressed to determine the impact of educational materials, which are short videos on knowledge of sexually transmitted diseases created by utilizing nursing students' peer assessment. What this paper adds? Peer‐based short‐form educational videos increase young people's sexually transmitted disease knowledge.People with parental responsibilities and a previous sexually transmitted infections responded to interventions more favourably.The effects of peer‐based short‐form educational videos persisted 3 months afterwards. The implications for this paper: This cost‐free method has a potential to be widely used as a public health intervention to educate young people on sexually transmitted diseases.The peer‐based short‐form educational videos can be combined with other interventions to increase young people's knowledge of sexually transmitted diseases. [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]

Background: Vaccination is a crucial protective intervention to prevent adult mortality and morbidity. Personal perceptions and resources have an important place in the vaccination decision. Aim: This study aimed to modify the Public Attitude Towards Vaccination–Health Belief Model scale for adult vaccines and evaluate its psychometric properties. Methods: Overall, 626 people participated in this methodological study. Content validity index, confirmatory factor analysis, internal consistency and item‐total score correlation were used for validity and reliability. The independent samples t test, logistic regression analysis and ROC analysis were used for criterion and concurrent validity. Results: In confirmatory factor analysis, values of fit indices were excellent or acceptable. The Cronbach alpha value was between 0.83 and 0.92. According to criterion validity, the susceptibility, severity, benefit, and health motivation scores of those with the vaccine were higher than those without, whereas their barrier score was lower. The barrier subscale was a risk factor, whereas the benefit score was a protective factor that increased the likelihood of vaccination. The concurrent validity of the scale was tested with the COVID‐19 vaccine. While the barrier subscale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is excellent, it is acceptable for the other subscales. Conclusion: Modified PAVS‐HBM is valid and reliable for adult vaccines. This scale was associated with vaccination behaviour and distinguished between vaccinated and unvaccinated individuals. Summary statement: What is already known about this topic? Vaccination rates are low in many countries due to issues of access, economy and infrastructure and in countries that provide vaccines.Low vaccination rates in adults are associated with mortality and morbidity.Vaccination management success is enhanced by orientation towards individual perceptions. What this paper adds? The modified Public Attitude Towards Vaccination Scale–Health Belief Model (PAVS‐HBM) was demonstrated as a reliable and valid scale.This scale explains the vaccination behaviour for different adult vaccines.This scale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is acceptable to excellent. The implications of this paper for practice: The scale can be used as a tool for researchers to evaluate the probability of individuals being vaccinated and to determine risk groups for vaccine refusal.It can be integrated with many models focused on behaviour change, and when used with a health model, the scale's explanation of individuals' vaccination behaviour can guide the structuring of nursing interventions for vaccination. [ABSTRACT FROM AUTHOR]

Background: The utilization of patient experience surveying by health care institutions has become increasingly prevalent, yet its effectiveness in promoting quality improvement remains uncertain. To enhance the utility of patient feedback, the examination of free‐text comments may provide valuable insights to guide patient experience strategy. Aims: This study aims to explore the utility of free‐text comments and identify key differences for patient experience drivers between Net Promoter Score (NPS) subcategories of Detractors, Passives, and Promoters. Methods: Evaluation and classification of comments was conducted using the eight Picker Principles of Person Centred Care, with descriptive analysis of patient comments performed on the NPS data. Results: Analysis of patient NPS comments can be classified into three key drivers: "feeling well‐treated" (for Detractors), "feeling comfortable" (for Passives), and "feeling valued" (for Promoters). Specifically, Detractor comments provided the most comprehensive and detailed feedback to guide patient experience improvement activities. Conclusion: This study highlights differences between NPS subcategories, particularly regarding aspects of safety, comfort, and feeling valued. Comments from Detractor respondents may be especially useful for guiding quality improvements due to increased specificity and insights. These results also emphasize the essential nature of empathy and compassionate interactions between patients and clinicians to achieve the highest level of patient satisfaction and experience. Summary statement: What is already known about this topic? There is a large amount of patient experience data collected worldwide, including system‐level mandated metrics, such as Net Promoter Score (NPS) and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.Despite this, health care organizations may experience challenges with effectively analysing patient experience data and gathering insights from patient feedback.As such, there is an opportunity to improve the analysis of patient experience data—particularly qualitative data from patient comments—which may improve the understanding of patient experiences and identify key areas for health care improvement. What this paper adds? The study revealed significant differences in patient experience drivers among NPS subcategories (i.e., Detractors, Passives, and Promoters).These findings emphasize the importance of addressing patients' needs for safety, comfort, and feeling valued.Specifically, the Detractor comments offered rich insights for guiding health care improvement activities. The implications of this paper: The findings illustrate the importance of empathetic and compassionate interactions between patients and clinicians, which is essential to attain the highest levels of patient‐reported experience measures.This study may assist health care organizations to maximize the insights obtained from patient feedback and support development of a data‐driven patient experience strategy. [ABSTRACT FROM AUTHOR]

Background: The management and nursing care of women's temperature during delivery is an important part of clinical obstetrics. We aimed to evaluate maternal intrapartum fever during epidural labour analgesia to provide evidence for the management and care of women in labour. Methods: This study was conducted and reported according to the STROBE statement. Women in labour undergoing epidural labour analgesia in our hospital from 1 January 2021 to 31 August 2022 were retrospectively selected. The characteristics of women in labour with and without intrapartum fever were compared. Pearson correlation and logistic regression analysis were used to analyse the influencing factors of postpartum fever. Results: A total of 196 women in labour were included, the incidence of maternal intrapartum fever in women in labour undergoing epidural analgesia was 27.5%. Pearson correlation analyses showed that BMI, oxytocin use, labour duration, number of vaginal examinations, time from rupture of the foetal membranes to the end of labour and duration of epidural analgesia were all correlated with the occurrence of intrapartum fever (all P < 0.05). Logistic regression analyses indicated that body mass index ≥28 kg/m2(OR = 1.825), oxytocin use (OR = 2.082), labour duration ≥9.2 h (OR = 2.613), number of vaginal examinations ≥8 (OR = 2.044–3.115), the time from rupture of the foetal membranes to the end of labour ≥250 min (OR = 2.766) and duration of epidural analgesia ≥300 min (OR = 3.106) were risk factors for intrapartum fever in women in labour undergoing epidural analgesia (all P < 0.05). Conclusions: Maternal intrapartum fever in women in labour undergoing epidural analgesia is common and influenced by many factors. Nurses should take early preventive care measures according to these factors during epidural analgesia in labour. Summary statement: What is already known about this topic? Maternal intrapartum fever is commonly seen during epidural analgesia in labour in clinical practice.Intrapartum fever management and nursing care are important to the comfort and prognosis of women in labour. What this paper adds The incidence of maternal intrapartum fever in women in labour undergoing epidural analgesia was 27.5%.BMI ≥ 28 kg/m2, oxytocin use, labour duration ≥9.2 h, number of vaginal examinations ≥8, the time from rupture of the foetal membranes to the end of labour ≥250 min and duration of epidural analgesia ≥300 min were risk factors for intrapartum fever. The implications of this paper Targeted nursing care to address identified risk factors are needed to reduce rates of maternal intrapartum fever. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the incidence, predictors, and outcomes of delirium in intensive care units. Background: Delirium is a common complication in intensive care units. In developing countries, it can be misdiagnosed or unrecognised. Design: Prospective cohort study reported according to the strengthening the reporting of observational studies in epidemiology criteria. Methods: We included patients who were conscious, >18 years old, and admitted to the intensive care units for at least 8 h between December 2019 and February 2020. Patients with a Richmond score of −4 or −5, mental disability, receptive aphasia and/or visual or auditory impairment were excluded from the study. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM‐ICU), whereas the functional outcome was assessed by the Katz Activity of Daily Living Index. Results: This study included 111 patients with a delirium incidence of 31.5%. The severity of illness was the only significant predictor of delirium. Patients with delirium had longer intensive care unit and in‐hospital stays in contrast to those without delirium. Delirium was associated with in‐hospital and 4‐month mortality but not the activities of daily living. Conclusions: Delirium is associated with increased length of stay and mortality. Further investigation to determine whether delirium management can improve outcomes is warranted. Summary statement: What is already known about this topic? Delirium is a common complication in the intensive care unit and can affect patients' outcomes.The incidence and the effect of delirium on patients' outcomes in low‐resource countries remain largely unexplored. Delirium is potentially underdiagnosed and commonly undetected in these countries. What this paper adds? Delirium is associated with a longer duration of stay in the hospital and the intensive care unit as well as mortality in the hospital and 4 months after discharge.Delirium may not affect long‐term functional outcomes after discharge.The severity of illness is an independent predictor of delirium. The implications of this paper In low‐resource countries, the increased length of stay can add a significant burden on healthcare systems.Proper management of delirium will potentially maximise resource utilisation.Delirium affects mortality and length of stay, thus investigating the effect of the current management protocols on these outcomes is warranted. [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]

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]

Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later. Results: The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. Trial registration: ClinicalTrials.gov ID: NCT03944642. Summary statement: What is already known about this topic? Breastfeeding is the gold standard for infant and young child nutrition.However, national and global prevalence is lower than expected.Breastfeeding support has focused on a biomedical approach with a predominantly clinical approach to breastfeeding difficulties.What this paper adds? Establishes an intervention proposal from an integral approach centred on a woman, her child and her family.Considers the perspective of health professionals in relation to their strengths and difficulties in supporting mothers with breastfeeding.Estimates the effect of the intervention on the self‐efficacy of professionals and mothers.The implications of this paper: This intervention was feasible and accepted by participants and health professionals working in primary health care centres. Therefore, the exploratory trial can be subjected to a full trial following the protocol and recommendations from the findings at this stage.Although the effects measurements of the intervention effects are preliminary, they show promising results regarding breastfeeding (BF) maintenance rates, together with a recovery of exclusive breastfeeding at 4 months and a decrease in maternal postpartum depression risk. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to appraise clinical guidelines about exercise for women with gestational diabetes mellitus and summarize consensus and inconsistent recommendations. Background: Exercise is an effective non‐pharmacological therapeutic for gestational diabetes mellitus, but the variety of relevant clinical practice guidelines is confusing for healthcare professionals. Design: This is a systematic review of clinical practice guidelines. Data Sources: Websites of guideline development institutions, eight literature databases and organizations of obstetricians, gynaecologists, midwives, and medical sports associations were searched for guidelines published from January 2011 to October 2021. Review Methods: Two reviewers independently extracted recommendations. Four reviewers assessed guideline quality using the AGREE II instrument independently. Results: Fifteen guidelines were included. All women with diabetes are recommended to exercise during pregnancy. The consistent recommendations were for pre‐exercise screening, for 30 min per exercise session on 5 days of the week or every day after meals, exercise at moderate intensity, using aerobic and resistance exercise, and walking. The main non‐consistent recommendations included warning signs for women on insulin during exercise, minimum duration per session, intensity assessment, duration and frequency of sessions for strengthening and flexibility exercise and detailed physical activity giving birth. Conclusions: Guidelines strongly support pregnant women with diabetes to exercise regularly. Research is needed to make non‐consistent recommendations clear. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with a higher risk of short‐ and long‐term adverse maternal and fetus outcomes.Physical activity is a safe and beneficial non‐pharmacological treatment for gestational diabetes mellitus.The methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus are unclear. What this paper adds? Methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus were identified by AGREE II instrument.Consensus and non‐consistent recommendations of the physical activity guidelines for pregnant women with gestational diabetes mellitus were summarized. The implications of this paper: The consensus recommendations make it clear that health professionals should offer physical activity guidance to pregnant women with gestational diabetes mellitus.Non‐consistent recommendations offer opportunities for further research directions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the risk factors for household transmission of the omicron variant of SARS‐CoV‐2. Background: The household infection rate has been reported to be higher for the omicron variant than for non‐omicron variants of SARS‐CoV‐2. Determination of the risk factors for household transmission of the omicron variant is therefore important. Design: A Retrospective Cohort Study was conducted. Methods: When family members of health care workers (HCWs) were found to be infected with SARS‐CoV‐2, the HCWs had to receive two nucleic acid amplification tests for SARS‐CoV‐2: immediately after and 5 to 10 days after the onset of COVID‐19 in the family members. Risk factors of household transmission were analysed by comparing cases (HCWs infected with SARS‐CoV‐2) and controls (HCWs not infected with SARS‐CoV‐2) using multivariable analysis. Results: Unvaccinated status (OR: 3.97), age of index cases (≤6 years) (OR: 1.94) and staying at home with index cases (OR: 10.18) were risk factors for household transmission. Conclusion: If there is a strong desire to avoid household infection, family members infected with SARS‐CoV‐2 should live separately during the period of viral shedding. Summary statement: What is already known about this topic? During the COVID‐19 pandemic, nurses have been exposed to SARS‐CoV‐2 not only from COVID‐19 patients but also from family members infected with SARS‐CoV‐2 but prevention of SARS‐CoV‐2 infection to nurses is important to maintain health services function.The household infection rate was reported to be higher for the omicron variant (42.7%) than for non‐omicron variants (36.4% for Alpha, 29.7% for Delta and 22.5% for Beta). Determination of the risk factors for household transmission of the omicron variant is therefore important. What this paper adds? Unvaccinated HCWs had higher transmission rates (OR: 3.97, 95% CI: 1.22–12.88) than those of HCWs who received more than two doses of BNT162b2 or mRNA‐1273 mRNA COVID‐19 vaccines.Index cases aged 6 years or younger had higher transmission rates (OR: 1.94, 95% CI: 1.13–3.35) than those of index cases aged 7 years or older.The odds of transmitting to HCWs was higher (OR: 10.18, 95% CI: 2.98–34.72) for HCWs who stayed at home with the index cases than for HCWs who spent time in a different building from the index cases. The implications of this paper: If there is a strong desire to avoid household infection, family members infected with SARS‐CoV‐2 should live separately during the period of viral shedding. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking. Background: Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour. Design: A cross sectional, comparative study was conducted. Methods: A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires. Results: Mental health nurses were less likely to consider quitting smoking within the next 6 months (P < 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P < 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040). Conclusion: Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke. Summary statements: What is already known about this topic? Smoking prevalence among nursing staff is high.Cultural variances may determine nursing staff's variability in their behaviour.Nurses can play a pivotal role in influencing their patients' smoking attitudes. What this paper adds? Mental health nurses are less likely to quit smoking compared with ward nurses.Specialized strategies that emphasize mental health nurses' perceptions and attitudes towards smoking are considered essential. The implications of this paper: It is imperative that educational institutes of nurses include in their bachelor programmes, courses that emphasize the importance of preventing smoking initiation along with smoking cessation strategies.Nurses who smoke should be supported by public health organizations in practice through tobacco cessation centres and several specialists. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the utility of latent profile analysis of illness perception, in comparison to treating illness perception as several dimensions, to predict breast cancer‐related lymphedema risk management behaviours among Chinese breast cancer patients. Methods: This is a 3‐month longitudinal study. From August 2019 to January 2021, patients who recently underwent breast cancer surgery including axillary lymphadenectomy were recruited. Illness perception and risk management behaviours were measured by breast cancer‐related lymphedema specific questionnaires before discharge following surgery (n = 268) and at 3 months postsurgery (n = 213), respectively. Results: Treating illness perception as several dimensions, 'illness coherence' and 'timeline (cyclical)' dimensions were found to be significantly associated with breast cancer‐related lymphedema risk management behaviours. Using the latent profile analysis, two illness perception profiles were identified and significant differences were revealed in breast cancer‐related lymphedema risk management behaviours between them. Overall, illness perception profiles explained smaller amounts of variability in breast cancer‐related lymphedema risk management behaviours than illness perception dimensions. Conclusion: Future studies could combine these two different perspectives of illness perception regarding breast cancer‐related lymphedema into the design of interventions to improve breast cancer‐related lymphedema risk management behaviours. Summary statement: What is already known about this topic? Risk management behaviours are essential to reduce the risk and severity of breast cancer‐related lymphedema (BCRL).Illness perception is a modifiable predictor of BCRL risk management behaviours.Traditional correlation or regression analysis treat illness perceptions as several isolated elements and make it difficult to synthesize our understanding of it. What this paper adds Treating illness perceptions as several isolated elements, illness coherence and timeline (cyclical) were main components predicting BCRL risk management behaviours.Treating illness perception as a whole, latent profile analysis assigned breast cancer patients into two distinct profiles with similar illness perception.Illness perception dimensions and illness perception profiles showed certain effects on predicting BCRL risk management behaviours. The implications of this paper This study adds our knowledge of illness perception regarding BCRL and its effect on predicting BCRL risk management behaviours.The two analysis approaches provided different perspectives on the design and implementation of future intervention. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. Background: Cancer‐related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. Design: A cross‐sectional design was used. Methods: This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. Result: The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. Conclusion: The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support. Summary statement: What is already known about this topic?: Cancer‐related cognitive impairment has significantly affected the quality of life of patients with advanced cancer.Risk factors associated with cognitive impairment in patients with advanced cancer have not been adequately documented, and neural network models have not been identified. What this paper adds?: This study found that long a cancer course, anxiety and ageing were the most important risk factors for cognitive impairment in patients with advanced cancer.The artificial neural network showed good predictive indicators, indicating that it can be used to predict cognitive impairment in patients with advanced cancer. The implications of this paper: Neural network models can help nurses and other clinicians predict cognitive impairment in advanced cancer patients early which will allow provision of timely intervention. [ABSTRACT FROM AUTHOR]

Aims: This systematic review and meta‐analysis aimed to evaluate the effects of home‐based telehealth compared with usual care on six‐minute walking distance (6MWD), health‐related quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease. Methods: We identified randomized controlled trials through a systematic multidatabase search. Titles and abstracts were assessed for relevance. Two authors independently extracted data and assessed the risk of bias and quality of evidence. Meta‐analyses were conducted using Review Manager and Stata. Results: We included 32 randomized controlled trials (n = 5232). Devices used for home‐based telehealth interventions included telephones, videos, and combined devices. The quality of the evidence was downgraded due to high risk of bias, imprecision, and inconsistency. Home‐based telehealth significantly increased 6MWD by 35 m (SD = 30.42) and reduced symptom burden by 3 points (SD = −2.30) on the COPD assessment test compared with usual care. However, no significant differences in anxiety and depression were noted between the home‐based telehealth group and the standard care group. In subgroup analysis, home‐based telehealth significantly improved 6MWD and health status after 6–12 months and >12 months. Conclusion: Low quality evidence showed that home‐based telehealth interventions reduce symptom burden and increase walking distance to a clinically meaningful extent in patients with COPD. However, no effects on depression and anxiety were observed. Summary statement: What is already known about the topic? In the context of chronic obstructive pulmonary disease progression, exacerbation of symptoms results in negative impacts on physical condition and psychological status.The overall effect of telehealth for patients living with chronic obstructive pulmonary disease is unclear based on different results reported in existing studies. What this paper adds? Home‐based telehealth improved the six‐minute walking distance and health status in patients with chronic obstructive pulmonary disease, but it did not improve anxiety and depression.Home‐based telehealth based on combined devices but not telephone or video improved the six‐minute walking distance and health status.Home‐based telehealth significantly improved six‐minute walking distance and health status in the 6–12 months subgroup and the more than 12 months subgroup but not at <6 months. The implications of this paper: Telehealth offers a feasible method to provide long‐term and regular health care to patients with chronic obstructive pulmonary disease living at home.Telehealth can help expand the recognition, accessibility and application of medical care services for patients with chronic obstructive pulmonary disease. [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: 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: Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy. Methods: A cross‐sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self‐reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression). Results: Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy‐Cognitive Function (FACT‐Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables. Conclusion: The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health‐care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment. Summary statement: What is already known about this topic? Cancer and associated treatments have diverse short‐ and long‐term side effects. Deficits in cognitive functions are one of the most frequently reported for breast cancer specifically due to chemotherapy.Subjective assessment of cognitive function is often neglected, although it might be clinically very useful and an important indicator of the impact of cognitive impairment on daily functioning.There is currently no Portuguese data on perceived cognitive impairment in cancer. What this paper adds? This Portuguese study shows that, compared to a matched healthy sample, breast cancer patients have significantly more cognitive complaints, as assessed by the FACT‐Cog scale.Furthermore, our findings showed that higher levels of anxiety and depression are associated with worse perceived cognitive functioning.Cognitive complaints in breast cancer patients are predicted by a complexity of factors, such as psychological adjustment, age, and education. The implications of this paper: Health‐care professionals, including nurses, should recognize cognitive complaints as legitimate in breast cancer patients.Findings may deepen nurses' knowledge about cognitive concerns in breast cancer patients, in order to improve the quality of care provided to this population.The results of the study highlight the importance of tackling this problem with specifically designed clinical interventions that target both the cognitive deficits and the psychological adjustment of patients, especially depressive symptomatology. [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: The purpose of this project was to examine the role of cultural differences in shaping the management of diabetes among Ethiopian immigrants living in Israel. Methods: A qualitative, in‐depth study involved semistructured interviews with 16 Ethiopian immigrants with diabetes living in Israel. The interviews were audio‐recorded, transcribed and translated into Hebrew, if necessary. The authors each identified themes in the responses and then through discussion came to a consensus about the most significant ones and how to categorize them. Results: A main theme was revealed structuring the participants' perception of diabetes: an oscillation between a familiar narrative, associated with traditional life in Ethiopia, and a foreign one. Five additional subthemes were also identified as an oscillation about the causes of disease, between collectivism and individualism, between accessible food and a balanced diet, between relying on bodily sensations and prescribed treatment and between culturally oriented and translated knowledge. Conclusion: The participants understood that they could be adversely affected both by the changes in lifestyle following their move and by adhering to the traditional norms. They agreed that professional liaisons and peers who have successfully managed their diabetes could help provide a bridge between the narratives. Summary statement: What is already known about this topic? Diabetes is a worldwide epidemic where immigrant populations are more likely to suffer from it.Language and cultural barriers pose a challenge to immigrants when accessing healthcare.Among immigrants, diabetes‐related distress is often accompanied by distress due to the challenges of immigration and acculturation.What this paper adds? Among Ethiopian immigrants, there exists a division between two main narratives about their illness and the way it is treated: the familiar and the foreign.Ethiopian communities play an important role in the treatment of an individual's illness, for better or worse.Translation alone is not sufficient to make language accessible; it must be combined with a medically‐culturally tailored approach.The implications of this paper: An understanding of the oscillations between narratives that Ethiopian immigrants experience is important for promoting person‐centred care for this population.During individual and group training, nurses should include Ethiopian immigrants who have successfully managed their diabetes.Nurse managers should ensure that their clinic has professional liaisons not only for translation but also for the provision of culture‐based health care. [ABSTRACT FROM AUTHOR]

Aim: This quasi‐experimental study aimed to explore effects of walking exercise on disease activity, sleep quality, and quality of life among individuals with systemic lupus erythematosus. Methods: After recruiting people with systemic lupus erythematosus from a hospital in Taiwan between October 2020 and June 2021, participants were free to opt to receive one walking exercise programme plus standard care for 3 months or to membership of a control group receiving routine care. Primary outcomes included Systemic Lupus Erythematosus Disease Activity Score, the Pittsburgh Sleep Quality Scale, and a quality‐of‐life scale for patients with systemic lupus erythematosus, namely, LupusQoL. These scales were administered first, at baseline and later, within 1 week following completion of the intervention. Between‐group effects were compared using generalized estimating equations with adjustment for baseline variables. Results: The experimental and control groups each included 40 participants. Multivariate analysis indicated that adding the walking exercise programme into routine care elevated sleep quality and LupusQoL (the latter in the subscales of physical health, planning, and intimate relationships), except for disease activity. Conclusion: Findings of this study supported the addition of walking exercise as part of routine care for people with systemic lupus erythematosus and may be a reference in the provision of adequate care for these patients. Summary statements: What is already known about this topic? Systemic lupus erythematosus is a lifelong autoimmune disease that affects any organs throughout the body, thus insidiously causing negative impacts on the affected patients.Today, use of exercise programmes such as walking exercise has been studied as a remedy for many medical conditions, but its effectiveness in minimizing the symptoms of distress among people with systemic lupus erythematosus is unknown. What this study adds? Participants with systemic lupus erythematosus who opt to receive the walking exercise programme for 3 months in addition to routine care experience improved sleep quality and quality of life compared with those receiving routine care alone. The implications of this paper: In accordance with the belief that "an ounce of prevention is worth a pound of cure," early implementation of an exercise programme should be considered in addition to routine care for patients with systemic lupus erythematosus.Evidence from this research could provide empirically informed and robust data for healthcare policymakers and in turn might help to reduce the incidence of morbidity among patients with systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey. Methods: This descriptive and cross‐sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey‐Turkish and the MISSCARE Survey‐Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data. Results: The total occurrence of missed nursing care was 2.93 (on a scale of 1.00–4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient–nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care. Conclusions: The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient–nurse ratio and nursing teamwork to reduce the incidence of missed nursing care. Summary statement: What is already known about this topic? Missed nursing care is a globally common patient safety issue that threatens quality nursing care.Although there are many studies from different countries in the international literature on missed nursing care, studies on this subject in Turkey have been limited. What this paper adds? Missed nursing care correlated with age, tenure in hospital, tenure in unit, weekly work hours, satisfied in current position, satisfaction with being a nurse, satisfaction with salary, technological, educational and career opportunities of the hospital, satisfaction with the level of teamwork in the unit, and satisfaction with support of first‐line nurse manager.Nurses' tenure in the profession, patient–nurse ratios, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. The implications of this paper: Strategies to improve nurses' work environment characteristics, especially teamwork, should be organized to prevent or reduce missed nursing care.Hospital administrators and nurse managers should address levels of missed nursing care through balancing patient–nurse ratios, providing adequate human and material resources, increasing technological, educational, and career opportunities of hospitals, meeting nurses' needs and providing support and performing activities to reduce absenteeism. [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]

Aim: This study aimed to explore nurses' views and experiences regarding remaining silent. Background: Silence is a barrier for organizational improvement and can occur for many reasons; it cannot be simply defined as the opposite of speaking out. Method: An exploratory qualitative design was used for this study. Data were collected using semi‐structured interviews in 2016 with 24 nurses who were recruited by using a snowball sampling method. Results: Three themes emerged as a result of the thematic analysis: fear, silence climate and disengagement. The first theme contained three subthemes: avoidance of being seen as a troublemaker, financial loss and reluctance to reveal lack of ability or knowledge. The results indicated that nurses remained silent when they felt unsupported or psychologically unsafe in their work environment. Conclusion: Encouraging nurses to express their opinions is essential for creating a psychologically safe nursing work environment and an organizational climate that supports open communication. Because the majority of healthcare professionals are nurses, they can act as role models and change agents for other nurses if they are encouraged to share their ideas and opinions without fear of retribution. Summary statement: What is already known about this topic? Silence negatively affects work environment and causes job dissatisfaction.Silence is a threat to the development of new ideas and prevents nurses from raising concerns about critical issues. What this paper adds? Nurses remain silent when they fear losing their jobs, showing weakness or being labelled as a troublemaker.Nurses' work environment affects their decision to speak up.If nurses do not receive any support or see any change, they tend not to speak up. The implications of this paper: Hospital managers should support a work environment that encourages open communication and productive feedback systems.Silence can be prevented by creating a psychologically safe environment in which no one is judged for their opinion. [ABSTRACT FROM AUTHOR]

Aims: To explore the factors related to hospital‐to‐home transitional self‐monitoring blood glucose behaviour among patients with diabetes‐related foot ulcer. Background: The 30‐day readmission rate of patients with diabetes‐related foot ulcer can be reduced when good glycaemic control is achieved. The practice of self‐monitoring blood glucose promotes optimal glycaemic control. Design A comparative descriptive study. Methods: In this study, 200 participants, who had been hospitalized due to diabetes‐related foot ulcer, were recruited from August 2017 to July 2018. Before participants were discharged from the hospital, psychosocial factors (family support, threat belief, self‐efficacy and knowledge) and pre‐hospitalization self‐monitoring blood glucose behaviour were collected using a structured questionnaire. Then, after discharge, self‐monitoring blood glucose behaviour delivery was collected again. Results: Five variables explained 47% of the variance in the delivery of self‐monitoring of blood glucose at home. The delivery of hospital‐to‐home transitional self‐monitoring blood glucose behaviour was more likely for individuals with higher pre‐discharge self‐efficacy, higher post‐discharge self‐efficacy, more attention to pre‐hospitalization glycaemic status and post‐discharge insulin usage and those without an insensitive foot. Conclusion: Self‐monitoring blood‐glucose behaviour should be promoted among post‐discharge patients with diabetes‐related foot ulcer. The modifiable factors identified in this study can be integrated into the discharge plan. Summary statement: What is already known about this topic? Patients with diabetes‐related foot ulcer have higher 30‐day readmission rates than the general inpatient population. Such readmissions can be prevented when good glycaemic control is achieved.As a centrepiece of diabetes self‐management, self‐monitoring blood glucose practice promotes optimal glycaemic control.Although there have been several survey studies of self‐monitoring blood glucose practice among patients with diabetes, to our knowledge, no study has used longitudinal data to explore the self‐monitoring of blood glucose behaviour. In addition, no study has explored hospital‐to‐home transitional self‐monitoring of blood glucose among patients with diabetes. What this paper adds? After participants were discharged from the hospital, approximately one‐fourth did not perform self‐monitoring of blood glucose at home.The delivery of hospital‐to‐home transitional self‐monitoring blood glucose practice was more likely for individuals with higher pre‐discharge self‐efficacy, higher post‐discharge self‐efficacy, more attention to pre‐hospitalization glycaemic status and post‐discharge insulin usage as well as for those without an insensitive foot.Self‐efficacy of self‐monitoring of blood glucose is the most powerful predictor of hospital‐to‐home transitional self‐monitoring blood‐glucose practice. The implications of this paper: For patients with less attention paid to their glycaemic status previously and with impaired foot sensation, an intensive discharge plan should be provided to promote their self‐monitoring blood‐glucose practice.To promote self‐monitoring blood‐glucose practice, strategies to improve self‐efficacy related to self‐monitoring of blood glucose should be integrated into the discharge plan and subsequent follow‐up. [ABSTRACT FROM AUTHOR]

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 paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students. Background: Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. Design Longitudinal comparative study. Measurements We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self‐administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed. Results: There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake. Conclusion: Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health‐promoting role. We need strategies to safeguard the professional nursing practice. SUMMARY STATEMENT: What is already known about this topic? Nursing includes the promotion of health, the prevention of illness and the shaping of healthy behaviours.Nurses are in a unique position to help individuals and communities modify their health risk behaviours.An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. What this paper adds? Using a longitudinal comparative study design, we recorded no major differences in behavioural health risk factors between nursing students and nonnursing peers at the beginning and the end of their studies.In relation to their first year of studies, both nursing students and nonnursing peers engaged in more health risk behaviours during their final year in delivery/junk food consumption, sunburns, hashish/marijuana use and number of sexual partners. The implications of this paper: Multiple strategies are needed to target norms regarding the scope of professional practice of nursing and advance undergraduate nursing curricula to explicitly provide the required knowledge for health promotion, lifestyle counselling and behaviour change interventions. [ABSTRACT FROM AUTHOR]

Aims: This study was conducted to describe and compare nurses' and inpatients' perceptions of caring attitudes and behaviours in rehabilitation. Methods: A comparative descriptive design was used. Perceptions of caring attitudes and behaviours were compared between 34 nurses working in rehabilitation and 64 elderly patients, using the Caring Nurse Patient Inventory‐23, to explore Watson's carative factors through four dimensions. Patients' and nurses' ratings of importance for each dimension were compared. The study data were collected from 8 November 2017 to 5 May 2018. Results: Patients' and nurses' responses showed high scores in terms of their perceptions of caring, with nurses having the higher scores, and significant differences were found between patients and nurses. Patients scored items linked to clinical aspects of caring as the most important, whereas nurses scored items linked to humanistic and clinical caring as equally important. Comfort care was considered important for nurses and patients. Both groups considered relational caring items as the least important. Conclusion: Results show that patients and nurses value clinical aspects of care, which is the visible aspect of care. The Caring Nurse Patient Inventory‐23 is a reliable instrument to measure the nurses' and patients' perception of caring behaviours in rehabilitation. SUMMARY STATEMENT: What is already known about this topic? A caring humanistic approach emphasizes the specific role of the nurse and is compatible with recent models of nursing in rehabilitation.Few studies have measured the perceptions of caring attitudes or behaviours among patients and nurses in the context of rehabilitation. What this paper adds? Patients scored items linked to clinical and comfort aspects of caring as the most important suggesting that patients value tangible aspects of caring.Nurses scored items linked to humanistic and clinical caring as equally important stressing the importance for nurses to link positive support and values to instrumental caring.Patients and nurses considered relational caring items as the least important; it may due to the problem solving and spiritual nature of this dimension of care, requiring a deeper involvement of nurses and patients. The implication of this paper: Nurses need to ensure their technical skills are up‐to‐date, even in a low technical environment such as rehabilitation.The Caring Nurse Patient Inventory‐23 was shown to be reliable for measuring patients' and nurses' perceptions of caring in rehabilitation. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate the effectiveness of individualized exercise counselling in changing exercise behaviour and relieving pregnancy‐related distress symptoms in pregnant women. Methods: A quasi‐experimental design and convenience sampling technique were used. Participants were recruited from the prenatal outpatient departments of medical centre hospitals in Taipei, Taiwan. The experimental group (n = 52) received face‐to‐face exercise counselling followed by 8 weeks of exercise sessions in their homes. The control group (n = 49) received no exercise counselling. Pregnancy‐related distress symptoms were assessed before and after 8 weeks in both groups. Results: The after‐counselling scores of total (t = 2.46, P < 0.05) and physical (t = 3.18, P < 0.01) distress symptoms were significantly lower than the before‐counselling scores in the experimental group. The total, physical and psychological distress scores significantly differed between groups and before and after counselling. The adjusted R2 values for total, physical and psychological distress symptoms ranged from 0.59 to 0.70. Participants' exercise habits increased from prepregnancy (19.2%) to after counselling (71.2%). Conclusion: Exercise counselling may effectively increase exercise habits and reduce pregnancy‐related distress symptoms among pregnant women. Women with higher pretest symptom distress scores also had higher posttest symptom distress scores. Based on our outcomes, health care providers should routinely provide exercise counselling to pregnant women. SUMMARY STATEMENT: What is already known about this topic? Previous studies have found that exercise can be very beneficial for pregnant women by relieving pregnancy‐related distress.Women also commonly reported that advice regarding exercise during pregnancy is generally vague (not individualized), constantly changing and often limited to a continuation of their previous routine or simply increased walking.Studies on the effectiveness of individual face‐to‐face exercise counselling for pregnant women for relieving their pregnancy‐related distress symptoms are limited. What this paper adds? Individual face‐to‐face exercise counselling can reduce pregnancy‐related symptoms in pregnant women.The pretest score was a significant factor that influenced the degree of relief from symptom distress. The implications of this paper: This study could help health care providers to provide pregnant women with exercise counselling as part of their routine prenatal care to relieve pregnancy‐related distress. [ABSTRACT FROM AUTHOR]

Aim: Social disengagement and cognitive decline commonly coexist among older adults, and living alone may be a significant risk factor for cognitive decline. This study aimed to identify differences in variables between older adults living alone and living with others; it also evaluated the association between social participation and cognitive function in older adults living alone. Methods: A secondary analysis was performed using the data collected between June and August 2017 of 10 299 nationally representative adults aged ≥65 years, obtained from the Korean Institute for Health and Social Affairs and the Ministry of Health and Welfare. Chi‐square and t tests were used to compare characteristics between the two groups. Multiple linear regression analyses were utilized to examine the association between social participation and cognition, after adjusting for other variables. Results: Among 10 055 adults, 24% lived alone. Sociodemographic and health‐related variables and social participation differed significantly between the two groups. On multiple linear regression, participation in fraternal group activity, religious activity, and contact with siblings and relatives through phone calls or letters contributed significantly to cognitive function in older adults living alone. Conclusion: Nurses can encourage various intellectually and emotionally stimulating social activities, as they help to maintain and improve the cognitive function of older people living alone. SUMMARY STATEMENT: What is already known about this topic? Maintaining cognitive function is an important aspect of aging well and is essential for independent life.Cognitive decline and social disengagement commonly coexist among older adults. What this paper adds? Older adults living alone were more vulnerable than those living with others; solitary older adults had lower incomes, more comorbidities, more severe depression, poorer physical and cognitive function, less health promoting behaviours, and poorer nutritional status.Social activity was independently associated with cognitive function in older adults living alone. The implications of this paper: This study showed that social activities may reduce cognitive decline in later life.Nurses can encourage various social activities through intellectual and emotional stimulation, as they help to maintain and improve cognitive function in older people living alone. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to cross‐culturally translate and adapt the Cardiac Self‐Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients. Method: The original English version of the Cardiac Self‐Efficacy Questionnaire was translated into Arabic following a process recommended by the World Health Organization. A convenience sample consisting of 268 Jordanian patients with coronary heart disease was recruited from a university‐affiliated hospital in Amman, Jordan. Data were collected from October 2018 to March 2019. The factor structure, face and content validities, and internal consistency of the Arabic Cardiac Self‐Efficacy Questionnaire (A‐CSEQ) were evaluated. Results: The factor structure analysis supported a three‐factor high‐order structure of the A‐CSEQ. Face validity showed that the language used, style, and format were clear. The content validity demonstrated a very good content validity index. The reliability was good with ranging from 0.89 to 0.93 for all questionnaire subscales. Conclusion: The A‐CSEQ is a valid and reliable instrument to assess the cardiac self‐efficacy of Arabic patients diagnosed with coronary heart disease. Further assessment of the psychometric properties of the A‐CSEQ with different cardiac problems is now recommended. SUMMARY STATEMENT: What is already known about this topic? Globally, cardiovascular diseases are the leading cause of death and are increasing progressively particularly in the Middle Eastern countries.High self‐efficacy level is associated with the adoption of a healthy lifestyle by patients with coronary heart disease (CHD).There is no valid and reliable Arabic tool to measure cardiac self‐efficacy among CHD patients comparable with the Cardiac Self‐Efficacy Questionnaire (CSEQ). What this paper adds? The Arabic version of the Cardiac Self‐Efficacy Questionnaire (A‐CSEQ) is a valid and reliable instrument to assess cardiac self‐efficacy level among patients with CHD.Using Modern Standard Arabic (Fusha) during the translation and cross‐cultural adaptation process makes the A‐CSEQ more broadly applicable for a range of cardiac patients in Arabic‐speaking countries. The implications of this paper: Nursing leaders can use the translated version of Cardiac Self‐Efficacy Questionnaire to evaluate cardiac self‐efficacy and to improve self‐management skills of patients with CHD in Arabic‐speaking countries.Measuring the self‐efficacy levels of Arabic speakers using the A‐CSEQ can help nurses applying secondary prevention intervention measures and developing cardiac rehabilitation programmes in Arabic‐speaking countries.The A‐CSEQ can be used in further research in the future, through implementing comparisons between study outcomes in Arabic contexts. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effect of reflexology on lactation and postpartum comfort in primiparas giving births through caesarean section. Methods: This randomized controlled trial was conducted in 100 women with first birth through caesarean section between May 2016 and May 2017. Expectant mothers were randomly included into an intervention and a control group. The intervention group consisted of mothers in whom reflexology was performed three times per day at every eight hours for 30 min for 3 days. Results: The mean scores of the breastfeeding chart system and breastfeeding satisfaction scores of the mothers in the intervention group were significantly higher than those of the controls, and the first lactation period of the mothers in the intervention group was shorter than that of the controls. Mean breast‐tension, breast‐heat, and breast‐pain scores were similar in both groups on day 1; however, a significant increase was seen the intervention group on days 2 and 3, compared to those in the controls. The mean scores of the Postpartum Comfort Questionnaire in the intervention group were significantly better than those of the controls. Conclusions: Reflexology starts lactation earlier in mothers giving birth via caesarean section, supports the breastfeeding period, and increases mothers' postpartum comfort. SUMMARY STATEMENT: What is already known about this topic? Immediately after caesarean birth, many women suffer from breastfeeding problems due to pain, fatigue, activity intolerance, anaesthesia, and delayed onset of lactation.As a result of these avoidable problems, the baby cannot get enough breast milk, and mothers' postpartum comfort decreases. What this paper adds? Evidence in the study indicates that nurses can support effective breastfeeding, especially for caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort. The implications of this paper: This randomized controlled trial study provides evidence to support effective breastfeeding, especially for the caesarean‐delivery primiparous mothers, by delivering reflexology, which may start lactation sooner and improve postpartum comfort.This controlled trial study contributes to the knowledge base of healthcare professionals who provide care during childbirth by promoting the ability to offer appropriate interventions according to individual needs. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to determine the effects of demographic and obstetric variables with body image on sexual dysfunction in pregnant women. Background: Sexual dysfunction is frequent in pregnant women. To what extent body image plays a role is incompletely understood. Methods: In the research, a cross‐sectional and comparative study was conducted. A personal information form, body image scale, and female sexual function index were applied to 472 pregnant women. Descriptive statistics, the Student t‐test, the χ2 test, and logistic regression analysis were employed for evaluating the data. Results: Sexual dysfunction was found in 54.7%. The frequency of sexual dysfunction in the first trimester was lower. In addition, factors like the place of residence of the pregnant women and number of pregnancies were found to be related to sexual dysfunction in pregnant women. Each unit decrease in body image score resulted in women being 0.98 times more likely to experience sexual dysfunction. Conclusion: It was determined that approximately one in two pregnant women experienced sexual dysfunction, and body image, place of residence, trimester of the pregnancy, and number of pregnancies were important factors affecting sexual function. SUMMARY STATEMENT: What is already known about this topic? Many factors cause sexual dysfunction, and one of these factors in women is pregnancy.In addition to the anatomical, physiological, and psychological changes caused by pregnancy, some demographic and obstetric variables can affect sexuality during pregnancy.To what extent body image plays role on sexual dysfunction in pregnancy is incompletely understood. What this paper adds? Approximately one in two pregnant women experienced sexual dysfunction in this study.We determined body image, living place, trimester of the pregnancy, and number of pregnancies were important factors affecting sexual function. The implications of this paper: The integration of findings with prenatal care services can be used to assess risk factors and provide protective services.Sexual dysfunction in pregnancy should be considered in the presentation of prenatal care services.Body image and all other variables should be considered as part of holistic follow up of pregnant women. [ABSTRACT FROM AUTHOR]

Background: Low physical activity is common in systemic lupus erythematosus populations. Aim: To evaluate the effect of physical activity counselling on physical activity and the association between physical activity changes and changes in fatigue, quality of sleep, and quality of life in women with systemic lupus erythematosus. Methods: A randomized, controlled, single‐blind trial was conducted from March 2015 to August 2016. Seventy‐six women with systemic lupus erythematosus were randomly assigned to the intervention or control groups. The intervention group received three sessions of physical activity counselling at 1, 4, and 8 weeks and three telephone follow‐ups over 13 weeks. Outcome measures, which include daily steps, fatigue, quality of sleep, and the quality of life, were collected at baseline and 8 and 12 weeks. Results: The study showed that daily steps, quality of sleep, and vitality in the intervention group were significantly improved compared with those in the control group at weeks 8 and 12. Mental health was significantly improved only at week 8 in the counselling group. A positive correlation between physical activity changes and changes in vitality and mental health was observed. Conclusions: Physical activity counselling can improve physical activity. As physical activity increases, systemic lupus erythematosus women feel more energetic and happier. SUMMARY STATEMENT: What is already known about this topic? Patients with systemic lupus erythematosus (SLE) have inactive lifestyles, and few of them exercise regularly.Patients with SLE have poor aerobic fitness and muscle strength.Fatigue, poor sleep, and low quality of life are common in patients with SLE. What this paper adds? The five A's physical activity counselling model is feasible and can enhance SLE patients' physical activity levels.Vitality and mental health improvement are associated with an increase in physical activity. The implications of this paper: Health care professionals could provide physical activity counselling to SLE patients during every clinical visit.Health care professionals could encourage patients with SLE to use a pedometer as a monitor to record their daily steps. [ABSTRACT FROM AUTHOR]

Eley DS, Eley RM. International Journal of Nursing Practice 2011; 17: 380-387 Personality traits of Australian nurses and doctors: Challenging stereotypes? This study compared temperament and character traits of Australian registered nurses and general practitioners. A cross-sectional quantitative design used the Temperament and Character Inventory. Total sample size was 426. Only main effects were detected. Nurses were higher in the temperament traits of Novelty Seeking and Reward Dependence, lower in the character traits of Self-Directedness and Cooperativeness but higher in Self-Transcendence compared with the sample of doctors. Differences in personality profiles between registered nurses and general practitioners might challenge existing stereotypes between these professions. Further exploration of traits exclusive to and shared among health professions would supplement a broad conceptualization of specialities and support the enhancement of appropriate training and career counselling. Awareness of one's temperament and character can lead to a clearer understanding of how they function in the workplace and might encourage reflection on and insight into the implications of their personality and career plans. [ABSTRACT FROM AUTHOR]

Al-Zaru IM, AbuAlRub R, Musallam EA. International Journal of Nursing Practice 2011; : 117-125 Surgical site infection (SSI) is one of the most devastating complications following cardiac surgery, which significantly lead to prolonged hospitalization and increased hospital costs. The aims of this retrospective study were to identify the incidence rate, causative microorganisms, and the clinical and economical impact of SSI. An existing coronary artery surgery data base on adults ( n = 631) who had undergone coronary artery bypass graft (CABG) surgeries between January 2005 and January 2008 at a Jordanian university hospital was used. The results of this study showed that: (i) the incidence rate of SSI after CABG was 16.8% at the targeted hospital; (ii) the most causative microorganisms was coagulase-negative staphylococci (40%); (iii) the predictors for SSI were sex/males, having chronic obstructive pulmonary disease, and having combined valve CABG surgery; and (iv) each patient who developed SSI had ≈ 9 additional days at the hospital and add ≈ $3159 to the total cost of care. [ABSTRACT FROM AUTHOR]

Lee YM, Hung YK, Mo FKF, Ho WM. International Journal of Nursing Practice 2010; 16: 508-516 Comparison between ambulatory infusion mode and inpatient infusion mode from the perspective of quality of life among colorectal cancer patients receiving chemotherapy Folfox and Folfiri are active chemotherapy treatments used in advanced colorectal cancer. The total admission for these treatments has been significantly increasing in the study hospital. An ambulatory infusion programme was launched to address the problems of long waiting list and bed shortage. The study objective was to compare the quality of life between patients receiving the chemotherapy treatments in the ambulatory infusion group and the inpatient infusion group. The results showed that some demographic variables of education level, family role and employment status were determinants of the treatment mode. Patients in the ambulatory infusion group of social and global domains performed better than the inpatient group. However, the inpatient group had better quality of life of nauseated symptom at different stages. Some nursing educations should be reinforced to address the symptom management for patients receiving ambulatory infusion at home. The ambulatory infusion programme offered considerable quality of life benefits to colorectal cancer patients receiving chemotherapy. [ABSTRACT FROM AUTHOR]

Aim: We explored the positions of nurses working in hospitals regarding the acceptability of refusing to give a repeat dose of painkiller to a postoperative patient who requested it. These positions were compared with that of lay people, physicians, and other health professionals. Design and Methods: Factorial design was used to assess the impact of 6 situational factors: the patient's age, the current level of pain as assessed by the nurse, the number of requests, the level of risk associated with the administration of a repeat dose, the outcome of surgery, and the giving of alternative mild analgesics. We implemented a combination of scenario technique and of cluster analysis. Data were collected from April 2013 to December 2015. Participants: 138 registered nurses, 32 nurse's aides, 33 physicians, 23 psychologists, and 169 lay people participated in the study. Results: We found 4 qualitatively different meaningful positions. A plurality of participants (57% of nurses) considered that refusing was not acceptable, irrespective of circumstances. A substantial minority of participants (but 52% of physicians) considered that refusing was acceptable only if the level of pain was low and the risk was high. Other participants (mostly lay people) considered that refusing was always acceptable each time a risk of side effects, either serious or simply mild, was present. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of writing a bachelor's thesis on nursing students' attitudes towards research and development in nursing. The study sample consisted of 91 nursing students who were required to complete a bachelor's thesis and 89 nursing students who were not required to complete a bachelor's thesis. Data were collected via self-report questionnaire that was distributed in May and June 2012. The questionnaire comprised 3 parts: (1) demographic items; (2) questions about 'scientific activities,' and (3) the nursing students' attitudes towards and awareness of research and development within nursing scale (version 2). The mean age of the students was 23 (1.3) years. The students who wrote a bachelor's thesis achieved a median score of 110.0, whereas the students in the other group had a median score of 105.0 on the scale. All the items were assigned a 3 or higher. A statistically significant difference was found between the 2 groups in their attitudes towards and awareness of research (U = 3265.5; P = .025). The results of this study suggest that writing a thesis in nursing education has a positive influence on nursing students' attitudes towards and awareness of research and development in nursing. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the predictive validity of the Braden, Norton, and Waterlow scales in 2 long-term care departments in the Czech Republic. Assessing the risk for developing pressure ulcers is the first step in their prevention. At present, many scales are used in clinical practice, but most of them have not been properly validated yet (for example, the Modified Norton Scale in the Czech Republic). In the Czech Republic, only the Braden Scale has been validated so far. This is a prospective comparative instrument testing study. A random sample of 123 patients was recruited. The predictive validity of the pressure ulcer risk assessment scales was evaluated based on sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve. The data were collected from April to August 2014. In the present study, the best predictive validity values were observed for the Norton Scale, followed by the Braden Scale and the Waterlow Scale, in that order. We recommended that the above 3 pressure ulcer risk assessment scales continue to be evaluated in the Czech clinical setting. [ABSTRACT FROM AUTHOR]

Low delivery care utilization continues to be a public health problem that significantly contributes to maternal morbidity and mortality, especially in developing countries like Ethiopia. The aim of the study is to determine the extent of urban-rural disparity of delivery care utilization and its determinants. A community-based cross-sectional quantitative study supplemented with qualitative data was conducted from February 15 to March 10, 2014. Data were collected from eligible woman using interviewer-guided semistructured questionnaires and focus group discussions. Logistic regression analysis with 95% confidence interval and p-value less than 5% was used to identify potential determinant variables. From 567 women, institutional delivery care was attended by 45.9% (260) respondents of whom 69.3% were urban and 21.3% were rural. Mass media and antenatal care attendance were the major determinants in urban respondents, whereas children ever born, partners' occupation, women's autonomy, and pregnancy-related health problems were statistically significant associations in rural women. The need for maternal health care is not met to the required level. There is a significant disparity in delivery care attendance among urban and rural women of the study area. Women's empowerment and awareness creation should be extensively worked on through mass media and posters or health information. [ABSTRACT FROM AUTHOR]

This quasi-experimental research examined the effect of the one-to-one interaction process with group supportive psychotherapy on the levels of hope, anxiety and self-care practice for patients that have experienced organ loss. Eighty patients from the hospital units were selected by matched pairs and paired according to gender, interval of age, type and time length of organ loss. Simple-random sampling was used to allocate each subject in the experimental and control groups, which consisted of 40 pairs. Questionnaires included hope, anxiety and self-care practice assessments. The experimental treatments consisted of the one-to-one interaction process with group psychotherapy. The results showed that the patients that received treatments in the experimental group had higher mean scores regarding the differences in levels of hope, anxiety and self-care practice than those in the control group. This integrative approach is an alternative method for giving patients self-confidence in their self-care practice, in maintaining hope and in reducing anxiety. The method assisted patients in understanding their own problems and corrective actions so that they could be accepted by others by exchanging their feelings, thoughts, opinions and experiences through confrontation and self-exploration both individually and in group. [ABSTRACT FROM AUTHOR]

This study was aimed to assess the effects of contact isolation application on anxiety and depression levels of the patients, the effects of certain sociodemographics and patient characteristics on anxiety and depression levels, and the thoughts of the isolated patients about contact isolation. This non-randomized quasi-experimental study was carried out with 60 isolated and 57 non-isolated patients with hospital infection. The data were acquired from Hospital Anxiety and Depression Scale ( HADS-A (anxiety) and HADS- D (depression)) and patient information form. There was no statistically significant difference between the anxiety and depression levels of the isolated and non-isolated patients. In the isolated patients, the depression points were higher in patients who were, women, received primary education and had lower income levels. Of the patients, 86.4% of them told that they were happy to be in the isolation room. Contact isolation application did not affect anxiety and depression levels of the patients. However, personal attributes increased the development of depression. In contact isolated patients, personal attributes should be taken into consideration in nursing care planning to prevent development of depression. [ABSTRACT FROM AUTHOR]