Search

Background: Obstetric critical illness is an important factor that leads to an increase in maternal mortality. Early warning assessment can effectively reduce maternal and neonatal mortality and morbidity. However, there are multiple early warning systems, and the effect and applicability of each system in China still need to be explored. Objectives: To elaborate on the application, effectiveness and challenges of the existing early warning systems for high‐risk obstetric women in China and to provide a reference for clinical practice. Design: A scoping review guided by the Arksey and O'Malley framework and reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis for scoping review (PRISMA‐ScR) guidelines. Eligibility criteria: We included original studies related to early warning and excluded those that were guidelines, consensus and reviews. The included studies were published in Chinese or English by Chinese scholars as of June 2021. Data sources: CNKI, Wanfang, VIP, Cochrane, CINAHL, Embase, PubMed and Web of Science databases were searched systematically, and the reference sections of the included papers were snowballed. Results: In total, 598 articles were identified. These articles were further refined using keyword searches and exclusion criteria, and 17 articles met the inclusion criteria. We extracted data related to each study's population, methods and results. Early warning tools, outcome indices, effects and challenges are discussed. Conclusions: Although all studies have shown that early warning systems have good application effects, the use of early warning systems in China is still limited, with poor regional management and poor sensitivity for specific obstetric women. Future research needs to develop more targeted early warning tools for high‐risk obstetric women and address the current challenges in clinical applications. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. Design: A scoping review. Methods: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross‐checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. Results: Ninety‐eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. Conclusions: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. Relevance to Clinical Practice: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. Reporting Method: PRISMA‐ScR Checklist. [ABSTRACT FROM AUTHOR]

Aims and objectives This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Background Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Design Systematic review using integrative methods. Methods Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: 'patient', 'healthcare provider', 'task', 'work environment', 'organisation & management'. Results We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Conclusions Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Relevance to clinical practice Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support patient involvement in patient safety. [ABSTRACT FROM AUTHOR]

Aims and Objective: To systematically review and synthesise existing qualitative research evidence describing the survival experience of patients undergoing oesophagectomy during recovery. Background: Patients with oesophageal cancer undergoing surgical treatment have severe physical and psychological burdens during the recovery period. Qualitative studies on the survival experience of patients undergoing oesophagectomy are increasing annually, but there is no integration of qualitative evidence. Design: A systematic review and synthesis of qualitative studies were conducted following the ENTREQ. Methods: Five English (CINAHL, Embase, PubMed, Web of Science and Cochrane Library) and three Chinese (Wanfang, CNKI and VIP) databases were searched for literature on the survival of patients undergoing oesophagectomy during the recovery period from its establishment in April 2022. The quality of the literature was evaluated by the 'Qualitative Research Quality Evaluation Criteria for the JBI Evidence‐Based Health Care Centre in Australia', and the data were synthesised by the thematic synthesis method of Thomas and Harden. Results: A total of 18 studies were included, and four themes were identified: physical and mental dual challenges, impaired social functioning, efforts to return to normal life, lack of knowledge and skills in post‐discharge care, and thirst for external support. Conclusions: Future research should focus on the problem of reduced social interaction during the recovery of patients with oesophageal cancer, formulating individualised exercise intervention programs and establishing a sound social support system. Relevance to Clinical Practice: The results of this study provide evidence‐based support for nurses to carry out targeted interventions and reference methods for patients with oesophageal cancer to rebuild their lives. No Patient or Public Contribution: The report was a systematic review and did not involve a population study. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to evaluate the effectiveness of telehealth‐based exercise intervention on pain, physical function and quality of life in patients with knee osteoarthritis. Design: A systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Six databases (PubMed, Embase, Cochrane Library, CINAHL, PEDro and Web of Science Core Collection) were searched for relevant randomised controlled trials published from database inception to 3 June 2021. Reviewers independently screened the literature, extracted data and used the Cochrane Collaboration Risk of Bias Tool for quality assessment. A meta‐analysis and subgroup analyses, stratified by control condition, intervention duration and delivery type, were conducted by Revman 5.4. The study was reported in compliance with PRISMA statement. Results: A total of 9 independent RCTs with 861 participants were included. The meta‐analysis showed that the telehealth‐based exercise interventions significantly reduced pain in KOA patients (SMD = −0.28, 95% CI [−0.49, −0.08], p <.01) and produced similar effects to controls in terms of physical function and quality of life. Subgroup analysis revealed that telehealth‐based exercise interventions were superior to the use of exercise booklet and usual care in terms of pain and physical function and were similar to face‐to‐face exercise treatment; a long‐term (>3 months) intervention and the use of web and smartphone APPs to deliver exercise interventions were associated with better pain relief and physical function. Conclusions: Telehealth‐based exercise intervention is an effective strategy for KOA management during the COVID‐19 epidemic, and it is significantly better than usual care in reducing knee pain and improving physical function and was able to achieve the effects of traditional face‐to‐face exercise treatment. Although the duration and type of delivery associated with the effect of the intervention have been identified, patient preference and acceptability need to be considered in practice. [ABSTRACT FROM AUTHOR]

Aims: A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background: Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design: A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods: Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results: Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions: The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population. [ABSTRACT FROM AUTHOR]

Aims and objective: To synthesise current international empirical evidence on loneliness and social isolation in Chinese late‐life immigrants. Background: Loneliness causes adverse health consequences in Chinese late‐life immigrants leading to increased utilisation of often increasingly limited healthcare resources. However, little is known about how Chinese late‐life immigrants perceive and experience loneliness and social isolation in their host countries. Design: An integrative review methodology. Methods: Using a systematic search strategy, Google scholar and databases, such as Scopus, Web of Science, PubMed, CHNAHL, Medline and open access Theses were searched. No limitation was placed on publication date. Peer‐reviewed studies published from the database inception to May 6, 2021 in the English language were included. The review process is reported according to PRISMA. Results: Eight articles met the criteria and were included in this review. Two themes resulting from the data synthesis process were identified. Firstly, 'disrupted social relations after late‐life immigration' and secondly 'moving away from filial expectations'. Conclusion: Loneliness and social isolation are commonly experienced by Chinese late‐life immigrants when residing in host countries. Understanding and identification of the sources of loneliness and social isolation among late‐life immigrants are essential prompts for healthcare professionals, particularly nurses, to engage sensitively with Chinese late‐life immigrants. Nurses culturally relevant care delivery in a variety of settings may best serve recipients' social and health related needs. Relevance to clinical practice: This integrated review informs the planning of health and social services for addressing Chinese late‐life immigrants' experiences of loneliness and social isolation. Focused attention on cultural responsiveness is an important component of providing quality and safe nursing care. This review of the recent evidence on socially‐rooted health concerns affected by both immigration and ageing will help advance nursing practice in providing culturally responsive care interventions. [ABSTRACT FROM AUTHOR]

Aims and objectives: This systematic review and meta‐analysis aimed to compare the incidence of PVC‐related complications between catheterisation in the forearm and back of the hand in adult patients. Background: A peripheral intravenous catheter (PVC) is often inserted as part of care during patients' hospitalisation. The catheter is typically inserted in the forearm or at the back of the hand in usual practice. Studies have not yet reached a consensus on the optimal insertion site in any clinical setting. Design: We performed a systematic review and meta‐analysis based on PRISMA guidelines. Methods: We searched the following electronic databases: PubMed, Cochrane Library, Embase, and CINAHL. Randomised controlled trials, cohort studies, case–control studies and cross‐sectional studies from inception to July 2021 reporting the incidence of PVC‐related complications at the forearm and back of the hand were included. Fixed‐effects models and random‐effects models were used to derive the pooled risk ratios. Results: Twenty‐four studies involving 16562 PVCs met our inclusion criteria. The meta‐analysis showed that compared with PVC placement in the back of the hand, placement in the forearm was associated with a higher incidence of total complications and infiltration/extravasation. However, the differences between the PVC indwelling sites were not significant (total complications: P = 0.43; phlebitis: P = 0.35; infiltration/extravasation: P = 0.51). Both incidence of total complications and infiltration/extravasation analyses showed high heterogeneity (total complications: I2 = 60%; infiltration/extravasation: I2 = 58%). Conclusion: Available evidence suggests that there is no significant difference between PVC placement in the forearm and at the back of the hand in terms of the incidence of complications, thus making both approaches suitable. Relevance to clinical practice: For patients who need indwelling PVC, medical staff can choose the best indwelling site, and both forearm and back of the hand are suitable. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish evidence‐based nursing‐sensitive quality indicators for emergency nursing in China. Background: China lacks nursing‐sensitive quality indicators necessary for assessing the quality of emergency nursing and essential to nursing management. Design: Prospective. Methods: A literature search for relevant evidence‐based studies was performed using several databases from January 2009–May 2014. Previously reported quality indicators were identified as appropriate for assessment by a panel of 40 experts in emergency medicine and nursing. Two successive rounds of Delphi surveys were conducted using questionnaires designed by the experts. Kendal's W coordination coefficients were calculated for indicator importance, rationality of calculation and feasibility of data collection. Results: Thirty‐three quality indicators were initially proposed for expert evaluation. After round 1 of expert discussion, Kendal's W coordination coefficients were .152 for importance, .092 for rationality and .141 for feasibility of data collection (all p < .001). Seven unsuitable items were discarded in round 1 and 11 discarded in round 2, which also added one new item. Finally, the experts reached consensus on 16 items established as appropriate nursing‐sensitive quality indicators for emergency nursing care. Conclusion: Evidence‐based nursing‐sensitive quality indicators were established through a consensus of experts in emergency nursing and medicine. Relevance to clinical practice: The current findings may provide a theoretical basis for establishing an emergency nursing quality database and improving the quality of emergency nursing care in China. [ABSTRACT FROM AUTHOR]