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Purpose: This study aimed to synthesize evidence for the association of psychological stress with Telomere Length (TL)-a potential biomarker of cellular aging. Methods: A systematic literature search was conducted to identify eligible studies in the Cochrane Library, PubMed, Embase, and CINHAL. In this review, we included all papers published since the initiative's inception and summarized results as of March 2022. Studies that investigated subjective stress using questionnaires and objective stress using biomarkers of adults (aged≥18 years) were included. Ultimately, 20 studies met our selection criteria. The risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Fifteen of the twenty studies (75.0%) reported that individuals with higher psychological stress levels had shorter TL. Eleven of sixteen studies (68.8%) measuring subjective stress and five of eight studies (62.5%) measuring objective stress showed significant associations of psychological stress with TL. However, five studies reported no association between psychological stress and TL shortening. Although the heterogeneous studies limited the ability to draw clear conclusions, it is suggested that psychological stress might accelerate the erosion of telomere ends. Conclusion: Our findings indicate that TL could be a useful emerging biomarker for measuring stress-related health outcomes in nursing. Further large-scale longitudinal studies using TL as a genetic biomarker with multidimensional stress measurements are needed to investigate the association between psychological stress and cellular senescence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to review articles that used the Pittsburgh Sleep Quality Index (PSQI) scale to measure sleep quality among adults with trauma experiences. Methods: Databases such as PubMed, CINAHL, Embase, Cochrane, Medline, Google Scholar, Riss, NDSL, and reference data were searched systematically for relevant studies from July 5 to 6, 2018. A quality assessment was conducted using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) risk of bias checklist, including content validity, structural validity, internal consistency, reliability, measurement error, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness. Results: Fourteen studies met the inclusion criteria. All selected studies confirmed the overall quality of sleep by total score, but only 28.6% of the papers presented subscales. The quality of the methodology used varied within and between studies. Internal consistency of 21.5%, cross-cultural validity of 7.1%, and criterion validity of 14.2% were all evaluated as sufficient (+). Reliability and measurement errors were not presented in selected studies. Conclusion: Our findings revealed that overall quality of sleep was measured by analyzing the characteristics and measurement attributes of the PSQI. However, as a result of the varying purposes of each study, the full potential of the tool could not be optimized. Future research should assess the attributes of the PSQI based on the content specified in the COSMIN evaluation standard, using it carefully to consider the target population's socio-cultural characteristics. [ABSTRACT FROM AUTHOR]

Purpose: This review aimed to determine the effectiveness of oral care using Chlorhexidine Gluconate (CHX) in Ventilator-Associated Pneumonia (VAP) in the intensive care unit. Methods: An electronic databases search was conducted with Ovid-MEDLINE, EMBASE, CENTRAL, CINAHL and four domestic databases from July 10 to 16, 2018. Two reviewers independently selected the studies; three reviewers assessed their methodological quality and extracted relevant data. We conducted a meta-analysis of the effect of CHX oral care versus placebo using the Review Manager 5.3 software program and summarized the results of intervention from the included studies. Results: Of the 512 articles identified, 17 randomized controlled trials met the inclusion criteria for review. The incidence of VAP differed significantly between the CHX and placebo groups (Relative Risk [RR]=0.72, 95% Confidence Interval [CI]=0.63~0.84). The pooled effects of oral care using 0.12% CHX were RR=0.65 (95% CI=0.52~0.80) and RR=0.68 (95% CI=0.54~0.86) using CHX solution, which were statistically significant. When CHX oral care was performed three times a day, the size of the effect was statistically significant (RR=0.63, 95% CI=0.40~0.99). There was no significant difference in mortality between the CHX oral care and placebo groups (RR=1.08, 95% CI=0.94~1.28). Conclusion: This review provides evidence that performing oral care using a 0.12% CHX solution three times a day could decrease the incidence of VAP. For improving the quality of nursing practice, the results of this review should be used as the basis for the oral care evidence-based practice guidelines for critical patients. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to define the concept of patient rights. Methods: A concept analysis on patient rights through the concept analysis method proposed by Walker and Avant was conducted. Results: The attributes of the concept identified in this study are as follows: (1) respect for the patient's opinion, (2) patient benefits, (3) human dignity, (4) equality, and (5) legal, moral, and ethical guarantees. The antecedents of patient rights include the recognition of the importance of patient rights and a medical system in which patient rights can be protected. Regarding the consequences of patient rights, this study identified the improvement of medical services, enhancement of professional awareness and reliability of medical staff, increase in awareness and establishment of patient safety, decline in medicolegal problems, and increase in satisfaction with medical services. Conclusion: This study aimed to clarify the concept and attributes of patient rights through a concept analysis, and to connect the same to practical work to enable useful application to nursing practice. In determining the attributes of patient rights through a concept analysis, the study hoped to contribute to research on nursing intervention and the development of tools, as well as the establishment and implementation of legal systems related to patient rights. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to develop evidence-based nursing practice guidelines for cold application in adult care. Methods: The study procedure was based on the Scottish Intercollegiate Guidelines Network and Korean Hospital Nurses Association's guideline development methods. The evidence review procedures included targeted searches from databases including the Cochrane Library, PubMed, CINAHL, Embase, KoreaMed, KERIS and NDSL. The initial search yielded 6,426 articles published from 2006 to 2016. Based on the screening process, 147 articles were selected and systematically reviewed. From evidence summaries of 20 clinical questions, recommendations were formulated and graded. Draft recommendation were evaluated through external review. Results: The guidelines consisted of 10 domains and 27 recommendations. The content validity index of the recommendations was above .80. Major recommendations include 1) applying external cooling to reduce acute pain, edema, and hemorrhage, 2) selecting cooling instruments based on the purpose, patient's condition, and preference, 3) preparing and maintaining cooling instruments at an adequate temperature, and 4) intermittent cold application for appropriate durations with sufficient recovery time. Conclusion: These guidelines can be utilized in both clinical and community settings to help narrow the gaps between nursing practices. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia. [ABSTRACT FROM AUTHOR]

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices. [ABSTRACT FROM AUTHOR]