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Background Integrating high fidelity simulation while teaching diabetes ketoacidosis would ensure a controlled therapeutic milieu for nursing students to practice. Purpose To evaluate the effectiveness of simulation teaching intervention for diabetes ketoacidosis in critical care nursing for undergraduate students' in a public university. Methods A simple, two-arm (parallel) randomized controlled trial was conducted in a national public university. A total of 164 nursing students were recruited and randomly assigned to two groups. The simulation group (N = 82) participated in the diabetes ketoacidosis high-fidelity simulation teaching intervention compared to the control group (N = 82) who were exposed to patient assignments on a clinical day on an acute medical unit. The primary outcomes were assessed using the Student Satisfaction and Self Confidence in Learning, Simulation Design Scale, Educational Practice Questionnaire, Critical Thinking Skills Tool and California Critical Thinking Skill Test from 2015 to 2016. Results The students in the randomized control trial have had significantly higher scores on Student Satisfaction, and Self Confidence in Learning, Simulation Design, Educational Practice, Critical thinking skills and Critical Thinking Skill post-test mean scores. Younger age groups who had higher satisfaction had better self-confidence and a positive perception of the simulation design and education practice, which reflected better learning outcomes in the simulation group compared to the control group. Conclusions This study supports the use of high-fidelity simulation scenarios as a teaching-learning strategy that is useful for students to assess, plan, intervene and evaluate in emergencies like diabetes ketoacidosis.

Objective The study determines the relationship between the socio-demographic, clinical factors and quality of life among adults with diabetic nephropathy and undergoing hemodialysis. Methods This was a cross-sectional, descriptive study conducted among adults diagnosed with diabetic nephropathy receiving hemodialysis in a dialysis unit. The kidney specific quality of life and the general quality of life (KDQOL-SF) was used to collect data between January 2015 to July 2016. A hundred and forty participants completed the survey from the selected sample of 185 adults. Results Adults with complex comorbidities, stage 3, 4 and 5 chronic kidney disease, higher body mass index, and uncontrolled glycemic control were significantly associated with lower quality of life, physical and mental component summary scores. Conclusions Poor physical functioning, role-physical, body pain, role-emotional, emotional well-being, general health, mental health scores significantly affected the quality of life in high-risk adults with diabetic nephropathy. The study demonstrated the significance of patient reported outcomes for adults with diabetic nephropathy and planning healthy lifestyle changes to improve the quality of life.

Objective A randomized clinical trial to examine the levels of body mass index, fasting blood glucose, blood pressure and glycemic control using multi-modality strategies among adults with type 2 diabetes. Methods A randomized control trial (RCT), two-arm, prospective, and an interventional was designed with an intervention group (IG) and a control group (CG) using stratified block randomization and triple-blinding. Adults with T2D (N = 200) were randomly assigned to an intervention group (IG, n = 100) and a control group (CG, n = 100) in a single site trial. The adults with T2D in the IG were exposed to multi-modality strategies using an animated digital video, motivational interviewing, telephone counseling and the structured diabetes education by the diabetes nurse educator. Adults in the CG were only exposed to the structured diabetes education. Body mass index (BMI), fasting blood glucose (FBG), blood pressure (BP), and glycosylated hemoglobin (HbA1c) were measured as primary outcomes. Results The adults with T2D in the IG had significant improvements in the HbA1c (2.4%), BMI (2.8 kg/m2), and a FBG (1.8 mmol/L); and they achieved lower HbA1c levels compared to the CG. Conclusion Multi-modality strategies were effective for lowering HbA1c and reducing BMI among adults with T2D. Implications. Integration of cognitive behavioural educational using multi-modality strategies promoted better primary outcomes among adults with T2D.

Objective The objective of this review is to assess the effectiveness and meaningfulness of breast cancer peer survivorship and support group in improving the quality of life of immigrant adults. Introduction Immigrant women use fewer follow-up and peer support services following treatment for breast cancer than people who have not recently immigrated to a new country. Review questions This JBI convergent segregated approach to a mixed methods systematic review will address the following review questions. What is the impact of survivorship and peer support groups on improving the quality of life for immigrant women survivors? What is the impact of acculturated interventions for breast cancer survivors to improve quality of life? Inclusion criteria The inclusion criteria include immigrant women who have completed their initial course of breast cancer treatment. The exclusion criteria include non-immigrant - women and men (above 18 years) who are not diagnosed with breast cancer, or currently undergoing active or advanced treatment, or end of life care. Methods The proposed systematic review will be conducted in accordance with the Joanna Briggs Institute methodology for mixed methods systematic reviews. The search strategy will include qualitative, quantitative, and mixed methods research reports published in academic journals and a grey literature search for unpublished research reports. A mixed method integrated approach to synthesis and integration will be used. Findings of method synthesis will be configured according to JBI methodology convergent segregated mixed methods systematic review. Systematic review registration number Registration of title in PROSPERO 2020: https://www.crd.york.ac.uk/prospero/#loginpage.