Dimensions of Critical Care Nursing最新文献

{"title":"Evidence-Based Recommendations: Management of Left Ventricular Thrombus Post-Acute Myocardial Infarction.","authors":"Mohamed Toufic El Hussein,&nbsp;Marianne Mikhail","doi":"10.1097/DCC.0000000000000553","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000553","url":null,"abstract":"<p><p>One of the potential complications of acute myocardial infarction is left ventricular thrombus (LVT). The incidence of LVT following acute myocardial infarction has decreased dramatically with early invasive reperfusion techniques or fibrinolysis. However, the risk of LVT formation remains significant and is associated with an increased risk of systemic embolism, stroke, cardiovascular events, and even death. Current guidelines indicate that dual antiplatelet therapy and anticoagulation therapy for at least 3 months can reduce the risk of these events. While vitamin K antagonist is the preferred oral anticoagulant, there is growing evidence to support the use of direct-acting oral anticoagulants in LVT management. Cardiac magnetic resonance has shown the highest diagnostic accuracy for LVT assessment, followed by echocardiography with contrast agents. This article serves as a general review of the pathophysiology, diagnosis, and management of LVT.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"313-320"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoring Joy.","authors":"Kathleen Ahern Gould","doi":"10.1097/DCC.0000000000000554","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000554","url":null,"abstract":"","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"285"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Type of Acute Myocardial Infarction on Cardiac Patient Self-efficacy After Hospitalization.","authors":"Abedalmajeed Methqal Shajrawi,&nbsp;Ahmed Mohammad Al-Smadi,&nbsp;Ala Ashour,&nbsp;Aaliyah Momani,&nbsp;Hekmat Yousef Al-Akash,&nbsp;Malcolm Granat,&nbsp;Ian Jones","doi":"10.1097/DCC.0000000000000547","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000547","url":null,"abstract":"<p><strong>Background: </strong>Self-efficacy is an important psychological construct associated with patient adherence with healthy lifestyle choices. Few studies have focused on the impacts of the type of acute myocardial infarction (AMI), non-ST-elevation myocardial infarction (STEMI) and STEMI, and the different treatment modalities of AMI on changes in cardiac self-efficacy after hospitalization.</p><p><strong>Objective: </strong>This study examined the changes in cardiac self-efficacy based on the type of AMI and aimed to investigate the impact of different treatment modalities on changes in cardiac self-efficacy among post-AMI patients during hospitalization and at the 3- and 6-month follow-ups subsequent to hospitalization.</p><p><strong>Methods: </strong>A repeated-measures design was used with a convenient sample of 210 patients diagnosed with first AMI. Patients completed the Cardiac Self-efficacy Questionnaire at the 3 time points. The study was implemented in 3 major hospitals in Jordan. Patients did not have access to cardiac rehabilitation.</p><p><strong>Results: </strong>There was a statistically significant impact of AMI type on changes in cardiac self-efficacy measured between T1 and T2, between T2 and T3, and subsequently between T1 and T3. Nevertheless, there was no statistically significant impact of treatment modalities of AMI on changes in cardiac self-efficacy measured at the 3 time points.</p><p><strong>Conclusions: </strong>Assessment of self-efficacy for post-AMI patients is recommended. Moreover, post-non-STEMI patients need more attention when implementing an intervention to enhance self-efficacy after hospitalization. Health decision makers have to consider establishing cardiac rehabilitation to improve self-efficacy in Jordan. Further research is needed to confirm the study results and to investigate other contributing factors that could influence self-efficacy after hospitalization.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"295-304"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability Testing of an iPad Communication Application for Mechanically Ventilated Patients.","authors":"Jill L Guttormson,&nbsp;Natalie S McAndrew","doi":"10.1097/DCC.0000000000000551","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000551","url":null,"abstract":"<p><strong>Background: </strong>Patient communication challenges during mechanical ventilation can negatively impact symptom management and psychological recovery. Alternative communication (AC) aids have the potential to improve mechanically ventilated (MV) patient experiences.</p><p><strong>Objectives: </strong>This study evaluated the feasibility and usability of a communication application on a tablet (iPad).</p><p><strong>Method: </strong>A single-group pilot study was guided by the augmentative and alternative communication acceptance model. We recruited patients from 1 medical intensive care unit. Existing communication application software (Proloquo2Go) was tailored to MV patients' needs. Usability testing included patient communication of 5 messages with data collected on success, message completion time, and patient feedback.</p><p><strong>Results: </strong>Ten patients with a mean age of 50 years (SD, 16.7) were enrolled. Of the 7 patients able to complete usability testing, 85.7% found the device easy to use, and 100% wanted the iPad available for their use when on the ventilator. Three patients were extubated immediately after usability testing. Two patients preferred other modes of communication (writing). Two patients used the iPad as their primary mode of communication during the remainder of their time on the ventilator. Nurse feedback on the communication application was positive.</p><p><strong>Discussion: </strong>Tablet-based communication applications can be successfully used by MV patients and should be considered as 1 tool to support effective patient communication during mechanical ventilation. Future research is needed to identify which patients may be most likely to benefit from the availability of these devices.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"340-346"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep of Intensive Care Patients: A Qualitative Study Based on Experiences of Nurses.","authors":"Ayyüce Tuba Koçak,&nbsp;Selda Arslan","doi":"10.1097/DCC.0000000000000550","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000550","url":null,"abstract":"<p><strong>Background: </strong>Intensive care patients experience a high rate of poor sleep quality. As the sleep quality is improved with nursing practices, patients' recovery and the length of stay in the intensive care unit (ICU) may be positively influenced, and patients may benefit from treatment and care at the highest level. Therefore, it is important to explore the experiences and evaluation of nurses working in ICUs.</p><p><strong>Objectives: </strong>This study was carried out to explore the experiences and evaluations of ICU nurses about patients' sleep.</p><p><strong>Methods: </strong>The study is a qualitative study conducted in a descriptive phenomenological design. The data were collected using the individual in-depth interview method with the semistructured interview form. Thematic analysis was performed to analyze the data. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used.</p><p><strong>Results: </strong>The analysis revealed 4 main themes, which are (1) importance of sleep, (2) evaluation of sleep, (3) reasons for poor sleep, and (4) sleep promotion interventions.</p><p><strong>Conclusions: </strong>This study revealed that nurses are aware of the importance of sleep; however, they do not evaluate sleep and try to improve sleep quality only based on their own knowledge and experience rather than on evidence-based approaches. However, their interventions are not sufficient and they are restricted because of physical conditions and intensive care procedures.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"305-312"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40385426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Prodromal Myocardial Infarction Symptom Perception, Attribution, and Care Seeking: A Qualitative Multiple Case Study.","authors":"John R Blakeman,&nbsp;Wendy M Woith,&nbsp;Kim S Astroth,&nbsp;Sheryl H Jenkins,&nbsp;Stephen J Stapleton","doi":"10.1097/DCC.0000000000000546","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000546","url":null,"abstract":"<p><strong>Background: </strong>Most women experience prodromal myocardial infarction (MI) symptoms, but more information is needed about the perception, attribution, and care-seeking behaviors related to these prodromal symptoms.</p><p><strong>Objectives: </strong>We aimed to describe women's perceptions, attributions, and care-seeking behaviors related to prodromal MI symptoms.</p><p><strong>Method: </strong>We used a qualitative, multiple case study approach, recruiting participants during summer 2019 from a large hospital in the Midwestern United States. Data were collected from interviews with the women who experienced MI and some of their family members, journals, and electronic health records. An inductive, comparative analysis procedure was applied.</p><p><strong>Results: </strong>Ten women, ages 42 to 84, participated in the study. The women experienced a mixture of certainty and uncertainty related to their symptoms and engaged in several cognitive processes to conceptualize and act upon their symptoms. Although all the women retrospectively reported at least 4 prodromal symptoms, they lacked knowledge of prodromal MI symptoms and often responded to prodromal sensations that they experienced using emotion- and avoidance-based strategies. It was difficult for the women to establish a symptom pattern that was attributable to heart disease.</p><p><strong>Discussion: </strong>The findings of this study may be used as evidence to support interventions that would facilitate women's care seeking for and health care providers' recognition of prodromal MI symptoms. Additional research is necessary to more fully characterize the cognitive processes at play for women of many different sociocultural backgrounds who experience prodromal MI symptoms.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 6","pages":"330-339"},"PeriodicalIF":1.7,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosuppressive properties of human PD-1 + , PDL-1 + and CD80 + dendritic cells from lymph nodes aspirates of lung cancer patients.","authors":"Iwona Kwiecień, Elżbieta Rutkowska, Agata Raniszewska, Rafał Sokołowski, Joanna Bednarek, Karina Jahnz-Różyk, Piotr Rzepecki, Joanna Domagała-Kulawik","doi":"10.1007/s00262-022-03178-5","DOIUrl":"10.1007/s00262-022-03178-5","url":null,"abstract":"<p><p>Dendritic cells (DCs) play a pivotal role in the homeostasis of the immune system. The tumor microenvironment impairs the proper function of DCs. The immunomodulatory properties of DCs in lung cancer are of interest. In the present study, we analysed DCs subsets and immune cells with the expression of immunomodulatory molecules: PD-1 and PD-L1 and co-stimulatory molecule CD80 in metastatic, non-metastatic lymph nodes (LNs) and peripheral blood (PB). LNs aspirates were obtained during the EBUS/TBNA procedure of 29 patients with primary lung cancer. The cells were analyzed by flow cytometry. We reported a higher percentage of DCs in the metastatic than in the non-metastatic LNs and the PB (0.709% vs. 0.166% vs. 0.043%, p < 0.0001). The proportions of PD-1 + , PD-L1 + and CD80 + DCs were higher in the metastatic LNs than in the non-metastatic ones. A higher proportion of regulatory DCs (DCregs) was found in the metastatic ones than in the non-metastatic LNs (22.5% vs. 3.1%, p = 0.0189). We report that DCs cells show increased expression of PD-1, PD-L1 and CD80 molecules that can interact with T lymphocytes. It can be assumed that mature DCs infiltrating metastatic LNs can develop into DCregs, which are involved in the suppression of anti-tumor response.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"4 1","pages":"2469-2483"},"PeriodicalIF":5.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10991341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83722450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive and Critical Care Nursing of a COVID-19 Patient in Turkey: A Case Study.","authors":"Dilek Yildirim,&nbsp;Zeliha Genc","doi":"10.1097/DCC.0000000000000540","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000540","url":null,"abstract":"<p><strong>Background: </strong>A multidisciplinary approach is required to provide holistic care and treatment in the fight against the COVID-19 pandemic. Being in the center of the multidisciplinary approach, nurses provide therapeutic, primary, and psychosocial care for the patients.</p><p><strong>Objectives: </strong>This study was conducted to diagnose according to the North American Nursing Diagnosis Associations by determining the care needs of a case who was diagnosed with COVID-19, planning interventions, and observing the results.</p><p><strong>Methods: </strong>This descriptive case study included a patient who applied to a university hospital located in Istanbul/Turkey between March and April 2020 because of COVID-19. As the inclusion criteria, only a positive result from a polymerase chain reaction test was accepted. The details of the patient presented in the study were obtained through face-to-face interviews and electronic medical records.</p><p><strong>Discussion: </strong>Specified care plans enable defining problems in practice for all needs of the individual and developing solution recommendations. It was observed that there were improvements and a decrease in symptom severity after the interventions were applied for the symptoms developing in the case. The execution of the treatment and care practices under quality and effective nursing care such as giving proper ventilatory support at the right time, giving prone position for a long time, and providing sufficient fluid resuscitation and an early and balanced diet contributed to the patient's discharge from the intensive care unit successfully without having any organ dysfunction. This presentation is expected to be a source for collaborative nursing care for other cases diagnosed with COVID-19 and intensive care indications.</p><p><strong>Conclusions: </strong>Nursing care interventions were applied for gas exchange, risk of decreased tissue perfusion, excess fluid volume, and constipation nursing diagnosis. It was observed that there were improvements and a decrease in symptom severity after the interventions were applied for the symptoms developing in the case. This presentation is expected to be a source for collaborative nursing care for other cases diagnosed with COVID-19 and intensive care indications.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 5","pages":"227-234"},"PeriodicalIF":1.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40557664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Sense of Presence\" in Immersive Virtual Reality Environment: An Evolutionary Concept Analysis.","authors":"Brigitte S Cypress,&nbsp;Meriam Caboral-Stevens","doi":"10.1097/DCC.0000000000000538","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000538","url":null,"abstract":"<p><p>There is no concept analysis in the literature about \"sense of presence\" in immersive virtual reality environment in the context of nursing clinical education. The purpose of this article is to explore the meaning and derive an operational definition of the concept of sense of presence within the context of immersive virtual reality environment in nursing clinical education. Using Rodgers' approach, this evolutionary concept analysis will clarify the concept's surrogate and related terms, attributes, antecedents, and consequences. A clearer conceptualization is paramount to help provide knowledge for nurses and other health care professionals, thus guiding their practice, theory, and research.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 5","pages":"235-245"},"PeriodicalIF":1.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40557666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Intensive Care Unit Diaries on Posttraumatic Stress Disorder, Anxiety, and Depression: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Arianna Gazzato,&nbsp;Tommaso Scquizzato,&nbsp;Guglielmo Imbriaco,&nbsp;Alessandra Negro,&nbsp;Maria Cristina Caballo Garrido,&nbsp;Giovanni Landoni,&nbsp;Alberto Zangrillo,&nbsp;Giovanni Borghi","doi":"10.1097/DCC.0000000000000539","DOIUrl":"https://doi.org/10.1097/DCC.0000000000000539","url":null,"abstract":"<p><strong>Introduction: </strong>Patients discharged from the intensive care unit (ICU) suffer from long-term symptoms affecting the physical, psychological, and cognitive well-being and cannot understand memories and dreams. Intensive care unit diaries describe daily events about the patient and may allow them to reconstruct their experience.</p><p><strong>Objective: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of ICU diaries on posttraumatic stress disorder (PTSD), depression, and anxiety.</p><p><strong>Methods: </strong>Five electronic databases were searched up to May 6, 2022. We included RCTs comparing patients admitted to the ICU who received a diary to those who did not receive a diary. The primary outcome was the rate of PTSD. Secondary outcomes were rates of depression and anxiety.</p><p><strong>Results: </strong>We included 7 RCTs. Patients who received a diary during the ICU admission had reduced rate of PTSD (78/432 [18%] vs 106/422 [25%]; risk ratio [RR], 0.73; 95% confidence interval [CI], 0.57-0.94; P = .02; I2 = 0%; trial sequential analysis-adjusted CI, 0.55-0.97) when compared with patients who did not receive a diary. We found a non-statistically significant difference toward a reduction in the rate of depression (38/232 [16%] vs 54/224 [24%]; RR, 0.70; 95% CI, 0.49-1.01; P = .06; I2 = 0%) and anxiety (63/232 [27%] vs 70/224 [31%]; RR, 0.64; 95% CI, 0.29-1.40; P = .26; I2 = 67%).</p><p><strong>Conclusions: </strong>Providing an ICU diary to patients admitted to the ICU reduced the rate of PTSD symptoms compared with usual care.</p>","PeriodicalId":46646,"journal":{"name":"Dimensions of Critical Care Nursing","volume":"41 5","pages":"256-263"},"PeriodicalIF":1.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40557667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}