Nursing Open最新文献

{"title":"A Critical Need for Advanced Practice Nurse Education in Sub-Saharan Africa and Lessons Learned From the COVID-19 Pandemic: A Discursive Review.","authors":"Jacqueline Itambo, Brenda Owusu, Danielle McCamey, Diana-Lyn Baptiste","doi":"10.1002/nop2.70079","DOIUrl":"10.1002/nop2.70079","url":null,"abstract":"<p><strong>Aim: </strong>To discuss the need to expand advanced practice nurse education in Sub-Saharan Africa as a strategic response to the impact of the COVID-19 pandemic.</p><p><strong>Design: </strong>Discursive paper.</p><p><strong>Method: </strong>Searching international literature in PubMed, CINAHL and Google Scholar databases, we explored the impact of COVID-19 in Sub-Saharan Africa and the advanced practice nurse role and education in the pandemic response.</p><p><strong>Discussion: </strong>The COVID-19 pandemic served as a barrier to healthcare access and disrupted routine immunizations and care, reduced facility-based healthcare services, increased disease burden and mortality, strain and is expected to worsen the healthcare workforce shortage in Sub-Saharan Africa. The COVID-19 pandemic has further emphasised the necessity to strengthen advanced practice nurse education in Sub-Saharan Africa.</p><p><strong>Conclusion: </strong>This discursive paper underscores the critical role of advanced practice nurse education in Sub-Saharan Africa as a proactive strategy to strengthen the healthcare workforce and systems. The lessons learned from the COVID-19 pandemic highlight the urgency to invest in advanced practice nurse education and training programmes in the region.</p><p><strong>Patient or public contribution: </strong>There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion about advanced nursing practice.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70079"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mathematics Anxiety and Undergraduate Nursing Students: A Mixed Methods Study.","authors":"Jen Austerberry, Thomas Mathew, Jacqueline Johnston, Maria Murphy, Kolsoom Safari, Christine Murray, Lisa McKenna","doi":"10.1002/nop2.70082","DOIUrl":"10.1002/nop2.70082","url":null,"abstract":"<p><strong>Background: </strong>Sound mathematical skills are paramount for effective nursing practice and patient safety.</p><p><strong>Objectives: </strong>To explore the factors that influence nursing student anxiety when engaging with mathematics-related activities in nursing education.</p><p><strong>Design: </strong>A concurrent mixed methods employing cross-sectional online survey and focus group interviews.</p><p><strong>Setting: </strong>One undergraduate nursing course at an Australian university.</p><p><strong>Participants: </strong>Bachelor of Nursing students from across academic years.</p><p><strong>Methods: </strong>An online survey comprising closed- and open-ended questions to assess mathematics anxiety and self-efficacy and associated factors affecting its application to practice. Focus group interviews to explore anxieties related to mathematics and students' approaches to nursing mathematics. Quantitative data were analysed using descriptive statistics and qualitative data using inductive content analysis.</p><p><strong>Results: </strong>A total of 202 nursing students commenced the survey, of which 135 were fully completed, while 17 students participated in focus groups. Less than half were school leavers. Around three-quarters reported some level of fear of mathematics, while many lacked confidence, fear of making errors and/or harming patients and negative childhood experiences of mathematics. Survey items demonstrated extensive variation in perceptions.</p><p><strong>Conclusions: </strong>The complexity and diversity of anxieties presents key challenges for nurse academics seeking to educate competent, safe students. Teaching approaches should be varied and consideration of having specialist mathematics teachers and learning psychologists on teaching teams to ensure student success.</p><p><strong>Reporting method: </strong>This study is reported using Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS).</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70082"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terminal Care Performance of Nurses Caring for COVID-19 Patients: A Cross-Sectional Descriptive Study.","authors":"Juyeon Oh, Dong-Hee Kim, Yujin Kim","doi":"10.1002/nop2.70103","DOIUrl":"10.1002/nop2.70103","url":null,"abstract":"<p><strong>Aims: </strong>To identify the effects of moral distress and terminal care stress on the terminal care performance of nurses who cared for COVID-19 patients.</p><p><strong>Design: </strong>This study was cross-sectional descriptive research.</p><p><strong>Methods: </strong>Using a convenience sampling method from June to October 2022, nurses who provided terminal care for COVID-19 patients in a Korean tertiary hospital within the last 6 months from the time of the study were selected as participants. Socio-demographic and work characteristics of the participants were collected, and COVID-19 moral distress, terminal care stress and terminal care performance were assessed. A total of 140 self-report questionnaires were distributed and returned (response rate: 100%).</p><p><strong>Results: </strong>In the terminal care performance, it was found that nurses performed relatively well in the physical area, but less well in the emotional and spiritual areas. Moral distress and terminal care stress were both positively correlated with terminal care performance for nurses who cared for COVID-19 patients. The predictors of terminal care performance were moral distress (β = 0.27, p = 0.003), gender (β = 0.20, p = 0.015) and experience in a dedicated COVID-19 unit (β = 0.22, p = 0.020).</p><p><strong>Conclusions: </strong>The study identified moral distress as the most significant factor influencing terminal care performance among nurses caring for COVID-19 patients. To enhance terminal care performance, it is crucial to address moral distress and provide clear guidelines and support, especially in the emotional and spiritual care domains. Future research should explore additional factors that may influence terminal care performance in pandemic situations.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70103"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Nursing Practices: Enhancing Patient Care Through Knowledge, Attitude and Practice Towards Urinary Catheterisation in Taicang City.","authors":"Lihong Zhang, Hong Zhang, Yaxuan Wang, Hui Li, Ting Liu, Jingjing Qian, Chi Wang","doi":"10.1002/nop2.70111","DOIUrl":"10.1002/nop2.70111","url":null,"abstract":"<p><strong>Aim: </strong>To assess the knowledge, attitude and practice (KAP) towards unnecessary urinary catheterisation among nurses in Taicang City, China.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>This study included nurses from our hospital and was conducted between February 2023 and June 2023.</p><p><strong>Data sources: </strong>A self-administered questionnaire was designed to collect their demographic characteristics and KAP.</p><p><strong>Results: </strong>A total of 233 valid questionnaires were collected. The mean KAP scores were 13.44 ± 1.62 (possible range: 0-17), 45.28 ± 3.87 (possible range: 10-50) and 43.85 ± 5.98 (possible range: 10-50), which indicated moderate knowledge, positive attitude and proactive practice, respectively. The Pearson's correlation analysis showed positive correlations between knowledge and attitude (r = 0.253, p < 0.001), knowledge and practice (r = 0.279, p < 0.001), as well as attitude and practice (r = 0.441, p < 0.001). Partial correlation analysis adjusted for age, gender, department, working experience and experience in treating patients with catheter-associated urinary tract infections also showed positive correlations among KAP. A structural equation modelling showed that both knowledge (β = 0.501, p = 0.047) and attitude (β = 0.691, p < 0.001) had direct effect on practice.</p><p><strong>Conclusion: </strong>This study found moderate knowledge, positive attitude and proactive practice among the participants. Both knowledge and attitude might affect their practice.</p><p><strong>Impact: </strong>We wanted to know the knowledge, attitude and behaviour of nurses in Taicang City towards unnecessary catheterisation. Moderate knowledge, positive attitude and proactive practice were found among the participants. The findings would provide evidence for policymakers to develop targeted educational intervention to improve nurses' practice and might improve the outcomes of patients.</p><p><strong>Reporting method: </strong>This study was reported to be adhered to the STROBE guideline.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p><p><strong>Implications for the profession and/or patient care: </strong>Targeted educational intervention was needed to improve nurses' practice.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70111"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Determinants of Antenatal Depression Risk Among Urban Women Seeking Antenatal Clinical Care at a District Hospital in Ghana.","authors":"Opei Kwafo Adarkwa, Douglas Aninng Opoku, Roderick E Larsen-Reindorf, Ellis Owusu-Dabo, Benedicta Boamah, Magdalene Adarkwa, Christian Obirikorang, Yvonne A Nartey, Timothy Kwabena Adjei, Aliyu Mohammed","doi":"10.1002/nop2.70097","DOIUrl":"10.1002/nop2.70097","url":null,"abstract":"<p><strong>Aim: </strong>To determine the prevalence and factors associated with antenatal depression risk among pregnant women attending antenatal care at a district hospital in Kumasi, Ghana.</p><p><strong>Study design: </strong>This was a hospital-based cross-sectional study.</p><p><strong>Methods: </strong>A questionnaire was used to collect data from 207 pregnant women attending antenatal care at Manhyia District Hospital from September 2020 to November 2020. The Edinburgh Postnatal Depression Scale was used to screen for depression risk. Factors associated with antenatal depression risk were evaluated using logistic regression analysis.</p><p><strong>Results: </strong>The prevalence of antenatal depression risk was 13.5% (n = 28). The most commonly reported intimate partner violence that contributed to depression risk was physical abuse (16.9%, n = 35). Factors such as physical abuse (AOR = 3.36, 95% CI: 1.13-10.02), domestic abuse (AOR = 3.88, 95% CI: 1.01-15.00) and self-harm ideation (AOR = 8.50, 95% CI: 2.44-29.63) were associated with increased odds of antenatal depression risk among the study participants.</p><p><strong>Conclusion: </strong>This study revealed a low prevalence of antenatal depression risk. Extra attention should be given to factors such as intimate partner violence (domestic and physical abuse) and self-harm ideation. Also, screening all pregnant women, especially those with risk factors, for the risk of antenatal depression and early diagnosis and treatment of the risk of depression are important for the health of the mother, fetus and newborn.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70097"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'I Feel Disempowered Because I Could Not Do Anything': Clinical Facilitators' Perception of Violence Towards Nursing Students During Clinical Placement.","authors":"Hila Ariela Dafny, Paul Cooper, Nasreena Waheed, Stephanie Champion, Christine Mccloud, Nicole Snaith, Leeanne Pront","doi":"10.1002/nop2.70125","DOIUrl":"10.1002/nop2.70125","url":null,"abstract":"<p><strong>Aims: </strong>To explore clinical facilitators' understanding, experiences and perceptions of their role in supporting registered nurse students (RNS) who experience workplace violence (WPV) during clinical placement.</p><p><strong>Design: </strong>An exploratory, qualitative design.</p><p><strong>Methods and data source: </strong>Data were collected between September and November 2022 using semi-structured interviews of 1-h duration with 11 clinical facilitators working in South Australia. The interviews were transcribed verbatim and analysed using thematic analysis.</p><p><strong>Results: </strong>Participants reported that WPV is experienced in many forms, including verbal and physical violence towards RNS during clinical placements. Clinical facilitators are not always aware of this experience and have mixed abilities to resolve the damage. Most importantly, clinical facilitators saw themselves as disempowered to provide the support required by RNS after WPV incidents as they perceived themselves as visitors to the facilities.</p><p><strong>Conclusion: </strong>Findings indicate that a clinical facilitator's scope and ability to support a RNS is often not at a level where real impact and safety can occur. Varying perceptions of what WPV is, what is acceptable, and the authority or influence of a clinical facilitator have all informed this issue and need to be considered in developing strategies to address WPV towards RNS.</p><p><strong>Implications for the nursing profession: </strong>This study highlights that by understanding the causation of WPV and recognising the lack of influence and scope of clinical facilitators to act to support RNS during WPV events, positive industry changes can be instigated to promote student placement experiences and healthcare provision.</p><p><strong>Impact: </strong>Clinical facilitators felt limited in their role to support RNS experiencing WPV. This research impacts future nursing students, education providers, clinical facilitators and clinical placement providers.</p><p><strong>Reporting method: </strong>COREQ guidelines were utilised to report qualitative research.</p><p><strong>No patient or public contribution: </strong>This paper explores specifically the clinical facilitators' perceptions of WPV.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70125"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Validation of the Defining Characteristics of the Nursing Diagnosis 'Activity Intolerance' in Patients With Acute Coronary Syndrome.","authors":"Diana Isabel Cáceres Rivera, Luz Mileyde Jaimes Rojas, Luisa Yaneth Cristancho Zambrano, Jennifer Vanesa Acosta Barón, Diana Ivonne Cañon Gómez, Lyda Z Rojas","doi":"10.1002/nop2.70050","DOIUrl":"10.1002/nop2.70050","url":null,"abstract":"<p><strong>Aim: </strong>To validate the defining characteristics (CDs) of the nursing diagnosis 'Activity intolerance [00092]' in patients with acute coronary syndrome (ACS).</p><p><strong>Design: </strong>Cross-sectional study. Patients over 18 years of age with a confirmed medical diagnosis of hospitalised ACS were included and those who were haemodynamically unstable, with alterations in the mental sphere or with communication limitations were excluded. The CDs were previously operationalised for standardised measurement and independently assessed by nurses.</p><p><strong>Results: </strong>A total of 111 patients with ACS were studied. The CDs with prevalence > 50% were: generalised weakness (80.56 vs. 78.70%), discomfort on exertion (72.07% vs. 75.68%) and ECG changes (71.17% vs. 68.47%). Inter-rater agreement for determining the CDs ranged from 0.69 to 1.00.</p><p><strong>Conclusions: </strong>This study established the clinical validation of the CDs of the nursing diagnosis 'Activity Intolerance [00092]' in patients with ACS identifying three major CDs: EKG changes, generalised weakness and exertional discomfort.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution the research was developed in its entirety by the authors.</p><p><strong>Implications for the profession and/or patient care: </strong>The clinical validation of the defining characteristics of the activity intolerance diagnosis was conducted. This validation was based on operationalising each characteristic using commonly employed nursing scales and instruments. This process contributes significantly to the establishment of evidence-based nursing practices. The customisation of nursing diagnoses gains further ground through the validation studies of NANDA-I diagnoses. This process solidifies standardised nursing language as a valuable strategy in nursing care, providing substantial support for practical decision-making. Among the evaluators, EKG changes, generalised weakness and discomfort on exertion emerged as the most frequently encountered defining characteristics with substantial agreement. This discovery offers crucial insights for devising individualised and collective care plans within coronary units.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70050"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Leadership Practices and Behaviours Following Postgraduate Leadership Education: A Qualitative Study.","authors":"Rebekkah Middleton, Suzanne Murray, Sally Peters, Amy Montgomery, Elizabeth Halcomb","doi":"10.1002/nop2.70108","DOIUrl":"10.1002/nop2.70108","url":null,"abstract":"<p><strong>Aim: </strong>To explore how postgraduate leadership education is translated into practice and how leadership practices and behaviours are sustained following completion of a leadership program.</p><p><strong>Design: </strong>A qualitative exploratory study using an appreciative inquiry approach.</p><p><strong>Methods: </strong>A single Health District, partnered with a regional university, offering a 12-month leadership program, the Effective Leadership in Health Program. Four semi-structured group interviews were undertaken with 11 registered nurses (RNs) and allied health professionals. Data were audio-recorded and transcribed before being analysed using thematic analysis.</p><p><strong>Results: </strong>Four themes were revealed relating to how the learning was translated and sustained in clinical practice, namely, within (1) self, (2) others, (3) relationships and (4) sustained leadership. All participants agreed that their participation in the leadership program impacted on their subsequent approach to leadership in multiple contexts, relationships and interactions.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70108"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents' Postnatal Sense of Security: A Concept Analysis.","authors":"Tieying Zeng, Lingjun Jiang, Deqing Huang, Meiliyang Wu, Aiqing Tu","doi":"10.1002/nop2.70102","DOIUrl":"10.1002/nop2.70102","url":null,"abstract":"<p><strong>Aim: </strong>Parents' postnatal sense of security is often mentioned in recent publications, but there is no consensus on its definitions and measurement. A concept analysis was conducted to clarify the definition, the attributes, antecedents and the consequences of parents' postnatal sense of security and to promote consistency in its usage.</p><p><strong>Design: </strong>Walker and Avant's eight-step concept analysis model was adopted to define the concept of parents' postnatal sense of security.</p><p><strong>Methods: </strong>A comprehensive search of multiple databases (Sinomed, CNKI, Wanfang database, CINAHL, PubMed, Embase, Web of Science, ProQuest, PsyInfo and Cochrane Library) was conducted to identify relevant articles from the inception of the databases until December 2022. In addition, a manual search was performed to gather any additional papers related to the topic. Ultimately, a total of 48 articles were included in the concept analysis.</p><p><strong>Results: </strong>Three attributes were identified: perceive one's physical well-being not being threatened, feel confident and in control of the parenting role, feel confident in one's available relationships. The identified antecedents were: being prepared for child rearing, being in familiar or safe environment, general well-being of the baby and parents, support from medical staff and family members, being empowered by medical staff. Consequences of parents' postnatal sense of security included successful adaptation to the parental role, decreased postpartum depression symptoms in mothers, successful infant care and the development of parent-infant relationship.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 12","pages":"e70102"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence and risk factors of gastrointestinal dysfunction during enteral nutrition in mechanically ventilated critically ill patients.","authors":"Ling Shi, Jianmei Shao, Yuxia Luo, Guiyan Liu, Miao OuYang","doi":"10.1002/nop2.2247","DOIUrl":"10.1002/nop2.2247","url":null,"abstract":"<p><strong>Aim: </strong>To assess the occurrence and risk factors of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in critically ill patients supported with mechanical ventilation.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>Totally 252 patients admitted at a mixed medical-surgical ICU were enrolled. GI symptoms and the potential risk variables were recorded during the first 14 days of EN.</p><p><strong>Results: </strong>The incidence of GI dysfunction was 65.5%, and the incidence of diarrhoea, constipation, abdominal distension, and upper GI intolerance was 28.2%, 18.3%, 6.7% and 12.3%, respectively. The median onset days of constipation, diarrhoea, abdominal distension and UDI was 3, 5, 5 and 6 days, respectively. Multivariable Cox regression analysis showed a significant relationship between GI dysfunction and age (HR = 2.321, 95% CI: 1.024-5.264, p = 0.004), APACHE-II score at ICU admission (HR = 7.523, 95% CI: 4.734-12.592, p = 0.018), serum albumin level (HR = 0.594, 95% CI: 0.218-0.889, p = 0.041), multidrug-resistant bacteria-positive culture (HR = 6.924, 95% CI: 4.612-10.276, p<0.001), negative fluid balance (HR = 0.725, 95% CI: 0.473-0.926, p = 0.037), use of vasopressor drugs (HR = 1.642, 95% CI: 1.297-3.178, p<0.001), EN way (HR = 6.312, 95% CI: 5.143-11.836, p<0.001), infusion rate (HR = 1.947, 95% CI: 1.135-3.339, p<0.001), and intra-abdominal hypertension (HR = 3.864, 95% CI: 2.360-5.839, p<0.001).</p><p><strong>Conclusion: </strong>Critically ill patients supported with mechanical ventilation are at a high risk of GI dysfunction. Interventions such as the use of laxatives or prokinetic agents, control of EN infusion rate, and maintaining a normal state of hydration, might be beneficial for the prevention of GI dysfunction in critically ill patients.</p><p><strong>Patient or public contribution: </strong>No.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"11 11","pages":"e2247"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}