Journal of Clinical Nursing最新文献

{"title":"Symptom Cluster Trajectories Among Patients With Hepatocellular Carcinoma After Partial Hepatectomy: A Longitudinal Study.","authors":"Yanxiu Cai, Jing Li, Liuna Bi, Linlin Wang, Jing Han","doi":"10.1111/jocn.17624","DOIUrl":"https://doi.org/10.1111/jocn.17624","url":null,"abstract":"<p><strong>Aims: </strong>To investigate types of symptom clusters in patients with hepatocellular carcinoma after partial hepatectomy and explore symptom cluster trajectories over time.</p><p><strong>Design: </strong>A longitudinal observational study was conducted.</p><p><strong>Methods: </strong>Symptoms of patients with hepatocellular carcinoma were assessed on the second day, seventh day, third week, fourth week and twelfth week post-operation using the MD Anderson Symptom Assessment Inventory and the Symptom Module for Primary Liver Cancer. Symptom clusters were extracted using exploratory factor analysis, and symptom cluster trajectories were analysed using a latent class growth model.</p><p><strong>Results: </strong>Two hundred and thirty patients with hepatocellular carcinoma completed the five-point investigation after partial hepatectomy. Three symptom clusters were identified: general somatic, psychological and liver impairment. Each symptom cluster was further categorised into three groups: severe, moderate and low. The severity of the three symptom clusters and subgroups decreased over time.</p><p><strong>Conclusion: </strong>Three symptom clusters were identified in patients who underwent partial hepatectomy for hepatocellular carcinoma, and symptom cluster trajectories decreased over time during the 12-week postoperative period. These findings will assist healthcare professionals in providing prompt symptom management and improve patient quality of life.</p><p><strong>Implications for the profession and/or patient care: </strong>Healthcare professionals should evaluate symptom clusters and their trajectories in patients with hepatocellular carcinoma after partial hepatectomy.</p><p><strong>Reporting method: </strong>This report was prepared in accordance with the Guidelines for Reporting Cohort Research.</p><p><strong>Patient or public contribution: </strong>Hepatobiliary surgery nurses worked closely with the research team to ensure the questionnaires were fully assessed before being sent to patients. The active participation of patients provided valuable information for the study.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400084232).</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress, Antipsychotic Medications and Cardiovascular Risk Factors Among Patients With Schizophrenia.","authors":"Tariq N Al-Dwaikat, Haya Khader Al-Samouri, Heyam Dalky, Shaher H Hamaideh, Mohammed ALBashtawy, Haitham Khatatbeh","doi":"10.1111/jocn.17606","DOIUrl":"https://doi.org/10.1111/jocn.17606","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to assess the correlation between antipsychotic drug use, psychological distress and cardiovascular risk factors among patients with schizophrenia.</p><p><strong>Methods: </strong>A cross-sectional correlational design was used to obtain data from 143 patients with schizophrenia who were conveniently selected. Data were collected by assessing selected cardiovascular risk indicators blood pressure (BP), random blood sugar (RBS), body mass index (BMI), waist-to-height ratio (WtHR) and waist circumference (WC). A self-administered questionnaire was used to collect sociodemographic data, clinical history and the 18-item Psychological Stress Index for patients with schizophrenia.</p><p><strong>Results: </strong>The use of antipsychotics was associated with increased cardiovascular risk factors including BP, BMI and WtHR. Atypical antipsychotic medications were associated with weight gain and obesity which increase the risk of diabetes and cardiovascular diseases. Age was significantly correlated with systolic BP (r = 0.31), diastolic BP (r = 0.30) and RBS (r = 0.26). Furthermore, significant correlations were found between the duration of diagnosis with systolic (r = 0.26) and diastolic (r = 0.21) BP. None of the correlations between stress and the other study variables were significant.</p><p><strong>Conclusion: </strong>Screening of antipsychotic side effects is needed in the early phases, and attention must be paid to the cardiovascular risk in patients with schizophrenia, particularly BP, glucose level and BMI. In addition, clinicians should be informed of this evidence to set guidelines for regular monitoring of metabolic parameters.</p><p><strong>Reporting method: </strong>STROBE guidelines were followed in this study.</p><p><strong>Patient or public contribution: </strong>Actively involving patients in data collection, this study ensured that their voices were heard and their experiences were central to informing the research findings. In addition, involving patients in the study would enhance the relevance and applicability of the study's conclusions to real-world contexts, promoting patient-centered care and improved health outcomes for patients with schizophrenia.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an Oral Health Tool for Clinicians to Screen Patients With Cardiovascular Disease.","authors":"Paula Sanchez, Shwetha Kezhekkekara, Shilpi Ajwani, Anlai Wei, Jaren Wong, Howard Wu, Sanjida Uddin, Yasin Sukarieh, Jessica O'brien, Ajesh George","doi":"10.1111/jocn.17623","DOIUrl":"https://doi.org/10.1111/jocn.17623","url":null,"abstract":"<p><strong>Aims: </strong>To develop and validate a screening tool to identify patients with cardiovascular disease at risk of poor oral health and requiring referrals.</p><p><strong>Design: </strong>This study was part of a larger pilot study involving a cross-sectional survey and an oral health assessment conducted with patients with cardiovascular disease.</p><p><strong>Methods: </strong>A four-item screening tool was developed by an expert panel and validated through a cross-sectional survey of patients with cardiovascular disease. The survey contained the tool and the oral health impact profile (OHIP-14) (first gold standard). Additionally, all survey participants were provided a clinical oral health assessment (second gold standard). Sensitivity and specificity analysis was undertaken comparing the tool to the two gold standards to assess patients with cardiovascular disease at risk of poor oral health.</p><p><strong>Results: </strong>Three hundred and twenty-one participants completed the cross-sectional survey and eighty nine undertook the oral health assessment. Results from both approaches showed that the tool had high sensitivities (OHIP-14 = 89%, Oral assessment = 88%) and low specificities (OHIP-14 = 33% and Oral assessment = 24%).</p><p><strong>Conclusion: </strong>The four-item screening tool is a simple and valid tool to identify patients with cardiovascular disease at risk of poor oral health and requiring a dental referral. The tool could be incorporated into routine practice of nurses across various cardiac settings.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Geriatric Nutritional Risk Index and Critically Ill Patients With Pressure Injury: Analysis of the MIMIC-IV Database.","authors":"Yilei Zhang, Chuan Qin, Li Xu, Mengjia Zhao, Jinan Zheng, Weilong Hua, Yutian Wei, Guanghao Zhang, Xiaoling Huang, Rundong Chen","doi":"10.1111/jocn.17610","DOIUrl":"https://doi.org/10.1111/jocn.17610","url":null,"abstract":"<p><strong>Aims and objectives: </strong>To explore the relationship between the Geriatric Nutritional Risk Index (GNRI) and the occurrence of Pressure injury (PI) in elderly Intensive Care Unit (ICU) patients.</p><p><strong>Background: </strong>PI represent a significant health concern within ICU, where the occurrence of such injuries is notably high among critically ill patients. However, few studies have explored the relationship between GNRI and PI.</p><p><strong>Design: </strong>A longitudinal, single-centre, retrospective study.</p><p><strong>Methods: </strong>The study utilised GNRI calculation to identify PI occurrences. A comprehensive set of covariates was analysed, including demographic information, severity of illness scores, comorbidities, therapeutic interventions, vital signs and laboratory values. Statistical analysis involved descriptive statistics, logistic regression and receiver operating characteristic curves, supplemented by a doubly robust estimation method and propensity score modelling. This study follows the STROBE-nut checklist.</p><p><strong>Results: </strong>Among 5327 critically ill patients enrolled in the study, with a median age of 76 years, of which 2339 were females, representing 43.91% of the total study population. Binary logistic regression analysis revealed that with each unit increase in the GNRI, the likelihood of PI occurrence decreased by 3.7% in the fully adjusted model. Furthermore, there was a significant decrease in PI occurrence among patients deemed to have no risk compared to those identified as at-risk.</p><p><strong>Conclusions: </strong>GNRI emerges as a significant, independent predictor of PI risk in elderly ICU patients, underscoring the importance of nutritional assessment and management in this population.</p><p><strong>Relevance to clinical practice: </strong>This study highlights the critical importance of nutritional assessment, specifically through GNRI, in early identification and prevention of pressure injuries among elderly ICU patients, underscoring the need for integrated nutritional strategies in clinical settings.</p><p><strong>No patient or public contribution: </strong>This is a retrospective cohort study, and no patients or the public were involved in the design and conduct of the study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Practice Nurses in Primary Care and Their Impact on Health Service Utilisation, Costs and Access Globally: A Scoping Review.","authors":"Madison Horton, Justinna Dixon, Eleanor Turi, Chinmayi Balusu, Rachel Paikoff, Claudia B Maier, Lusine Poghosyan","doi":"10.1111/jocn.17614","DOIUrl":"10.1111/jocn.17614","url":null,"abstract":"<p><strong>Aim: </strong>Synthesise evidence on advanced practice nurses' impact on health services utilisation, healthcare costs, access and quality of care globally.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Methods: </strong>A scoping review guided by the Joanna Briggs Institute Manual for Evidence Synthesis and the PRISMA-ScR checklist.</p><p><strong>Data sources: </strong>PubMed, CINHAL and Embase for articles between 2016 and 2023.</p><p><strong>Results: </strong>Eighteen studies were included (14 from the United States, two from the Netherlands and one from Australia and New Zealand each). Outcomes included health services utilisation, healthcare costs, access, and quality of care. Most studies reported advanced practice nursing patients had fewer emergency department (9 of 11 studies), fewer hospital (re-)admissions (9 of 10 studies) and primary care visits (3 of 3 studies). Seven (of eight) studies found advanced practice nursing care was associated with significantly lower healthcare costs. For access and quality of care, advanced practice nursing care was associated with lower consultation rates, similar mean number of patients seen, higher protocol adherence, more rural patient care and lower-to-similar quality delivery of chronic disease management.</p><p><strong>Conclusion: </strong>Majority of the studies reported that advanced practice nursing care was associated with lower emergency department visits, hospital readmissions and costs. Access to care outcomes varied under advanced practice nursing care.</p><p><strong>Implications for the profession and/or patient care: </strong>Advanced practice nursing care can improve patient outcomes, reduce costs and impact access and quality of care. Practices need supportive work environments for advanced practice nurses to deliver high-quality, effective care.</p><p><strong>Impact: </strong>Addressing the need for a synthesis of up-to-date evidence, this review highlights the importance of advanced practice nurses in primary care. Findings can inform global workforce development strategies to address health inequalities through effective advanced practice nursing integration.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution is required for this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Nursing Need Proxies Using Vital Signs and Biomarkers Data: Application of Deep Learning Models.","authors":"Yunmi Baek, Kihye Han, Eunjoo Jeon, Hae Young Yoo","doi":"10.1111/jocn.17612","DOIUrl":"https://doi.org/10.1111/jocn.17612","url":null,"abstract":"<p><strong>Aim: </strong>To develop deep learning models to predict nursing need proxies among hospitalised patients and compare their predictive efficacy to that of a traditional regression model.</p><p><strong>Design: </strong>This methodological study employed a cross-sectional secondary data analysis.</p><p><strong>Methods: </strong>This study used de-identified electronic health records data from 20,855 adult patients aged 20 years or older, admitted to the general wards at a tertiary hospital. The models utilised patient information covering the preceding 2 days, comprising vital signs, biomarkers and demographic data. To create nursing need proxies, we identified the six highest-workload nursing tasks. We structured the collected data sequentially to facilitate processing via recurrent neural network (RNN) and long short-term memory (LSTM) algorithms. The STROBE checklist for cross-sectional studies was used for reporting.</p><p><strong>Results: </strong>Both the RNN and LSTM predicted nursing need proxies more effectively than the traditional regression model. However, upon testing the models using a sample case dataset, we observed a notable reduction in prediction accuracy during periods marked by rapid change.</p><p><strong>Conclusions: </strong>The RNN and LSTM, which enhanced predictive performance for nursing needs, were developed using iterative learning processes. The RNN and LSTM demonstrated predictive capabilities superior to the traditional multiple regression model for nursing need proxies.</p><p><strong>Implications for the profession: </strong>Applying these predictive models in clinical settings where medical care complexity and diversity are increasing could substantially mitigate the uncertainties inherent in decision-making processes.</p><p><strong>Patient or public contribution: </strong>We used de-identified electronic health record data of 20,855 adult patients about vital signs, biomarkers and nursing activities.</p><p><strong>Reporting method: </strong>The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross-sectional studies.</p><p><strong>Impact: </strong>Despite widespread adoption of deep learning algorithms in various industries, their application in nursing administration for workload distribution and staffing adequacy remains limited. This study amalgamated deep learning technology to develop a predictive model to proactively forecast nursing need proxies. Our study demonstrates that both the RNN and LSTM models outperform a traditional regression model in predicting nursing need proxies. The proactive application of deep learning methods for nursing need prediction could help facilitate timely detection of changes in patient nursing demands, enabling the effective and safe nursing services.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor on 'Habitual Dietary Patterns of Maintenance Haemodialysis Patients and the Relationship Between Malnutrition Risk-A Multicentre Cross-Sectional Diet Survey'.","authors":"Na Zhao, Weifang Xu, Yingying Ruan","doi":"10.1111/jocn.17594","DOIUrl":"https://doi.org/10.1111/jocn.17594","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Perceived Nursing Workload and Occupational Fatigue in Clinical Nurses: The Moderating Role of Nursing Teamwork.","authors":"Reza Nemati-Vakilabad, Erfan Ebadi, Amirreza Homaei, Soraya Hoseini, Alireza Mirzaei","doi":"10.1111/jocn.17616","DOIUrl":"https://doi.org/10.1111/jocn.17616","url":null,"abstract":"<p><strong>Aim: </strong>This study investigated the association between perceived nursing workload and occupational fatigue in clinical nurses. We specifically focused on how nursing teamwork moderates this relationship.</p><p><strong>Background: </strong>Hospital nurses often face heavy workloads, leading to significant fatigue. Understanding the link between workload, fatigue and teamwork is crucial to addressing nurse burnout.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 356 clinical nurses from five educational-therapeutic hospitals in Ardabil, Iran. Data were collected using validated instruments, including the Occupational Fatigue Exhaustion Recovery-15 (OFER) scale, the Quantitative Workload Inventory (QWI) and the Nursing Teamwork Survey (NTS). Hierarchical linear regression analysis assessed the relationships between perceived workload, occupational fatigue and nursing teamwork.</p><p><strong>Results: </strong>The study's findings show that increased nursing workloads were significantly linked to higher levels of both acute (B = 5.70 to 6.76, p < 0.001) and chronic fatigue (B = 6.71 to 7.16, p < 0.001). Additionally, effective nursing teamwork, comprising trust, team orientation, support, shared mental models and team leadership was associated with reduced fatigue levels.</p><p><strong>Conclusion: </strong>Our study shows high workloads are linked to increased fatigue among nursing professionals. Teamwork can help lessen the adverse effects of workload on fatigue. Healthcare organisations should focus on optimising workload distribution and strengthening teamwork. Further research is needed to understand these dynamics and develop targeted interventions to support nursing staff in high-demand environments.</p><p><strong>Implications for nursing and health policy: </strong>The study emphasises the need for healthcare organisations to prioritise workload management and enhance teamwork among nursing staff. Implementing structured workload assessments and fostering a collaborative work environment, along with policies promoting work-life balance, can improve patient care quality, benefit nursing professionals and contribute to a more resilient healthcare system.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Social Work Interventions: Insights and Recommendations Based on the Impact of Sedentary Behaviour and Physical Activity on Muscle Strength in Older Adults.","authors":"Zhongxing Liu, Mengzhe Tian, Lincheng Duan","doi":"10.1111/jocn.17620","DOIUrl":"https://doi.org/10.1111/jocn.17620","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Effects of Music Intervention on Physical and Psychological Problems in Adults Receiving Haemodialysis Treatment: A Systematic Review and Meta-Analysis'.","authors":"Xiaohong Zhu, Jine Peng","doi":"10.1111/jocn.17573","DOIUrl":"https://doi.org/10.1111/jocn.17573","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}