Clinical Nursing Research最新文献

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Caring for the Older Transgender Adults: Social, Nursing, and Medical Challenges. 照顾老年变性成人:社会、护理和医疗挑战。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-02-10 DOI: 10.1177/10547738241231054
Charalampos Milionis, Ioannis Ilias, Stella Olga Milioni, Evaggelia Venaki, Eftychia Koukkou
{"title":"Caring for the Older Transgender Adults: Social, Nursing, and Medical Challenges.","authors":"Charalampos Milionis, Ioannis Ilias, Stella Olga Milioni, Evaggelia Venaki, Eftychia Koukkou","doi":"10.1177/10547738241231054","DOIUrl":"10.1177/10547738241231054","url":null,"abstract":"<p><p>Aging is a challenging process for people with gender nonconformity. Indeed, the older transgender population faces several disparities in accessing and using health care and social support services. Furthermore, the clinical management of gender transition in later life is empirical since clear research evidence is lacking. This paper aimed to present the problems encountered by older transgender adults in their access to social support and health care and to propose insightful solutions to address them both from a social and medical/nursing perspective. Trans elders face profound disparities in health and social care due to factors associated with limited accessibility to health services, social restrictions, administrative failures, and physical vulnerabilities. The medical treatment of older transgender adults also needs a careful approach to achieve satisfying gender affirmation without clinically significant risks. The potential induction of hormone-sensitive malignancies and the provocation of major adverse vascular events are the main concerns. Gender transition in older adults without a prior history of following gender-affirming therapy is challenging due to biological factors related to advanced age. Caring for elderly trans people unfolds at multiple levels. International organizations and governmental bodies should address the underprivileged status of elderly transgender people by creating and implementing inclusive policies. Safe and respectful clinical and residential environments and the formation of clearer medical guidelines could meet the unique needs of older trans adults. Care providers must advocate for their patients and be equipped to provide safe and effective services.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"277-284"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Poverty and Disability: A State-Level Geospatial Analysis. 贫困与残疾:州级地理空间分析。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-05-21 DOI: 10.1177/10547738241249834
Patricia R Lawrence, Raeda K Anderson
{"title":"Poverty and Disability: A State-Level Geospatial Analysis.","authors":"Patricia R Lawrence, Raeda K Anderson","doi":"10.1177/10547738241249834","DOIUrl":"10.1177/10547738241249834","url":null,"abstract":"<p><p>Individuals with disabilities are a growing yet understudied population. Nurses are in a prime position to address social determinants of health (SDOH), which is defined as the conditions in which people work, live, and learn that affect health. SDOH are largely responsible for the health inequities seen among individuals with disabilities. The purpose of this study was to explore the relationships between state-level poverty rates and state-level social determinants, such as housing, education, employment, health, and health care for adults with disabilities using geospatial, state-level data. This secondary data analysis used national data from the 2021 American Community Survey. Data on state poverty rates and rates of particular social determinants were used to examine differences between high- and low-poverty states for adults with disabilities. Rates, rather than numbers of adults with disabilities in poverty, were used to control for state size. The median poverty rate (27.8%) for adults with disabilities was used to create a dichotomous variable for low-poverty (<i>n</i> = 26) and high-poverty (<i>n</i> = 25) states. Independent samples <i>t</i>-tests were used to compare geospatial and SDOH data to understand differences between high- and low-poverty states. More adults with disabilities, regardless of race, live in high-poverty states, particularly those with ambulatory and cognitive disabilities. Adults with disabilities residing in low-poverty states have higher employment rates and more private insurance coverage. More adults with disabilities in high-poverty states smoke, live in mobile homes, and are less educated. Using an SDOH lens in caring for individuals with disabilities helps nurses better understand how economic stability, education, health, health care access, the built environment, and the community, rather than individual factors, impact the health of adults with disabilities. To improve the health of disabled persons, nurses must have a greater awareness of the influence that social determinants have on health for individuals with disabilities. Nurse training programs must build disability cultural competence into nursing curricula. Universal screening for SDOH, particularly for individuals with disabilities residing in high-poverty states, is pivotal for the best chance of improving the health and well-being of individuals with disabilities.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"344-354"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social Determinants of Health are Associated with Coping of Informal Caregivers of Adults with Heart Failure. 健康的社会决定因素与心力衰竭成人非正规照顾者的应对能力有关。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-01-30 DOI: 10.1177/10547738231223790
Austin Matus, Ryan Quinn, Michael A Stawnychy, Gladys Thomas, Miatta Goba, Jenna Garo, Deborah Gordon, Barbara Riegel
{"title":"Social Determinants of Health are Associated with Coping of Informal Caregivers of Adults with Heart Failure.","authors":"Austin Matus, Ryan Quinn, Michael A Stawnychy, Gladys Thomas, Miatta Goba, Jenna Garo, Deborah Gordon, Barbara Riegel","doi":"10.1177/10547738231223790","DOIUrl":"10.1177/10547738231223790","url":null,"abstract":"<p><p>We explored the influence of social determinants of health (SDH) risk on stress and coping style in heart failure (HF) caregivers. In this cross-sectional study, data from 250 caregivers were analyzed. Multivariable linear regression analyses were performed to determine the extent to which SDH risk (measured using a modified PRAPARE tool (National Association of Community Health Centers), range 0-22) predicted stress (Perceived Stress Scale, 0-56) and coping style (active (0-45), avoidance (0-30), and minimization (0-30)) while accounting for caregiver burden (HF Caregiver Questionnaire (HF-CQ) 0-100). Multivariable regression analysis with backwards elimination variable selection approach was used to identify which SDH risk factors best predicted coping styles. SDH risk was significantly associated with avoidance and minimization coping styles. Each unit increase in SDH risk was associated with an increase of 0.6 ± 0.2 units (<i>p</i> = .0008) in avoidance and 0.7 ± 0.2 units (<i>p</i> < .0001) in minimization coping style. Race and \"supporting others\" significantly predicted avoidance coping style; scores were 3.3 ± 0.8 units greater for caregivers who were not White (<i>p</i> < .0001) and 1.4 ± 0.5 units greater (<i>p</i> < .01) for each additional person whom they supported. Race significantly predicted minimization coping style; scores were 4.4 ± 0.7 units greater for caregivers who were not White (<i>p</i> < .0001). Caregivers with higher SDH risk may avoid and minimize to cope with caregiving challenges.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"334-343"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11188556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577203","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}
引用次数: 0
An Integrative Review of Social Determinants of Glycemic Targets Achievement in Adults with Type 2 Diabetes in the United States. 美国 2 型糖尿病成人血糖目标实现的社会决定因素综合评述》。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-01-28 DOI: 10.1177/10547738231223577
Bootan Hasan Ahmed, Joachim G Voss, Nicholas Schiltz, Ahmed A Naif, Suebsarn Ruksakulpiwat, Stephanie Griggs
{"title":"An Integrative Review of Social Determinants of Glycemic Targets Achievement in Adults with Type 2 Diabetes in the United States.","authors":"Bootan Hasan Ahmed, Joachim G Voss, Nicholas Schiltz, Ahmed A Naif, Suebsarn Ruksakulpiwat, Stephanie Griggs","doi":"10.1177/10547738231223577","DOIUrl":"10.1177/10547738231223577","url":null,"abstract":"<p><p>Several individual social determinants of health have been identified as significant factors contributing to achieving glycemic targets (glycated hemoglobin < 7). However, it remains unclear how these social variables individually or collectively contribute to glycemic targets among adults with type 2 diabetes (T2D) in the United States (U.S.) The purpose of the current integrative review (IR) was to describe and synthesize findings from studies on social determinants of glycemic target achievement in adults with T2D in the U.S. and integrate them into the United States Department of Health and Human Services Conceptual Framework. The databases searched included PubMed, CINAHL Plus with Full Text, Medline with Full Text [EBSCO], Google Scholar, bibliography, and hand searching. A total of 948 records were identified. After excluding duplicates and irrelevant studies based on inclusion and exclusion criteria through title, abstract, and full-text screening, 13 studies were finally included in this IR. The results revealed that race/ethnicity, economic access and stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context contribute to glycemic target achievement among adult patients with T2D in the U.S. Integrating findings from key studies on social determinants of glycemic health may contribute to developing interventions aimed at reducing and eventually eradicating health disparities for individuals with and at risk for T2D in the U.S.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"405-415"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Psychological Examination of the Status Syndrome and Its Application for Promoting Well-Being. 状态综合症的心理学研究及其在促进福祉方面的应用。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-02-13 DOI: 10.1177/10547738241231044
Laura Cristina Rodríguez-González, Paula Beatriz Repetto
{"title":"A Psychological Examination of the Status Syndrome and Its Application for Promoting Well-Being.","authors":"Laura Cristina Rodríguez-González, Paula Beatriz Repetto","doi":"10.1177/10547738241231044","DOIUrl":"10.1177/10547738241231044","url":null,"abstract":"<p><p>The status syndrome proposed by Marmot is located at the closest level of influence within the Social Determinants of Health (SDH) framework, connecting the body's response to the mental states that arise from the subjective experience of social status. Marmot defines these psychological states through concepts of autonomy and social integration articulated in the Capability Approach (CA). These elements are further explored and expanded upon with the Self-Determination Theory (SDT), an empirically based framework with an extensive tradition of practical application. This lays the groundwork not only for understanding what makes a social environment conducive to well-being but also for shedding light on ways to promote it. The article goes beyond theoretical discussions by introducing a structured model based on the principles of the SDT for health promotion interventions. The model emphasizes the importance of providing a supportive atmosphere and is organized into four distinct phases aimed at aligning interventions with individual motivations, and cultural contexts. Ultimately, the goal is to engage individuals to actively participate in their own well-being while addressing the complexities associated with social inequalities in developed societies.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"285-291"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediction of Positive Patient Health Questionnaire-2 Screening Using Area Deprivation Index in Primary Care. 利用基层医疗中的地区贫困指数预测患者健康问卷-2 筛选阳性结果。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-06-01 Epub Date: 2024-05-27 DOI: 10.1177/10547738241252887
Martha Duarte, Mayra Salamanca, Juan M Gonzalez, Roberto Roman Laporte, Karina Gattamorta, Fernando Enrique Lopez Martinez, John Clochesy, Juan Carlos Rincon Acuna
{"title":"Prediction of Positive Patient Health Questionnaire-2 Screening Using Area Deprivation Index in Primary Care.","authors":"Martha Duarte, Mayra Salamanca, Juan M Gonzalez, Roberto Roman Laporte, Karina Gattamorta, Fernando Enrique Lopez Martinez, John Clochesy, Juan Carlos Rincon Acuna","doi":"10.1177/10547738241252887","DOIUrl":"10.1177/10547738241252887","url":null,"abstract":"<p><p>Depression is recognized as a significant public health issue in the United States. The National Survey on Drug Use and Health reports that 21.0 million adults aged 18 or older had major depressive disorder in 2020, including 14.8 million experiencing a major depressive episode with severe impairment. The aim is to predict the positivity of Patient Health Questionnaire-2 (PHQ-2) outcomes among patients in primary care settings by analyzing a range of variables, including socioeconomic status, demographic characteristics, and health behaviors, thereby identifying those at increased risk for depression. Employing a machine learning approach, the study utilizes retrospective data from electronic health records across 15 primary care clinics in South Florida to explore the relationship between social determinants of health (SDoH), including area of deprivation index (ADI) and PHQ-2 positivity. The study encompasses 15 primary care clinics located in South Florida, where a diverse patient population receives care. Analysis included 94,572 patient visits; 74,636 records were included in the study. If a zip+4 was not available or an ADI score did not exist, the visit was not included in the final analysis. Screening involved the PHQ-2, assessing depressed mood and anhedonia, with a cutoff >2 indicating positive screening. ADI was used to assess SDoH by matching patients' residential postal codes to ADI national percentiles. Demographics, sexual history, tobacco use, caffeine intake, and community involvement were also evaluated in the study. Over 40 machine learning algorithms were explored for their accuracy in predicting PHQ-2 outcomes, using software tools including Scikit-learn and stats models in Python. Variables were normalized, scored, and then subjected to predictive regression models, with Random Forest showing outstanding performance. Feature engineering and correlation analysis identified ADI, age, education, visit type, coffee intake, and marital status as significant predictors of PHQ-2 positivity. The area under the curve and model accuracies varied across clinics, with specific clinics showing higher predictive accuracy and others (<i>p</i> > .05). The study concludes that the ADI, as a proxy for SDoH, alongside other individual factors, can predict PHQ-2 positivity. Health organizations can use this information to anticipate health needs and resource allocation.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"355-369"},"PeriodicalIF":1.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intensive Primary Care Nursing: Exploring the Impact of a Nurse-Led Model for Medically and Social Complex Patients. 强化初级护理:探索护士主导模式对医学和社会复杂病人的影响。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-05-17 DOI: 10.1177/10547738241253654
M. Darby, Linda Smith, Bailey Waldron, K. Fiandt
{"title":"Intensive Primary Care Nursing: Exploring the Impact of a Nurse-Led Model for Medically and Social Complex Patients.","authors":"M. Darby, Linda Smith, Bailey Waldron, K. Fiandt","doi":"10.1177/10547738241253654","DOIUrl":"https://doi.org/10.1177/10547738241253654","url":null,"abstract":"Lack of access to primary care contributes to health inequities. Treatment settings that utilize the full experience and training of nurses, both registered nurses (RNs) and advanced practice registered nurses (APRNs), can expand in primary care and successfully address health inequities. This small study describes the implementation of a model of primary care called intensive primary care (IPC), which has eight elements that support the full utilization of a nurse's experience and training. This is a mixed method qualitative study, which reports the observations of the implementation and pre- and post-intervention measures. The IPC model was implemented at a free clinic, which targeted underserved population between 2020 and 2023. Participants were selected as a convenience sample. Participants were to have two or more chronic health problems The participants received primary care using the IPC model, which included setting self-management goals, and meeting with RN or APRN on a monthly basis (face to face, via phone or zoom) to monitor progress toward goals. Twenty-two people were approached, and 19 completed the intervention. Pre- and Post-intervention measures (Patient Assessment of Chronic Illness Care [PACIC]-20); Functional, Communicative, Critical Thinking Health Literacy; Perceived Stress; Patient Activation; Perceived Self Efficacy for Chronic Disease; EuroQo- 5 Dimension (EQ-5D); Trust in Provider; Emotional Support-Patient Reported Outcome Measure Information System (PROMIS); and Patient Health Questionnaire-9) were obtained and analyzed with paired T test (α < .05). Nurses involved meet weekly to share observations recorded in free form notes. These observations were summarized by two of the authors (MD and KF) at the end of the study. All patients had improved physical health outcomes, but more importantly, there were significant improvements in measures known to impact health and health outcomes, specifically, patient activation, self-efficacy for chronic illness, PACIC, and trust in provider. Time spent with patients, both duration and frequency of contact, was observed to have significant impacts.","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"9 12","pages":"10547738241253654"},"PeriodicalIF":1.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intensive Primary Care Nursing: Exploring the Impact of a Nurse-Led Model for Medically and Social Complex Patients. 强化初级护理:探索护士主导模式对医学和社会复杂病人的影响。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-05-17 DOI: 10.1177/10547738241253654
Mark Darby, Linda Smith, Bailey Waldron, Kathryn Fiandt
{"title":"Intensive Primary Care Nursing: Exploring the Impact of a Nurse-Led Model for Medically and Social Complex Patients.","authors":"Mark Darby, Linda Smith, Bailey Waldron, Kathryn Fiandt","doi":"10.1177/10547738241253654","DOIUrl":"https://doi.org/10.1177/10547738241253654","url":null,"abstract":"<p><p>Lack of access to primary care contributes to health inequities. Treatment settings that utilize the full experience and training of nurses, both registered nurses (RNs) and advanced practice registered nurses (APRNs), can expand in primary care and successfully address health inequities. This small study describes the implementation of a model of primary care called intensive primary care (IPC), which has eight elements that support the full utilization of a nurse's experience and training. This is a mixed method qualitative study, which reports the observations of the implementation and pre- and post-intervention measures. The IPC model was implemented at a free clinic, which targeted underserved population between 2020 and 2023. Participants were selected as a convenience sample. Participants were to have two or more chronic health problems The participants received primary care using the IPC model, which included setting self-management goals, and meeting with RN or APRN on a monthly basis (face to face, via phone or zoom) to monitor progress toward goals. Twenty-two people were approached, and 19 completed the intervention. Pre- and Post-intervention measures (Patient Assessment of Chronic Illness Care [PACIC]-20); Functional, Communicative, Critical Thinking Health Literacy; Perceived Stress; Patient Activation; Perceived Self Efficacy for Chronic Disease; EuroQo- 5 Dimension (EQ-5D); Trust in Provider; Emotional Support-Patient Reported Outcome Measure Information System (PROMIS); and Patient Health Questionnaire-9) were obtained and analyzed with paired <i>T</i> test (<i>α</i> < .05). Nurses involved meet weekly to share observations recorded in free form notes. These observations were summarized by two of the authors (MD and KF) at the end of the study. All patients had improved physical health outcomes, but more importantly, there were significant improvements in measures known to impact health and health outcomes, specifically, patient activation, self-efficacy for chronic illness, PACIC, and trust in provider. Time spent with patients, both duration and frequency of contact, was observed to have significant impacts.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"10547738241253654"},"PeriodicalIF":1.7,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In Vitro and In Vivo Testing of Microbe Growth on Antimicrobial Nursing Scrubs. 抗菌护理袍上微生物生长的体外和体内测试。
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-05-01 Epub Date: 2024-03-17 DOI: 10.1177/10547738241238250
Jennifer A Thornburg, Phong Nguy, Katelyn M Mortland, Karen M Mortland, Rudolph E Sloup, Brenda K Naylor, Robert V Topp, Jyl S Matson, Terry P Bigioni
{"title":"In Vitro and In Vivo Testing of Microbe Growth on Antimicrobial Nursing Scrubs.","authors":"Jennifer A Thornburg, Phong Nguy, Katelyn M Mortland, Karen M Mortland, Rudolph E Sloup, Brenda K Naylor, Robert V Topp, Jyl S Matson, Terry P Bigioni","doi":"10.1177/10547738241238250","DOIUrl":"10.1177/10547738241238250","url":null,"abstract":"<p><p>Around 5% to 10% of hospitalized patients develop a hospital-acquired infection (HAI). Scrubs are a potential vector of HAIs. To compare the antimicrobial characteristics of scrubs with and without an antimicrobial fabric coating, as tested in the laboratory (in vitro) and hospital (in vivo) environments. Two protocols were conducted to address the purpose. The in vitro protocol was a laboratory study that involved observing the microbe growth after inoculating coated and uncoated scrub fabric swatches with <i>S. aureus</i> and then processing them in moist and dry environments. The in vivo protocol was a clinical trial that measured microbe growth on coated and uncoated scrubs prior to and following nursing staff completing a 12-hr shift on an acute care unit, as measured by colony forming units (CFUs). For high-humidity environments, the in vitro study indicated that swatches treated with an antimicrobial coating exhibited minimal microbe growth, while untreated swatches exhibited significant microbe growth. For low-humidity environments, coated and uncoated swatches were all found to exhibit minimal microbe growth. In the in vivo study, the CFUs increased on scrubs worn by nurses over a 12-hr shift with no significant difference in CFUs for coated and uncoated scrubs. For bacteria in a warm and moist environment, the antimicrobial coating was found to be important for inhibiting growth. For bacteria in a warm and dry environment, both coated and uncoated fabrics performed similarly as measured at 24 hr, with minimal bacterial growth observed. In a hospital environment, microbe growth was observed, but no significant difference was detected when comparing coated and uncoated scrubs. This may have been due to the short time between exposure and culturing the scrubs for analysis immediately at the end of the shift not allowing for enough time to kill or inhibit growth. Contact time between the bacteria and scrub fabric (coated or uncoated) in the in vivo study more directly correlated with the 0-hr observations for the in vitro study, suggesting that the ineffectiveness of the treated scrubs in the clinical results may be due in part to short residence times before collection.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"253-261"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of Inflammatory Mediators in Saliva Samples From Hospitalized Newborns: Potential Biomarkers? 鉴定住院新生儿唾液样本中的炎症介质:潜在的生物标记物?
IF 1.7 4区 医学
Clinical Nursing Research Pub Date : 2024-05-01 Epub Date: 2024-03-20 DOI: 10.1177/10547738241238249
Vanderlei Amadeu da Rocha, Sanseray da Silveira Cruz-Machado, Isília Aparecida Silva, Pedro Augusto Carlos Magno Fernandes, Regina Pekelmann Markus, Mariana Bueno
{"title":"Identification of Inflammatory Mediators in Saliva Samples From Hospitalized Newborns: Potential Biomarkers?","authors":"Vanderlei Amadeu da Rocha, Sanseray da Silveira Cruz-Machado, Isília Aparecida Silva, Pedro Augusto Carlos Magno Fernandes, Regina Pekelmann Markus, Mariana Bueno","doi":"10.1177/10547738241238249","DOIUrl":"10.1177/10547738241238249","url":null,"abstract":"<p><p>Saliva measurements serve as a noninvasive tool for clinically monitoring newborns (NB) and children, a vulnerable population with promising potential for both research and clinical practice. Saliva acts as a repository for various inflammatory biomarkers involved in diverse biological functions. Particularly for children, it offers numerous advantages when compared to plasma and urine sampling. Nevertheless, there is a significant knowledge gap regarding detectable levels of cytokines in the saliva of newborns and children, as well as studies aiming to assess the relationship of this content with physiological and pathological processes.</p><p><strong>Objectives: </strong>To characterize the levels of 11 inflammatory mediators (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF) in saliva samples from NB on the first and second day of hospitalization in the Neonatal Intensive Care Unit (NICU).</p><p><strong>Method: </strong>Exploratory study, descriptive, nested within a primary clinical, observational, and prospective study, conducted in the NICU of a public hospital in São Paulo, Brazil. Demographic data and vital signs were recorded in the clinical records of 90 NB, and five saliva samples from 5 NB were collected between the first and second day of life (D1-D2) at approximately 8-hr intervals (8-9 am, 4-5 pm, and 11-12 pm). Saliva samples were used for the measurement of 11 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17, TNF, and VEGF).</p><p><strong>Results: </strong>Five NBs participated in this exploratory study, and the vital signs showed variability from the first (D1) to the second day (D2) of hospitalization, variability similar to that of the total population of the primary study. The presence and levels of the 11 cytokines were detected in the saliva samples, as well as a statistical correlation between 10 cytokines (IFNg, IL1b, IL2, IL4, IL6, IL10, IL12, IL17, TNF, and VEGF) and vital signs.</p><p><strong>Conclusions: </strong>The novelty of measuring inflammatory mediators in saliva samples from hospitalized NBs in the NICU is highlighted, providing support and new perspectives for the development of clinical and experimental research and an opportunity for developing and implementing new salivary biomarkers in different population segments.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":" ","pages":"207-219"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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