Clinical Nursing Research最新文献

{"title":"Impact of Dementia on Incidence and Severity of Postoperative Pulmonary Complications Following Hip Fracture Surgery Among Older Patients.","authors":"Hideyo Tsumura, Eleanor S McConnell, Tingzhong Michelle Xue, Sijia Wei, Chiyoung Lee, Wei Pan","doi":"10.1177/10547738231194098","DOIUrl":"10.1177/10547738231194098","url":null,"abstract":"<p><p>Postoperative pulmonary complications (PPCs) are the leading cause of death following hip fracture surgery. Dementia has been identified as a PPC risk factor that complicates the clinical course. By leveraging electronic health records, this retrospective observational study evaluated the impact of dementia on the incidence and severity of PPCs, hospital length of stay, and postoperative 30-day mortality among 875 older patients (≥65 years) who underwent hip fracture surgery between October 1, 2015 and December 31, 2018 at a health system in the southeastern United States. Inverse probability of treatment weighting using propensity scores was utilized to balance confounders between patients with and without dementia to isolate the impact of dementia on PPCs. Regression analyses revealed that dementia did not have a statistically significant impact on the incidence and severity of PPCs or postoperative 30-day mortality. However, dementia significantly extended the hospital length of stay by an average of 1.37 days.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 8","pages":"1145-1156"},"PeriodicalIF":1.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10811580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10630460","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":"Decisional Regret in Long-Term Australian Allogeneic Hematopoietic Stem Cell Transplantation Survivors: A Cross-Sectional Survey.","authors":"Gemma McErlean,&nbsp;Caley Tapp,&nbsp;Lisa Brice,&nbsp;Anisha Pradhan,&nbsp;Nicole Gilroy,&nbsp;Masura Kabir,&nbsp;Matt Greenwood,&nbsp;Stephen R Larsen,&nbsp;John Moore,&nbsp;David Gottlieb,&nbsp;Mark Hertzberg,&nbsp;Louisa Brown,&nbsp;Megan Hogg,&nbsp;Gillian Huang,&nbsp;Christopher Ward,&nbsp;Ian Kerridge","doi":"10.1177/10547738231180337","DOIUrl":"10.1177/10547738231180337","url":null,"abstract":"<p><p>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an intensive but effective treatment for malignant and non-malignant diseases. However, long-term survival often comes at a cost, with survivors experiencing chronic morbidity and are at risk of relapse and secondary malignancy. This study aimed to describe decisional regret in a large cohort of Australian long-term allo-HSCT survivors. A cross-sectional survey was conducted with 441 adults in New South Wales, assessing quality of life (QoL), psychological, social, demographic, and clinical variables. Less than 10% of survivors expressed regret, with chronic graft-versus-host disease being the most important clinical factor. Psycho-socioeconomic factors such as depression, lower QoL scores, lower household income, higher treatment burden, and not resuming sex post-HSCT were also associated with regret. Findings highlight the need for valid informed consent and ongoing follow-up and support for allo-HSCT survivors dealing with life post-transplant. Nurses and healthcare professionals play a critical role in addressing decisional regret in these patients.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 8","pages":"1134-1144"},"PeriodicalIF":1.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299397","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":"Symptom Clusters in Adults with Post-COVID-19: A Cross-Sectional Survey.","authors":"Janet L Larson,&nbsp;Weijiao Zhou,&nbsp;Philip T Veliz,&nbsp;Sheere Smith","doi":"10.1177/10547738231191655","DOIUrl":"10.1177/10547738231191655","url":null,"abstract":"<p><p>More than 100 symptoms have been reported for post-coronavirus disease 2019 (COVID-19) and this study aimed to organize self-reported symptoms by identifying symptom clusters. We used a cross-sectional survey with a convenience sample of 491 adults who reported experiencing prolonged symptoms of COVID. A list of 25 symptoms of post-COVID-19 was used to measure the symptoms, and exploratory factor analysis was undertaken to identify symptom clusters for people with symptoms lasting 5 to 8 weeks and 9 weeks or longer. Six symptom clusters were identified for each of the two groups, and five clusters were similar across both groups: respiratory, general viral, smell/taste, cognitive cardiac, and mental health. The >9-week group reported symptoms primarily from two factors: respiratory-muscular and mental health. Post-COVID-19 symptom clusters differ across timeframes. Symptom clusters were useful in establishing coherent patterns of multiple complex symptoms.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 8","pages":"1071-1080"},"PeriodicalIF":1.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274345","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}

{"title":"Virtual Reality Headset Simulating a Nature Environment to Improve Health Outcomes in Pregnant Women: A Randomized-Controlled Trial.","authors":"Süreyya Kılıç,&nbsp;Sema Dereli Yılmaz","doi":"10.1177/10547738231184923","DOIUrl":"10.1177/10547738231184923","url":null,"abstract":"<p><p>The single-blind randomized-controlled experimental study aimed to determine the effects of watching nature images through virtual reality (VR) headset on stress, anxiety, and attachment levels of pregnant women with preterm birth threats (PBTs). The participants were 131 primiparous pregnant women admitted to the perinatology clinic due to PBT between April 5, 2022 and July 20, 2022. The intervention group watched videos containing nature images accompanied by nature sounds in six sessions through VR headset three times daily for 2 days. Each session lasted for 5 min. The data were accumulated with the Information Form, Stress Subscale of Depression Anxiety Stress Scale-21, State Anxiety Inventory, Prenatal Attachment Inventory, and Information Form of Satisfaction Level of VR Headset. State anxiety and stress levels of pregnant women in intervention group were statistically significantly lower than those in controls. There was no difference in prenatal attachment levels concerning intragroup comparisons of intervention group.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 8","pages":"1104-1114"},"PeriodicalIF":1.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10332691","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}

{"title":"Kidney Donor Perspectives on Acute Postoperative Pain Management.","authors":"Nathan J Dreesmann, Wonkyung Jung, Makiah Shebaili, Hilaire J Thompson","doi":"10.1177/10547738231156151","DOIUrl":"10.1177/10547738231156151","url":null,"abstract":"<p><p>This study employed a qualitative descriptive approach to examine living kidney donor's experience of postoperative pain. Thirteen living kidney donors aged 46.5 (±14.4) years participated in this study. Semi-structured interviews were conducted and transcribed. Transcripts were inductively coded and reviewed for trends, patterns, and insights into donor's experience of postoperative pain. Donors experienced postoperative pain from a variety of sources that hindered recovery and created anxiety and fear in some. Donors managed pain with opioid and non-opioid medications, social support, and ambulation. Donor's past experiences with and expectations about pain, relationships with intended recipients, social support, as well as motivations for and meaning of donation informed their experience of postoperative pain. Prompt pharmacologic intervention for pain, as well as further coaching and education about pain management should be emphasized for nurses caring for living kidney donors. Further study of how donor's motivation might mediate their pain experience is needed.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 8","pages":"1124-1133"},"PeriodicalIF":1.7,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10278841","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":"Predicting the Onset of Sepsis Using Vital Signs Data: A Machine Learning Approach.","authors":"An Tran,&nbsp;Robert Topp,&nbsp;Ebrahim Tarshizi,&nbsp;Anthony Shao","doi":"10.1177/10547738231183207","DOIUrl":"https://doi.org/10.1177/10547738231183207","url":null,"abstract":"<p><p>Sepsis is a major cause of mortality among hospitalized patients. Existing sepsis prediction methods face limitations due to their reliance on laboratory results and Electronic Medical Records (EMRs). This work aimed to develop a sepsis prediction model utilizing continuous vital signs monitoring, offering an innovative approach to sepsis prediction. Data from 48,886 Intensive Care Unit (ICU) patient stays were extracted from the Medical Information Mart for Intensive Care -IV dataset. A machine learning model was developed to predict sepsis onset based solely on vital signs. The model's efficacy was compared with the existing scoring systems of SIRS, qSOFA, and a Logistic Regression model. The machine learning model demonstrated superior performance at 6 hrs prior to sepsis onset, achieving 88.1% sensitivity and 81.3% specificity, surpassing existing scoring systems. This novel approach offers clinicians a timely assessment of patients' likelihood of developing sepsis.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 7","pages":"1000-1009"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393436","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}

{"title":"Performance of PROMIS Measures to Assess Fatigue and Sleep Symptom Severity Among African American Patients Newly Diagnosed With Obstructive Sleep Apnea.","authors":"Nicholas A Giordano, Francisco J Pasquel, Victoria Pak, Ann E Rogers, Selma Selimovic, Jordan Pelkmans, Andrew H Miller","doi":"10.1177/10547738231182550","DOIUrl":"10.1177/10547738231182550","url":null,"abstract":"<p><p>This pilot study examined the concurrent validity of Patient-Reported Outcomes Measurement Information System (PROMIS), Short Form, measures with the longer Multidimensional Fatigue Inventory among patients living with obstructive sleep apnea (OSA). A total of 26 African American patients living with prediabetes and newly diagnosed with OSA completed the six-item short form versions of PROMIS Fatigue and PROMIS Sleep Disturbance, and the longer 20-item Multidimensional Fatigue Inventory. Both PROMIS Fatigue and Sleep Disturbance scales demonstrated high reliability with Cronbach's α of .91 and .92, respectively. PROMIS Fatigue scores were significantly correlated with Multidimensional Fatigue Inventory scores (<i>r</i>_s = .53; <i>p</i> = .006) and demonstrated concurrent validity. However, PROMIS Sleep Disturbance scores and Multidimensional Fatigue Inventory scores were not associated with one another. The brief PROMIS Fatigue scale is a useful, succinct approach to assess fatigue severity among diverse patient populations living with OSA. This study is among the first to evaluate the performance of PROMIS Fatigue in a sample living with OSA.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 7","pages":"1041-1045"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11205279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393445","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":"Exploring Stigma, Resilience, and Alternative HIV Preventive Service Delivery Among Young Men who Have Sex with Men of Color.","authors":"Allysha C Maragh-Bass, Tia Williams, Harsh Agarwal, Akilah K Dulin, Jessica Sales, Kenneth H Mayer, Aaron J Siegler","doi":"10.1177/10547738231184295","DOIUrl":"10.1177/10547738231184295","url":null,"abstract":"<p><p>Stigmatization on the basis of race, sexuality, gender identity, and/or use of pre-exposure prophylaxis (PrEP) exacerbates HIV disparities for young men who have sex with men of color (YMSM). We explored resilience, healthcare experiences, stigma, and impact of coronavirus disease 2019 (COVID-19) on PrEP care needs among YMSM of color through virtual in-depth interviews. Analyses used adapted grounded theory/constant comparison. Regarding healthcare-based stigma, participants enacted multilevel resilience which was critical to their care retention during COVID-19 (Themes 1 and 2). Some participants noted that remote care could minimize healthcare stigma and promote retention in care and/or on PrEP (Theme 3). Participants were interested in long-acting injectable (LAI) PrEP but expressed concerns about cost, effectiveness, and side effects (Theme 4). Community-based venues like pharmacies were preferred spaces for getting LAI PrEP injections (Theme 4). Although expansion of telehealth that helped mitigate care retention challenges during COVID-19 was temporary, continued telehealth use may reduce stigmatization and promote long-term retention and PrEP persistence.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 7","pages":"1046-1056"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039914","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":"Predictors of Post-Percutaneous Coronary Intervention Chest Pain Among Coronary Heart Disease Patients.","authors":"Mohammad Jamil Abdelhaq,&nbsp;Abedalmajeed Methqal Shajrawi,&nbsp;Samantha Ismaile,&nbsp;Ahmed Mohammad Al-Smadi,&nbsp;Hekmat Yousef Al-Akash,&nbsp;Ala Ashour,&nbsp;Anas Salah,&nbsp;Ahmad Mohammad Abu-Safia","doi":"10.1177/10547738231184085","DOIUrl":"https://doi.org/10.1177/10547738231184085","url":null,"abstract":"<p><p>Patients who undergo percutaneous coronary intervention (PCI) procedure frequently suffer post-PCI chest pain (PPCP). This study aims to identify the changes in PPCP level and investigate the predictors of PPCP among patients with coronary heart disease at three measurement times: on admission (T1), 24 hours post-PCI (T2), and 30 days post-PCI (T3). A repeated-measure design was used. Significant differences were observed in PPCP levels between T1 and T2; between T2 and T3; and between T1 and T3. The predictors of PPCP are (1) high-intensity physical activities duration per week, (2) cardiac enzyme level upon admission, (3) increased ejection fraction, and (4) increased heart rate. The results highlight that identifying predictors of PPCP helps in determining high-risk patients, whereby evidence-based interventions can decrease readmission rates and reduce patient exposure to unnecessary investigations and procedures. More research is needed to explain the changes in PPCP level and to confirm these results.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 7","pages":"1010-1020"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982662","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}

{"title":"Home Healthcare Patients With Distinct Psychological, Cognitive, and Behavioral Symptom Profiles and At-Risk Subgroup for Hospitalization and Emergency Department Visits Using Latent Class Analysis.","authors":"Se Hee Min, Jiyoun Song, Lauren Evans, Kathryn H Bowles, Margaret V McDonald, Sena Chae, Maxim Topaz","doi":"10.1177/10547738231183026","DOIUrl":"10.1177/10547738231183026","url":null,"abstract":"<p><p>One-third of home healthcare patients are hospitalized or visit emergency departments during a 60-day episode of care. Among all risk factors, psychological, cognitive, and behavioral symptoms often remain underdiagnosed or undertreated in older adults. Little is known on subgroups of older adults receiving home healthcare services with similar psychological, cognitive, and behavioral symptom profiles and an at-risk subgroup for future hospitalization and emergency department visits. Our cross-sectional study used data from a large, urban home healthcare organization (<i>n</i> = 87,943). Latent class analysis was conducted to identify meaningful subgroups of older adults based on their distinct psychological, cognitive, and behavioral symptom profiles. Adjusted multiple logistic regression was used to understand the association between the latent subgroup and future hospitalization and emergency department visits. Descriptive and inferential statistics were conducted to describe the individual characteristics and to test for significant differences. The three-class model consisted of Class 1: \"Moderate psychological symptoms without behavioral issues,\" Class 2: \"Severe psychological symptoms with behavioral issues,\" and Class 3: \"Mild psychological symptoms without behavioral issues.\" Compared to Class 3, Class 1 patients had 1.14 higher odds and Class 2 patients had 1.26 higher odds of being hospitalized or visiting emergency departments. Significant differences were found in individual characteristics such as age, gender, race/ethnicity, and insurance. Home healthcare clinicians should consider the different latent subgroups of older adults based on their psychological, cognitive, and behavioral symptoms. In addition, they should provide timely assessment and intervention especially to those at-risk for hospitalization and emergency department visits.</p>","PeriodicalId":50677,"journal":{"name":"Clinical Nursing Research","volume":"32 7","pages":"1021-1030"},"PeriodicalIF":1.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11080676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10034515","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}