Nursing in Critical Care最新文献

{"title":"The effect of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit.","authors":"Dahae Choi, Hyewon Shin","doi":"10.1111/nicc.13154","DOIUrl":"10.1111/nicc.13154","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making is essential for improving infant prognoses. Medical staff should consider the effect of illness uncertainty and self-efficacy on parents' perceptions of shared decision-making.</p><p><strong>Aims: </strong>This study examined the impact of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit.</p><p><strong>Study design: </strong>A descriptive-analytical cross-sectional study design was used. Data were collected from April to June 2023. A total of 103 parents of infants admitted to the neonatal intensive care unit participated in this study. The participants used a self-report questionnaire that included general characteristics of their infants, uncertainty of illness, self-efficacy and perception of shared decision-making. Data were analysed using descriptive statistics, independent t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient and multiple linear regression.</p><p><strong>Results: </strong>Illness uncertainty (r = -.659, p < .001, 95% confidence interval = [-1.209, -0.765]) was negatively correlated with self-efficacy, and self-efficacy (r = .255, p = .009, 95% confidence interval = [0.082, 0.569]) was positively correlated with the perception of shared decision-making. Using multiple linear regression, the number of visits to the intensive care unit (β = -1.939, p = .015, 95% confidence interval = [-3.490, -0.389]) and parents' self-efficacy (β = .271, p = .028, 95% confidence interval = [0.030, 0.512]) had a statistically significant effect on the perception of shared decision-making, accounting for 11.9% of the total explanatory power.</p><p><strong>Conclusions: </strong>The results support that higher self-efficacy is associated with a higher degree of perception of shared decision-making among parents of infants in the intensive care unit. Therefore, clinicians might support parents in taking a more active role in shared decision-making by discussing available options with clinicians and reaching treatment plans together.</p><p><strong>Relevance to clinical practice: </strong>The study suggests creating scales to assess nurses' participation in shared decision-making and recommends educational programmes to boost parents' self-efficacy with infants, significantly affecting perceptions of shared decision-making.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13154"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-efficacy as a psychological resource in the management of stress suffered by ICU nurses during the COVID-19 pandemic: A prospective study on emotional exhaustion.","authors":"Fernanda Gil-Almagro, F Javier Carmona-Monge, Fernando J García-Hedrera, Cecilia Peñacoba-Puente","doi":"10.1111/nicc.13172","DOIUrl":"10.1111/nicc.13172","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) nurses have experienced a high degree of stress during the COVID-19 pandemic. While the literature on the consequences on emotional symptomatology is abundant, studies on the protective psychosocial variables that have contributed to buffering these consequences are scarcer.</p><p><strong>Aim: </strong>This study analyses the role of self-efficacy as a protective personality trait in ICU nurses during the COVID-19 pandemic, using a moderated mediation model that begins with the stress and anxiety experienced at the onset of the pandemic and concludes with the emotional exhaustion experienced 6 months later.</p><p><strong>Study design: </strong>Prospective longitudinal study with two data collection periods during the COVID-19 pandemic: (1) from 5 May to 21 June 2020 and (2) a follow-up 6 months after the state of alarm finalized (January-April 2021). These were both very stressful periods for ICU staff because of the COVID-19 pandemic. This study was conducted with 129 ICU nurses (a non-probabilistic convenience sample in the Spanish health care system). Socio-demographic, occupational and psychosocial variables (i.e. stress, anxiety, self-efficacy and emotional exhaustion) were assessed. Descriptive analyses, Pearson correlations, covariate analyses (i.e. Student's t-test, one-factor ANOVA) and moderated mediation analyses were carried out (SPSS PROCESS macro, model 7). STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) reporting guidelines were followed.</p><p><strong>Results: </strong>It shows that the higher the self-efficacy score, the lower the effect of stress on anxiety (p < .001); likewise, the moderating role of self-efficacy was equally valid for the whole final model (F = 8.790, p < .001), showing self-efficacy to be a good buffer for emotional exhaustion derived from the stress suffered in the ICU.</p><p><strong>Conclusions: </strong>Self-efficacy (i.e. the belief of being able to do certain tasks successfully) is shown to be a highly relevant trait to enhance among ICU nurses during the COVID-19 pandemic, allowing them to manage work stress effectively and thus buffering the development of anxiety in the short term and emotional exhaustion in the long term.</p><p><strong>Relevance to clinical practice: </strong>Our results point to the need to assess and take action on self-efficacy in ICU nurses in highly stressful situations such as the COVID-19 pandemic. As a psychological variable, self-efficacy refers to beliefs and therefore has to be trained by evidence-based psychological techniques, such as cognitive behavioural therapy. In addition, previous literature has pointed out that previous experience or specific training is an influential (although not a determining) factor in self-efficacy, so specialization for ICU nurses could also be considered.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13172"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of parents with very premature-born children at risk of neurodevelopmental disorders: A qualitative study.","authors":"Carmen Ropero-Padilla, Miguel Rodriguez-Arrastia, José Enrique Bernabé-Zuñiga, Antonio Javier Alias Castillo, Lola Rueda-Ruzafa, María Del Mar Sánchez-Joya","doi":"10.1111/nicc.13182","DOIUrl":"10.1111/nicc.13182","url":null,"abstract":"<p><strong>Background: </strong>Premature birth is a traumatic and stressful situation for parents who are immediately separated from their infant because of the newborn's need for specialized care. The staff of these units are in charge of following the principles of family-centred care and practices for neonates at risk of neurodevelopmental disorders, including providing training to the family during their hospital stay and after being discharged.</p><p><strong>Aim: </strong>The aim of this study is to explore the perceptions of parents of premature children at risk of neurodevelopmental disorders in regard to care, interventions and assistance provided during the first months of their child's life.</p><p><strong>Study design: </strong>A qualitative descriptive study was carried out through individual interviews. The data analysis was conducted through a thematic analysis. The methodology and results were reported following the standards for preparing qualitative research reports and recommendations.</p><p><strong>Results: </strong>Twenty-one parents of premature children were interviewed. From these interviews, three main themes emerged: (i) parents' perspectives on preterm birth risk communication, (ii) navigating parental support and early interventions in preterm birth and (iii) perceptions of preterm birth protective and challenging factors.</p><p><strong>Conclusions: </strong>The parents of premature children need to receive better communication about the care and interventions for their child, and it is necessary that health personnel are better trained in terms of management and administration of public resources. Strategies must be implemented that continuously guide parents on the follow-up and care of their premature child not only during their first moments of life but also after being discharged from the hospital.</p><p><strong>Relevance to clinical practice: </strong>This study highlights the need to improve care for parents with premature infants at risk, emphasizing the necessity for health care system reforms and support structures, allowing health care professionals to enhance attention and care.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13182"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience of surrogate decision-making and deciphering critically ill patient values: A qualitative study.","authors":"Yuling Lei, Weijing Sui, Ling Chen, Qi Zhou, Yiyu Zhuang","doi":"10.1111/nicc.13171","DOIUrl":"10.1111/nicc.13171","url":null,"abstract":"<p><strong>Background: </strong>Surrogate decision-makers (SDMs) who make decisions for critically ill patients often face great challenges. Although shared decision-making has been advocated, its implementation has been less than satisfactory.</p><p><strong>Aim: </strong>To explore the experience of the surrogate decision-making process and determine how SDMs understand the values and preferences of critically ill patients.</p><p><strong>Study design: </strong>A constructivist qualitative study was used. The data were collected using semistructured interviews with four questions conducted between January and February 2023. The audio recordings were transcribed verbatim and analysed via thematic analysis. Fourteen SDMs (all family members) of 10 critically ill patients were recruited according to the inclusion criteria.</p><p><strong>Results: </strong>We identified eight sub-themes that were classified into three themes: (a) the unbalanced act: no respite for the surrogates, conflict between rationality and emotion, and sacrifice in surrogate decision-making; (b) unclear values and preferences: ignored values, intentional silence and substituted values; and (c) unsatisfying surrogate decisions: decision regret and decreased surrogate decision-making self-efficacy.</p><p><strong>Conclusion: </strong>These findings underscore the urgent need for enhanced communication strategies and support systems to better assist SDMs in navigating their roles. Effective interventions could help clarify patients' values and preferences, thereby improving the decision-making process and outcomes for both SDMs and patients.</p><p><strong>Relevance to clinical practice: </strong>Misalignment between patient values and those of SDMs can potentially degrade the quality of decision-making. Clinicians should be skilled in stimulating SDMs to think about patient values and preferences.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13171"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480254","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":"Iron, selenium, copper and magnesium in critical care: Impact on acquired weakness risk through Mendelian randomization.","authors":"Li Zhang, Hong Zhi Sun, Yuwei Sun, Jinxin Zhang, Xinli Ma","doi":"10.1111/nicc.70032","DOIUrl":"https://doi.org/10.1111/nicc.70032","url":null,"abstract":"<p><strong>Background: </strong>Trace elements play a crucial role in the health of critically ill patients, yet their impact on acquired weakness remains unclear.</p><p><strong>Aim: </strong>This study utilized Mendelian randomization (MR) to explore the relationship between iron, selenium, copper, magnesium, zinc and debilitation risk in this population. The aim of study was to investigate the influence of specific trace elements on acquired weakness in critically ill patients and determine their protective or risk effects.</p><p><strong>Study design: </strong>This project collected a total of 164 627 exposure related datasets and 4 518 732 outcome related datasets. Mendelian randomization was employed to analyse data on trace elements in critically ill patients, assessing how iron, selenium, copper, magnesium and zinc may impact debilitation risk.</p><p><strong>Results: </strong>This study explored the causal relationships between trace elements (iron, copper, zinc, selenium and magnesium) and outcomes (muscle dysfunction, muscle damage and respiratory infections) in critically ill patients. For example, the analysis of iron (ukb-b-20 447) and diaphragmatic hernia (ukb-b-8848) using the Inverse Variance Weighted (IVW) method showed an odds ratio (OR) of 0.996 (95% CI: 0.993-0.999, p = .004). Overall, MR results indicated that iron and selenium are protective factors, while copper and magnesium are risk factors for acquired weakness. Zinc was not causally associated with acquired weakness in critically ill patients.</p><p><strong>Conclusions: </strong>This study highlights the importance of understanding the role of specific trace elements in acquired weakness among critically ill patients, providing valuable insights for personalized care strategies to enhance patient outcomes.</p><p><strong>Relevance to clinical practice: </strong>The findings offer new theoretical foundations and potential molecular targets for the prevention and treatment of debilitation in critical care settings.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70032"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008396","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":"Development and validation of a prediction model for in-hospital mortality in patients with sepsis.","authors":"Wen Shi, Mengqi Xie, Enqiang Mao, Zhitao Yang, Qi Zhang, Erzhen Chen, Ying Chen","doi":"10.1111/nicc.70015","DOIUrl":"10.1111/nicc.70015","url":null,"abstract":"<p><strong>Background: </strong>Sepsis, a life-threatening condition marked by organ dysfunction due to a dysregulated host response to infection, involves complex physiological and biochemical abnormalities.</p><p><strong>Aim: </strong>To develop a multivariate model to predict 4-, 6-, and 8-week mortality risks in intensive care units (ICUs).</p><p><strong>Study design: </strong>A retrospective cohort of 2389 sepsis patients was analysed using data captured by a clinical decision support system. Patients were randomly allocated into training (n = 1673) and validation (n = 716) sets at a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression identified variables incorporated into a multivariate Cox proportional hazards regression model to construct a prognostic nomogram. The area under the receiver operating characteristic curve (AUROC) assessed model accuracy, while performance was evaluated for discrimination, calibration and clinical utility.</p><p><strong>Results: </strong>A risk score was developed based on 11 independent predictors from 35 initial factors. Key predictors included minimum Acute Physiology and Chronic Health Evaluation II (APACHE II) score as having the greatest impact on prognosis, followed by days of mechanical ventilation, number of vasopressors, maximum and minimum Sequential Organ Failure Assessment (SOFA) scores, infection sources, Gram-positive or Gram-negative bacteria and malignancy. The nomogram demonstrated superior discriminative ability, with AUROC values of 0.882 (95% confidence interval [CI], 0.855-0.909) and 0.851 (95% CI, 0.804-0.899) at 4 weeks; 0.836 (95% CI, 0.798-0.874) and 0.820 (95% CI, 0.761-0.878) at 6 weeks; and 0.843 (95% CI, 0.800-0.887) and 0.794 (95% CI, 0.720-0.867) at 8 weeks for training and validation sets, respectively.</p><p><strong>Conclusion: </strong>A validated nomogram and web-based calculator were developed to predict in-hospital mortality in ICU sepsis patients. Targeting identified risk factors may improve outcomes for critically ill patients.</p><p><strong>Relevance to clinical practice: </strong>The developed prediction model and nomogram offer a tool for assessing in-hospital mortality risk in ICU patients with sepsis, potentially aiding in nursing decisions and resource allocation.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70015"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending the interval for changing flushing solutions for central venous and arterial line systems in the intensive care unit: An evidence-based quality improvement project.","authors":"Junel Padigos, Lauren Murray, Olivia Bredhauer, Jenny Jaspers, Sue Bethune","doi":"10.1111/nicc.70034","DOIUrl":"10.1111/nicc.70034","url":null,"abstract":"<p><strong>Background: </strong>Central venous lines (CVLs) and arterial lines (ALs) are commonly used for patients in the intensive care units (ICUs) to facilitate the administration of medications and haemodynamic monitoring. In an ICU in Queensland, Australia (AU), saline (sodium chloride 0.9%) flush bags used for these lines were routinely changed every 24 h following organizational policy that all intravenous fluid bags are to be changed within a 24-h period.</p><p><strong>Aim: </strong>This quality improvement (QI) project aimed to evaluate current practice guided by the Plan-Do-Study-Act (PDSA) model of QI and implementation science. Benchmarking practices with other ICUs was conducted.</p><p><strong>Study design: </strong>A narrative literature review focused on evaluating the safe interval for changing flush solutions every 24 h was performed using EBSCO Medline, CINAHL, Cochrane Library, Embase and Google Scholar databases for citations up to November 2022. Bloodstream infection rates attributed to CVLs and/or ALs were monitored. Economic analysis was performed. End-user feedback was sought. A change of practice was implemented for a 1-year study period (March 2023 - March 2024) to extend dwell times of flushing solutions for CVLs and ALs from every 24 h to every 96 h.</p><p><strong>Results: </strong>One-year post-implementation, no bloodstream infections were linked to CVLs or ALs. A simplified economic analysis was performed based on costs of 0.9% sodium chloride 500-mL fluid bags, which revealed that changing the fluid bags once every 96 h resulted in a per patient saving of AU$3.21 for any individual AL or CVL and up to AU$6.42 per patient where both an AL and CVL are in situ, based on fluid bag cost at AU$1.07 per bag. This saving excludes potential savings from reduced nursing time, infection-related costs and recycling costs.</p><p><strong>Conclusion: </strong>A sustainable practice change based on evidence was implemented in the local ICU. The use of the PDSA model of the QI process and the principles of implementation science strengthened the buy-in and implementation of the project.</p><p><strong>Relevance to clinical practice: </strong>This practice change was examined through lenses of evidence-based practice, environmental sustainability (minimizing environmental footprint by limiting plastic bag usage), patient safety, cost minimization, and reduced nursing workload.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70034"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trial protocol for continuous glucose monitoring in critical care at Hospital Clinic of Barcelona (CGM-UCI23).","authors":"Marc Pañero-Moreno, Eva Maria Guix-Comellas, Alberto Villamor-Ordozgoiti","doi":"10.1111/nicc.13198","DOIUrl":"10.1111/nicc.13198","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycaemia is common in intensive care units (ICUs), with a prevalence of up to 86.2%, increasing mortality. Technology has evolved towards continuous glucose monitoring (CGM), and its use in ICUs began especially during the coronavirus pandemic (COVID-19). Various studies have evaluated the reliability of CGM, indicating that it is safe for use in critically ill patients.</p><p><strong>Aim: </strong>The aim of this study was to compare the use of CGM with point-of-care glucose (POC-G) testing in ICU. Specific objectives include evaluating the glycaemic control, the frequency of POC-G measurements, the incidence of hyperglycaemia, hypoglycaemia and morbidity and mortality at 90 days.</p><p><strong>Study design: </strong>An experimental, controlled and randomized clinical trial with a single-blind design will be conducted at Hospital Clinic of Barcelona (HCB). A sample size of 376 participants will be recruited and randomly assigned to two groups: an experimental group, where glycaemic management will be based on CGM; and a control group, where glucose will be managed through POC-G testing, with a blinded CGM.</p><p><strong>Results: </strong>The primary variable considered will be time in range (TIR), with secondary outcomes including, time above range (TAR), time below range (TBR), number of POC-G measurements, incidence of hyperglycaemia and hypoglycaemia, and mortality. Hypothesis testing will use the Kolmogorov-Smirnov test to assess data normality, with appropriate statistical tests applied, considering a p-value <.05.</p><p><strong>Relevance to clinical practice: </strong>The results obtained will help us understand the impact of CGM on critically ill patients. CGM could potentially reduce the workload of nurses and improve the efficiency of decision-making by the ICU team, enabling early identification and treatment of glucose complications, thereby enhancing safety. Patient safety, a reduction in patient fingerstick and a decreased care burden are the criteria that add value to this research.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13198"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soulful support: Exploring critical care nurses' spiritual caregiving towards end-of-life scenario.","authors":"Ayman Mohamed El-Ashry, Sameh Eltyebani, Shimmaa Mohamed Elsayed, Mahmoud Abdelwahab Khedr, Mona Metwally El-Sayed, Mohamed Adel Ghoneam, Haitham Mokhtar Mohamed Abdallah","doi":"10.1111/nicc.70026","DOIUrl":"10.1111/nicc.70026","url":null,"abstract":"<p><strong>Background: </strong>Critical care nursing often involves providing care in environments where mortality is prevalent. Nurses' attitudes towards death significantly influence their approach to spiritual caregiving, which addresses patients' emotional, psychological and spiritual needs. Understanding this relationship is crucial for improving holistic care and patient outcomes.</p><p><strong>Aim: </strong>Investigates how spiritual caregiving affects critical care nurses' attitudes towards death.</p><p><strong>Study design: </strong>A descriptive correlational research design was used. The study included a convenient sample of 931 critical care nurses from four hospitals. Data were collected using the death attitude profile and the Arabic version of the Spiritual Caregiving Scale.</p><p><strong>Results: </strong>Nurses showed a positive attitude towards spiritual caregiving, with mean scores ranging from 3.89 to 4.24 across spiritual subscales. However, high levels of fear (mean = 4.48, SD = 1.32) and death avoidance (mean = 4.66, SD = 1.29) were prevalent, particularly among younger, male and urban nurses. A significant positive correlation was found between spiritual caregiving and acceptance of death (r = 0.266, p < 0.001, 95% CI [0.198, 0.334]), while a negative correlation was observed with fear of death (r = -0.109, p < 0.001, 95% CI [-0.182, -0.036]) and death avoidance (r = -0.010, p = 0.755, 95% CI [-0.083, 0.063]). Multivariate regression indicated that deeper engagement in spiritual caregiving predicted more positive or neutral attitudes towards death (B = -0.390, p < 0.001, 95% CI [-0.467, -0.313], R² = 0.117).</p><p><strong>Conclusion: </strong>Spiritual caregiving was associated with more positive death attitudes among critical care nurses, indicating its potential to enhance holistic care in critical settings.</p><p><strong>Relevance to clinical practice: </strong>Integrating spiritual caregiving into clinical practice enhances holistic care by addressing patients' emotional, psychological and spiritual needs while helping nurses manage their fear and avoidance of death. This approach promotes emotional resilience, job satisfaction and compassionate care, ultimately improving patient outcomes and supporting critical care nurses in delivering high-quality care in demanding, mortality-prevalent environments.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":"30 3","pages":"e70026"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007810","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":"Characteristics of oral mucosal pressure injuries in children with orotracheal intubation in intensive care units: An observational study.","authors":"Yueyue Zhao, Jie Guo, Jie Ma, Yanjun Ge, Junna Wang, Conghui Li, Caixiao Shi","doi":"10.1111/nicc.13174","DOIUrl":"10.1111/nicc.13174","url":null,"abstract":"<p><strong>Background: </strong>Tracheal intubation can be used for ventilation to ensure an unobstructed respiratory tract, and it is the most common respiratory support technique used in paediatric intensive care unit (PICU) patients. Orotracheal intubation is usually the preferred method of tracheal intubation. However, it can cause stress-related damage to the oral mucosa. Identifying the factors that cause oral mucosal pressure injury (OMPI) can prevent its occurrence in children with oral endotracheal intubation.</p><p><strong>Aim: </strong>To examine the characteristics of OMPI in children who underwent orotracheal intubation in the PICU and to assess their influencing factors.</p><p><strong>Study design: </strong>An observational, prospective study. Data were gathered from the PICU of a tertiary hospital in China between January 2023 and October 2023. The patient data were obtained from the 'General Information Questionnaire', 'Paediatric Critical Illness Score', 'STRONGkids Scale' and 'OMPI Staging and Assessment Tools'. Data analysis was subsequently performed using univariate and logistic regression analyses.</p><p><strong>Results: </strong>A total of 187 children who underwent orotracheal intubation were analysed. During the observation period, 44.92% (n = 84) of the children developed OMPI. It comprised 63.10% (n = 53) of stage I injuries, 33.33% (n = 28) of stage II injuries and 3.57% (n = 3) of stage III injuries. The common injury sites were the lower jaw (48.81%), upper jaw (29.76%), tongue (20.24%) and joints (10.71%). The logistic regression analysis results revealed that high critical illness (OR = 0.835, 95% CI: 0.726-0.961), long intubation time (OR = 1.043, 95% CI: 1.021-1.067), prone ventilation (OR = 6.708, 95% CI: 1.421-31.670), hypothermia (OR = 5.831, 95% CI: 1.208-28.149), use of dental pads (OR = 5.520, 95% CI: 1.150-26.487) and low albumin levels (OR = 6.238, 95% CI: 1.285-30.281) were the main contributing factors for OMPI in children with orotracheal intubation (p < .05).</p><p><strong>Conclusions: </strong>The occurrence of OMPI in children who underwent orotracheal intubation in the PICU was notable and was predominantly observed in stages I and II. Consequently, clinical nursing personnel should proactively recognize risk factors and administer timely interventions to mitigate the occurrence of OMPI in such children.</p><p><strong>Relevance to clinical practice: </strong>The incidence of OMPI in children who underwent orotracheal intubation was relatively high. Nurses and doctors should closely monitor the risk factors for orotracheal intubation in children to prevent the occurrence of OMPI.</p>","PeriodicalId":51264,"journal":{"name":"Nursing in Critical Care","volume":" ","pages":"e13174"},"PeriodicalIF":3.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}