American Journal of Critical Care最新文献_第9页

Moral Distress, Coping Resilience, and Self-Care: A Study of Nurses in the Intensive Care Unit. 道德困扰、应对弹性与自我护理：重症监护室护士的研究。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-11-01 DOI: 10.4037/ajcc2025894

Brittany Kelly, Cara Gallegos, Anna C Quon

{"title":"Moral Distress, Coping Resilience, and Self-Care: A Study of Nurses in the Intensive Care Unit.","authors":"Brittany Kelly, Cara Gallegos, Anna C Quon","doi":"10.4037/ajcc2025894","DOIUrl":"https://doi.org/10.4037/ajcc2025894","url":null,"abstract":"Background: Critical care nurses are regularly exposed to situations that may create moral distress. Moral distress has been correlated with higher rates of nursing burnout, emotional withdrawal, and traumatic stress syndrome.Objectives: This descriptive correlational study aimed to describe the relationships between moral distress, coping resilience, and self-care practices.Methods: An electronic survey was sent to nurses in 5 intensive care units within 1 hospital system from February 2023 through April 2023. Nurses were asked to answer questions about their demographic characteristics, moral distress, coping resiliency, and self-care practices.Results: Seventy-four staff nurses participated in the survey. Overall, nurses reported the highest levels of moral distress from the following: a family's insistence on aggressive treatment, continuing to provide aggressive treatment despite unlikely effectiveness, and excessive documentation requirements. Results showed a statistically significant (but weak) positive correlation between mindful self-care and resilient coping (r65 = 0.27, P = .03).Conclusions: A positive correlation between mindful self-care and coping resilience was identified, which suggests that self-care may influence resiliency. Participants indicated frequent use of outside support systems such as supportive structures and supportive persons. These systems may be ideal mechanisms through which to support nurses in the future.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 6","pages":"451-457"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420920","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}

引用次数: 0

Pediatric Intensivist Coverage and Outcomes in Critically Ill Children: A Cohort Study. 危重儿童的儿科重症医师覆盖率和预后：一项队列研究。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-11-01 DOI: 10.4037/ajcc2025981

Kyunghoon Kim, In-Ae Song, Chang Won Choi, Kyung Soon Kim, Sun Hee Shin, Chun Han Kim, Tak Kyu Oh

{"title":"Pediatric Intensivist Coverage and Outcomes in Critically Ill Children: A Cohort Study.","authors":"Kyunghoon Kim, In-Ae Song, Chang Won Choi, Kyung Soon Kim, Sun Hee Shin, Chun Han Kim, Tak Kyu Oh","doi":"10.4037/ajcc2025981","DOIUrl":"https://doi.org/10.4037/ajcc2025981","url":null,"abstract":"Background: The impact of trained intensivist staffing on critically ill pediatric patients requiring intensive care unit (ICU) admission is not clear.Objective: To examine whether trained intensivist coverage is associated with improved survival outcomes in critically ill pediatric patients.Methods: The analysis included all pediatric patients hospitalized in ICUs in South Korea from 2017 through 2021. The intensivist and nonintensivist groups included pediatric ICU patients in hospitals with and without trained intensivists, respectively.Results: This study included 28 047 critically ill pediatric patients. Among them, 9909 (35.3%) were admitted to ICUs of hospitals where trained intensivists were dedicated to patient management, and these patients were subsequently assigned to the intensivist group. After propensity score matching, 16 992 critically ill pediatric patients (8496 in each group) were included in the final analysis. The all-cause mortality rates for 90 days and 1 year were 6.7% (566/8496) and 8.3% (709/8496) in the intensivist group, and 8.6% (732/8496) and 9.8% (835/8496) in the nonintensivist group, respectively. In the Cox regression analysis, the intensivist group showed 24% (hazard ratio [HR], 0.76; 95% CI, 0.68-0.85; P < .001) and 17% (HR, 0.83; 95% CI, 0.75-0.92; P < .001) lower 90-day and 1-year all-cause mortality rates, respectively, than the nonintensivist group.Conclusions: The presence of pediatric intensivists in the ICU substantially reduced the mortality of critically ill pediatric patients. The findings highlight the significant role of pediatric intensivists in reducing long-term mortality among critically ill pediatric patients.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 6","pages":"e46-e58"},"PeriodicalIF":2.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420943","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}

引用次数: 0

"Leave No Question Unanswered": Nurses' Role in Preparing Children's Families During End-of-Life Care. “不留任何疑问”：护士在临终关怀中为儿童家庭做准备的角色。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025791

Elizabeth G Broden Arciprete, Ijeoma J Eche-Ugwu, Danielle D DeCourcey, Abby R Rosenberg, Jennifer M Snaman

{"title":"\"Leave No Question Unanswered\": Nurses' Role in Preparing Children's Families During End-of-Life Care.","authors":"Elizabeth G Broden Arciprete, Ijeoma J Eche-Ugwu, Danielle D DeCourcey, Abby R Rosenberg, Jennifer M Snaman","doi":"10.4037/ajcc2025791","DOIUrl":"https://doi.org/10.4037/ajcc2025791","url":null,"abstract":"Background: Parents who report feeling prepared for symptoms and circumstances around their child's end of life report less adverse bereavement outcomes. Yet, the actions that bedside clinicians can initiate to help families feel prepared for a child's death remain unclear.Objectives: To identify actions that nurses engage in to prepare families for the dying process.Methods: A deductive approach was used to analyze qualitative data from focus groups and interviews with 20 pediatric intensive care unit nurses.Results: Most of the 20 nurse participants identified as White women (n = 17; 85%). They reported a broad range of pediatric intensive care unit experience (1-24 years), and most (n = 17; 85%) had cared for at least 10 patients nearing end of life. The study included 3 categories of preparatory actions: leveraging experience and familiarity (processes nurses used to ready themselves to support families navigating end-of-life care), coordinating collaborative team support (optimizing interprofessional teamwork and developing adaptable care plans), and titrating family-responsive support (adjusting interactions or behaviors based on the family's needs).Conclusions: Combining nurse experience and familiarity, clinical team collaborations, and family-responsive support may offer a comprehensive approach to preparing families of children nearing end of life. Studying end-of-life preparation with larger samples of nurses and families is necessary. Nurses may incorporate these actions into their serious illness care to help support families of children nearing end of life.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"380-384"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939020","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}

引用次数: 0

Racial Disparities in Cardiogenic Shock Outcomes: Single-Center Retrospective Study. 心源性休克结果的种族差异：单中心回顾性研究。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025563

Rafik I Issa, Sarah K Adie, Vince D Marshall, Scott W Ketcham, Matthew C Konerman

{"title":"Racial Disparities in Cardiogenic Shock Outcomes: Single-Center Retrospective Study.","authors":"Rafik I Issa, Sarah K Adie, Vince D Marshall, Scott W Ketcham, Matthew C Konerman","doi":"10.4037/ajcc2025563","DOIUrl":"10.4037/ajcc2025563","url":null,"abstract":"Background: Race influences outcomes in patients with cardiovascular diseases. However, the impact of race on cardiogenic shock outcomes is unclear.Methods: This retrospective cohort study included adult patients admitted to a cardiac intensive care unit for cardiogenic shock from June 2019 through June 2023. For analysis, patients were divided into 3 racial groups: White, Black, and other. Baseline demographics, comorbidities, admission source, and Sequential Organ Failure Assessment scores were collected. Primary outcomes were hospital and cardiac intensive care unit mortality. Secondary outcomes were hospital and cardiac intensive care unit lengths of stay and temporary mechanical circulatory support use. Propensity score weighting was used; pairwise comparisons between each group were performed.Results: The analysis included 2458 patients (1959 White, 327 Black, 172 other). Black patients were younger, were less likely to be admitted from the emergency department (and more likely to be admitted from inpatient wards), and had higher Sequential Organ Failure Assessment scores than patients in the other 2 groups. Propensity-weighted pairwise comparisons demonstrated no significant differences in hospital and cardiac intensive care unit mortality. However, Black patients had significantly longer hospital (incidence rate ratio, 1.31; P < .001) and cardiac intensive care unit (incidence rate ratio, 1.33; P = .03) stays than did White patients but not patients in the \"other\" group. Temporary mechanical circulatory support use did not differ among groups.Conclusions: The results highlight disparities in clinical management of cardiogenic shock and the need for further research to address these inequities.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"385-389"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939170","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}

引用次数: 0

Response. 响应。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025789

Valerie J Renard, Parisa Farahani, Amy L B Frazier, Lana Wahid, Leanne M Boehm, Marianna LaNoue, Oluwatosin Akingbule, Hanzhang Xu, David Edelman, Truls Østbye

引用次数: 0

Ethics, Artificial Intelligence, and Critical Care Nursing. 伦理、人工智能和重症护理。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025758

Catherine Green

引用次数: 0

Pulmonary Artery Catheter Guidelines for Invasive Hemodynamic Monitoring on the Cardiology Progressive Care Unit. 心内科进展监护病房有创血流动力学监测肺动脉导管指南。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025808

Ryan MacGillivray, Linda Hoke

引用次数: 0

Acting on Purpose in Clinical Care and Research. 临床护理与研究中的目的性行为。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025653

Cindy L Munro, Lakshman Swamy

引用次数: 0

Registered Nurses and Meaningful Recognition: Contemporary Preferences of a Diverse Workforce. 注册护士和有意义的认可：多元化劳动力的当代偏好。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025995

Michelle C Hehman, Nicole M Fontenot, Carliss D Ramos, Joanne D Muyco, Alexis E Hayes, Regis E Meyer, Kevin Asirifi

{"title":"Registered Nurses and Meaningful Recognition: Contemporary Preferences of a Diverse Workforce.","authors":"Michelle C Hehman, Nicole M Fontenot, Carliss D Ramos, Joanne D Muyco, Alexis E Hayes, Regis E Meyer, Kevin Asirifi","doi":"10.4037/ajcc2025995","DOIUrl":"https://doi.org/10.4037/ajcc2025995","url":null,"abstract":"Background: Meaningful recognition acknowledges the value of individuals' professional contributions to an organization's work. Long recognized as necessary to retain nurses, it includes formal awards programs, informal feedback processes, salary, and scheduling flexibility. With demographic characteristics of the nursing workforce changing, new research is needed to understand how contemporary nurses view meaningful recognition.Objectives: To evaluate nurses' perceptions of meaningful recognition and the health of their work environment and to explore associations between demographic characteristics and meaningful recognition preferences.Methods: Participants were registered nurses from a large, urban health care system. Study instruments included the Meaningful Recognition Questionnaire, Healthy Work Environment Assessment Tool, and open-ended questions. Analysis of variance was used to test associations between demographics and meaningful recognition preferences.Results: Surveys were completed by 565 nurses (mean [SD] age, 43 [11] years; 521 women [92.2%]). Salary was the most valued form of recognition, followed by private verbal feedback and written acknowledgment. Unlike earlier studies, professional development opportunities were the least valued form of recognition, reflecting a shift in nurse preferences. Demographic differences influenced recognition preferences, highlighting the need for personalized and inclusive recognition programs.Conclusions: Effective meaningful recognition is crucial to foster a healthy work environment and improve nurse retention. Updating recognition practices to align with evolving nurse preferences and demographic changes is essential to maintain a supportive and engaging work environment.","PeriodicalId":7607,"journal":{"name":"American Journal of Critical Care","volume":"34 5","pages":"335-344"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939092","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}

引用次数: 0

Personalizing Meaningful Recognition. 个性化有意义的认可。

IF 2.2 3区医学

American Journal of Critical Care Pub Date : 2025-09-01 DOI: 10.4037/ajcc2025964

Cindy Cain

引用次数: 0