Nursing Reports

(1) Background: Currently, Taiwan has adopted a “person-centered” approach to Advance Care, including Hospice Palliative Care and Advance Decisions, both of which are intended to enhance the right of individuals to choose their own end-of-life care; however, it is extremely challenging and difficult to implement the principle of autonomy for psychiatric patients. (2) Methodology: The aim in this study is to investigate the factors affecting the intention of day ward patients to sign up for hospice and palliative care by using the questionnaire content of the “Survey on Knowledge, Attitude Toward, Experience, and Behavior Intention to Sign Up for Hospice and Palliative Care”. A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. An independent sample t-test, Pearson’s correlation analysis, and stepwise regression analysis were used to determine the factors influencing the intention of psychiatric patients to sign up for advanced care planning. (3) Results: The relationships between knowledge of and attitude toward advanced care planning, knowledge of and behavior intention to sign up for advanced care planning, and attitude toward and behavior intention to sign up for advanced care planning were all positive (p-value < 0.001). The final three most relevant indicators were attitude toward hospice and palliative care, hospitalization of family members during the previous five years, and death of a close friend within the previous five years. (4) Conclusions: The results of the study show that the hospice and palliative care attitude and past experience of psychiatric patients affect the intention to sign up, reminding us that psychiatric patients are at an increased risk of decision-making disability as their illness progresses and that, in addition to initiating the discussion of Advance Care Planning as soon as possible, it may be an opportune time for medical professionals to actively promote Advance Care Planning among their patients. Full article

Among healthcare workers, nurses are considered the core of healthcare auth–info services in healthcare facilities because of their responsibilities and duties toward patients. All healthcare professionals, especially nurses, must be completely knowledgeable about the hazards of ionizing radiation, and the most effective radiation protection techniques. This study assessed the attitude and awareness toward radiation protection among final-year nursing students in the Fatima College of Health Sciences (FCHS) campuses. An online cross-sectional survey was conducted between March and April 2022. A total of 200 out of 224 female participants ranging from 18 to 30 years old agreed to participate in the study. The highest percentage of final-year nursing students did not attend any radiation protection course (52%). The results of the last section of the survey indicate a lack of awareness of basic radiation protection knowledge among final-year nursing students in FCHS campuses (less than 80%). The results showed a lack of knowledge and poor attitude toward radiation hazards and radiation protection from final-year nursing students in the FCHS. Formal education about basic radiation and radiation is recommended in the nursing program for safe clinical practice. Full article

Patients with diabetes must have self-efficacy to perform necessary self-care tasks. Self-efficacy has been considered as one of the primary motivators on diabetes self-care; therefore, it is essential for health care professionals to assess the self-efficacy of patients with diabetes to provide optimal care. Despite older Korean immigrants having greater difficulty in diabetes management, research on self-efficacy for them is lacking. This study aims to examine the psychometric property of the General Self-Efficacy scale Korean version for older Korean immigrants with diabetes in the United States. In this cross-sectional, methodological study, data were collected using convenience sampling. Cronbach’s alpha, exploratory factor analysis, and confirmatory factor analysis were employed to examine the psychometric properties. Cronbach’s alpha for the entire GSE scale Korean version is 0.81. The initial Eigenvalues show two factors, coping and confidence; however, the confirmatory factor analysis showed reasonable goodness of fit to the data (χ²(35) = 86.24, p < 0.01), χ²/df ratio = 2.46, AGFI = 0.87, GFI = 0.91, IFI = 0.90, ECVI = 0.74, CFI = 0.89, and RMSEA = 0.093 in the one-factor model. The General Self-Efficacy scale Korean version demonstrated acceptable reliability and validity. It can be used to investigate self-efficacy and to devise culturally tailored diabetes interventions. Full article

Weight self-stigma refers to negative self-prejudice due to the internalization of negative social messages about one’s weight. People with high self-stigma may have low self-esteem and decreased social activity. Weight-related self-stigma can create diet-related disorders since it is highly related to the recognition of body types. However, there are no tools available to measure the weight-related stigma of the general public in Korea. This study evaluated the validity and reliability of the Korean version of the Weight Self-Stigma Questionnaire (WSSQ-K). A methodological study was conducted with 150 Korean university students. Construct validity was evaluated using exploratory factor analysis. The WSSQ-K was correlated with body mass index and measures of self-esteem and weight concern to evaluate concurrent validity. Internal consistency reliability was evaluated with Cronbach’s alpha. In the exploratory factor analysis, two factors were proposed: “self-devaluation” (Cronbach’s α = 79) and “fear of enacted stigma” (Cronbach’s α = 82). Factor loadings for the 12 items on two factors ranged from 0.539 to 0.811, which explained 53.3% of the total variance. The WSSQ-K correlated with body mass index, self-esteem, and weight concern. The findings showed that the WSSQ-K was a reliable and valid measure that could be used for evaluating weight self-stigma in normal-weight adults in Korea. Full article

Background: Health literacy was identified as a main determinant in self-care of chronic diseases. This results in responsibilities for health professionals for daily practice. For primary care setting, special requirements arise due to the heterogeneity of communities. The objective of this scoping review was to explore and map the scope of the research material on strategies led by community health nurses to improve health literacy in (patients with) chronic diseases. This review aimed to identify gaps in the literature and existing approaches on promoting health literacy by community nurse practitioners. Methods: The following criteria were included for the research: Adults with chronic diseases, health literacy, community health nursing and primary healthcare. All types of searches for studies from 1970 to present were carried out in electronic databases and in a Google and a Google Scholar search. The search procedure is presented in a flow chart. Results: From all reviewed studies, nine records were included in the review. Findings with regard to the increase in health literacy in self-management of chronically ill patients were identified. Conclusion: Studies focusing on specific demands with regard to the role of community health nurses need to be carried out in depth. Full article

Innovation is crucial to an effective healthcare system, and nurses are key figures in the innovation process. A potential factor behind innovation in nursing is the creative style of nurses. Creativity is an essential component of innovation. However, the relationship between creative style and innovation is complex and involves many different factors. Among them, given the nature of the nursing profession, we propose emotional regulation, or the ability to effectively manage one’s emotions. In this study, we hypothesize that two specific emotion-regulation strategies, positive reappraisal and putting into perspective, play a role in the relationship between nurses’ creative style and innovative behaviors. We tested a moderated mediation model using cross-sectional data from 187 nurses working in 3 university hospitals in Bojnord, Iran, in 2019. Our results show that positive reappraisal completely mediates the relationship between creative style and innovative behaviors, while putting into perspective moderates the relationship between positive reappraisal and innovative behaviors. These results suggest that nurses with a flair for creativity may be able to implement innovative behaviors in the workplace due to their ability to understand work-related situations and events positively. This may be especially true for nurses who can adopt alternative viewpoints. Our study discusses these findings by highlighting the importance of emotional regulation mechanisms in transforming nurses’ creativity into effective innovation. Finally, we provide suggestions for healthcare organizations to promote innovation as an added value in the healthcare environment and services provided. Full article

Chronic musculoskeletal pain (CMP) is one of the most common symptoms of musculoskeletal disorders. Carpal tunnel syndrome (CTS) and subacromial syndrome (SAS) are the most prevalent musculoskeletal disorders of the upper limbs. By collecting the opinions of patients with CTS and SAS, we aim to identify variables that could be introduced in the follow-up of CMP, and to detect barriers and facilitators of its treatments to improve their acceptance. This qualitative study is being conducted in Lleida, Spain, and explores the experiences and feelings of patients, and their acceptance of the standard of care. It follows the consolidated criteria for reporting qualitative research (COREQ) through focus groups, addressing issues with rigor and representativeness. By collecting patients’ opinions, we expect to obtain valuable information to complement the set of variables previously used by health professionals in the follow-up of CMP, and to understand treatment barriers and facilitators. Full article

Three years after the outbreak of the coronavirus disease (COVID-19) pandemic, turnover among frontline nurses has increased. The participants of this study were nurses at two general hospitals in Ishikawa, Japan, receiving COVID-19 patients. An original self-report questionnaire was created based on previous research. The questionnaire was distributed to 400 nurses, and responses were received from 227 nurses (response rate: 56.8%). The factors influencing turnover intention at the facilities were having less time to relax (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.12–7.41) and wanting to receive counseling (OR: 5.21, 95% CI: 1.30–20.91). As a strategy to prevent turnover, nurse managers should provide opportunities for nurses to receive counseling during normal working hours and pay particular attention to changes in nurses’ daily lives, such as changes in the time available for relaxation. Full article

Background: The prevention of occupational risks is part of the quality of work life and it is a component that improves the physical work environment. The purpose of the present study was to investigate how to maintain posture and to reduce pain and fatigue for nurses, with an exoskeleton adapted to the work at hospital. Methods: The exoskeleton was used between 2022 to 2023 at Foch Hospital, France. Phase 1 consisted of the selection of the exoskeleton, and Phase 2 included the testing of the device by the nurses and a questionnaire to assess it. Results: The “active” ATLAS model from JAPET, ensuring lumbar protection, was selected because it corresponds to all the specification criteria to tackle the nurses’ unmet need. Among the 14 healthcare professionals, 86% were women; the age of the nurses was between 23 years old and 58 years old. The global median satisfaction score of the nurses relative to the use of the exoskeleton was 6/10. The median impact of the exoskeleton on nurses’ fatigue was 7/10. Conclusions: The implementation of the exoskeleton received global positive qualitative feedback from the nurses concerning the improvement of posture and the reduction in fatigue and pain. Full article

Thromboembolic disease (TED) is an important health problem in Europe due to its high morbimortality. Pharmacological prevention is achieved with low-molecular-weight heparin (LMWH), among other strategies, which are supported by a high degree of evidence in the scientific literature. According to its safety data sheet, this injection produces local injuries at a rate of 0.1–1% after administration; however, these percentages are much lower than others reported in several studies focusing on LMWH (44–88%). This high incidence of injuries might be associated with procedural or individual variables. (1) Background: Among the most frequent side effects after the administration of LMWH are pain and haematomas (HMTs), which are influenced by obesity. We aimed to determine the relationship between abdominal skinfold (ASF) value and incidence of HMTs. In addition, I sought to determine how the risk of HMT changed with each mm increase in ASF. (2) Methods: A cross-sectional descriptive study developed in the hospital unit of orthopaedic and trauma surgery was conducted over one year. All participants in the sample were classified based on their ASF and the appearance and area of HMTs were assessed after the administration of enoxaparin. The STROBE checklist was used to evaluate the study. Descriptive statistical analysis and analysis of variance of non-parametric factors were carried out. (3) Results: In a sample of 202 participants (808 Clexane injections), more than 80% presented HMTs. More than 70% of the sample was overweight and more than 50% had an ASF > 36 millimetres (mm). (4) Conclusions: An ASF over 36 mm confers a higher risk of developing HMTs: with each mm increase in the ASF, the risk increases by 4%. Participants who are overweight or obese also present a higher risk of HMT, and these conditions correlate positively with the area of the HMTs. Providing education for the self-administration of the drug after discharge and information about the probability of suffering from local injuries in a more individualised way will lead to fewer primary care nursing consultations, more adherence to the antithrombotic treatment, and, as a consequence, a decrease in TED and health costs. Full article

Patients on extracorporeal membrane oxygenation (ECMO) often require prolonged periods of bed rest owing to the severity of their illness. Care is also required to maintain the position and integrity of the ECMO cannula. However, they experience a range of effects due to prolonged bed rest. This systematic review examined the possible effects of the early mobilization in patients on ECMO. The database PUBMED was searched by using appropriate keywords: “rehabilitation”, “mobilization”, “ECMO” and “extracorporeal membrane oxygenation”. The selection criteria for the article search were the following: (a) studies published in the last five years, (b) descriptive studies, (c) randomized studies, (d) published in the English language and (e) studies in adults. A total of 259 studies were found, 8 of which were finally selected. Most of the studies showed that early intensive physical rehabilitation related to a decrease in in-hospital stay and a reduction in the duration of mechanical ventilation and doses of vasopressors. In addition, improvements in the functional status and rate of mortality were observed along with a reduction in health care costs. Exercise training should be a fundamental part of the management of patients on ECMO. Full article

Interprofessional learning (IPL), where nursing students learn how to work with multiple health professionals in their future practice to deliver the highest quality of care, has become an essential feature of undergraduate nursing programs. Intraprofessional learning (IaPL) is where individuals of two or more disciplines within the same profession collaborate; however, there is a dearth of literature investigating its effects in nursing education. The aim of this study is to investigate the impact of IaPL on the development of nursing students’ knowledge, skills, and attitudes for collaborative practice. The study will utilize a mixed methods approach with surveys conducted at six time points across two years of two nursing programs and focus groups at the end of the program. Participants will be recruited from the Diploma and Bachelor of Nursing programs at an Australian Training and Further Education institute. Four specific IaPL educational experiences incorporating simulation will be developed on aged care, mental health, complex care and acute care. The study will provide nursing students with multiple opportunities to develop the necessary capabilities for collaborative practice. It will longitudinally evaluate nursing students’ attitudes towards IaPL and examine whether IaPL motivates Diploma of Nursing students to pathway into a Bachelor of Nursing degree. The study will also investigate awareness amongst nursing students of the scope of practice, roles and responsibilities of the nursing team. Full article

Background: Pain in patients under haemodialysis affects the quality of life of chronic renal patients. Distraction has been effective in controlling pain induced by the insertion of needles. Once applied adequately, distraction promotes endorphin release, with efficacy in acute pain management. This study evaluates pain perception while puncturing the haemodialysis device, using an anti-stress ball as a distraction strategy. Methods: This study is a retrospectively registered pilot randomised controlled trial of 47 chronic renal patients undergoing regular haemodialysis programs in a dialysis unit, in the central region of Portugal. Patients were randomly allocated into control and intervention groups. The intervention group received an anti-stress ball on the opposite limb of the vascular access, while the control group underwent pain evaluation without any intervention. Pain was monitored using a numeric pain scale. The study aimed to evaluate pain during vascular access cannulation and explore the potential benefits of using an anti-stress ball to reduce this pain. Results: Patients in the intervention group experienced significantly lower pain scores (−1.23; p < 0.05) during vascular access cannulation compared to the control group (−0.51). Conclusion: Distraction through an anti-stress ball reduces the perception of pain experienced by the chronic renal patients undergoing haemodialysis. However, the trial’s retrospective registration may introduce a risk of selective-outcome reporting. Further research with prospectively registered trials is recommended to validate the findings. Full article

Background: Burnout Syndrome (BS) is a work fatigue phenomenon that leads to physical exhaustion during care work, and there could be an increase in the proportion of nurses affected during the COVID-19 pandemic, especially in those caring for infected patients. We aimed to determine BS in nurses during the COVID-19 pandemic. Methods: An observational study was conducted on 100 nurses over the age of 18 and working in COVID-19 medical units in 2021. The 22-item Maslach Burnout Inventory questionnaire was used to estimate BS, and differences between age groups, gender, work time, and previous infection were estimated. Results: The majority of nurses (mean 30 ± 5.5 years) were women (78%), and the most frequent working time was from 1 to 10 years (58%). A total of 88% of the nurses had moderate BS, affecting more males, aged between 20 and 30 years, and without previous infection. The youngest age group, 20–30 years, presented the highest mean BS with 53.8 (SD 4.18) points (95% CI: 52.79 to 54.8), showing differences with older nurses (p < 0.05). Prediction analysis showed that only age was a significant predictor for the development of SB (p < 0.001). Conclusions: BS negatively impacts young nurses during the care of COVID-19 patients, so strategies should be promoted to ensure a better working environment. Improving the workspace can include self-care strategies, changes in the system and work organization, an improvement of interpersonal relationships, and risk prevention. Full article

Foot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed. The prevalence rates of skin dryness (Support level 88.2%, Care level 85.2% for men; Support level 84.9%, Care level 93% for women) and suspected and existing fungal infections in nails (Support level 94.1%, Care level 92.6% for men; Support level 98.1%, Care level 95.2% for women) were high in both sexes regardless of the level of care required. Furthermore, in both sexes, the prevalence rates of toe and arch deformities were significantly increased in the people who required care. Regression analysis revealed that some right-sided foot-related problems were significantly associated with right toe grip strength and walking speed. The decrease in toe grip strength was significantly associated with walking speed. Our study provides evidence that some specific conditions were associated with toe grip force and walking speed. This finding can contribute to future strategies to protect foot health in community-dwelling older individuals. Full article

Alcohol misuse is a common problem in many countries, where alcohol is often portrayed as a fun and interactive coping strategy for mothers to manage the demands of motherhood. Social media platforms have established themselves as a popular forum for mothers to share information and create an environment in which mothers may be exposed to and influenced by alcohol-related content. Given the increased social acceptance and normalization of drinking among mothers, especially during the recent pandemic, a critical analysis of social media influences on alcohol behaviours and consumption is warranted. A scoping review mapped the evidence on social media influences and alcohol consumption among mothers of children and teenagers younger than eighteen years old. Several databases were consulted, and the evidence was collated into two themes and seven subthemes. Factors related to alcohol consumption in motherhood include (1) community and social support, (2) coping and mental health, (3) motherhood expectations and identity, (4) alcohol consumption, (5) marketing strategies, (6) everyday issues, and (7) social media influence. Numerous social, economic, and health problems are associated with alcohol misuse. The current literature suggests that social media is a powerful tool to disseminate messages about alcohol and normalize mothers’ drinking behaviours. Full article

Psychiatric clinical placement is as essential as other placements in any discipline in nursing education as it allows student nurses to correlate theory to practice. Several research studies have been conducted on nurses’ experiences of the clinical supervision of students, but absenteeism is still a challenge globally. In this study, professional nurses’ experiences of student nurses’ absenteeism from psychiatric clinical placements in Limpopo Province, South Africa, were examined. Three designated specialty mental institutions in Limpopo Province were the sites of the study. Explorative, descriptive, and contextual designs were used in a qualitative approach. A qualitative approach was used because the study sought professional nurses to narrate their experiences through in-depth, semi-structured interviews, which could only be achieved through a qualitative approach. A total of eleven professional nurses, four from two specialized psychiatric hospitals and three from one specialized psychiatric hospital, were purposively sampled and interviewed. These nurses participated in in-depth interviews that were used to gather data, which were then thematically analyzed. One theme and three sub-themes on professional nurses’ experiences of the absenteeism of student nurses during psychiatric clinical placement were revealed. The theme was student factors leading to absenteeism, while the sub-themes were fear of mental health care users, negative attitudes towards psychiatric nursing science, and students’ lifestyles. Based on the findings, student nurses’ absenteeism can be caused by many factors. A qualitative study should be conducted to seek strategies to mitigate the absenteeism of student nurses during clinical placement in the psychiatric hospitals of Limpopo Province. Full article

In the UK, Attention Deficit Hyperactivity Disorder and waits for assessment, diagnosis, and treatment are all growing problems. This study set out to gather service users’ suggestions as to how one specialist ADHD service could improve the experiences of people on their waiting list. Following a semi-structured focus group, an inductive thematic analysis of data yielded three themes: (1) support for psychoeducation in principle, (2) psychoeducation regarding the wider, holistic impact of ADHD, and (3) suggested structures and approaches, as well as (4) a set of general feedback that could inform service developments. Service users supported the notion of psychoeducation sessions to inform people on the waiting list about the wide range of potential impacts of ADHD, the most common psychiatric comorbidities, some potential coping strategies they could try, and the service they could ultimately expect to receive. Some form of one-to-one telephone support was also advocated, primarily to address their concerns about the lack of individualisation group psychoeducation could offer. The potential benefits of these suggestions combined with the low risk of adverse effects makes group psychoeducation a worthwhile waiting list initiative. However, as with any service development, it should be piloted and evaluated before being termed treatment as usual for the service. Full article