PeerJ:Nursinghttps://peerj.com/articles/index.atom?journal=peerj&subject=5500Nursing articles published in PeerJBeliefs, barriers, and promotion practices of Indian nurses’ regarding healthy eating for cancer survivors in a tertiary care hospital—A cross sectional surveyhttps://peerj.com/articles/171072024-03-192024-03-19Hritika D. PaiStephen Rajan SamuelK. Vijaya KumarCharu EapenAlicia OlsenJustin W.L. Keogh
Purpose
To describe the beliefs, barriers and promotion practices of Indian nurses’ regarding healthy eating (HE) behaviours amongst cancer survivors, and to gain insights into whether their educational qualifications might affect the promotion of HE.
Methods
Data was gathered using a validated questionnaire, 388 of the approached 400 nurses who worked at a tertiary care hospital in India gave informed consent to participate in the study. The Mann-Whitney U test and the Chi square analysis (for continuous and categorical variables respectively) were performed to carry out sub-group comparisons based on the qualification of the nurses i.e., Bachelor of Science in Nursing (BSc) and General Nursing and Midwifery (GNM).
Results
The nurses believed that dieticians/nutritionists were primarily responsible for educating the cancer survivors regarding HE. HE was promoted by nurses’ relatively equally across multiple treatment stages (“during” treatment 24.4%, “post” treatment 23.1%; and “pre” treatment 22.3%). Nurses’ believed HE practices had numerous benefits, with improved health-related quality of life (HRQoL) (75.7%), and mental health (73.9%) being the most frequent responses. The most frequently cited barriers by the nurses in promoting HE were lack of time (22.2%), and lack of adequate support structure (19.9%). Sub-group comparisons generally revealed no significant difference between the BSc and GNM nurses in their perceptions regarding HE promotion to cancer survivors. Exceptions were how the GNM group had significantly greater beliefs regarding whether HE can “reduce risk of cancer occurrence” (p = 0.004) and “whether or not I promote HE is entirely up to me” (p = 0.002).
Conclusion
The nurses in India believe in the promotion of HE practices among cancer survivors across various stages of cancer treatments. However, they do face a range of barriers in their attempt to promote HE. Overcoming these barriers might facilitate effective promotion of HE among cancer survivors and help improve survivorship outcomes.
Implications for cancer survivors
Indian nurses employed in the two tertiary care hospitals wish to promote HE among cancer survivors, but require further knowledge and support services for more effective promotion of HE.
Purpose
To describe the beliefs, barriers and promotion practices of Indian nurses’ regarding healthy eating (HE) behaviours amongst cancer survivors, and to gain insights into whether their educational qualifications might affect the promotion of HE.
Methods
Data was gathered using a validated questionnaire, 388 of the approached 400 nurses who worked at a tertiary care hospital in India gave informed consent to participate in the study. The Mann-Whitney U test and the Chi square analysis (for continuous and categorical variables respectively) were performed to carry out sub-group comparisons based on the qualification of the nurses i.e., Bachelor of Science in Nursing (BSc) and General Nursing and Midwifery (GNM).
Results
The nurses believed that dieticians/nutritionists were primarily responsible for educating the cancer survivors regarding HE. HE was promoted by nurses’ relatively equally across multiple treatment stages (“during” treatment 24.4%, “post” treatment 23.1%; and “pre” treatment 22.3%). Nurses’ believed HE practices had numerous benefits, with improved health-related quality of life (HRQoL) (75.7%), and mental health (73.9%) being the most frequent responses. The most frequently cited barriers by the nurses in promoting HE were lack of time (22.2%), and lack of adequate support structure (19.9%). Sub-group comparisons generally revealed no significant difference between the BSc and GNM nurses in their perceptions regarding HE promotion to cancer survivors. Exceptions were how the GNM group had significantly greater beliefs regarding whether HE can “reduce risk of cancer occurrence” (p = 0.004) and “whether or not I promote HE is entirely up to me” (p = 0.002).
Conclusion
The nurses in India believe in the promotion of HE practices among cancer survivors across various stages of cancer treatments. However, they do face a range of barriers in their attempt to promote HE. Overcoming these barriers might facilitate effective promotion of HE among cancer survivors and help improve survivorship outcomes.
Implications for cancer survivors
Indian nurses employed in the two tertiary care hospitals wish to promote HE among cancer survivors, but require further knowledge and support services for more effective promotion of HE.Assessing the professional quality of life in the context of pediatric carehttps://peerj.com/articles/171202024-03-152024-03-15Manal F. AlharbiAljawharah M. Alkhamshi
Background
This study examines the professional quality of life (ProQOL), including compassion satisfaction (CS) and compassion fatigue (CF), burnout (BO) and secondary traumatic stress (STS) among registered nurses in the context of pediatric care in Riyadh city in Saudi Arabia.
Methods
This study utilised a random multistage sampling method and a survey to collect data from 250 participants on personal characteristics, work-related aspects, lifestyle, and professional quality of life.
Results
The study participants were all female. Only 2.0% were under 25, with 27.2% aged between 25 and 30 years, 24.0% aged between 31 and 35, and 26.4% over 40 years old. The majority, 74%, were non-Saudis. The participants reported low compassion satisfaction (CS) and compassion fatigue (CF) levels. The CS, burnout (BO), and secondary traumatic stress (STS) scores were 3.23 ± 0.764, 2.75 ± 0.68, and 2.69 ± 0.54, respectively. The study found a significant difference in ProQOL level based on factors such as age, nationality, previous experience, department, shift length, overtime work, state of overtime (mandatory versus optional), and salary.
Conclusions
Working with vulnerable groups poses unique challenges for pediatric nurses. The nationality, salary, and state of overtime were found to be significantly different when compared to CS scores. Additionally, age, department, previous experience, shift length, and overtime work were very different compared to CF scores. However, lifestyle factors did not affect CS and CF scores significantly.
Implications
To improve their well-being and interest in activities, pediatric nurses should practice self-compassion and utilise available educational resources such as workshops. They should also strive to achieve a work-life balance and adopt healthy habits to reduce CF.
Background
This study examines the professional quality of life (ProQOL), including compassion satisfaction (CS) and compassion fatigue (CF), burnout (BO) and secondary traumatic stress (STS) among registered nurses in the context of pediatric care in Riyadh city in Saudi Arabia.
Methods
This study utilised a random multistage sampling method and a survey to collect data from 250 participants on personal characteristics, work-related aspects, lifestyle, and professional quality of life.
Results
The study participants were all female. Only 2.0% were under 25, with 27.2% aged between 25 and 30 years, 24.0% aged between 31 and 35, and 26.4% over 40 years old. The majority, 74%, were non-Saudis. The participants reported low compassion satisfaction (CS) and compassion fatigue (CF) levels. The CS, burnout (BO), and secondary traumatic stress (STS) scores were 3.23 ± 0.764, 2.75 ± 0.68, and 2.69 ± 0.54, respectively. The study found a significant difference in ProQOL level based on factors such as age, nationality, previous experience, department, shift length, overtime work, state of overtime (mandatory versus optional), and salary.
Conclusions
Working with vulnerable groups poses unique challenges for pediatric nurses. The nationality, salary, and state of overtime were found to be significantly different when compared to CS scores. Additionally, age, department, previous experience, shift length, and overtime work were very different compared to CF scores. However, lifestyle factors did not affect CS and CF scores significantly.
Implications
To improve their well-being and interest in activities, pediatric nurses should practice self-compassion and utilise available educational resources such as workshops. They should also strive to achieve a work-life balance and adopt healthy habits to reduce CF.The application of two drainage angles in neurocritical care patients with complicated pneumonia: a randomized controlled trialhttps://peerj.com/articles/169972024-02-292024-02-29Anna ZhaoHuangrong ZengHui YinJinlin WangWenming YuanChao LiYan ZhongLanlan MaChongmao LiaoHong ZengYan Li
Background
Although head elevation is an early first-line treatment for elevated intracranial pressure (ICP), the use of the head-down or prone position in managing neurocritical patients is controversial because a change in a position directly affects the intracranial and cerebral perfusion pressure, which may cause secondary brain injury and affect patient outcomes. This study compared the effects of two postural drainage positions (30° head-up tilt and 0° head flat) on the prognosis of neurocritical care patients with complicated pneumonia and a clinical pulmonary infection score (CPIS) ≥5 points to provide a reference for selecting appropriate postural drainage positions for patients with pneumonia in neurocritical care units.
Methods
A prospective randomized controlled study was conducted with 62 neurocritical care patients with complicated pneumonia. The patients were categorized into control (=31) and experimental (=31) groups in a 1:1 ratio using a simple randomized non-homologous pairing method. Emphasis was placed on matching the baseline characteristics of the two groups, including patient age, sex, height, weight, Glasgow Coma Scale score, heart rate, mean arterial pressure, cough reflex, and mechanical ventilation usage to ensure comparability. Both groups received bundled care for artificial airway management. The control group maintained a standard postural drainage position of 0° head-flat, whereas the experimental group maintained a 30° head-up tilt. The efficacy of the nursing intervention was evaluated by comparing the CPIS and other therapeutic indicators between the two groups after postural drainage.
Results
After the intervention, the within-group comparison showed a significant decrease in the CPIS (P < 0.001); procalcitonin levels showed a significant decreasing trend (P < 0.05); the arterial oxygen pressure significantly increased (P < 0.05); the oxygenation index significantly increased (P < 0.001); and the aspiration risk score showed a significant decreasing trend (P < 0.001). A between-group comparison showed no significant differences in any of the indicators before and after the intervention (P < 0.05).
Conclusion
Postural drainage positions of 30° head-up tilt and 0° head-flat can improve the CPIS and oxygenation in patients without adverse effects. Therefore, we recommend that patients under neurological intensive care and having pneumonia be drained in a 30° head-up tilt position with good centralized care of the lung infection.
Trial registration
The study, “Study of Angles of Postural Drainage in Neurocritical Patients with Pneumonia,” was registered in the Protocol Registration Data Element Definitions for Interventional Study database (# ChiCTR2100042155); date of registration: 2021-01-14.
Background
Although head elevation is an early first-line treatment for elevated intracranial pressure (ICP), the use of the head-down or prone position in managing neurocritical patients is controversial because a change in a position directly affects the intracranial and cerebral perfusion pressure, which may cause secondary brain injury and affect patient outcomes. This study compared the effects of two postural drainage positions (30° head-up tilt and 0° head flat) on the prognosis of neurocritical care patients with complicated pneumonia and a clinical pulmonary infection score (CPIS) ≥5 points to provide a reference for selecting appropriate postural drainage positions for patients with pneumonia in neurocritical care units.
Methods
A prospective randomized controlled study was conducted with 62 neurocritical care patients with complicated pneumonia. The patients were categorized into control (=31) and experimental (=31) groups in a 1:1 ratio using a simple randomized non-homologous pairing method. Emphasis was placed on matching the baseline characteristics of the two groups, including patient age, sex, height, weight, Glasgow Coma Scale score, heart rate, mean arterial pressure, cough reflex, and mechanical ventilation usage to ensure comparability. Both groups received bundled care for artificial airway management. The control group maintained a standard postural drainage position of 0° head-flat, whereas the experimental group maintained a 30° head-up tilt. The efficacy of the nursing intervention was evaluated by comparing the CPIS and other therapeutic indicators between the two groups after postural drainage.
Results
After the intervention, the within-group comparison showed a significant decrease in the CPIS (P < 0.001); procalcitonin levels showed a significant decreasing trend (P < 0.05); the arterial oxygen pressure significantly increased (P < 0.05); the oxygenation index significantly increased (P < 0.001); and the aspiration risk score showed a significant decreasing trend (P < 0.001). A between-group comparison showed no significant differences in any of the indicators before and after the intervention (P < 0.05).
Conclusion
Postural drainage positions of 30° head-up tilt and 0° head-flat can improve the CPIS and oxygenation in patients without adverse effects. Therefore, we recommend that patients under neurological intensive care and having pneumonia be drained in a 30° head-up tilt position with good centralized care of the lung infection.
Trial registration
The study, “Study of Angles of Postural Drainage in Neurocritical Patients with Pneumonia,” was registered in the Protocol Registration Data Element Definitions for Interventional Study database (# ChiCTR2100042155); date of registration: 2021-01-14.Nonpharmacological pain relief for labour pain: knowledge, attitude, and barriers among obstetric care providershttps://peerj.com/articles/168622024-02-022024-02-02Heba Abdel-Fatah IbrahimMajed Said AlshahraniAmlak Jaber Al-QinnahWafaa Taha Elgzar
Background
Labor pain is considered the worst pain in a woman’s life. Hence, pain control should be essential to labor management at any level. There is scarce information, and there are gaps regarding the knowledge, attitude, and barriers to the utilization of nonpharmacological approaches for pain relief in Saudi Arabia. Therefore, the current study aims to evaluate nonpharmacological pain relief (NPPR)-related knowledge, attitudes, and barriers among obstetric care providers in Najran, Saudi Arabia.
Methods
A cross-sectional analytical study was performed at maternity departments in Maternal and Children Hospital (MCH), Najran, Saudi Arabia, from April 1 to May 26 2023. The study involved 186 obstetric care providers (OPCs), physicians (19), nurses (144), and midwives (23). A structured self-reported questionnaire was used to collect data and involves five main sections: demographic data, work-related data, nonpharmacological pain relief-related attitude, perceived barriers, and knowledge quiz. The adjusted odds ratio (AOR) along with 95% CI was estimated to determine the factors associated with nonpharmacological pain relief-related knowledge and attitude using multivariate analysis in the binary logistic regression.
Results
Over three-quarters (79%) of obstetric care providers had adequate knowledge of nonpharmacological pain relief methods. The majority (85.5%) of the participants had a positive attitude toward NPPR in labour pain management, with the mean scores ranging from 3.55–4.23 for all sub-items. Obstetric care providers acknowledged that patient belief, lack of time, and workload were the strongest barriers to offering nonpharmacological pain relief methods for labour pain 67.6%, 64.5%, and 61.3%, respectively. In binary logistic regression analysis, the in-service training related to nonpharmacological pain relief (AOR = 5.871 (2.174–15.857), p = 0.000), (AOR = 3.942 (1.926–11.380), p = 0.013) and years of work experience (AOR = 1.678 (1.080–2.564), p = 0.019), (AOR = 1.740 (1.188–2.548), p = 0.003) were significantly associated with obstetric care providers’ knowledge and attitudes regarding nonpharmacological pain relief (p ≤ 0.05).
Conclusion
Although most OPCs have adequate knowledge and a positive attitude regarding NPPR, they need motivational strategies to enhance their utilization. In addition, an effort should be made to decrease OPCs’ workload to provide more time for NPPR application and patient education. Training courses and in-service training can play an important role in enhancing NPPR knowledge and attitude and, consequently, its application. Also, in each working unit, the policymakers should provide clear guidelines and policies that enhance and control the utilization of NPPR.
Background
Labor pain is considered the worst pain in a woman’s life. Hence, pain control should be essential to labor management at any level. There is scarce information, and there are gaps regarding the knowledge, attitude, and barriers to the utilization of nonpharmacological approaches for pain relief in Saudi Arabia. Therefore, the current study aims to evaluate nonpharmacological pain relief (NPPR)-related knowledge, attitudes, and barriers among obstetric care providers in Najran, Saudi Arabia.
Methods
A cross-sectional analytical study was performed at maternity departments in Maternal and Children Hospital (MCH), Najran, Saudi Arabia, from April 1 to May 26 2023. The study involved 186 obstetric care providers (OPCs), physicians (19), nurses (144), and midwives (23). A structured self-reported questionnaire was used to collect data and involves five main sections: demographic data, work-related data, nonpharmacological pain relief-related attitude, perceived barriers, and knowledge quiz. The adjusted odds ratio (AOR) along with 95% CI was estimated to determine the factors associated with nonpharmacological pain relief-related knowledge and attitude using multivariate analysis in the binary logistic regression.
Results
Over three-quarters (79%) of obstetric care providers had adequate knowledge of nonpharmacological pain relief methods. The majority (85.5%) of the participants had a positive attitude toward NPPR in labour pain management, with the mean scores ranging from 3.55–4.23 for all sub-items. Obstetric care providers acknowledged that patient belief, lack of time, and workload were the strongest barriers to offering nonpharmacological pain relief methods for labour pain 67.6%, 64.5%, and 61.3%, respectively. In binary logistic regression analysis, the in-service training related to nonpharmacological pain relief (AOR = 5.871 (2.174–15.857), p = 0.000), (AOR = 3.942 (1.926–11.380), p = 0.013) and years of work experience (AOR = 1.678 (1.080–2.564), p = 0.019), (AOR = 1.740 (1.188–2.548), p = 0.003) were significantly associated with obstetric care providers’ knowledge and attitudes regarding nonpharmacological pain relief (p ≤ 0.05).
Conclusion
Although most OPCs have adequate knowledge and a positive attitude regarding NPPR, they need motivational strategies to enhance their utilization. In addition, an effort should be made to decrease OPCs’ workload to provide more time for NPPR application and patient education. Training courses and in-service training can play an important role in enhancing NPPR knowledge and attitude and, consequently, its application. Also, in each working unit, the policymakers should provide clear guidelines and policies that enhance and control the utilization of NPPR.Knowledge of cardiovascular disease risk factors among caregivers of cardiology patients attending Jordan University Hospitalhttps://peerj.com/articles/168302024-01-312024-01-31Hanna Al-MakhamrehAmro AlkhatibAhmed AttarriAhmad A. ToubasiAya DabbasBasel Al-BkoorZaid SarhanOsama Alghafri
Cardiovascular disease (CVD) is an umbrella term that includes various pathologies involving the heart and the vasculature system of the body. CVD is the leading cause of death worldwide, accounting for an estimated 32% of all deaths. More than 40% of annual deaths in Jordan are due to CVD; this number is further expected to rise, particularly in the Eastern Mediterranean region where Jordan is located. Due to the chronic nature of CVD, the presence of a caregiver who can help mitigate the challenges patients face is essential, and their level of knowledge determines the quality of care they can provide. Hence, this cross-sectional study was conducted in the cardiology clinics at Jordan University Hospital (JUH). Questionnaires were distributed to 469 participants, defined in this study as the caregivers escorting patients with established coronary heart disease (CHD). The self-administered questionnaire included three sections: sociodemographic and health factors, knowledge of CVD risk factors, and CHD symptoms. The mean age of the study population was 44.38 years ± 15.92 and 54.2% of participants were males. Regarding knowledge of CVD risk factors, 84.6% of participants answered more than 70% of the questions correctly. More than 95% knew that chest pain is a symptom of an acute cardiovascular event. However, only 53.5% and 74.8% of the participants reported that jaw pain and arm pain are symptoms of an acute event, respectively. Several factors influenced the caregiver’s knowledge, such as age, income, frequent health checkups, having a history of CVD, CKD, or DM, and their relationship to the patient. This study sheds light on the importance of caregiver knowledge in patient care. By improving the caregivers’ knowledge, identifying their role in patient care, and raising CVD awareness in susceptible populations, healthcare professionals can improve the patients’ quality of life. Overall, assessing caregivers’ knowledge pertaining to CVD can provide invaluable data, which may enhance patient care by educating their caregivers.
Cardiovascular disease (CVD) is an umbrella term that includes various pathologies involving the heart and the vasculature system of the body. CVD is the leading cause of death worldwide, accounting for an estimated 32% of all deaths. More than 40% of annual deaths in Jordan are due to CVD; this number is further expected to rise, particularly in the Eastern Mediterranean region where Jordan is located. Due to the chronic nature of CVD, the presence of a caregiver who can help mitigate the challenges patients face is essential, and their level of knowledge determines the quality of care they can provide. Hence, this cross-sectional study was conducted in the cardiology clinics at Jordan University Hospital (JUH). Questionnaires were distributed to 469 participants, defined in this study as the caregivers escorting patients with established coronary heart disease (CHD). The self-administered questionnaire included three sections: sociodemographic and health factors, knowledge of CVD risk factors, and CHD symptoms. The mean age of the study population was 44.38 years ± 15.92 and 54.2% of participants were males. Regarding knowledge of CVD risk factors, 84.6% of participants answered more than 70% of the questions correctly. More than 95% knew that chest pain is a symptom of an acute cardiovascular event. However, only 53.5% and 74.8% of the participants reported that jaw pain and arm pain are symptoms of an acute event, respectively. Several factors influenced the caregiver’s knowledge, such as age, income, frequent health checkups, having a history of CVD, CKD, or DM, and their relationship to the patient. This study sheds light on the importance of caregiver knowledge in patient care. By improving the caregivers’ knowledge, identifying their role in patient care, and raising CVD awareness in susceptible populations, healthcare professionals can improve the patients’ quality of life. Overall, assessing caregivers’ knowledge pertaining to CVD can provide invaluable data, which may enhance patient care by educating their caregivers.Psychometric validation of the Ostomy Skin Tool 2.0https://peerj.com/articles/166852023-12-182023-12-18Gregor JemecNana Overgaard HerschendHelle Doré HansenAmy FindleyAbi WilliamsKate SullyTonny KarlsmarkZenia Størling
Background
Peristomal skin complications (PSCs) pose a major challenge for people living with an ostomy. To avoid severe PSCs, it is important that people with an ostomy check their peristomal skin condition on a regular basis and seek professional help when needed.
Aim
To validate a new ostomy skin tool (OST 2.0) that will make regular assessment of the peristomal skin easier.
Methods
Seventy subjects participating in a clinical trial were eligible for the analysis and data used for the validation. Item-level correlation with anchors, inter-item correlations, convergent validity of domains, test-retest reliability, anchor- and distribution-based methods for assessment of meaningful change were all part of the psychometric validation of the tool.
Results
A final tool was established including six patient reported outcome items and automatic assessment of the discolored peristomal area. Follow-up with cognitive debriefing interviews assured that the concepts were considered relevant for people with an ostomy.
Conclusion
The OST 2.0 demonstrated evidence supporting its reliability and validity as an outcome measure to capture both visible and non-visible peristomal skin complications.
Background
Peristomal skin complications (PSCs) pose a major challenge for people living with an ostomy. To avoid severe PSCs, it is important that people with an ostomy check their peristomal skin condition on a regular basis and seek professional help when needed.
Aim
To validate a new ostomy skin tool (OST 2.0) that will make regular assessment of the peristomal skin easier.
Methods
Seventy subjects participating in a clinical trial were eligible for the analysis and data used for the validation. Item-level correlation with anchors, inter-item correlations, convergent validity of domains, test-retest reliability, anchor- and distribution-based methods for assessment of meaningful change were all part of the psychometric validation of the tool.
Results
A final tool was established including six patient reported outcome items and automatic assessment of the discolored peristomal area. Follow-up with cognitive debriefing interviews assured that the concepts were considered relevant for people with an ostomy.
Conclusion
The OST 2.0 demonstrated evidence supporting its reliability and validity as an outcome measure to capture both visible and non-visible peristomal skin complications.A nomogram model for predicting lower extremity deep vein thrombosis after gynecologic laparoscopic surgery: a retrospective cohort studyhttps://peerj.com/articles/160892023-09-212023-09-21Yuping ZhaoRenyu WangShuiling ZuYanbin LinYing FuNa LinXiumei FangChenyin Liu
Objective
To investigate the risk factors associated with lower extremity deep vein thrombosis (LEDVT) and to establish a predictive model for patients who undergo gynecologic laparoscopic surgery.
Methods
A review of clinical data was conducted on patients who underwent gynecologic laparoscopic surgery between November 1, 2020, and January 31, 2022. Patients who developed LEDVT after surgery were included as the observation group, while the control group comprised patients who did not experience complications. Multivariate forward stepwise logistic regression models were used to identify independent risk factors associated with LEDVT. A nomogram model was then developed based on these risk factors.
Results
A total of 659 patients underwent gynecologic laparoscopic surgery during the study period, and 52 (7.89%) of these patients developed postoperative LEDVT. Multivariate logistic regression analysis showed that older age (adjusted OR, 1.085; 95% CI [1.034–1.138]; P < 0.05), longer operation duration (adjusted OR, 1.014; 95% CI [1.009–1.020]; P < 0.05), shorter activated partial thromboplastin time (APTT) (adjusted OR, 0.749; 95% CI [0.635–0.884]; P < 0.05), higher D-dimer (adjusted OR, 4.929; 95% CI [2.369–10.255]; P < 0.05), higher Human Epididymis Protein 4 (HE4) (adjusted OR, 1.007; 95% CI [1.001–1.012]; P < 0.05), and history of hypertension (adjusted OR, 3.732; 95% CI [1.405–9.915]; P < 0.05) were all independent risk factors for LEDVT in patients who underwent gynecologic laparoscopic surgery. A nomogram model was then created, which had an area under the curve of 0.927 (95% CI [0.893–0.961]; P < 0.05), a sensitivity of 96.1%, and a specificity of 79.5%.
Conclusions
A nomogram model that incorporates information on age, operation duration, APTT, D-dimer, history of hypertension, and HE4 could effectively predict the risk of LEDVT in patients undergoing gynecologic laparoscopic surgery, potentially helping to prevent the development of this complication.
Objective
To investigate the risk factors associated with lower extremity deep vein thrombosis (LEDVT) and to establish a predictive model for patients who undergo gynecologic laparoscopic surgery.
Methods
A review of clinical data was conducted on patients who underwent gynecologic laparoscopic surgery between November 1, 2020, and January 31, 2022. Patients who developed LEDVT after surgery were included as the observation group, while the control group comprised patients who did not experience complications. Multivariate forward stepwise logistic regression models were used to identify independent risk factors associated with LEDVT. A nomogram model was then developed based on these risk factors.
Results
A total of 659 patients underwent gynecologic laparoscopic surgery during the study period, and 52 (7.89%) of these patients developed postoperative LEDVT. Multivariate logistic regression analysis showed that older age (adjusted OR, 1.085; 95% CI [1.034–1.138]; P < 0.05), longer operation duration (adjusted OR, 1.014; 95% CI [1.009–1.020]; P < 0.05), shorter activated partial thromboplastin time (APTT) (adjusted OR, 0.749; 95% CI [0.635–0.884]; P < 0.05), higher D-dimer (adjusted OR, 4.929; 95% CI [2.369–10.255]; P < 0.05), higher Human Epididymis Protein 4 (HE4) (adjusted OR, 1.007; 95% CI [1.001–1.012]; P < 0.05), and history of hypertension (adjusted OR, 3.732; 95% CI [1.405–9.915]; P < 0.05) were all independent risk factors for LEDVT in patients who underwent gynecologic laparoscopic surgery. A nomogram model was then created, which had an area under the curve of 0.927 (95% CI [0.893–0.961]; P < 0.05), a sensitivity of 96.1%, and a specificity of 79.5%.
Conclusions
A nomogram model that incorporates information on age, operation duration, APTT, D-dimer, history of hypertension, and HE4 could effectively predict the risk of LEDVT in patients undergoing gynecologic laparoscopic surgery, potentially helping to prevent the development of this complication.Surgical vs. transcatheter aortic valve replacement in patients over 75 years with aortic stenosis: sociodemographic profile, clinical characteristics, quality of life and functionalityhttps://peerj.com/articles/161022023-09-202023-09-20Víctor Fradejas-SastrePaula Parás-BravoManuel Herrero-MontesMaría Paz-ZuluetaEster Boixadera-PlanasLuis Manuel Fernández-CachoGabriela Veiga-FernándezMaria Elena Arnáiz-GarcíaJose María De-la-Torre-Hernández
Background
Aortic valve stenosis (AVS) affects 25% of the population over 65 years. At present, there is no curative medical treatment for AVS and therefore the surgical approach, consisting of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR), is the treatment of choice.
Methodology
The aim of this study was to analyze the sociodemographic and clinical characteristics, quality of life and functionality of a sample of patients with AVS over 75 years of age, who underwent TAVR or SAVR, applying standard clinical practice. A prospective multicenter observational study was conducted in two hospitals of the Spanish National Health System. Data were collected at baseline, 1, 6 months and 1 year.
Results
In total, 227 participants were included, with a mean age of 80.6 [SD 4.1]. Statistically significant differences were found in terms of quality of life, which was higher at 1 year in patients who underwent SAVR. In terms of functionality, SAVR patients obtained a better score (p < 0.01). However, patients who underwent TAVR began with a worse baseline situation and managed to increase their quality of life and functionality after 1 year of follow-up.
Conclusion
The individualized choice of TAVR or SAVR in patients with AVS improves patients’ quality of life and function. Moreover, the TAVR procedure in patients with a worse baseline situation and a high surgical risk achieved a similar increase in quality of life and functionality compared to patients undergoing SAVR with a better baseline situation.
Background
Aortic valve stenosis (AVS) affects 25% of the population over 65 years. At present, there is no curative medical treatment for AVS and therefore the surgical approach, consisting of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR), is the treatment of choice.
Methodology
The aim of this study was to analyze the sociodemographic and clinical characteristics, quality of life and functionality of a sample of patients with AVS over 75 years of age, who underwent TAVR or SAVR, applying standard clinical practice. A prospective multicenter observational study was conducted in two hospitals of the Spanish National Health System. Data were collected at baseline, 1, 6 months and 1 year.
Results
In total, 227 participants were included, with a mean age of 80.6 [SD 4.1]. Statistically significant differences were found in terms of quality of life, which was higher at 1 year in patients who underwent SAVR. In terms of functionality, SAVR patients obtained a better score (p < 0.01). However, patients who underwent TAVR began with a worse baseline situation and managed to increase their quality of life and functionality after 1 year of follow-up.
Conclusion
The individualized choice of TAVR or SAVR in patients with AVS improves patients’ quality of life and function. Moreover, the TAVR procedure in patients with a worse baseline situation and a high surgical risk achieved a similar increase in quality of life and functionality compared to patients undergoing SAVR with a better baseline situation.Ophthalmic nurses’ knowledge, attitude, and practice toward venous thromboembolic prevention: a dual-center cross-sectional surveyhttps://peerj.com/articles/159472023-08-282023-08-28Xiaoxi ZhouMinhui DaiLingyu SunChunyan LiWendi XiangYaoyao LinDandan Jiang
Background
Venous thromboembolism (VTE) is a severe preventable complication among ophthalmic surgical patients. The knowledge, attitude, and practice (KAP) of nurses play a key role in effective VTE prevention. However, little is known about the KAP of ophthalmic nurses’ VTE prevention. This study aimed to examine the level of KAP toward VTE prevention among Chinese ophthalmic nurses and to investigate the influencing factors of their VTE practice.
Methods
A total of 610 ophthalmic nurses from 17 cities in Hunan and Zhejiang Provinces, China, participated in this study. Data was collected via the Sojump online platform from March to April 2021. A self-administered VTE questionnaire was developed to assess nurses’ KAP toward VTE prevention. Multiple linear regression analysis was used to analyze the influencing factors of ophthalmic nurses’ VTE prevention practice.
Results
The scores (correct rates) of ophthalmic nurses’ knowledge, attitude, and practice were 103.87 ± 20.50 (76.4%), 21.96 ± 2.72, and 48.96 ± 11.23 (81.6%), respectively. The three lowest-scored knowledge items were related to VTE complications, physical prevention, and risk assessment. The three lowest-scored attitude items were related to nurses’ training, VTE risk, and patient education. The three lowest-scored practice items were related to the assessment scale, VTE assessment, and patient education. Nurses’ knowledge, attitude, and practice were significantly correlated with each other. Multiple linear regression analysis showed that Hunan Province (B = 2.77, p = 0.006), general hospital (B = 2.97, p = 0.009), outpatient department (B = 3.93, p = 0.021), inpatient department (B = 2.50, p = 0.001), previous VTE prevention training (B = 3.46, p < 0.001), VTE prevention management in hospital (B = 4.93, p < 0.001), better knowledge (B = 0.04, p = 0.038), and positive attitude towards VTE prevention (B = 1.35, p < 0.001) were all significantly and positively associated with higher practice scores in VTE prevention.
Conclusions
Our study provided a comprehensive understanding of the ophthalmic nurses’ knowledge, attitude, and practice in VTE prevention, as well as identified specific items in each dimension for improvement. In addition, our study showed multiple factors were associated with ophthalmic nurses’ practice in VTE prevention, including environmental factors, training and management, knowledge and attitudes toward VTE prevention. Our findings provide important implications and guidance for future intervention programs to improve the ophthalmic nurses’ knowledge, attitude, and practice in VTE prevention.
Background
Venous thromboembolism (VTE) is a severe preventable complication among ophthalmic surgical patients. The knowledge, attitude, and practice (KAP) of nurses play a key role in effective VTE prevention. However, little is known about the KAP of ophthalmic nurses’ VTE prevention. This study aimed to examine the level of KAP toward VTE prevention among Chinese ophthalmic nurses and to investigate the influencing factors of their VTE practice.
Methods
A total of 610 ophthalmic nurses from 17 cities in Hunan and Zhejiang Provinces, China, participated in this study. Data was collected via the Sojump online platform from March to April 2021. A self-administered VTE questionnaire was developed to assess nurses’ KAP toward VTE prevention. Multiple linear regression analysis was used to analyze the influencing factors of ophthalmic nurses’ VTE prevention practice.
Results
The scores (correct rates) of ophthalmic nurses’ knowledge, attitude, and practice were 103.87 ± 20.50 (76.4%), 21.96 ± 2.72, and 48.96 ± 11.23 (81.6%), respectively. The three lowest-scored knowledge items were related to VTE complications, physical prevention, and risk assessment. The three lowest-scored attitude items were related to nurses’ training, VTE risk, and patient education. The three lowest-scored practice items were related to the assessment scale, VTE assessment, and patient education. Nurses’ knowledge, attitude, and practice were significantly correlated with each other. Multiple linear regression analysis showed that Hunan Province (B = 2.77, p = 0.006), general hospital (B = 2.97, p = 0.009), outpatient department (B = 3.93, p = 0.021), inpatient department (B = 2.50, p = 0.001), previous VTE prevention training (B = 3.46, p < 0.001), VTE prevention management in hospital (B = 4.93, p < 0.001), better knowledge (B = 0.04, p = 0.038), and positive attitude towards VTE prevention (B = 1.35, p < 0.001) were all significantly and positively associated with higher practice scores in VTE prevention.
Conclusions
Our study provided a comprehensive understanding of the ophthalmic nurses’ knowledge, attitude, and practice in VTE prevention, as well as identified specific items in each dimension for improvement. In addition, our study showed multiple factors were associated with ophthalmic nurses’ practice in VTE prevention, including environmental factors, training and management, knowledge and attitudes toward VTE prevention. Our findings provide important implications and guidance for future intervention programs to improve the ophthalmic nurses’ knowledge, attitude, and practice in VTE prevention.The mediating role of attention deficit in relationship between insomnia and social cognition tasks among nurses in Saudi Arabia: A cross-sectional studyhttps://peerj.com/articles/155082023-07-042023-07-04Md. Dilshad ManzarFaizan KashooAbdulrhman AlbougamiMajed AlamriJazi Shaydied AlotaibiBader A. AlrasheadiAhmed Mansour AlmansourMehrunnisha AhmadMohamed Sherif SirajudeenMohamed Yacin SikkandarMark D. Griffiths
Purpose
Insomnia-related affective functional disorder may negatively affect social cognition such as empathy, altruism, and attitude toward providing care. No previous studies have ever investigated the mediating role of attention deficit in the relationship between insomnia and social cognition.
Methods
A cross-sectional survey was carried out among 664 nurses (Mage = 33.03 years; SD ± 6.93 years) from December 2020 to September 2021. They completed the Scale of Attitude towards the Patient (SAtP), the Athens Insomnia Scale (AIS), a single-item numeric rating scale assessing the increasing severity of attention complaints, and questions relating to socio-demographic information. The analysis was carried out by examining the mediating role of attention deficit in the relationship between insomnia and social cognition.
Results
The prevalence of insomnia symptoms was high (52% insomnia using the AIS). Insomnia was significantly correlated with attention problems (b = 0.18, standard error (SE) = 0.02, p < 0.001). Attention problems were significantly negatively correlated with nurses’ attitudes towards patients (b = −0.56, SE = 0.08, p < 0.001), respect for autonomy (b = −0.18, SE = 0.03, p < 0.001), holism (b = −0.14, SE = 0.03, p < 0.001), empathy (b = −0.15, SE = 0.03, p < 0.001), and altruism (b = −0.10, SE = 0.02, p < 0.001). Attention problems indirectly mediated the effect of insomnia on attitudes toward patients (99% CI = −0.10 [−0.16 to −0.05]), respect for autonomy (99% CI = −0.03 [−0.05 to −0.02]), holism (99% CI = −0.02 [−0.04 to −0.01]) empathy (99% CI = −0.03 [−0.04 to −0.01]), and altruism (99% CI = −0.02 [−0.03 to −0.01]).
Conclusion
Nurses with insomnia-related attention problems are likely to have poor explicit social cognition such as attitude toward patients, altruism, empathy, respect for autonomy, and holism.
Purpose
Insomnia-related affective functional disorder may negatively affect social cognition such as empathy, altruism, and attitude toward providing care. No previous studies have ever investigated the mediating role of attention deficit in the relationship between insomnia and social cognition.
Methods
A cross-sectional survey was carried out among 664 nurses (Mage = 33.03 years; SD ± 6.93 years) from December 2020 to September 2021. They completed the Scale of Attitude towards the Patient (SAtP), the Athens Insomnia Scale (AIS), a single-item numeric rating scale assessing the increasing severity of attention complaints, and questions relating to socio-demographic information. The analysis was carried out by examining the mediating role of attention deficit in the relationship between insomnia and social cognition.
Results
The prevalence of insomnia symptoms was high (52% insomnia using the AIS). Insomnia was significantly correlated with attention problems (b = 0.18, standard error (SE) = 0.02, p < 0.001). Attention problems were significantly negatively correlated with nurses’ attitudes towards patients (b = −0.56, SE = 0.08, p < 0.001), respect for autonomy (b = −0.18, SE = 0.03, p < 0.001), holism (b = −0.14, SE = 0.03, p < 0.001), empathy (b = −0.15, SE = 0.03, p < 0.001), and altruism (b = −0.10, SE = 0.02, p < 0.001). Attention problems indirectly mediated the effect of insomnia on attitudes toward patients (99% CI = −0.10 [−0.16 to −0.05]), respect for autonomy (99% CI = −0.03 [−0.05 to −0.02]), holism (99% CI = −0.02 [−0.04 to −0.01]) empathy (99% CI = −0.03 [−0.04 to −0.01]), and altruism (99% CI = −0.02 [−0.03 to −0.01]).
Conclusion
Nurses with insomnia-related attention problems are likely to have poor explicit social cognition such as attitude toward patients, altruism, empathy, respect for autonomy, and holism.