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AnteayerInternacionales

Development of clinical items to identify dysphagia in patients with dementia—An e‐Delphi study

Abstract

Aim

To identify clinical observable items that can be used to identify dysphagia while observing a typical eating situation.

Design

A three-round e-Delphi survey.

Methods

An expert panel consisting of five nurses, eight speech language therapists and five physicians participated in this three-round e-Delphi survey from November 2022 to January 2023. Round 1 presented the results of a literature research conducted in September 2022 and an open question to the participants. The answers were analysed using the content analysis method. In the following rounds, the results were presented back to the participants with a request to rate them for usefulness. Means, standard deviations, ANOVA and Fisher's exact test were used to demonstrate the panel's opinion, level of agreement, demographic characteristics of the participants as well as differences between the professional groups in regard of the rating of the items. Methods and results are reported in accordance with the ‘Guidance on Conducting and Reporting Delphi Studies’ (CREDES).

Results

The content analysis initially generated 36 items suggested by the expert panel. Seven additional items were incorporated from the literature review. In rounds 2 and 3, a 4-point Likert scale was used to rate each item and to calculate the level of agreement. The predetermined level of agreement exceeded 70% for 23 items.

Conclusion

Based on the expert opinions, it is possible for nurses to identify dysphagia in patients with dementia by using the determined 23 items while observing a typical eating situation.

Patient or Public Contributions

The expert panel contributed to the creation of this study by participating in the Delphi rounds.

Implications for the profession and/or patient care

The 23 items determined in this e-Delphi study enable nurses to make dietary adjustments or consult other members of the multidisciplinary team based on available evidence, enabling complications to be avoided.

Impact

What problem did the study address? This study provides evidence regarding the identification of dysphagia in patients with dementia by nurses.

What were the main findings? Twenty-three items were determined by an expert panel that can be used by nurses to identify dysphagia in patients with dementia while observing a typical eating situation.

Where and on whom will the research have an impact? This research will have an impact on patients with dementia and the nurses caring for them.

Reporting method

Methods and results are reported in accordance with the ‘Guidance on Conducting and Reporting Delphi Studies’ (CREDES) (Jünger et al., 2017), which promotes consistency and quality in conducting Delphi studies.

Mental health nurses' empathy towards consumers with dual diagnosis: A descriptive study

Abstract

Aim

This study aimed to assess mental health nurses' empathy towards consumers with dual diagnosis in Australian mental health settings. The research question was What is mental health nurses' empathy towards consumers with co-existing mental health and drug and alcohol problems?

Design and Methods

A cross-sectional survey was carried out to understand mental health nurses' empathy. The convenience sample included 96 mental health nurses from various mental health settings with experience working with consumers with dual diagnosis. We assessed empathy using the Toronto Empathy Questionnaire. We utilised SPSS™ software to analyse both the descriptive data and multiple-regression.

Results

The mean empathy score was 47.71 (SD 8.28). The analysis of the association between demographic variables and individual subscales showed an association between the clinical setting and empathy (p = .031) and sympathetic physiological arousal (p = .049). The work sector was associated with sympathetic physiological arousal (p = .045) and conspecific altruism (p = .008). Emotional contagion (β = .98, p < .001), emotional comprehension (β = 1.02, p < .001), sympathetic physiological arousal (β = 1.01, p < .001) and conspecific altruism (β = 10.23, p < .001) predicted mental health nurses' empathy.

Conclusions

This study found that most mental health nurses showed empathy towards consumers with dual diagnosis. Mental health nurses who are more empathetic towards their consumers experience emotional contagion. They understand emotions better, show sympathetic physiological responses and exhibit kind behaviour towards consumers.

Implications for the Profession and Patient Care

Further research is required to understand how mental health nurses adapt to consumers' emotional states in different mental health settings. This information can help clinicians make better decisions about care quality for consumers with dual diagnosis.

Impact

This study addressed mental health nurses' empathy towards consumers with dual diagnosis. Mental health nurses showed increased empathy towards consumers with dual diagnosis. The empathy levels vary based on age, clinical setting, work sector and work experience. Mental health nurses' empathy levels were predicted by emotional contagion, emotion comprehension, sympathetic physiological arousal and conspecific altruism. Empathy enhancement among mental health nurses, particularly towards consumers with dual diagnosis, is crucial and should be regarded as a top priority by healthcare leaders and educators.

Reporting Method

Outlined by the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

Patient or Public Contribution

No Patient or Public Contribution.

Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross‐sectional study

Abstract

Introduction

Investigations about the interrelationships of nurses' safety climate, quality of care, and standard precautions (SP) adherence and compliance remain particularly scarce in the literature. Thus, we tested a model of the associations between nurses' safety climate, quality of care, and the factors influencing adherence and compliance with SPs utilizing the structural equation modeling (SEM) approach.

Design

Cross-sectional design complying with STROBE guidelines.

Methods

Using convenience sampling, nurses (n = 730) from the Philippines were recruited. Data were collected between April and September 2022 using four validated self-report measures. Spearman Rho, mediation and path analyses, and SEM were employed for data analysis.

Results

Acceptable model fit indices were shown by the emerging model. The safety climate is positively associated with quality of care and factors influencing adherence to and compliance with SPs. Quality of care directly affected factors influencing adherence to SPs. The factors influencing adherence to SPs directly affected SP compliance. Quality of care mediated between safety climate and the factors influencing adherence to SPs. Factors influencing adherence to SPs mediated between safety climate, quality of care, and SP compliance.

Conclusions

The study's variables are not distinct but overlapping nursing concepts that must be examined collectively. Nurse administrators can utilize the emerging model to formulate strategies and regulations for evaluating and enhancing nurses' safety climate, quality of care, and SP adherence and compliance.

Clinical Relevance

Our findings may impact policymaking, organizational, and individual levels to improve nurses' clinical practice.

Patient or Public Contribution

This study had no patient contribution or public funding.

I'm a 45‐year‐old woman in the body of an 80‐year‐old: The multiple losses of living and aging in the shadow of prostitution

Abstract

Introduction

Research on aging women who are involved in prostitution is currently limited, both in terms of the number of studies conducted and their scope. Nevertheless, the available research suggests that women who are aging while involved in prostitution may confront some unique challenges. Thus, the study aims to explore the experiences of aging as narrated by Arab women in prostitution, using Intersectionality as a theoretical framework.

Method

Interpretive phenomenological analysis was used, and semistructured interviews were performed with 12 participants.

Findings

Four themes emerged: “I'm a 45-year-old woman in the body of an 80-year-old:” Loss of physical and mental health; “There is no retirement plan in prostitution: Economic and social losses; As they were taken, my soul went with them too: The loss of the parenting experience and motherhood”; and “I'm going to get older with the disgust clinging to me:” The loss of authentic identity and dignity.

Conclusion

The findings demonstrate how aging serves to exacerbate overlapping forms of discrimination and marginalization.

Clinical Relevance

Healthcare professionals, including nurses caring for older women in prostitution, should be aware of their unique circumstances, considering the social, economic, and healthcare obstacles they face. By being cognizant of these factors, healthcare practitioners can provide meaningful assistance in their pursuit of improved quality of life.

Invasive device‐associated skin complications and mechanical dysfunctions in paediatric healthcare: A systematic review and meta‐analysis

Abstract

Aim

This study aimed to estimate the proportion and rate of skin complications and mechanical dysfunction associated with indwelling invasive devices in paediatric healthcare.

Design

This systematic review is reported in accordance with Cochrane standards for randomized controlled trials and the Meta-analysis of Observation Studies in Epidemiology for cohort studies.

Data Sources

MEDLINE, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases were searched.

Review Methods

Cohort studies and trials published from January 2011 to June 2022, including (1) indwelling invasive devices, (2) paediatric participants admitted to a hospital, (3) reporting post-insertion device-associated skin complication and/or mechanical dysfunction, and (4) published in English, were included. Device-associated skin complication and mechanical dysfunction (infiltration, leakage, occlusion/blockage, dislodgement/malposition, breakage and others). Pooled proportion and incidence rate per 1000 device days are reported.

Results

This review synthesized 114 studies (30,782 devices; 1,635,649 device-days). Skin complications were reported in 40 studies, but none exclusively reported individual device-related pressure injuries. Mechanical dysfunctions were well-reported for central venous access devices, peripheral intravenous catheters, nasogastric/gastric tubes and peritoneal dialysis catheters but less for arterial catheters, extracorporeal membrane oxygenation and ventricular assist devices.

Conclusions

This systematic review highlights the need for standardized definitions and reporting methods to better surveil and benchmark device-related complications, particularly for understudied device types. Device-related pressure injuries were not reported in any of the included studies, and all devices except for vascular access devices require standardized reporting of complications.

Impact

Despite the widespread use of invasive devices, comprehensive data on their prevalence, utility, and associated paediatric complications is limited. This review identified prevalent skin complications, occlusions and dislodgments in children with devices, underscoring the need for standardized reporting to enhance surveillance and understanding of paediatric device-related complications.

Reporting Method

MOOSE (Meta-analyses Of Observational Studies in Epidemiology) Checklist.

Patient or Public Contribution

No Patient or Public Contribution.

Views of family members on using video calls during the hospital admission of a patient: A qualitative study

Abstract

Background

Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice.

Aim

The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission.

Methods

A qualitative study was carried out. Semi-structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited.

Results

Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available.

Conclusion

Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours.

Implications

Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes.

Impact

Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement.

Reporting Method

COREQ guidelines.

Patient or Public Contribution

Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews.

What does this paper contribute to the wider global clinical community?

Family members perceive additional value from the use of video calls on hospital wards. For family, use of video calls needs to be facilitated with clear instruction materials and support.

Trial and Protocol Registration

Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).

‘It's very values driven’: A qualitative systematic review of the meaning of compassion according to healthcare professionals

Abstract

Aims and Objectives

To explore the meaning ascribed to the concept of compassion by healthcare professionals.

Background

Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear.

Design

A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines.

Method

Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed.

Findings

Seventeen papers met the inclusion criteria. An overarching theme, ‘It's very values driven’ underpins the four main themes identified: (1) ‘It's about people and working with them’: Compassion as being human, (2) ‘There is this feeling’: Compassion as being present, (3) ‘If I don't understand them, I won't be able to help’: Compassion as understanding, (4) ‘Wanting to help in some way’: Compassion as action.

Conclusions

Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice.

Relevance to Clinical Practice

To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers.

Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice.

No Patient or Public Contribution

This systematic review had no patient or public contribution.

Interactions that support older inpatients with cognitive impairments to engage with falls prevention in hospitals: An ethnographic study

Abstract

Aims

To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention.

Design

Ethnographic study.

Methods

Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi-structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach.

Results

Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses.

Conclusions

Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient-facing staff.

Implications for Profession and Patient Care

Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non-nursing staff, with potential to reduce pressures on busy nurses and improve patient safety.

Reporting Method

The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research.

Patient or Public Contribution

Patient/public contributors were involved in study design, evaluation and data analysis. They co-authored this manuscript.

Exploring older people's experiences of the interpersonal care relationship between nurses and patients during hospitalization in the pandemic period: A qualitative study

Abstract

Aim

This article presents the findings of a qualitative study focusing on the experiences of people aged over 70 years in the interpersonal nurse–patient care relationship in hospital settings during and after the COVID-19 pandemic. The aim was to analyse different aspects of this relationship, including nurses' behaviour and caring attitudes, the person-centred model of care, patients' involvement in their own care and communication in the hospital context.

Design

An exploratory qualitative study was conducted on the basis of an interpretative framework.

Methods

Six focus groups were conducted. A total of 34 participants were purposively recruited from three nursing homes in Spain, Italy and Portugal. Specific inclusion criteria were used to select participants.

Results

Five main categories were identified. Analysis revealed the importance of empathy and sensitivity in caring relationships, as well as the need for personalized and patient-centred care. The importance of effective communication and recognition of ageist behaviour by professionals was highlighted. In addition, independent of the pandemic, situational factors in the hospital environment were identified that influence the interpersonal care relationship.

Conclusions

The study highlights the need to promote a person-centred model of care that takes into account the specific preferences and needs of older people. This is achieved by identifying elements of the interpersonal nurse–patient relationship. In addition to highlighting the disparity of opinion regarding an active or passive role in self-care and decision making, the importance of addressing ageism and improving communication is emphasized.

What problem did the study address?

The importance of the patient–nurse relationship in hospital care has been highlighted in previous studies. Critical elements of the patient care experience have been identified as empathy and effective communication. Ageism in healthcare has been recognized as a potential barrier to patient-centred care.

What were the key findings?

The main findings highlight the importance of empathy and personalized care, emphasize the importance of effective communication and address ageist behaviours in the nurse–patient relationship.

Where and who will the research impact?

By highlighting the need for person-centred care and improved communication strategies, particularly in the context of caring for older patients during and after the COVID-19 pandemic, this research will have an impact on healthcare professionals, policy makers and carers.

Reporting Method

The COREQ guideline was used.

Patient or public contribution

This study adopted a collaborative approach to ensure that patient perspectives were integrated into the research process. We organized regular focus groups. Patients were actively involved in shaping the research questions, refining the study design and interpreting the emerging findings. Their valuable input helped us to understand the nuances of their experience and to prioritize the aspects that were critical to their well-being. In addition, their insights guided the development of practical recommendations aimed at improving the interpersonal care relationship between nurses and patients in hospital settings, ensuring that their voices were heard and reflected in the proposed interventions. This patient-centred approach fostered a sense of empowerment among the participants. It reinforced the notion that their experiences and opinions are integral to shaping healthcare practice.

Coping profiles and their association with vicarious post‐traumatic growth among nurses during the three waves of the COVID‐19 pandemic

Abstract

Aims

This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints.

Background

Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time.

Design

This was a cross-sectional web-based survey at three timepoints during the pandemic.

Methods

A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study.

Results

Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant.

Conclusions

Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor—let it be trying to avoid it—was better than doing nothing.

Relevance to Clinical Practice

The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic.

Patient or Public Contribution

No patient or public contribution since the study was exclusively conducted by the authors.

Evidence‐based approach to mitigate cumulative stress in pediatric nurses through the development of respite rooms

Abstract

Background

The cumulative stress toll on nurses increased during the COVID-19 pandemic. An evidence-based practice (EBP) project was conducted to understand what is known about the impacts of cumulative stress within nursing and if there are ways to mitigate stress during a nurse's shift.

Aim/Implementation

A project team from three clinical units completed an extensive literature review and identified the need to promote detachment while supporting parasympathetic recovery. Based on this review, leaders from three pediatric clinical units (neonatal intensive care unit, cardiovascular intensive care unit, and acute pulmonary floor) implemented respite rooms.

Outcomes

Follow-up outcomes showed a statistically significant stress reduction. For all shifts combined, the Wilcoxon Signed-Rank Test revealed that perceived stress scores from an 11-point Likert scale (0 = no stress and 10 = maximum perceived stress) were significantly lower in the post-respite room (Md = 3, n = 68) compared to in the pre-respite room (Md = 6, n = 68), Z = −7.059, p < .001, with a large effect size, r = .605. Nurses and other staff frequently utilized respite rooms during shifts.

Implications for Practice

Clinical inquiry and evidence-based practice processes can mitigate cumulative stress and support staff wellbeing. Respite rooms within the hospital can promote a healthy work environment among nurses and promote a self-care culture change. Evidence-based strategies to mitigate cumulative stress using respite rooms are a best practice to promote nurse wellbeing and mitigate cumulative stress.

Caregiving in the COVID‐19 pandemic: Family adaptations following an intensive care unit hospitalisation

Abstract

Aim and Objective

To identify how family caregivers adapt to the caregiving role following a relative's COVID-19-related intensive care unit (ICU) hospitalisation.

Background

Family caregiving is often associated with poor health amongst caregivers which may limit their capacity to effectively support patients. Though severe COVID-19 infection has necessitated increasing numbers of persons who require caregiver support, little is known about these caregivers, the persons they are caring for, or the strategies used to effectively adjust to the caregiving role.

Design

A qualitative descriptive study design was adopted, and findings are reported using COREQ.

Methods

A secondary analysis of transcripts from semi-structured interviews conducted with recently discharged ICU patients who had COVID-19 (n = 16) and their family caregivers (n = 16) was completed using thematic analysis. MAXQDA 2020 and Miro were used to organise data and complete coding. Analysis involved a structured process of open and closed coding to identify and confirm themes that elucidated adaptation to family caregiving.

Results

Six themes highlight how family caregivers adapt to the caregiving role following an ICU COVID-19-related hospitalisation including (1) engaging the support of family and friends, (2) increased responsibilities to accommodate caregiving, (3) managing emotions, (4) managing infection control, (5) addressing patient independence and (6) engaging support services. These themes were found to be congruent with the Roy adaptation model.

Conclusions

Family caregiving is a stressful transition following a patient's acute hospitalisation. Effective adaptation requires flexibility and sufficient support, beginning with the care team who can adequately prepare the family for the anticipated challenges of recovery.

Relevance to Clinical Practice

Clinical teams may improve post-hospitalisation care outcomes of patients by preparing families to effectively adjust to the caregiver role—particularly in identifying sufficient support resources.

Patient or Public Contribution

Participation of patients/caregivers in this study was limited to the data provided through participant interviews.

Experiences of improvement of everyday life following a rehabilitation programme for people with long‐term cognitive effects of COVID‐19: Qualitative study

Abstract

Aim and Objectives

To explore challenges in everyday life for people with long-term cognitive effects of COVID-19 and whether a rehabilitation programme contributed to the remedy thereof.

Background

Healthcare systems around the world need knowledge about acute COVID-19 treatment, long-term effects exerting an impact on peoples' everyday lives, and how to remedy these.

Design

This is a qualitative study with a phenomenological approach.

Methods

Twelve people with long-term cognitive effects of COVID-19 participated in a multidisciplinary rehabilitation programme. Individual semi-structured interviews were made. Data were analysed thematically.

Results

Three themes and eight sub-themes emerged with respect to everyday life challenges and experiences of the rehabilitation programme. The themes were (1) Personal insight and knowledge, (2) Changed daily routines at home and (3) Coping with working life.

Conclusion

Participants experienced long-term effects of COVID-19 as cognitive challenges, fatigue and headaches, which affected their everyday lives, that is inability to overcome daily tasks at home and at work, maintaining family roles and relations with relatives. The rehabilitation programme contributed to a vocabulary and insights related to the long-term effects of COVID-19 and the experience of being a different person. The programme contributed to changes in daily routines, organising breaks in everyday life and explaining challenges to family/relatives and the way in which they affected daily routines and their role in the family. In addition, the programme supported several of the participants in finding the right workload and working hours.

Relevance to Clinical Practice

We recommend multidisciplinary rehabilitation programmes inspired by cognitive remediation of long-term COVID-19 cognitive effects. Municipalities and organisations could collaborate in the development and completion of such programmes, possibly comprising both virtual and physical elements. This could facilitate access and reduce costs.

Patient or Public Contribution

Patients contributed to the conduct of the study by participating in the data collection via interviews.

Clinical Trial Registration Number

Data collection and processing of data are approved by the Region of Southern Denmark (journal number: 20/46585).

Professional quality of life and fear of COVID‐19 among Spanish nurses: A longitudinal repeated cross‐sectional study

Abstract

Aim and Objectives

To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign.

Background

The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential.

Design

A repeated cross-sectional design was carried out with a time-lapse of 12 months.

Methods

A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies.

Results

The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = − .16, p = .001; r = − .22, p ≤ .001).

Relevance to Clinical Practice

Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care.

Patient or Public Contribution

The nurses collaborated by participating in the present study anonymously and disinterestedly.

Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID‐19 infection: A six‐ to seven‐month prospective cohort

Abstract

Aims

To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.

Background

Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.

Design

A longitudinal cohort study.

Methods

In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.

Results

HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)).

Conclusion

A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.

Relevance to clinical practice

Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients’ HRQoL from being impaired at 6–7 months after their reported recovery.

Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID‐19 pandemic: Testing an integrated model using structural equation modelling

Abstract

Purpose

A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic.

Background

Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety.

Methods

A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist.

Results

The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life.

Conclusion

The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.

Relevance to clinical practice

These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.

Prevalence of adverse events in pronated intubated adult COVID‐19 patients: A systematic review with meta‐analysis

Abstract

Aim

To present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients.

Design

A systematic review and meta-analysis.

Data sources

This study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources.

Methods

The studies were meta-analysed using JAMOVI 1.6.15 software. A random-effects model was used to identify the global prevalence of adverse events, confidence intervals and the heterogeneity data. Risk of bias was assessed using the Joanna Briggs Institute tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Of the 7904 studies identified, 169 were included for full reading, and 10 were included in the review. The most prevalent adverse events were pressure injuries (59%), haemodynamic instability (23%), death (17%) and device loss or traction (9%).

Conclusion

The most prevalent adverse events in mechanically ventilated pronated patients with COVID-19 are pressure injuries, presence of haemodynamic instability, death and device loss or traction.

Implications for the patient care

The evidence identified in this review can help improve the quality and safety of patient care by helping to design care protocols to avoid the development of adverse events that can cause permanent sequelae in these patients.

Impact

This systematic review addressed the adverse events related to prone position in intubated adult COVID-19 patients. We identified that the most prevalent adverse events in these patients were pressure injuries, haemodynamic instability, device loss or traction and death. The results of this review may influence the clinical practice of nurses who work in intensive care units and, consequently, the nursing care provided not only to COVID-19 patients but for all intubated patients due to other reasons in intensive care units.

Reporting method

This systematic review adhered to the PRISMA reporting guideline.

Patient or public contribution

As this is a systematic review, we analysed data from primary studies conducted by many researchers. Thus, there was no patient or public contribution in this review.

Family members' experiences of COVID‐19 visiting restrictions in the intensive care unit—A qualitative study

Abstract

Objective

To describe how family members of critically ill patients experienced the COVID-19 visiting restrictions in Sweden.

Background

In Sweden, the response to COVID-19 was less invasive than in many other countries. However, some visiting restrictions were introduced for intensive care units, with local variations. Although there is a growing body of literature regarding healthcare professionals' and family caregivers' perspectives on visiting restriction policies, there may be inter-country differences, which remain to be elucidated.

Design

This study has a qualitative descriptive design. Focus group interviews with 14 family members of patients treated for severe COVID-19 infection were conducted. The interviews took place via digital meetings during the months after the patients' hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting of the study followed the COREQ checklist.

Results

Two categories—dealing with uncertainty and being involved at a distance—described family members' experiences of coping with visiting restrictions during the COVID-19 pandemic. These restrictions were found to reduce family members' ability to cope with the situation. Communication via telephone or video calls to maintain contact was appreciated but could not replace the importance of personal contact.

Conclusions

Family members perceived that the visiting restriction routines in place during the COVID-19 pandemic negatively influenced their ability to cope with the situation and to achieve realistic expectations of the patients' needs when they returned home.

Relevance to Clinical Practice

This study suggests that, during the COVID-19 pandemic, the visiting restrictions were experienced negatively by family members and specific family-centred care guidelines need to be developed for use during crises, including the possibility of regular family visits to the ICU.

Patient and Public Contribution

None in the conceptualisation or design of the study.

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