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AnteayerInternacionales

Exploring Nurses' Work Resumption Behaviour and Its Related Factors Under Emerging Infectious Diseases Pandemic: A Cross‐Sectional Study

ABSTRACT

Aim

In December 2022, a large population infected with COVID-19 emerged in China, including frontline nurses. To maintain the medical system's function, many infected nurses returned to work before full recovery. This study aims to examine the characteristics of work resumption behaviour among the infected nurses and its influencing factors.

Design

A nationwide cross-sectional study utilising questionnaire data.

Methods

An indicator was developed to assess the work resumption behaviour: work resumption type (autonomous work resumption, constrained work resumption). As the possible influencing factors of work resumption type, professional commitment, organisational commitment and psychological capital were included and measured by the Professional Commitment Scale (PCS), Organizational Commitment Questionnaire (OCQ), and Psychological Capital Questionnaire (PCQ). The logistic regression models were applied to estimate the association between the score of the PCS, OCQ, PCQ, and work resumption type.

Results

A total of 30,062 nurses were included. The mean time of nurses returning to work after infection was 1.8 days, with 88.6% exhibiting autonomous work resumption behaviour. One standard deviation increment in the score of the PCS, OCQ, and PCQ was associated with a 41% (OR = 1.41), 29% (OR = 1.29) and 42% (OR = 1.42) average increase in the odds of having an autonomous work resumption, respectively.

Conclusion

The majority of nurses returned to work before full recovery during the pandemic. Elevated professional commitment, organisational commitment and psychological capital were associated with autonomous work resumption behaviour.

Impact

The large-scale work resumption in this emerging infectious disease outbreak demonstrated that the healthcare system should reevaluate nursing workforce growth targets for pandemics. It is still warranted for future research to explore the long-term effects of work resumption on individual and organisational levels.

Trial Registration

Chinese clinical trial registry: ChiCTR2300067706 (January 8, 2023)

The Incidence and Risk Factors of Stress Hyperglycaemia in Patients Who Received Enteral Nutrition in Intensive Care Units: A Retrospective Cohort Study

ABSTRACT

Aim and Objectives

This study aimed to investigate the incidence and identify risk factors of stress hyperglycaemia among patients who received enteral nutrition (EN) in the intensive care unit (ICU).

Background

Stress hyperglycaemia is common among ICU patients receiving EN and is related to worse outcomes. However, the factors associated with stress hyperglycaemia during EN remain unclear, especially among patients who are not diagnosed with diabetes.

Design

A retrospective cohort study.

Methods

Electronic medical records of 614 non-diabetic patients receiving EN at two ICUs in Guizhou Provincial People's Hospital were reviewed. Patients were classified into hyperglycemic and non-hyperglycemic groups. Social demographics, clinical characteristics, treatment regimens, nutrition therapy, and point-of-care blood glucose values were collected. Univariate and multivariable analyses identified risk factors for stress hyperglycaemia. This study followed the STROBE guideline.

Results

The incidence of stress hyperglycaemia among ICU patients without diabetes receiving EN was 35.50%. Multivariable analysis revealed that obesity (BMI ≥ 28 kg/m2), high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions were independent risk factors for stress hyperglycaemia. In contrast, a moderate carbohydrate intake (3.0–3.9 g/kg/day) was associated with a significantly lower risk of stress hyperglycaemia.

Conclusions

The 35.50% of ICU patients without diabetes experienced stress hyperglycaemia during EN. Potential risk factors included BMI ≥ 28 kg/m2, high carbohydrate intake (> 5.0 g/kg/day), and the use of semi-elemental EN solutions. A moderate carbohydrate intake (3.0–3.9 g/kg/day) was protective. Future research should explore optimal carbohydrate intake ranges and personalised nutrition protocols to reduce stress hyperglycaemia in critically ill patients.

Relevance to Clinical Practice

Reducing stress hyperglycaemia in ICU patients without diabetes receiving EN is crucial. Recommendations include monitoring patients with BMI ≥ 28 kg/m2 and considering moderate carbohydrate intake (3.0–3.9 g/kg/day), and reasonably selecting the type of enteral nutrition solution based on the patient's individual condition.

Patient and family engagement interventions for hospitalized patient safety: A scoping review

Abstract

Aim

To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps.

Design

A scoping review.

Methods

Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross-checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries.

Results

Ninety-eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects.

Conclusions

International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels.

Relevance to Clinical Practice

Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions.

Reporting Method

PRISMA-ScR Checklist.

Effects of multicomponent exercise on quality of life, depression and anxiety among stroke survivors: A systematic review and meta‐analysis

Abstract

Background

Current guidelines stress the importance of exercise, especially multicomponent exercise to older adults with chronic conditions.

Aim

To critically synthesise evidence that evaluates the effects of multicomponent exercise on quality of life, depression and anxiety after stroke.

Design

Systematic review and meta-analysis followed the PRISMA 2020 statement.

Methods

A systematic search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL and PsycINFO from inception to 12 June 2023 was performed. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2). Meta-analyses were conducted using Review Manager 5.4 and narrative syntheses were adopted whenever meta-analysis was inappropriate. The overall certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Of 15,351 records identified, nine were eligible and data were available for seven randomised controlled trials, three of which were identified as having a high risk of bias, one as low risk, and five as having some concerns. Subgroup pooled analyses indicated that multicomponent exercise engaged in longer exercise sessions (>60 min) was effective in improving quality of life immediately post-intervention and through 3–6 months post-intervention. However, multicomponent exercise did not significantly affect depression and anxiety.

Conclusions

Multicomponent exercise with longer duration of exercise sessions has promising effects on both short- to medium-term quality of life among stroke survivors.

Patient or Public Contribution

This does not apply to our work as it is a review paper.

Relevance to Clinical Practice

Healthcare providers could consider encouraging the patients to participate in multicomponent exercise sessions for more than 60 min. It is important to note that stroke survivors should be supervised by trained personnel at the beginning of the training.

Registration

The protocol was registered on PROSPERO.

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