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Dysphagia not only affects the nutritional intake of head and neck cancer (HNC) patients but may also lead to social avoidance, emotional fluctuations, and a decline in life confidence. Furthermore, dysphagia places an additional psychological and physical burden on caregivers, significantly altering their lifestyles.
This study employed a qualitative systematic review approach to comprehensively analyse the experiences and coping strategies of HNC patients and their caregivers in relation to dysphagia. Relevant qualitative studies published from the inception of the database through September 2024 were selected. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research (2016), and a meta-aggregation method was applied to synthesise and categorise the research themes. This study standardised the presentation of results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.
A total of 14 studies were included, resulting in 63 research outcomes, which were consolidated into 12 new categories and integrated into 4 main themes: (1) the impact of dysphagia on daily life; (2) coping with the changes caused by dysphagia; (3) understanding of dysphagia and related needs; and (4) the physiological and psychological challenges faced, and the efforts to seek support.
The dual physiological and psychological challenges posed by dysphagia profoundly affect patients' daily lives, prompting ongoing adjustments to cope with these changes. Both patients and caregivers have a limited understanding of dysphagia but exhibit a strong need for support. These findings underscore the importance of providing comprehensive, individualised support for patients and caregivers to improve their quality of life and coping experiences.
No Patient or Public Contribution. This study aims to analyse and synthesise the experiences and perspectives of patients and their caregivers reported in existing research. As no original data were collected and no direct interaction with patients or the public occurred, specific patient or public contributions are not included.
The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care.
Explore the experiences of patients and families during the transition from the intensive care unit to the general ward.
A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis.
PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024.
Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method.
Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories.
Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being.
Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications. The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care. Identify patient and family needs when designing transition interventions. Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings.
This is a meta- synthesis without direct patient involvement.
by Wenlong Qian, Kou Xu, Shuo Li, Zhuo Zhang, Xiaoxiao Hou, Bingjie Min, Jia Ling, Xinyu Zhu, Hui Zhou, Wenjuan Xu, Wenming Yang, Shijian Cao, Yonghua Chen
BackgroundPenicillamine(D-Penicillamine) and trientine are first-line therapies for Wilson’s Disease (WD), yet real-world data on their adverse events (AEs) remain scarce. We analyzed the FDA Adverse Event Reporting System (FAERS) to comprehensively assess the safety of penicillamine and trientine in WD treatment.
MethodsAEs for penicillamine and trientine (2004Q1–2024Q4) were analyzed using Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and Bayesian Confidence Propagation Neural Network (BCPNN).
ResultsWe found 1,452 and 760 AEs related to penicillamine and trientine, respectively. In all adverse event (AE) reports, the ratio of females to males was approximately 1.3, with the highest proportion of AE reports in the 21–30 age group, and the largest number of AE reports coming from the United States. Signal detection showed that the most commonly reported AEs for penicillamine and trientine were drug hypersensitivity and tremor, respectively, with the highest proportions in the SOC categories of immune system disorders and gastrointestinal disorders. The main AEs for both drugs involved condition aggravated, and identified potential safety signals requiring further validation for the two drugs, such as decreased bone density and brain atrophy for penicillamine, and memory impairment, oesophageal ulcer and starvation for trientine. In addition, we found that women were more likely to experience drug hypersensitivity in penicillamine adverse event reports, while men were more likely to experience cutis laxa.
ConclusionThis study reveals the characteristics of AEs and potential associated risks in the clinical application of penicillamine and trientine, emphasizing individualized medication and vigilant monitoring strategies to provide guidance for safe medication use.
To explore the mediating effect of team job crafting on the transformational leadership–occupational well-being association in newly graduated nurses.
A multicentre cross-sectional study was conducted in three tertiary hospitals in China. Using convenience sampling, 677 newly graduated nurses were recruited between August 2024 and September 2024, and completed the transformational leadership questionnaire, team job crafting scale for nurses, and healthcare providers' occupational well-being scale. Data analysis was performed using IBM SPSS 27.0 software and the PROCESS 4.2 plugin. Hayes' mediation model (Model 4) was employed to test the indirect effect. The significance of the mediating effect was assessed using the bias-corrected bootstrap method (5000 resamples).
Ultimately, 546 valid questionnaires were collected. The participants' transformational leadership, nurse team job crafting and healthcare providers' occupational well-being scores were all above average. Linear regression analysis revealed that transformational leadership and team job crafting positively predicted occupational well-being (β = 0.549, p < 0.001; β = 0.695, p < 0.001). Mediating analysis revealed that the indirect effect of transformational leadership on occupational well-being was 0.276 (95% confidence interval: 0.174, 0.377), indicating the presence of an indirect effect. Additionally, team job crafting accounted for 33.5% of the effect of transformational leadership on occupational well-being.
Perceived transformational leadership among newly graduated nurses could positively influence their occupational well-being, with team job crafting playing a partial mediating role between the two. Therefore, it is recommended that nursing managers strengthen their transformational leadership practices to promote the accumulation and internalisation of job resources among newly graduated nurses, thereby enhancing their ability and level of team job crafting and further promoting their occupational well-being.
To systematically analyse international empirical literature and establish a comprehensive understanding of the push and pull factors influencing retention and turnover among mid-career nurses.
An integrative review.
PubMed, Web of Science, Scopus, EMBASE (Ovid), and CINAHL (EBSCO) were searched for studies published between January 2001 and November 2024.
An integrative literature review was conducted following the five-step process outlined by Whittemore and Knafl. Articles were screened by title, abstract, and full text based on predefined inclusion and exclusion criteria. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and synthesised narratively, and the findings were presented according to the socio-ecological framework.
A total of 1930 studies were identified, with 14 included for analysis: 10 qualitative, 3 quantitative, and 1 mixed-methods study. Guided by the socio-ecological framework, four themes and 10 subthemes emerged: (1) Intrapersonal (professional knowledge/skills, health issues, work-family balance); (2) Interpersonal (professional collaborative relationships, supervisor support); (3) Organisational (organisational characteristics, work characteristics, career development); and (4) Societal (salary/benefits, Social/governmental recognition).
This review reveals the heterogeneity of research on this topic and confirms previous findings. It identifies certain push-and-pull factors common to nurses across all stages of their careers. However, mid-career nurses face unique challenges, including more complex healthcare demands, declining health status, growing family caregiving responsibilities, unclear organisational roles, underutilisation of professional skills, career stagnation, and limitations on salary growth. These findings highlight the need for tailored retention strategies for mid-career nurses.
A “one-size-fits-all” retention strategy does not meet the needs of all nurses. To improve nurse retention rates, it is essential to address the shifting demands and priorities that arise as nurses reassess and transition through different career stages. For mid-career nurses, acknowledging and valuing their expertise and capabilities, providing sufficient resources, and fostering a supportive work environment that promotes career development may be effective strategies for retaining these experienced professionals.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No Patient or Public Contribution.
To examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information–motivation–behavioural (IMB) skills model from a behavioural perspective.
Cross-sectional study.
A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.
The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.
Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.
Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.
The STROBE checklist was used as a guideline.
Nurses completed questionnaires.
Trial Registration: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216
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