共查询到20条相似文献，搜索用时 645 毫秒
1.
Anna M. Pirsch PhD RN-BC Robin R. Austin PhD DNP DC RN-BC FAMIA Lisa Martin PhD RN PHN AHNBC FAAN David Pieczkiewicz PhD Karen A. Monsen PhD RN FAMIA FNAP FAAN 《Public health nursing (Boston, Mass.)》2023,40(6):905-913
Background
Public Health Nurses (PHN) caring for vulnerable populations amid systemic inequality must navigate complex situations, and consequently they may experience serious moral distress known to be detrimental to PHN wellbeing.Objective
Given PHN awareness of social inequities, the study aimed to determine if PHNs were motivated to enact social change and engage in social and political action to address inequality.Design and sample
A survey of 173 PHNs was conducted in fall 2022. The convenience sample was mainly female (96.5%), White (85%), had associate/bachelor's degrees (71.7%), and worked in governmental public health settings (70.7%).Measure
The study employed the Short Critical Consciousness Scales’ subscales: Critical Reflection, Critical Motivation, and Critical Action.Results
PHNs were highly motivated to address inequities (Critical Motivation = 20.83; SD = 3.16), with similarly high awareness (Critical Reflection = 17.89; SD = 5.18). However, social and political action scores were much lower (Critical Action = 7.13; SD = 2.63). A subgroup of PHNs with strong agreement regarding the impact of poverty were more likely to be younger (p = .039) and work in a community setting (p = .003); with higher scores across subscales (p < .001).Conclusions
High critical reflection and motivation among PHNs aligned with literature. Lower Critical Action scores warrant investigation into validity for PHNs, and possible role constraints. 相似文献2.
3.
Anna Winquist MN RN PhD Candidate Elizabeth C. Schenk PhD RN FAAN Cara Cook MSN RN Shanda Demorest DNP RN Ekaterina Burduli PhD 《Public health nursing (Boston, Mass.)》2023,40(2):306-312
Objective
To confirm the factor structure of the Climate, Health, and Nursing Tool (CHANT) tool via confirmatory factor analysis.Design and sample
This is a cross-sectional analysis of voluntary, anonymous responses collected online in 2019, from a non-representative sample of 489 nurses from 12 nations with 95% of the respondents from the United States.Measurements
A confirmatory factor analysis (CFA) was conducted to test a five-factor measurement model of the 22-item CHANT. Reliability was examined via Cronbach's α coefficient.Results
The five CHANT subscales demonstrated acceptable reliability with Cronbach's α ranging from 0.67 to 0.91. The five-factor model of CHANT demonstrated good fit, x2(199) = 582.747, p < .001, CFI = 0.94, RMSEA = 0.06, and SRMR = 0.04 with statistically significant item-factor loadings.Conclusion
CHANT is a reliable and robust instrument to measure nurses’ awareness, concern, motivation, and home and work behaviors regarding climate change and health, and is ready to be utilized in research, policy, professional settings, and among educators. 相似文献4.
5.
Joint effects of prothrombotic genotypes and body height on the risk of venous thromboembolism: the Tromsø study 
下载免费PDF全文
下载免费PDF全文 L. D. Horvei S. K. Brækkan E. N. Smith T. Solomon K. Hindberg K. A. Frazer F. R. Rosendaal J.‐B. Hansen 《Journal of thrombosis and haemostasis》2018,16(1):83-89
Essentials
- Body height and prothrombotic genotypes are associated with risk of venous thromboembolism (VTE).
- The joint effect of prothrombotic genotypes and tall stature on VTE risk is scarcely investigated.
- We investigated the joint effect of prothrombotic genotypes and tall stature on VTE risk.
- Prothrombotic genotypes did not yield excess risk of VTE in subjects with a tall stature.
Summary
Background
Studies have reported synergistic effects of prothrombotic single‐nucleotide polymorphisms (SNPs) and obesity on the risk of venous thromboembolism (VTE). Tall stature is associated with an increased VTE risk, but the joint effect of prothrombotic genotypes and tall stature on the VTE risk is unknown.Aims
To investigate the joint effects of prothrombotic genotypes and tall stature on the VTE risk.Methods
Cases with incident VTE (n = 676) and a randomly selected age‐weighted subcohort (n = 1842) were sampled from the Tromsø study (cohort follow‐up: 1994–2012). DNA was genotyped for rs6025 (factor V Leiden), rs1799963 (FII), rs8176719 (ABO blood group), rs2066865 (fibrinogen‐γ), and rs2036914 (FIX). Age‐adjusted and sex‐adjusted hazard ratios (HRs) of VTE were calculated by categories of risk alleles (de Haan 5‐SNP score: 0–1, 2–3, and ≥ 4) and body height (< 40th, 40th–80th and > 80th percentiles).Results
The VTE risk increased by increasing category of body height, and subjects with height ≥ 178 cm had a two‐fold higher VTE risk (HR 2.03; 95% confidence interval [CI] 1.51–2.73) than those with height ≤ 165 cm. The VTE risk also increased across categories of risk alleles. However, the combination of a tall stature and risk alleles, either individual SNPs or risk score, did not result in an excess VTE risk. Subjects with four or more risk alleles and height ≥ 178 cm had a two‐fold (HR 2.08; 95% CI 1.24–3.52) higher VTE risk than subjects ≤ 165 cm with no risk allele or one risk allele.Conclusions
In contrast to obesity, the presence of prothrombotic genotypes did not result in an excess VTE risk in subjects with a tall stature. 相似文献6.
Elina Turunen MSc RN Merja Miettinen Docent MSc RM Leena Setälä MD PhD EMBA Katri Vehviläinen‐Julkunen PhD RM RN 《Journal of clinical nursing》2018,27(1-2):288-305
Aims and objectives
To evaluate the impact of implementing an evidence‐based, structured preoperative protocol on day of surgery cancellations in 13 operative specialties.Background
Surgery cancellations cause unnecessary harm for patients and organisations as many cancellations could be prevented. Preoperative care has developed in recent years, and several preoperative interventions have been introduced. However, the optimal model for organising preoperative care remains unknown. Cancellations are a commonly used indicator when evaluating the success of preoperative care.Design
Observational study with two study phases: before and after.Methods
The cancellation data were collected from the hospital register from 1 September 2013–31 May 2014 (n = 591) and from September 2015–May 2016 (n = 542). The compliance rate of the preoperative protocol was evaluated in group sessions (n = 13) during spring 2016 using the participation of preoperative healthcare professionals (n = 49). The data were analysed statistically.Results
Cancellation rates varied between 1.6%–9.7% (in the first phase) and between 1.5%–7.7% (in the second phase). A remarkable decrease was found in patients who failed to attend their scheduled procedures. The mean of compliance to the preoperative protocol across all specialties was 82.3%. A correlation between the rate of cancellation and the rate of compliance with the preoperative protocol was found.Conclusions
A preoperative protocol promotes the scheduled arrival of surgical patients to the hospital and therefore decreases cancellation rates.Relevance to clinical practice
An evidence‐based preoperative care protocol should be introduced for all healthcare professionals working in preoperative care to ensure smooth, safe and high‐quality care for surgical patients. 相似文献7.
Lyuna Su RN Orn-Anong Wichaikhum PhD RN Kulwadee Abhicharttibutra PhD RN 《International nursing review》2023,70(1):111-116
Aim
To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID-19.Background
Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID-19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments.Methods
A cross-sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses.Results
Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment.Discussion
The COVID-19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses’ organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential.Conclusion and implications for the field of nursing and health policy
Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID-19. 相似文献8.
Mary E. Kantz PhD RN PhD graduate Comfort Enah PhD RN FAAN Lisa M. Abdallah PhD RN CNE 《Public health nursing (Boston, Mass.)》2023,40(6):931-939
Objective
To examine the health-housing relationship in low-income older adults, and differences by income and receipt of housing assistance.Design
Secondary analysis of longitudinal survey data.Sample
About 10,858 adults aged 62+ who completed at least one wave of the 2014 Survey of Income and Program Participation (SIPP) (n = 37,333 observations).Measurements
SIPP variables representing demographics and housing quality, affordability, stability, and neighborhood were analyzed. Low-income and higher-income participants were differentiated by the household income-to-poverty ratio.Results
Low-income participants were significantly more likely to be in poor health and report problems with housing quality, affordability, and neighborhood safety compared to higher-income participants (p < .001). Increased household size and problems with housing quality and neighborhood safety were associated with poor health in both groups (p < .05). Low-income participants who received housing assistance were significantly poorer, less healthy, and food insecure than participants not receiving assistance (p < .001); however, the health-housing relationship was not different in the two groups.Conclusions
Results provide additional support for housing as a social determinant of older adult health. Though housing assistance programs reached a subset of low-income older adults, the results suggest a housing assistance shortfall. Implications for public health nurses and researchers are explored. 相似文献9.
Orlaith Cormican RGN BSc MHSc PG Cert in Cancer Care Haematology Maura Dowling PhD RNT RGN 《Journal of clinical nursing》2018,27(7-8):1713-1721
Aims and Objectives
To explore which symptoms relapsed myeloma patients experience and what self‐care strategies are used.Methods
This was a qualitative study utilising focus group interviews (n = 4) with relapsed myeloma patients (n = 15) and carers (n = 9). The focus groups were analysed and guided by thematic analysis.Results
Three major themes with subthemes were identified following analysis of the interview data: “difficult symptoms; “self‐care” and “feeling vulnerable.” These findings indicate the challenges relapsed myeloma patients experience with ongoing symptoms and highlight the importance of continuity of care.Conclusions
Symptom management for myeloma patients remains complex due to the array of treatments given. These patients require holistic care and thorough regular assessments to help them cope with the adverse effects on their physical and psychological health. For patients with a long‐term diagnosis of myeloma, self‐management workshops and regular education sessions may be of benefit.Relevance to clinical practice
This study highlights the key role of healthcare professionals in going beyond assessment of symptoms to offering advice and support to assist relapsed myeloma patients in managing their symptoms. 相似文献10.
Iraia Bidaurrazaga-Letona Carlos Ayán Iratxe Duñabeitia Izaro Esain Xabier Monasterio Biotz Zulueta Jon Torres-Unda 《Journal of Applied Research in Intellectual Disabilities》2023,36(4):768-776
Background
Adults with intellectual disabilities often experience mobility limitations. Baduanjin, a mindfulness-based exercise intervention, can exert positive effects on functional mobility and balance. This study examined the impact of Baduanjin on physical functioning and balance of adults with intellectual disabilities.Method
Twenty-nine adults with intellectual disabilities participated in the study. Eighteen received a Baduanjin intervention for 9-months; 11 participants did not receive any intervention (comparison group). Physical functioning and balance were assessed using the short physical performance battery (SPPB) and stabilometry.Results
Participants in the Baduanjin group experienced significant changes in the SPPB walking test (p = .042), chair stand test (p = .015), and SPPB summary score (p = .010). No significant changes between groups were observed in any of the variables assessed at the end of the intervention.Conclusions
Baduanjin practice may cause significant, albeit small, improvements in physical functioning of adults with intellectual disabilities. 相似文献11.
Background
Research indicates that diabetes mellitus (DM) may be a risk factor for frailty and individuals with DM are more likely to be frail than individuals without DM; however, there is limited research in hospitalised older adults.Objectives
To determine the extent of frailty in hospitalised older adults with and without DM using a 16‐item Frailty Risk Score (FRS) and assess the role of frailty in predicting 30‐day rehospitalisation, discharge to an institution and in‐hospital mortality.Methods
The study was a retrospective, cohort, correlational design and secondary analysis of a data set consisting of electronic health record data. The sample was older adults hospitalised on medicine units. Logistic regression was performed for 30‐day rehospitalisation and discharge location. Cox proportional hazards regression was used to analyse time to in‐hospital death and weighted using propensity scores.Results
Of 278 hospitalised older adults, 49% had DM, and the mean FRS was not significantly different by DM status (9.6 vs. 9.1, p = 0.07). For 30‐day rehospitalisation, increased FRS was associated with significantly increased odds of rehospitalisation (AOR = 1.24, 95% CI [1.01, 1.51], p = 0.04). Although 81% were admitted from home, 57% were discharged home and 43% to an institution. An increased FRS was associated with increased odds of discharge to an institution (AOR = 1.48, 95% CI [1.26, 1.74], p < 0.001). The FRS was not significantly associated with increased risk of in‐hospital death (p = 0.17), but DM was associated with a 484% increase in the instantaneous risk of death (AHR = 5.84, 95% CI [1.71, 19.9], p = 0.005).Conclusion
Diabetes mellitus and frailty were highly prevalent; the mean FRS was not significantly different by DM status. Although increased frailty was significantly associated with rehospitalisation and discharge to an institution, only DM was significantly associated with in‐hospital mortality.Relevance to clinical practice
Frailty assessment may augment clinical assessment and facilitate tailoring care and determining optimal outcomes in patients with and without DM. 相似文献12.
J. Schliessbach A. Siegenthaler L. Bütikofer P. Vuilleumier P. Jüni U. Stamer L. Arendt‐Nielsen M. Curatolo 《European Journal of Pain》2018,22(5):973-988
Background
Drugs are prescribed for chronic low back pain without knowing in advance whether a patient will respond to them or not. Quantitative sensory tests (QST) can discriminate patients according to sensory phenotype, possibly reflecting underlying mechanisms of pain processing. QST may therefore be a screening tool to identify potential responders to a certain drug. The aim of this study was to investigate whether QST can predict analgesic effects of oxycodone, imipramine and clobazam in chronic low back pain.Methods
Oxycodone 15 mg (n = 50), imipramine 75 mg (n = 50) and clobazam 20 mg (n = 49) were compared to active placebo tolterodine 1 mg in a randomized, double‐blinded, crossover fashion. Electrical, pressure and thermal QST were performed at baseline and after 1 and 2 h. Pain intensity was assessed on a 0–10 numeric rating scale every 30 min for up to 2 h. The ability of baseline QST to predict pain reduction after 2 h was analysed using linear mixed models. Genetic variants of drug‐metabolizing enzymes and genes affecting pain sensitivity were examined as covariables.Results
No predictor of analgesic effect was found for oxycodone and clobazam. Thermal QST was associated with analgesic effect of imipramine: patients more sensitive to heat or cold were more likely to experience an effect of imipramine. Pharmacogenetic variants and pain‐related candidate genes were not associated with drug efficacy.Conclusions
Thermal QST have the potential to predict imipramine effect in chronic low back pain. Oxycodone and clobazam effects could not be predicted by any of the selected QST or genetic variants.Significance
Predicting drug efficacy in chronic low back pain remains difficult. There is some evidence that patients more sensitive to heat and cold pain respond better to imipramine. 相似文献13.
Lachlan Philpott Ellie Clemensen Gabriel T Lau MD FACEM 《Emergency medicine Australasia : EMA》2023,35(4):605-611
Objective
A randomised single-blind trial was undertaken in an adult ED population, comparing the effectiveness of droperidol 2.5 mg IV with ondansetron 8 mg IV for the treatment of nausea and vomiting.Methods
Patients were randomly allocated to receive droperidol (n = 60) or ondansetron (n = 60). Patients rated their nausea severity on a Visual Analogue Scale (VAS) immediately before and 30 min after drug administration. The primary outcome was of symptom improvement, defined by a VAS change ≥−8 mm 30 min post-treatment. Mean VAS change and percentage experiencing desired effect were secondary outcomes compared.Results
Of 120 study patients, 60 (50%) received droperidol or ondansetron. Symptom improvement occurred in 93% (56 of 60) and 87% (52 of 60), respectively (P = 0.362). Mean VAS change was −38 mm and −29 mm, respectively (P = 0.031). Percentage of patients indicating desired effect was 85% and 63%, respectively (P = 0.006). Additional antiemetics were required for 16% and 37% of subjects, respectively (P = 0.006).Conclusion
There was no statistically significant difference in the primary outcome of symptom improvement between droperidol and ondansetron. Secondary outcomes which favour droperidol warrant further exploration. 相似文献14.
Objective
The aim of our study was to investigate the correlation between serum carbohydrate antigen 153 (CA153) and renal function in patients with type 2 diabetes mellitus (T2DM).Methods
A total of 184 patients with T2DM were included, and renal function was assessed by the modification of diet in renal disease (MDRD) formula adjusted coefficient of the Chinese people.Results
Serum CA153 concentrations were positively correlated with blood glucose (BG) and glycated hemoglobin (HbA1c) (r = .204, P = .005; r = .165, P = .025) in patients with T2DM. There was a negative correlation between serum CA153 and estimated glomerular filtration rate (GFR) (r = −.229, P = .002) in whole patients with T2DM; similarly, the correlations were observed in both women and men (r = −.228, P = .028 for women, r = −.231, P = .028 for men). Multiple linear regression analysis suggested that serum CA153 was still significantly correlated with estimated GFR (beta = −0.286, P < .001).Conclusions
Serum CA153 is negatively correlated with estimated GFR in patients with T2DM, and serum CA153 may be a potentially useful clinical biomarker to assess renal function in the study population.15.
16.
17.
Outcome in patients with left common pulmonary vein after cryoablation with second‐generation cryoballoon 下载免费PDF全文
下载免费PDF全文 Thomas Beiert MD Pia C. Lodde MD Lutz P.T. Linneborn MD Jessica Werner MD Lisa Prinz MD Florian Stöckigt MD Markus Linhart MD Lars Lickfett MD Georg Nickenig MD Jan W. Schrickel MD René P. Andrié MD 《Pacing and clinical electrophysiology : PACE》2018,41(1):22-27
1 Background
Pulmonary vein isolation (PVI) has become a widely accepted therapy in patients suffering from symptomatic atrial fibrillation (AF).2 Hypothesis
AF‐free survival differs in patients with left common pulmonary vein (LCPV) after PVI with second‐generation cryoballoon.3 Methods
We included patients scheduled for first PVI for paroxysmal or persistent AF. Symptomatic and/or documented arrhythmia episodes (>30 seconds) were defined as AF recurrence, excluding a 3‐month blanking period.4 Results
We observed a LCPV in 37 of 270 consecutive patients (13.7%). Analyses were performed in a 1:1 propensity score matched cohort of 68 patients. During a median follow‐up of 77.0 weeks, 37 patients (54.4%) had recurrent AF. The prevalence of LCPV was numerically higher in patients with AF recurrence (62.2% vs 35.5%, P = 0.051) and Kaplan‐Meier analysis showed lower AF‐free survival in patients with existence of a LCPV (P = 0.028). At 1‐year follow‐up, 70.6% of patients without versus 55.1% of patients with LCPV were free of AF. Multivariate Cox regression analysis revealed presence of a LCPV (hazard ratio [HR]: 2.996), chronic heart failure (HR: 3.423), and mitral regurgitation > I° (HR: 2.571) as predictors of AF recurrence.5 Conclusion
Patients with LCPV had significantly reduced AF‐free survival after ablation with the second‐generation cryoballoon, despite similar acutely successful PVIs. 相似文献18.
Background
In May 2019, the World Health Organization (WHO) added burn out to the list of occupational phenomena in the 11th Revision of the International Classification of Diseases (ICD-11). Soon thereafter, in March 2020, a global pandemic of SARS-COV-2 was declared.Objective
To investigate the interplay between transformational leadership, a proactive personality, employee proactive behaviors, and burn out in the field of physiotherapy during the SARS-COV-2 pandemic.Methods
Physiotherapists working at the Meuhedet Health Maintenance Organization (HMO) were asked to fill an online cross-sectional survey, in which they were asked to evaluate the transformational behavior of their manager and to assess their own burn out rate, degree of self-efficacy, proactive personality, and proactive behaviors. Eighty-one physical therapists (average age of 37.3 years (SD = 9.0)) responded to the survey, most of whom were female (67.9%, n = 55).Results
Transformational leadership and proactive personality were negatively associated with occupational burn out (β = −0.231, p < 0.05, β = −0.243, p < 0.05, respectively) among physiotherapists. The effect of the interaction between transformational leadership and proactive personality on proactive behaviors at work was not significant. However, a strong, significant positive relationship was found between proactive personality and proactive behaviors (β = 0.425, p < 0.001), and between self-efficacy and proactive behaviors (β = 0.479, p < 0.001).Conclusions
This up-to-date survey of transformational leadership and proactive personality among physiotherapists highlights these traits' important impact on burn out and proactive behaviors during the SARS-COV-2 pandemic. Furthermore, the transformational manager plays an important role in reducing burnout levels among physiotherapists, especially during a crisis such as the SARS-COV-2 pandemic. 相似文献19.
E. E. Amin M. A. Joore H. ten Cate K. Meijer L. W. Tick S. Middeldorp G. J. M. Mostard M. ten Wolde S. M. van den Heiligenberg S. van Wissen M. H. W. van de Poel S. Villalta E. H. Serné H.‐M. Otten E. H. Klappe P. Prandoni A. J. ten Cate‐Hoek 《Journal of thrombosis and haemostasis》2018,16(8):1555-1563
Essentials
- The value of compression therapy in acute phase of deep vein thrombosis is still unclear.
- Patients with deep vein thrombosis received acute compression hosiery, bandaging, or none.
- Acute compression reduces irreversible skin signs related to post thrombotic syndrome.
- Compression hosiery may be the preferred choice for the acute phase
Summary
Background
The effectiveness of compression therapy in the acute phase of deep vein thrombosis (DVT) is not yet determined.Objectives
To investigate the impact of compression therapy in the acute phase of DVT on determinants of the Villalta score, health‐related quality of life (HRQOL), and costs.Patients/Methods
Eight hundred and sixty‐five patients with proximal DVT (substudy of the IDEAL DVT study) received, immediately after DVT diagnosis, either no compression, multilayer bandaging, or hosiery. In the acute phase and 3 months after diagnosis, HRQOL was determined by use of the EQ‐5D, SF6D, and VEINES‐QoL intrinsic method (VEINES‐QoLint). At 3 months, signs and symptoms were assessed for the total and separate items of the Villalta score, and healthcare costs were calculated.Results
The compression groups had lower overall objective Villalta scores than the no‐compression group (1.47 [standard deviation (SD) 1.570] and 1.59 [SD 1.64] versus 2.21 [SD 2.15]). The differences were mainly attributable to irreversible skin signs (induration, hyperpigmentation, and venectasia) and pain on calf compression. Subjective and total Villalta scores were similar across groups. Differences in HRQOL were only observed at 1 month; HRQOL was better for hosiery (EQ‐5D 0.86 [SD 0.18]; VEINES‐QoLint 0.66 [SD 0.18]) than for multilayer compression bandaging (EQ‐5D 0.81 [SD 0.23; VEINES‐QoLint 0.62 [SD 0.19]). Mean healthcare costs per patient were €417.08 (€354.10 to €489.30) for bandaging, €114.25 (€92.50 to €198.43) for hosiery, and €105.86 (€34.63 to €199.30) for no compression.Conclusions
Initial compression reduces irreversible skin signs, edema, and pain on calf compression. Multilayer bandaging is slightly more effective than hosiery, but has substantially higher costs, without a gain in HRQOL. From a patient and economic perspective, compression hosiery would be preferred when initial compression is applied. Trial registration: IDEAL DVT study ClinicalTrials.gov number, NCT01429714. 相似文献20.