The effectiveness of humanoid diagram teaching strategy on care capacity and retention in novice nurses

AimTo examine the effectiveness of a Humanoid Diagram Teaching Strategy (HDTS) on care capabilities and retention of novice nurses.BackgroundGuiding novice nurses in clinical practice is a matter of concern and the use of diagrams in assisting the learning process and to promote learning efficiency has been acknowledged.DesignThis is a quasi-experimental study with asynchronous repeated measurements for the experimental and control groups.MethodsThe study was conducted in a medical centre in southern Taiwan with 24 novice nurses. The intervention, Humanoid Diagrams Teaching Strategy, contained three parts: the head and neck; trunk; and limbs. The HDTS was applied three time weekly. Each session lasted approximately 30 min and the training lasted 4 weeks. The effectiveness of HDTS was measured using Mini-CEX, CbD and retention rates in the 3rd and 6th months of novice nurses’ experience.ResultsAfter the HDTS, although increases in mini-CEX and CbD scores in the experimental group were greater than the control group, these differences were not statistically significant after considering the time interaction. But the 3rd month and 6th month novice nurses’ retention rates were statistically significantly different by comparing the differences under the time interaction effects in both groups.ConclusionsThe Humanoid Diagram Teaching Strategy is an effective tool for preceptors to use in assisting novice nurses in learning, improving their nursing care knowledge and technical skills and to increase their retention rate.     

The EQ-HWB: Overview of the Development of a Measure of Health and Wellbeing and Key Results

ObjectivesExisting measures for estimating quality-adjusted life-years are mostly limited to health-related quality of life. This article presents an overview of the development the EQ-HWB (EQ Health and Wellbeing), which is a measure that encompasses health and wellbeing.MethodsStages: (1) Establishing domains through reviews of the qualitative literature informed by a conceptual framework. (2) Generation and selection of items to cover the domains. (3) Face validation of these items through qualitative interviews with 168 patients, social care users, general population, and carers across 6 countries (Argentina, Australia, China, Germany, United Kingdom, United States). (4) Extensive psychometric testing of candidate items (using classical, factor analysis, and item response theory methods) on > 4000 respondents in the 6 countries. Stakeholders were consulted throughout.ResultsA total of 32 subdomains grouped into 7 high-level domains were identified from the qualitative literature and 97 items generated to cover them. Face validation eliminated 36 items, modified 14, and added 3. Psychometric testing of 64 items found little difference in missing data or problems with response distribution, the conceptual model was confirmed except in China, and most items performed well in the item response theory in all countries. Evidence was presented to stakeholders in 2 rounds of consultation to inform the final selection of items for the EQ-HWB (25-item) and the short version of EQ-HWB (9-items).ConclusionsEQ-HWB measures have been developed internationally for evaluating interventions in health, public health, and social care including the impact on patients, social care users, and carers.     

The Effects of the 2020 COVID-19 Lockdown on Mood,Behavior, and Social and Cognitive Functioning in Older Long-Term Care Residents

ObjectivesWe aimed to explore the effects of the Dutch COVID-19 lockdown (March 20–May 25, 2020) on mood, behavior, and social and cognitive functioning of older residents of long-term care facilities (LTCFs) prospectively.DesignMixed methods: historically controlled longitudinal cohort study and focus groups.Setting and ParticipantsResidents of Dutch LTCFs.MethodsResidents who were assessed during and prior to the lockdown were compared to residents of the same wards with 2 assessments prior to the lockdown. We used mixed models and generalized estimating equation analyses to explore differences in changes in mood, withdrawal and aggressive behavior, loneliness and conflict, and cognition and delirium. We also explored whether the effect of the lockdown differed for different subgroups. In 2 online focus groups, LTCF care professionals, ranging from care staff to physicians, reflected on their experiences of the effect of the lockdown and the cohort study results.ResultsThe lockdown group of 298 residents was compared to the control group of 625 residents. Self-reported mood symptoms showed a slightly greater increase during the lockdown. During the first half of the lockdown, the level of conflict with other residents decreased whereas it increased in the control group. The subgroup with moderate-severe cognitive impairment showed a decrease in withdrawal during the lockdown, whereas the group with no-mild cognitive impairment showed a statistically nonsignificant relative increase. Professionals described great individual variation in the effects of the lockdown on residents. Facilities attempted to preserve the experienced positive effects, for example, by promoting tranquility in shared rooms and continuing to organize individualized ward-based activities.Conclusions and ImplicationsWe did not find clinically relevant negative effects of the lockdown on mood, behavior, and social and cognitive functioning in older residents of LTCFs at the group level. Possibly, staff mitigated the negative effects at the group level. Meanwhile, they learned lessons that they continue to apply to enhance resident well-being.     

Residual limb strength and functional performance measures in individuals with unilateral transtibial amputation

BackgroundIndividuals with lower limb amputation exhibit lower residual limb strength compared to their sound limb. Deficits in residual limb knee flexion and extension strength may impact functional performance during tasks relevant to daily living.Research questionDoes knee flexor and extensor strength in the residual limb impact functional outcome measures, such as walking energetics and performance metrics, in individuals with unilateral transtibial amputation?MethodsFourteen individuals with traumatic unilateral transtibial amputation were recruited for this observational study. Participants completed metabolic testing at three standardized speeds based on leg length, as well maximum isokinetic knee flexion and extension strength for both residual and sound limbs. Participants also completed a series of functional outcome tests, including a two-minute walk test, timed stair ascent test, and four-square step test. Walking energetics (metabolic cost, heart rate, and rating of perceived exertion) and performance metrics were compared to percent deficit of residual limb to sound limb knee flexion and extension muscle strength. A linear regression assessed significant relationships (p < 0.05).ResultsA significant relationship was observed between percent deficit of knee extension strength and heart rate (p = 0.024) at a fast walking speed. Additionally, percent deficit knee flexion strength related to rating of perceived exertion at slow and moderate walking speeds (p = 0.038, p = 0.024). Percent deficit knee extension strength related to two-minute walk time performance (p = 0.035) and percent deficit knee flexion strength related to timed stair ascent time (p = 0.025).SignificanceThese findings suggest the importance of strength retention of the residual limb knee flexion and extension musculature to improve certain functional outcomes in individuals with unilateral transtibial amputation.     

品管圈在植入式静脉输液港患者护理中的应用

目的探讨品管圈在植入式静脉输液港(IVAP)患者护理中的应用。方法选取本院2018年10月-2018年12月IVAP患者30例作为对照组,2019年1月-2019年3月品管圈活动干预后IVAP患者30例作为观察组。对照组采用常规护理措施,观察组采用品管圈活动干预后的护理措施。比较两组IVAP患者并发症的发生率和对护理工作的满意度。结果观察组导管堵塞1例;并发症发生率为3.33%(1/30)。对照组感染4例,血栓2例,导管堵塞4例;并发症发生率为33.33%(10/30)。观察组并发症发生率低于对照组(P <0.05)。观察组对优质服务、技术水平、关怀、出院指导、护理总满意度评分分别为(42.39±5.27)分、(31.49±4.32)分、(22.25±4.69)分、(20.26±4.91)分、(112.24±10.38)分;对照组分别为(38.65±4.91)分、(28.68±4.26)分、(19.96±4.30)分、(19.94±4.63)分、(103.37±10.12)分;观察组对优质服务、技术水平、关怀、出院指导、护理总满意度评分均高于对照组(P <0.05)。结论通过品管圈活动干预后的护理措施明显降低IVAP患者并发症的发生率,提高患者对护理工作的满意度。     

Normative Data of the Hip Disability and Osteoarthritis Outcome Score,JR in a Healthy United States Population

BackgroundPatient-reported outcome measures (PROMs) play a vital role in the care we provide our patients. To help understand the application of PROMs in arthroplasty, normative and benchmark data to serve as a comparison to patients presurgery and postsurgery would be extremely valuable. We collected normative data of the Hip Disability and Osteoarthritis Outcome Score (HOOS), JR on a healthy population, greater than 17 years of age, in the United States devoid of hip injury and/or surgery.MethodsThis is a cross-sectional study, where hard copy surveys were administered to 1140 patients, being seen for an orthopedic issue unrelated to their hip, and nonpatient visitors in July 2018 at an outpatient orthopedic clinic in a suburban metropolitan city. Participants were eligible if they self-reported a medical history negative for hip arthroplasty, current hip pain/disability, or hip procedure (surgery or injection) within the past year. Mean, standard deviation, 95% confidence intervals, and ranges on the HOOS, JR interval scores were calculated by sex, age decade, body mass index (BMI), reason for visit, history of orthopedic procedure, and medical history.ResultsWe included 425 men and 575 women in the final study cohort. Women aged between 70+ years reported the lowest mean interval score (mean = 89.8). Overall women scored lower as well (93.3 vs 95.7, P = .001). There was not a statistical difference between the interval scores by tobacco consumption (93.5 vs 94.4, P = .49) and between patients versus nonpatient visitors (94.2 vs 94.5, P = .672). Lower scores were observed in participants with a past nonhip orthopedic procedure (92.6 vs 94.9, P = .016), with a medical history of a chronic illness (92.5 vs 95.9, P = <.001), and classified as obese (BMI > 30) (91.7 vs 95.2, P < .001). On regression analysis, there was a decrease of 0.3 and 0.1 in the interval score for each unit of BMI and age by year, respectively (P < .001).ConclusionThis study provides normative reference values for the HOOS, JR in a US population from a suburban metropolitan city for individuals greater than 17 years of age. These scores can facilitate physician-patient shared decision-making to help patients understand expectations after hip arthroplasty in respect to PROMs.     

Narrative review of the psychometric properties of language tests used in anomia treatment for primary progressive aphasia (PPA)

Background: Primary progressive aphasia (PPA) is a neurodegenerative dementia in which language decline is the first and most prominent symptom. Among several interventions for PPA, language rehabilitation has been the most frequently used.

Aims: This narrative review aimed to evaluate existing standardised language tests used in the assessment of PPA, in order to determine whether they are appropriate and psychometrically adequate to detect change over time in the treatment of anomia.

Main Contribution: The present findings highlight the scarcity of psychometrically robust instruments used to measure therapy-induced gains in PPA. Additionally, most of these instruments were not validated for use with the PPA population, which consequently might bias the results. There is a need for population-based norms for existing instruments.

Conclusions: The accurate assessment of lexico-semantic deficits in PPA should rely on objective, reliable, valid, and responsive outcome measures. Psychometric studies are needed to evaluate and eventually improve the quality of language tests used in clinical practice.     

手术烟雾对大鼠生理功能损害的实验研究

目的 探讨手术烟雾对生理功能的危害性及采取防护措施的必要性。 方法 采用60只SD大鼠，随机分为空白组、烟雾组及干预组三组，每组20只。空白组不接受烟雾刺激，无任何防护；烟雾组和干预组大鼠在烟雾环境中安置30min；干预组大鼠提前接受预防措施。连续两周后检测手术烟雾环境中大鼠生理、生化指标及预防措施的有效性。 结果 使用电刀3min后，空气质量受到严重污染，并且随电刀使用时间增加而持续下降；连续两周后烟雾组大鼠心功能、血流动力学、呼吸功能受到明显损害，血清炎性因子IL-6、IL-8和TNF α浓度明显增加；而干预组大鼠生理功能受到明显保护，炎性因子浓度降低。在两周实验期内，手术烟雾对肝肾功能无明显影响。结论 手术烟雾会引起明显的生理功能损害，采取防护措施能起到良好的保护作用。