What makes emergency department patients reduce their alcohol consumption? – A computer-based intervention study in Sweden

ObjectivesThis study investigates the effectiveness of a computerized emergency department intervention for alcohol consumption and identifies explanation factors associated with reduced alcohol consumption from risk to non-risk drinking.MethodsPatients aged 18–69 years registered at the ED triage answered alcohol-related questions on a touch-screen computer. Follow-up data were collected by means of a postal questionnaire that was mailed to the patients 6 months after their ED visit.ResultsThere were four independent explanations for reduced alcohol consumption: being motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider. 339 patients could be followed up and of these were 97 categorized as risk drinkers at baseline and 45 became non-risk drinker 6 month later.ConclusionsBeing motivated to reduce alcohol consumption at baseline, influenced by just visiting the emergency department, considering the alcohol-related feedback information and impact from a health care provider were predictors for change from risk to non-risk drinking 6 months later.     

Pandemia COVID-19 sobre profesionales sanitarios en un hospital de tercer nivel en España: cambios laborales durante la primera ola,salud mental a los 4 meses y seguimiento a los 9 meses

ObjectiveTo determine the impact that the COVID-19 pandemic has had on health professionals, in terms of work changes and mental health.Method1) Cross-sectional study and 2) longitudinal prospective study on health professionals who worked directly with patients affected by COVID-19 pandemic during the period between March-June 2020 in a tertiary hospital in Barcelona. Baseline (July-November 2020) and follow-up (November 2020-March 2021) data were collected. Data related to the job and toxic habits were collected with ad hoc questionnaires, and data related to perceived stress, post-traumatic stress, depression, and anxiety using validated questionnaires.ResultsIn the baseline group (cross-sectional study), 90 professionals participated, 76% nurses. More than a third were on sick leave or took drugs to manage stress. Half of smokers increased tobacco use, and one in 5 increased alcohol consumption. Habitual shift change is significantly associated with depression, professional profile with anxiety, and perceived stress with age. In the longitudinal prospective study, the follow-up group (n = 64) shows high levels of stress and anxiety, which are maintained or even significantly increased over time.ConclusionsThe structural changes that occurred in the hospital during the first wave of the COVID-19 pandemic had a strong impact on professionals, many of them presenting an increase in toxic habits, as well as impaired mental health that is maintained over time.     

Complete blood count,measures of iron status and inflammatory markers in inner-city African Americans with undiagnosed hepatitis C seropositivity

BackgroundHepatitis C virus (HCV) infection may be associated with thrombocytopenia and increased iron stores in patients receiving medical care. We aimed to determine how often changes in hematologic, iron metabolic and inflammatory markers occur in individuals with undiagnosed HCV in the community.MethodsInner-city African Americans (n = 143) were recruited from the community according to reported ingestion of alcohol. They were divided broadly into those who drank more or less than 56 g alcohol/day as assessed by dietary questionnaire. HCV serology was determined and laboratory values were compared according to HCV seropositivity in analyses that adjusted for alcohol consumption.ResultsThe prevalence of HCV seropositivity was 23% among men and 29% among women. Levels of hepatocellular enzymes were higher with HCV seropositivity (P < 0.0001) but hemoglobin concentrations, white blood cell and platelet counts and serum ferritin concentrations did not differ. The globulin fraction of the serum protein concentration (P = 0.002) was increased with HCV seropositivity as expected with chronic inflammation. However, erythrocyte sedimentation rate and serum iron and haptoglobin levels did not differ significantly according to HCV status. Furthermore, multivariate analysis revealed that C-reactive protein was decreased and transferrin concentration was increased with both HCV and alcohol consumption (P < 0.014).ConclusionsPreviously undiagnosed HCV seropositivity has little effect on the complete blood count and body iron stores but appears to perturb the response to an inflammatory stimulus, causing reduced rather than increased circulating CRP concentrations and increased rather than decreased transferrin concentrations.     

Satisfaction and gains perceived by nursing students with medium and high-fidelity simulation: A randomized controlled trial

BackgroundThe use of simulation to reproduce the experience of health care settings and its use as a strategy in the teaching of nurses has grown at an unprecedented rate. There is little scientific evidence to examine the differences in satisfaction and gains perceived by the students with the use of medium and high fidelity.ObjectivesTo analyse and benchmark gains and satisfaction perceived by nursing students, according to their participation in medium- and high-fidelity simulated practice.DesignRandomized control trial post-test only design with control group.Setting and ParticipantsStudents of the 4th year of the Bachelor's Degree in Nursing who performed medium and high-fidelity simulated practice in a Simulation Centre environment.MethodsA satisfaction scale and a scale of perceived gains from the simulation were applied to the students who underwent simulated practice in a medium-fidelity environment (control group) and high-fidelity environment (experimental group). Statistical analysis was performed and a significance level of p < 0.05 was established.ResultsOf the 85 students who participated in the study, the majority were female (92.94%), with an average age of 21.89 years (SD = 2.81 years). Satisfaction is statistically significant in the realism dimension and overall satisfaction. In the gains perceived with the simulation there is a statistically significant difference in the dimension recognition/decision.ConclusionStudents are very satisfied with the realism of high-fidelity simulated practice and consider that this helps them more with recognition and decision compared with the medium-fidelity simulation.     

Acceptability and feasibility of a randomized clinical trial of oral naltrexone vs. placebo for women living with HIV infection: Study design challenges and pilot study results

BackgroundWomen living with HIV/AIDS who drink alcohol are at increased risk for adverse health outcomes, but there is little evidence on best methods for reducing alcohol consumption in this population. We conducted a pilot study to determine the acceptability and feasibility of conducting a larger randomized clinical trial of naltrexone vs. placebo to reduce alcohol consumption in women living with HIV/AIDS.MethodsWe designed the trial with input from community and scientific review. Women with HIV who reported current hazardous drinking (> 7 drinks/week or ≥ 4 drinks per occasion) were randomly assigned to daily oral naltrexone (50 mg) or placebo for 4 months. We evaluated willingness to enroll, adherence to study medication, treatment side effects, and drinking and HIV-related outcomes.ResultsFrom 2010 to 2012, 17 women enrolled (mean age 49 years, 94% African American). Study participation was higher among women recruited from an existing HIV cohort study compared to women recruited from an outpatient HIV clinic. Participants took 73% of their study medication; 82% completed the final assessment (7-months). Among all participants, mean alcohol consumption declined substantially from baseline to month 4 (39.2 vs. 12.8 drinks/week, p < 0.01) with continued reduction maintained at 7-months. Drinking reductions were similar in both naltrexone and placebo groups.ConclusionsA pharmacologic alcohol intervention was acceptable and feasible in women with HIV, with reduced alcohol consumption noted in women assigned to both treatment and placebo groups. However, several recruitment challenges were identified that should be addressed to enhance recruitment in future alcohol treatment trials.     

Calidad de vida relacionada con la salud en trabajadores de unidades de cuidados intensivos

ObjectiveTo analyse health-related quality of life in a sample of doctors and nurses from 2 intensive care units in the city of Buenos Aires, Argentina.MethodAn analytical, cross-sectional and quantitative study. The Spanish version of the SF-36 questionnaire was used, which comprises 8 dimensions grouped into 2 components (physical and mental) and evaluates the health status of respondents on a scale from 0 to 100; the higher the score, the better the perception of health status.ResultsNinety-five professionals from 2 intensive care units participated, 58% from a private institution and the rest from a public institution. The majority were women (57%), doctors (37%) with an average age of 42 years and with a maximum undergraduate degree and degree (59%). Of the dimensions making up health-related quality of life, the vitality dimension was perceived poorest with an average of 53.3, and physical function was the best evaluated at 87.8. The physical component dimensions were better evaluated than those of the mental component. The variables sex (male), age (> 40 years), presence of chronic diseases, qualification (medical), hourly workload (> 40 h per week) and years of service (> 11 years), seem to have a negative influence on the perception of health-related quality of life.ConclusionsStrategies need to be implemented to reduce the impact of work activity on the mental and physical health of health professionals. Strategies for health promotion and the prevention of known psychosocial and ergonomic risks are required, and workloads and duration of working hours need to be adjusted to preserve the integrity of health workers.     

A cross-sectional study of assessing knowledge,attitude, and practice of COVID-19 resuscitation among health care workers in a hybrid hospital for COVID-19 in Malaysia

BackgroundThe COVID-19 pandemic is an international public health emergency. As hospitals receive more severe forms of COVID-19 that necessitate resuscitation, emergency health care workers (HCW) must follow interim COVID-19 resuscitation guidelines.ObjectiveThe aim is to evaluate the levels of knowledge, attitude, and practice among emergency HCW of the COVID-19 resuscitation protocol by the European Resuscitation Council (ERC).MethodsA cross-sectional study using a validated questionnaire was conducted among HCW in the emergency department of University of Malaya Medical Centre (UMMC), Malaysia from April to June 2021.ResultsA total of 159 respondents were included in the analysis (89% response rate). Sixty-eight percent of respondents had adequate knowledge regarding COVID-19 resuscitation. Majority of the respondents had knowledge on airborne-precaution personal protective equipment (PPE) (99%) and infection control measures (98%). Nearly 73% were pessimistic about the COVID-19 prognosis. Seventy-three percent of respondents thought an arrested COVID-19 patient may benefit from cardiopulmonary resuscitation (CPR) and 94% were willing to administer CPR provided airborne-precaution PPE was available. Ninety percent of respondents reported adherence to resuscitation guidelines. There were significant differences in the mean knowledge scores between designation, education levels, and COVID-19 training. Overall, the respondents’ level of practice was insufficient (27%), with a mean score of 53.7% (SD = 14.7). There was a lack of practice in the resuscitation of the intubated and patients who were being prone. There was insufficient practice about ventilation technique, use of supraglottic devices, and intubation barriers. There was a positive correlation between adequate knowledge and good practice.ConclusionEmergency HCW have adequate knowledge, but poor compliance to the ERC COVID-19 guidelines. Emergency HCW were willing and confident to resuscitate COVID-19 patients, despite fears of nosocomial infection and expectation of poor patients’ prognosis. Ongoing education and training programs are recommended to improve their knowledge, cultivate a positive attitude, and achieve good compliance with COVID-19 resuscitation guidelines.     

Handling of hazardous drugs – Effect of an innovative teaching session for nursing students

BackgroundImparting knowledge and practical skills in hazardous drug handling in nursing students' education is essential to prevent hazardous exposure and to preserve nurses' health.ObjectivesThis study aimed at comparing routine nursing education with an additional innovative teaching session.DesignA prospective controlled study in nursing students was conducted in two study periods: (i) a status-quo period (routine education on handling hazardous drugs) followed by (ii) an intervention period (additional innovative teaching session on handling hazardous drugs).Settings/ParticipantsNursing students at a vocational school were invited to participate voluntarily.MethodsIn both study periods (i) and (ii), the following factors were analysed: (a) knowledge of hazardous drug handling by questionnaire, (b) practical skills in hazardous drug handling (e.g. cleaning) by a simulated handling scenario, (c) contamination with drug residuals on the work surface by fluorescent imaging.ResultsFifty-three nursing students were enrolled. (a) Median knowledge improved from status-quo (39% right answers) to intervention (65%, p < 0.001), (b) practical skills improved from status-quo (53% of all participants cleaned the work surface) to intervention (92%, p < 0.001). (c) Median number of particles/m² decreased from status-quo to intervention (932/97, p < 0.001).ConclusionsCompared with routine education, knowledge and practical skills in hazardous drug handling were significantly improved after an innovative teaching session. Additionally, the amount of residuals on the work surface decreased. This indicates a lower risk for hazardous drug exposure.     

The impact of a sense of self-efficacy on the level of stress and the ways of coping with difficult situations in Polish nursing students

IntroductionDuring their first practical classes at a clinical ward nursing students face a new environment; they take on new roles which is associated with stress and a need to handle it.ObjectiveThe aim of this study was to evaluate the effect of a sense of self-efficacy on the level of stress and the ways of coping by Polish nursing students during the first practical classes at a clinical ward.Material and MethodsThe study included 394 undergraduate subjects studying nursing at two universities in Southern Poland. The study used the method of diagnostic questionnaire and estimation. The research tools included: an original questionnaire, Stress Scale (PSS10), Inventory to measure coping with stress (Mini Cope) and Generalized Self-efficacy Scale (GSES). Data analysis was performed using the IBM Statistical Package for Social Sciences, version 21 for Windows. The verification of differences between variables was performed using χ² independence test, Kruskal-Wallis test, and Spearman rank correlation coefficient. The level of significance was accepted at α = 0.005.ResultsThe level of stress and a sense of self-efficacy in majority of tested nursing students were high. The people with low levels of perceived stress had a significantly higher sense of self-efficacy (rhoSpearman = − 0.196; p = 0.0001). The people with a higher sense of self-efficacy significantly more often used active strategies in stressful situations, such as Active coping (rhoSpearman = 0.284; p < 0.0001), Planning (rhoSpearman = 0.318, p ≤ 0.0001), Positive revaluation (rhoSpearman = 0.228, p < 0.0001), Acceptance (rhoSpearman = 0.188; p = 0.0002), Seeking Emotional Support (rhoSpearman = 0.123; p = 0.0143).ConclusionsA sense of self-efficacy had a significant impact on the level of stress and the ways of coping with difficult situations in nursing students.     

Effects of a nurse-led transitional care program on clinical outcomes,health-related knowledge,physical and mental health status among Chinese patients with coronary artery disease: A randomized controlled trial

BackgroundCoronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China.ObjectivesTo examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease.DesignRandomized controlled trial.MethodsThe Omaha system and Pender’s health promoting model were employed in planning and implementing this nurse-led transitional care program. The sample was comprised of 199 Chinese patients with coronary artery disease. The experimental group (n = 100) received nurse-led transitional care intervention in addition to routine care. The nurse-led transitional care intervention included a structured assessment and health education, followed by 7 months of individual teaching and coaching (home visits, telephone follow-up and group activity). The control group (n = 99) received a comparable length routine care and follow-up contacts. Evaluations were conducted at baseline and completion of the interventions using the perceived knowledge scale for coronary heart disease, the medical outcomes study 36-item short-form health survey and clinical measures (blood pressure, blood glucose, lipids, body mass index). Data were collected between March and October 2014.ResultsCompared with the control group, participants in the experimental group showed significant better clinical outcomes (systolic blood pressure, t = 5.762, P = 0.000; diastolic blood pressure, t = 4.250, P = 0.000; fasting blood glucose, t = 2.249, P = 0.027; total cholesterol, t = 4.362, P = 0.000; triglyceride, t = 3.147, P = 0.002; low density lipoprotein cholesterol, t = 2.399, P = 0.018; and body mass index, t = 3.166, P = 0.002), higher knowledge scores for coronary artery disease (total knowledge score, t = −7.099, P = 0.000), better physical health status (t = −2.503, P = 0.014) and mental health status (t = −2.950, P = 0.004).ConclusionsThis study provides evidence for the value of a nurse-led transitional care program using both the Omaha system and Pender’s health promoting model as its theoretical framework. The structured interventions in this nurse-led transitional care program facilitate the use of this program in other settings.     

Factors influencing preventive behavior against Middle East Respiratory Syndrome-Coronavirus among nursing students in South Korea

BackgroundMiddle East Respiratory Syndrome Coronavirus (MERS-CoV), an emerging infectious disease introduced in South Korea in 2015, spreads quickly through hospitals, and Korea became one of the major areas affected by the disease after the Middle East region. To stop the spread of an emerging disease, it is important to practice prevention guidelines correctly.ObjectivesThe purpose of this study was to investigate factors influencing preventive behavior against MERS-CoV among Korean nursing students.MethodsThis is a cross-sectional study using a questionnaire survey. Data were collected from 429 nursing students from three colleges of nursing in Korea from June 25 to July 3 in 2015.ResultsPreventive behavior against MERS-CoV was affected mostly by attitude (β = .243, p < .001). Such behavior was also high in relation to the variables of perceived risk (β = .232, p < .001), older students (β = .202, p < .001), knowledge level (β = .153, p < .01), and female respondents (β = .115, p < .05).ConclusionPreventive behavior against emerging infectious diseases such as MERS-CoV was found to be affected most significantly by attitude and risk perception. It is crucial to provide nursing students with information or knowledge, but it is also important to help those in nursing education recognize that active preventive behavior can prevent this infectious disease and stop its spread.