Technological Competency As Caring in Nursing: a Description,Analysis and Evaluation of The Theory

IntroductionWhen introducing and using technology in nursing, there is a danger that too much focus is placed on technology over caring for patients. The ‘Technological competency as caring in nursing’ theory can facilitate technology in caring, but the theory needs to be described, analysed and evaluated before it is used. The purpose of the literature review was to determine the possibility of applying the theory in education, research and practice, and whether the theory could be used to guide research into the use of electronic nursing record systems.MethodsA literature search was conducted in PubMed, CINAHL, ScienceDirect, Google Scholar and Google Books, and supplemented with manual searching using the keywords ‘Locsin’, ‘technology’, ‘caring’ and ‘nursing theory’. The criteria for inclusion were fully accessible articles and books in English on the relevant topics. The review process is shown in a PRISMA diagram. A hierarchy of evidence was used to evaluate the relative strength of the results. Pajnkihar’s model was used to describe, analyse and evaluate the theory.ResultsA total of 26 hits were included in the final analysis. The theory in question meets the criteria of clarity, simplicity and complexity, adequacy, importance and significance; it can be tested; and it is useful in patient care that employs technology.Discussion and conclusionThe theory is useful in nursing education, research and practice. The theory will be used to guide research on the perception of technological competency and care of internal medicine patients by nurses when using the electronic nursing record system in three Slovenian hospitals.     

Epoetin responsiveness in peritoneal dialysis patients: a multi-center Slovenian study

The objective of our study was to assess the influence of residual renal function and other factors on epoetin requirements in chronic peritoneal dialysis patients. Fifty-one stable patients (mean age +/- SD: 52 +/- 13 years; 20 women) without recent bleeding, bone marrow disease or malignancy were recruited in four Slovenian centers. The target hemoglobin was above 110 g/L. The peritoneal equilibration test results and relevant clinical and laboratory parameters were recorded. The epoetin resistance index was expressed as a weekly epoetin dose/body weight/hemoglobin concentration. Twenty-four percent of the patients did not need epoetin treatment, the rest were treated with epoetin-beta in a dose of 70 +/- 56 U/kg per week s.c.; the hemoglobin concentration was 124 +/- 15 g/L. Ferritin >100 microg/L and transferrin saturation >20% fulfilled 63% of patients whose epoetin resistance index was not significantly lower (0.43 +/- 0.5 U/kg per week per g/L vs 0.6 +/- 0.72 U/kg per week per g/L, P = 0.502). No difference was found between diabetic and non-diabetic patients. Treatment with angiotensin system antagonists, but not with aluminum phosphate binders, was associated with increased epoetin resistance index (0.56 +/- 0.59 vs 0.3 +/- 0.4 U/kg per week per g/L, P = 0.038). No correlation between epoetin resistance index and residual glomerular filtration rate was found (r = -0.2, P = 0.173). A multiple linear regression analysis showed C-reactive protein, intact parathormone level, female sex and treatment with angiotensin system antagonists to be the independent predictors influencing epoetin resistance index. Our results show that systemic inflammation, secondary hyperparathyroidism and angiotensin system antagonist treatment are the most important modifiable parameters affecting epoetin requirements in stable peritoneal dialysis patients.     

Preoperative Serum CA-125 Level As a Predictor for The Extent of Cytoreduction in Patients with Advanced Stage Epithelial Ovarian Cancer

BackgroundOvarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125.Patients and methodsAt the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).ResultsThe median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4–9.5) and 18 months (95% CI 12.5–23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6–29.5) and 46 months (95% CI 32.9–62.1), respectively.ConclusionsPreoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.Key words: ovarian cancer, tumour marker, CA-125, primary debulking surgery, neoadjuvant chemotherapy     

Prevalence and social correlates of postnatal depression in a low income country

Summary Background: Postnatal depression is an important public health problem worldwide. Recent evidence suggests that rates may be relatively higher in developing countries. We aimed to explore the prevalence of postnatal depression and its association with social support and other risk factors in a sample of Pakistani women. Methods: Population-based survey of 149 women at 12 weeks postnatal using the Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Personal Information Questionnaire (PIQ). Results: Thirty six percent women scored ≥12 on EPDS. High depression score was associated with lower social support, increased stressful life events in the preceding year and higher levels of psychological distress in the antenatal period. Conclusions: There is a high prevalence of postnatal depression in Pakistani women. Early interventions should be developed that target the antenatal period and strengthen social support networks in women at risk.     

Asymptomatic hyperuricemia and cardiovascular mortality in patients with chronic kidney disease who progress to hemodialysis

International Urology and Nephrology - Hyperuricemia has been associated with higher mortality in the general population, but less is known about CKD patients. The aim of our study was to determine...     

2 Renal Anemia Treatment In Peritoneal Dialysis Patients: A Multicenter Slovenian Study

Abdominal surgery is considered problematic if performed on dialysis patients who are on peritoneal dialysis. There is a common clinical practice to switch these patients to hemodialysis postoperatively for a period of time. Our attempt was to keep these patients on peritoneal dialysis after abdominal surgery, using a modified protocol of low volume exchanges. During the last two years, three of our patients on peritoneal dialysis underwent abdominal surgery. In one patient, laparoscopic cholecystectomy was performed, and abdominal hernia repair was performed in the other two. The day after the operation, we started with low volume (500 mL) exchanges with solutions with 1.36% glucose. During the daytime we prescribed four exchanges, and during the nighttime we put patients on automatic peritoneal dialysis (APD), also with low volume exchanges. After 5 days, the volume of exchanges was gradually increased and after 3 weeks all three patients were on their standard preoperative dialysis regime. Periodically, we controlled the adequacy of dialysis with Kt/V, which was not changed during these procedures. There were no complications postoperatively. We conclude that this modified protocol of peritoneal dialysis was useful and safe in all our patients and there was no need to switch patients to hemodialysis. Further clinical experience with a large number of patients might confirm the usefulness of low volume exchange protocol.     

The Influence of Age Hardening and Shot Peening on the Surface Properties of 7075 Aluminium Alloy

The present study investigates the effect of shot peening (SP) on the mechanical properties and surface roughness of 7075 aluminum alloy during different stages and conditions of heat treatment. The mechanical properties were determined by measuring Vickers microhardness profiles and residual stress profiles, while the amount of alloying elements present in the solid solution of the samples under different heat treatment conditions was determined by measuring the electrical conductivity. The results show that the increase in microhardness near the SP surface and the maximum compressive residual stresses are mainly related to the content of alloying elements in the solid solution. Surface roughness increases with increasing SP Almen intensity, and samples with the highest microhardness and residual stresses have the lowest surface roughness.     

Asymptomatic atherosclerosis and hypertension in nondiabetic patients with chronic kidney disease

Abstract:  Atherosclerosis is accelerated in dialysis patients, but less is known about asymptomatic atherosclerosis and major risk factors in patients with different stages of chronic kidney disease (CKD). We compared intima media thickness (IMT) and plaque occurrence in the carotid arteries in 104 nondiabetic patients (stages 1–5 of CKD; mean age: 51.6 years) with those in 40 healthy control subjects. The IMT values (0.69 vs. 0.59 mm; P  < 0.002) were higher in patients. More patients had plaques (46.2 vs. 17.5%; P  < 0.002), and number of plaques was higher ( P  < 0.003). Negative correlation between IMT ( P  < 0.0001), presence of plaques ( P  < 0.0001), their number ( P  < 0.040), and chromium 51-labeled ethylenediaminetetraacetate (⁵¹Cr-EDTA) clearance were found in patients. With multiple regression analysis, relationship between IMT and ⁵¹Cr-EDTA clearance ( P  < 0.001) and presence of hypertension ( P  < 0.001) was found. Nondiabetic patients with CKD showed advanced atherosclerosis and IMT, plaque occurrence, and number increased directly with the level of renal dysfunction. Another important risk factor was hypertension.