Predictors of parenting stress in parents of children with cancer Çınar, Sevil; Boztepe, Handan; Ay, Ayşe ...
European journal of oncology nursing : the official journal of European Oncology Nursing Society,
October 2021, 2021-10-00, 20211001, Letnik:
54
Journal Article
Recenzirano
In the present study, we investigated the parenting stress experienced by parents of children with cancer and the influencing factors.
This was a cross-sectional and descriptive correlational study ...that consisted of parents of 136 children in the age group of 0–18 years who were followed up for cancer in the outpatient clinics and services of a university hospital in Turkey. Parenting Stress Index, Burden Interview, Multidimensional Scale of Perceived Social Support, Marital Life Satisfaction Scale, and Ways of Coping Questionnaire were used to collect the data.
No statistically significant difference was found between the parenting stress mean scores and gender of the parents of children with cancer (t = −0.350; P = 0.727). The results of the present study showed that the economic status (t = −4.16; P = 0.000), parents’ physical (t = 3.606; P = 0.000) and mental health status after the child is diagnosed (t = 5.647; P = 0.000), accompanying mental health problems of the child (t = 2.567; P = 0.011), and diagnosis of children at a young age (t = −2.776; P = 0.006) increased the parenting stress of the parents.
Nursing interventions can reduce parental stress by providing sufficient care and support during the disease process.
•Financial status, parents’ physical and mental health status increased the parenting stress of the parents.•It is important to apply interventions that will reduce parental stress by providing sufficient care for the disease process.•Healthcare professionals should be trained to understand factors affecting parenting stress.
Aims
To evaluate the effectiveness of a two‐session multicomponent family strengths‐ oriented therapeutic conversation intervention among family caregivers of an individual with advanced/final stage ...cancer during ongoing palliative home‐care.
Background
Family caregivers of patients in the advanced/final phases of cancer, experience multifaceted psychological distress and morbidity. Psychosocial interventions improve the well‐being of family members who are caring for their close relative.
Design
A pre‐experimental design with a one‐group pre‐test/posttests measurements.
Methods
Forty‐eight family caregivers were assigned to receive two 60–90 min sessions of the intervention. The primary outcome was perceived emotional and cognitive support and psychological well‐being, measured at baseline (T1). Then the participants were offered the first session of the intervention. About 1 week later, the second session was administered. The participants answered the same questionnaires again (T2) and then 2–4 weeks later (T3). The guideline; Criteria for Reporting Development and Evaluation of Complex Interventions 2, guided the reporting of the study.
Results
Family caregivers reported significantly higher emotional and cognitive support post‐intervention (T2) and at (T3). They also reported significantly reduced stress symptoms at (T3) and reduced caregiver burden post‐intervention (T2) and at (T3).
Conclusion
The provision of the intervention contributed to extending knowledge about the usefulness of family conversations in the context of advanced/final stage cancer care.
Impact
There is a lack of knowledge about the benefit of therapeutic conversation interventions for family caregivers. The therapeutic conversation intervention offered, resulted in perceived support, decreased stress, and decreased caregiving demands among caregivers in palliative home‐care. Trial registration number: ISRCTN 21786830.
目的
评估持续进行的保守家庭护理中,对照料癌症晚期病人的家庭护理员进行两个阶段多组成部分的以家庭为导向的对话治疗干预的有效性。
背景
癌症晚期患者的家庭护理人员都有多方面的心理困扰和高发病率。心理社会干预改善了照料近亲的家属的健康。
设计
一个包含一组测前/测后测量值的提前实验设计。
方法
设计让四十八名家庭护理人员接受了两次60‐90分钟的干预。以基线测量(T1),主要成果是感知到的情感、认知支持以及心理健康。然后让实验对象参加第一阶段的干预。大约一周以后,进行第二阶段。实验对象再次回答了同样的问卷然后2‐4周以后(T3),指导方针、报告发展的准则以及复杂干预2的评估指导了研究报告。
结果
接收(T2)和(T3)干预以后,家庭护理人员的情感和认知支持得到了显著提升。(T3)以后压力明显下降以及在(T2)和(T3)干预之后,护理人员的负担大大减轻。
结论
进行干预有助于拓展癌症晚期护理背景下家庭谈话的有用知识。
影响
对家庭护理人员的对话治疗干预缺乏了解,且保守家庭护理的护理需求有所减少。对话治疗干预导致了被感知到的支持、压力减少以及保守家庭护理中护理需求的减少。试验注册编号:ISRCTN 21786830。
Aim(s)
To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery.
Design
This scoping ...review was conducted according to the JBI scoping review framework.
Methods
Review included systematic reviews that evaluated any nurse‐initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a ‘certainty (quality) of evidence’ according to the Grading of Recommendations, Assessment, Development and Evaluations criteria.
Data Sources
Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023.
Results
A total of 428 articles were identified; following screening, 81 reviews underwent full‐text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%).
Conclusions
This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice.
Implications for the profession and/or patient care
Implementing up‐to‐date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes.
Patient or public contribution
No patient or public involvement in this scoping review.
Patients staying in the intensive care unit (ICU) require constant monitoring and numerous nursing interventions performed as needed, irrespective of daytime or night‐time. The disturbing effect of ...nocturnal nursing interventions and their contribution to sleep disruptions are unclear. The review analysed nocturnal nursing interventions, and their character, frequency and effects on sleep quality. The databases CINAHL, PubMed and Scopus were searched to identify and subsequently evaluate 19 studies (1,531 patients) meeting the algorithm used. Although nocturnal nursing interventions provided to ICU patients were frequent and varied, they were responsible for only a minority of observed sleep disruptions. The most frequent nocturnal intervention was Vital signs monitoring (Nursing Interventions Classification, 6,680). Implementation of sleep protocols, of which an integral part is clustering and planning of nocturnal interventions, appears to be effective. The review suggests that nursing interventions are not the main cause of sleep disruptions in the ICU. In an effort to improve the quality of sleep in ICU patients, other factors causing disturbance need to be addressed as well. The current trend is more careful planning of nursing care, clustering of interventions and minimizing nocturnal disruptions to allow patients at least one uninterrupted sleep cycle (90 min).
Objectives
To determine the effect of endotracheal aspiration at different head heights on oxygenation brain by non‐invasive method in neurosurgery intensive care patients.
Background
Head elevation ...of mechanical ventilator‐dependent neurosurgery patients and the possible risks of endotracheal aspiration are closely related to the clinical conditions of the patients.
Design
A prospective quasi‐experimental study with repetitive measurements in a single group.
Methods
In the study, neurosurgery intensive care patients were adjusted to a head height of 15, 30 and 45° (n = 46, power analysis %90). Cerebral oxygenation levels were determined with a non‐invasive device at each head height before and in the 1st, 5th and 30th min of endotracheal aspiration. Data were collected with Patient Information Form and cerebral oxygenation device based on NIRS technology. This study performed according to the TREND reporting guidelines for non‐randomized/quasi experimental study.
Results
The highest cerebral oxygenation value was obtained at 30 min. The decrease in the cerebral oxygenation levels of the patients was highest in the 1st min after endotracheal aspiration, at a head height of 15 degrees for the right cerebral region and at a head height of 30 degrees for the left cerebral region. The increase in oxygenation of the right and left cerebral regions occurred highest at a head height of 45 degrees.
Conclusions
The ideal head height should be 45 degrees during and after endotracheal aspiration in regard to maintaining cerebral oxygenation in neurosurgery intensive care patients. It is extremely important to monitor the cerebral oxygenation status of patients, with non‐invasive measurement tools during and after endotracheal aspiration, to prevent secondary complications.
Relevance to clinical practice
This study reveals the importance of raising the head 45 degrees in the best preservation of cerebral oxygenation values in neurosurgery intensive care patients. Intensive care nurses should pay attention to maintaining this head height.
The purpose of this paper is to summarize existing evidence about nursing interventions to selected symptoms experienced by patients undergoing radical cystectomy (RC) to maintain or return to their ...daily life activities.
A non-systematic narrative review was conducted. A search in PubMed and CINAHL was conducted eliciting evidence about frequent symptoms experienced after RC. The following search terms were used: radical cystectomy and/or nursing interventions, pain, distress, fatigue, urinary dysfunction, sexual dysfunction, loss of appetite, sleep disturbance, and enhanced recovery after surgery (ERAS).
Evidence in the ERAS pathway is still lacking regarding the effect of preoperative education and counseling of the patient and the most difficult part to implement is related to preoperative optimization of the patient such as lifestyle changes. Most nursing interventions to alleviate symptoms in the rehabilitation period after RC are still practice based.
Priority should be given to implementation of the ERAS protocol. To improve the management of symptoms experienced by patients in the RC rehabilitation period it is essential that validated screening tools to identify the symptoms be used. Accepted and effective strategies for treating the individual symptoms should be initiated and clear treatment outcomes should be defined. Urology nurse researchers should investigate the concept of symptom clusters to clarify whether there are more efficient methods to identify symptoms or symptom clusters and if so would the use of symptom clusters knowledge improve patient care.
Nursing is an integral part of all healthcare services, and has the potential of having a wide and enduring impact on health outcomes for a global ageing population. Over time nurses have developed ...new roles and assumed greater responsibilities. It is increasingly important to demonstrate the safety and overall impact of nurses’ practice through research, to support the case for greater investment and development of nursing services around the world.
To provide an overview of existing research evidence on the impact of nursing on patient outcomes, identify gaps in evidence, and point to future priorities for global research. Specifically to address two questions: what is the evidence that nursing contributes to improving the health and well-being of populations?; and where should research activity be focused to strengthen the evidence base for the impact of nursing?
A search of the literature from 1996 using CINAHL, MEDLINE, the Cochrane Library, Google Scholar and the NICE evidence databases using the key words: nursing, nurse led, nursing interventions and patient outcomes. Initial analysis of the retrieved citations to reveal clusters of evidence of nursing impact in clinical areas which had been subject to systematic/integrative reviews or meta-analyses. Further analysis of these reviews to provide an overview of the research evidence for nurses’ contributions to healthcare to inform discussion on future research agendas. We use the terms low, moderate and high quality evidence to reflect the assessments made by the review authors whose work is presented throughout.
Analysis of 61 reviews, including ten Cochrane reviews and two scoping/selective reviews to provide a summary of the research evidence for nurses’ contributions to healthcare in the following areas of practice: nursing in acute care settings; nurses’ involvement in public health; the contribution of specialist nurse and nurse-led services to the management of chronic disease; comparison of care provided by nurses and doctors; and task shifting to invasive procedures.
There is evidence that adequate numbers of well-educated nurses working in acute care areas can reduce the risk of patient mortality, although the evidence for this is confined to studies in high income countries and the evidence is not sufficiently robust to draw up definitive nurse: patient ratios. There is also moderate evidence that well trained nurses can produce health outcomes that are equivalent to those of doctors for patients with a range of chronic health problems, particularly for those patients managed in primary care, and that nurse-led care may be more effective than medical care in promoting patient adherence to treatment and patient satisfaction. There is low to moderate evidence for the benefits of parenting support programmes delivered by nurses on a range of health outcomes; and for the impact of home visiting on improving function and other health service outcomes for older people.
The wider societal benefits of home visiting by nurses and the impact of this on long term outcomes and related cost-effectiveness of home visiting has not been established. There is limited available information regarding the wider global impact of increasing the numbers of nurses and their contribution to healthcare through improved education. Moreover there is very little evidence for the cost-effectiveness of changing care providers from doctors to nurses and as the majority of cost data available has tended to come from studies based in higher income countries, their external validity in terms of applicability to settings in low and middle income countries is questionable. In addition to effectiveness, cost and safety, future research needs to address how implementing expanded nursing roles and task shifting impacts on the morale, retention, and professional development of nurses and the other workforces, and the longer term implications of these developments both locally and internationally.
Aims
To identify strategies used by registered nurses and non‐registered nursing care staff in overcoming barriers when providing fundamental nursing care for non‐invasively ventilated inpatients ...with COVID‐19.
Design
Online survey with open‐ended questions to collect qualitative data.
Methods
In August 2020, we asked UK‐based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non‐invasively ventilated patients with COVID‐19. We analysed data using Framework Analysis.
Results
A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non‐verbal communication with patients, using information technology to enable patients’ significant others to communicate with staff and patients, and establishing clear information‐sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self‐care and using ‘runners’ and interdisciplinary input. 3) Addressing patients’ well‐being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients’ wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks.
Conclusions
Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well‐being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing.
Impact
As these strategies are unlikely to be exclusive to the COVID‐19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.
Hospital-acquired pressure ulcers are a serious patient safety concern, associated with poor patient outcomes and high healthcare costs. They are also viewed as an indicator of nursing care quality.
...To evaluate the effectiveness of a pressure ulcer prevention care bundle in preventing hospital-acquired pressure ulcers among at risk patients.
Pragmatic cluster randomised trial.
Eight tertiary referral hospitals with >200 beds each in three Australian states.
1600 patients (200/hospital) were recruited. Patients were eligible if they were: ≥18 years old; at risk of pressure ulcer because of limited mobility; expected to stay in hospital ≥48h and able to read English.
Hospitals (clusters) were stratified in two groups by recent pressure ulcer rates and randomised within strata to either a pressure ulcer prevention care bundle or standard care. The care bundle was theoretically and empirically based on patient participation and clinical practice guidelines. It was multi-component, with three messages for patients’ participation in pressure ulcer prevention care: keep moving; look after your skin; and eat a healthy diet. Training aids for patients included a DVD, brochure and poster. Nurses in intervention hospitals were trained in partnering with patients in their pressure ulcer prevention care. The statistician, recruiters, and outcome assessors were blinded to group allocation and interventionists blinded to the study hypotheses, tested at both the cluster and patient level. The primary outcome, incidence of hospital-acquired pressure ulcers, which applied to both the cluster and individual participant level, was measured by daily skin inspection.
Four clusters were randomised to each group and 799 patients per group analysed. The intraclass correlation coefficient was 0.035. After adjusting for clustering and pre-specified covariates (age, pressure ulcer present at baseline, body mass index, reason for admission, residence and number of comorbidities on admission), the hazard ratio for new pressure ulcers developed (pressure ulcer prevention care bundle relative to standard care) was 0.58 (95% CI: 0.25, 1.33; p=0.198). No adverse events or harms were reported.
Although the pressure ulcer prevention care bundle was associated with a large reduction in the hazard of ulceration, there was a high degree of uncertainty around this estimate and the difference was not statistically significant. Possible explanations for this non-significant finding include that the pressure ulcer prevention care bundle was effective but the sample size too small to detect this.
Objective: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complaint in critically ill patients. Therefore, the present study was conducted to ...determine the effect of nursing interventions, based on the Wells results, on the incidence of DVT in intensive care unit (ICU) patients.Methods: The present clinical trial was conducted on 72 ICU patients without DVT and PE who met the inclusion criteria according to Wells score in Dr. Ganjavian Hospital, Dezful in 2012. The participants were investigated and randomly divided into intervention (n=36) and control groups (n=36). The intervention group received preventive nursing measures based on the risk level determined by the Wells score, and routine therapeutic interventions were performed for the control group. Then, patients were evaluated using Wells score, D-dimer testing, and Doppler sonography on the 1st, 5th, and 10th days. Data were finally coded and entered into SPSS version 23. Data analysis was performed using Chi-square, Fisher’s exact, and Mann–Whitney U tests.Results: The incidence of DVT in both groups showed that 2 patients of the control group who were identified to be at risk using the Wells score were diagnosed with DVT while none of the patients of the intervention group experienced DVT. The present study showed that 22.2% of the patients of the control group suffered from non-pitting edema, which was significantly different from the intervention group (p=0.005).Conclusion: The results of the present study showed that using the Wells score for early identification of the at-risk patients and nursing interventions based on this score’s results is helpful in the prevention of DVT. Appropriate nursing interventions were also effective in reducing the incidence of non-pitting edema in the lower extremities.
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