Background
Intensive care unit (ICU) patients can experience emotional distress and post‐traumatic stress disorder when they leave the ICU, also referred to as post‐intensive care syndrome. A deeper ...understanding of what patients go through and what they need while they are transitioning from the ICU to the general ward may provide input on how to strengthen patient‐centred care and, ultimately, contribute to a positive experience.
Aim
To describe the patients' experience while transitioning from the ICU to a general ward.
Design
A descriptive qualitative study.
Method
Data were gathered through in‐depth interviews and analysed using a qualitative content analysis. The qualitative study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
Findings
Forty‐eight interviews were conducted. Impact on emotional well‐being emerged as a main theme, comprising four categories with six subcategories.
Conclusion
Transition from the ICU can be a shock for the patient, leading to the emergence of a need for information, and an impact on emotional well‐being that has to be planned for carefully and addressed prior to, during, and following transition from the ICU to the general ward.
Relevance to clinical practice
It is essential that nurses understand patients' experiences during transfer, identifying needs and concerns to be able to develop and implement new practices such as ICU Liaison Nurse or Nurse Outreach for the follow‐up of these patients, the inclusion of a consultant mental health nurse, and the application of patient empowerment during ICU discharge.
Aim
The aim of this study was to develop and validate the Nursing Intensive‐Care Satisfaction Scale to measures satisfaction with nursing care from the critical care patient's perspective.
Background
...Instruments that measure satisfaction with nursing cares have been designed and validated without taking the patient's perspective into consideration. Despite the benefits and advances in measuring satisfaction with nursing care, none instrument is specifically designed to assess satisfaction in intensive care units.
Design
Instrument development.
Methods
The population were all discharged patients (January 2013 ‐ January 2015) from three Intensive Care Units of a third level hospital (N = 200). All assessment instruments were given to discharged patients and 48 hours later, to analyse the temporal stability, only the questionnaire was given again. The validation process of the scale included the analysis of internal consistency, temporal stability; validity of construct through a confirmatory factor analysis; and criterion validity.
Results
Reliability was 0.95. The intraclass correlation coefficient for the total scale was 0.83 indicating a good temporal stability. Construct validity showed an acceptable fit and factorial structure with four factors, in accordance with the theoretical model, being Consequences factor the best correlated with other factors. Criterion validity, presented a correlation between low and high (range: 0.42‐0.68).
Conclusions
The scale has been designed and validated incorporating the perspective of critical care patients. Thanks to its reliability and validity, this questionnaire can be used both in research and in clinical practice. The scale offers a possibility to assess and develop interventions to improve patient satisfaction with nursing care.
Aim
Validate the Nursing Intensive‐Care Satisfaction Scale in ICUs throughout Spain. Identify the improvement strategies recommended by the patients and professionals.
Design
Quantitative ...psychometric methodology and a cross‐sectional descriptive correlational design.
Methods
The study population will be all patients discharged from 19 participating ICUs in Spain. Consecutive sampling (n = 564). Once discharged from the ICUs, they will receive the questionnaire and then, after 48 hours it will be given to them again to analyse the temporal stability. To validate the questionnaire, the internal consistency (Cronbach's Alpha) and temporal stability (test–retest) will be analysed.
Results
Improve the quality of nursing care by modifying, changing or strengthening behaviours, skills, attitudes or areas for improvement involved in the process.
Aim
To evaluate the efficacy of the reduction of visual and auditory stimuli on pain during venipuncture in premature newborns of 32–36 weeks of gestation.
Design
Open, randomized, non‐blind parallel ...clinical trial.
Method
Study to take place at the neonatal intensive care unit of a University Hospital in 2019–2021. Fifty‐six recently born babies between 32‐36 weeks of gestation will participate. The dependent variable is the level of pain determined using the premature infant pain profile instrument. The intervention will be assigned randomly using the random.org software. Data analysis will be carried out using the IBM SPSS v.25 software assuming a level of significance of 5%.
Discussion
The evidence for the efficacy of reducing sensory stimulation and its effect on pain in minor procedures has not been studied in depth. There are no studies that evaluate the reduction of visual and auditory stimuli in a combined way.
Impact
It is easy to incorporate the reduction of visual and auditory stimuli into nursing practice. The results of this study could have a direct impact on clinical practice.
Trial registered at clinicaltrials.gov: NCT04041635
目的
评价减少视觉和听觉刺激对32˜36周妊娠早产儿静脉穿刺疼痛的影响
设计
开放式随机非盲平行临床试验。
方法
2019年至2021年期间,对某大学附属医院新生儿重症监护室开展该研究。56名32~36周妊娠早产儿参与了该研究。依变量是使用早产儿疼痛曲线仪确定的疼痛水平。
讨论
尚未深入研究在小手术中减少感官刺激的有效性及其对疼痛的影响。目前尚无有关以综合方式评估视觉和听觉刺激减少的研究。
影响
将减少视觉和听觉纳入护理实践中是很容易实现的。该研究结果可能会对临床实践产生直接影响。
试验注册地址
clinicaltrials.gov;注册编号:NCT04041635
The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with ...the level of satisfaction of critical care patients.
To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables.
This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire.
Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health.
Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health.
Professionals that work in neonatal units need to identify the strengths and weaknesses of the premature infant who is in the transition process from feeding through a gastric tube to oral feeding. ...The main aim of this study was to validate the Oral FEeding Assessment in premaTure INfants (OFEATINg) instrument. A psychometric validity and reliability study was conducted in Neonatal Intensive Care Units of two public, metropolitan, university hospitals. The study population were premature infants at a postconceptional age of 31-35 weeks. The study included evaluation of the reliability, convergent, discriminant and construct validity, sensitivity and specificity of the OFEATINg instrument. A total of 621 feedings of 56 preterm infants were evaluated. Confirmatory factor analysis identified 3 factors and 13 indicators with a good fit to the model. Cronbach's alpha coefficient was 0.78. The instrument showed high indices of inter-rater reliability (Pearson 0.9 and intraclass correlation coefficient 0.95). The OFEATINg scale is a valid and reliable instrument for evaluating the readiness for oral feeding of preterm infants. It may enable clinicians to evaluate the physiological and behavioral abilities involved in the oral feeding process and help them make decisions related to the transition to full oral feeding.Clinical trial registration: This study was prospectively registered at the two Institutional review boards.
The purpose of this review is to describe how quality of life (QoL) is impaired in patients with hypercortisolism due to Cushing's syndrome of any aetiology, including pituitary-dependent Cushing's ...disease. It is worse in active disease, but improvement after successful therapy is often incomplete, due to persistent physical and psychological co-morbidities, even years after endocrine “cure”. Physical symptoms like extreme fatigability, central obesity with limb atrophy, hypertension, fractures, and different skin abnormalities severely impair the affected patients’ everyday life. Psychological and cognitive problems like bad memory, difficulties to concentrate and emotional distress, often associated with anxiety and depression, make it difficult for many patients to overcome the aftermath of treated Cushing's syndrome. Recent studies have shown diffuse structural abnormalities in the central nervous system during active hypercortisolism, thought to be related to the wide distribution of glucocorticoid receptors throughout the brain. Even though they improve after treatment, normalization is often not complete. Shortening the exposure to active Cushing's syndrome by reducing the often long delay to diagnosis and promptly receiving effective treatment is highly desirable, together with preparing the patient for the difficult periods, especially after surgery. In this way they are prepared for the impairments they perceive in every day life, and live with the hope of later improvement, which can be therapeutic in many instances.
L’objectif de cette revue est de décrire l’altération de la qualité de la vie en cas d’hypercorticisme induit par la maladie de Cushing, toutes étiologies confondues, y compris le Cushing hypophysaire. Cette altération est maximale en phase active de la maladie, mais l’amélioration apportée par le traitement n’est souvent que partielle, à cause des comorbidités physiques et psychologiques résiduelles, même des années après la « guérison » endocrinologique. Des symptômes physiques tels qu’une fatigabilité extrême, uneobésité centrale avec atrophie musculaire des membres, une hypertension artérielle, des fractures et diverses anomalies cutanées diminuent la qualité de vie quotidienne. Des problèmes psychologiques et cognitifs, tels la perte de mémoire, des difficultés de concentration et la souffrance émotionnelle, souvent associés à l’anxiété et la dépression, empêchent souvent les patients de vaincre les séquelles d’une maladie de Cushing pourtant guérie. Des études récentes rendent compte d’anomalies structurelles diffuses au niveau du système nerveux central en cas de d’hypercorticisme actif, qui seraient dues à la large répartition cérébrale des récepteurs glucocorticoïdes. Ces anomalies sont améliorées par la thérapie, mais le retour au normal est souvent incomplet. Il est donc fortement souhaitable que la durée d'exposition à la maladie de Cushing active soit réduite, en réduisant le délai diagnostique, qui est souvent long, et en initiant rapidement un traitement adapté, tout en préparant le patient à faire face aux périodes difficiles, notamment au décours de la chirurgie. Ainsi, le patient peut se préparer à une certaine baisse de la qualité de la vie de tous les jours, mais vivre dans l’espoir d’une amélioration ultérieure, espoir qui est souvent lui-même de valeur thérapeutique.
In nursing education, essential skills include Critical Thinking (CT). There is scant evidence on how nurse educators could promote CT in students in a clinical context.
To analyse the level of CT ...and correlated variables in healthcare nurses overseeing the clinicals of nursing undergraduates.
The study population were all nurse educators for clinicals at hospitals with nursing undergraduates. To evaluate the CT skills of nurses the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 practice) was administered. Frequencies, percentages and measures of central tendency and scatter were obtained. A bivariate analysis was performed to analyze the correlation between the nurse educators’ CT level and the sociodemographic, professional and academic levels. The nonparametric Mann-Whitney and Kruskal-Wallis tests were used to compare two independent groups. Statistical significance was defined as P < .05.
The total number of participants was 639. The highest mean CT level was seen in clinical nurses involved in undergraduate nursing instruction and with experience of up to 10 years (mean CT score = 372 (33.3), p = .007). Global CT levels were similar in women and men (mean CT score: 364 (31.9) in women and 358 (40.5) in men, p = .187), with statistically significant differences only observed in the intellectual and cognitive indicator (P = .022).
CT levels are high in teaching healthcare professionals in the clinical environment.
To determine the development of competency acquisition, the satisfaction of the agents involved and recording incidents with a digital platform CliPrAS @UB on the Clinical Placements I and II courses ...in the second and third years of the Bachelor's Degree in Nursing.
The teaching of clinical practice subjects requires an analysis of the competence evolution, a management structure and an analysis of the satisfaction of the agents involved in the subject.
Prospective, analytical, observational cohort study.
The study was carried out in a public university center in Barcelona with 387 students distributed in nine centers of the network of Health Institutions.
An increase of 2.32 points was observed in the competence dimensions of Professional Practice and with a reduction in the average score in the skills of care provision, therapeutic communication and professional development of more than 0.08 points. Regarding the seminars, a reduction of the average global score of 0.58 points was observed.
The use of the CliPrAS @ UB computer platform has improved the implementation of the mandatory documents, the recording of incidents and the overall satisfaction of the students.
•The subjects of clinical practice present a complex teaching plan.•The use of common rubrics allowed analyzing the evolution of competence.•The computerized registry facilitates academic management and the recording of incidents.•The use of a computer platform improves student satisfaction.
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