Care Scores Research Articles

Impact of family care on sleep quality in perimenopausal women: mediating roles of anxiety and depression

BackgroundThis study aimed to investigate the relationship between family care, anxiety, depression, and sleep quality in perimenopausal women. Furthermore, it also aimed to examine the role of anxiety and depression in mediating family care and sleep quality. The study findings aim to provide theoretical support for alleviating anxiety and depression levels and improving sleep quality in perimenopausal women.MethodsPerimenopausal women (n = 860) in Gansu Province were surveyed using the self-rating scale of sleep, self-rating anxiety scale, self-rating depression scale, and family adaptation partnership growth affection resolve.ResultsThe sleep quality, anxiety, and depression scores of the perimenopausal women in Gansu Province were 25.33 ± 5.00, 40.74 ± 10.89, and 40.77 ± 10.03, respectively, and the family care score was 6.64 ± 2.36. Family care was negatively correlated with sleep quality, anxiety, and depression scores; anxiety was positively correlated with depression and sleep quality scores, and depression was positively correlated with sleep quality scores. Anxiety and depression in perimenopausal women partially mediated family care and sleep quality, with mediating effects accounting for 15.74% and 60.69% of the total effect, respectively.ConclusionAnxiety and depression are mediating variables between family care and sleep quality in perimenopausal women. It is recommended that hospital and community staff pay attention to the role of good family care in perimenopausal women, actively implement intervention strategies aimed at reducing anxiety and depression pathways, and improve their sleep quality.

Core functions of primary care in Amathole district, South Africa: a descriptive study.

Strengthening primary care is a priority globally and for the South African health system. The current measurement tools in South Africa do not measure the core functions of primary care: access, comprehensiveness, coordination, continuity and person-centredness. A new regional version of the Primary Care Assessment Tool (PCAT) has just been validated and can measure these core functions. To field test the regional PCAT and measure the core functions of primary care performance. A descriptive cross-sectional survey in Amathole District, South Africa. Data were collected from 386 randomly selected patients from 40 clinics and six subdistricts. Data was collected using the REDCap mobile App and analysed in the Statistical Package for Social Sciences version 27. The median primary care score was 3.3 (IQR 3.2-3.5) where a score>3 was seen as acceptable performance and>3.5 as good. Person-centredness, coordination and utilisation were all scored as good (4.0 (IQR 4.0-4.0). Comprehensiveness (3.3 (IQR 2.9-3.6) and continuity (3.2 (IQR 3.1-3.6) were scored as acceptable. Access to care was scored as poor (1.7 (IQR 1.0-2.9). There were significant differences in primary care scores between subdistricts. Those with a worse health status or chronic condition gave lower scores. The most affluent and the poorest groups also gave lower scores. The district needs to focus on improving access to care as well as some aspects of comprehensiveness, continuity, and coordination. The newly validated regional PCAT provided the district with novel information for performance management and improvement.

The Significance of Psychological Support in Managing Depression in Parkinson's Disease: Combining Venlafaxine with Pramipexole and Psychological Care.

Depression is a common comorbidity in patients with Parkinson's disease (PD) and can significantly impact their overall well-being. The combination of venlafaxine and pramipexole is a standard treatment approach for depression in PD. However, the effects of incorporating psychological care into the treatment regimen remain unclear. This study aimed to investigate the impact of psychological intervention in the treatment of depression in Parkinson's disease, using a combination of venlafaxine and pramipexole. The clinical data of 151 patients with both Parkinson's disease (PD) and depression, treated in Geriatric Hospital of Hainan from May 2021 to May 2023, were analyzed retrospectively. Among the 151 patients, 71 received routine nursing care and were allocated to the control group, while the remaining 80 patients received psychological nursing care based on routine nursing care and were assigned to the study group. The Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Scale (HAMA) were used to evaluate the degree of depression and anxiety in both groups before and after care. The MOS 36-Item Short-Form Health Survey (SF-36) was employed to assess the quality of life of both groups before and after care. The efficacy and adverse reactions in both groups were also analyzed. Before care, the HAMD and HAMA scores did not significantly differ between the two groups (p > 0.05). However, after care, both groups exhibited a significant reduction in HAMD and HAMA scores (p < 0.0001), with a more pronounced decrease observed in the study group (p < 0.0001). Prior to care, there was no significant difference in SF-36 scores between the two groups (p > 0.05). However, following care, the SF-36 scores markedly increased in both groups (p < 0.0001), with a more pronounced increase in the study group (p < 0.0001). Additionally, a significantly lower overall response rate was noted in the control group compared to the study group (p = 0.013), while no significant difference was observed in the total incidence of adverse reactions between the two groups (p = 0.273). Utilizing venlafaxine combined with pramipexole in the treatment of depression in PD, supplemented by psychological nursing care, significantly enhances therapeutic efficacy. This combined approach effectively alleviates symptoms of depression and anxiety in patients without introducing additional side effects. Hence, it emerges as a valuable clinical treatment option.

Assessment of Iranian Intensive Care Nurses’ Perception of Futile Care

This study aimed to evaluate the perceptions of ICU nurses regarding futile care in hospitals affiliated with Kerman University of Medical Sciences in 2018. The research specifically targeted nurses working in the ICU departments of these hospitals who held at least a bachelor’s degree. The questionnaire used in the study consisted of eight questions related to nurses’ views on futile care in the ICU. Additionally, the questionnaire included a section that explored nurses’ perspectives on the causes of futile care and its persistence, covering topics such as communication, information exchange, respect for patient preferences, involvement in decision-making, and quality of patient care. Non-normal data distribution led to the use of the Mann-Whitney U and Kruskal-Wallis tests to analyse the relationship between nurses’ perceptions of futile care, its causes, and various nurse-related factors. The study involved 236 ICU nurses who met the inclusion criteria, with 179 nurses participating in the research. The average age of the nurses was 32.78 ± 6.50 years. The results indicated a significant correlation between nurses’ perception scores of futile care and their views on the causes and dimensions of futile care (r = 0.65, p &lt; 0.001). Further research is recommended to gain a deeper understanding of ICU nurses’ perceptions and experiences related to futile care.

COmplexity of CARE and Discharge barriers: the 'modern internal medicine patient'. Results from the CO-CARED Study.

The ongoing demographic, epidemiological and social changes are dramatically raising the clinical and care complexity of patients admitted to internal medicine (IM) departments. Collecting evidence for a better characterization of patients is crucial to tailor future interventions based on patient's real needs. The aim of this prospective multicenter study was to describe the complexity of care of patients hospitalized in IM by calculating the complexity of care (ICC) score, through the combination of clinical instability (NEWS score) and care dependency scales (mICD). Furthermore, social frailty was assessed according to potential difficulty in discharge planning. 3912 patients were enrolled (median age 78years); 71% had a Charlson Comorbidity Index ≥ 5. The ICC score was high in 14.7% of patients, while 15% exhibited a NEWS score at least moderate. One in four patients presented moderate to critical social frailty. The length of stay was correlated with social frailty, mICD and ICC scores, but not with NEWS. In-hospital mortality was correlated with the severity of all the considered scores. A relevant proportion of IM patients exhibited a high complexity of care. Our data support a model in which approximately 15% of IM beds are designated for clinically unstable patients managed in intermediate care sub-units. The substantial burden of social frailty highlights the urgency of national plans allowing at the same time to cover the needs of not self-sufficient and socially disadvantaged patients, and to efficiently address the issue of emergency department boarding.

Barriers to Accessing Care (BACE) Score in Patients Attending Mental Health Services

Background: The World Health Organization's definition of health has stressed mental health as an important component. Terms such as access, availability, utilization and coverage have often been used interchangeably to reveal whether people are receiving the services, they need. To reduce the unmet need for treatment and it is crucial to identify barriers in mental health to reduce adverse effects associated with the absence or postponement of timely treatment. Methods: A cross-sectional study was performed in Mental Hospital, Lalitpur, Nepal. People suffering from mental illness who fulfilled the inclusion criteria were recruited and BACE scale was administered along with relevant details of participants. Results: Among the patient reported barriers related to stigma, the most reported concern was “ concerned that I might be seen as weak for having a mental health problem “(33.6 %), Among the reported instrumental barriers in BACE scale , “having no one who could help me get professional care (18.2)“ was the most reported major barrier, Among the different attitudinal components in BACE scale “wanting to solve problem on my own” (21.9%) was the most reported barrier. Conclusion: Thus, it can be concluded that people people suffering from mental illness also experience different barriers during help seeking . This barriers is found more on people below 45 years of age and people with low socio economic status. These barriers influence the quality of life in terms of decline in physical health and environment. Novelty: BACE scale administered on large sample size.

A novel acute basic palliation concept for patients without specialised palliative needs

INTRODUCTION. Among all Danish dying patients, 80% rely on non-specialised palliative care, an area lacking national and international guidelines. In this pilot study, we developed and tested an acute basic palliation concept (ABPC), a structured end-of-life (EOL) care plan for patients discharged from the emergency department to die at home compared with standard care. METHODS. This study compared symptom scores and EOL care statement scores during a standard care period with an ABPC period using unvalidated questionnaires. Each period included 25 patients. The study was conducted across two emergency departments in Denmark and included patients aged ≥ 18 nearing EOL. Furthermore, we asked if healthcare professionals would use the ABPC again. RESULTS. Relatives reported better symptom scores for three of four symptoms during the ABPC period. Doctors and municipal caregivers reported better scores for most EOL care statements during the ABPC period, whereas hospital nurses' scores remained unchanged between periods. All (100%, n = 67) healthcare professionals would use the ABPC again, and 96% provided positive free-text comments. CONCLUSIONS. Relatives and healthcare professionals reported better symptom and EOL care scores during the ABPC period, with all healthcare professionals stating that they would use the ABPC again. Larger sample sizes and validated questionnaires are needed to verify our findings. FUNDING. Funding was provided by Beta.Health, the Health Innovation Fund of the North Denmark Region, and Health Hub by Spar Nord Fund. TRIAL REGISTRATION. Not relevant.

The relationship between work-family conflict and missed nursing care; a cross-sectional study in Iran

Background & aimsWork–family conflict, an important issue in nursing management, has been examined extensively worldwide among nurses. Nurses’ inability to handle these conflicts affect their quality of care and may lead to missed nursing care. This study aimed to investigate the relationship between work-family conflict and missed nursing care in Iran.Materials & methodsThis cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in the study in a targeted and quota sampling after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including: Demographic information form, Carlson’s work-family conflict and Kalisch MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25.ResultsThe results of Pearson’s correlation test showed that there is a positive relationship between nurses’ work-family conflict and missed nursing care scores (r = 0.21) (p = 0.001). The mean (SD) score of nurses’ work-family conflict was reported at a moderate level (61.58(11.57)) and the mean (SD) score of missed nursing care was reported at a low level (47.84(16.48)). Nurses under 29 years old and male nurses had more missed nursing care other than their participants. No more relationship was observed between other demographic variables with missed nursing care and nurses’ work-family conflict.ConclusionAccording to the results of this research, it can be concluded that the existence of work-family conflict can be an obstacle for the correct implementation of nursing care. In such a way that nurses exposed to higher work-family conflict level had higher missed nursing care. Based on the findings of this research, it is recommended for health care providers and nursing managers to identify nurses exposed to high work-family conflicts, adopt programs to decrease their conflicts and consequently reduce missed nursing care.

Health-Related Behaviors and Risk of Common Age-Related Brain Diseases Across Severities of Genetic Risk.

The 21-point Brain Care Score (BCS) is an index that ranks behaviors and clinical measurements with the aim of encouraging lifestyle adjustments to lower the incidence of age-related brain disease, including stroke, late-life depression (LLD), and dementia. A higher BCS at baseline is associated with a lower risk of these outcomes. We aimed to investigate whether the associations between BCS and stroke, LLD, and dementia risks are independent of genetic predisposition for these conditions and quantify the effect of healthy lifestyle across genetic risk distributions for these outcomes. Using the UK Biobank (UKB) prospective cohort study, we computed baseline BCSs and polygenic scores to estimate genetic predisposition for stroke and LLD and APOE ε allele status to stratify dementia risk. As for outcomes again in UKB, we measured incidence of stroke, LLD, and dementia. We used multivariate Cox proportional hazard models to assess associations between BCS, genetic predisposition, and these outcomes. We also conducted stratified and interaction analyses to estimate the incidence of these outcomes across quartiles of genetic risk and BCS. We included 368,340 UKB participants (median age 58 years (interquartile range 51-63 years), 46.3% male). Independent of genetic risk, a 5-point increase in BCS corresponded to lowered hazards of stroke (hazard ratio [HR] 0.70, 95% CI 0.68-0.73), LLD (HR 0.65, 95% CI 0.63-0.67), and dementia (HR 0.82, 95% CI 0.78-0.85). Incidences of all 3 outcomes were higher among participants with high genetic risk of these outcomes. However, these increased risks were offset for individuals with a higher BCS (incidence rates per 1,000 person-years were 2.76 vs 1.19 for stroke, 7.34 vs 4.46 for LLD, and 3.64 vs 2.05 for dementia, when comparing low and high BCS). Across different genetic predispositions for stroke, LLD, and dementia, healthier lifestyle behaviors are protective for brain health, demonstrating the nondeterminism of genetic risk. Furthermore, differences in BCS behave as aggregate risk estimators of all 3 outcomes. Further work is needed to prospectively investigate the utility and performance of the BCS as a targeted intervention in populations at elevated genetic risk of age-related brain disease.

Examining the Impact of Integrated Obstetric Simulation Training on the Quality of Antenatal Care in Northern Ghana.

This study aims to assess if anintegrated simulation-based training on respectful maternity care (RMC) and management of obstetric and neonatal emergencies could improve the qualityof antenatal care (ANC). The data are from two cross-sectional surveys administered in the East Mamprusi District of Northern Ghana in 2017 to evaluate the impact of integrated simulation-based training for healthcare providers. Surveys were administered to two groups of women aged 15-49 who delivered in a health facility before (baseline; n = 266) and 6 months after (end-line; n = 320) the intervention began. We assessed the quality of antenatal care pre- and post-training across two dimensions: service provision and experience of care. Analyses included linear and logistic regression. Women in the end-line group reported higher quality of antenatal care than those in the baseline group. The average ANCexperience of care score increased by 10 points at the end-line (Coeff = 10.3, 95%CI: 9.0,11.6), whereas the mean ANCservice provision score increased by three points (Coeff = 2.6, 95%CI: 2.2, 3.1). End-line participants were more likely to have an ultrasound (OR: 24.1, 95%CI: 11.5, 50.3). Parity,tribe, education, employment, partner occupation, six or more antenatal visits, ANC facility, and provider type were also associated with ANC quality. Integrated simulation-based training for health providers has the potential to improve the quality of ANC. Incorporating such training into continuing professional development courses will aid global efforts to increase the quality of care throughout the maternity continuum of care.

Early life adversity blunts the subjective and physiological relaxation response in healthy adults

While Early Live Adversity (ELA) is a known risk factor for mental and physical diseases, the investigation into the mechanisms behind this connection is ongoing. In the present study, we investigated whether ELA blunts the relaxation response in healthy adults. Using a within-subjects design, we employed a paced breathing exercise (four seconds inhale, six seconds exhale) and a 360° nature video as relaxation interventions while measuring physiological relaxation using heart rate variability and subjective relaxation using the Relaxation State Questionnaire. A total of 103 participants (63.11% female; agemean = 22.73 ± 3.43 years) completed the Parental Bonding Instrument and the Childhood Trauma Questionnaire to assess ELA retrospectively. For subjective relaxation, a blunted relaxation reaction was associated with lower scores of paternal care and higher scores of paternal overprotection, physical abuse, physical neglect, and emotional abuse. For heart rate variability emotional abuse in interaction with nicotine consumption was related to a blunted relaxation response. This indicates that experiencing ELA negatively affects the relaxation capability in a healthy sample and emphasizes the importance of assessing relaxation at a physiological and subjective level.

Abstract 4144502: Comparing Readmission Rates and Exercise Capacity Following Left Ventricular Assistive Device Placement With and Without Post-Operative Inpatient Rehabilitation

Introduction: Patients with heart failure may undergo mechanical assistive device placement as a bridge to heart transplantation or for destination therapy. Thereafter, patients may be discharged home or admitted to inpatient rehabilitation. Research Question: We hypothesized that within 8 months, patients admitted to inpatient rehabilitation (IR) would have fewer readmissions and greater exercise capacity compared to patients discharged home following left ventricular assistive device (LVAD) placement. Aim: The readmission rates and exercise capacity of patients admitted to (IR) were compared to those discharged home within 8 months of (LVAD) placement. Methods: Readmission rates, impairment percentages (IP) (determined by Activity Measure for Post-Acute Care scores) and walking distance after (LVAD) placement between March 1 st , 2020 to November 30 th , 2022 were collected via retrospective chart review at Jackson Memorial Hospital. Adults with heart failure and heart assistive device (ICD10 code Z95.811), discharged home or admitted to the Christine E. Lynn Rehabilitation Center for at least 7 consecutive days within 8 months were included. Patients who were noncompliant, expired, transferred, or unable to ambulate were excluded. 24 patients were admitted to rehab, and 16 were discharged home. Statistical significance was denoted at the 0.05 level using the Mann-Whitney U Test. Results: There was a higher proportion of females in the rehab group (45.8%) and males in the no rehab group (93.8%) (p=0.02). The groups were otherwise comparable. Average (IP) at hospital discharge was higher for the rehab group (51.79%, SD 17.65) compared to the no rehab group (14.20%, SD 18.93) (p&lt;.001). Average post-(LVAD) walking distance (feet) at hospital discharge was higher for the no rehab group (305, SD 206.72) compared to the rehab group (127.73, SD 132.11) (p=0.005). Within 8 months, there was no significant difference between groups. Average readmissions were higher for the no rehab group (1.375, SD 0.957) compared to the rehab group (0.958, SD 1.49) (p= 0.059), but was not statistically significant. Conclusions: Patients with greater (IP) and shorter walking distances were admitted to rehab and became functionally comparable to the no rehab group by 8 months. Though readmission rates were lower for the rehab group, this was not statistically significant. Additional studies are warranted to evaluate the impact of (IR) following (LVAD) placement.

Development and validation of the prediction score for augmented renal clearance in critically Ill Japanese adults.

Augmented renal clearance (ARC) decreases the therapeutic concentration of drugs excreted by the kidneys in critically ill patients. Several ARC prediction models have been developed and validated; however, their usefulness in Japan has not been comprehensively investigated. Thus, we developed a unique ARC prediction model for a Japanese mixed intensive care unit (ICU) population and compared it with existing models. This retrospective study enrolled a mixed ICU population in Japan from January 2019 and June 2022. The primary outcome was the development and validation of a model to predict ARC onset based on baseline information at ICU admission. Patients admitted until May 2021 were included in the training set, and external validation was performed on patients admitted thereafter. A multivariate logistic regression model was used to develop an integer-based predictive scoring system for ARC. The new model (the JPNARC score) was externally validated along with the ARC and Augmented Renal Clearance in Trauma Intensive Care (ARCTIC) scores. A total of 2,592 critically ill patients were enrolled initially, with 651 patients finally included after excluding 1,941 patients. The training and validation datasets comprised 456 and 195 patients, respectively. Multivariate analysis was performed to develop the JPNARC score, which incorporated age, sex, serum creatinine, and diagnosis upon ICU admission (trauma or central nervous system disease). The JPNARC score had a larger area under the receiver operating characteristic curve than the ARC and ARCTIC scores in the validation dataset (0.832, 0.633, and 0.740, respectively). An integer-based scoring system was developed to predict ARC onset in a critically ill Japanese population and showed high predictive performance. New models designed to predict the often-unrecognized ARC phenomenon may aid in the decision-making process for upward drug dosage modifications, especially in resource- and labor-limited settings.

Primary care performance in a Ugandan rural district: cross-sectional descriptive study.

To strengthen primary health care (PHC), there is a need to measure its performance. To measure primary care performance in one rural Ugandan district. A cross-sectional survey of Tororo District administered the Primary Care Assessment Tool (PCAT) across a sample of 51 facilities. There were four levels of health facilities (health centres II to general hospital). Random sample of 100 users was obtained from each level while including all primary care providers and managers. Data was collected in REDCap software, and analysed using Statistical Package for Social Sciences vs23. Only 35.1% of users had a strong affiliation with their PHC facility. Overall primary care score suggested that performance was acceptable to the majority of users (58.9% rating performance at least acceptable). Ongoing care was rated by users as very poor (<25% of people rating it at least acceptable). Comprehensiveness (services available) was rated poor by users (<50% finding it at least acceptable). Users rated first contact access and coordination (information systems) acceptable (51-75% finding them at least acceptable). Person-centredness and comprehensiveness (services provided) were rated good by users (>75% rating them as acceptable or more). Providers and users differed significantly in their scoring across all domains, with providers usually more positive. Performance significantly improved as the PHC level increased. Primary care performance in the study district was sub-optimal. The PCAT identified primary care functions that needed improving and may be a useful tool to measure PHC performance across the region.

Moving Beyond Systemic Inflammatory Response Syndrome and Bacteremia: Are Modern Critical Care Calculators Useful in Predicting Debridement, Antibiotics, and Implant Retention Treatment Outcomes in Periprosthetic Joint Infection?

BackgroundIn critically ill periprosthetic joint infection (PJI) patients, surgeons need to balance the need for aggressive, definitive treatment against the health state of a potentially unstable patient. A clear understanding of the association between treatment outcomes and assessment scores for sepsis would benefit clinical decision-making in these urgent cases. The current study evaluates the effect of critical illness on debridement, antibiotics, and implant retention (DAIR) outcomes, as defined by systemic inflammatory response syndrome (SIRS) and, for the first time, by contemporary markers quick Sequential Organ Failure Assessment (qSOFA) and Modified Early Warning Score (MEWS). MethodsWe retrospectively identified 253 patients who underwent DAIR for PJI at a single institution between 2017 and 2021. The SIRS, qSOFA, and MEWS scores were calculated based on variables on admission. A DAIR treatment failure, defined as reoperation or mortality, was measured at 90 days and two years. Univariate analysis was used to determine the association between elevated critical care scores and DAIR failure. ResultsThe DAIR treatment success was 59% at two years, with hip procedures and Charlson comorbidity index (CCI) ≥ 1 independently associated with higher odds of DAIR failure. There were 43 patients (16%) who presented with SIRS, however, only four (2%) had positive qSOFA scores. Neither SIRS nor qSOFA were predictive of DAIR failure. For knees only, elevated MEWS scores were predictive of 90-day DAIR failure (P = 0.019). ConclusionOver one in six patients undergoing DAIR for PJI presented with SIRS, while only one in 50 had a positive qSOFA. The SIRS and qSOFA scores were not predictive of DAIR failure. Elevated MEWS scores were associated with DAIR failure at 90 days postoperatively in knee PJIs only, and should be confirmed in a larger cohort. Our results suggest that SIRS is not predictive of DAIR outcomes, possibly because it overestimates the proportion of critically ill patients.

Exploring the Role of Narrative Medicine in the Cultivation of Humanistic Spirit among Respiratory Medicine Interns

Objective: To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns. Methods: Thirty interns were selected, all of whom were received by the respiratory department of our hospital from September 2023 to June 2024 and underwent narrative medicine teaching. Scores on narrative medicine knowledge, empathy ability, humanistic care ability, and teaching recognition were compared before and after the internship. Results: Compared to before the internship, the interns’ scores on narrative medicine knowledge were significantly higher after the internship, as were their empathy and humanistic care scores (P &lt; 0.05). Among the 30 interns, 25 expressed interest in narrative medicine, and 29 were willing to continue with the narrative medicine teaching model. Conclusion: The application of narrative medicine in respiratory medicine internship teaching is highly effective. It cultivates the humanistic spirit of interns, improves their empathy and humanistic care abilities, and is worthy of wider implementation.

Application of clinical case-guided, task-driven escape room teaching in nursing education: A quasi-experimental study

BackgroundIn the new era, the professional ability requirements for nursing personnel are no longer limited to traditional nursing knowledge and skills, but pay more attention to the cultivation and enhancement of their diversified abilities, such as humanistic caring ability, creative thinking, and so on. As a new type of education model that integrates gamification, flipped learning, and problem-based learning, escape room teaching plays an important role in effectively developing and stimulating students' humanistic care ability and creative thinking. PurposeTo investigate the effectiveness of an Escape Room teaching approach, clinical cases (C) as guide (G) and task (T) as driver (D) , within the CGTD model in the undergraduate Adult Nursing course. MethodUsing purposive sampling, 108 undergraduate nursing students in the class of 2020 were selected as the study subjects, and 11 innovative escape room teaching activities were conducted. Real clinical cases were selected, so that the student teams were immersed in clinical scenarios to complete the escape room game focusing on circulatory care, and the humanistic caring and creative thinking of the students in the two groups were compared before and after the intervention. ResultsNursing students' humanistic care and creative thinking scores at the end of the instruction were significantly better than those before the escape room instruction (P<0.05). ConclusionThe use of the CGTD-based escape room teaching method applied to adult nursing practice courses is an innovative teaching strategy that integrates theoretical knowledge into the game, which can significantly improve undergraduate nursing students' humanistic caring ability and creative thinking.

Shared decision-making in the treatment of bipolar disorder: findings from a nationwide naturalistic cohort study in everyday clinical practice.

Shared decision-making (SDM) is of increasing importance in mental health care, however, large studies on the effects of SDM in bipolar disorder (BD) are scarce. To gain insight into the relationships between SDM, guideline concordance of treatments in everyday practice, satisfaction with care, and medication adherence in BD. In a nationwide observational study on the treatment of BD, patients were asked questions about their involvement in treatment. These questions were clustered according to the three-talk model (TTM) for SDM, which involves team talk, option talk, and decision talk. A composite concordance score for multimodal treatments was made, and satisfaction with care (score 1 to 10) and medication adherence (DAI-10) were measured. 839 patients with BD from various outpatient treatment centers were included. Patients were highly involved in decision-making. In multiple regression, team talk was significantly positively associated with guideline concordance (b = 5.10, p = .045), and decision talk was positively associated with satisfaction with care (b = 0.82, p < .001) and medication adherence (b = 1.18, p = .003). Positive associations were found between SDM, guideline concordance, satisfaction with care, and medication adherence, suggesting that investing in these steps of the decision-making process together with patients and their significant others, will help to improve quality of care.

The relationship between spiritual health and resilience of nurses with their compassionate care in intensive care units.

Nurses experience a demanding work environment, and the state of their spiritual health and resilience can impact their ability to provide compassionate care. The objective of this study was to examine the connection between spiritual health, resilience, and compassionate care among nurses working in intensive care units. This descriptive cross-sectional study employed stratified sampling to select 340 nurses. The research utilized several instruments, including Demographic Information, Nurses' Compassionate Care, Iranian Muslim Adult Spiritual Health, and Connor and Davidson Resilience Questionnaires (significance level: 0.05). The data was analyzed by SPSS software version 24 using statistical tests including Chi-square, t-test, and Pearson's correlation coefficient. The results indicated that the majority of participants were female, with an average age of 32.65 years. The mean score for spiritual health was 192.53 ± 23.67, and the resilience score was 71.52 ± 13.43. The average score for compassionate care was 119.82 ± 13.93. The study revealed a significant positive relationship between spiritual health, resilience, and compassionate care in nurses (P < 0.05). Consequently, enhancing spiritual health and resilience scores positively influenced the compassionate care, and vice versa. To summarize a significant association exists between nurses' spiritual health, resilience, and their ability to provide compassionate care. It is recommended that educational programs are developed and implemented to enhance and maintain the spiritual health, compassionate care, and resilience of nurses, ultimately improving patient care.

The quality of nursing care in dying children from the nurses’ point of view in Iran: A cross-sectional study

BackgroundNowadays, the quality of nursing care is one of the most essential factors in health services and patient care. The quality of end-of-life care is of high importance, especially in vulnerable groups such as children. In the final stages of life, the needs of patients and their companions, as well as stressful conditions cause avoidance of participation in treatment, and dissatisfaction of caregivers which can reduce the quality of patient care. The present study aimed to examine the quality of nursing care in children from the point of view of nurses in hospitals related to Birjand, Iran. Materials and methodsThe present descriptive study was conducted on 350 nurses. The data collection tools used in this study were demographic questionnaire and Quality Patient Care Scale (QUALPAC). ResultsA total of 270 completed questionnaires were entered into the statistical analysis. The average quality of nursing care score in dying children was 266.17 ± 27.79. Also, the results of the present study showed that the gender, age, marital status, and work experience of nurses have no significant effect on the quality of nursing care in dying children from the nurses’ viewpoint. ConclusionThe quality of nursing care of dying children from the point of view of nurses was satisfactory. Nurses reported that the physical dimension of nursing care had the highest quality and the psychosocial dimension had the lowest quality. Therefore, psychological support and follow-ups for improving social support for these clients are suggested to the nursing managers and healthcare administrators.