General Nursing Care Research Articles

Nursing care for people with Chagas disease: a scoping review

Introduction: Chagas disease is an infectious disease caused by the parasitism process of the protozoan Trypanosoma cruzi. Given its potential for chronicity, nursing care in the health care of patients with Chagas disease will provide an improvement in quality of life and the prognosis of the disease. Objective: Review scientific knowledge about nursing care for individuals with Chagas disease. Material and Methods: descriptive and exploratory research, carried out with two independent reviewers using high sensitivity criteria in databases and gray literature sources between June and July 2022. Results: The review identified 12 relevant publications that emphasized health care, education, relationships, disease prevention and health promotion. The most frequent and diverse nursing diagnoses were related to the Activity/Rest, Health Promotion and Coping/Stress domains. Discussion: To meet the care needs of Chagas disease, it is essential to ensure nursing care that recognizes individualities, highlighting the importance of creating tools that facilitate the nursing process. The main points highlighted were related to the health education process, longitudinal monitoring, healthy lifestyle habits, general nursing care during hospitalization and the use of nursing diagnoses. Conclusion: the need for comprehensive nursing care that meets the main needs of individuals with Chagas disease is emphasized, considering their unique circumstances. Developing tools to support the nursing process is essential to improve the results of care for this population.

Application of Group Counseling Based on Positive Psychology Theory in Postoperative Total Hip Arthroplasty

Objective: This paper aims to explore and analyze the application of group counseling based on positive psychology theory in postoperative total hip arthroplasty. Methods: From July 2021 to April 2023, 110 patients with total hip arthroplasty admitted to the Department of Traumatology and Orthopedics in our hospital were selected as subjects of this study. They were divided into study group and control group by simple random sampling, with 55 cases in each group. The study group received group counseling based on positive psychology theory, and the control group received general nursing care. Harris hip function score, activities of daily living score (ADL), Hamilton depression rating scale (HAM-D), Hamilton anxiety rating scale (HAM-A), and postoperative complications were compared between the two groups. Results: Before nursing, the Harris and ADL scores of the two groups were compared, and the difference was not statistically significant (P > 0.05). After nursing, the Harris and ADL scores of the study group were significantly better than those of the control group, the difference was statistically significant (P < 0.05). Before nursing, the HAM-D and HAM-A scores of the two groups were compared, and there was no statistically significant difference (P > 0.05). After nursing, the HAM-D and HAM-A scores of the study group were significantly better than those of the control group, and the difference was statistically significant (P < 0.05). The incidence of postoperative complications in the study group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.05). Conclusion: Based on the theory of positive psychology, the effect of group counseling after total hip arthroplasty is more significant, and it is recommended to be applied in clinical practice.

Effect of PI3K/AKT/mTOR signaling pathway-based clustered nursing care combined with papaverine injection on vascular inflammation and vascular crisis after replantation of severed fingers

This research aimed to investigate the effect of PI3K (phosphatidylinositol 3-kinase)/AKT (protein kinase B)/mTOR (mammalian target protein of rapamycin) signaling pathway-based clustering care combined with papaverine injection on vascular inflammation and vascular crisis after finger amputation and replantation. 100 patients admitted in General Hospital of Ningxia Medical University from April 2022 to December 2022 for replantation of severed fingers were selected and divided into a control group (n = 50) and an observation group (n = 50) using the randomized grouping principle. The control group received a papaverine injection and general nursing care, the observation group received a papaverine injection and clustered care. The pain score; constipation incidence; replantation finger survival rate; physician, nurse, and patient satisfaction; serum inflammatory factors; vascular crisis parameters; and occurrence of adverse reactions were compared between the two patient groups. Enzyme-linked immunosorbent assay was performed to detect PI3K, AKT, and mTOR protein concentrations in the venous blood of the two groups, and statistical analysis of the data was performed. On postoperative day 7, the pain score and incidence of constipation in the observation group were lower than those in the control group (P < 0.05); the survival rate of reimplanted fingers in the observation group was 88.00%, which was higher than that in the control group 80.00% (P < 0.05); the satisfaction of doctors, nurses, and patients in the observation group was higher than that in the control group; the concentrations of interleukin-1 (IL-1), tumor necrosis factor (TNF-α), blood flow resistance index (RI), and arterial pulsatility index (PI) in the observation group were lower than those in the control group, while the concentration of interleukin-10 (IL-10), vascular diameter, and Vm (mean blood flow velocity) were higher in the observation group than those in the control group; the differences were statistically significant (P < 0.05). The difference in the incidence of adverse reactions between the two groups was not statistically significant (P > 0.05). The concentrations of PI3K, AKT, and mTOR proteins in the observation group were higher than those in the control group (P < 0.05). The concentrations of PI3K, AKT, and mTOR proteins in the observation group were higher than those in the control group (P < 0.05). Overall, these findings suggest that clustered care combined with papaverine injection reduces vascular inflammatory symptoms and vascular crisis in the treatment of severed finger replantation through the PI3K/AKT/mTOR signaling pathway.

Care of the brain dead organ donor

Organ donation is becoming more common but there is still a large gap between the number of people requiring transplants and the organs donated. There are set criteria for organ donation. When organ donation is considered after brain death, the physician must ensure that the prerequisites for testing are met and proceed to establish brain death using standard guidelines. The pathophysiological changes that occur after brain death must be borne in mind and utmost care should be given to counter those changes that would result in dysfunction of the donated organs. The brain dead patient must be maintained as stable as possible in the ICU. General nursing and medical care must continue. Core temperature must be maintained and infections must be treated. Blood pressure is best maintained with fluids and minimal vasopressors. Low tidal volume ventilation, optimal levels of positive end-expiratory pressures to maintain minimal FIO2, will maintain airways open and reduce extravascular lung water. Maintain euvolaemia. Maintain urine output at 0.5–3 ml/kg/h. Electrolyte abnormalities must be corrected. Maintain blood glucose concentrations between 120-180 mg %. Triple hormonal therapy improves organ function. Organ retrieval is performed in an operation theatre and a well conducted anaesthetic care is essential for the viability of these organs. One brain-dead organ donor can potentially donate ‘lives’ to eight individuals. To enhance or preserve the maximum potential of the donated organs, the anaesthesiologist and intensivist play a vital role in preserving the organs as best as possible.

Integrative medicine in treating post-stroke depression: Study protocol for a multicenter, prospective, randomized, controlled trial.

BackgroundPost-stroke depression (PSD) is one of the most common neuropsychiatric diseases in patients with stroke, and it can increase the disability rate, mortality, and recurrence rate of stroke. Currently, many clinical studies have indicated that traditional Chinese medicine (TCM), such as acupuncture and herbs, Western medicine, rehabilitation, repeated transcranial magnetic stimulation, and other treatment methods, are effective in treating PSD. However, no study has formulated a comprehensive treatment plan that integrates TCM, Western medicine, and rehabilitation for PSD. Thus, this trial aims to assess the efficacy and safety of integrative medicine for treating PSD.MethodsThis multicenter, prospective, randomized, controlled study aims to form a set of effective clinical treatment schemes that integrate TCM, Western medicine, and rehabilitation for PSD. A total of 202 participants recruited from four centers will be randomized into either the integrative medicine or standard care group. Standard care—basic treatment, general nursing care, and exercise therapy—will be provided to all participants. The integrative medicine group will also receive acupuncture, Chinese herbs, and repeated transcranial magnetic stimulation (rTMS). Participants will receive acupuncture and rTMS treatments five times per week for 4 weeks and will be administered Chinese herbs, basic treatment, general nursing care, and exercise therapy for 4 weeks. The primary outcomes include the Hamilton Depression Scale (HAMD), Self-Rating Depression Scale (SDS), and Activity of Daily Living Scale (ADL). And the secondary outcomes include the Montreal Cognitive Assessment Scale, the Fugl-Meyer Assessment (FMA) Scale, and the Pittsburgh Sleep Quality Index (PSQI). All outcome measures will be evaluated at baseline, week 4 (the end of the treatment courses), and week 8 (the end of follow-up). Safety assessments will be performed throughout the study.DiscussionThis study is expected to verify the efficacy and safety of integrative medicine for treating PSD, providing an evidence-based clinical reference for the future development of a standardized scheme.Clinical trial registrationClinicalTrials.gov, identifier: NCT05187975

A comparative study to assess the quality of nursing care rendered by staff nurses and the level of satisfaction perceived by patients in selected wards of selected government and private hospitals of Srinagar, Kashmir

The objectives of the study were to assess the quality of nursing care rendered by staff nurses in medical and surgical wards of government and private hospitals, to compare the quality of nursing care rendered by staff nurses in medical and surgical wards of government and private Hospitals, to find association between quality of nursing care rendered by staff nurses and selected demographic variables, to assess the level of satisfaction perceived by patients in medical and surgical wards of government and private hospitals, to compare the level of satisfaction perceived by patients in medical and surgical wards of government and private hospitals, to find association between level of satisfaction perceived by patients and selected demographic variables.Quantitative research approach and (descriptive comparative) research design was used. Tools used for data collection comprised of a structured observation checklist to assess quality of nursing care and a structured patient satisfaction questionnaire for assessment of patient satisfaction. Convenient sampling was adopted to select the 60 staff nurses, 30 from each hospital and 60 patients, 30 from each hospital. The study was conducted at a government (SMHS) hospital and a private (Noorah) Hospital, Srinagar.Data was analyzed and interpreted using both descriptive and inferential statistics. The findings showed that better quality of nursing care was rendered by staff nurses in private than in the government hospital. In government hospital, the areas in which staff nurses rendered good quality of care were nurse’s communication and behavior and patient safety, average quality in areas of documentation and environment and poor quality in the area of general nursing care. In case of private hospital, good quality of nursing care was rendered under the areas environment, patient safety, nurse’s communication and behavior and average quality of nursing care was rendered in the area documentation. No significant association was found between the quality of nursing care and selected demographic variables viz. age, educational qualification and years of work experience in both hospitals. A significant association was found between the level of satisfaction perceived by patients and age and marital status, and no significant association with gender, days of stay in the hospital and history of previous hospitalization in the government hospital. On average, in the government hospital, patients were satisfied with nurse’s communication and behavior and were dissatisfied with general nursing care and care facilities in the ward. In private hospital, no significant association was found between the level of satisfaction perceived by patients and demographic variables viz. age, gender, marital status, days of stay in the hospital and history of previous hospitalization. In the private hospital, on average the patients were satisfied with the general nursing care and nurse’s communication and behavior but were dissatisfied with care facilities in the ward.The study concluded that better quality of nursing care is rendered by staff nurses in private hospital than in government hospital. The level of satisfaction perceived by patients in private hospitals is better in private hospital than in government hospital.

Experiences of nurses practising mindfulness during self-leadership in delivering a rapid response system for general wards in a private hospital in Gauteng.

BackgroundThe increased complexity of the nursing care needs of patients and acuity in general wards present nursing care challenges for nurses. Self-led nurses are attentive, taking responsibility for activating the rapid response service when a patient is starting to deteriorate.ObjectivesThe purpose of this article is to describe nurses’ experiences practising mindfulness during self-leadership in delivering a rapid response system (RRS) in a private hospital in Gauteng.MethodA qualitative, exploratory, descriptive and contextual design was followed. Homogenous purposive sampling was used and a total of eight focus groups were conducted. Focus groups durations were between 45 min and 60 min. The data analysis was carried out through open coding on Atlas.ti using the noticing things, collecting things and thinking about things (NCT) approach. An independent coder met with the researcher during a consensus meeting and finalised the analysis.ResultsThe findings indicated an underlying theme of nurses being mindful in their self-leadership through the development of self-motivation and self-direction in the RRS. Three categories with six subcategories emerged from the data analysis, namely self-motivation in an RRS by the team, self-direction through role-modelling to peers and training.ConclusionNurses practised mindfulness during self-leadership, utilising behavioural and natural reward approaches and constructive thought patterns. These findings could assist management with developing training programmes for nurses.

Educational Needs of European Intensive Care Nurses with Respect to Multicultural Care: A Mix-Method Study.

The aim of the study is the analysis of educational needs of European intensive care nurses (ICNs) with regard to multicultural care. A mixed-method multinational study was performed among 591 ICNs coming from 15 European countries. An online survey was utilised with three research tools: participants’ sociodemographic details, Healthcare Provider Cultural Competence Instrument, and a tool to assess the educational needs of ICU nurses with respect to multicultural care. The highest mean values in self-assessment of preparation of ICU nurses to provide multicultural nursing care and their educational needs in this regard were detected in the case of nurses coming from Southern Europe (M = 4.09; SD = 0.43). With higher age, nurses recorded higher educational needs in the scope of multicultural care (r = 0.138; p = 0.001). In addition, speaking other languages significantly correlated with higher educational needs related to care of patients coming from different cultures (Z = −4.346; p < 0.001) as well as previous education on multicultural nursing care (Z = −2.530; p = 0.011). Experiences of difficult situations when caring for culturally diverse patients in ICU were classified into categories: ‘treatment procedures and general nursing care’, ‘family visiting’, ‘gender issues’, ‘communication challenges’, and ‘consequences of difficult experiences’. The educational needs of intensive care nurses in caring for culturally diverse patients are closely related to experiencing difficult situations when working with such patients and their families.

Perception of other healthcare professionals about the nurses' role and competencies in veno-venous extracorporeal membrane oxygenation care: A qualitative study.

AimThis study aimed to explore the perception of other healthcare professionals, including the doctors, physiotherapists and perfusionists, about the nurses' role and competencies in veno‐venous extracorporeal membrane oxygenation.BackgroundExtracorporeal membrane oxygenation is considered as a challenging clinical activity that requires critical decision and rapid response from nurses, particularly in emergencies. It was observed that nurses are primarily responsible for bedside management of these patients, and teamwork was found helping the nurses to manage this high‐acuity care. However, little is known on the perception of other healthcare professionals about the nurses' roles and competencies, which would contribute to further improvements in quality extracorporeal membrane oxygenation care.DesignThis was a qualitative descriptive study.MethodsOne‐to‐one in‐depth interviews were conducted with nine healthcare professionals working in extracorporeal membrane oxygenation care in an adult intensive care unit of a general hospital in Kuwait.ResultsParticipants reported that nurses play critical and multiple roles and responsibilities in the insertion, maintenance, weaning, and retrieval of extracorporeal membrane oxygenation, plus providing general nursing care, and performed their roles competently. Heavy workload, less recognition and support, and individual differences in competence were reported as possible barriers to the nurses' performance.ConclusionOther healthcare professionals recognize continuous training, having experience, teamwork, and increased staffing as measures that can promote the nurses' role in extracorporeal membrane oxygenation.

Nurse staffing and patient-perceived quality of nursing care: a cross-sectional analysis of survey and administrative data in German hospitals

ObjectiveTo examine the impact of nurse staffing on patient-perceived quality of nursing care. We differentiate nurse staffing levels and nursing skill mix as two facets of nurse staffing and use...

Impact of Pre-Transplantation Psychological Counseling in Improving the Mental Well-Being of Patients on Hemodialysis.

Background: Patients who are on hemodialysis (HD) and are waiting for kidney transplantation encounter various psychological issues.Objective: The current research aimed to compare the effectiveness of regular nursing care with that of nursing care coupled with dedicated psychological counseling in patients who were on HD before they underwent kidney transplantation.Methods: Baseline data were collected 1 month before kidney transplantation in patients of both the control (patients who received general nursing care between August 2011 and June 2015) and intervention (patients who received nursing care and psychological counseling between June 2015 and July 2018) groups. The Mental Status Scale in Non-Psychiatric Settings (MSSNS) was administered to assess and record the psychological status. Clinicodemographic and end-stage renal disease (ESRD)-related details, including duration of dialysis, causes for ESRD, the number of dialysis sessions performed before transplantation, and MSSNS scores, were recorded and compared between the groups.Results: A total of 37 patients were enrolled, including 19 in the control group and 18 in the intervention group. The number of dialysis sessions performed before transplantation was 143 (26, 564) and 227.5 (39, 767), and dialysis duration was 20.4 ± 14.5 and 14.4 ± 12.1 months in the intervention and control groups, respectively. There was no significant difference in baseline negative emotions between the two groups (P > 0.05). The psychological intervention group reported significantly lower anxiety, depression, anger, and loneliness scores than the control group (P < 0.05).Conclusion: Psychological counseling before kidney transplantation in patients on HD could reduce their negative emotions and enhance mental well-being.

Outpatient healthcare utilization 30 days before and after hospitalization for heart failure in France: Contribution of the national healthcare database (Systèmenationaldesdonnéesdesanté)

Guidelines have been published concerning patient management after hospitalization for heart failure. The French national healthcare database (Systèmenationaldesdonnéesdesanté; SNDS) can be used to compare these guidelines with real-life practice. To study healthcare utilization 30 days before and after hospitalization for heart failure, and the variations induced by the exclusion of institutionalized patients, who are less exposed to outpatient healthcare utilization. We identified the first hospitalization for heart failure in 2015 of adult beneficiaries of the health insurance schemes covering 88% of the French population, who were alive 30 days after hospitalization. Outpatient healthcare utilization rates during the 30 days after hospitalization and the median times to outpatient care, together with their interquartile ranges, were described for all patients, and for a subgroup excluding institutionalized patients. Among the 104,984 patients included (mean age 79 years; 52% women), 74% were non-institutionalized (mean age 78 years; 47% women). The frequencies of at least one consultation after hospitalization and the median times to consultation were 69% (total sample) vs. 78% (subgroup excluding institutionalized patients) and 8 days (interquartile range 3; 16) vs. 7 days (3; 15) for general practitioners, 20% vs. 21% and 14 days (7; 23) vs. 16 days (9; 24) for cardiologists and 58% vs. 69% and 3 days (1; 9) vs. 2 days (1; 7) for nurses, with reimbursement of diuretics in 77% vs. 86%, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in 48% vs. 55% and beta-blockers in 55% vs. 63%. Departmental variations, excluding institutionalized patients, were large: general practice consultations (interquartile range 74%; 83%), cardiology consultations (11%; 23%) and nursing care (68%; 77%). Low outpatient healthcare utilization rates, long intervals to first healthcare utilization and departmental variations indicate a mismatch between guidelines and real-life practice, which is accentuated when including institutionalized patients.

The Analgesic Effects of Intrathecal Morphine in Comparison With Ultrasound-Guided Transversus Abdominis Plane Block After Caesarean Section: A Randomised Controlled Trial at a Ugandan Regional Referral Hospital

(Anaesthesia. 2019;74:167–173) Worldwide, cesarean section is the most frequently performed major surgery. However, most research regarding anesthesia and postoperative analgesia for cesarean section has been performed in high-income countries that have extensive health care resources. In comparison, low-income and middle-income countries have markedly fewer resources for health care in general and postoperative nursing care specifically. This study was performed to compare analgesic outcomes after cesarean section. At a hospital in Southwestern Uganda where this study was undertaken, most of the basic postoperative nursing care after cesarean section is provided by family or friends of the patient. The current study was performed to compare outcomes when intrathecal morphine or transversus abdominis plane (TAP) block was used to provide postcesarean pain control in a resource-limited setting.

Health care utilization after hospitalization following a road traffic accident

Purpose: In recent years, there has been an increasing interest in measuring and modeling health care utilization. However, only limited research has been performed in the field of health care utilization following road traffic accidents. This article aims to measure the incremental health care utilization after hospital discharge after a road traffic accident and explore the association between socio-demographic and injury-related variables and health care utilization.Material and methods: Generalized linear models with negative binomial distribution and log-link were executed per type of health care provider (general practitioner, medical specialists, rehabilitation services and outpatient nursing care) and per type of discharge location (discharged to home, discharged to in-hospital rehabilitation). Health care utilization of the 6 months after discharge was compared with the 6 months before the accident (baseline care).Results: Health care utilization six months after discharge is significantly higher than baseline care, except for outpatient nursing care and general practitioners in in-hospital rehabilitation. The increase in visits to medical specialists ranged on average between 1 and 2.2 visits. For general practitioner, there was an increase of 0.4 visits and 0.8 in outpatient nursing care for those who returned home after acute hospitalization. The average increase in rehabilitation services ranged between 3.6 and 20. Associated influential factors differ per health care provider and discharge destination.Conclusion: Evidence of this study suggests higher health care utilization during the first 6 months following hospitalization due to a road traffic injury, compared with baseline care. Associated variables differ per type of health care provider and discharge-destination. More in-depth research on subgroups is needed.Implications for rehabilitationHealth care utilization varies across different patient characteristics and type of injuries which should be considered in the communication with patients on their care trajectory post-discharge.General descriptions of health care utilization in traffic victims at the population level are lacking. Output similar to our study could serve as a reference for post-discharge care planning.The research output can be a starting point for future research on quality indicators of the expected quantity of care.Efforts must be made to estimate suchlike reference tables on post-discharge services in other patient groups and secondary data are a suitable data-source for those analyses.

Inpatients nursing care provided in a tertiary hospital of Nepal

Introduction: Nursing care is necessary for every client seeking any type of healthcare such as health promotion, diagnosis, treatment and recovery. Despite these facts, nurses are given less importance and their works are even unrecognized. Objective: The objective of this study was to explore nursing care provided to inpatients of medical ward at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Methodology: Hospital based cross-sectional study was carried out in medical ward of B. P. Koirala Institute of Health Sciences, Dharan from Feb 2017 to Oct 2018. Data were retrieved from inpatient admission record book of medical ward of previous 15 months from the initiation of this research work. Admission record book was reviewed and checked for completeness of the record. A total of 290 patients having complete records were enrolled. Collected data were entered in Microsoft excel and analysed by SPSS software. Results: More than half patients (52.8%) were male and 44.8% belonged to Janajati ethnicity. The major age group was 15-25 years (17.9%) with mean and standard deviation of 49.4±20.6. About 28.6 % of the patients were admitted due to cardiovascular related problems and poisoning (13.1%). Most of the patients (67%) were admitted from emergency. Median duration of stay was 4 days. Every 8 out of 10 patients were recovered and discharged. General nursing care provided were maintenance of personal hygiene (91.03%), cannula site care (49.7%), providing psychological support (41%), ambulation (8.3%), back care (7.6%), catheter care(6.9%), passive exercise (2.4%), chest physiotherapy(3.7%), sponge bath(9.3%). Specific care provided were propped-up positioning (36.2%), 2 hourly position change (23.4%), random blood sugar monitoring (12.4%), SpO2monitoring (8.9%), watch for oxygen toxicity (9.3%), weight monitoring (3.1%) and pre CAG (coronary angiography) care(2.1%). Conclusion: Maintenance of personal hygiene, cannula site care, psychological support, two hourly positioning and oral care were the common practices performed.BIBECHANA 16 (2019) 204-212

Topical steroid versus placebo for the prevention of radiation dermatitis in head and neck cancer patients receiving chemoradiotherapy: the study protocol of J-SUPPORT 1602 (TOPICS study), a randomized double-blinded phase 3 trial

BackgroundTo date, the clinical benefit of topical steroid use has only been demonstrated for radiation dermatitis induced by 50–60 Gy irradiation in breast cancer. However, these agents are also often used clinically for the control of radiation dermatitis induced by high-dose (>60Gy) irradiation with chemotherapy in head and neck cancer. Despite this, the prophylactic efficacy of topical steroids for radiation dermatitis induced by high-dose irradiation is still unclear.The aim of this study is to clarify the benefit of topical steroids in basic nursing care for radiation dermatitis induced by chemoradiotherapy in patients with head and neck cancer.MethodsThe study is being conducted as a multicenter 2-arm randomized double-blinded placebo-controlled Phase 3 trial in Japan. The study was started in May 2017, with participant enrollment between May 2017 and April 2019.Patients scheduled to receive definitive or postoperative chemoradiotherapy for head and neck cancer are eligible for enrollment. All patients will receive chemoradiotherapy, consisting of single agent CDDP and 70-Gy irradiation. Bilateral neck irradiation is mandatory.Supportive care for radiation dermatitis will consist of basic nursing care with topical steroid or placebo. When radiation dermatitis grade 1 is seen or total radiation dose reaches 30 Gy, minimally required intervention will be started as a first step.If radiation dermatitis worsens to grade 2, the irradiated area will be covered with a moderately absorbent surgical pad and steroid or placebo topical cream.The primary endpoint is a comparison of the proportion of patients with ≥ grade 2 radiation dermatitis by NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.Ethical approval has been obtained from all participating sites. The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences.DiscussionEvidence supporting the benefit of adding topical steroids in general nursing care for radiation dermatitis induced by high-dose irradiation with chemotherapy is insufficient. This trial aims to clarify the clinical benefit of topical steroid for radiation dermatitis induced by high-dose irradiation with chemotherapy. The trial is ongoing and is currently recruiting.Trial registration numberUMIN000027161. Protocol version 3.0, 18 April 2017.

The effects of early-stage neurodevelopmental treatment on the growth of premature infants in neonatal intensive care unit

The purpose of this study was to investigate the effects of early-stage neurodevelopmental treatment on the growth of premature infants in the neonatal intensive care unit. A total of 85 premature infants were included in this study. Infants with a birth weight of less than 2.5 kg and of 2.5 kg or higher were classified as premature infants with a high risk of growth delay and with a low risk of growth delay respectively. Of the 55 premature infants with a high risk of growth delay, 27 premature infants were placed in the intervention group and 28 were placed in the control group according to their hospitalization time. Thirty premature infants with a low risk of growth delay were included in the comparative group. The same general nursing care of the neonatal intensive care unit was provided to the intervention group, the control group, and the comparative group, but an additional neurodevelopmental treatment program was given only to the intervention group, for 15 min per session, 4 times a week, up to 40 weeks after conception. As growth indicators, the body weight and head circumference were measured before and 2 weeks after the intervention, and at 40 weeks after conception when the intervention was completed. The body weight and head circumference of the intervention group, which received the neurodevelopmental treatment, were significantly improved compared to the control group (P<0.05), but they were not significantly different from those of the comparative group. However, the body weight and head circumference of the control.

A Comparison of Patients' Nursing Service Satisfaction, Hospital Commitment and Revisit Intention between General Care Unit and Comprehensive Nursing Care Unit

Purpose: The study aim was to compare nursing service satisfaction, hospital commitment and revisit intention between patients on general care units and comprehensive nursing care units. Methods: Participants were 201 hospitalized patients in a WHO tertiary hospital and a general hospital. Data were analyzed using SPSS/WIN 23.0 program. Results: There was a significant difference in the satisfaction with nursing service between patients on general care units and comprehensive nursing care units (t=14.73, p＜.001). There was a significant difference in the hospital commitment between general care units and comprehensive nursing care units (t=7.52, p＜.001). There was a significant difference in the revisit intention between patients on general care units and patients on comprehensive nursing care units (t=6.01, p＜.001). There were significant relationships among nursing service satisfaction, hospital commitment and revisit intention. Conclusion: The findings reveal that patients on comprehensive nursing care units were more satisfied with the nursing service, hospital commitment, and revisit intention compared to general care unit patients. Nursing service satisfaction and hospital commitment were factors affecting hospital revisit intention. Therefore, these results are important data for complementing and expanding the comprehensive nursing service system to improve satisfied with nursing service and hospital commitment to increase hospital revisit intention.

Patient Satisfaction with Services Provided at Night and the Assessment of the Quality of Care in the Hospital

Night nursing care has different priorities from the care in the morning and afternoon hours. The patient as the subject of nursing activities may assess the quality of this care in a more or less objective way, thus giving the opportunity to improve or improve these services. The study was conducted to assess the quality of care and general nursing care. The studied population constituted 585 patients hospitalized in the Clinical Hospitals of the city of Rzeszow. The research was carried out from 1 January 2016 to 31 May 2016. In the patients opinion survey, the method of the diagnostic survey was used, using two standardized NSNS questionnaires, the PASAT HOSPIT1 package and the original questionnaire. The assessment of services provided by nurses at night that was made with the use of the Newcastle scale was high (experience - 63.7 points, satisfaction - 60.3 points), and the assessment based on the Author's Questionnaire. The correlation between the assessment of night-time care and the overall assessment of nursing care indicates statistically significant (R=0.51 and R=0.47) and significantly influenced assessment of the overall nursing care. The quality of the night tasks resulting from the therapeutic function and caring were considerably related to the overall assessment of the nursing care. The relationship between the assessment according to the PASAT HOSPIT 1 questionnaire and the assessment of nursing care on the basis of the Newcastle scale is most correlated with the nurse's availability (satisfaction -p=0.0000***), the speed of response to the call (satisfaction -p=0.0000***) and the satisfaction from nursing care.

Protocol-Directed Sedation Versus Non-Protocol-Directed Sedation to Reduce the Duration of Mechanical Ventilation in Intensive Care Patients.

Protocol-Directed Sedation Versus Non-Protocol-Directed Sedation to Reduce the Duration of Mechanical Ventilation in Intensive Care Patients.