Nursing Services Research Articles

The effect of Orem's Self-Care Deficit Theory-based care during pregnancy and postpartum period on health outcomes: A systematic review and meta-analysis.

To examine the effect of the provision of care on health outcomes when provided based on Orem's Self-Care Deficit Theory during perinatal period. The perinatal period is a process with multidimensional care needs for the mother, baby and family. Care based on nursing theories can improve the quality of perinatal care. A systematic review and meta-analysis. Studies on this topic from 2006 to 2020 have been accessed by nine database searches. The methodological quality of the studies was assessed using the Critical Appraisal Checklists for experimental and quasi-experimental studies, developed by the Joanna Briggs Institute. This study was conducted by following the Preferred Reporting System for Systematic Reviews and Meta-Analyses. This systematic review included nine studies with a total sample size of 839 women. These studies showed that care based on Orem's theory significantly helped prolong the mean duration of pregnancy, reduced the incidence of preterm labor, improved hygiene behaviour and increased empowerment. Concerning the perinatal period, this intervention significantly improved self-care and readiness for hospital discharge, adaptation and breastfeeding self-efficacy and reduced nipple pain and pain due to abdominal distension. The implementation of this theory into care during the perinatal period can contribute to improved health outcomes. What is already known about this topic? The quality of pregnancy and postpartum care is important for the maternal health. The use of nursing theories-which nursing knowledge is produced-improves care quality and ensures that care is organized systematically. What this paper adds? There is insufficient research that supports Orem's theory of self-care deficit in pregnancy and postpartum care and also no systematic review about this topic, but the current meta-analysis showed that postnatal and prenatal treatments based on Orem's theory have a positive impact on the self-care agency. The implications of this paper: The use of Orem's theory helps nurses understand women and their needs during pregnancy and postpartum periods. Integrating Orem's theory of self-care deficit into pregnancy and postpartum nursing care services can help increase women's self-care power.

Attitudes of Emergency Department Staff Toward Individuals Who Have Attempted Suicide and Associated Factors.

To determine the attitudes of emergency department (ED) staff toward people who have attempted suicide and the factors associated with these attitudes. This study was conducted between January and February 2023 and included 147 participants working in an ED in a city in Türkiye. Data were collected using a personal information form and the Attitude Scale Towards Attempted Suicide Cases for Evaluating Emergency Medical Teams (ASETSA). Participants' mean years of experience in emergency services was 4.63 years (SD = 3.97 years) and mean perceived level of competence in intervening in suicidal behavior was 6.08 (SD = 2.16). Total mean ASETSA score of participants was 114.68 (SD = 12.31). Factors such as marital status, educational level, profession, working unit, working shift, having received training on how to approach a person who has attempted suicide, existence of a written procedure in the department, years of ED experience, and perceived level of competence in intervening in suicidal behavior were associated with positive attitudes toward people who have attempted suicide. It is recommended that formal education curricula address how to approach people who have attempted suicide, that randomized controlled trials regarding the impact of in-service training be performed, and that studies evaluating the contribution of trainings to improvements in patient outcomes be conducted. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Relationships Among Internalized Stigma, Readiness to Change and Treatment Eagerness, and Recovery Among Individuals With Substance Use Disorder in Turkey.

To investigate relationships among internalized stigma, readiness to change and treatment eagerness, and recovery among people with substance use disorder (SUD) (N = 131). This study used a cross-sectional and correlational research design. Multiple linear regression was used for analysis. A 1-unit increase in alienation and discrimination experiences led to 0.220- and 0.337-unit increases in readiness to change and treatment eagerness, respectively (p = 0.001); however, a 1-unit increase in stigma resistance led to a 0.306-unit decrease in recovery (p < 0.001). There was a negative correlation between internalized stigma and recovery and positive correlations between internalized stigma and readiness to change and treatment eagerness; however, there was no significant relationship between recovery and readiness to change and treatment eagerness. Early intervention programs targeting internalized stigma in individuals with SUD may improve readiness to change and treatment eagerness and recovery attitudes. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Improving Self-Regulation: Resiliency Skills in the Classroom.

The impact of daily living often results in unimaginable stress for children, which can be exhibited as lack of self-control. Children with decreased self-regulation are often not successful in school. Many schools do not have the resources needed to employ professionals who could provide programs to improve self-regulation. Creative programs that can be implemented into the classroom without disrupting the school day are needed. The current article describes a resiliency program that was implemented in a school setting to increase self-regulation. This pilot project used descriptive statistics to analyze the feasibility of incorporating resiliency skills into an elementary school curriculum and the resulting impact on self-regulation among school-aged children. Improvements were identified in self-esteem, compassion, and classroom behavior. Implementing resiliency skills into the curriculum can result in positive outcomes by improving self-regulation in school-aged children. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Latent Profile Analysis of Self-Stigma Among Individuals With Schizophrenia and Its Relationship With Illness Perception.

To investigate self-stigma among individuals with schizophrenia, identify potential categories of self-stigma, and analyze the association between self-stigma categories and dimensions of disease perception. Convenience sampling was used to select individuals with schizophrenia (N = 216) in psychiatric hospitals. A General Demographic Information Questionnaire, the Internalized Stigma of Mental Illness Inventory, and Brief Illness Perception Questionnaire were used for data collection. A latent profile analysis was performed on self-stigma characteristics of participants, and potential categories of influencing factors and their relationship with illness perception were examined. Participants were classified into three potential categories: low self-stigma-low resistance (19.4%), medium self-stigma (55.6%), and high self-stigma-high discrimination (25%). Compared with the low self-stigma-low resistance group, those with higher illness representation and illness understanding scores were more likely to be classified as medium self-stigma, and emotional representation was the strongest predictor for high self-stigma-high discrimination. Self-stigma among participants was mostly medium to high. Self-stigma of individuals with schizophrenia demonstrates group heterogeneity; therefore, nurses should formulate targeted interventions based on the characteristics of each category to achieve precise interventions and reduce self-stigma. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Nurses' Perspectives on Risk Factors and Strategies to Control Workplace Violence: A National Survey in Vietnam.

We aimed to describe nurses' perspectives on risk factors and strategies to control workplace violence. To accomplish the study objectives, an online cross-sectional questionnaire-based investigation was conducted. The scales were developed in accordance with the guidelines provided by reputable organizations such as the International Labour Office (ILO), International Council of Nurses (ICN), WHO, and Public Services International (PSI), as well as previous scholarly works. Prior to implementation, the validity and reliability of the Likert scales were rigorously tested. The survey, conducted from March to May 2022, encompassed 163 public hospitals in Vietnam and was completed by 2,280 nurses employed in these institutions. According to nurses' perceptions, several key risk factors contribute to workplace violence (WPV). These include low socio-cultural awareness among patients and their family members, overcrowding in hospitals, non-compliance with hospital regulations, unrealistic expectations regarding treatment outcomes, communication issues among staff members. To effectively control WPV, nurses propose a range of strategies. These include enhancing the quality of hospital services and the hospital environment, fostering a positive workplace culture, establishing a comprehensive system for reporting and responding to incidents of WPV and developing patient care protocols. These strategies are believed to mitigate the occurrence and impact of WPV, ensuring a safer and more secure work environment for nurses. Workplace violence in healthcare settings is influenced by organizational, clinical, and environmental risk factors. Nurses adopt a multi-component approach to manage workplace violence. This study provides valuable insights for developing effective strategies to combat workplace violence in Vietnam.

A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services.

This study aimed to compare the number of assigned and appropriate patients per nurse in integrated nursing care service wards and analyze factors associated with the gap. For this cross-sectional secondary analysis, data were collected from surveys of 2312 nurses and institutional data from their affiliated 106 hospitals in Korea. We used the Wilcoxon signed-rank test and t-test to compare the number of patients assigned to nurses with the number they considered appropriate. We used ratio analysis for measuring the gap between these numbers, and robust regression to evaluate the factors affecting this gap. The results found an average gap of 1.45, indicating that the reported number of assigned patients per nurse was 1.45 times higher than the appropriate number. Gender, employment type, wage satisfaction, workload, overtime work, and hospital level of care were identified as factors associated with the gap. Findings suggest that the current nurse staffing standard should be revised to consider nurses' professional judgments of appropriate staffing levels and adopt policies that reduce nurses' workload.

The impact of antenatal cluster management on maternal delivery and postpartum rehabilitation

ObjectivePregnancy care can improve maternal pregnancy outcomes. Cluster nursing, an evidence-based, patient-centered model, enhances pregnancy care, can provide patients with high-quality nursing services, has been widely used in clinical practice in recent years. However, most previous studies evaluated cluster nursing program only for a single clinical scenario. In this study, we developed and implemented a antenatal cluster care program for various prenatal issues faced by puerpera to analyze its application effect.MethodsThis is a historical before and after control study. 89 expectant mothers who had their prenatal information files registered in the outpatient department of a grade III, level A hospital from June 2020 to September 2021 were finally enrolled in observation group, and received prenatal cluster management. Another set of 89 expectant mothers from January 2019 to December 2019 were included in the control group and received traditional routine prenatal management. The effect of cluster nursing management on maternal delivery and postpartum rehabilitation was evaluated and compared between the two groups.ResultsCompared with the control group, the observation group had a significantly higher natural delivery rate, better neonatal prognosis, higher rates of exclusive breastfeeding, lower incidence of postpartum complications, shorter postpartum hospital stay, better postpartum health status, and higher satisfaction with nursing services. Compared with before intervention, the SAS and SDS scores of the observation group showed significant improvement after intervention.ConclusionAntenatal cluster care is beneficial to improve maternal and neonatal outcomes, and can have positive effects on natural pregnancy and breastfeeding, while improving the multimedia health education ability of medical care and emphasizing the importance of social support.

Development and validation of a rating scale for barriers to and facilitators of nurses’ participation intentions in “Internet + Nursing Service”

BackgroundGiven increases in China’s aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, “Internet + Nursing Services” have received more attention. Thus, exploring the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” and utilizing internet technology to increase the supply of nursing services has become a key issue.ObjectiveThis study aimed to develop a scale for assessing the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” and to test the validity and reliability of the scale.MethodsA preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale.ResultsThe final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach’s α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ2/df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953.ConclusionThe scale for assessing the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” has good reliability and validity, and provides a reference for evaluating nurses’ willingness to participate in “Internet + Nursing Services”.

Analysis of the Current Situation of “Internet Plus Nursing Service”

Analysis of the Current Situation of “Internet Plus Nursing Service”

Emerging Nurse Billing and Reimbursement Models.

To explore and make recommendations to implement direct billing and reimbursement models for nursing care in the United States. Nurses make up the largest group of healthcare professionals and within hospitals, nurses represent approximately a quarter of all resources and associated costs of patient care. This care is mostly hidden in daily room and board charges. The authors surveyed the recent and historical literature related to costing and billing for nursing care. These results were synthesized and led to the recommendation of several new models to cost, bill, and pay for nursing care provided by nurses who are not currently billing for their services. Two basic billing models are proposed: the 1st is to remove nursing care out of the current daily room or facility-based charges and allocate nursing care time provided to each patient during each day of stay. The 2nd is to expand existing Current Procedural Terminology codes to bill for specific activities and interventions by nurses in all settings where nursing care is delivered. It is feasible to implement the proposed methods to identify patient-level nursing intensity, cost, services, and interventions provided by individual nurses in all healthcare settings.

Effects of high-quality neurosurgical nursing care on improving clinical nursing quality.

With continuous advancements in medical technology, neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services. To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing. Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups. The study group comprised 40 patients who received 4 different types of high-quality nursing care, whereas the control group comprised 40 patients who received conventional nursing care. After a specific period, nursing satisfaction levels and adverse event and complication rates were compared between the two groups. Satisfaction with high-quality care was higher than that with conventional care, and high-quality health services and regional services showed the highest satisfaction levels, with an average score of 12 on the Glasgow scale. The satisfaction levels of the study and control groups were 75% and 57%, respectively, with a statistically significant difference (t = 7.314, P < 0.05). During the nursing period, the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery (40.02% and 85.93%, respectively), and the difference was statistically significant. In neurosurgical nursing, employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients, thereby improving the quality of nursing care and increasing clinical nursing value.

The influence of hospital services on patient satisfaction in OPDs: evidence from the transition to a digital system in South Punjab, Pakistan

BackgroundPakistani’s health services delivery system has been rarely evaluated regarding patient satisfaction. This study examined the performance of the Pakistani health system from the perspective of doctor services (DS), digital payment system (DPS), nurses’ services (NS), laboratory services (LS), pharmacy services (PHS), registration services (RS), physical services (environmentally and tangible) and doctor-patient communication (DPC) about patient satisfaction. A random sampling technique was adopted for data collection.MethodologyThe Social Science Statistical Package (SPSS), analysis of moment structures (AMOS), and structural equation modeling were used to analyze the data for reliability, validity, correlations, and descriptive findings. The 879 responses were used for study analysis.ResultsThe study revealed that patient satisfaction was found to be significantly affected positively by LS, PHS, DS, NS, and DPS, while DPC, RS, and PF were impacted non-significantly. Consequently, there is a considerable communication gap in the doctor-patient interaction, and Pakistan's healthcare system is confronted with a shortage of physical infrastructure and challenges in the digital system.ConclusionFurthermore, the insufficient emphasis on registration services necessitates immediate action to improve the entire patient experience and satisfaction. Identifying these shortcomings has the potential to result in a healthcare system that is more efficient and focused on the needs of the patients.

Impact of Dialectical Behavioral Therapy on Anxiety Levels Among African American Adolescents.

Anxiety and depression among adolescents in the United States has steadily increased. In addition, significant disparities in access to mental health care exist for African Americans. The purpose of the current project was to support the mental health of African American adolescents involved in faith-based youth groups through implementation of dialectical behavioral therapy (DBT). The community partner was an African American church in Southwest Georgia. Mindfulness training modules are offered in monthly sessions. Pre- and post-intervention surveys and the Generalized Anxiety Disorder-7 (GAD-7) were analyzed, comparing mean GAD-7 scores before and after participation. Nurse-led quality improvement initiatives support adolescent mental health and provide sustainable resources for mental health in rural areas. Results of the quality improvement project reveal improvement in self-reported anxiety symptoms among participants after the 4-month DBT intervention. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 7-10.].

Nursing undergraduates' experience of participating in the Internet + Nursing Program and their spiritual education needs: A qualitative study from the perspective of the Neuman System Model.

This study aimed to explore the qualitative aspects of nursing undergraduates' experience of participating in the Internet + nursing program and their spiritual education needs from the perspective of the Neuman system model. Using a descriptive qualitative study design, twelve full-time undergraduates at Chengde Medical University from June to July 2022 who had completed their clinical internship were interviewed one-on-one, and a purposive sampling method was adopted. Moreover, Colaizzi's phenomenological method was employed to analyze the data and improve the themes. In the Internet + nursing program, the lack of spiritual education for undergraduates can be summarized into the following four themes: lack of spiritual consciousness; lack of spiritual education and spiritual nursing knowledge; high demand for spiritual education; and cognition of the current situation of basic nursing education in China and thoughts on incorporating Internet-related technologies into future nursing education. At the school and hospital level, importance should be placed on the basic education of spirituality and psychological nursing, and appropriate measures should be taken to improve the knowledge level of spirituality and psychological nursing as well as the capacity of spiritual nursing, in order to ensure high-quality nursing services.

Construction of a Full-Process Nursing Service Platform for Day Surgery Patients Based on Kano Model.

This study was based on the Kano model and rely on the Internet hospital to build a day surgery patient full-process nursing service platform. Based on the Internet hospital's HIS system, nursing Yuanzhuo system, patient mobile terminal (WeChat) and other information systems. The platform was designed by following the WHO's conceptual framework for developing a scaling-up strategy. It was tested and refined by a pilot in a hospital in China. The full-process care platform for day surgery patients realizes information interconnection and interoperability of patient surgical consultation, surgical inquiries, and postoperative follow-up. It consists of a WeChat applet (client) and an online website (server). Pre-experiment results show that patients are more likely to recommend the hospital's day surgery to others. The mHealth-based perioperative full-process nursing service platform for day surgery patients can initially meet the health education needs, surgical consultation needs and follow-up needs of day surgery patients.

Intention to Leave the Service in Nurses During the COVID-19 Pandemic: A Systematic Review Intention to Leave the Service in Nurses During the COVID-19 Pandemic: A Systematic Review

Introduction: Leaving the profession, especially during the COVID-19 pandemic, has become one of the global challenges raised by healthcare service providers. This study aimed to review the tendency of nurses to leave their service during the COVID-19 pandemic. Materials and Methods: In this systematic review, all the studies conducted inside and outside the country during the period of the COVID-19 pandemic from 2019 to 2022 using the keywords of leaving the service of nurses, leaving the service in COVID, nursing in Covid, willingness to leave the service in Covid, the tendency to leave service, leaving the service of nurses in Covid, resignation from a nursing job, covid and leaving service, from the internal databases Google Scholar, Iranmedex, Magiran, Nindex, MediLib and Noor magazines and external databases WoS, ProQuest, PubMed, Scopus. Were placed the articles that met the inclusion criteria were selected and finally analyzed more closely. Results: In the extensive search for information, 127 articles were obtained, and 10 articles were finally selected and evaluated during the screening process and review of the inclusion criteria. The results of this review showed that fear of disease, not having enough immunity, having children, not being able to afford personal equipment, inappropriate salary and benefits compared to the difficulty of work, fear of transmitting infection to the family, lack of support from officials, working in the Covid department and the heavy workload during the Covid-19 era was cited as one of the most important reasons for leaving a job. Conclusion: Choosing life solutions, financial and occupational safety, and more effective support of the authorities towards nurses are among the solutions that can help to continue the nursing profession, especially during crises like COVID-19.

Nutrition Care Practices in Mental Health Nursing Services: Insights from a Preliminary Study from Pune, Maharashtra, India.

To assess nutrition care practices in selected mental health care facilities in Pune, Maharashtra, India. A preliminary cross-sectional study was conducted in individuals (N = 100) residing in five private mental health care facilities. Data were collected on diet quality, nutritional status, and health status of adult patients with mild to moderate mental health disorders. Food safety practices of the care facilities were also investigated. Of 100 recruited participants, 68% were over-nourished (body mass index >23 kg/m2), 32% were given vitamin B complex supplements, 81% used antipsychotic drugs, and 72% reported drug-induced gastric issues. Most participants (n = 71; 71%) consumed medium-quality diets (four to five food groups per day). Food sanitation and hygiene scores indicated fair standards (range = 46% to 51%) at these facilities. Further, partial compliance with World Health Organization guidelines was observed. Findings underscore the need for induction of nutritionists or, in their absence, additional nutrition training for mental health nurses to enhance diet quality, nutritional and health status of patients, and food safety. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Examining Factors Associated With Intention to Seek Professional Mental Health Support Among First-Generation Iranian Americans.

Research suggests immigrants are at a greater risk of mental health disorders compared to native-born populations. Thus, the current study investigated factors associated with professional mental help-seeking intention among American immigrants. A cross-sectional study was conducted with 207 first-generation Iranian Americans, and data were collected using survey questionnaires. Younger Iranians living in western states in the United States and those with positive attitudes toward professional mental health services had greater intention to seek these services. Unexpectedly, those with better mental health literacy (MHL) held more mental health stigma (MHS). Findings elucidated valuable insights into the complex dynamics among sociodemographic factors, acculturation, MHL, MHS, attitudes, and intentions toward professional mental health help-seeking. We also highlighted the intricate relationship between MHL and MHS, suggesting that strategies to improve MHL may not necessarily mitigate MHS within this community. Therefore, integrating anti-stigma, contact-based approaches to MHL programs could effectively reduce stigma while facilitating mental health help-seeking. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Self-Esteem Among U.S. African American and Latinx Adolescents With Depressive Symptoms and Overweight and/or Obesity.

To examine the concept of self-esteem among African American and Latinx adolescents with overweight and/or obesity and depressive symptoms in the United States. Using key terms in CINAHL, PubMed, and PsycINFO databases, an initial search yielded 371 articles; after examining title, abstract, and full text, 33 articles remained. The concept of adolescent self-esteem was analyzed using Rodger's evolutionary method. Several antecedents of self-esteem in this context were identified, including bullying, negative portrayal in the media, stressors and hassles, low socioeconomic status, dieting, and family dietary influences. Attributes identified were body image and misperception, body image dissatisfaction, diminished social status, and isolation. Consequences included stigma, somatic complaints, decreased earnings over a lifetime, decreased quality of life, lower educational attainment over a lifetime, and increased substance use. Increased self-esteem, increased number of friends, and in-depth friendships were associated with a lower risk of being overweight or obese. Adolescent self-esteem varied based on gender, racial and ethnic group, and changed over time in the African American population but remained static in the Latinx population. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].