Identification of subgroups of patients with gastrointestinal cancers based on symptom severity and frequency: A latent profile and latent class analysis.

PURPOSE: Identify subgroups of patients with gastrointestinal cancer with different frequency and severity of symptoms and assess differences in demographics, clinical characteristics, and degree of interference with daily life. METHODS: This was a cross-sectional study. A total of 202 patients with gastrointestinal cancers completed the Chinese version of the MD Anderson Symptom Inventory for Gastrointestinal Cancer Module by convenience sampling. Subgroups of patients were identified using latent profile analysis and latent class analysis. Chi-squared, Mann-Whitney-U, and Kruskal-Wallis tests assessed differences among subgroups. RESULTS: In terms of symptom severity, low (70.3%), Moderate (13.4%), and high (16.3%) classes were identified. Compared with the other two classes, the Moderate group had a higher proportion of patients with a history of tobacco and alcohol, esophageal cancer, and gastric cancer (P < 0.05). In terms of symptom frequency, all -high (57.9%), high physical symptoms (9.9%), and all-low (32.2%) classes were identified. All-high groups had a younger age and a higher proportion of patients with cancer stage IV (P < 0.05). The high group had the most interference with daily life in both perspectives (P < 0.001), and psycho-emotional symptoms were frequent and severe. CONCLUSIONS: The two perspectives of symptom severity and frequency can play a complementary role in identifying high-risk groups. Clinical practitioners should strengthen psychological interventions in young and advanced cancer patients and provide pharmaceutical and non-pharmaceutical interventions for dysphagia symptoms in esophageal and gastric cancer patients with a history of tobacco and alcohol.

Assessing the risk factors associated with sarcopenia in patients with liver cirrhosis: a case-control study.

Sarcopenia is a disease characterized by decreased muscle mass and strength, affecting 20-70% of patients with cirrhosis, and is associated with poor prognosis, complications, and high mortality. At present, the epidemiological investigation of sarcopenia in patients with liver cirrhosis is relatively limited, and because of the differences in population characteristics, regions, diagnostic criteria and diagnostic tools, the prevalence of sarcopenia in various studies varies greatly. The definition of sarcopenia in this study adopted the criteria of the Asian Working Group on Sarcopenia (AWGS 2019), including muscle mass and muscle strength / physical performance. A total of 271 patients with liver cirrhosis were included in this cross-sectional study to explore the influencing factors of sarcopenia in patients with liver cirrhosis. The prevalence of sarcopenia was 27.7%, 27.3% in male and 28.4% in female. The results of binary logistic regression analysis showed that age, physical activity, BMI, mid-upper arm muscle circumference, hepatic encephalopathy, nutritional status, alkaline phosphatase, albumin and total cholesterol were significantly correlated with the occurrence of sarcopenia in patients with liver cirrhosis. After adjusting for the potential influencing factors, it was found that the correlation between age and sarcopenia was weakened (OR = 0.870, 95% CI 0.338-2.239). The current findings show that sarcopenia is common in patients with cirrhosis and is independently associated with age, physical activity, BMI, nutritional status, and albumin, and serum alkaline phosphatase and total cholesterol are associated with the development of sarcopenia. Regular exercise may help maintain the grip strength of patients with cirrhosis and delay the deterioration of liver function.

Identification of Core Symptom Cluster in Patients With Digestive Cancer: A Network Analysis.

BACKGROUND: A lack of identified core symptom clusters in digestive cancer patients hinders achieving precision symptom intervention. There are few studies on identifying digestive cancer symptom clusters based on network analysis. OBJECTIVES: The aims of this study were to construct the symptom network of digestive cancer patients and identify the core symptom cluster. METHODS: A cross-sectional study was conducted among 202 digestive cancer patients. The Chinese version of the MD Anderson Symptom Inventory for gastrointestinal cancer scale was used to assess the symptoms by convenience sampling. R software was used to construct a symptom network and identify core symptom clusters. Edge weight and centrality difference tests were used to test the accuracy of core symptom cluster identification. RESULTS: The most common symptoms were distress, poor appetite, and sadness. The most serious symptoms were poor appetite, disturbed sleep, and fatigue. The core symptom cluster of the psychoemotional symptom group was distress, sadness, and numbness. The centrality index showed that the top 3 in strength were distress (Rs = 1.11), fatigue (Rs = 1.09), and sadness (Rs = 1.04). The edge weight difference test showed that the psychoemotional symptom group had high stability. CONCLUSIONS: The psychoemotional symptoms of digestive cancer patients should be given priority for intervention. Network analysis must be extended to the symptom research of cancer patients as soon as possible to provide a scientific basis for symptom management. IMPLICATIONS FOR PRACTICE: Nurses must perform comprehensive psychological and emotional assessments, initiate referrals for psychoemotional symptom management and psychological services, and administer pharmacologic and nonpharmacologic interventions to improve appetite loss in digestive cancer patients.

Needs and influence factors of medical-nursing-pension of disabled elderly.

As the population ages, the incidence of disabled elderly persons increases, and the need for medical-nursing-pension services among disabled senior persons increases. The purpose of this study is to determine the needs and affecting factors of disabled elderly living in community homes in Nanning, Guangxi, China. The study utilized the descriptive comparative cross-sectional study. Stratified random sampling was utilized, based on inclusion and exclusion criteria, a total of 168 disabled elderly were randomly selected and investigated using a self-designed questionnaire which included basic nursing services domain, professional nursing services domain, rehabilitative nursing services domain, living nursing services domain, and spiritual nursing services domain. The t test, one-way ANOVA, and multivariate logistic regression were used to determine the influencing factors of medical-nursing-pension demands for community-dwelling disabled elderly. Majority of impaired seniors have a moderate to high-level of demand for medical-nursing-pension services. Age (t = 2.369, 95% confidence interval [CI]: 0.673-7.414), educational level (t = -16.946, 95% CI: -31.247 to -24.726), monthly income (t = -16.273, 95% CI: -22.104 to -17.320), economic source (t = 8.891, 95% CI: 16.850-26.470), time spent disabled (t = -11.151, 95% CI: -31.845 to -22.264), living with children (t = 10.852, 95% CI: 24.491-35.521), and medical insurance participation (t = 4.556, 95% CI: 9.032-22.848) all influence the demand for medical-nursing-pension services for disabled seniors in the community ( P = .05). Majority of community-dwelling impaired seniors have a moderate to high demand for medical-nursing-pension services. Relevant departments and community nurses should pay increased attention to the elderly who are older, have a low educational level, a low monthly income, have an economic source of pension from their own, have been disabled for long period of time, are single, and do not have children, to improve the health care system for disabled elderly by implementing more personalized home visits in medical-nursing-pension on health education about oxygen inhalation and wound dressing.

The Registered Nurses amid COVID-19 in Saudi Arabia: A descriptive phenomenological study.

AIM: To investigate the experiences of registered nurses' lived experiences in the Coronavirus Disease 2019 (COVID-19) pandemic crisis in a government hospital in the Eastern Region of Saudi Arabia. DESIGN: Qualitative descriptive phenomenology. METHODS: Utilizing in-depth interviews with twenty registered nurses with the use of purposive sampling from September to December 2020. Data was analyzed using Colaizzi methods, and a COREQ checklist was utilized to report the study's results. RESULTS: The participants' narratives generated three major themes, namely: 'one foot below the ground', 'the nightingale pledge'; and 'hope beyond COVID-19'. The lived experiences of Registered Nurses throughout the pandemic brought by the COVID-19 virus increase a person's understanding of the phenomenon under investigation and plan collective actions to improve the nurses' welfare. The unique challenges faced by Registered Nurses as they carry out their duties in a variety of healthcare settings can be better appreciated if their experiences are taken into account. Nursing administrations all around the world can use the findings of this research to create safeguards for their staff.

'Triple-A: Acquaint, analyse and act': The insights of nurse educators towards a better understanding of workplace violence in Saudi Arabia.

AIM: This study aims to investigate the experiences and insights of nurse educators in order to acquire a better understanding of the nature and various factors associated with workplace violence, which could lead to the establishment of future actions and recommendations to eliminate or reduce aggression, abuse, incivility and any other forms of violence in the health sector. BACKGROUND: Workplace violence is one of the social phenomena that have not been fully explored in various settings such as educational institutions and health care facilities. A worker who has experienced violence could provide valuable insights that could help to better understand and sustainably protect an individual, a group or an organization from workplace violence and its unfavourable consequences. METHODS: Qualitative description is used in this phenomenological study. A total of 18 nurse educators who met the inclusion criteria were enrolled as the study participants in a government university located in the Eastern Region of Saudi Arabia. Purposive sampling method was used in the recruitment. In addition, a semi-structured interview guide was employed to explore the participants' experiences and insights from February to June 2021. Data were analysed using Colaizzi's methods, and a consolidated criteria for reporting qualitative research checklist was utilized to report the study's results. RESULTS: The participants' narratives generated three major themes, namely, the 'Triple-A': (1) 'acquaint', (2) 'analyse' and (3) 'act', to better understand workplace violence themes. CONCLUSION: The 'Triple-A: Acquaint, analyse, and act' workplace violence themes can serve as a simple guide to better understand the nature and different factors associated with workplace violence: 'acquaint' illustrates self-awareness; 'analyse' pertains to the recognition to possible indications and signals; and 'act' depicts an individual's proactiveness and responsiveness to workplace violence and conceivably catalyses the decrease of this social hazard's prevalence. IMPLICATION FOR NURSING MANAGEMENT: Leaders and managers in the nursing field should prioritize their participation in developing creative strategies and their implementation of policies to manage and mitigate violence in the workplace, such as initiating ongoing education (acquaint), creating robust procedures for reporting and referral (analyse), establishing support networks, listening to victims' experiences and promoting respect to individual differences (act).

Revisiting the roles of neonatal intensive care unit nurses towards vision 2030 of Saudi Arabia: A descriptive phenomenological study.

AIM: The study aimed to revisit the roles of nurses working in the neonatal intensive care unit in a specific university hospital located in the Eastern Region to pursue Saudi Vision 2030-to provide excellent quality of life and well-being for its national citizens. BACKGROUND: The neonatal intensive care unit is one of the most crucial hospital units caring for high-risk neonates with conditions like pre- and post-maturity and congenital anomalies. The nurses' experiences are vital to achieving the Saudi Vision 2030's Health Sector Transformation Strategy. METHODS: Descriptive Phenomenology. Data collection utilized semi-structured individual interviews with sixteen (16) neonatal intensive care unit nurses for 10 months from March 2019 to January 2020. Colaizzi Method was used in data analysis, and the COREQ criteria list was utilized in data reporting. RESULTS: Three major themes emerged from the participants' narratives: (1) 'mokadem alreayah alshamela': holistic caregiver; (2) 'muzawed malomat': information provider; and (3) 'yad almusaadah': helping hand. CONCLUSION: Revisiting the various roles will align neonatal intensive care unit nurses' critical characteristics towards Saudi Vision 2030, focusing solely on improving service providers' quality and safety principles and skills. IMPLICATION FOR NURSING MANAGEMENT: Revisiting the roles of the neonatal intensive care unit nurses would provide an alignment to the goals and objectives of the future initiatives of Saudi Arabia towards its Vision 2030.

Workplace violence among Registered Nurses in Saudi Arabia: A qualitative study.

AIM: The primary aim of this qualitative inquiry is to explore the experiences of Registered Nurses working in Saudi Arabia, which was a guide to answer the question, "what are the lived experiences of Registered Nurses working in a selected government hospital in Eastern Region of Saudi Arabia towards workplace violence?" BACKGROUND: Workplace violence is a social phenomenon that needs a widespread campaign to eradicate. Incidence from all over the world continues to grow in number, especially among Registered Nurses in Saudi Arabia. METHODS: Descriptive phenomenology. Purposive-convenience sampling was used in selecting 21 Registered Nurses as participants for individual in-depth interviews. Data were gathered over an 11 month's period from September 2017 to August 2018. We used Colaizzi's method for analysing the data. COREQ criteria were adapted in reporting the results of the study. RESULTS: Three themes had emerged from the experiences of the participants: "co-workers become unjust and violent"; "socio-cultural divergence towards healthcare workers"; and "violence from outside influences affecting the workplace."