Nurses' perceptions of night shifts: A qualitative study.

AIM: To describe the experiences and perceptions of emergency nurses regarding the shortening of night shifts and identify aspects of nurses' preferences for night shifts. BACKGROUND: Shift work can be associated with distinct physical and psychological disadvantages for nurses, especially night nurses. Knowledge regarding the factors influencing their perceptions of night shifts is limited. METHODS: A qualitative description design. Fifteen nurses from the emergency setting with 6 to 14 years of work experience participated in interviews. Semistructured interviews were conducted between November 2018 and March 2019. A thematic analysis was performed for the data analysis. FINDINGS: The following three themes emerged: (1) maintaining quality within quantity, (2) maintaining comfort within busyness, and (3) buffering the gap between ideal and reality. CONCLUSIONS: Considering work intensity and patient safety, nurses believe that an 8 h night shift is the most suitable length for the emergency department. Long shifts are probably more suitable for other departments with lower night workloads.

'It is my turn to raise her' - Decision-making regarding physical restraint in home care in China: A descriptive qualitative study.

BACKGROUND: The phenomenon of physical restraint applied to people with dementia in home care is receiving increasing interest from nursing scholars. Although family caregivers play key roles in caring for people with dementia, little is known regarding the ways in which family caregivers make decisions with respect to physical restraint. OBJECTIVES: The aim of this study was to explore Chinese family caregivers' decision-making regarding physical restraint in home care for persons living with dementia. DESIGN: A descriptive qualitative study was employed. METHODS: Using maximum variation sampling and purposive sampling, 18 family caregivers were recruited. Semistructured interviews were conducted in a memory clinic in northeast China between July 2020 and September 2020; the interviews were transcribed verbatim and analysed via thematic analysis. RESULTS: 'It is my turn to raise her' is a strong thread, which links three themes: (a) identifying culture-based family and filial ties; (b) maintaining culture-based family and filial ties; and (c) decision-making between belief and reality. The quote reflects the context of a Confucian and filial piety culture, which children care for their parents to repay the kindness of being provided an upbringing. Decisions based on this point are aimed at providing good personal care for people with dementia. Evaluating whether physical restraint is beneficial to people with dementia in general is an important factor in decisions regarding physical restraint. To repay the kindness of being provided an upbringing, children in the context of a Confucian culture cannot bear imposing physical restraint on their parents. CONCLUSIONS: This qualitative study provides new insight into the substantial influence of culture on family caregivers' decision-making. Perpetuating Confucian culture and improving the home care system can help reduce the use of physical restraint for people with dementia at home.

Multidomain lifestyle interventions for cognition and the risk of dementia: A systematic review and meta-analysis.

BACKGROUND: Cognitive impairment and dementia have emerged as one of the greatest global challenges for health and social care. Multidomain interventions that target several risk factors simultaneously may achieve optimal preventive effects for dementia. OBJECTIVE: This systematic review aimed to evaluate the effectiveness of multidomain lifestyle interventions for improving cognition and reducing the risk of dementia. DESIGN: Systematic review and meta-analysis. METHODS: Five electronic databases, PubMed, Embase, Cochrane Library, CINAHL, and PsycINFO, were systematically searched from inception to April 17, 2021. Randomised controlled trials (RCTs) that assessed multidomain lifestyle interventions on the outcomes of cognition or dementia risk were included. The standardized mean difference (Hedges' g) was calculated using random-effects models. Risk of bias was assessed using the Revised Cochrane risk-of-bias assessment tool for randomised trials (RoB2), and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. RESULTS: Seventeen RCTs involving 12,312 participants were included. The meta-analysis indicated that multidomain lifestyle interventions showed small but significant effects on both the risk of dementia (SMD = -0.11; 95%CI, -0.18 to -0.05; P <0.001; I2 = 0%; 6RCTs, 1981 participants) and the cognitive composite score (SMD = 0.10; 95%CI, 0.02 to 0.17; P = 0.012; I2 = 27.5%; 7 RCTs, 2643 participants). No significant improvements were found in global cognition (SMD = -0.04; 95% CI, -0.12 to 0.04; P = 0.330; I2 = 38.3%; 9 RCTs, 3740 participants). CONCLUSIONS: Multidomain lifestyle interventions have the potential to reduce the risk of dementia (high-certainty evidence) and improve the cognitive composite score (moderate-certainty evidence). There is no moderate- or high-certainty evidence that multidomain interventions improve global cognition. Future large-scale, high-quality studies are required to determine the effects of multidomain interventions on global cognition or other cognitive domains. REGISTRATION: The systematic review and meta-analysis have been registered in PROSPERO (CRD42021260122).