Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis.

OBJECTIVE: Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. METHODS: A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. RESULTS: Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31-40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. CONCLUSION: Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.

Organ donation and transplantation: Awareness and roles of healthcare professionals-A systematic literature review.

AIMS AND OBJECTIVES: To examine the role of healthcare professionals in the organ donation and transplantation process. BACKGROUND: Globally, there remains a perennial disequilibrium between organ donation and organ transplantation. Several factors account for this disequilibrium; however, as healthcare professionals are not only strategically positioned as the primary intermediaries between organ donors and transplant recipients, but also professionally situated as the implementers of organ donation and transplantation processes, they are often blamed for the global organ shortage. DESIGN: Mixed-method systematic review using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 checklist. METHODS: Databases were searched including CINAHL, MEDLINE, Web of Science and EMBASE using the search terms "organ donation," "healthcare professionals," "awareness" and "roles" to retrieve relevant publications. RESULTS: Thirteen publications met the inclusion criteria. The global organ shortage is neither contingent upon unavailability of suitable organs nor exclusively dependent upon healthcare professionals. Instead, the existence of disequilibrium between organ donation and transplantation is necessitated by a web of factors. These include the following: healthcare professionals' attitudes towards, and experience of, the organ donation and transplantation process, underpinned by professional education, specialist clinical area and duration of professional practice; conflicts of interests; ethical dilemmas; altruistic values towards organ donation; and varied organ donation legislations in different legal jurisdictions. CONCLUSION: This review maintains that if this web of factors is to be adequately addressed by healthcare systems in different global and legal jurisdictions, there should be sufficient organs voluntarily donated to meet all transplantation needs. RELEVANCE TO CLINICAL PRACTICE: There is a suggestion that healthcare professionals partly account for the global shortage in organ donation, but there is a need to examine how healthcare professionals' roles, knowledge, awareness, skills and competencies might impact upon the organ donation and transplantation process.

Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper.

AIM: A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice. BACKGROUND: The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional-social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally. DESIGN: Discussion paper. DATA SOURCES: A search of published evidence from 1990-2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion. IMPLICATIONS FOR NURSING/MIDWIFERY: Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications for all stakeholders in the healthcare professions with responsibility for maintaining high standards of care. This includes all grades of nurses and midwives, students entering the professions, managerial staff, academics and policy makers. CONCLUSION: This paper discusses the conceptual models of leadership and emotional intelligence and demonstrates an important link between the two. Further robust studies are required for ongoing evaluation of the different models of emotional intelligence and their link with effective leadership behaviour in the healthcare field internationally. This is of particular significance for professional undergraduate education to promote ongoing compassionate, safe and high quality standards of care.

How critical care nurses' roles and education affect organ donation.

Organ and tissue dysfunction and failure cause high mortality rates around the world. Tissue and organs transplantation is an established, cost-effective, life-saving treatment for patients with organ failure. However, there is a large gap between the need for and the supply of donor organs. Acute and critical care nurses have a central role in the organ donation process, from identifying and assessing potential donors and supporting their families to involvement in logistics. Nurses with an in-depth knowledge of donation understand its clinical and technical aspects as well as the moral and legal considerations. Nurses have a major role to play in tackling organ and tissue shortages. Such a role cannot be adequately performed if nurses are not fully educated about donation and transplant. Such education could be incorporated into mandatory training and completed by all nurses.

Medically unexplained symptoms: the need for effective communication and an integrated care strategy.

Much is already known about medically unexplained symptoms (MUS) in terms of incidence, presentation and current treatment. What needs to be urgently addressed is a strategy for dealing with patients and their conditions, particularly when they do not fall neatly into medical frameworks or pathologies where the syndrome can be easily explained. This article will consider the provision of health and social care support for patients with MUS within an interprofessional education context. The author will contend that a sensitive and valued service for this large client group is dependent upon services without professional boundaries and practitioners with a clinical interest that can work together and agree an appropriate way forward in terms of care, support and strategic service provision. The article will support the idea that clear guidelines through the National Institute for Health and Care Excellence can offer clear clinical direction for practitioners working in primary and secondary care settings to work together interprofessionally to ensure a seamless and sensitive service for people with this condition.

Service-user involvement in nurse education: partnership or tokenism?

Following on from the Keogh Report, the need for a framework of service-user involvement exists not just in the health service, but also in higher education. There are wide variances globally in the levels of service-user interaction and involvement in healthcare education. Health policy internationally has indicated a move towards developing partnerships with service users, but to date this remains elusive, with the majority of user involvement consultative in approach. This article aims to discuss the health policy background and the current approaches taken in the involvement of service users in healthcare education.

International Postgraduate Study in the United Kingdom: An Exploration of Nursing Students.

BACKGROUND: This study explored the experiences of international postgraduate nursing students from the Gulf Cooperation Council region as they transitioned from home to a university in the United Kingdom and then again as they reintegrated to work and life at home after completing their studies. METHOD: This research was grounded in Schlossberg's transition theory. A two-phased qualitative approach was followed, and semistructured interviews were conducted. RESULTS: Analysis of qualitative data revealed the following themes: the presence of social integration, retransition, and readjustment. CONCLUSION: International students faced challenges as they adapted socially and academically to living in another country and also on their return home. The mechanisms students use to negotiate and make sense of the transition process suggest a need for universities to consider increasing preparation and orientation of students, supporting host and international student friendships, and ensuring students are equipped to reintegrate to their careers and cultures on their return home. [J Nurs Educ. 2023;62(3):125-132.].

A palliative nursing strategy to enhance communication and support for patients and families in intensive care units.

AIM: There have been significant advancements in palliative nursing in health services, but less so in intensive care units (ICUs). The purpose of this literature review was to examine palliative nursing care in ICUs and consider how a nursing strategy could improve communication and support for patients and their families. METHOD: An exploratory literature review was conducted to evaluate and compare ICU care strategies with palliative support. The search was conducted using CINAHL Plus and Medline All databases and was limited to a 6-year period. Eight publications were selected for review and a full text review was undertaken using the Critical Appraisal Skills Programme systematic review checklist. RESULTS: Two themes emerged around the use of palliative nursing strategies. These were: improving communication between health professionals and patients; and providing support for patients and families. CONCLUSIONS: Palliative nursing has the potential to improve the quality of communication in ICU settings and support for patients and families. Further training and preparation of nurses in palliative care would improve the patient and family experience during a critical and emotional period of health service provision.

Using natural language processing in facilitating pre-hospital telephone triage of emergency calls.

Introduction: Natural language processing (NLP) is an area of computer science that involves the use of computers to understand human language and semantics (meaning) and to offer consistent and reliable responses. There is good evidence of significant advancement in the use of NLP technology in dealing with acutely ill patients in hospital (such as differential diagnosis assistance, clinical decision-making and treatment options). Further technical development and research into the use of NLP could enable further improvements in the quality of pre-hospital emergency care. The aim of this literature review was to explore the opportunities and potential obstacles in implementing NLP during this phase of emergency care and to question if NLP could contribute towards improving the process of nature of call screening (NoCS) to enable earlier recognition of life-threatening situations during telephone triage of emergency calls. Methods: A systematic search strategy using two electronic databases (CINAHL and MEDLINE) was conducted in December 2021. The PRISMA systematic approach was used to conduct a review of the literature, and selected studies were identified and used to support a critical review of the actual and potential use of NLP for the call-taking phase of emergency care. Results: An initial search offered 204 records: 23 remained after eliminating duplicates and a consideration of title and abstracts. A further 16 full-text articles were deemed ineligible (not related to the subject under investigation), leaving seven included studies. Following a thematic review of these studies two themes emerged, that are considered individually and together: (i) use of NLP for dealing with out-of-hospital cardiac arrest and (ii) responding to increased accuracy of NLP. Conclusions: NLP has the potential to reduce or eliminate human bias during the emergency triage assessment process and contribute towards improving triage accuracy in pre-hospital decision-making and an early identification and categorisation of life-threatening conditions. Evidence to date is mostly linked to cardiac arrest identification; this review proposes that during the call-taking phase NLP should be extended to include further medical emergencies (including fracture/trauma, stroke and ketoacidosis). Further research is indicated to test the reliability of these findings and a proportionate introduction of NLP simultaneous with increased quality and reliability.

Falls prevention and support: translating research, integrating services and promoting the contribution of service users for quality and innovative programmes of care.

Falls are a significant threat to the safety, health and independence of older citizens. Despite the substantial evidence that is available around effective falls prevention programmes and interventions, their translation into falls reduction programmes and policies has yet to be fully realised. While hip fracture rates are decreasing, the number and incidence of fall-related hospital admissions among older people continue to rise. Given the demographic trends that highlight increasing numbers of older people in the UK, which is broadly reflected internationally, there is a financial and social imperative to minimise the rate of falls and associated injuries. Falling is closely aligned to growing older (Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010). According to the World Health Organization, around 30% of older people aged over 65 and 50% of those over 80 will fall each year (Falls Fact Sheet Number 344, WHO, Geneva, 2010). Falls happen as a result of many reasons and can have harmful consequences, including loss of mobility and independence, confidence and in many cases even death (Cochrane Database Syst Rev 15, 2009, 146; Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010; Falling Standards, Broken Promises: Report of the National Audit of Falls and Bone Health in Older People 2010, Health Care Quality Improvement Partnership, London, 2011). What is neither fair nor correct is the common belief by old and young alike that falls are just another inconvenience to put up with. The available evidence justifiably supports the view that well-organised services, based upon national standards and expert guidance, can prevent future falls among older people and reduce death and disability from fractures. This paper will draw from the UK, as an exemplar for policy and practice, to discuss the strategic direction of falls prevention programmes for older people and the partnerships that need to exist between researchers, service providers and users of services to translate evidence to the clinical setting. Second, it will propose some mechanisms for disseminating evidence to healthcare professionals and other stakeholders, to improve the quality and capacity of the clinical workforce.

Estimating the strength and direction of functional coupling in the lamprey spinal cord.

A method of estimating coupling strength between two neural oscillators based on their spikes trains (Kiemel and Cohen, J. Comput. Neurosci. 5: 267-284, 1998) is tested using simulated data and then applied to experimental data from the central pattern generator (CPG) for swimming in the lamprey. The method is tested using a model of two connectionist oscillators and a model of two endogenously bursting cells. For both models, the method provides useful estimates of the relative strength of coupling in each direction, as well as estimates of total strength. The method is applied to pairs of motor-nerve recordings from isolated 50-segment pieces of spinal cords from adult silver lampreys (Ichthyomyzon unicuspus). The strength and direction of coupling is estimated under control conditions and conditions in which intersegmental coupling between the two recording locations is weakened by hemisections of the spinal cords and/or chambers containing an inhibitory solution that blocks firing in postsynaptic cells. The relevance of these measures in constraining models of the CPG is discussed.