Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital.

PURPOSE: Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland's francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital. DESIGN: A mixed design with methodologic phases and descriptive study. METHODS: A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild's 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (N = 88). FINDINGS: Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (m = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86). CONCLUSIONS: The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.

Kinetic glass transition in granular gases and nonlinear molecular fluids.

In this paper, we investigate, both analytically and numerically, the emergence of a kinetic glass transition in two different model systems: a uniformly heated granular gas and a molecular fluid with nonlinear drag. Despite the profound differences between these two physical systems, their behavior in thermal cycles share strong similarities, which stem from the relaxation time diverging algebraically at low temperatures for both systems. When the driving intensity--for the granular gas-or the bath temperature-for the molecular fluid-is decreased to sufficiently low values, the kinetic temperature of both systems becomes "frozen" at a value that depends on the cooling rate through a power law with the same exponent. Interestingly, this frozen glassy state is universal in the following sense: for a suitable rescaling of the relevant variables, its velocity distribution function becomes independent of the cooling rate. Upon reheating, i.e., when either the driving intensity or the bath temperature is increased from this frozen state, hysteresis cycles arise and the apparent heat capacity displays a maximum. The numerical results obtained from the simulations are well described by a perturbative approach.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model.

AIM: To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment. DESIGN: Cross-sectional, predictive-correlational design. METHODS: Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey. RESULTS: Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics. CONCLUSION: The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies. IMPACT: The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching. PATIENT OR PUBLIC CONTRIBUTION: Eligible participants contributed in the data collection with the survey responses.

[Autoimmune and inflammatory pathologies associated with systemic scleroderma: Clinical, serological and prognostic profiles. Bi-centric retrospective series in the PACA region]. / Pathologies auto-immunes et inflammatoires associées à la sclérodermie systémique : profils cliniques, sérologiques et pronostiques. Série rétrospective bi-centrique en région PACA.

INTRODUCTION: Systemic sclerosis (SSc) is a rare auto-immune disease, affecting principally women between 40 and 60 years old. It is caracterised by a cutaneous and visceral fibrosis, an alteration of the microvascular network and the presence of autoantibodies. SSc can be associated with another connectivite tissue disease or to other autoimmune diseases, thus defining the overlap syndrome. The goal of our study is to describe these overlap syndromes. METHODS: We have analysed the data of a retrospective and bicentrique cohort, from the internal medicine unit of Hôpital Nord in Marseille and from the internal medicine unit of the Hôpital Sainte-Anne in Toulon, of patients followed for a SSc between January 1st, 2019 and December 1st, 2021. We have collected clinical, imunological features, associated auto-immune and inflammatory diseases with its morbidity and mortality. RESULTS: The cohort included 151 patients including 134 limited cutaneous SSc. Fifty-two (34.4%) patients presented at least one associated auto-immune or inflammatory disease. The association of two connectivite tissue diseases including SSc was found in 24 patients (15.9%), a third with Sjögren's syndrome and a third with autoimmune myositis. The principal associated disease to SSc was the autoimmune thyroiditis found in 17 patients (11.3%). The occurrence of complications (hospitalization, long-term oxygene therapy, death) was not significantly different depending on the existence or not of an overlap syndrom. CONCLUSION: SSc is often associated with other autoimmune diseases. This interrelation between associated pathologies and SSc, modifying sometimes the evolution of SSc, enhances the need of a personalized follow-up.

Social connectedness and health-related quality of life among patients with cancer undergoing chemotherapy: A mixed method approach using structural equation modelling and photo-elicitation.

OBJECTIVE: To develop and test the model of association of social connectedness and health-related quality of life (HRQoL) among patients with cancer undergoing chemotherapy and to describe their social connectedness through photo-elicitation. BACKGROUND: Social connectedness has been empirically associated with several well-being outcomes. However, little is known on the association of social connectedness among patients with cancer undergoing chemotherapy. METHODS: Employing a mixed-methods design following the good reporting of a mixed methods study guideline, the quantitative approach involved 230 consecutively-selected patients with cancer undergoing chemotherapy who answered a three-part survey. From these patients, six informants participated in the photo-elicitation and key informant interview sessions. Gathered data were quantitatively analyzed using structural equation modelling and qualitatively processed using polytextual thematic analysis. RESULTS AND FINDINGS: Social connectedness had a positive influence on social well-being (ß = .22, p = .008) and emotional well-being (ß = .20, p = .023); however, it had a negative effect on functional well-being (ß = -.20, p = .007). The overall model revealed good model indices: χ2 /df = .82, RMSEA = .01, GFI = 1.00. Qualitative analysis culled from photo-elicitation uncovered five interconnected themes yielding the Honeycomb model of social connectedness which was composed of correspondence, cohesion, constitution, convergence and corroboration. CONCLUSION: HRQoL among patients with cancer undergoing chemotherapy is a multi-factorial health construct affected by social connectedness. The presented model emphasises the importance of social connectedness and paves way for the development of appropriate strategies to promote social connectedness among patients with cancer undergoing chemotherapy. RELEVANCE TO CLINICAL PRACTICE: The findings provide impetus in the modification and development of appropriate practices, policies and strategies in promoting social connectedness. These approaches are geared towards patient-family empowerment and health education techniques to ascertain that assistance from significant others is provided without limiting the patient's autonomy or independence.

Adaptation of the pain management self-efficacy questionnaire into Turkish.

OBJECTIVES: The aim of this study is to examine the Turkish validity and reliability of the Pain Management Self-Efficacy Ques-tionnaire (PMSEQ). METHODS: The study was carried out descriptively and methodologically between September and December 2018 with 214 nurses and 248 nursing students. The data were collected using the descriptive characteristics form and the PMSEQ. RESULTS: Cronbach's alpha internal consistency coefficient was 0.90 in the total scale. In repeated measurements to test time reliability, there was no statistically significant difference between the two measurements (t=0.320, p=0.751), and there were a high power and positively highly significant relationship (r=0.997, p<0.001). CONCLUSION: Turkish version of the PMSEQ can be used as a valid and reliable scale in assessing the self-efficacy of clinical nurses and nursing students in pain management.

Exploring the challenges and needs of home caregivers of hemodialysis patients in the Philippines: A mixed methods study.

OBJECTIVES: Although the importance of home caregivers of chronic kidney disease patients has been increasingly recognized, their perceived caregiving difficulties and requisites remain underexplored. This study investigated the challenges and needs of home caregivers of hemodialysis patients in the Philippines. METHODS: We utilized a mixed-method (QUAN + qual), explanatory sequential design. Data were collected from July 2017 to May 2018 from 46 home caregivers of hemodialysis patients. A three-part researcher-made survey were developed from literature search, personal values and cultural context, while some items were generated from a standardized tool that measures caregiver infrastructure and needs of those caring from frail US veterans. The tool developed gathered the participants' profile, caregiving characteristics, and related needs. The tool was validated and pretested for reliability. Fifteen participants were also interviewed to explore caregiving challenges and needs. Descriptive and χ2 statistics were used for quantitative outcomes, while thematic analysis was employed for qualitative data. RESULTS: Participants provided moderate assistance to patients, spending an average of 10.65 h/day and 5.08 days/week in caregiving. The most difficult caregiving circumstances were having costly expenses (78.26%); missing work (50.00%); and experiencing negative feelings (47.83%), stress (43.48%), and physical difficulties (34.78%). They also had the lowest confidence in deciding when to contact health providers (x̅ = 3.31, SD = 0.94) and finding patient care services (x̅ = 2.93, SD = 1.08). Qualitative findings further revealed caregiving needs and challenges in cost management, physical and psychological health, assumption of multiple roles, lifestyle adjustment, and reinforcement of carer knowledge, skills, and attitudes. CONCLUSION: Supportive strategies are needed to address the challenges encountered by home caregivers of hemodialysis patients. Findings can be utilized in developing appropriate interventions for home caregivers in low-resource settings where home caregiving and healthcare system issues, such as lack of access to resources and social support, are prevalent.

Mechanical ventilation preserves diaphragm mitochondrial function in a rat sepsis model.

BACKGROUND: To describe the effect of mechanical ventilation on diaphragm mitochondrial oxygen consumption, ATP production, reactive oxygen species (ROS) generation, and cytochrome c oxidase activity and content, and their relationship to diaphragm strength in an experimental model of sepsis. METHODS: A cecal ligation and puncture (CLP) protocol was performed in 12 rats while 12 controls underwent sham operation. Half of the rats in each group were paralyzed and mechanically ventilated. We performed blood gas analysis and lactic acid assays 6 h after surgery. Afterwards, we measured diaphragm strength and mitochondrial oxygen consumption, ATP and ROS generation, and cytochrome c oxidase activity. We also measured malondialdehyde (MDA) content as an index of lipid peroxidation, and mRNA expression of the proinflammatory interleukin-1ß (IL-1ß) in diaphragms. RESULTS: CLP rats showed severe hypotension, metabolic acidosis, and upregulation of diaphragm IL-1ß mRNA expression. Compared to sham controls, spontaneously breathing CLP rats showed lower diaphragm force and increased susceptibility to fatigue, along with depressed mitochondrial oxygen consumption and ATP production and cytochrome c oxidase activity. These rats also showed increased mitochondrial ROS generation and MDA content. Mechanical ventilation markedly restored mitochondrial oxygen consumption and ATP production in CLP rats; lowered mitochondrial ROS production by the complex 3; and preserved cytochrome c oxidase activity. CONCLUSION: In an experimental model of sepsis, early initiation of mechanical ventilation restores diaphragm mitochondrial function.

Influence of dityrosine nanotubes on the expression of dopamine and differentiation in neural cells.

In this study, we report the synthesis of self-assembled dityrosine nanotubes as a biologically functional scaffold and their interactions with neural cells. Quantum chemical methods were used to determine the forces involved in the self-assembly process. The physicochemical properties of the nanostructures relevant to their potential as bioactive scaffolds were characterized. The morphology, secondary structure, crystallinity, mechanical properties, and thermal characteristics of YY nanotubes were analyzed. The influence of these nanotubes as scaffolds for neural cells was studied in vitro to understand their effects on cell proliferation, morphology, and gene expression. The scanning electron microscopy and fluorescence confocal microscopy demonstrated the feasibility of nanotube scaffolds for enhanced adhesion to rat and human neural cells (PC12 and SH-SY5Y). Preliminary ELISA and qPCR analyses demonstrate the upregulation of dopamine synthesis and genes involved in dopamine expression and differentiation. The expression levels of DßH, AADC, VMAT2 and MAOA in SH-SY5Y cells cultured on the nanotube scaffolds for 7 days were elevated in comparison to the control cells.

Computational and experimental investigation of the effect of cation structure on the solubility of anionic flow battery active-materials.

Recent advances in clean, sustainable energy sources such as wind and solar have enabled significant cost improvements, yet their inherent intermittency remains a considerable challenge for year-round reliability demanding the need for grid-scale energy storage. Nonaqueous redox flow batteries (NRFBs) have the potential to address this need, with attractive attributes such as flexibility to accommodate long- and short-duration storage, separately scalable energy and power ratings, and improved safety profile over integrated systems such as lithium-ion batteries. Currently, the low-solubility of NRFB electrolytes fundamentally limits their energy density. However, synthetically exploring the large chemical and parameter space of NRFB active materials is not only costly but also intractable. Here, we report a computational framework, coupled with experimental validation, designed to predict the solubility trends of electrolytes, incorporating both the lattice and solvation free energies. We reveal that lattice free energy, which has previously been neglected, has a significant role in tuning electrolyte solubility, and that solvation free energies alone is insufficient. The desymmetrization of the alkylammonium cation leading to short-chain, asymmetric cations demonstrated a modest increase in solubility, which can be further explored for NRFB electrolyte development and optimization. The resulting synergistic computational-experimental approach provides a cost-effective strategy in the development of high-solubility active materials for high energy density NRFB systems.

Strong nonexponential relaxation and memory effects in a fluid with nonlinear drag.

We analyze the dynamical evolution of a fluid with nonlinear drag, for which binary collisions are elastic, described at the kinetic level by the Enskog-Fokker-Planck equation. This model system, rooted in the theory of nonlinear Brownian motion, displays a really complex behavior when quenched to low temperatures. Its glassy response is controlled by a long-lived nonequilibrium state, independent of the degree of nonlinearity and also of the Brownian-Brownian collisions rate. The latter property entails that this behavior persists in the collisionless case, where the fluid is described by the nonlinear Fokker-Planck equation. The observed response, which includes nonexponential, algebraic, relaxation, and strong memory effects, presents scaling properties: the time evolution of the temperature-for both relaxation and memory effects-falls onto a master curve, regardless of the details of the experiment. To account for the observed behavior in simulations, it is necessary to develop an extended Sonine approximation for the kinetic equation-which considers not only the fourth cumulant but also the sixth one.

Designing high energy density flow batteries by tuning active-material thermodynamics.

The cost of electricity generated by wind and solar installations has become competitive with that generated by burning fossil fuels. While this paves the way for a carbon-neutral electrical grid, short- and long-term intermittency necessitates energy storage. Flow batteries are a promising technology to accommodate this need, with numerous advantages, including decoupled power and energy ratings, which imparts flexibility, thermal stability, and safety. Further, development of robust nonaqueous systems has the potential to greatly improve energy density, approaching that of lithium-ion batteries, while maintaining the advantages of flow systems. Herein we report a breakthrough on a bio-inspired nonaqueous redox flow battery (NRFB) electrolyte, which contains high-concentration active-material and maintains stability during deep cycling for extended time-periods. These advances are reinforced by thermodynamic considerations and computational investigations, which provide a clear path to further improvements. Electrochemical studies confirm that the active-material maintains its high stability at high concentration. This molecular scaffold clears two important hurdles in designing active-materials for nonaqueous electrolytes - low solubility and poor stability - providing an in-road to development of high-performance NRFB systems.

Social support from nurses and non-adherence with directly observed therapy (DOTS) maintenance phase among patients with tuberculosis in Metro Manila, Philippines.

OBJECTIVE: To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB). DESIGN: Prospective-cohort. SAMPLE: One hundred purposively selected patients with TB starting with DOTS maintenance phase. MEASUREMENTS: Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form. Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. RESULTS: With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045). High received emotional support increased non-adherence (HR = 2.65, p = .039). CONCLUSION: Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote support-seeking skills.

Cross-Cultural Validation Into Filipino of the Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS).

Surgical experience is increasingly being recognized; however, Consumer Assessment of Health-Care Providers and Systems Surgical Care Survey (S-CAHPS), the tool for surgical experience, is available in English and Spanish only. To measure surgical experience among Filipinos, a culturally appropriate version should be validated. This study culturally adapted the S-CAHPS into Filipino. A five-step cross-cultural validation study was conducted. Language experts conducted forward translation, back translation, and panel reconciliation. Pretesting included content validation and pretesting of the Filipino S-CAHPS. Field testing involved 55 purposively selected postoperative patients who completed a 3-part survey from March to July 2018. The English S-CAHPS was reduced to 34 items to account cultural variations, yielding an item content validity index (I-CV) of 1.00. One-sample t test and Bland-Altman plots showed good linguistic equivalence. Correlation coefficients were ≥0.30, suggestive of good conceptual equivalence. Cronbach's alpha values were 0.83 and 0.85 indicative of good reliability. The Filipino S-CAHPS showed acceptable psychometric properties. It is a valid and culturally appropriate instrument to measure surgical experience among Filipinos which can be utilized for quality improvement measures on both practice and policy levels.

Psychometric Properties of the Filipino Version of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS): A Cross-Cultural Validation Study.

Albeit the importance of patient experience, most questionnaires are only available in English. To understand the hospital experience of Filipino patients, a psychometrically sound instrument in Filipino is warranted. This study culturally adapted and validated the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) into Filipino. A 5-step cross-cultural validation process was conducted. Forward translation, back-translation, and panel reconciliation involved 7 language experts. Pretesting included content validation and pretesting of the Filipino HCAHPS, while field testing involved 64 purposively selected hospitalized patients who completed a 4-part survey from July to December 2018. Content, linguistic, and conceptual equivalence and internal consistency were statistically appraised. Content validation yielded a scale content validity index/average of 1.00. Comparative analysis and Bland-Altman plots indicated good linguistic equivalence. All correlation coefficients were ≥.30, denoting good conceptual equivalence. Cronbach's α for both versions of HCAHPS were ≥0.80, suggestive of good internal consistency. The Filipino HCAHPS is a psychometrically sound and culturally appropriate tool to measure patient experience among Filipinos. This understanding can be utilized for quality improvements on both practice and policy levels.

A conjoint analysis of the communication preferences of registered nurses towards mechanically ventilated patients.

BACKGROUND: The nurse-patient communication is a dyadic process involving the transmission and recognition of information and feelings. However, communication difficulty is a common phenomenon among mechanically ventilated patients which causes distress among patients and may compromise the quality of patient care that nurses provide. AIM: To explicate the communication preferences of registered nurses towards mechanically ventilated patients. DESIGN: Cross-sectional, choice-based conjoint analysis METHODS: From August to November 2017, 201 purposively selected registered nurses with prior experience in caring for mechanically ventilated patients were surveyed and ranked 12 choice bundles with four selected attributes of the communication process. RESULTS: Family participation was the most important attribute (40.40%) while communication initiator was the least important attribute (15.44%). Registered nurses prefer to communicate with mechanically ventilated patients if family members are involved (utility = 1.03), if conventional communication equipment are used (utility = 0.24), if open-ended questions are asked (utility = 0.13), and if nurses are the communication initiator (utility = 0.22). CONCLUSION: The model of communication preferences highlights the importance of involving the family in the communication process and can inform family-centered policies for mechanically ventilated patients. Unit policies on the use of conventional communication equipment should be considered to maximize the nurse-patient communication and potentially improve patient care.

Occupational determinants of compassion satisfaction and compassion fatigue among Filipino registered nurses.

AIMS AND OBJECTIVES: To determine the prevalence and to identify the occupational determinants of compassion satisfaction and compassion fatigue among general medical-surgical registered nurses. BACKGROUND: Compassion fatigue and compassion satisfaction are caring concepts that have been explored among nurses in specialised hospital units. However, there is paucity of studies exploring the occupational determinants among general medical-surgical registered nurses. DESIGN: Cross-sectional. METHODS: From August-November 2017, 121 consecutively selected general medical-surgical registered Nurses from five hospitals completed a four-part survey packet composed of the participant information sheet, the Professional Quality of Life Version 5, the McCloskey-Mueller Satisfaction Scale and the Eden Warmth Survey-Employee Questionnaire. Stepwise-forward multiple linear regression was employed to identify the occupational determinants of compassion fatigue and compassion satisfaction. The STROBE checklist was followed in reporting this study (see Appendix S1). RESULTS: The prevalence of moderate to high levels of compassion satisfaction was 90.09% while burnout and secondary stress, the facets of compassion fatigue, had a prevalence of 74.38% and 83.47%, respectively. Among the identified occupational determinants, only job satisfaction and nurse colleague relationship positively influenced compassion satisfaction. In contrary, although higher monthly income positively influenced both dimensions of compassion fatigue, nurse colleague relationship had the strongest negative effect. CONCLUSION: Among the occupational determinants of compassion fatigue and compassion satisfaction, nurse colleague relationship had the strongest influence. This result highlights the importance of positive nurse colleague relationships and paves way for the development and initiation of appropriate strategies. RELEVANCE TO CLINICAL PRACTICE: The findings of this study paves way for the development of institutional policies and individualised programmes geared towards building rapport and communication among registered nurses assigned in general medical-surgical units. Likewise, the high prevalence of compassion fatigue needs further exploration to develop appropriate measures to mitigate its development among general medical-surgical nurses.

Enfermedad de paget mamaria. presentación de un caso / Mammary paget disease. case report

RESUMEN: La enfermedad de Paget mamaria es una patología poco común de la mama que tiene una gran importancia por su alta asociación a carcinoma mamario y por requerir de un alto índice de sospecha para arribar a su diagnóstico. Se presenta el caso de una mujer de 65 años de edad, con diagnóstico de enfermedad de Paget mamaria asociada a carcinoma ductal infiltrante de mama izquierda con compromiso ganglionar axilar homolateral. Se realizó la revisión bibliográfica de esta patología, con especial énfasis en la clínica, diagnóstico, estadificación, tratamientoy pronóstico.

ABSTRACT: Paget's disease of the breast is a rare pathology in the breast, however, it is very important because of its high association with mammary carcinoma and because it requires a high index of suspicion. We present the case of a 65-year-old woman with Paget's disease of the breast associated with an infiltrating ductal carcinoma of the left breast with homolateral axillary lymph node involvement. A bibliographic review of this pathology was carried out, with special emphasis on the clinic, diagnosis, staging, treatment and prognosis.

A conjoint analysis of the acute and critical care experiential learning preferences of Baccalaureate student nurses.

With the increasing need for competent nurses specializing in acute and critical care, educators must consider the needs and preferences of students in designing experiential learning programs. This cross-sectional, choice-based conjoint analysis determined the acute and critical care experiential learning preferences of student nurses. From March to July 2016, 213 randomly-selected student nurses from a higher education institution in Manila, Philippines were surveyed and ranked 20 choice bundles with 5 selected attributes of the experiential learning program. Results showed that duration of unit exposure (48.73%) and group structure (7.46%) were the most and least valued attributes, respectively. Additionally, student nurses prefer an experiential learning program that lasts for 1 week (21 h) per unit (utility = 0.93), has a stay-in instructor (utility = 0.30), encourages full student involvement (utility = 1.08), deploys 2-3 students per group (utility = 0.09), and provides both single program and on-going unit orientation (utility = 0.52). Part-worth utilities of duration of unit exposure (t = 3.65, p = 0.0001) and group structure (t = 3.46, p = 0.001) differed between gender. With a model explaining the acute and critical care experiential learning preferences of student nurses, nursing institutions can restructure their clinical placement to maximize positive learning.

Fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis: Single-blind, Randomized-Controlled Pilot Study.

AIM: To determine the effects of a fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing haemodialysis. BACKGROUND: Fluid restriction is necessary among patients with chronic kidney disease. However, treatment adherence remains a challenge. DESIGN: Single-blind, randomized-controlled pilot study. METHODS: From September - December 2016, 24 consecutively-selected patients with end-stage renal disease from a single dialysis clinic were randomly assigned using computer-generated sequences of randomly permuted blocks stratified according to gender to receive the fluid distribution timetable or standard care. Adherence to fluid restriction was measured using two indicators-thirst and interdialytic weight gain- and were compared using One-way RM-MANOVA and MANCOVA. Secondary outcomes included baseline patient demographic and clinical characteristics and were compared according to treatment allocation. Both groups were followed-up for 4 weeks, assessing outcome measures during the second haemodialysis session for each week. RESULTS: At baseline, the demographic and clinical characteristics and indicators of adherence to fluid restriction were comparable between the two groups. Thirst scores, however, were statistically lower in the treatment group than the control group on the fourth week follow-up. There was also a remarkable decrease from baseline thirst and interdialytic weight gain scores in the treatment group, with partial eta-squared of 0.43 and 0.39, respectively. CONCLUSION: The fluid distribution timetable was an effective adjunct treatment strategy in promoting adherence to fluid restriction. However, since this is just a pilot study, further investigation must be conducted to determine the effects of fluid distribution timetable. TRIAL REGISTRATION: NCT03582592.