The effectiveness of online breastfeeding education and support program on mothers of preterm infants: A quasi-experimental study.

OBJECTIVE: To develop a WeChat-mini-program-based Online breastfeeding education and support program and explore its impacts on promoting mothers of preterm infants' breastfeeding knowledge, attitudes, self-efficacy, and rates. DESIGN, SETTING, AND PARTICIPANTS: This was a quasi-experimentation with two-group comparisons. The eligible preterm mother-infant pairs were recruited from the NICU within seven days postpartum. The first 25 mothers admitted to the NICU during the study period were included in the control group, and the following 25 mothers were in the intervention group according to the admission order of their preterm infants. A generalized linear mixed model was used to detect the effects of the online intervention program and the interaction effects of group and time. INTERVENTIONS: The participants received a 3-month online breastfeeding intervention from a WeChat mini program for the intervention group. MEASUREMENTS: Mothers of preterm infants' breastfeeding knowledge, attitudes, self-efficacy, and breastfeeding rates of different patterns were respectively evaluated by the Breastfeeding Knowledge Questionnaire (BKQ), Iowa Infant Feeding Attitude Scale (IIFAS), and Breastfeeding Self-Efficacy Scale (BSES) at three different points of times including before intervention (T0), at one month postpartum (T1) and three months postpartum (T2). FINDINGS: The breastfeeding knowledge significantly differed between the two groups but without differences between different time points and in the grouping*time interaction. Within the intervention group, significant improvements were observed from T0 to T2 and T1 to T2. No significant differences in breastfeeding attitudes, self-efficacy, and breastfeeding rates were found between and within groups. KEY CONCLUSIONS: The WeChat-mini-program-based online breastfeeding intervention may improve the breastfeeding knowledge level of mothers of preterm infants but has no significant impact on mothers' breastfeeding attitudes, breastfeeding self-efficacy, and breastfeeding rates. IMPLICATIONS FOR PRACTICE: The WeChat mini program can be used to improve the breastfeeding knowledge level of mothers of preterm infants. Future interventions need to target both mothers of preterm infants and their family members by combing online and offline approaches.

Artificial intelligence empowered digital health technologies in cancer survivorship care: A scoping review.

Objective: The objectives of this systematic review are to describe features and specific application scenarios for current cancer survivorship care services of Artificial intelligence (AI)-driven digital health technologies (DHTs) and to explore the acceptance and briefly evaluate its feasibility in the application process. Methods: Search for literatures published from 2010 to 2022 on sites MEDLINE, IEEE-Xplor, PubMed, Embase, Cochrane Central Register of Controlled Trials and Scopus systematically. The types of literatures include original research, descriptive study, randomized controlled trial, pilot study, and feasible or acceptable study. The literatures above described current status and effectiveness of digital medical technologies based on AI and used in cancer survivorship care services. Additionally, we use QuADS quality assessment tool to evaluate the quality of literatures included in this review. Results: 43 studies that met the inclusion criteria were analyzed and qualitatively synthesized. The current status and results related to the application of AI-driven DHTs in cancer survivorship care were reviewed. Most of these studies were designed specifically for breast cancer survivors' care and focused on the areas of recurrence or secondary cancer prediction, clinical decision support, cancer survivability prediction, population or treatment stratified, anti-cancer treatment-induced adverse reaction prediction, and so on. Applying AI-based DHTs to cancer survivors actually has shown some positive outcomes, including increased motivation of patient-reported outcomes (PROs), reduce fatigue and pain levels, improved quality of life, and physical function. However, current research mostly explored the technology development and formation (testing) phases, with limited-scale population, and single-center trial. Therefore, it is not suitable to draw conclusions that the effectiveness of AI-based DHTs in supportive cancer care, as most of applications are still in the early stage of development and feasibility testing. Conclusions: While digital therapies are promising in the care of cancer patients, more high-quality studies are still needed in the future to demonstrate the effectiveness of digital therapies in cancer care. Studies should explore how to develop uniform standards for measuring patient-related outcomes, ensure the scientific validity of research methods, and emphasize patient and health practitioner involvement in the development and use of technology.

Nursing research capacity and its management in China: A systematic review.

AIMS: To review the studies on nursing research capacity and the managerial approaches that have been taken to promote nursing research capacity building in China. BACKGROUND: In the nursing profession, research has become increasingly important worldwide. Over the last two decades, continuous efforts have been devoted to improving nursing research capacity in China. However, the results of these efforts were rarely evaluated in a national scale. EVALUATION: A systematic literature review was conducted in accordance with the PRISMA checklist and guidelines. The literature was sourced from PubMed, CINAHL and two Chinese databases. In total, 19 articles were selected and their results were integrated, compared and analysed. KEY ISSUES: The development of nursing research has become a recent phenomenon in China. Chinese nurses' perceptions regarding research were mostly positive. However, their participation in research activity has traditionally been minimal. The factors associated with nursing research capacity in China were nurses' personal characteristics and organisational contexts. Several effective strategies (e.g. on-the-job research education) have been used to promote nursing research capacity. CONCLUSION: Currently, nursing research capacity in China is low despite hospital-promoting efforts. Systematic approaches need to be implemented to increase nursing research capacity in China in the near future. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing administrators need to seek innovative strategies to resolve issues (e.g. lack of research time and limited nursing research resources). They also need to strengthen their leadership skills in order to achieve the above objectives.

The development and psychometric testing of Inpatients' Involvement in Medication Safety Scale (IIMSS).

AIM: To develop and test the psychometric characteristics of the Inpatients' Involvement in Medication Safety Scale. BACKGROUND: Medication safety is the third biggest challenge threatening patient safety. Patient involvement in medication safety management is essential, and however, few tools have been developed to assess the related process. METHODS: The scale was formulated through literature review, semi-structured interviews and Delphi expert consultation. A group of 461 inpatients from a tertiary hospital were selected to examine the reliability and validity of the scale. RESULTS: The scale consisted of three dimensions and 23 items. Cronbach's α coefficient was 0.916 for the total scale and was 0.777-0.858 for three subscales; the test-retest reliability was 0.742 for the total scale. The content validity was 0.957, and the item content validity ranged from 0.833 to 1.000. The cumulative variance contribution of three selected factors was 51.19%. CONCLUSIONS: The Inpatients' Involvement in Medication Safety Scale has good reliability and validity and can be used to evaluate inpatients' involvement in medication safety. IMPLICATIONS FOR NURSING MANAGEMENT: The scale provides theoretical reference for clinical nursing safety management, as well as helps nurses to provide targeted medication care for patients and their families.

Implementation of Knowledge Management in Chinese Hospitals.

The implementation of knowledge management (KM) in hospitals affects efficiency and outcomes of hospitals. However, few studies explored the implementation of KM in China. Twenty-two questions were designed concerning KM implementation status in over 50 hospitals. In order to understand the KM level and attitude to KM of the hospital's managers, a random sampling survey was conducted among 138 managers from 50 different scales of hospitals in 15 provinces of China. The survey showed that overall level of KM implementation in Chinese hospitals was still low and differed among different scales of hospitals (P<0.05, or P<0.01). In all the hospitals investigated, 63.8% did not implement KM yet, among which 46% even had not planned for that. 49.8% of the hospitals investigated had no training program about KM ever and the main source of hospital staff to get knowledge was internet. It suggested that hospital managers should make much more efforts to get to know and understand theories on KM, so that hospital KM could be promoted more rapidly.

Liberal versus restrictive fluid management in abdominal surgery: a meta-analysis.

PURPOSE: This study compared perioperative restrictive fluid therapy to liberal (conventional) fluid therapy in patients undergoing major abdominal surgery and investigated the rate of post-operative morbidity (complication rates), recovery (time to flatus), and the length of hospital stay. METHODS: The Medline, PubMed, Cochrane, and EMBASE databases were searched until June 18, 2015. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in our analyses. A sensitivity analysis, publication bias assessment, and quality assessment were performed. RESULTS: The effects of the two therapies were similar in the subgroup analysis of patients who underwent hepato-gastroenterological surgery (P = 0.287). However, in a subgroup of patients who underwent vascular abdominal surgery, the restricted fluid treatment regimen was associated with a lower risk of complications in comparison with the conventional regimen (pooled OR = 0.12, 95 % CI 0.03-0.47, P = 0.002). There was no difference between the two regimens with respect to the incidence of cardiopulmonary complications (P = 0.733). However, the patients who received the restricted fluid treatment regimen had a shorter time to flatus (P = 0.031) and a shorter hospital stay (P = 0.033) than the patients who received the conventional regimen. CONCLUSIONS: Restrictive fluid therapy and liberal conventional therapy were associated with similar rates of overall and cardiopulmonary complications; however, restrictive fluid therapy was associated with a more rapid recovery and a shorter length of hospital stay.