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2.
Nurs Ethics ; 30(7-8): 1138-1155, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37247413

RESUMO

BACKGROUND AND OBJECTIVES: People living with dementia have historically been excluded from qualitative research and their voices ignored due to the perception that a person with dementia is not able to express their opinions, preferences and feelings. Research institutions and organizations have contributed by adopting a paternalistic posture of overprotection. Furthermore, traditional research methods have proven to be exclusionary towards this group. The objective of this paper is to address the issue of inclusion of people with dementia in research and provide an evidence-based framework for dementia researchers based on the five principles of human rights: Participation, Accountability, Non-discrimination and equality, Empowerment and Legality (PANEL). DESIGN: This paper adapts the PANEL principles to the research context, and uses evidence from the literature to create a framework for qualitative research in people with dementia. This new framework aims to guide dementia researchers in designing studies around the needs of people with dementia, to improve involvement and participation, facilitate research development and maximize research outcomes. RESULTS: A checklist is presented with questions related to the five PANEL principles. These questions cover ethical, methodological and legal issues that researchers may need to consider while developing qualitative research for people with dementia. CONCLUSIONS: The proposed checklist offers a series of questions and considerations to facilitate the development of qualitative research in patients with dementia. It is inspired by current human rights work of recognized dementia researchers and organizations who have been directly involved in policy development. Future studies need to explore its utility in improving participation, facilitating ethics approvals and ensuring that outcomes are relevant to people with dementia.


Assuntos
Demência , Humanos , Direitos Humanos , Projetos de Pesquisa , Pesquisa Qualitativa
3.
Nutrients ; 14(23)2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36501168

RESUMO

Background: Nutritional interventions such as the use of prebiotics can promote eubiosis of gut microbiome and maintain glucose homeostasis in patients with type 2 diabetes (T2D). However, it would appear that results of the effects of prebiotics on the community of microbes in the gut are not consistent. Aim: To examine the effect of prebiotics and oral antidiabetic agents on gut microbiome in patients with T2D. Methods: The PRISMA Extension Statement for Systematic Reviews and Network Meta-analyses was used to conduct this review. Searches were carried out in EMBASE, EBSCO-host databases, Google Scholar and the reference lists of articles for studies that are relevant to the research question, from database inception to 15 August 2022. The search strategy was based on PICOS framework. Network Meta-analysis which allows the estimation of relative treatment effects by combing both direct trial evidence (e.g., treatment A vs. treatment B) and indirect evidence was conducted. Furthermore, pairwise meta-analysis was also carried out to estimate effect sizes based on head-to-head comparisons of treatments and/or control conditions. Results: Findings of the Network meta-analysis revealed that prebiotics significantly reduced HbA1c compared with control and the SMD was −0.43 [95% CI, −0.77, −0.08; p = 0.02], whereas there was no significant difference (p > 0.05) between the other treatments and control. In addition, anti-diabetic agents including glipizide and metformin also reduced HbA1C, although these were not significantly different (p > 0.05) from control. While prebiotics promoted Bifidobacterium and Akkermansia, the improvements were not significantly different (p > 0.05) from control. On the other hand, metformin decreased the relative abundance of Bifidobacterium, but increased Lactobacillus and Akkermansia, although the differences were not significant (p > 0.05) compared with control. With respect to fasting blood glucose and BMI, the effects of prebiotics and oral antidiabetic agents did not differ significantly (p > 0.05) from controls. Conclusions: The findings of the systematic review and Network meta-analysis demonstrated prebiotics were significantly (p < 0.05) more effective in reducing HbA1c than control in patients with T2D. However, the effects of prebiotics and oral antidiabetic agents did not differ significantly (p > 0.05) from the controls in relation to fasting blood glucose, post-prandial blood glucose, body mass index and the genera of gut bacteria examined. More studies are required to fully investigate the effects of prebiotics and oral antidiabetic agents in patients with T2D


Assuntos
Diabetes Mellitus Tipo 2 , Metformina , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Metanálise em Rede , Glicemia , Prebióticos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Metformina/farmacologia , Metformina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Nurse Educ Pract ; 65: 103463, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36265432

RESUMO

AIM: A systematic review of the literature to explore nursing students' lived experience of a clinical placement in a healthcare setting in a prison, to identify how and if their needs were met to enable an optimal learning environment BACKGROUND: There is an increasing demand for clinical placements to support undergraduate/prelicense nurse education, especially within primary and community healthcare settings. A clinical placement in a prison has the potential to provide multiple learning opportunities for nursing students due to the unique requirements of prisoners. However, there remains a need to understand nursing students' experiences of a clinical placement in a prison. METHODS: The updated PRISMA guidelines for reporting systematic reviews guided the development of this study. Inclusion and exclusion criteria informed the search strategy of recognised MeSH terms and Boolean operators, which were applied to search CINAHL complete, APA Psycinfo, MEDLINE, Google Scholar and Grey Open. Manual searching of the reference lists of all identified studies was completed. Standardised critical appraisal instruments were applied to each included study. Data extraction and analysis was completed by adhering to the thematic analysis process described by Thomas and Harden. RESULTS: The electronic database and reference list search identified 81 studies published between January 2000 and December 2021 in the English language, which was reduced to the inclusion of five studies. Following screening, studies were completed in USA (n = 2), Australia (n = 1), Canada (n = 1) and UK (n = 1). A total of 228 nursing students had completed a clinical placement in prison. Four themes were identified: 1) pre-placement anxiety; 2) a sense of safety; 3) impact on negative stereotypes; and 4) an opportunity for learning CONCLUSION: The voluntary and opt-in nature of clinical placements in prison may have created some bias in the results. However, standardised preparation and orientation of nursing students prior to commencing a clinical placement in prison is essential. Nursing students require structured support to understand their anxieties, the rules and regulations of security and how to interact with prisoners prior to entering a prison. Clinical placements within prison provide nursing students with an opportunity to challenge negative attitudes towards diverse and marginalised populations, develop clinical practice, knowledge and become socialised into the profession. However, the experience, knowledge and willingness of Registered Nurses to support nursing students is essential, to enable and empower their learning within this non-traditional clinical placement. Tweetable abstract On completion of a placement in prison healthcare nursing students identified pre-placement anxiety, a sense of safety, impact on negative stereotypes and an opportunity for learning, however, the need for preparation, orientation and realistic understanding of safety remains.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Prisões , Atenção à Saúde , Aprendizagem , Austrália , Bacharelado em Enfermagem/métodos
5.
J Adv Nurs ; 78(12): 4177-4189, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35919020

RESUMO

AIMS: To explore how older people's experiences of COVID-19 restrictions influenced their decision to receive a vaccine and to support nurse-patient vaccination conversations. DESIGN: A longitudinal hermeneutic phenomenological study. The application of the COREQ checklist informed the reporting of this study. METHODS: Data were collected through semi-structured telephone interviews with older people (age ≥70) during two national restrictions implemented in England due to COVID-19. Phase one of interviews occurred between April and July 2020 (six interviews), and phase two of interviews between January and April 2021 (four interviews). Data analysis was performed through content analysis. RESULTS: Thirteen older people (mean age 78) worked through six stages about their thoughts and beliefs about receiving a vaccine, which encompassed four of the five elements of the 5C model of vaccine hesitancy, confidence, convenience, calculation, collective, but not complacency. Stages included 'our only hope is a vaccine'; 'understanding and acceptance of an effective vaccine'; 'social responsibility to protect others'; 'organized but left with unanswered questions'; 'need to feel secure' and finally 'vaccination alone is not enough'. CONCLUSION: The experience of COVID-19 restrictions by older people informed their approach of engaging with scientific information to inform their decisions to be vaccinated but also developed their sense of collective responsibility to younger generations and those at risk, which informed their adherence to restrictions and the vaccination programme. IMPACT: Nurses are optimally placed to support older people to implement and adhere to national government restrictions as appropriate and prevent obsessive routines, and support discussions and the provision of scientific information on COVID-19 vaccinations, whilst being inclusive of older peoples' sense of collective responsibility.


Assuntos
COVID-19 , Vacinas , Humanos , Idoso , COVID-19/prevenção & controle , Hesitação Vacinal , Vacinação , Relações Enfermeiro-Paciente
6.
Nurs Older People ; 34(4): 20-26, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35582820

RESUMO

BACKGROUND: Older people's health is vulnerable to the effects of long-term changes to everyday life and their recovery from ill health can be delayed by the deconditioning effects of isolation. Social isolation can increase the likelihood of loneliness in older people, which has negative implications for their mental and physical health. AIM: To explore the effects of social isolation and social distancing on older people in the Republic of Ireland during and following the government-enforced lockdown in the first wave of the coronavirus disease 2019 (COVID-19) pandemic. METHOD: This study involved a convenience sample of four participants from the Republic of Ireland. Semi-structured interviews were conducted and audio-recorded with each participant over six sessions, two weeks apart, between 6 April 2020 and 7 July 2020. Transcripts were analysed using content analysis of longitudinal data to identify themes. FINDINGS: Three themes were identified: the effect on health and mental well-being; commitment to restrictions; and concern about the non-adherence of others. CONCLUSION: Participants committed fully to 'cocooning' and other government restrictions, sometimes to the detriment of their health. Healthcare professionals need to be mindful of potential post-pandemic deconditioning in older people resulting from adherence to government restrictions and lingering anxieties about returning to normality after prolonged isolation.


Assuntos
COVID-19 , Pandemias , Idoso , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Solidão , Isolamento Social
7.
Nutrients ; 14(5)2022 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-35268095

RESUMO

Background: Patients who are critically ill with COVID-19 could have impaired nutrient absorption due to disruption of the normal intestinal mucosa. They are often in a state of high inflammation, increased stress and catabolism as well as a significant increase in energy and protein requirements. Therefore, timely enteral nutrition support and the provision of optimal nutrients are essential in preventing malnutrition in these patients. Aim: This review aims to evaluate the effects of enteral nutrition in critically ill patients with COVID-19. Method: This systematic review and meta-analysis was conducted based on the preferred reporting items for systematic review and meta-Analysis framework and PICO. Searches were conducted in databases, including EMBASE, Health Research databases and Google Scholar. Searches were conducted from database inception until 3 February 2022. The reference lists of articles were also searched for relevant articles. Results: Seven articles were included in the systematic review, and four articles were included in the meta-analysis. Two distinct areas were identified from the results of the systematic review and meta-analysis: the impact of enteral nutrition and gastrointestinal intolerance associated with enteral nutrition. The impact of enteral nutrition was further sub-divided into early enteral nutrition versus delayed enteral nutrition and enteral nutrition versus parenteral nutrition. The results of the meta-analysis of the effects of enteral nutrition in critically ill patients with COVID-19 showed that, overall, enteral nutrition was effective in significantly reducing the risk of mortality in these patients compared with the control with a risk ratio of 0.89 (95% CI, 0.79, 0.99, p = 0.04). Following sub-group analysis, the early enteral nutrition group also showed a significant reduction in the risk of mortality with a risk ratio of 0.89 (95% CI, 0.79, 1.00, p = 0.05). The Relative Risk Reduction (RRR) of mortality in patients with COVID-19 by early enteral nutrition was 11%. There was a significant reduction in the Sequential Organ Failure Assessment (SOFA) score in the early enteral nutrition group compared with the delayed enteral nutrition group. There was no significant difference between enteral nutrition and parenteral nutrition in relation to mortality (RR = 0.87; 95% CI, 0.59, 1.28, p = 0.48). Concerning the length of hospital stay, length of ICU stay and days on mechanical ventilation, while there were reductions in the number of days in the enteral nutrition group compared to the control (delayed enteral nutrition or parenteral nutrition), the differences were not significant (p > 0.05). Conclusion: The results showed that early enteral nutrition significantly (p < 0.05) reduced the risk of mortality among critically ill patients with COVID-19. However, early enteral nutrition or enteral nutrition did not significantly (p > 0.05) reduce the length of hospital stay, length of ICU stay and days on mechanical ventilation compared to delayed enteral nutrition or parenteral nutrition. More studies are needed to examine the effect of early enteral nutrition in patients with COVID-19.


Assuntos
COVID-19 , Nutrição Enteral , COVID-19/terapia , Estado Terminal/terapia , Nutrição Enteral/métodos , Humanos , Nutrição Parenteral/métodos , SARS-CoV-2
8.
Int J Older People Nurs ; 17(5): e12459, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35322541

RESUMO

BACKGROUND: Due to the global pandemic, governments have enforced household isolation and social distancing to reduce infection and mortality rate. However, the impact of prolonged enforced isolation for older people who are prone to social isolation and loneliness has yet to be understood. OBJECTIVES: A longitudinal study to understand the lived experience of people aged 70 and older, living in England during COVID-19 restrictions. METHODS: All participants completed five qualitative telephone interviews from 20 April to 7 July 2020. The majority completed individual interviews (n = 13), whilst two participants completed these interviews as a couple. Interviews were audio-recorded, transcribed verbatim and thematic analysis completed from the perspective of hermeneutic phenomenology. RESULTS: Three themes included (1) engagement and confusion with government restrictions; (2) socialisation through virtual platforms and opportunistic physical social contact; and (3) accessing health care during COVID-19 restrictions. CONCLUSION: Older people are committed to following government restrictions, and government campaigns need to consider the potential impact of placing an emphasis on avoiding healthcare services. Virtual platforms are supportive but not sufficient to reduce social isolation and loneliness of older people. Thus, nurses supporting older people living in the community need to understand these concepts to provide holistic care and support older people's mental and physical health. IMPLICATIONS FOR PRACTICE: Nurses are ideally placed to support older people to understand the current government restrictions, when to attend acute healthcare services or to engage virtually with healthcare appointments, and to discuss the risks of physically socialising with others.


Assuntos
COVID-19 , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Humanos , Estudos Longitudinais , Pandemias , Distanciamento Físico , Isolamento Social
9.
Violence Vict ; 37(1): 116-140, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35165163

RESUMO

This study applied the Behaviour Change Wheel (BCW) to understand barriers and facilitators to bystander behaviors in UK students. The BCW includes detailed examination of the capabilities, opportunities, and motivations involved in behaviors. Two surveys (n = 515; n = 201) and a focus group study (n = 12) were undertaken. Capability to intervene may be influenced by confidence and beliefs about physical ability and safety. Students appeared to have the physical opportunity to intervene, but social opportunity might be influenced by cultural norms. Motivations might be influenced by beliefs as well as inherent stereotypes about perpetrators and victims. Behavior change techniques (BCTs) such as instruction on how to perform the behavior, reattribution and creating a valued self-identity should be applied to overcome these barriers. A logic model to theorize the change processes underlying bystander behaviors in this population offers a new perspective on what needs to be addressed in interventions.


Assuntos
Delitos Sexuais , Terapia Comportamental , Humanos , Motivação , Estudantes , Inquéritos e Questionários
10.
J Clin Nurs ; 31(13-14): E17-E19, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34779064
11.
J Adv Nurs ; 77(11): 4511-4524, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34245169

RESUMO

AIMS: To, firstly, explore student and academic nurse perceptions of classroom content about the assessment and identification of pressure injuries across skin tone diversity and, secondly, to describe the impact of classroom content on student nurse understanding of pressure injury in people with dark skin tones. DESIGN: Qualitative case study employing focus groups and semi-structured interviews. METHODS: Five higher education institutions in the United Kingdom were purposively chosen. At each of the five-case sites, one focus group with student nurses and one semi-structured interview with a nurse academic were conducted between May 2018 and April 2019. The participants' narratives were transcribed verbatim and analysed via thematic analysis. RESULTS: Classroom learning was predominately framed through a white lens with white normativity being strongly reinforced through teaching and learning activities. This reinforcement of white normativity was evidenced through two main themes: (i) dominance of whiteness in the teaching and learning of pressure injuries in undergraduate nurse education and (ii) the impact and implications for student nurses of whiteness as the norm in pressure injury teaching. CONCLUSION: Nurses responsible for the design and delivery of teaching and learning experiences for nursing students need to ensure meaningful teaching and learning experiences. This learning should assist future nurses to interrogate their complicity in a system of white dominance. IMPACT: Nurse education delivered today influences and shapes nurses of the future. Nurses are the cornerstone of healthcare and play a significant role in the delivery of equitable healthcare. Nurse academics have a duty of care to inform and highlight health inequities in nursing and ultimately to enhance equity in care.


Assuntos
Educação em Enfermagem , Úlcera por Pressão , Humanos , Aprendizagem , Pesquisa Qualitativa , Pigmentação da Pele , Estudantes de Enfermagem
12.
Nurse Res ; 29(2): 17-24, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-33792211

RESUMO

BACKGROUND: Dismantling structural racism challenges nurses to consider the extent to which issues of inclusion, diversity and race are operationalised in day-to-day professional practice. This includes nurse education. To be truly effective, any examination of teaching content in nurse education needs to be investigated through document analysis plus observation in the classroom. However, tools to ensure consistency between these methods of collecting data are limited. AIM: To design a structured tool for collecting data by analysing teaching materials and observing teaching on pressure injuries and people with darker skin tones. DISCUSSION: This novel approach of using a single tool provides a unique opportunity to explore teaching materials and what is actually taught in the classroom. The data collected can assist with comparative analysis, enabling an in-depth view of curriculum content. CONCLUSION: The nuanced and subtle data gathered using the complementarity of analysis between teaching materials and teaching observations in the exemplar tool presented created a unique data set for examination. IMPLICATIONS FOR PRACTICE: This tool has broad applications for nurse researchers, particularly for examining topics that are often perceived to be sensitive, such as race and skin tone. It can be used for in-depth scrutiny of classroom teaching, to develop and influence curriculum content and team discussions, and in larger studies exploring nurse education content.


Assuntos
Educação em Enfermagem/organização & administração , Úlcera por Pressão/enfermagem , Pigmentação da Pele , Currículo , Humanos , Pesquisa em Educação em Enfermagem
14.
Artigo em Inglês | MEDLINE | ID: mdl-33371227

RESUMO

The use of blenderised enteral nutrition formula (ENF) is on the increase globally. However, concerns remain regarding the microbial quality and safety of blenderised ENF compared with standard recommendations and commercial ENF. AIM: This was a systematic review which sought to compare the microbial quality of blenderised ENF and commercial ENF and to evaluate the effect of storage time on blenderised ENF. METHOD: Four databases (Pubmed, EMBASE, PSYCInfo and Google scholar) were searched for relevant articles based on the Population, Intervention, Comparator, Outcomes framework. RESULTS: Eleven studies which met the criteria were included in the systematic review. Two major areas were identified; Microbial Quality of Blenderised ENF versus Commercial ENF; and The Effect of Storage Time on Microbial Quality of Blenderised ENF. Overall, 72.7% of the studies showed microbial contamination in blenderised ENF compared with 57.1% of commercial ENF, and the storage time was another important factor in the rates of contamination. The extent of handling or manipulation of the enteral formula was critical in determining the level of contamination. CONCLUSION: Preparation techniques for blenderised ENF need to be established and caregivers taught how to prepare and administer it appropriately in order to reduce contamination. Further, well-designed studies are required, which compare the microbial quality of blenderised ENF using adequate handling techniques and commercial ENF.


Assuntos
Nutrição Enteral , Staphylococcus aureus , Estudos Transversais , Escherichia coli , Alimentos Formulados , Humanos
15.
J Clin Nurs ; 29(21-22): 4387-4402, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32891063

RESUMO

AIM AND OBJECTIVE: To explore older people's initial experience of household isolation, social distancing and shielding, and the plans they constructed to support them through the COVID-19 pandemic. BACKGROUND: Public health guidance for those aged 70 or older was predominantly to undertake stringent social distancing within their household. Little is known about older people's experience of these measures. This paper explores changes experienced by those over the age of 70 during the first two weeks of household isolation, social distancing and shielding in the UK and the Republic of Ireland, and their early perceptions and plans to support them through the pandemic. METHODS: An inductive phenomenological study. University staff posted the study invitation flyer on social media, such as WhatsApp neighbourhood groups, the Nextdoor App and Twitter. Qualitative semi-structured interviews were undertaken with 19 participants and repeated at 2-week intervals for 10 weeks; further data collection is still in progress. This paper presents the findings from the baseline interviews, which showed older peoples' early responses. The COREQ (COnsolidated criteria for REporting Qualitative research) checklist was adhered to in the reporting of this study. RESULTS: Three themes emerged from older people's early experiences of social distancing: protective measures; current and future plans; and acceptance of a good life, but still a life to live. CONCLUSION: People over 70 adapted to household isolation, social distancing and shielding, by using social media and neighbourhood resources. Nurses and other professionals can develop holistic care for older people by listening to their experiences of what works for them, helping them link to local and distant supports. Understanding the holistic life view of older people, including death anxiety, is an important element of care planning; to help older people access the protective resources, they need to reduce the serious risks associated with coronavirus. RELEVANCE TO CLINICAL PRACTICE: Older people engage with social media, and during the current pandemic and beyond nurses can engage with this medium to communicate with older people. The importance of nurses to understand some older people consider quality of life to be more important than longevity, which may impact on their adherence to health advice.


Assuntos
COVID-19/psicologia , Vida Independente/psicologia , Distanciamento Físico , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , COVID-19/prevenção & controle , Feminino , Humanos , Irlanda , Masculino , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Apoio Social , Reino Unido
16.
J Clin Nurs ; 29(21-22): 4358-4367, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32845552

RESUMO

OBJECTIVE: To explore health disparity in on-campus undergraduate nurse education through the analysis of teaching and teaching material exploring pressure injuries. BACKGROUND: As a discipline, nursing espouses ideologies of inclusion, equity and valuing diversity. However, little is known about how these ideologies translate into clinical care. Pressure injury prevention is a routine aspect of nursing care; yet, there is evidence of inequity in relation to clinical care and patient assessment, as people with darker skin tones have a higher prevalence of severe pressure injuries before detection of damage occurs. Despite limited literature being available surrounding the topic of pressure injuries and skin tone diversity, it remains the responsibility of nurse educators to address contemporary issues and health disparity within the nursing curriculum. DESIGN: A multiple method collective case study. The STROBE checklist was followed in reporting this study. METHODS: Documentary and observational data of lectures regarding pressure injuries were collected during 2017 and 2018 from five Higher Education Institutes in England delivering approved nursing undergraduate programmes. RESULTS: Documentary analysis confirmed all Higher Education Institutes overwhelmingly directed teaching and learning activities about pressure injury towards people with Caucasian skin tones. Observation of teaching indicated all teaching sessions only contained brief, separate and superficial information on people with pressure injuries and darker skin tones. There was no discursive language or awareness of colour or colour blindness. CONCLUSION: Radical critique of all teaching and learning activities needs to occur, to help explore, improve and meaningfully and authentically include diversity and inclusivity in nurse education, and in particular, how people across the skin tone spectrum are included and represented in teaching and learning activities. RELEVANCE TO CLINICAL PRACTICE: Critical examination of current teaching practice is crucial to address disparity and ensure care for people with darker skin tones is optimised. Nurse educators have a responsibility to educate for the care needs of all, as the quality of nurse education has a direct impact on care delivery and health disparity. This paper highlights the importance of addressing skin tone diversity and offers the opportunity for reflective practice, not just in formal education, but in clinical settings by preceptors and senior staff.


Assuntos
Bacharelado em Enfermagem , Úlcera por Pressão , Estudantes de Enfermagem , Humanos , Currículo , Inglaterra , Docentes de Enfermagem , Aprendizagem , Pigmentação da Pele
17.
Nutrients ; 12(6)2020 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-32575695

RESUMO

BACKGROUND: Although there are merits in using commercial "enteral nutrition formula" (ENF) compared with blended ENF, there is a growing preference for the use of blended ENF in many countries globally. However, the nutritional value and physical properties of blended ENF compared with commercial ENF may be limiting its use. We have not found any evidence of a meta-analysis on the nutritional value of blended diets in the adult population. AIM: The aim of this review was to compare the nutritional value, physical properties, and clinical outcomes of blended ENF with commercial ENF. METHODS: The preferred reporting items for systematic reviews and meta-analyses were used for this review. The search strategy was based on a Population, Intervention, Comparator, Outcome framework. The following databases; Pubmed, EMBASE, PSYCInfo, and Google scholar were searched for articles of interest using keywords, Medical Subject Heading (MeSH) and Boolean operators (AND/OR) from the inception of each database until 23 February 2020. The articles were evaluated for quality. RESULTS: Based on the systematic review and meta-analysis, four distinct themes were identified; Nutritional value, Physical properties, Clinical outcomes; and Adverse events. The findings of this review showed inconsistencies in the macronutrient and micronutrient values of the blenderised ENF compared with the commercial ENF. The results of the meta-analysis demonstrated that there were no significant differences (p > 0.05) between the blenderised ENF and the commercial ENF in relation to the fat and protein contents of the diets. However, the blenderised ENF was significantly lower (p < 0.05) than the commercial ENF regarding the energy content of the diets, with an overall mean difference of -29.17 Kcal/100 mL (95% CI, -51.12, -7.22) and carbohydrate content with an overall mean difference of -5.32 g/100 mL (95% CI, -7.64, -3.00). In terms of sodium, potassium, and vitamin A, there were no significant differences (p > 0.05) between the blenderised and commercial ENF, although significant differences (p < 0.05) were observed between the two diets with respect to calcium, phosphorus, magnesium, zinc, iron, and vitamin C contents. Furthermore, the blenderised ENF showed significantly higher levels (p < 0.05) of viscosity and osmolality than the commercial ENF. The significantly lower levels of some of the macro-nutrients and micro-nutrients in the blenderised ENF compared with the commercial ENF and the difference in the expected nutritional values may be due to the fact blenderised ENF is produced from common foods. Thus, the type of foodstuffs, cooking, and processing methods may lead to loss of nutrients and energy density. The deficits in the energy content and some of the macro- and micro-nutrients in the blenderised ENF compared with commercial ENF may have implications for patients' health and clinical outcomes. The clinical implications of the underdelivering of nutrients may include increased risk of undernutrition, including energy malnutrition, which could have a negative effect on body composition and anthropometric parameters, morbidity, mortality, length of hospital stay, and costs. For outpatient care, this could increase the risk of hospital re-admission and homecare costs. Additionally, the higher viscosity and osmolality of the blenderised ENF compared with the commercial ENF can increase the risk of complications, including tube blockage, and impaired delivery of feed, water, and medications, with significant implications for patients' nutritional status and health outcomes. CONCLUSION: The results of this systematic review and meta-analysis identified significant variability in the nutritional value of blenderised ENF compared with commercial ENF. Furthermore, the nutritional values of the blenderised ENF do not meet the expected recommended levels compared with commercial ENF and these may have implications for patients' nutritional status and health outcomes, including the effect on body composition, morbidity, mortality, hospital re-admission, and costs. Further studies are needed to elucidate the nutritional value of blenderised ENF on patients' clinical outcomes.


Assuntos
Dieta , Nutrição Enteral , Alimentos Formulados/análise , Nutrientes/análise , Estado Nutricional , Valor Nutritivo , Adulto , Idoso , Idoso de 80 Anos ou mais , Comércio , Feminino , Manipulação de Alimentos , Hospitalização , Humanos , Masculino , Desnutrição/etiologia , Pessoa de Meia-Idade
19.
J Clin Nurs ; 29(13-14): 2044-2046, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32239784
20.
J Correct Health Care ; 26(2): 159-167, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32249709

RESUMO

The world's prison population is aging. Older prisoners, those aged 50 years and older, are at risk of poor health and developing a dementia. Prisoners with dementia may present challenges to the regime within the prison and require extra support. However, prison staff and health and social care professionals have reported a lack of skills and knowledge to identify and support prisoners with dementia. This may be due to a lack of dementia education programs developed specifically for the prison setting and delivered comprehensively for all who work with prisoners. The aim of this article is to describe the development and implementation of a dementia education workshop for the prison setting that is suitable for all prison staff, prisoners, and health and social care professionals.


Assuntos
Demência , Capacitação em Serviço , Prisioneiros/psicologia , Prisões , Desenvolvimento de Programas , Apoio Social , Pessoal Administrativo/educação , Idoso , Envelhecimento/psicologia , Inglaterra , Pessoal de Saúde/educação , Humanos , Masculino , Pessoa de Meia-Idade
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