Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 24
Filtrar
1.
Obes Rev ; 23(12): e13510, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36261077

RESUMO

The dose-response association between sedentary time and the risk of metabolic syndrome is unclear, which indicates an important knowledge gap in public health. The objective of this study was to determine the categorical and continuous dose-response associations between sedentary time and the risk of metabolic syndrome. A systematic literature search of English articles published in PubMed, CINHAL, Embase, and Web of Science Core Collection prior to June 2022 was conducted. All cohort and cross-sectional studies that examined the association between sedentary time and the risk of metabolic syndrome were considered, and duplicate and non-related studies were excluded. Data extraction using a standardized chart and quality assessment using two appraisal tools were also performed. Two independent reviewers were involved in these processes. In categorical meta-analyses, the pooled effect sizes for metabolic syndrome associated with different categories of sedentary time were calculated by comparing the highest and intermediate with the lowest categories. In continuous meta-analyses, the linear and nonlinear dose-response associations were estimated using generalized least squares and restricted cubic spline models, respectively. Data were collected and analyzed from March to June 2022. Four prospective cohort studies and 22 cross-sectional studies with 105,239 participants and 16,185 MetS cases were included in this study. In categorical analyses, both intermediate (median duration: 4.11 h/day; pooled OR: 1.17, 95% CI: 1.08-1.26, P < 0.001) and high levels (median duration: 7.26 h/day; pooled OR: 1.71, 95% CI: 1.43-2.04, P < 0.001) of total sedentary time were significantly associated with an increased risk of metabolic syndrome. Similarly, a significant association between screen time and the risk of metabolic syndrome was also found in intermediate (median duration: 2.22 h/day; pooled OR: 1.20, 95% CI: 1.10-1.32, P < 0.001) and high levels (median duration: 3.40 h/day; pooled OR: 1.63, 95% CI: 1.44-1.86, P < 0.001) of exposure. Of note, these associations were significantly stronger in women. Different patterns of the behavior-disease association were not observed in children, adolescents, and adults. The findings of continuous meta-analyses could not provide solid evidence for the linearity and nonlinearity of the behavior-disease association. This study demonstrated that long-time sedentary behavior was associated with a higher risk of MetS independent of physical activity and the patterns of association varied by gender instead of age. These findings have implications for future guideline recommendations on physical activity, sedentary behavior, and prevention of metabolic syndrome.


Assuntos
Síndrome Metabólica , Comportamento Sedentário , Criança , Adolescente , Adulto , Humanos , Feminino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Estudos Transversais , Estudos Prospectivos , Exercício Físico
2.
BMC Public Health ; 22(1): 1740, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104817

RESUMO

BACKGROUND: Adherence to physical activity is inadequate in adults with metabolic syndrome. Adherence to physical activity recommendations is crucial and can result in improved health outcomes and reduced medical burdens. A comprehensive behavior change intervention, including identifying determinants of adherence to physical activity recommendations, intervention options, intervention content and implementation options, was imperative for enhancing physical activity adherence. The aim of the study is to develop an intervention to increase physical activity adherence among individuals with metabolic syndrome. METHODS: The study followed the eight steps of the Behavior Change Wheel guide, including defining the problem in behavioral terms (Step 1), selecting target behavior (Step 2), specifying target behavior (Step 3), identifying what needs to change (Step 4), identifying intervention functions (Step 5), identifying policy categories (Step 6), identifying behavior change techniques (Step 7), and determining model of delivery (Step 8). The semi-structured, in-depth interviews were employed to identify the determinants of adherence to physical activity among twenty-eight individuals with metabolic syndrome based on capability, opportunity, motivation and behavior model. Next, the intervention functions and policy categories were chosen to address these determinants. Finally, behavior change techniques were selected to assist in the delivery of the intervention functions and be translated into intervention content. RESULTS: Our study identified eighteen facilitators and fifteen barriers to physical activity adherence. It resulted in the selection of seven intervention functions and nineteen behavior change techniques for the intervention program. Then, the current study identified an app as the delivery mode. Finally, a behavioral change intervention was generated for individuals with metabolic syndrome to increase physical activity recommendation adherence. CONCLUSIONS: The Behavior Change Wheel provided a systematic approach to designing a behavior change intervention, which helped improve the health outcomes and reduce medical burdens and economic burdens among individuals with metabolic syndrome. The findings suggested that potential intervention should pay special attention to increasing knowledge in metabolic syndrome, imparting skills of physical activity, offering a supportive environment, and providing suggestions on regular physical activity using the appropriate behavior change techniques. A feasibility study will be undertaken to assess the acceptability and effectiveness of the intervention program in the future.


Assuntos
Síndrome Metabólica , Adulto , Terapia Comportamental/métodos , Exercício Físico , Estudos de Viabilidade , Humanos , Síndrome Metabólica/terapia , Motivação
3.
Front Psychol ; 13: 966770, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36017447

RESUMO

Background and aim: The postpartum depression literacy (PoDLi) of perinatal women is closely related to the occurrence, recognition, and treatment of postpartum depression, therefore valid instruments for evaluating the level of PoDLi are of great significance for both research and clinical practice. This study aimed to cross-culturally adapt the postpartum depression literacy scale (PoDLiS) into Chinese and to test its psychometric properties among Chinese perinatal women. Materials and methods: A cross-sectional study was conducted from April to May 2022 in a tertiary hospital in Hangzhou, Zhejiang Province, China. 619 out of the 650 perinatal women that were approached via a convenience sampling method completed the Chinese version of the PoDLiS (C-PoDLiS). Content validity [the content validity index of items (I-CVI) and scale-level content validity index (S-CVI)] was evaluated by an expert panel. Psychometric properties, including item analysis, structure validity (exploratory factor analysis, confirmatory factor analysis), convergent and discriminant validity, reliability (internal consistency, test-retest reliability), criterion validity (concurrent validity, predictive validity), and floor/ceiling effect were examined. Results: The final version of C-PoDLiS is a six-factor structure consisting of 27 items, which explained 61.00% of the total variance. Adequate content validity (I-CVI = 0.833-1.00, S-CVI = 0.920) was ensured by the expert panel. The modified confirmatory factor analysis model revealed that the 6-factor model fitted the data well (χ2/df = 1.532, root mean square error of approximation = 0.042, goodness of fit = 0.900, incremental fit index = 0.949, comparative fit index = 0.948, Tucker-Lewis index = 0.940). The total Cronbach's α was 0.862, the total McDonald's ω was 0.869, and the test-retest reliability coefficient was 0.856. Results of convergent validity (average variance extracted = 0.486-0.722) and discriminant validity provided good or acceptable psychometric support. Significant correlations between scores of the C-PoDLiS and Mental health literacy scale (r = 0.155-0.581, p < 0.01) and Attitudes toward seeking professional psychological help short form scale (r = 0.361-0.432, p < 0.01) supported good concurrent and predictive validity, respectively. No floor/ceiling effect was found. Conclusion: The C-PoDLiS was demonstrated to be a sound instrument with good reliability and validity for evaluating Chinese perinatal women's PoDLi levels. Its use in the future can facilitate data aggregation and outcome comparisons across different studies on this topic.

4.
Artigo em Inglês | MEDLINE | ID: mdl-35672276

RESUMO

AIMS: Adherence to diet and exercise recommendations is crucial among metabolic syndrome (MetS) individuals. However, no studies have focused on comprehensive behavioural changes of diet and exercise among individuals with MetS. The present study aimed to explore determinants of adherence to diet and exercise behaviours among people with MetS based on the Capability, Opportunity, Motivation, and Behaviour (COM-B) model. METHODS AND RESULTS: A cross-sectional study was conducted in a health promotion centre of a large and general university hospital in Zhejiang Province, China, in 2021. A total of 241 individuals with MetS completed all scales. The mediation model was tested using structural equation modelling with bootstrapped samples. In the regression-based path analysis, MetS knowledge (ß = 0.140), socioeconomic status (ß = 0.162), and social support (ß = 0.143) directly positively influenced diet behaviour. In addition, social support indirectly positively influenced exercise behaviour through coping and adaptation (ß = 0.090). The final theoretical model showed a good fit (root mean square error of approximation = 0.057, comparative fit index = 0.946). CONCLUSION: Factors associated with diet behaviour were knowledge of MetS, socioeconomic status, and social support. Adaptation may be a mediator between social support and exercise behaviour. Intervention programmes targeting increased adherence to diet and exercise could include these factors for individuals with MetS.

5.
Front Med (Lausanne) ; 9: 806945, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35573001

RESUMO

Background: There is a relationship between the application of physical restraints and negative physiological and psychological effects on critically ill patients. Many organizations have supported and advocated minimizing the use of physical restraints. However, it is still common practice in many countries to apply physical restraints to patients in intensive care. Objective: This study aimed to assess the effectiveness of various non-pharmacological interventions used to minimize physical restraints in intensive care units and provide a supplement to the evidence summary for physical restraints guideline adaptation. Methods: Based on the methodology of umbrella review, electronic databases, including Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, MEDLINE, EMBASE, CINAHL, Web of Science, PsycInfo/Psyc Articles/Psychology and Behavioral Science Collection, China National Knowledge Infrastructure, SinoMed, and Wanfang Data, were searched to identify systematic reviews published from January 2016 to December 2020. Two independent reviewers undertook screening, data extraction, and quality appraisal. The methodological quality of systematic reviews was evaluated by AMSTAR 2. Evidence quality of each intervention was assessed according to GRADE. The corrected covered area was calculated as a measure of overlap. Results: A total of 47 systematic reviews were included in the umbrella review, of which six were evaluated as high quality, five were of moderate quality, and the rest were of low or critically low quality. The corrected covered area range was from 0.0 to 0.269, which indicated that there was mild overlap between systematic reviews. The included systematic reviews evaluated various types of non-pharmacological interventions for minimizing physical restraints in intensive care units, which included multicomponent interventions involving healthcare professionals' education, family engagement/support, specific consultations and communication, rehabilitation and mobilization (rehabilitation techniques, early mobilization, inspiratory muscle training), interventions related to reducing the duration of mechanical ventilation (weaning modes or protocols, ventilator bundle or cough augmentation techniques, early tracheostomy, high-flow nasal cannula), and management of specific symptoms (delirium, agitation, pain, and sleep disturbances). Conclusion: The number of systematic reviews related to physical restraints was limited. Multicomponent interventions involving healthcare professionals' education may be the most direct non-pharmacological intervention for minimizing physical restraints use in intensive care units. However, the quality of evidence was very low, and conclusions should be taken with caution. Policymakers should consider incorporating non-pharmacological interventions related to family engagement/support, specific consultations and communication, rehabilitation and mobilization, interventions related to reducing the duration of mechanical ventilation, and management of specific symptoms as part of the physical restraints minimization bundle. All the evidence contained in the umbrella review provides a supplement to the evidence summary for physical restraints guideline adaptation. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242586, identifier: CRD42021242586.

6.
Intensive Crit Care Nurs ; 70: 103193, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34980516

RESUMO

BACKGROUND: Guidelines concerning the use of physical restraints in medical facilities have been published and amended over the years. However, the quality and suitability of these guidelines have not been appraised. OBJECTIVES: This study aims to assess the suitability and quality of guidelines for the use of physical restraints in intensive care units with the AGREE-REX and AGREE Ⅱ instruments. METHODS: A systematic search of electronic databases (e.g., EMBASE), cross-database search platforms (e.g., Clinical Key), guideline web portals (e.g., Guidelines International Network) and society websites (e.g., Society of Critical Care Medicine) was conducted from January 2011 to December 2020. The methodological quality was assessed using AGREE Ⅱ, and the recommendation quality and suitability were assessed using AGREE-REX instruments. RESULTS: A total of eight guidelines were included. The criteria for overall quality and suitability of guidelines for the use of physical restraints were met by 50-72% and 59-76%, respectively. The "Values and Preferences" domain had the lowest score (38% ± 9%). The criteria for methodological quality of the guidelines were met by 50-83%. Two domains, "Applicability" and "Editorial Independence", achieved lower scores. There was a strong, positive correlation between the overall methodological quality of guidelines and the overall quality of recommendations (r = 0.968). CONCLUSION: There is a potential feasibility of guideline adaptation for the management of physical restraints. In order to implement a physical restraint guideline, the following aspects should be considered: (i) minimize the use of physical restraints, (ii) analyze barriers and facilitators relative to the local context, (iii) consider any specifications, and (iv) modify recommendations to local situation or individual conditions of the patient.


Assuntos
Unidades de Terapia Intensiva , Restrição Física , Cuidados Críticos , Bases de Dados Factuais , Humanos
7.
Front Psychiatry ; 12: 753851, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34819886

RESUMO

Background: To date, a large body of literature focuses on the experience of healthcare providers who cared for COVID-19 patients. Qualitative studies exploring the experience of healthcare workers in the workplace after recovering from COVID-19 are limited. This study aimed to describe the experience of healthcare workers who returned to work after recovering from COVID-19. Methods: This study employed a qualitative descriptive approach with a constructionist epistemology. Data were collected through semi-structured in-depth interviews with 20 nurses and physicians, and thematic analysis was used to identify themes from the interview transcripts. Results: Three major themes about the psychological experiences of healthcare workers who had recovered from COVID-19 and returned to work were identified: (1) holding multi-faceted attitudes toward the career (sub-themes: increased professional identity, changing relationships between nurses, patients, and physicians, and drawing new boundaries between work and family), (2) struggling at work (sub-themes: poor interpersonal relationships due to COVID-19 stigma, emotional symptom burden, physical symptom burden, and workplace accommodations), (3) striving to return to normality (sub-themes: deliberate detachment, different forms of social support in the workplace, and long-term care from organizations). Conclusions: The findings have highlighted opportunities and the necessity to promote health for this population. Programs centered around support, care, and stress management should be developed by policymakers and organizations. By doing this, healthcare workers would be better equipped to face ongoing crises as COVID-19 continues.

8.
BMJ Open ; 11(11): e055073, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732505

RESUMO

OBJECTIVES: To understand why critical care clinicians still implement physical restraints, to prevent unplanned extubation and to explore the driving factors influencing the decision-making of physical restraints use. DESIGN: A qualitative descriptive design was used. The data were collected through one-to-one, semistructured interviews and analysed through the framework of thematic analysis. PARTICIPANTS AND SETTING: The study was conducted from December 2019 to May 2020 at one general intensive care unit (ICU) and one emergency ICU in a general tertiary hospital with 3200 beds in Hangzhou, China. The sampling strategy was combined maximum variation sampling and criterion sampling. RESULTS: A total of 14 clinicians participated in the study. The reason why critical care clinicians implemented physical restraints to prevent unplanned extubation was that the tense healthcare climate was caused by family members' rejection of mismatched expectations. As unplanned extubation was highly likely to create medical disputes, hospitals placed excessive emphasis on unplanned extubation, which resulted in a lack of analysis of the cause of unplanned extubation and strict measures for dealing with unplanned extubation. The shortage of nursing human resources, unsuitable ward environments, intensivists' attitudes, timely extubation for intensivists, nurse experiences and the patient's possibility of unplanned extubation all contributed to the decision-making resulting in the use of physical restraints. CONCLUSIONS: Although nurses played a crucial role in the decision-making process of using physical restraints, changing the healthcare climate and the hospital management mode for unplanned extubation are fundamental measures to reduce physical restraints use.


Assuntos
Cuidados Críticos , Restrição Física , Extubação , Humanos , Unidades de Terapia Intensiva , Pesquisa Qualitativa
9.
Risk Manag Healthc Policy ; 14: 4361-4368, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34707419

RESUMO

PURPOSE: Machine learning (ML) techniques have emerged as a promising tool to predict risk and make decisions in different medical domains. We aimed to compare the predictive performance of machine learning-based methods for 4-year risk of metabolic syndrome in adults with the previous model using logistic regression. PATIENTS AND METHODS: This was a retrospective cohort study that employed a temporal validation strategy. Three popular ML techniques were selected to build the prognostic models. These techniques were artificial neural networks, classification and regression tree, and support vector machine. The logistic regression algorithm and ML techniques used the same five predictors. Discrimination, calibration, Brier score, and decision curve analysis were compared for model performance. RESULTS: Discrimination was above 0.7 for all models except classification and regression tree model in internal validation, while the logistic regression model showed the highest discrimination in external validation (0.782) and the smallest discrimination differences. The logistic regression model had the best calibration performance, and ANN also showed satisfactory calibration in internal validation and external validation. For overall performance, logistic regression had the smallest Brier score differences in internal validation and external validation, and it also had the largest net benefit in external validation. CONCLUSION: Overall, this study indicated that the logistic regression model performed as well as the flexible ML-based prediction models at internal validation, while the logistic regression model had the best performance at external validation. For clinical use, when the performance of the logistic regression model is similar to ML-based prediction models, the simplest and more interpretable model should be chosen.

10.
Risk Manag Healthc Policy ; 14: 4073-4081, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34616194

RESUMO

BACKGROUND: Despite a flood of research on job satisfaction, few studies have examined how and why social support influences job satisfaction. This study aimed to explore how social support has an indirect effect on job satisfaction by examining its impact on emotional exhaustion and anxiety symptoms among residents of the physicians standardized residency training program in China. METHODS: This cross-sectional study adopted questionnaires to collect data from residents in the standardized residency training program in China. The PROCESS macro for SPSS based on ordinary least-squares regression and the bootstrap method was used. The indirect effect of social support was examined using bootstrapping procedures. A serial multiple mediation model was examined in which social support was associated with job satisfaction via emotional exhaustion and anxiety symptoms. RESULTS: There were 269 residents who provided usable data for the analysis. The mean age of residents was 25.98 years old. Close to half (52%) of the participants were female. The total indirect effect of social support on job satisfaction was significant (ab=0.21, SE=0.05, CI=0.12 to 0.32). The specific indirect effect 1 (social support→emotional exhaustion→job satisfaction) was significant (a1b1=0.12, SE=0.04, CI=0.05 to 0.19). The specific indirect effect 2 (social support→anxiety symptoms→job satisfaction) was significant (a2b2=0.07, SE=0.03, CI=0.02 to 0.13).The specific indirect effect 3 (social support→emotional exhaustion→anxiety symptoms→job satisfaction) was also found to be significant through both optimism and work engagement (a1a3b2=0.03, SE=0.01, CI=0.01 to 0.05). CONCLUSION: It seems critical for hospital management to develop a supportive work environment to improve the effects of emotional exhaustion and anxiety symptoms and to provide sufficient support to improve job satisfaction among residents in standardized residency training programs.

11.
BMJ Open ; 11(9): e048875, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493514

RESUMO

OBJECTIVE: Caregiver contribution (CC) is important for the self-care behaviors of chronic disease individuals, as it could enhance patient outcomes. Therefore, it is necessary to assess this CC by using a good validity and reliability instrument. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) was designed to assess CC to self-care behaviors of patients with chronic illness in Italy. However, it was unclear whether this tool had sound psychometrics properties in the context of Chinese culture. Therefore, we performed the cross-cultural adaption of the CC-SC-CII and we tested its psychometric properties among Chinese caregivers of patients with chronic disease. DESIGN: A cross-sectional observational design. SETTINGS: Participants were recruited from communities and institutions in Pingdingshan, Henan Province, China. PARTICIPANTS: 301 caregivers of care recipients with chronic disease completed the Chinese version of the CC-SC-CII (C-CC-SC-CII). PRIMARY AND SECONDARY OUTCOME MEASURES: The content validity index of items (I-CVI), the scale content validity index-average (S-CVI/Ave), exploratory factor analysis, confirmatory factor analysis (CFA), internal consistency and item analysis were tested. RESULTS: The range of I-CVI was between 0.833 and 1.00, and the score of S-CVI was 0.991. In CFA, the C-CC to self-care monitoring scale had satisfactory fit indices. However, the C-CC to self-care maintenance and management scales had unsupported fit indices. The reliability coefficients of C-CC-SC-CII were 0.792, 0.880 and 0.870 for its three scales. Item-total correlations were all over 0.590. Test-retest reliability showed that the range of intraclass correlation coefficients was from 0.728 to 0.783. CONCLUSION: The C-CC-SC-CII has sound psychometrics characteristics and is a culturally appropriate and reliable instrument for assessing CC to the self-care behaviours of patients with chronic disease in China.


Assuntos
Cuidadores , Autocuidado , China , Doença Crônica , Comparação Transcultural , Estudos Transversais , Análise Fatorial , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
BMC Psychiatry ; 21(1): 460, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548045

RESUMO

BACKGROUND: Although studies indicate that social support is related to emotional exhaustion, depression symptoms, and anxiety symptoms, the underlying mechanism between those variables remains unknown. METHODS: Based on a sample of 254 residents in standardized residency training programs, two mediation models were tested in which emotional exhaustion served as a mediator in the relationship between social support and anxiety symptoms/depression symptoms. We used the following self-reported questionnaires as instruments to collect data: zung self-rating depression scale, zung self-rating anxiety scale, social support rating scale, and emotional exhaustion scale. RESULTS: In the final study sample, the mean age of the residents was 25.92 years old (SD =1.88), and a total of 41.3% were male, and 58.7% were female. This current study suggested that social support was proven to be a relevant factor affecting anxiety symptoms and depression symptoms. Particularly, the results also indicated that emotional exhaustion partially mediated the impact of social support on anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program. CONCLUSIONS: Our study signifies that enhancements in social support and reduction of emotional exhaustion can directly or indirectly affect anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program. These findings will offer insight for health-sector managers to develop programs aimed at social support and adopt individual-level interventions and organization-level interventions to reduce emotional exhaustion.


Assuntos
Depressão , Internato e Residência , Adulto , Ansiedade/diagnóstico , Depressão/diagnóstico , Emoções , Feminino , Humanos , Masculino , Apoio Social , Inquéritos e Questionários
13.
Front Med (Lausanne) ; 8: 573601, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34368171

RESUMO

Aim: The aim of the study was to explore the perception and practice of physical restraints used by critical care nurses. Design: A qualitative descriptive design was used. Method: From December 2019 to May 2020, a one-to-one, semi-structured in-depth interview with 10 critical care nurses from two intensive care units in a tertiary general hospital with 3,200 beds in China was conducted using the method of purposeful sampling. The data were analyzed using inductive thematic analysis. Findings: The perception of physical restraints among critical care nurses was that patient comfort can be sacrificed for patient safety. Physical restraints protected patient safety by preventing patients from unplanned extubation but influenced patient comfort. Physical restraints were common practice of critical care nurses. Relative physical restraints provided patients with more freedom of movement and rationalization of physical restraints which were the practical strategies. Conclusion: The study identified problems in critical care nurses' perception and practice on physical restraints. Critical care nurses are confident that physical restraints can protect patient safety, and the influence of physical restraints on patient comfort is just like the side effect. Although physical restraints were common practice, critical care nurses still faced dilemmas in the implementation of physical restraints. Relative physical restraints and rationalization of physical restraints help critical care nurses cope with the "bad feelings," which may also be the cause of unplanned extubation. It is necessary for the adaptation of clinical practice guidelines about physical restraints for critically ill patients in the Chinese context, to change the perception and practice of critical care nurses and deliver safe and high-quality patient care.

14.
BMC Nurs ; 20(1): 133, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34320972

RESUMO

BACKGROUND: Ethical conflicts are common in the critical care setting, and have compromised job satisfaction and nursing care quality. Using reliable and valid instruments to measure the ethical conflict is essential. This study aimed to translate the Ethical Conflict in Nursing Questionnaire - Critical Care Version into Chinese and determine the reliability and validity in the population of Chinese nurses. METHODS: Researchers obtained permission and followed the translation-backward method to develop the Chinese version of the Ethical Conflict in Nursing Questionnaire - Critical Care Version (ECNQ-CCV-C). Relevant psychometric properties were selected according to the Consensus-based standards for the selection of health status measurement instruments checklist. Critical care nurses were recruited from two tertiary public hospitals in Hangzhou, Zhejiang Province, and Kunming, Yunnan Province. Of the 264 nurses we approached, 248 gave their consent and completed the study. RESULTS: The ECNQ-CCV-C achieved Cronbach's alphas 0.902 and McDonald's omega coefficient 0.903. The test-retest reliability was satisfactory within a 2-week interval (intraclass correlation coefficient = 0.757). A unidimensional structure of the ECNQ-CCV-C was determined. Confirmatory factor analysis supported acceptable structure validity. Concurrent validity was confirmed by a moderate relation with a measure for hospital ethical climate (r = - 0.33, p < 0.01). The model structure was invariant across different gender groups, with no floor/ceiling effect. CONCLUSIONS: The ECNQ-CCV-C demonstrated acceptable reliability and validity among Chinese nurses and had great clinical utility in critical care nursing.

15.
Diabetes Metab Syndr Obes ; 14: 3027-3034, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34234498

RESUMO

PURPOSE: A prediction model for 4-year risk of metabolic syndrome in adults was previously developed and internally validated. However, external validity or generalizability for this model was not assessed so it is not appropriate for clinical application. We aimed to externally validate this model based on a retrospective cohort. PATIENTS AND METHODS: A retrospective cohort design and a temporal validation strategy were used in this study based on a dataset from 1 January 2015 to 31 December 2018. Multiple imputation was used for missing values. Model performance was evaluated by using discrimination, calibration (calibration plot, calibration slope, and calibration intercept), overall performance (Brier score), and decision curve analysis. RESULTS: In external validation, the C-statistic was 0.782 (95% CI, 0.771-0.793). The calibration plot shows good calibration, calibration slope was 1.006 (95% CI, -0.011-1.063), and calibration intercept was -0.045 (95% CI, -0.113-0.022). Brier score was 0.164.The discrimination and calibration of the prediction model were good in temporal external validation. CONCLUSION: The discrimination and calibration of the prediction model were satisfactory in the temporal external validation. However, clinicians should be aware that this prediction model was developed and validated in a tertiary setting. It is strongly recommended that further studies validate this model in international cohorts and large, prospective cohorts in different institutions.

16.
Ann Palliat Med ; 10(6): 6892-6899, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34154364

RESUMO

BACKGROUND: As the last resort in intensive care units, physical restraint reduction is affected by various interventions. Several non-pharmacological interventions may directly reduce physical restraints, such as staff education, or indirectly reduce physical restraint, such as delirium prevention; however, their effectiveness has remained inconclusive. Therefore, we devised a protocol for umbrella reviews to summarize the evidence integrating data of different non-pharmacological interventions that may reduce physical restraint use. METHODS: The umbrella review will be conducted following the methodology formulated by the Joanna Briggs Institute (JBI). Electronic databases, including Web of Science, PubMed, EMBASE, PsycInfo, Psyc Articles, Psychology and Behavioral Science Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JBISRIS (JBI Database of Systematic Reviews and Implementation Reports), Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI, for Chinese literature), SinoMed (for Chinese literature), and WANFANG DATA (for Chinese literature), will be searched to identify articles published from January 2016 to December 2020. A systematic review and meta-analysis quality will be critically assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews). According to the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) guidelines, the evidence quality of each intervention will be assessed. Overlapping studies and the excess significance test will be performed to assess whether previous evidences are bias. DISCUSSION: This protocol was devised according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Umbrella reviews will be an excellent supplement to the evidence of the guideline adaptation and provide a broader picture of non-pharmacological interventions that may reduce the use of physical restraint, which can provide critical care nurses in intensive care units with the evidence they need. TRIAL REGISTRATION: This umbrella review protocol was documented in the PROSPERO registry (CRD42021242586).


Assuntos
Unidades de Terapia Intensiva , Restrição Física , China , Humanos , Metanálise como Assunto , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
17.
Diabetes Metab Syndr Obes ; 14: 2229-2237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34040408

RESUMO

PURPOSE: A prognostic prediction model for metabolic syndrome can help nurses or physicians evaluate the future individual absolute risk of MetS in order to develop personalized care strategies. We aimed to derive and internally validate a prognostic prediction model for 4-year risk of metabolic syndrome in adults. PATIENTS AND METHODS: This was a retrospective cohort study conducted in a tertiary care setting, and the dataset was obtained from the Healthcare Information and Management Systems of a tertiary hospital. The cohort included Chinese adults attending health examination from 1 January 2011 to 31 December 2014. A total of 6793 participants without metabolic syndrome were included in the cohort and were followed up for 4 years. Available candidate predictors in the dataset were weight, MCV, MCH, AST, ALT, BMI, NGC, TC, serum uric acid, gender, smoking, WBC, LC, Hb, HCT, and age. A logistic regression model was adopted to build the risk equation, and bootstrapping was used when considering internal validation. Calibration, discrimination, and the clinical utility were calculated for the model's performance. RESULTS: Of the 6793 participants, 1750 participants were diagnosed with metabolic syndrome within 4 years. The developed prediction model contained 5 predictors (body mass index, age, total cholesterol, alanine transaminase, and serum uric acid). After internal validation, the C-statistic was 0.783 (95% CI, 0.772-0.795). Additionally, the current model had good calibration. Calibration slope was 0.995 (95% CI, 0.934-1.058), and calibration intercept was -0.008 (95% CI, -0.088-0.073). The Brier score was 0.156. The decision-curve analysis indicated that the prediction model provided greater net benefit than the default strategies of providing treatment or not providing treatment for all patients. CONCLUSION: A prognostic risk prediction model for determining 4-year risk of metabolic syndrome onset in adults was developed and internally validated. This model was based on routine clinical measurements that quantified individual future risk of metabolic syndrome.

18.
Int J Gen Med ; 14: 709-720, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33688242

RESUMO

INTRODUCTION: With the effective treatments of novel coronavirus disease 2019 (COVID-19), thousands of patients have recovered from COVID-19 globally. The public perceptions and views are vital to facilitate recovered COVID-19 patients reintegrate into society. In China, the rural population accounts for nearly 70% of the total population. Therefore, we chose to evaluate perceptions and views of rural residents towards COVID-19 recovered patients in China. METHODS: Fifteen participants were sampled from a village with the severe COVID-19 epidemic in Zibo city, Shandong Province. The fifteen participants who lived in the village with COVID-19 recovered patients were included. They were over 18 years of age and were voluntary to participant in the study. A descriptive qualitative design using semi-structured telephone interviews was undertaken. Thematic analysis was undertaken. RESULTS: Five main themes emerged from the data: (1) Perceived personal characteristics of COVID-19 recovered patients; (2) Perceived difficulties faced by COVID-19 recovered patients; (3) Perceptions on the social relationship with COVID-19 recovered patients; (4) Views on COVID-19 recovered patients going to public venues; (5) Views on helping COVID-19 recovered patients. Each theme was supported by several subthemes. CONCLUSION: Our study showed that discrimination and reduced social intimacy exist among rural residents. To improve their views or the situation, relevant departments could lead health educational programs and encourage supportive social connections. Through these strategic messaging, rural residents are expected to recognize that COVID-19 recovered patients need more social support, rather than discrimination and resistance, which helps recovered patients better return to society.

19.
Ann Palliat Med ; 10(4): 4889-4896, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33691462

RESUMO

BACKGROUND: The effectiveness of physical restraints (PRs) in the prevention of unplanned extubation has been increasingly questioned, and several countries have developed clinical practice guidelines for reducing the use of PRs. However, some countries, including China, have failed to establish their guidelines, and the adaptation of existing guidelines to local circumstances may be an attractive alternative. METHODS: Following the guideline definition of Institute of Medicine, the guideline will be adapted following the CAN-IMPLEMENT©. Guideline scope and clinical questions will be established based on an integrative review, retrospective study, and stakeholder interviews. The guideline's quality will be assessed by the Appraisal of Guidelines for Research and Evaluation II and Appraisal of Guidelines Research and Evaluation-Recommendations Excellence. A systematic review and meta-analysis will be evaluated by A Measurement Tool to Assess Systematic Reviews. The guidelines will meet the criteria of the RIGHT-Ad@pt Checklist. DISCUSSION: This study describes the proposed protocol for adapting clinical practice guidelines on PRs in critically ill patients. We believe the guideline will help health professionals, especially critical care nurses, deliver safe, high-quality patient care by reducing the implementation of PRs in China. GUIDELINE REGISTRATION: The guideline has been registered at the International Practice Guidelines Registry Platform (http://www.guidelinesregistry.org/). The registration number is IPGRP-2019CN094, registration date 27-Dec-2019.


Assuntos
Estado Terminal , Restrição Física , China , Cuidados Críticos , Humanos , Metanálise como Assunto , Estudos Retrospectivos , Revisões Sistemáticas como Assunto
20.
Nurse Educ Pract ; 51: 102996, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33652192

RESUMO

The shortage of human resources in nursing is a global challenge, and males may play an important role in alleviating this shortage, especially in China. Just as single-sex education has a potentially positive impact on women in male-dominated professions, it may also have the same impact on men in nursing, which may promote male engagement in nursing. This study delved into the experiences and perceptions that are peculiar to male nursing students in a single-sex class. A qualitative, descriptive design was employed using conventional content analysis. A purposive sample of 12 male nursing students in a male-only class of a university in China participated. Individual semi-structured interviews were performed between January and March 2019. Data analysis revealed five themes. Considering the negative peer influence and potential communication barriers of a male-only nursing class, establishing a male nursing student alliance instead of a male-only nursing class may be a better choice. In Asian culture, reconstructing the current social norms of gender is crucial to eliminating prejudice and male dividends and changing the definitions of masculinity, all of which are conducive to the development of male involvement in nursing.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , China , Feminino , Humanos , Masculino , Percepção , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...