[Systematic Review and Meta-Analysis of Non-Invasive Acupoint Therapy as an Approach to Urinary Itching Control in Dialysis Patients].

BACKGROUND: Uremic pruritus, one of the most painful symptoms experienced by patients receiving dialysis, seriously affects patient quality of life and health, causes physical and mental damage, and increases hospitalization and mortality rates. Multi-modal therapies with evidence-based healthcare are needed to provide patients receiving dialysis with more convenient and feasible medical resources. PURPOSE: Relevant domestic and international research on the effectiveness and methods of non-invasive acupoint therapy in improving uremic pruritus in dialysis patients was reviewed. Discussing related knowledge can facilitate the evidence-based use of non-invasive acupoint therapy in clinical practice by clinical medical personnel. METHODS: Based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) systematic literature review and integrated analysis method, a keyword search of related articles published before September 2023 was conducted in the following databases: PubMed, Cochrane Library, Embase, Web of Science, Airiti Library, Taiwan Master and Doctoral Dissertation System, Chinese Journal Full-text Database and Wanfang Data Knowledge Service Platform. In 2019, the second version of the Risk of Bias Tool for Randomized Controlled Trials was used to evaluate research quality, after which RevMan 5.4 and Stata 14.0 suite software were used for meta-analysis. RESULTS: Nine of the 112 articles selected, including 10 sets of data and 597 participants, were included in the meta-analysis. The results indicate non-invasive acupoint therapy significantly reduces the degree of uremic pruritus (synthetic effect size = -1.30, 95% confidence interval [-1.67, -0.93], p < .00001). Because the heterogeneity test I² = 76%, showed a high degree of heterogeneity, a subgroup analysis was performed, showing that acupoint massage combined with traditional Chinese medicine fumigation and washing, a general simple itching assessment scale, and the Chinese region achieved better effect sizes. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Non-invasive acupoint therapy is easy to implement, inexpensive, non-invasive, and associated with few side effects. The authors hope these findings may increase the awareness and understanding of patients with dialysis regarding the practical operation techniques of itching acupoints. According to the results of this systematic review and meta-analysis, massage of the lung and endocrine acupoints at ST-6, SP-10, and LI-11 as well as the relevant points on the ear may be most effective in achieving urinary itching relief. Also, acupoint massage combined with traditional Chinese medicine fumigation, ST-6 far-infrared irradiation, or LI11 transcutaneous acupoint electrical stimulation can further relieve uremic pruritus in this patient population. Based on the results, acupoint massage combined with traditional Chinese medicine fumigation and washing is a complementary method of treatment for uremic pruritus that may be recommended to patients in the future.

[Workplace Fatigue, Metabolic Syndrome, and Cardiovascular Disease Risks: A Study of Long-Term Night Shift Nurses].

BACKGROUND: Night-shift work affects the physical and mental health of employees. Early identification of relevant high-risk groups may be referenced in health promotion, job analysis, and job design. PURPOSE: To explore the differences in workplace fatigue, physiological index of metabolic syndrome, and risk of cardiovascular disease between long-term and non-long-term night-time working nursing staff. METHODS: The health examination data of 91 long-term and 119 non-long-term night-shift nurses were collected. A sub-data analysis approach was used and t-test, chi-square, Pearson`s correlation, and hierarchical multiple regression were used to conduct statistical analysis. RESULTS: A positive correlation between cardiovascular risk and workplace fatigue was found in the long-term night-shift working group. Moreover, a lower average duration of sleep was found in the non-long-term night-shift working group. Finally, the participants with workplace fatigue and metabolic syndrome were found to have higher levels of cardiovascular risk. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Nursing staff who work night shifts for long-term and non-long-term periods should all receive regular health check-ups and practice healthy eating, exercise, and sleep habits. Employers should provide regular health checkups to their nursing staff and implement measures to identify health hazards in accordance with laws on labor standards, occupational safety, and health and labor health protection regulations, and then adopt appropriate plans and necessary safety and health measures to achieve a mutually beneficial result for both employers and employees in the healthcare industry.

[Lower Extremity Exercise Improves Functional Fitness, Physiological Indexes, Exercise Self-Efficacy, Sleep Quality, and Mental Health in Middle-Aged and Older Individuals].

BACKGROUND: Middle-aged and older individuals suffer from skeletal muscle loss due to aging, increasing the risk of sarcopenia. Muscular dystrophy reduces lower-extremity muscle endurance. The annual incidence of falls in the community is about 30-40%. Falls contribute to disability and fractures, affect quality of life, reduce mental health, and, in severe cases, result in death. Therefore, preventing lower limb muscle weakness in middle-aged and older individuals should be taken seriously. PURPOSE: The purpose of this study was to promote community health with a focus on older, community-dwelling individuals. The effects of a lower-extremity exercise intervention on middle-aged and older individuals in terms of improving functional fitness, physiological indexes, exercise self-efficacy, sleep quality, and mental health were explored. METHODS: This study used convenience sampling to recruit community residents over 55 years old as participants, with 50 participants assigned to the control group and to the experimental group, respectively. The experimental group participated in a 50-min lower extremity exercise intervention three times a week for 12 weeks. Differences in functional fitness, basic physiological index, exercise self-efficacy, sleep quality, and mental health variables between the two groups were assessed at the conclusion of the intervention. RESULTS: The lower-extremity muscle exercise program significantly improved functional fitness, physiological indexes, exercise self-efficacy, sleep quality, and overall mental health status in the experimental group, as compared to the control group (p < .05). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: It is recommended that the concept and application of lower extremity movement intervention should be popularized among middle-aged and older individuals to promote physical and mental health, prevent the decline and loss of lower extremity muscle strength, and help realize healthy aging goals.

[Improving Depression, Hope, and Quality of Life in Dialysis Patients Using Health Promotion Education Groups].

BACKGROUND: Taiwan has the highest incidence and prevalence of dialysis in the world. The literature suggests that severity of depression at the beginning of dialysis treatment is an independent predictor of survival. Depression significantly worsens the condition of chronic renal disease patients, with the adverse consequences of depression including increased mortality and hospitalization rates as well as poor compliance and quality of life. Given the importance of this problem, providing safe and effective information and good nursing care to dialysis patients is urgently needed. PURPOSE: The purpose of this study was to explore the effects of implementing health promotion education groups on self-perceived depression, hope, and quality of life in dialysis patients. METHODS: Dialysis patients who met the study criteria and had provided consent to participate in the health promotion education group were randomly assigned to either the treatment group (20 persons) or the control group (20 persons). In the control group, routine dialysis treatment and nursing care were maintained. In addition to receiving routine dialysis treatment and nursing care, the experimental group participated in health promotion education group activities for 90 minutes, twice a week for a total of 8 sessions. The quantitative data from both groups and the qualitative data analysis of the experimental group were used to assess the effects of the intervention. RESULTS: The results showed that the intervention had significantly improved self-perceived depression, hope, and quality of life in the experimental group. The participants indicated that the health promotion education group had helped them learn to adapt to their physical conditions, change their mindset, learn to regard happiness as the purpose of life, and maintain hope and increase mutual support in the face of difficulties. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study demonstrated that the cross-disciplinary integrated care provided through health promotion education groups is able to significantly improve depression, hope, and quality of life in dialysis patients. Thus, health promotion education groups arranged by the case management nurses for dialysis patients have the potential to promote mental health and quality of life in these patients. Therefore, continuing education is recommended to strengthen the awareness and knowledge of dialysis case management nurses with regard to applying integrated cross-disciplinary care in health promotion education groups and to promoting the implementation of these groups in the holistic care of dialysis patients.

Effects of Artificial Intelligence on Surgical Patients' Health Education.

Today, the various abilities that nurses require to meet patients' healthcare needs adequately are all affected by AI-enabled systems. This research used an experimental study design in which 60 subjects were randomly assigned to either an experimental (AI image e-book guidance) group or a control (text paper guidance) group after meeting the admission conditions and agreeing to participate in the study. It was proven that providing AI image e-book guidance before surgery significantly changed the behavior of patients and promoted relief of urinary catheter discomfort through self-efficacy to reduce urinary catheter pain after surgery (p < 0.001). It was found that providing AI image e-book guidance can shorten the time for health education and provide patients with repeated medical education and familiarity with health guidance, which can help to address the important clinical service demand issue and the shortage of nursing staff.

Effectiveness of Advanced Fire Prevention and Emergency Response Training at Nursing Homes.

In long-term care facilities, there are many residents aged 65+ who do not have the ability to seek shelter by themselves in the case of an emergency. Therefore, it is extremely important that nursing home staff be equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. The purpose of this study was to discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes, and the relationship and predictivity of awareness to self-efficacy. We used a quasi-experimental research method and recruited staff from two nursing homes through purposive sampling, using a two-team pre- and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool was the "Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale", which was used to compare the effectiveness of advanced and general fire safety training. After receiving improved advanced fire safety training, the total score and the result of the experiment group in fire prevention and emergency response awareness and self-efficacy were both better than those of the control group who had received only general fire safety training (p < 0.001); fire prevention and emergency response awareness had a significant and positive correlation with self-efficacy (r = 0.601, p < 0.001), and awareness was a significant predictor variable of self-efficacy (ß = 0.601, p < 0.001). This study finds that the key to improving learning effectiveness includes adding a fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duties and responsibilities for staff fire defense formation, thereby enabling mutual responsive support for the needs of the site. Moreover, becoming familiarized with the knowledge requires the appropriate frequency of training and enhancement of the staff's awareness of fire prevention and emergency response, which is the most important key to learning effectiveness.