Effectiveness of nursing interventions for preoperative anxiety in adults: A systematic review with meta-analysis.

AIMS: The aim of this review and meta-analysis is to analyse the effectiveness of nursing interventions for the management of preoperative anxiety in adults. BACKGROUND: The perioperative process is a stressful situation for many people who are going to be operated and it can generate feelings of anxiety. Also, preoperative anxiety can appear in the perioperative period. Nursing management of preoperative anxiety through individualized interventions can be effective for reducing anxiety. DESIGN: A systematic review with meta-analysis was performed. DATA SOURCES: CINAHL, CUIDEN, Pubmed, ProQuest and Scopus databases were consulted without restriction per year of publication. The search was conducted in February 2020. REVIEW METHODS: Experimental studies on nursing management in preoperative anxiety with adults sample (>18 years) published in English and/or Spanish were included. All types of surgery were included in the review. A random effects meta-analysis was performed to estimate the effect size for preoperative anxiety measured with STAI. RESULTS: After the selection process n = 9 quantitative studies with nursing interventions for preoperative anxiety were included. A preoperative educational and informative interview was used in six studies, one study used empathic interview, one used motivational interview and one used hand massage. The meta-analysis, including four studies using nursing interviews, had a sample of n = 419 in the intervention group and n = 445 in the control group. The mean difference in preoperative state anxiety measured with the STAI was in favour of the nursing intervention. CONCLUSION: Nursing interventions for patients who are going to be operated seems to have a positive impact in their preoperative anxiety. However, due to the low number of studies and the heterogeneity of the sample, more research is needed about the topic.

Nurses Training and Capacitation for Palliative Care in Emergency Units: A Systematic Review.

Palliative care (PC) prevents and alleviates patients´ suffering to improve their quality of life in their last days. In recent years, there has been an increase in visits to the emergency services (ES) by patients who may need this type of care. The aims were to describe the training and capacitation of nurses from ES in PC. Accordingly, a systematic review was performed. Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used. The search equation was "Palliative care and nursing care and emergency room". A total of 12 studies were selected. The studies agree on the need for training professionals in PC to provide a higher quality care, better identification of patient needs and to avoid unnecessary invasive processes. Similarly, the implementation of a collaborative model between ES and PC, the existence of a PC specialized team in the ES or proper palliative care at home correspond to a decrease in emergency visits, a lower number of hospitalizations or days admitted, and a decrease in hospital deaths. The development of PC in the different areas of patient care is necessary. Better palliative care leads to a lower frequency of ES by terminal patients, which has a positive impact on their quality of life. Access to PC from the emergency unit should be one of the priority health objectives due to increment in the aged population susceptible to this type of care.

Evaluation of the Evolution of Digital Nursing Interventions in an Emergency Unit: An Observational Study.

This study aimed to examine the influence of new ICTs on the recording of nursing interventions in the Emergency Unit of the High Resolution Hospital (HRH) of Loja (Granada), Spain. A descriptive observational study was conducted to analyze the evolution of the Nursing Interventions (NIC) records in the Emergency Unit of the Loja HRH (Granada) from 2017 to 2021. Results showed that 11,076 NIC registrations were exploited, which increased by 51.2% from 2017 to 2021. The linear correlation between the NIC and the years was analyzed with Spearman's coefficient, obtaining a low level of correlation (p = 0.166), but one that is statistically significant (p < 0.001). The introduction of tablet devices in the emergency room of the Loja HRH (Granada) led to a significant increase in the percentage of NIC recorded and collated during the study period without increasing the number of emergencies attended. However, usability barriers of ICTs were detected, highlighting the need to guide and train health professionals in their use and in the culture of patient safety.

Using "Diraya" System as a Complementary Tool in Nursing Process Education: A Controlled Clinical Study.

Background: Healthcare has been revolutionized by the application of information and communication technologies. The implementation of electronic health record systems improves the quality and safety of patient healthcare. Nursing students who start learning the nursing process without contact with real patients experience difficulties in its correct application. Purpose: To compare the acquisition of skills and competencies in the nursing process by undergraduate nursing students between conventional learning with books and learning with an academic electronic health record system (Diraya). Methods: A controlled experimental study was conducted and included 379 students with a mean age of 20.54 ± 5.09 years, enrolled in the "Nursing Process and Basic Care" degree course at the School of Health Sciences in Granada. All participants gave their informed consent and were allocated by convenience sampling to a control group (n = 187; 21.20 ± 5.77 years) or an experimental group (n = 192, 19.91 ± 4.24 years). Findings: The experimental and control groups did not differ in sex distribution (p = 0.20), mean age (p = 0.01), or previous knowledge of the nursing process (p = 0.96). The groups did not significantly differ in multi-choice test results on the acquisition of theoretical knowledge (p = 0.13). However, the experimental group scored higher on clinical case planning (9.47 ± 0.80 vs. 8.95 ± 1.17; p < 0.001), took less time to complete it (46.9 ± 8.76 min vs. 82.66 ± 13.14 min; p < 0.001), and needed fewer autonomous learning hours to prepare for the final examination (2.26 ± 2.41 vs. 9.58 ± 3.83; p < 0.001). Satisfaction with the program and the rating of its quality were generally higher in the experimental group, while greater difficulty with most phases of the nursing process was reported by the control group. Conclusions: The academic electronic health record system "Diraya" is a useful tool to improve the learning and implementation of the nursing process by undergraduate nursing students.

Effect of a 16-Session Qigong Program in Non-Hodgkin Lymphoma Survivors: A Randomized Clinical Trial.

Background: The treatment associated with non-Hodgkin lymphoma patients may cause adverse effects on their physical and psychological condition. The aim of this study is to detect the response to an eight-week, 16-session, 60-min presential Qigong program in anxiety, depression and vagal nerve activity alongside a control group. Methods: A randomized controlled clinical trial was managed. Randomization was carried out by generating a numerical sequence of three cycles through the software EPIDAT 4.1. Numbers were placed in sealed opaque envelopes for assignment to the different groups. Results: Anxiety levels were substantially decreased in the experimental group, with a large effect size (F = 30.38, p < 0.00). Depression levels had an improvement in the experimental group in contrast to the control group, reaching statistical significance (F = 19.19, p < 0.00). Heart Rate Variability unveiled significant results in terms of between-group differences, with a large effect size in the HRV Index (F = 15.80, p < 0.00), SDNN (F = 8.82, p < 0.00), and RMSSD (F = 6.72, p < 0.01) in the time domain, and a medium effect size in the HF (F = 9.78, p < 0.003), LF (F = 9.78, p < 0.00), and LF/HF Ratio (F = 18.44, p < 0.00) in the frequency domain, which were all bettered in the experimental group, after the Qigong program. Conclusions: Qigong therapy can be an effective therapeutic activity in consonance with traditional medicine to improve psychological health and autonomic nervous system balance in non-Hodgkin lymphoma survivors.

Coping Strategies in Elderly Colorectal Cancer Patients.

In Spain, 34,331 new cases of colorectal cancer were diagnosed in 2018 and 15,923 individuals died from this disease in the same year. The highest incidence of colorectal cancer is among individuals aged 65-75 years and the physiological consequences of aging, alongside the effects of the disease and its treatment, can exacerbate their physical deterioration and cognitive impairment and reduce their social relationships. The learning of coping strategies may help to improve the quality of life of patients after cancer diagnosis. To test the hypothesis that the utilization of coping strategies can improve the quality of life of elderly patients with colorectal cancer, PubMed and EBSCO databases were searched, up to 2021, using the following terms: "coping strategies and colorectal cancer" with "anxiety", "quality of life", "depression", "unmet needs", "optimism", "intimacy", "distress", "self-efficacy" and "self-esteem" with Boolean operators "AND", "OR". The literature search retrieved 641 titles/abstracts written in English. After an exhaustive analysis, only 7 studies met the inclusion criteria. Randomized evidence was scant and was reported only in 3/7 of the studies analyzed. Data from available randomized evidence support that patients improved on their depression and quality of life and felt more prepared to deal with their cancer. Coping strategies in patients with colorectal cancer were effective in improving patient adaptation to their new situation. Healthcare professionals working with these patients should receive training in this complementary treatment, to be able to conduct comprehensive care in order to improve the quality of life of these patients.

Autonomic Imbalance in Lymphoma Survivors.

Among the types of blood cancers, non-Hodgkin lymphoma is the most common. The usual treatments for this type of cancer can cause heart failure. A descriptive observational study was conducted that included 16 non-Hodgkin lymphoma survivors and 16 healthy controls matched by age and sex. Vagal tone was evaluated in the short term with a three-channel Holter device, and the time and frequency domains were analyzed following a previously accepted methodology to evaluate cardiac autonomic balance. The results of the analysis revealed that the standard deviation of the NN interval (F = 6.25, p = 0.021) and the square root of the mean of the sum of the differences between NN intervals (F = 9.74, p = 0.004) were significantly higher in healthy subjects than in lymphoma survivors. In the heart rate variability (HRV) index, there were no significant differences between the groups (F = 0.03, p = 0.85), nor in the parameters of the frequency domains LF (F = 1.94, p = 0.17), HF (F = 0.35, p = 0.55), and the ratio LF/HF (F = 3.07, p = 0.09). HRV values were lower in non-Hodgkin lymphoma survivors in the first year after treatment, resulting in autonomic imbalance compared to healthy paired subjects.

Effects of Meditation on Mental Health and Cardiovascular Balance in Caregivers.

BACKGROUND: Caring for a loved one can be rewarding but is also associated with substantial caregiver burden, developing mental outcomes and affecting happiness. The aim of this study was to determine the effects of a four-week, 16-h presential meditation program on physiological and psychological parameters and vagal nerve activity in high-burden caregivers, as compared to a control group. METHODS: A non-randomized repeated-measures controlled clinical trial was conducted. RESULTS: According to the ANCOVA results, the global happiness score (F = 297.42, p < 0.001) and the scores for all subscales were significantly higher in the experimental group than in the control group at 5 weeks. Anxiety levels were also significantly reduced in the experimental group (F = 24.92, p < 0.001), systolic (F = 16.23, p < 0.001) and diastolic blood (F = 34.39, p < 0.001) pressures, and the resting heart rate (F = 17.90, p < 0.05). HRV results revealed significant between-group differences in the HRV Index (F = 8.40, p < 0.05), SDNN (F = 13.59, p < 0.05), and RMSSD (F = 10.72, p < 0.05) in the time domain, and HF (F = 4.82 p < 0.05)) in the frequency domain, which were all improved in the experimental group after the meditation program. CONCLUSIONS: Meditation can be a useful therapy to enhance the mental health and autonomic nervous system balance of informal caregivers, improving symptoms of physical and mental overload.

Analysis of the Anti-Vaccine Movement in Social Networks: A Systematic Review.

The aim of this study was to analyze social networks' information about the anti-vaccine movement. A systematic review was performed in PubMed, Scopus, CINAHL and CUIDEN databases. The search equations were: "vaccine AND social network" and "vaccine AND (Facebook[title] OR Twitter[title] OR Instagram[title] OR YouTube[title])". The final sample was n = 12, including only articles published in the last 10 years, in English or Spanish. Social networks are used by the anti-vaccine groups to disseminate their information. To do this, these groups use different methods, including bots and trolls that generate anti-vaccination messages and spread quickly. In addition, the arguments that they use focus on possible harmful effects and the distrust of pharmaceuticals, promoting the use of social networks as a resource for finding health-related information. The anti-vaccine groups are able to use social networks and their resources to increase their number and do so through controversial arguments, such as the economic benefit of pharmaceuticals or personal stories of children to move the population without using reliable or evidence-based content.

Study of the Predictive Validity of the Burnout Granada Questionnaire in Police Officers.

Professionals with burnout have negative physical and psychological effects, with adverse consequences in their workplace. Burnout mainly affects assisting professions; amongst them, police work is one of the professions at risk of suffering from this syndrome. The aim of this research is to study the adequacy of the Maslach Burnout Inventory and Granada Burnout Questionnaire instruments to measure burnout in police officers through the study of the reliability and validity (concurrent and predictive) of these instruments. A cross-sectional study was carried out. The sample was composed of 1884 police officers, mostly men (85.4%), with an average age of 35.04 (SD = 8.30). The Maslach Burnout Inventory and Granada Burnout Questionnaire were used to measure burnout. The results obtained in this study support the adequacy of both instruments for measuring burnout. The correlation coefficients between the dimensions are significant, with a medium-high magnitude. Participants with burnout had significantly higher scores in emotional exhaustion and depersonalization and lower scores in personal accomplishment in both instruments. The area under the curve estimated for the Granada Burnout Questionnaire provided evidence of the predictive validity of the instrument. The police profession needs validated and sensitive tools to identify police changes in the dimensions of burnout. The Granada Burnout Questionnaire instrument correctly classifies burnout in police professionals.

Play Therapy as an Intervention in Hospitalized Children: A Systematic Review.

BACKGROUND: Hospitalization disrupts children's lives and can produce feelings such as anxiety, fear, or pain. Playing is an important part of children's lives. Thus, it is necessary to ensure holistic care during the process, including play therapy. The aim of this study was to analyze the effect of therapeutic play in hospitalized children. METHODS: A systematic review was performed. The search was conducted in CINAHL (Cumulative Index of Nursing and Allied Health Literature), CUIDEN, and PubMed (Medline). The search equation was "pediatric nurs* AND play therapy". The search was performed in March 2020. RESULTS: n = 14 studies were included in the review. The studies reveal that the application of therapeutic play in hospitalized children decreases postoperative pain, improves behavior and attitude, and reduces anxiety during the hospital stay. CONCLUSIONS: play therapy has a beneficial impact on the care of hospitalized children and should be implemented in pediatric units after assessing the resources and training needed for pediatric nurses.

Anxiety prevalence in lymphoma: A systematic review and meta-analysis.

OBJECTIVE: Hodgkin and non-Hodgkin lymphoma patients are at high risk of experiencing anxiety because the clinical processes and therapies they undergo produce strong adverse effects. In this review we discuss the prevalence of anxiety among these patients and examine the methods used for data collection, intervention frequency, types of instruments used to recognize anxiety, and data collection purposes, both in Hodgkin and non-Hodgkin lymphoma survivors and patients being treated or diagnosed with these diseases. METHODS: This systematic review and meta-analysis of the literature was carried out using the following sources: PubMed, Scopus, LILACS, and PsycINFO. RESULTS: The meta-analysis sample was n = 2,138 and the overall prevalence of anxiety was 19% (95% CI [12%, 25%]). According to the Egger test, there were no publication biases and no studies were eliminated after the sensitivity analysis. The I2 for the heterogeneity analysis was 92.6%. CONCLUSIONS: Hodgkin and non-Hodgkin lymphoma patients are vulnerable to suffering anxiety. It is important to focus on the psychological effect of anxiety during remission or current cancer treatments because they can affect patient outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Burnout in Nursing Managers: A Systematic Review and Meta-Analysis of Related Factors, Levels and Prevalence.

Burnout syndrome is a major problem in occupational health, which also affects nursing managers. The main aim was to analyze the level, prevalence and risk factors of burnout among nursing managers. A systematic review with meta-analysis was conducted. The databases used were Medline (Pubmed), PsycINFO, CINAHL, LILACS, Scielo and Scopus. The search equation was "burnout AND nurs* AND (health manager OR case managers)". Nursing managers present high levels of emotional exhaustion and a high degree of depersonalization. Some studies show that variables like age, gender, marital status, having children or mobbing and other occupational factors are related with burnout. The prevalence estimation of emotional exhaustion with the meta-analysis was high; 29% (95% CI = 9-56) with a sample of n = 780 nursing managers. The meta-analytical estimation of the correlation between burnout and age was r = -0.07 (95% CI = -0.23-0.08). Work overload, the need to mediate personnel conflicts, lack of time and support from superior staff, contribute to the development of burnout among nursing managers.

Prevalence and Predictors of Burnout in Midwives: A Systematic Review and Meta-Analysis.

The prevalence of burnout in midwives has been briefly studied. Given the negative effects of burnout syndrome in the physical and mental health, and also related to the quality of care provided, rates of absenteeism and sick leave; identifying related factors for the syndrome are needed. The aim was to determine the prevalence, levels, and factors related to the burnout syndrome, measured with the Copenhagen Burnout Inventory in midwives. A systematic review and meta-analysis were selected from CINAHL, LILACS, ProQuest, PsycINFO, PubMed, SciELO, and Scopus databases, with the search equation "burnout AND (midwife OR midwives OR nurses midwives)". Fourteen articles were found with a total of 8959 midwives. Most of the studies showed moderate levels of personal burnout. The prevalence obtained was 50% (95% CI = 38-63) for personal burnout; 40% (95% CI = 32-49) for work-related burnout; and 10% (95% CI = 7-13) for client-related burnout. Midwives' age, less experience, and living alone constitute the main related factors, as well as, the scarcity of resources, work environment, and the care model used. Most midwives present personal and work-related burnout, which indicates a high risk of developing burnout. Personal factors and working conditions should be taken into account when assessing burnout risk profiles of midwives.