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1.
BMC Health Serv Res ; 24(1): 1071, 2024 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-39285375

RESUMEN

BACKGROUND: In the literature, obesity has been correlated with coronary artery diseases (CADs) and high health costs. This study aimed to investigate the relationships between obesity parameters and the health costs among patients with CADs undergoing cardiac catheterization. METHOD: A secondary data analysis was done for an original study. The original study was conducted among 220 hospitalized patients undergoing cardiac catheterization from two main hospitals located in the Middle and Northern regions of Jordan. Bivariate Pearson's correlation and forward linear regression analysis were calculated in this study. RESULTS: The average health cost for the participants was 1,344 JOD (1,895.63 USD). A significant positive moderate correlation (r = 0.4) was found between hip circumference (HC) and health cost. There were significant positive weak correlations between low-density lipoprotein (LDL), triglycerides, high-sensitivity C-reactive protein (HS-CRP), hemoglobin A1c (HbA1c), and depression, and the health cost (correlation coefficient 0.17, 0.3, 0.29, 0.22 and 0.17, respectively. HC, waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and body adiposity index (BAI) were significantly associated with health costs among male participants. In contrast, among females, none of the obesity parameters was significantly associated with health costs. The forward regression analysis illustrated that an increase of HC by 3.9 cm (ß (0.292) * SD (13.4)) will increase the health cost by 1 JOD (0.71 USD). The same analysis revealed that HS-CRP increased by 0.4 mg/dl (ß (0.258)*SD (1.43)), or triglycerides increased by 8.3 mg/dl (ß (0.241)* SD (34.3)), or depression score increased by 0.32 score (ß (0.137)* SD (2.3)), or total cholesterol increased by 4 mg/dl (ß (0.163)* SD (24.7)), the health cost will increase by one JOD (0.71 USD). CONCLUSION: Healthcare providers, including nurses, should significantly consider these factors to reduce the health costs for those at-risk patients by providing the appropriate healthcare on time.


Asunto(s)
Cateterismo Cardíaco , Enfermedad de la Arteria Coronaria , Obesidad , Humanos , Masculino , Femenino , Enfermedad de la Arteria Coronaria/economía , Cateterismo Cardíaco/economía , Persona de Mediana Edad , Jordania , Anciano , Costos de la Atención en Salud/estadística & datos numéricos , Adulto
2.
Holist Nurs Pract ; 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39166821

RESUMEN

Compassion fatigue is a syndrome defined by both mental and physical restlessness. Mindfulness intervention can enhance one's emotions with nonjudgmental awareness and greater consciousness of thoughts and feelings. This study aims to examine the effect of mindfulness intervention on compassion fatigue among nurses. A randomized controlled trial was conducted, recruiting 100 nurses from three hospitals and dividing participants into an intervention and a control group. Increased mindfulness awareness was found in the comparison group in the research. The intervention group's mean burnout level was significantly lower than the comparison group. Age, gender, marital status, household size, and household income were among the sociodemographic factors that significantly correlated with compassion fatigue, which was determined through burnout and secondary traumatic stress. Nurses reported significant levels of compassion fatigue; however, this was significantly decreased through mindfulness intervention.

3.
Sci Rep ; 14(1): 5084, 2024 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-38429355

RESUMEN

Sleep disturbance (SD) makes it difficult for nurses in intensive care units (ICUs) to perform activities that require focused and continual concentration, which raises the risk of medical errors, health issues, loss of sleep, and patient care mistakes. The mindfulness intervention (MI) was created to give participants the capacity to approach their own emotions with non-judgmental awareness and to become more conscious of their thoughts and feelings, and it reduced psychological symptoms. This study examined the effect of MI on SD among nurses. A randomized control trail (RCT) was conducted and recruited 100 nurses from intensive care and medical-surgical units from three hospitals located at the northern and middle regions of Jordan. Bivariate analysis including independent T-test and multiple linear regressions were used to study the differences between the interventional group (MI) and the comparison group (watching mindfulness videos) in terms of the impact on the SD. Nurses reported significant and high levels of SD. MI significantly reduced the level of SD and improved sleep quality among nurses. MI should be integrated into nursing competences to combat the negative impacts of poor sleep quality on nurses and organizational-sensitive outcomes.


Asunto(s)
Atención Plena , Trastornos del Inicio y del Mantenimiento del Sueño , Trastornos del Sueño-Vigilia , Humanos , Emociones , Sueño , Trastornos del Sueño-Vigilia/terapia
4.
Medicine (Baltimore) ; 102(51): e36731, 2023 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-38134084

RESUMEN

There is a strong association between obesity and coronary artery disease (CAD). Obesity is measured using traditional obesity parameters, such as body mass index, body adiposity index, waist circumference (WC), and hip circumference. The aim of this study is to explore the association between traditional obesity parameters and the length of stay (LOS) among hospitalized CAD patients. An original correlative descriptive study was carried out using secondary data analysis, in which 220 hospitalized Jordanian CAD patients were recruited from Jordan northern and middle regions. Age, WC, triglycerides, and high- sensitivity C-reactive protein were all positive predictors of the total hospital LOS among hospitalized patients with CAD. The WC, age, triglycerides, and high-sensitivity C-reactive protein levels were significantly positively associated with total LOS. Healthcare providers, including nurses, should take into account these significant positive predictors of LOS to achieve better health outcomes and improve patient satisfaction.


Asunto(s)
Enfermedad de la Arteria Coronaria , Humanos , Enfermedad de la Arteria Coronaria/epidemiología , Enfermedad de la Arteria Coronaria/complicaciones , Estudios Transversales , Proteína C-Reactiva , Tiempo de Internación , Factores de Riesgo , Obesidad/complicaciones , Obesidad/epidemiología , Circunferencia de la Cintura , Índice de Masa Corporal , Triglicéridos , Relación Cintura-Cadera
5.
Medicina (Kaunas) ; 59(10)2023 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-37893441

RESUMEN

Background and Objectives: This cross-sectional study examined the predictors of negative and positive affect among individuals with dementia. Materials and Methods: A sample of 102 Jordanian participants diagnosed with dementia was recruited from residential care facilities, and data were collected using different measures. Results: The results revealed that higher levels of negative affect were significantly associated with increased physical and verbal agitation among individuals with dementia. Conversely, lower levels of positive affect were associated with residing in a nursing home. Conclusions: These findings highlight the importance of recognizing the impact of both negative and positive affect on the well-being of individuals with dementia. Interventions targeting the reduction of negative affect and promoting positive affect could alleviate agitation and enhance emotional closeness in this population.


Asunto(s)
Demencia , Casas de Salud , Humanos , Estudios Transversales , Demencia/complicaciones , Demencia/psicología
6.
J Taibah Univ Med Sci ; 18(6): 1288-1298, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37275956

RESUMEN

Objectives: Diaper dermatitis (DD) is one of the most common dermatological disorders in children. Commonly used drugs for treatment have several adverse effects; therefore, assessment of safe therapeutic strategies is necessary. We, therefore, aimed at comparing the efficacy of argan spinosa oil and 1% hydrocortisone ointment on DD healing. Methods: A quasi-experimental study was conducted in Jordan on children 2 years old or younger with mild to severe DD. Initially, 73 participants were enrolled in the argan spinosa oil group, and 74 participants were enrolled in the 1% hydrocortisone ointment group. Participants were assigned to groups randomly after the baseline measurement of DD. Healing was measured on a 5-point scale on days 1, 3, and 7, through home visits. Data were analyzed with Fisher's exact test, the Mann-Whitney U test, and generalized estimating equation (GEE) models in SPSS version 25 software, with a significance level of p < 0.05. Results: Of the 147 enrolled children, 140 completed the study. A significant decrease in the DD grades was observed in both groups. After the exclusion of confounding factors, the GEE models revealed that children treated with argan spinosa oil were approximately 0.25 times less likely to have severe DD grades and to show faster improvement than children treated with 1% hydrocortisone (p < 0.025). Multiple logistic regression on the baseline data revealed that the use of barrier cream (OR: 0.35; 95% CI: 0.18, 0.72; p = 0.004) and a frequency of bathing one or fewer times per week (OR: 1.15; 95% CI: 0.65, 2.10; p = 0.002) predicted DD occurrence. Conclusion: Argan spinosa oil is more effective than 1% hydrocortisone in healing DD and might be used as a complementary treatment. However, further clinical trials on larger samples will be essential for confirming the results and making a reliable judgment. Trial registration: NCT04210674.

7.
Pain Manag ; 13(2): 105-114, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36515086

RESUMEN

Aim: To examine critical care nurses' perceived barriers and enablers of pain assessment and management. Materials/methods: This descriptive correlational study recruited a convenience sample of 200 Jordanian nurses. Pain Assessment and Management for the Critically Ill questionnaire was used to measure the study variables. Results: The most common barriers to pain assessment and management were patient inability to communicate (57.5%), patient instability (56.5%), and the lack of protocols/guidelines for pain assessment (55.0%). Whereas the most common enablers for effective pain management practices were the ongoing education on pain for nurses (60.5%) and physicians who prescribe adequate doses of analgesia (60.0%). Conclusion: Addressing nurses' perceived barriers and the enablers of pain assessment and management is crucial for optimal pain practice.


This descriptive study recruited 200 Jordanian nurses to measure their perceived barriers and enablers of pain assessment and management in critical care patients. The most common barriers to pain assessment and management were the patient's inability to communicate, patient instability and the lack of guidelines for pain assessment. The most common enablers for effective pain management practices were the ongoing education on pain for nurses and physicians who prescribe adequate painkillers. Addressing nurses' perceived barriers and the enablers of pain assessment and management is crucial for optimal pain practice. The study has several implications for nursing education, practice and research.


Asunto(s)
Enfermeras y Enfermeros , Dolor , Humanos , Dimensión del Dolor , Dolor/diagnóstico , Manejo del Dolor , Encuestas y Cuestionarios , Cuidados Críticos
8.
Healthcare (Basel) ; 10(10)2022 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-36292297

RESUMEN

BACKGROUND: Ventilator-associated pneumonia (VAP) has been identified as a serious complication among hospitalized patients and is associated with prolonged hospitalizations and increased costs. The purpose of this study was to examine the knowledge, practices, compliance, and barriers related to ventilator-associated pneumonia among critical care nurses in the eastern Mediterranean region. METHODS: The PRISMA guidelines guided this systematic review. Four electronic databases (EMBASE, MEDLINE (via PubMed), SCOPUS, and Web of Science) were used to find studies that were published from 2000 to October 2021. RESULTS: Knowledge of ventilator-associated pneumonia was the highest outcome measure used in 14 of the 23 studies. The review results confirmed that nurses demonstrated low levels of knowledge of ventilator-associated pneumonia, with 11 studies assessing critical care nurses' compliance with and practice with respect to ventilator-associated pneumonia. Overall, the results showed that most sampled nurses had insufficient levels of compliance with and practices related to ventilator-associated pneumonia. The main barriers reported across the reviewed studies were a lack of education (N = 6), shortage of nursing staff (N = 5), lack of policies and protocols (N = 4), and lack of time (N = 4). CONCLUSIONS: The review confirmed the need for comprehensive interventions to improve critical care nurses' knowledge, compliance, and practice toward ventilator-associated pneumonia. Nurse managers must address barriers that impact nurses' levels of knowledge, compliance with, and practices related to ventilator-associated pneumonia.

9.
Int J Clin Pract ; 2022: 8676274, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36160288

RESUMEN

Background: Obesity has been reported to be associated with frailty and coronary artery disease (CAD). Objective: The present study aimed to investigate the role of the seven traditional obesity parameters body mass index (BMI), waist-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), body shape index (BSI), waist circumference (WC), and hip circumference (HC) in the prediction of frailty among CAD patients undergoing cardiac catheterization. Design: A secondary data analysis was conducted. Setting. Three main hospitals were located at the northern and middle regions of Jordan. Participants. 220 hospitalized patients undergoing cardiac catheterization were recruited. Measurements. The traditional obesity parameters were measured using an anthropometric tape and weight scale and frailty was measured using the Tilburg Frailty Indicator (TFI). Data were analyzed using bivariate Pearson's correlation and forward linear regression analysis. Results: Total cholesterol, HC, triglycerides, age, random blood sugar, and WC had significant positive associations with and were predictors of frailty (p < 0.05). The model of the seven predictors explained 32.4% of the variance in frailty (p = 0.02). Conclusion: The incidence of frailty can be predicted by the increase in total cholesterol, HC, triglycerides, age, random blood sugar, and WC. The results of this study may help healthcare providers, including nurses, to identify the factors that could lead to frailty among CAD patients undergoing cardiac catheterization.


Asunto(s)
Enfermedad de la Arteria Coronaria , Fragilidad , Glucemia , Índice de Masa Corporal , Cateterismo Cardíaco , Colesterol , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/epidemiología , Fragilidad/diagnóstico , Humanos , Obesidad/epidemiología , Factores de Riesgo , Triglicéridos , Circunferencia de la Cintura , Relación Cintura-Cadera
10.
Sci Rep ; 12(1): 13830, 2022 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-35970873

RESUMEN

The correlation between obesity and coronary artery disease (CAD) has been well-documented in the literature. Body mass index, waist-height ratio, waist-hip ratio, body adiposity index, body shape index, waist circumference, and hip circumference are traditional obesity parameters used to measure obesity. This study aimed to investigate the role of these traditional obesity parameters in the prediction of the number of stenosed coronary arteries (≥ 60%) among patients undergoing cardiac catheterization. A descriptive cross-sectional study was conducted among 220 hospitalized patients undergoing cardiac catheterization in two hospitals in Jordan. Bivariate Pearson's correlation and forward linear regression analysis were used in the current study. Hip circumference was identified as being the best predictor of CAD (r = 0.5), with the best cut-off value of 103 cm (sensitivity = 0.92, specificity = 0.58). Hip circumference had significant regression levels with the number of stented coronary arteries (P = 0.002) and the number of severe stenosed coronary arteries (P = 0.04). The second-best obesity parameter in predicting CAD was waist circumference (r = 0.4), with a cut-off value of 0.95 m (sensitivity = 0.76, specificity = 0.68). High-sensitivity C-reactive protein (HS-CRP), triglycerides, and smoking had significant positive correlations with the number of stented coronary arteries (P < 0.05). Hip circumference of ≥ 103 cm, increased serum level of triglycerides, HS-CRP, and being a smoker are all factors which can predict CAD or the risk of developing it.


Asunto(s)
Proteína C-Reactiva , Enfermedad de la Arteria Coronaria , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Cateterismo Cardíaco , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/epidemiología , Estudios Transversales , Humanos , Obesidad , Triglicéridos , Circunferencia de la Cintura , Relación Cintura-Estatura , Relación Cintura-Cadera
11.
PLoS One ; 17(7): e0270711, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35776738

RESUMEN

BACKGROUND: Early assessment and management of patients with sepsis can significantly reduce its high mortality rates and improve patient outcomes and quality of life. OBJECTIVES: The purposes of this review are to: (1) explore nurses' knowledge, attitude, practice, and perceived barriers and facilitators related to early recognition and management of sepsis, (2) explore different interventions directed at nurses to improve sepsis management. METHODS: A systematic review method according to the PRISMA guidelines was used. An electronic search was conducted in March 2021 on several databases using combinations of keywords. Two researchers independently selected and screened the articles according to the eligibility criteria. RESULTS: Nurses reported an adequate of knowledge in certain areas of sepsis assessment and management in critically ill adult patients. Also, nurses' attitudes toward sepsis assessment and management were positive in general, but they reported some misconceptions regarding antibiotic use for patients with sepsis, and that sepsis was inevitable for critically ill adult patients. Furthermore, nurses reported they either were not well-prepared or confident enough to effectively recognize and promptly manage sepsis. Also, there are different kinds of nurses' perceived barriers and facilitators related to sepsis assessment and management: nurse, patient, physician, and system-related. There are different interventions directed at nurses to help in improving nurses' knowledge, attitudes, and practice of sepsis assessment and management. These interventions include education sessions, simulation, decision support or screening tools for sepsis, and evidence-based treatment protocols/guidelines. DISCUSSION: Our findings could help hospital managers in developing continuous education and staff development training programs on assessing and managing sepsis in critical care patients. CONCLUSION: Nurses have poor to good knowledge, practices, and attitudes toward sepsis as well as report many barriers related to sepsis management in adult critically ill patients. Despite all education interventions, no study has collectively targeted critical care nurses' knowledge, attitudes, and practice of sepsis management.


Asunto(s)
Enfermeras y Enfermeros , Sepsis , Adulto , Competencia Clínica , Enfermedad Crítica , Humanos , Calidad de Vida , Sepsis/diagnóstico , Sepsis/terapia
12.
Heliyon ; 8(7): e09752, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35800254

RESUMEN

Background: It is well-established in the literature that coronary artery disease (CAD) is a risk factor for depression and that depressive symptoms inversely affect the development and progression of CAD. No published studies have examined the relationship between depression and adherence to healthy lifestyle behaviors among patients with CAD in Jordan. Therefore, the purpose of this study is to investigate the impact of depression on adherence to healthy lifestyle behaviors among CAD patients in Jordan. Methods: A correlational, cross-sectional study of convenience sample of 130 patients with CAD was conducted from out-patient cardiac clinics in a university-affiliated hospital and government-operated hospital in Northern Jordan. Data were collected using self-administered questionnaires on depression and adherence to healthy lifestyle behaviors among CAD patients. Results: Our data showed that 41% of the participants were non-adherent to healthy lifestyle behaviors, especially in the areas of physical activity (6.2%), maintaining a healthy diet (24.6%), and weight loss (26.15%). Gender, smoking status, and number of cardiac catheterization procedures were found to be significant predictors of patient adherence to healthy lifestyle behaviors. Although depressive symptoms were present in 56.9 % of the participants, depression was not found to be a significant predictor of adherence to healthy lifestyle behaviors among our sample. Conclusion: There was no significant relationship between depression and adherence to healthy lifestyle behaviors among CAD patients in Jordan. Physical activity, maintaining a healthy diet, and weight loss were the least lifestyle behaviors that were adopted, while quitting smoking and medication compliance were the most adopted behaviors among the patients. Our study provides valuable data regarding the levels and predictors of adherence to healthy lifestyle behaviors among CAD patients with CADs. Implications for future research and practice are addressed.

13.
Nurse Educ Today ; 110: 105270, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35051870

RESUMEN

BACKGROUND: Nurses have a key role in the early assessment and management of sepsis, which is crucial for optimal quality of care and better patient outcomes. However, sepsis in critical care patients is underrecognized and untreated due to nurses' poor knowledge, attitudes, practice, and decision-making skills related to sepsis assessment and management. OBJECTIVES: This study aimed to test the effectiveness of branching simulations in improving nurses' knowledge, attitudes, practices, and decision-making related to sepsis assessment and management. METHODS: This experimental study was conducted on a convenience sample of 70 nurses (35 nurses in each of the intervention and control groups) with at least one year of experience working in an emergency room at a university hospital. The nurses' knowledge, attitudes, and practices were measured using a knowledge, attitudes, and practices survey, whilst their decision-making modes were assessed using the Nursing Decision-Making Instrument. RESULTS: Compared to the control group, a significant improvement in practices (F (1, 68) = 10.77, p = 0.002, η2 = 0.137) and decision-making (F (1, 68) = 10.68, p = 0.002, η2 = 0.136) was observed among the nurses in the intervention group both immediately and two weeks post the branching simulations intervention. Compared to the baseline data, a significant improvement in knowledge (F (2, 136) = 27.93, p < 0.001, η2 = 0.291), practices (F (2, 136) = 41.00, p < 0.001, η2 = 0.376), and decision-making modes (F (2, 136) = 29.15, p < 0.001, η2 = 0.300) was observed both immediately and two weeks post branching simulations only among the nurses in the intervention group. CONCLUSIONS: Education programs integrated with an interactive strategy of learning (branching simulations) can improve nurses' knowledge, attitude, practice, and decision-making related to sepsis assessment and management. Therefore, continuous education and professional training programs following an evidence-based intervention protocol/guideline are recommended for better nurse and patient outcomes.


Asunto(s)
Enfermeras y Enfermeros , Sepsis , Competencia Clínica , Conocimientos, Actitudes y Práctica en Salud , Humanos , Sepsis/diagnóstico , Sepsis/terapia , Encuestas y Cuestionarios
14.
Pain Manag ; 12(4): 461-469, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35001650

RESUMEN

Aim: This study examined the use of analgesics and associated factors among nursing home residents (NHRs). Materials & methods: A descriptive correlational design and a convenience sample of 209 NHRs receiving analgesics was used in this study. Results: Higher use of analgesics was noted among NHRs without cognitive impairment (p < 0.001), those with higher anticholinergic burden scores (p = 0.002) and those with a higher average number of oral pills taken daily (p = 0.045). Conclusion: These findings contribute to a better understanding of the prevalence and associated factors of analgesic use, which will inform the development and application of evidence-based pain practice and guidelines in nursing homes in Jordan and beyond.


This study looked at the use of pain killers among 209 older adults residing in a nursing home in Jordan. The study found higher prescriptions for pain killers among nursing home residents who did not have cognitive impairment, those who were taking more drugs that blocked the neurotransmitter acetylcholine and those who took a higher average number of oral pills per day. The results of our study contribute to a better understanding of the use of pain killers in nursing home residents, which will inform the development and application of better pain practices in nursing homes in Jordan and beyond.


Asunto(s)
Analgésicos , Casas de Salud , Analgésicos/efectos adversos , Humanos , Dolor/tratamiento farmacológico , Dimensión del Dolor , Prevalencia
15.
Clin Nurs Res ; 31(3): 364-375, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34412541

RESUMEN

The prevalence of prehospital delay is high among older adults with acute coronary syndrome (ACS). The current study aimed to examine the associated factors of prehospital delay among patients with ACS during the COVID-19 pandemic. This cross-sectional study was conducted on a convenience sample of 300 older adults with ACS admitted to the emergency department in Jordan. Data were collected from June 1 to September 1, 2020. Bivariate and multivariate analyses were used to explore the predictors of prehospital delay. Being widowed, educational level, pain intensity, the gradual onset of ACS symptoms, symptoms lasting for more than 30 minutes, patients' feeling anxious about their ACS symptoms, patients' perceiving their symptoms to be particularly dangerous, history of myocardial infarction (MI), and mode of transportation were associated with the time taken before seeking emergency care. Significant predictors of time to seek help were chief complaint of chest pain or palpitations, abrupt onset of symptoms, the associated symptom of vertigo, and a higher number of chronic illnesses; they explained about 17.9% of the variance in the time to seek care. The average time to seek care among patients with ACS during the COVID-19 pandemic was found to be longer than the average time reported by studies conducted prior the pandemic. Improved understanding of the associations between prehospital delay is crucial for optimal ACS patient outcomes under the impacts of the COVID-19 pandemic.


Asunto(s)
Síndrome Coronario Agudo , COVID-19 , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/epidemiología , Síndrome Coronario Agudo/terapia , Anciano , COVID-19/epidemiología , Estudios Transversales , Servicio de Urgencia en Hospital , Hospitales , Humanos , Tiempo de Internación , Pandemias
16.
Heliyon ; 7(12): e08529, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34926859

RESUMEN

OBJECTIVE: Perioperative poor glycemic control in diabetic patients undergoing Coronary Artery Bypass Graft (CABG) surgery has been associated with infectious complications, particularly surgical site infections that are linked with adverse health surgical outcomes. The purpose of this study was to investigate the effect of two different intraoperative glycemic control protocol, tight and conventional, on thirty-day postoperative surgical site infection (SSI) rates among diabetic patients undergoing CABG surgery. DESIGN: A randomized controlled trial (RCT) design was employed in the study, with a convenience sample of 144 adult patients who were scheduled to undergo coronary artery bypass grafting surgery. SETTING: A main referral heart institute in Amman, Jordan. PARTICIPANTS: Subjects were randomly assigned to either the tight glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 110-149 mg/dl via continuous intravenous insulin infusion, or the conventional glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 150-180 mg/dl via continuous intravenous insulin infusion. The postoperative SSIs among both groups were evaluated and compared by independent blinded physicians. RESULTS: The primary findings of this study indicated no statistically significant difference between the two treatment groups in terms of SSI rates and their potential adverse surgical outcomes (p = 0.512). CONCLUSION: Nurses should consider the glycemic stability and glycemic control approach to minimize adverse surgical outcomes post CABG surgery. Healthcare providers should also carefully consider diabetic patients who have undergone CABG surgery and are at risk of developing postoperative SSIs. CLINICALTRIALSGOV IDENTIFIER: NCT04451655 was retrospectively registered in 30/06/2020.

17.
J Wound Care ; 30(Sup12): S22-S28, 2021 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-34882005

RESUMEN

OBJECTIVE: Surgical site infection (SSI) is one of the most serious potential complications post cardiac surgery among patients with diabetes and has a number of adverse health outcomes. The literature shows discrepancies regarding the effect of different glycaemic control protocols on reducing adverse health outcomes including SSIs. The aim of this study was to conduct a systematic review that investigated the effect of the optimal range of tight glycaemic control protocols using a continuous insulin infusion on reducing the incidence of SSIs in adult patients with diabetes undergoing cardiac surgery. METHOD: A systematic review was conducted following the PRISMA statement and guidelines. Search terms were used to identify research studies published between 2000 and 2019 across five key databases, including CINAHL, Medline, PubMed, Cochrane Database and Google Scholar. RESULTS: A total of 12 studies met the review inclusion criteria. The reviewed literature tended to support the implementation of a tight glycaemic control protocol, particularly in the postoperative phase, that demonstrated fewer potential complications associated with cardiac surgery. On the other hand, the literature also supported the application of a moderate glycaemic control protocol in the intraoperative phase to obtain better glycaemic stability with fewer potential complications among those patients with diabetes undergoing cardiac surgery. CONCLUSION: This analysis concludes that tight glycaemic control is more effective than moderate glycaemic control intraoperatively in terms of glycaemic stability among patients with diabetes undergoing cardiac surgery. Results also emphasised the importance of time-based protocol implementation to ensure better health outcomes and better quality of care for patients.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Infección de la Herida Quirúrgica , Adulto , Glucemia , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Control Glucémico , Humanos , Insulina/uso terapéutico , Infección de la Herida Quirúrgica/prevención & control
18.
Dement Geriatr Cogn Disord ; 50(5): 407-413, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34929708

RESUMEN

INTRODUCTION: Suffering from both frailty and poverty may have significant negative consequences on older adults' lives. This study aimed to conduct a systematic review to investigate the relationship between frailty and low income among older adults. METHODS: This systematic review was guided by the PRISMA guidelines and was aimed at exploring the frailty in older adults with low income and evaluating the robustness of the synthesis. Cross-sectional and longitudinal studies published in English between 2008 and 2020 were identified using search terms entered into the following databases: CINAHL, Medline, Google Scholar, and PubMed. RESULTS: Nine articles met the inclusion criteria. This review revealed a positive relationship between frailty and poverty. Such a relationship could be explained through 3 dimensions of the relationship between frailty and poverty among older adults identified based on the findings of the reviewed studies. DISCUSSION/CONCLUSION: The social life, environmental conditions, and financial issues were positively correlated and coexisted with both frailty and poverty. Frailty should be treated on a holistic basis, considering financial issues. Among these financial issues is poverty, which disrupts older adults' social activities, hinders them from building successful social relationships, and reduces their quality of life.


Asunto(s)
Fragilidad , Anciano , Estudios Transversales , Anciano Frágil , Humanos , Estudios Longitudinales , Pobreza , Calidad de Vida
19.
J Pain Res ; 14: 3475-3491, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34764688

RESUMEN

AIM: This review aims to examine nurses' perceived barriers to and facilitators of pain assessment and management in adult critical care patients. BACKGROUND: Pain is one of the worst memories among critically ill patients. However, pain among those patients is still undertreated due to several barriers that impede effective management. Therefore, addressing the perceived barriers and facilitators to pain assessment management among critical care nurses is crucial. METHODS: A systematic search of pain assessment and management in critical care patient-relevant literature from four databases was done, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The barriers and facilitators were categorized into four groups: nurse-related, patient-related, physician-related, and system-related. The most frequently reported barriers in this study included nurses' lack of knowledge regarding the use of pain assessment tools, patients' inability to communicate, physicians' prescription of analgesics being independent of pain scores evaluation, and absence of standardized guidelines and protocols for pain evaluation and control. For the facilitators, the most reported ones include ongoing education and professional training related to pain assessment and management, patients' ability to self-report pain, effective collaboration between physicians and nurses, and productive discussion of patients' pain scores during nurse-to-nurse handovers. CONCLUSION: Various barriers and facilitators to pain assessment and management were identified and examined in this review. However, future research is still needed to further investigate these barriers and facilitators and examine any other potential associated factors among critical care nurses. RELEVANCE TO CLINICAL PRACTICE: The findings of our study could help hospital managers in developing continuous education and staff development training programs on assessing and managing pain for critical care patients. Also, our findings could be used to develop an evidence-based standard pain management protocol tailored to effectively assess and promptly treat pain in critical care patients.

20.
Dement Geriatr Cogn Disord ; 50(4): 357-363, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34569493

RESUMEN

BACKGROUND: Frailty syndrome is characterized by a decline in physiological and psychological reserve and may be associated with poor health outcomes. OBJECTIVES: The current study explored frailty and its correlates among cognitively intact community-dwelling older adults. METHODS: A secondary analysis of data collected from 109 community-dwelling older adults who are cognitively intact was conducted for the purpose of this study. The Arabic versions of the culturally adapted Tilburg Frailty Indicator, the Montreal Cognitive Assessment, the Geriatric Depression Scale, and the Short Form-36 Quality of Life (QOL) survey. Multiple linear regression was used to examine the relationships between frailty and depression. RESULTS: The results indicated a high prevalence of frailty (78%) and depression (38%) among cognitively intact community-dwelling older adults. Frailty was found to be associated with increased age, being single or illiterate, living alone, having a high number of comorbid conditions, having high rate of depression, and having poor QOL. CONCLUSION: High prevalence of frailty is associated with high depression scores, a high number of comorbid conditions, and poor QOL among cognitively intact community-dwelling older adults.


Asunto(s)
Fragilidad , Anciano , Anciano Frágil , Fragilidad/diagnóstico , Fragilidad/epidemiología , Evaluación Geriátrica , Ambiente en el Hogar , Humanos , Vida Independiente , Calidad de Vida
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