RESUMEN
ABSTRACT: Appropriate monitoring of opioid use in patients with pain conditions is paramount, yet it remains a very challenging task. The current work examined the use of a wearable sensor to detect self-administration of opioids after dental surgery using machine learning. Participants were recruited from an oral and maxillofacial surgery clinic. Participants were 46 adult patients (26 female) receiving opioids after dental surgery. Participants wore Empatica E4 sensors during the period they self-administered opioids. The E4 collected physiological parameters including accelerometer x-, y-, and z-axes, heart rate, and electrodermal activity. Four machine learning models provided validation accuracies greater than 80%, but the bagged-tree model provided the highest combination of validation accuracy (83.7%) and area under the receiver operating characteristic curve (0.92). The trained model had a validation sensitivity of 82%, a specificity of 85%, a positive predictive value of 85%, and a negative predictive value of 83%. A subsequent test of the trained model on withheld data had a sensitivity of 81%, a specificity of 88%, a positive predictive value of 87%, and a negative predictive value of 82%. Results from training and testing model of machine learning indicated that opioid self-administration could be identified with reasonable accuracy, leading to considerable possibilities of the use of wearable technology to advance prevention and treatment.
Asunto(s)
Trastornos Relacionados con Opioides , Dispositivos Electrónicos Vestibles , Adulto , Analgésicos Opioides/uso terapéutico , Femenino , Humanos , Aprendizaje Automático , Trastornos Relacionados con Opioides/diagnóstico , PrescripcionesRESUMEN
BACKGROUND: Although nurses typically view spiritual care as important, it is provided infrequently. OBJECTIVES: This research investigated psychiatric mental health nurses' perceived barriers to providing spiritual care, and how these barriers were associated with frequency of spiritual care and demographic factors. METHODS: This cross-sectional correlational study of 159 psychiatric mental health nurses used questionnaires to measure frequency of spiritual care and barriers to spiritual care. RESULTS: The most frequent barriers to providing spiritual care were lack of education and fear of exacerbating psychiatric symptoms. Psychiatric mental health nurses provided spiritual care infrequently. CONCLUSIONS: Nurses need education about providing spiritual care to those with psychiatric mental health needs.
Asunto(s)
Enfermeras y Enfermeros , Terapias Espirituales , Actitud del Personal de Salud , Estudios Transversales , Humanos , Salud Mental , Espiritualidad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Promoting spiritual well-being aids the mental health recovery process. Furthermore, nursing governance bodies and national mental health care regulators support spiritual care as a mental health-promoting approach. Although spiritual well-being is integral to quality of life in people with mental illness, little is known about the psychiatric mental health (PMH) nurses' provision of spiritual care. AIMS: Spiritual perspectives, frequency of spiritual care, and knowledge of recovery-oriented practice were measured. Variables were explored to identify a model of spiritual care. METHOD: A descriptive correlational cross-sectional design was employed. Analyses of data using descriptive statistics, correlations, and hierarchical multiple regression were conducted with a convenience sample of 171 PMH nurses. RESULTS: Participants scored high on measurement of spiritual perspectives, moderate on measurement of knowledge about recovery-oriented practice, and indicated a moderate degree of frequency of provision of spiritual care. Nurses who viewed themselves as "spiritual and religious" provided more frequent spiritual care and had higher levels of spiritual perspectives than those who viewed themselves as "spiritual but not religious." Significant contributors to spiritual care were spiritual perspectives and years of experience as a PMH nurse. Knowledge of recovery-oriented practice, however, did not contribute to a model of spiritual care. CONCLUSIONS: Nurses' spiritual perspectives, religiosity, and years of experience are factors that may explain nurse-provided spiritual care. Findings imply that spiritual and/or religious development may support PMH nurses to provide spiritual care.
Asunto(s)
Recuperación de la Salud Mental , Enfermería Psiquiátrica , Espiritualidad , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Encuestas y CuestionariosRESUMEN
BACKGROUND: A theoretical foundation and clinical experience are necessary to prepare nursing students for the care requirements of people with dementia. METHOD: A quasi-experimental design was used to examine the impact of Dementia Care Bootcamp (DCB) and clinical experience on students' dementia knowledge and attitudes, self-confidence for dementia care, and empathy, compared with students who received only the DCB. All students received a 10-hour DCB; half also received a clinical experience and completed a journal assignment. RESULTS: The DCB had a positive and significant effect on students' dementia attitudes, knowledge, and dementia care confidence and no effect on empathy. There was no significant difference between students who participated in the clinical experience and those who did not on any of the outcome measures. CONCLUSION: Although the DCB improved student outcomes, one clinical day was insufficient to further improve students' knowledge, attitudes, self-confidence, or empathy. Several reasons for the findings are discussed. [J Nurs Educ. 2019;58(3):136-143.].
Asunto(s)
Competencia Clínica , Demencia/enfermería , Bachillerato en Enfermería/organización & administración , Estudiantes de Enfermería/psicología , Prácticas Clínicas/métodos , Curriculum , Demencia/psicología , Femenino , Humanos , MasculinoRESUMEN
Translating and integrating scholarship into practice is a difficult concept for students to embrace through a passive education model. Therefore, innovative teaching strategies were integrated into a translational science course for online graduate nursing students. The purpose of this project was to increase understanding of the research process and stimulate interest in translating nursing evidence into practice. The result was an effective educational strategy for teaching and learning about the research process in a virtual environment.
Asunto(s)
Proyectos de Investigación , Enseñanza , Realidad Virtual , Educación a Distancia/métodos , Educación de Postgrado en Enfermería , Enfermería Basada en la Evidencia , Humanos , Estudiantes de EnfermeríaRESUMEN
PURPOSE: To evaluate the feasibility of Tai Chi (TC) and electronic tablet (ET) interventions on older adults' cognition and health and to explore participants' perceptions of intervention activities. DESIGN: An emergent embedded experimental mixed methods design was used in which the qualitative strand helped explain intervention results. METHOD: Older adults who participate in TC classes will have improved cognition and health compared with older adults who participate in ET classes. Twenty-six participants from two assisted living residences were recruited and randomized to receive nine TC or ET classes. The Modified Mini Mental State Exam was used to measure cognition and the SF-12v2 assessed perceived health before and after the intervention. Participants were invited to share perceptions of the two interventions. Institutional review board approval was obtained and participants provided signed consent for both quantitative and qualitative strands. FINDINGS: There was no significant difference within or between groups on cognition and health scores. CONCLUSIONS: TC and ET use are activities that can be delivered in the community and have the potential to promote compensatory scaffolding as described by the revised scaffolding theory of aging and cognition. Future research should involve larger samples and teaching methods that promote learning postures.
Asunto(s)
Cognición , Estado de Salud , Taichi Chuan/normas , Interfaz Usuario-Computador , Anciano , Anciano de 80 o más Años , Computadoras de Mano/normas , Femenino , Grupos Focales/métodos , Humanos , Masculino , Proyectos Piloto , Investigación Cualitativa , Taichi Chuan/métodosRESUMEN
BACKGROUND: Newly licensed RNs (NLRNs) are at risk for leaving employment in the first year. Nurse residency programs have demonstrated success for NLRN retention, yet other variables remain to be explored. METHOD: A retrospective correlational approach was used to determine the effect of autonomy, competence, group cohesion, structural empowerment, and job satisfaction on organizational commitment, turnover intent, and actual job turnover using secondary data of 1,498 nurse residents. RESULTS: At 1 year post-residency, turnover intent was low. The turnover rate at year 2 was 8.3% (n = 125). Group cohesion, job satisfaction, and structural empowerment had a significant effect on organizational commitment. Organizational commitment had a significant effect on turnover intent. CONCLUSION: As part of the global NLRN population, findings based on the U.S. residency programs provide nursing professional development with information to foster the needs of NLRNs and nursing administrators with information to support the development and effectiveness of nurse residency programs in the organization. J Contin Educ Nurs. 2018;49(10):482-488.
Asunto(s)
Actitud del Personal de Salud , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/estadística & datos numéricos , Lealtad del Personal , Reorganización del Personal/estadística & datos numéricos , Preceptoría/organización & administración , Adulto , Competencia Clínica , Femenino , Humanos , Masculino , Cultura Organizacional , Autonomía Personal , Estudios Retrospectivos , Estados Unidos , Adulto JovenRESUMEN
The aim of the study is to investigate the impact of CD40 and CD226 gene single-nucleotide polymorphism (SNP) and additional gene-gene interaction on systemic lupus erythematosus (SLE) risk in Chinese Han populations. Three SNPs were selected for genotyping in the case-control study: rs4810485, rs763361, and rs3765456. Logistic regression was performed to investigate association between SNP within CD40 and CD226 and SLE. Generalized multifactor dimensionality reduction (GMDR) was used to analyze the interaction among three SNPs. Logistic regression analysis showed that SLE risk was significantly higher in carriers of T allele of rs4810485 in CD40 gene than those with GG genotype (GT+ TT vs GG), adjusted OR (95 % CI) 1.84 (1.40-2.29). In addition, we also found SLE risk was also significantly higher in carriers of rs763361 T allele within CD226 gene than those with CC genotype (CT+ TT vs CC), adjusted OR (95 % CI) 1.89 (1.38-2.13). GMDR analysis suggested a potential gene-gene interaction between rs4810485 and rs763361. Overall, cross-validation consistency of the two-locus model was 10/10, and the testing accuracy was 62.17 %. We also found that subjects with GT or TT of rs4810485 and CT or TT of rs763361 genotype have the highest SLE risk, compared with subjects with GG of rs4810485 and CC of rs763361 genotype, and OR (95 % CI) was 2.14 (1.67-3.08), after covariates adjustment. Our results support an important association of rs4810485 in CD40 gene and rs763361 in CD226 gene polymorphism, combined effect of rs4810485 and rs763361 with increased risk of SLE.