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PROBLEM: Trust is central to the development of nurse-patient relationships. Pediatric nurses encounter difficulties developing trust with children and their caregivers. The purpose of this scoping review was to identify, examine, and summarize available evidence on the concept of trust among nurses and children/caregivers when admitted to hospital inpatient care units. ELIGIBILITY CRITERIA: Using the Joanna Briggs Institute (JBI) methodology for conducing and reporting scoping reviews, CINAHL, MEDLINE, PsycINFO, Cochrane DSR, Cochrane Central, and JBI EBP were searched for qualitative, quantitative, mixed methods, and review studies with no time limits published in English. Included studies presented findings on the experiences of developing trust between pediatric nurses and children under 18 years of age and their caregivers within inpatient care units. RESULTS: A total of 12,269 titles and abstracts were reviewed independently by two reviewers. 366 full-text articles were retrieved, a final of 81 studies were included in the review. CONCLUSIONS: Trust was bi-directional between nurses and children/caregivers, developed over time during multiple interactions, and foundational to the development of relationships. Distinct facilitators and barriers to the development of trust between nurses and children/caregivers were identified. The development of trust was rewarding and enriching for both nurses and children/caregivers and was the fundamental to the provision of safe and high-quality nursing care. IMPLICATIONS: Findings provide nurses with direction and strategies on how to develop and maintain trust with children/caregivers on inpatient care units. The development of training programs and interventions geared at equipping nurses with the skills to develop trust with children/caregivers is needed.
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Relaciones Enfermero-Paciente , Confianza , Humanos , Niño , Cuidadores/psicología , Enfermeras Pediátricas/psicología , Enfermería Pediátrica , Masculino , Femenino , Niño HospitalizadoRESUMEN
AIMS: Detraining refers to a loss of training adaptations resulting from reductions in training stimulus due to illness, injury, or active recovery breaks in a training cycle and is associated with a reduction in left ventricular mass (LVM). The purpose of this study was to conduct a systematic review and meta-analysis to determine the influence of detraining on LVM in endurance-trained, healthy individuals. METHODS AND RESULTS: Using electronic databases (e.g. EMBASE and MEDLINE), a literature search was performed looking for prospective detraining studies in humans. Inclusion criteria were adults, endurance-trained individuals with no known chronic disease, detraining intervention >1 week, and pre- and post-detraining LVM reported. A pooled statistic for random effects was used to assess changes in LVM with detraining. Fifteen investigations (19 analyses) with a total of 196 participants (ages 18-55 years, 15% female) met inclusion criteria, with detraining ranging between 1.4 and 15 weeks. The meta-analysis revealed a significant reduction in LVM with detraining (standardized mean difference = -0.586; 95% confidence interval = -0.817, -0.355; P < 0.001). Independently, length of detraining was not correlated with the change in LVM. However, a meta-regression model revealed length of the detraining, when training status was accounted for, was associated with the reduction of LVM (Q = 15.20, df = 3, P = 0.0017). Highly trained/elite athletes had greater reductions in LVM compared with recreational and newly trained individuals (P < 0.01). Limitations included relatively few female participants and inconsistent reporting of intervention details. CONCLUSION: In summary, LVM is reduced following detraining of one week or more. Further research may provide a greater understanding of the effects of sex, age, and type of detraining on changes in LVM in endurance-trained individuals.
In healthy, endurance-trained individuals, detraining results in significant reductions in left ventricular mass. When accounting for training status, the length of the detraining period is positively associated with reductions in left ventricular mass. Limited research on this topic hinders the ability to assess sex differences or the impact of the type of detraining (i.e. only activities of daily living vs. reduced training load) on the response to detraining.
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Entrenamiento Aeróbico , Función Ventricular Izquierda , Humanos , Atletas , Resistencia Física , Estudios ProspectivosRESUMEN
AIMS: To determine the impact of endurance training (ET) interventions on left ventricular (LV) chamber size, wall thickness, and mass in healthy adults. METHODS AND RESULTS: Electronic databases including CINAHL, MEDLINE, PsycINFO, SPORTDiscus, Cochrane library, and EBM Reviews were searched up to 4 January 2022. Criteria for inclusion were healthy females and/or males (>18 years), ET intervention for ≥2 weeks, and studies reporting pre- and post-training LV structural parameters. A random-effects meta-analysis with heterogeneity, publication bias, and sensitivity analysis was used to determine the effects of ET on LV mass (LVM) and diastolic measures of interventricular septum thickness (IVSd), posterior wall thickness (PWTd), and LV diameter (LVDd). Meta-regression was performed on mediating factors (age, sex, training protocols) to assess their effects on LV structure. Eighty-two studies met inclusion criteria (n = 1908; 19-82 years, 33% female). There was a significant increase in LVM, PWTd, IVSd, and LVDd following ET [standardized mean difference (SMD) = 0.444, 95% confidence interval (CI): 0.361, 0.527; P < 0.001; SMD = 0.234, 95% CI: 0.159, 0.309; P < 0.001; SMD = 0.237, 95% CI: 0.159, 0.316; P < 0.001; SMD = 0.249, 95% CI:0.173, 0.324; P < 0.001, respectively]. Trained status, training type, and age were the only mediating factors for change in LVM, where previously trained, mixed-type training, young (18-35 years), and middle-aged (36-55 years) individuals had the greatest change compared with untrained, interval-type training, and older individuals (>55 years). A significant increase in wall thickness was observed in males, with a similar augmentation of LVDd in males and females. Trained individuals elicited an increase in all LV structures and ET involving mixed-type training and rowing and swimming modalities conferred the greatest increase in PWTd and LVDd. CONCLUSION: Left ventricular structure is significantly increased following ET. Males, young and trained individuals, and ET interventions involving mixed training regimes elicit the greatest changes in LV structure.
Heart structure significantly increases the following endurance training (ET) ≥2 weeks.Changes in heart structure were most prominent in males, who are young (1835 years), already trained, and following concurrent continuous and interval training.Changes in heart size were not shown in older individuals (>55 years) compared with young and middle-aged individuals.While both males and females similarly increase their cavity size and heart mass, sex differences were revealed for wall thickness where significant increases were seen in males but not females.