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Postoperative Care Quality in Gynecological Surgery Techniques
No full textIntroduction: Benign uterine tumors, such as fibroids and adenomyosis, affect up to 40% of women of reproductive age, causing symptoms such as abnormal menstruation, anemia, abdominal discomfort, and infertility. Minimally involves surgery (MIS) are the mainstream choice of treatment due to a shortened surgical duration and recovery time as well as decreased blood loss when compared with open surgery. This study seeks to explore the differences in postoperative care depending on the method of MIS involved.
Methods: This is a retrospective study on women who underwent gynecological surgeries from January 1, 2018, to December 31, 2021 in a hospital in southern Taiwan . A total of 673 patients were followed for one year, with data analyzed using SPSS, including chi-square tests, t-tests, and logistic regression to identify factors affecting postoperative care quality.
Results: The average age of patients was 42.45± 7.29 years, and the average hospital stay was 2.36± 1.81 days. Most common surgery was laparoscopic myomectomy (70%), followed by laparoscopic subtotal hysterectomy (16.9%) and tumor ablation (13.1%). Significant factors influencing postoperative complications included BMI (χ2 = 9.259, p = 0.026) and tumor size(χ2 = 25.682, p = 0.000) . Independent t-tests showed significant differences in hospitalization duration related to menstrual pain (p = 0.04), tumor size (p = 0.00), hemoglobin levels (p = 0.00), and menstrual bleeding volume (p = 0.01). Logistic regression analysis indicated that patients with BMI \u3e27kg/m2 = 3.356 times the risk of postoperative complications compared to those with a BMI of 18.5–24 kg/m2(β=3.356, p=0.048) and 5.635 times the risk compared to those with BMI 24–27kg/m2 (β=5.635, p=0.007). Tumors ≥ 4 cm were significantly associated with postoperative complications (β=0.264, p=0.000). Laparoscopic total hysterectomy was associated with a reduced risk of reoperation within a year compared to uterine tumor ablation (β=0.294, p=0.036).Larger tumors and higher BMI were associated with increased complications. Logistic regression showed that patients with BMI \u3e27kg/m2 or tumors ≥4 cm are statistically significant to be associated with an increased risk of postoperative complications. Laparoscopic subtotal hysterectomy patients had a lower risk of repeated operation with to other methods
Strategies to Enhance Your Work/Life Balance
No full textThis program explores strategies to enhance work/life balance, focusing on practical techniques to manage time, reduce stress, and increase overall well-being. Participants will learn to prioritize tasks, set boundaries, and develop effective organizational skills. The initiative emphasizes the importance of self-care, fostering healthy relationships, and leveraging support systems. Through workshops and interactive sessions, individuals will gain essential tools and insights to create a balanced life, ultimately improving productivity and satisfaction both personally and professionally
Breaking Down Barriers to Becoming a Nurse
No full textIt is estimated that between 2021-2031 there will be 194,500 openings for registered nurses (RNs) in the United States annually. The American Nurses’ Association calls for “real solutions” to this nursing shortage crisis by addressing barriers that prohibit students from earning nursing degrees. Barriers for students include personal financial status, exorbitant tuition, an unobliging work schedule, lack of emotional support, access to nursing programs and insufficient study time. Factors that support the obtainment of a nursing degree include employer support such as a flexible work schedule, tuition reimbursement or tuition funding.A nursing professional development (NPD) position specializing in nursing workforce was created within an academic health organization to implement and oversee nursing development pathway programs to address these barriers. Collaboration with community partners, including local schools of nursing have resulted in the development of two programs and three different pathways to meet the unique needs of students on their journey to becoming a nurse.Program A was established for those on an alternative pathway to nursing with the goal to mitigate barriers to success such as the need to maintain full time employment while accommodating class and clinical schedules. This program has three fully funded tuition pathways, and offers an hourly incentive and feasible work schedule to address these barriers. The pathways include patient care associate-licensed professional nurse (PCA- LPN), licensed professional nurse – registered nurse (LPN-RN) and a concurrent licensed professional nurse- Bachelor of Science in nursing (LPN-BSN).Program B provides nursing students enrolled in a pre-licensure registered nursing (RN) program a tuition award, with a work commitment that begins after graduation. This program supports student’s tuition needs while mitigating the barrier of conflicting work schedules, and providing adequate study time and support.Program outcomes tracked include nursing program completion rates, NCLEX pass rates, and organizational retention. Program A, PCA-LPN pathway has a 60% completion rate which is commensurate with the state nursing program completion rate of 60% and better than the academic partner’s completion rate of 53%. Program B has an anticipated ROI of 233% per participant. With an anticipated forty participants enrolled each year, the projected annual average savings are over $2,000,000
Student Nurses\u27 Perceptions of High-Fidelity Simulation-Based Learning on Critically-Ill Patients
No full textBackground and Objective. Replicating critical care practice settings in high-fidelity simulation (HFS) provides more learning opportunities to develop competencies, improve self-confidence, and learner satisfaction in a safe environment. Simulation is increasingly adopted globally as an alternative teaching strategy. Yet, data on the HFS experience of Filipino undergraduate nursing students is limited. This study describes the satisfaction, self-confidence, and perception of undergraduate nursing students on the use of HFS-based learning on critically-ill adult and pediatric patients requiring advanced life support (ALS).Methods. A quantitative, descriptive, correlational study was conducted using purposive sampling on all fourth-year BS Nursing students enrolled in Critical Care Nursing course in a state university. Data were collected through an online survey on demographic data, and the students’ perceptions towards high-fidelity simulation-based learning (SBL) using three tools, namely: Simulation Design Scale, Educational Practices Questionnaire, and Student Satisfaction and Self-confidence in Learning. T-test and ANOVA were used to compare the means of the variables. Bivariate analysis (Pearson’s product-moment correlation) was performed to find the relationship between variables.Results. A total of 86 students participated in the survey. Overall, the students were highly satisfied with the simulation experience (4.46 out of 5.0, SD=0.47), and had high ratings of self-confidence in SBL (4.44 out of 5.0, SD=0.42). Overall satisfaction level was positively related to student’s perception on simulation design (r=0.61, p\u3c0.01) and educational practices (r=0.59, p\u3c0.01). Similarly, the students’ overall self-confidence with SBL was also positively correlated with their perceptions on the simulation design (r=0.32, p\u3c0.01), and educational practices (r=0.34, p\u3c0.01).Conclusion: Effective use of technology through HFS-based learning is useful in increasing satisfaction and confidence of Filipino undergraduate nursing students in caring for critically-ill patients needing ALS. Educators must highly consider all parameters of simulation design and educational practices in planning and implementing HFS-based learning to achieve meaningful learner experience
Smartphone-based ecological momentary assessment (EMA) tool to collect momentary psychological data from older adults with mild cognitive impairment (MCI): A feasibility and acceptability study.
No full textUsing a user-centered approach, the specific aim is to develop a feasible and acceptable smartphone-based EMA protocol to collect real-time psychological data, including momentary emotions, perceived stress levels, and environmental stressors from individuals with MCI in their everyday environments. Such a tool is a crucial step that enables testing of the theoretical framework underlying neuropsychiatric symptoms (NPS) in MCI, a significant and prevalent risk factor known to speed up progression to dementia. We will evaluate the feasibility and acceptability of this tool by examining adherence metrics (completion rate, compliance rate, response latency, number of technical support requests), and conducting qualitative interviews to gather user experience and suggestion for improvement for further enhancement
The Current Status of Academic Nurse Educator (ANE) Programs at Graduate Schools in Japan
No full textBackground: In Japan, the rapid increase in the number of baccalaureate nursing programs1) has made it difficult to allocate qualified faculty. Since there is no system for academic nurse educators (ANE) in Japan, newly appointed faculty members struggle to adapt educator role2)3).
Purpose: The purpose of this study was to clarify the patterns of graduate courses offering educational subjects in Japan.
Method: Syllabi of 215 nursing graduate programs were examined from August to September 2023 by browsing those schools’ websites. Courses which include “education” in their title were included in the analysis. Those courses were classified into the patterns of provision.
Results: Of the 215 programs, 39 (90.7%) national, 41 (87.2%) public, 108 (87.1%) private, and 1 (100.0%) ministerial school offered nursing education or other education-related classes. At least one education-related class was offered at 189(87.9%) schools. The pattern of provision was as follows: Pattern A (clinical nurse educator: CNE/ANE courses) - 6 courses; Pattern B (science of nursing education major, but no CNE/ANE courses) - 41 courses; Pattern C (nursing pedagogy-related subjects for CNS/NP courses) - 72 courses; Pattern D (other than A, B, and C, there are courses related to nursing education) - 65 courses; Pattern E (there are no courses related to nursing education other than A, B, and C)- 26 courses; Pattern F (cannot be specified due to lack of information) - 4 courses; and Pattern G (other) - 1 course.
Discussion and Conclusion: Although many graduate programs offer education-related classes, few of them make mandatory classes, and graduate students may have few opportunities to acquire educational knowledge. While courses in Patterns A and B enable graduate students to acquire the knowledge, skills, and attitudes necessary for nursing faculty, it is difficult to do so in courses in other patterns
Effectiveness of Blended Learning in Enhancing Nursing Students\u27 Communication With Older AdultsEffectiveness of Blended Learning in Enhancing Nursing Students\u27 Communication With Older Adults
No full textBackground: Given the aging population, addressing specific communication needs in geriatric care is crucial in healthcare education. Traditional approaches often lack practical interaction, focusing instead on theoretical content.
Objectives: This study tests a newly developed digital material using a blended learning model that combines online and in-person components to improve students\u27 communication skills.
Methodology: Using an experimental design, students were divided into two groups—an experimental group using digital materials and a control group using traditional learning methods. Both groups completed older adult communication modules, with assessments conducted pre- and post-study. Key outcomes measured included knowledge of aging, attitudes toward older adults, willingness to serve, communication skills, and motivation.
Key Findings: Both groups showed improvements across several metrics, though significance varied. Knowledge of aging saw slight, non-significant increases; the experimental group’s score rose from 64.83 to 65.40 (p=0.67), and the control group’s from 62.30 to 63.05 (p=0.65). Attitude scores toward aging also improved modestly, with the experimental group increasing from 145.14 to 149.26 (p=0.15) and the control group from 149.40 to 152.70 (p=0.17). Self-assessed communication skills improved significantly, with the experimental group rising from 146.49 to 154.02 (p=0.01) and the control group from 144.77 to 149.85 (p=0.01), indicating the blended model’s effectiveness. Feedback from older adults rated students highly in adaptability when clarifying communication (mean = 5.60, SD = 0.55) and appropriate expression (mean = 5.53, SD = 0.55), with listening skills rated highest (mean = 5.62, SD = 0.54). Overall satisfaction was high, with a mean rating of 5.60 (SD = 0.55), underscoring the model’s impact.
Conclusion: This blended learning model effectively improved students’ communication abilities with older adults, as shown by positive self-assessments and feedback from older adults. While changes in knowledge and attitudes were minor, the impact on communication skills was clear, underscoring this model’s value in preparing healthcare students for geriatric care
Socio-Demographic Influences on Digital Game Engagement and Self-Care in Adults With Heart Failure
No full textBackground: Heart failure (HF) affects 64 million people worldwide, contributing to significant morbidity, mortality, and healthcare costs.1,2 Effective self-care is essential for improving HF outcomes, and digital health interventions have shown promise in supporting these practices.3-5 This study explores how socio-demographic factors influence engagement with a digital game app and related self-care behaviors in HF management, presenting preliminary data from a remote, digital health study.
Methods: Descriptive and correlational analyses were conducted on 40 adults from the intervention arm of an RCT after 6 months. Participants used a mobile game app, activity tracker, and smart scale to support physical activity and weight monitoring. Independent variables included sex, race, ethnicity, living situation, housing type, employment status, and work hours, and financial strain. Engagement metrics were days of game app usage, final game level, and days of weight monitoring and step goal achievement. Spearman’s correlation assessed relationships between game usage, game level, weight monitoring, and step goals due to non-normal data distribution.Results: Of 40 participants, 77% were male, 77% White, and 82% non-Hispanic. Females engaged more in game usage and weight monitoring, while males met step goals slightly more. White, non-Hispanic participants exhibited the highest engagement in all metrics, compared to other racial/ethnic groups. Higher engagement was seen in those living with family and in single-family homes compared to those living alone or in apartments. Participants reporting financial strain exhibited lower engagement across all metrics. Significant strong positive correlations were found between game app usage and final game level (rs = .767, p \u3c .01), days weight monitored (rs = .840, p \u3c .01), and days meeting step goals (rs = .767, p \u3c .01).Conclusion: Strong positive correlations between game usage and self-care behaviors highlight the potential of mobile games in supporting HF management. However, observed differences in engagement across socio-demographics underscore the importance of identifying and addressing disparities in digital interventions to prevent reinforcing existing inequities. The ongoing RCT is focused on recruiting a more diverse participant base to strengthen these insights. Further research is needed to better understand the factors influencing differences in engagement in digital interventions across socio-demographics
Structure, Processes & Outcomes of SCI Peer Mentoring: A Community-Engaged, Cross-Sectional Survey
No full textBackground: Peer mentoring is a vital resource for individuals with spinal cord injury (SCI), providing emotional support, practical advice, and guidance from others who share a similar lived experience (1,2,3). Additionally, peer mentoring is an important component of SCI rehabilitation and supports the role of the rehabilitation nurse in promoting effective self-management and independence after SCI. Research on the effect of community-based peer mentoring interventions\u27 structure and processes on outcomes, as well as quality and effectiveness, is limited (4).
Aim: The primary aim of this study, informed by Donabedian\u27s Model of quality assessment (5), was to describe the structure, processes, and outcomes of quality peer mentoring valued by the SCI community using an online survey as the first phase of a mixed methods sequential explanatory design.
Methods: Using a community-engaged research approach, a team of academic and SCI community partners developed a cross-sectional survey which was pretested with 10 community volunteers with SCI. The survey included questions in the domains of mentoring structure, processes, and outcomes, and was distributed online via REDCap. Participants were recruited nationally through social media, direct emails, and peer support networks, with a target sample size of 96. Inclusion criteria were adults over 18 with chronic paralysis due to SCI. Data collected included demographic information, injury profiles, experience with peer mentor or mentee role, and perspectives on peer mentoring.
Results: The final sample consisted of 99 participants with SCI with a mean age of 48.1 years. Related to structure, preferred roles for peer mentors included coach, advocate, and counselor. Priority characteristics for matching mentors and mentees included level of injury, personality, communication style, and age. Preferred processes of mentoring included 1:1 in-person and video chat interactions, with the mentor and mentee having autonomy over scheduling and topics discussed. Preferred outcomes included improved self-care management, independent living skills, and coping with emotional challenges.
Conclusions: The findings highlight characteristics of SCI peer mentoring programs that are prioritized by people with SCI and guide consideration of individual preferences and needs. Next steps in the research design will include in-depth qualitative interviews with SCI peer mentors and mentees to provide explanatory data related to survey findings
Early Detection of Congenital Heart Disease: From Heart to Sole
No full textIntroduction: From Heart to Sole” is a study exploring a non-invasive, low cost screening method for congenital heart disease (CHD).
Methods: This pilot study explores identification of a specific crease on the sole of the foot as a marker for early detection of CHD in newborns. A Qualitrics survey was developed and distributed on social media platforms (Facebook, LinkedIn, etc) and the Adult Congenital Heart Association “Studies Recruiting Subjects” webpage. Participants were queried whether they have been diagnosed with a CHD and what type, whether they have the specific crease on either foot, and about the presence other health issues including a genetic syndrome. This study has been approved by the Institutional Review Board at The College of New Jersey and the Medical Advisory Board Research Committee of the Adult Congenital Heart Association.
Results: Study participants were all over the age of 18 years, with a total of 53 responses, 69.8% female (n = 37), nine people did not disclose their gender(17%). The majority of the respondents were Caucasian(n=36 or 67.9%). Nine surveys were not fully completed. Thirty-two people reported a CHD diagnosis while 21 respondents did not answer this item. Approximately 40% of respondents reported having a diagnosis of Tetralogy of Fallot(TOF) (n=20, 62.5%). A Fisher exact test was conducted using SPSS IBM (version 29). A statistically significant association was found between having any CHD diagnosis and the presence of a crease on any foot (p value = 0.15). All participants who reported presence of a foot crease except for one with a chromosomal syndrome also reported a diagnosis of a CHD. No association was found between a TOF diagnosis and presence of a crease on any foot (p value = 0.235). No association was found between Caucasian race and presence of a crease on any foot (p value= 1). No association was found between gender and presence of a crease on any foot (p value = 0.214). Associations between other CHD diagnoses, other racial groups, and presence of a crease could not be analyzed due to small sample size.
Conclusions: A statistically significant association was identified between having a CHD and the presence of a crease on any foot. Further research is needed to identify whether there is an association between presence of the crease and a specific CHD and to evaluate the effectiveness of evaluating for the presence of a crease on either foot as a screening for CHD in newborns