Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 5 Articles
Background: Worldwide, hypertension affects approximately 25% of the adult population and diabetes about 8.5%.\nLack of adherence to prescribed treatment regimen remains a problem among patients undergoing long-term\ntreatment, showing high non-adherence rates, at estimated range of between 36 and 93%. In our city, patients\nwith hypertension and diabetes in primary care are looked after mainly by doctors with little nursing support; also,\nthere is no published dataset among Colombian populations on the effect of nursing intervention to increase\nadherence to therapeutic regimen. The aim of this study was to evaluate the efficacy of nursing intervention\nâ??Teaching: Individualâ? compared with usual care, to increase adherence to therapeutic regimen in people with\nhypertension and/or type-2 diabetes, and to analyze the impact to glycosylated hemoglobin and systolic blood\npressure levels.\nMethods: A two-arm, single-blinded, randomized controlled trial, with participants allocated to either intervention\ngroup with â??Teaching: Individualâ? provided by two nurses, or control group receiving routine care only. Two Hundred\npatients attending cardiovascular risk programs of Bucaramanga, Colombia were included. Nursing intervention\nconsisted of six educational sessions about Coping Enhancement; Behavior Modification; Teaching: Disease Process,\nPrescribed Medication, Prescribed Diet and Prescribed Exercise. The outcomes were Treatment Behavior: Illness or\nInjury (adherence to treatment), levels of both glycosylated hemoglobin (HbA1c) and systolic blood pressure for 24 h,\nto be measured at baseline and two follow-up time points. Basic characteristics of the groups were compared through\nchi-square/Fisherâ??s exact or Students-T/Mann-Whitney U test. Outcomes were evaluated with repeated data methods\nand investigated changes in the outcomes over time and to compare these changes among treatment groups, and\nstatistical significance with p-value < 0.05 were considered.\nDiscussion: The nursing intervention â??Teaching: Individualâ? to increase adherence to therapeutic regimen in people\nwith hypertension and/or type-2 diabetes represents an innovative care approach intended for low-income population.\nThe study will advise district health system policy makers and managers as to the efficacy of implementing this\nintervention. Should this intervention turn out efficacious, it can potentially achieve wide application in cardiovascular\nrisk programs....
Background: The rational length of stay following non-complicated percutaneous coronary intervention (PCI) for\nNon-ST elevation myocardial infarction (NSTEMI) patients remains controversial. Few studies have examined the\nimpact of early discharge on short-term outcomes in NSTEMI patients, but short-time discharge is not uncommon\nin real world practice. This study examined the impact of short time discharge following non-complicated PCI on\n30-day net adverse clinical events in NSTEMI patients.\nMethods: This retrospective study enrolled 1424 consecutive patients with NSTEMI diagnoses who underwent noncomplicated\nPCI. Of these patients, 432 were discharged early (< 24 h), whereas the remaining 992 NSTEMI patients\nunderwent routine discharge. The primary end points of the study were the net adverse clinical events including\nmajor adverse cardiac or cerebral events or access site vascular/bleeding complications within 30 days. The\ndifferences between the two groups were analyzed after propensity score matching to reduce selection bias.\nResults: The incidence of crude 30-day net adverse events was numerically higher in the long-time discharge\ngroup at 11.6% (115/992) compared with 8.6% (37/432) in the short-time discharge group, although this difference\nwas not significant (P = 0.09). This difference was mainly due to lesser radial access selected in the long-time\ndischarge group (827/932, 83.4% vs. 387/432, 89.5%, P < 0.0005). After PS matching to balance the access difference,\nthere was no significant difference in the incidence of the events mentioned above between two groups.\nConclusions: If an NSTEMI patient undergoes PCI without any procedural or hospital complications, short-time\ndischarge after successful PCI would be feasible and safe in selected NSTEMI patients....
Background: In response to multiple United Kingdom investigations and inquiries into the care of adults with\nlearning disabilities, Mencap produced the Getting it Right Charter which campaigned for the appointment of a\nLearning Disability Liaison Nurse in every hospital. More recent best practice guidelines from the Care Quality\nCommission included the need for all childrenâ??s units to have access to a senior learning disability nurse who can\nsupport staff and help them manage difficult situations. However, little evidence exists of the extent of learning\ndisability nurse provision in childrenâ??s hospitals or the nature and impact of this role. Here we report selected\nfindings from a national mixed methods study of hospital care for children and young people with and without\nlearning disabilities in England. The extent of learning disability nurse provision in childrenâ??s hospitals is described\nand perceptions of staff working in hospitals with and without such provision is compared.\nMethods: Semi-structured interviews were conducted with senior staff across 15 childrenâ??s hospitals and an\nanonymous survey was sent to clinical and non-clinical staff with patient (children and young people) contact\nwithin these hospitals. The survey focused on six different elements of care for those with and without learning\ndisability, with additional questions concerning identifying and tracking those with learning disabilities and two\nopen-ended questions.\nResults: Forty-eight senior staff took part in interviews, which included a subset of nine nurses and one allied\nhealth professional employed in a dedicted learning disability nurse role, or similar.\nSurveys were completed by 1681, of whom 752 worked in a hospital with dedicated learning disability nurse\nprovision. We found evidence of limited and varied learning disability nurse provision which was valued by hospital\nstaff and shown to positively impact their perceptions of being capable to care for children and young people with\nlearning disabilities, but not shown to increase staff perceptions of capacity or confidence, or how children and\nyoung people are valued within the hospital, their safety or access to appointments.\nConclusion: Further consideration must be given to how learning disability nurse roles within childrenâ??s hospitals\nare best operationalised in practice to have the greatest impact on staff and families, as well as how we monitor\nand evaluate them to ensure they are being utilised effectively and efficiently....
Background: Non-pharmacological interventions hold promise in reducing labour pain, with minimal or no harm\nto the mother, foetus and the progress of labour and are simple and cost-effective. Yet their use has not been\nadequately explored in clinical settings, especially in sub-Saharan Africa.\nMethods: This was a descriptive phenomenological study. Fifteen (15) nurses and midwives working in labour\nwards of two hospitals in Ghana were interviewed. Data analysis was guided by the principles of coding by Bailey\nand the constant comparative approach to generate themes. Ethics approval was obtained from the 37 Military\nTeaching Hospital Institutional Review Board in Ghana.\nResults: Three major themes were identified that described the experiences of nurses and midwives regarding\ntheir use of non-pharmacological interventions in managing labour pain. These were familiarity with nonpharmacological\ninterventions, perceived benefits of non-pharmacological interventions, and barriers to the use of\nnon-pharmacological interventions in the management of labour pain.\nConclusions: While some non-pharmacological pain management interventions were known and used by the\nnurses and midwives, they were not familiar with a good number of these interventions. Nurses and midwives\nperceived these interventions to be beneficial yet a number of barriers prevented easy utilisation....
Background: Human papillomavirus (HPV) is one of the most common sexually transmitted\ninfections nationwide. Methods: This is the first cross-sectional survey assessing physiciansâ?? and\nnursesâ?? knowledge of HPV and recording their attitudes to HPV vaccination in Hong Kong. Survey\nquestions were derived from the Health Belief Model. Results: 1152 clinicians (170 physicians and\n982 nurses) aged 21 and 60 participated in this study. A multiple stepwise regression model was used\nto examine associations between cognitive factors (cliniciansâ?? attitudes) and subjectsâ?? intention to HPV\nvaccine uptake. Results showed that only 30.2% of physicians and 21.2% nurses found vaccinating\nfor HPV acceptable. Conclusions: Perceived self-efficacy was the only significant background and\ncognitive variable associated with physiciansâ?? and nursesâ?? accepting HPV vaccines. Further, when\nnurses found HPV vaccination acceptable, cues to action was featured as a significant background\nvariable in their choice....
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