bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Deprescribing Acetylcholinesterase Inhibitors in Older Nursing Home Residents With Severe Dementia
Authors: Niznik Joshua D. , Zhao Xinhua , He Meiqi , Aspinall Sherrie L. , Hanlon Joseph T. , Nace David , Thorpe Joshua M. , Thorpe Carolyn T. 
Published: June 2019

BACKGROUND/OBJECTIVEUncertainty regarding benefits and risks associated with acetylcholinesterase inhibitors (AChEIs) in severe dementia means providers do not know if and when to deprescribe. We sought to identify which patient‐, provider‐, and system‐level characteristics are associated with AChEI discontinuation.DESIGNAnalysis of 2015 to 2016 data from Medicare claims, Part D prescriptions, Minimum Data Set (MDS), version 3.0, Area Health Resource File, and Nursing Home Compare. Cox‐proportional hazards models with time‐varying covariates were used to identify patient‐, provider‐, and system‐level factors associated with AChEI discontinuation (30‐day or more gap in supply).SETTINGUS Medicare–certified nursing homes (NHs).PARTICIPANTSNonskilled NH residents, aged 65 years and older, with severe dementia receiving AChEIs within the first 14 days of an MDS assessment in 2016 (n = 37 106).RESULTSThe sample was primarily white (78.7%), female (75.5%), and aged 80 years or older (77.4%). The most commonly prescribed AChEIs were donepezil (77.8%), followed by transdermal rivastigmine (14.6%). The cumulative incidence of AChEI discontinuation was 29.7% at the end of follow‐up (330 days), with mean follow‐up times of 194 days for continuous users of AChEIs and 105 days for those who discontinued. Factors associated with increased likelihood of discontinuation were new admission, older age, difficulty being understood, aggressive behavior, poor appetite, weight loss, mechanically altered diet, limited prognosis designation, hospitalization in 90 days prior, and northeastern region. Factors associated with decreased likelihood of discontinuation included memantine use, use of strong anticholinergics, polypharmacy, rurality, and primary care prescriber vs geriatric specialist.CONCLUSIONAmong NH residents with severe dementia being treated with AChEIs, the cumulative incidence of AChEI discontinuation was just under 30% at 1 year of follow‐up. Our findings provide insight into potential drivers of deprescribing AChEIs, identify system‐level barriers to deprescribing, and help to inform covariates that are needed to address potential confounding in studies evaluating the potential risks and benefits associated with deprescribing. J Am Geriatr Soc 67:1871–1879, 2019
The effect of an educational program based on Roy's adaptation model on the quality of life of patients suffering from heart failure: A clinical trial study
Authors: Mansouri Akram , Baraz Shahram , Elahi Nasrin , Malehi Amal S. , Saberipour Bayan 
Published: June 2019

AbstractAimHeart failure is a progressive, debilitating disease with exacerbated physical and psychological symptoms that reduces the quality of life of patients. Nursing intervention based on nursing theories could help in the adaptation of patients to the disease and improving quality of life. The aim of this study was to determine the effect of an educational program based on Roy's adaptation model on the quality of life of patients with heart failure.Methods and MaterialIn this randomized controlled trial, 76 patients with heart failure were allocated to either the intervention or control group through a blocked randomization method. The data were collected between May and October 2017. The intervention group received oral and written educational programs for 4 weeks. Minnesota quality‐of‐life questionnaire and Roy's adaptation model‐based evaluation form was completed at the beginning of the trial, and 1 month after the completion of the study.ResultsIntervention patients showed statistically significantly improved scores on the physiologic, role function, independence‐interdependence dimensions and the total score of Roy's adaptation model over time compared with control patients (p < .05). The mean score of all of the three quality‐of‐life dimensions and total score of quality of life increased significantly (p < .05).ConclusionThe study results help nursing staff detect the stimuli and the behaviors of patients with heart failure. Roy's adaptation model can be used as a standard practice to increase adaptation to the disease and improving quality of life.
Age‐related macular degeneration among the elderly: The 5th National Health and Nutrition Examination Survey, 2010 through 2012
Authors: Kim Chul‐Gyu , Park Seungmi , Kim Youngji 
Published: June 2019

AbstractAimThis study was conducted to identify the prevalence and factors associated with age‐related macular degeneration (AMD) in Korean elderly.MethodsThe study population of this cross‐sectional survey was the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2012, the fifth population‐based study.ResultsAnalysis of 2,767 elderly (above age 65) from 23,376 participants showed the prevalence of any AMD to be 17.6% in the Korean elderly. Factors that were significantly positively associated with AMD included age, sex, occupation, low socioeconomic status, liver cirrhosis and physical activity (p < .01). Significantly negatively associated with AMD were cardiovascular disease, obesity, and beta‐carotene intake (p < .05).ConclusionsThis study estimated the prevalence rate and assessed factors associated with AMD in the elderly. This can be used to build a strategy for elderly eye health, and provides valuable information for screening for putative risks in the elderly.
Effect of triage nurse‐led application of the Ottawa Ankle Rules on number of radiographic tests and length of stay in selected emergency departments in Oman
Authors: Al Abri Fatema H. , Muliira Joshua K. , Al Awaisi Huda 
Published: June 2019

AbstractAimAnkle injuries are commonly seen in the emergency department (ED) and contribute to overcrowding. In Oman, injuries are a leading cause of years of life lost, disability‐adjusted life years, and pose a burden to the healthcare system. This study aimed to evaluate the effectiveness of ED triage nurse‐led application of the Ottawa Ankle Rules (OARs) toward improving the healthcare outcomes of ankle injury patients.MethodsA quasi‐experimental design was used to collect data (demographic characteristics, waiting time, length of stay, and number of radiographic tests) from 96 patients. The intervention group (n = 46) received ED triage nurse‐led assessment and initiation of radiographic tests based on the OARs. The control group (n = 50) received usual care.ResultsThe participants' mean age was 26.4 ± 7.90 years. The main causes of ankle injuries were football (36%), falls (31%) and twisting while walking (24%). There was a significant difference in number of ankle X‐rays (t = 6.19; p < .001); length of stay (U = 549; p < .001); and waiting time (U = 167; p < .001) between the control and intervention group. The intervention reduced the mean waiting time and length of stay by 25.09 and 41.01 min, respectively.ConclusionApplication of the OARs by the ED triage nurse can decrease the number of unnecessary radiographic tests, waiting time and length of stay in the ED. Nurses' utilization of evidence‐based clinical decision‐making tools can improve ED care outcomes of common acute conditions such as ankle injuries.
Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery
Authors: Guo Min , Wang Cui , Yin Xiumin , Nie Liting , Wang Gongchao 
Published: June 2019

AbstractAimTo explore symptom clusters experienced by patients with oesophageal cancer 3 months after surgery and examine whether symptom clusters are related to demographic, clinical and quality of life variables.BackgroundThere are multiple symptoms in patients with oesophageal cancer after surgery, which seriously affect their quality of life. Exploring the mechanics of concurrent symptoms such as symptom clusters may facilitate the development of strategies to reduce the impact of these symptoms and improve quality of life.DesignCross‐sectional survey. The STROBE Statement was chosen as the EQUATOR checklist.MethodsA convenience sample of 128 oesophageal cancer patients was followed up at 3 months after surgery. Participants completed the demographic questionnaire, the M. D. Anderson Symptom Inventory for Gastrointestinal Cancer, the Functional Assessment of Cancer Therapy‐General and the Connor‐Davidson Resilience Scale. Exploratory factor analysis, stepwise regression and correlation analysis were applied.ResultsFour symptom clusters were identified: dysphagia–psychological, chemoradiotherapy side‐effect, digestive tract reconstruction and fatigue–sleep. Gender, stage of disease and resilience influenced the dysphagia–psychological symptom cluster. Gender, stage of disease, resilience and treatment were significant factors affecting the chemoradiotherapy side‐effect and fatigue–sleep symptom clusters. Gender, stage of disease, resilience and anastomotic position were significant factors influencing the digestive tract reconstruction symptom cluster. The correlations between symptom clusters and quality of life were significant, with the highest correlation between the dysphagia–psychological cluster and quality of life.ConclusionsNurses should pay more attention to symptom management in patients with oesophageal cancer 3 months after surgery by focusing on four symptom clusters. It is necessary to implement individualised care depending on the influence factors including gender, stage of disease, resilience, treatment and anastomotic position.Relevance to clinical practiceThese findings will help develop targeted interventions to facilitate further symptom management for transitional nursing from the peri‐operative phase to long‐term rehabilitation.
The experience of advance care planning discussion among older residents in a long‐term care institution: A qualitative study
Authors: Fan Sheng‐Yu , Sung Huei‐Chuan , Wang Shu‐Chen 
Published: June 2019

AbstractAims and objectivesTo explore the experiences and processes of advance care planning (ACP) discussions in older residents of a long‐term care institution.BackgroundAdvance care planning can facilitate discussion about end‐of‐life care and help to identify individual's views, wishes and beliefs about dying at a time when they have the cognitive capacity to reflect on and/or make such decisions.DesignA qualitative study was conducted.MethodsTwenty‐eight older adults in a long‐term care institution participated in person‐to‐person interviews using an ACP booklet, which included topics such as life review, healthy habits and behaviours, and end‐of‐life care issues and information. The discussions were recorded, and thematic analysis was used to analyse the qualitative data. The Standards for Reporting Qualitative Research (SRQR) checklist was followed.ResultsThree themes were identified. First, participants identified that ACP could help to ensure that they achieved their view of a “good death.” Second, the process of ACP bought up difficult decisions that many participants expressed uncertainty about making. Third, participants' ability and willingness to plan for end of life were shaped by considerations about their family members' needs, views and potential role as their future carer.ConclusionsThe ACP process involved not only personal ideas about good death but also families' concerns. Uncertainty and lack of information created difficult barriers.Relevance to clinical practiceHealthcare professionals could address the concept of good death, deliver information for their concerns and promote communication with family members.
Exploring women's health care experiences through an equity lens: Findings from a community clinic serving marginalised women
Authors: Prodan‐Bhalla Natasha , Browne Annette J. 
Published: June 2019

AbstractAims and objectivesTo explore how marginalised women perceive and rate equity‐oriented health care at a primary care clinic using items that evaluate patients' experiences of care.BackgroundDespite an increased recognition of the importance of health care that is equity‐oriented, and that understands the patient within the context of the broader social determinants of health, inequities in health remain prevalent around the world.DesignItems from the “EQUIP Primary Health Care" research programme were used to explore patients' experiences of equity‐oriented health care. Women were invited to complete the questionnaire with the explicit aim of gaining their input to improve quality of care at the clinic. The Strengthening the Reporting of Observational Studies in Epidemiology Statement was followed for the study.MethodsSixty‐seven women who experienced significant health and social inequities, and were seeking care at a women's only nurse practitioner primary health care clinic in Canada, were invited to complete the questionnaire. For quality improvement purposes, correlational analyses were used to explore women's experiences of care.ResultsWomen's responses showed that Promote Emotional Safety and Trust and Overall Quality of Care were the most highly correlated domains, indicating the importance of the health care team in establishing trusting relationships, particularly for women who experience stigma and negative judgement when seeking care.ConclusionSeeking feedback from patients on their experiences of care using items developed to explicitly tap into equity issues is useful in understanding how patients experience equity‐oriented health care. Responses from the women highlight the importance of understanding not only the what of equity‐oriented care but also the how.Relevance to clinical practiceThe results of this study illustrate the importance of establishing trusting relationships, tailoring care, and using a nondiscriminatory approach when working with women who experience negative judgements when seeking care.
Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders
Authors: dos Santos Treichel Carlos Alberto , da Rosa Jardim Vanda Maria , Prado Kantorski Luciane , Guimarães Lima Margareth 
Published: June 2019

AbstractAims and objectivesThis study aimed to analyse the prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders.BackgroundStudies conducted with family caregivers of people with dementia and cancer point out a high prevalence of suicidal ideation among these subjects; however, this aspect has not yet been investigated among family caregivers of people with mental disorders.DesignThis is a cross‐sectional study, conducted with 537 family caregivers of patients from 16 Psychosocial Care Centers (CAPS) of the 21st Health Region of the state of Rio Grande do Sul, Brazil.MethodsQuestion 17 of the Self‐Reporting Questionnaire (SRQ‐20) was used for suicidal ideation screening. The prevalence of suicidal ideation was calculated according to sociodemographic and care variables, with confidence interval estimate (95% CI). Crude and adjusted odds ratios were calculated by logistic regression. The Guidelines to Reporting of Observational Studies in Epidemiology (STROBE Statement) was adhered in this study (See File S1).ResultsThe prevalence of suicidal ideation found in this study for the 30 days preceding the interview was 12.5% (95% CI: 10–15). The factors associated with the outcome were lower age, lower schooling, feeling of burden, self‐report of stress problem and dissatisfaction with family relationships.ConclusionThe prevalence of suicidal ideation among the studied family caregivers was high and strongly associated with issues regarding care, showing the need for interventions that provide support.Relevance for clinical practiceNurses are a large part of the workforce of the community mental health services. The careful characterisation of the subjects who show suicidal ideation, as performed in this study, may reveal specificities capable of refining the diagnostic potential for establishment of action plans in a timely manner, avoiding possible attempts or even the consummation of suicide.
“You only have time for so much in 12 hours” unmet social needs of hospitalised patients: A qualitative study of acute care nurses
Authors: Brooks Carthon J. Margo , Hedgeland Taylor , Brom Heather , Hounshell Danielle , Cacchione Pamela Z. 
Published: June 2019

AbstractAims and objectivesTo explore the experiences of nurses caring for socially at‐risk patients and gain an understanding of the challenges nurses face when providing care.BackgroundNurses play a pivotal role in caring for hospitalised patients with social risk factors and preparing them for discharge. Few studies have explored whether acute care nurses are adequately supported in their practice environments to address the unique needs of socially at‐risk patients as they transition back into community settings.DesignA qualitative descriptive study of nurses working in a large urban academic medical centre.MethodsWe conducted six semi‐structured focus groups of nurses (n = 21). Thematic content analysis was performed to analyse the transcripts from the focus groups. We adhered to COREQ guidelines for reporting this qualitative study.ResultsSix key themes emerged: (a) nurses’ assessments of social risk factors, (b) experiences providing care, (c) barriers to care, (d) fear of “labelling” socially at‐risk patients, (e) unmet social care needs and (f) recommendations to improve care.ConclusionsOur findings suggest that nurses are able to identify social risk factors. However, prioritisation of medical needs during acute care hospitalisation and lack of organisational supports may deter nurses from fully addressing social concerns.Relevance to clinical practiceAcute care nurses should be involved in the development of future efforts to address the needs of socially at‐risk patients and be provided with additional supports in their practice environments. This could include continuing education to build nursing competencies in community‐based care and social vulnerability.
Psychosocial behaviour reactions, psychosocial needs, anxiety and depression among patients with rectal cancer before and after colostomy surgery: A longitudinal study
Authors: Jin Ying , Zhang Jing , Zheng Mei‐Chun , Bu Xiu‐Qing , Zhang Jun‐E 
Published: June 2019

AbstractAims and objectivesTo compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions.BackgroundColorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed.DesignA longitudinal study.MethodsUsing a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013–January 2014. Data collection consisted of two phases, conducted 1–2 days before surgery and 1–2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self‐designed demographic questionnaire were used to collect data. STROBE guidelines were followed.ResultsThe participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions.ConclusionsPatients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery.Relevance to clinical practiceAn increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice.
Instruments measuring behavioural aspects of the nurse–patient relationship: A scoping review
Authors: Feo Rebecca , Conroy Tiffany , Wiechula Rick , Rasmussen Philippa , Kitson Alison 
Published: June 2019

AbstractAims and objectivesTo identify and map tools measuring behavioural aspects of the nurse–patient relationship.BackgroundThe behaviours nurses employ to develop relationships with patients form a key part of nursing practice. Systematically measuring these behaviours provides an objective means of assessing and evaluating how nurses establish and maintain relationships with patients in a variety of settings. Whilst tools exist to measure these behaviours, little is known about their aims/scope, structure, method of development and contexts of use. Such knowledge is crucial for understanding the nature of the literature, including in which contexts and for which patient groups existing tools are suited.DesignScoping review informed by Joanna Briggs Institute methodology.MethodsA database search was undertaken using CINAHL, PsycINFO, Pubmed and Embase. Primary research articles, theses and methodological papers that developed, refined and/or administered tools measuring behavioural aspects of the nurse–patient relationship, in any setting and for any patient group, were included. Tools had to measure actual not hypothetical behaviour (e.g., perceptions regarding importance). Data from included studies and tools were mapped. Results are reported in accordance with PRISMA‐ScR guidelines.ResultsOne hundred and twenty‐seven studies, containing 35 tools, were included. The literature was characterised by substantial variability, stemming from the continued refinement of tools (e.g., reduction to short forms) but also the development of new tools that appeared to duplicate existing work and the inconsistent use of tools across studies.ConclusionsThe volume of tools available demonstrates the importance of measuring the nurse–patient relationship. However, the existing duplication and variability create challenges in choosing amongst the tools available and show that, as a concept, the nurse–patient relationship remains poorly understood.Relevance to clinical practiceResearch is required to synthesise, and assess the quality of, existing tools, enabling clinicians, leaders/managers, educators and researchers to administer appropriate tools to evaluate the nurse–patient relationship.