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Expert consensus on diagnosis and treatment of ulcerative colitis with integrated traditional Chinese and Western medicine: A nursing perspective
Bing XU, Miao LIU, Hairong HU, Jing ZHANG, Yanping HUANG, Ling TANG
Journal of Integrative Nursing    2023, 5 (1): 1-7.   doi: 10.4103/jin.jin_22_22
Abstract85)      PDF(pc) (521KB)(89)      

Ulcerative colitis (UC) is a chronic nonspecific intestinal inflammatory disease of unclear etiology, characterized by continuous and diffuse inflammatory changes of colorectal mucosa. In recent years, the incidence rate of UC in China has increased year by year, but there is no effective cure method in Western medicine. Traditional Chinese medicine treatment based on syndrome differentiation has the unique advantages of simplicity, convenience, effectiveness, and low cost. Therefore, integration of Chinese and Western medicine has become an important strategy for UC diagnosis and treatment, and has made significant progress in UC. On the basis of learning from a number of consensuses at home and abroad, combined with Chinese research results and the actual clinical situation of traditional Chinese and Western medicine, the UC group of the Chinese Association of Integrative Medicine has formulated the expert consensus on the diagnosis and treatment of UC with integrated traditional Chinese and Western medicine. In this consensus, the pathogenesis, etiology and pathogenesis, diagnosis, integrated traditional Chinese and Western medicine treatment, and chronic disease management with integrated traditional Chinese and Western medicine for UC were recommended by experts. This article interprets the consensus from the perspective of nursing in order to provide reference basis for clinical nursing workers.

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Effect of health Qigong on rehabilitation of stroke patients: A systematic review and meta-analysis
Fengguang GUAN, Qiulu JI
Journal of Integrative Nursing    2023, 5 (1): 15-20.   doi: 10.4103/jin.jin_67_22
Abstract65)      PDF(pc) (1554KB)(106)      
Objective: The objective of this study is to evaluate the effects of health Qigong on the rehabilitation of hemiplegic patients after stroke.
Methods: The randomized controlled trials on health Qigong intervention in rehabilitation after stroke were searched in eight databases: PubMed, Cochrane Library, Embase, Web of Science, CBM, CNKI, Wanfang Database, and VIP Database from the inception to February 2022, and the data were analyzed using RevMan 5.3 software.
Results: A total of 17 studies involving 1146 hemiplegic patients after stroke were included. Meta-analysis results showed that the motor function and activities of daily living in the intervention group were better than those in the control group at different intervention times (intervention time <3 months and 3 months–24 weeks) (P < 0.01). When the intervention time was <3 months, the improvement of balance function in the intervention group was better than that in the control group (P < 0.01). However, when the intervention time was 3 months–24 weeks, there was no significant difference in the balance function between the intervention group and the control group (P = 0.10).
Conclusion: Health Qigong has a positive effect on the improvement of motor function and activities of daily living in hemiplegic patients after stroke, but the improvement of balance function is not sure. Due to the low overall quality of the included literature and the heterogeneity of some research results, more rigorous randomized controlled trials are needed to verify its efficacy.
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A comparison of the effect of Vitamin D and Vitamin E supplementations, alone, and in combination, on reducing the intensity and duration of dysmenorrhea in women: A randomized controlled trial
Tahereh BEHROUZI LAK, Nader AGHAKHANI, Davoud VAHABZADEH, Samereh EGHTEDAR, Rozita CHERAGHI, Nazafarin GHASEMZADEH, Vahid ALINEJAD, Maryam MESGARZADEH
Journal of Integrative Nursing    2023, 5 (1): 21-26.   doi: 10.4103/jin.jin_49_22
Abstract93)      PDF(pc) (660KB)(167)      

Objective: The aim of this study is to compare the effect of Vitamin D and Vitamin E supplementations, alone, and in combination, on reducing the intensity and duration of dysmenorrhea in women who were referred to the Kowsar gynecological clinics of Shahid Motahari Hospital of Urmia University of Medical Sciences.
Materials and Methods: A double-blinded clinical trial was conducted on 112 women with dysmenorrhea who were randomly allocated into the four study groups. Finally, 100 women complete the study and received capsules containing a placebo (n = 25), 1000 IU of Vitamin D (n = 25), 400 mg of Vitamin E (n = 25), and 1000 IU of Vitamin D + 400 mg of Vitamin E (n = 25) every 24 h for 2 consecutive months at the beginning of the menstrual period. The pain intensity and duration among groups were compared before and after the intervention.
Results: The mean menstrual pain duration in all three experimental groups (Vitamin E, Vitamin D, and the combination of them) was lower than the placebo group (all P < 0.05), and the mean pain intensity scores in all three experimental groups were significantly lower than the placebo group (all P < 0.05). The results (means) for all of the drugs administered at the end of the 2nd month were better than the 1st month (all P < 0.01).
Conclusions: Vitamin E and Vitamin D, as well as their combination, are recommended as an effective and safe treatment for the management of the complications of dysmenorrhea.

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Evaluation of adolescent/youth‑friendly sexual and reproductive health services: A 7‑year systematic review from January 2016 to April 2022
Oladayo Damilola AKINWALE, Cecilia Bukola BELLO, Oluwaseyi Abiodun AKPOR, Mayowa Grace ELEMILE
Journal of Integrative Nursing    2022, 4 (4): 177-192.   doi: 10.4103/jin.jin_79_22
Abstract34)      PDF(pc) (687KB)(10)      

Adolescent/youth-friendly sexual and reproductive health services (SRHS) play a vital role in reducing morbidity and mortality associated with adolescent SRH. This review examined studies carried out on adolescent/youth-friendly SRHS with focus on availability, accessibility, utilization as well as perception of health care providers, and adolescents about the services. The study design was systematic review of empirical studies using a well-defined strategy. Online journal was searched comprehensively using Web of Science, Google Scholars databases, PubMed, Medline, and EMBASE. Other sources were identified through the scanning of references of selected sources. The articles selected were between 2016 and 2022 and had qualitative/quantitative and mixed methods. The articles that met the selection criteria were also screened using PRISMA-P guidelines and SPIDER framework for systematic review was further used for inclusion criteria based on the following concepts: sample, phenomenon of interest, design, evaluation and research type. A total number of 32 studies were included in the study and findings were reported based on the five emerging themes. The review showed that majority of the adolescents were not aware of adolescent/youth-friendly SRHS, some health care providers were not also in support of the services which accounted for low utilization of the services among adolescents. The review further showed poor accessibility and nonavailability of AYFSRHS as the only available SRHS were meant for married adults. Therefore, these findings serve as evidence for policy-makers at all the levels of healthcare delivery system to considered all the factors observed in this review and develop strategies that will make adolescent/youth-friendly SRHS available and accessible to adolescents. More so, other stakeholders, especially health care providers must improve their attitude toward provision of adolescent/youth-friendly SRHS.

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Symptom experience in patients with cancer-related fatigue: A systematic review and meta-synthesis
Ke PENG, Mi ZHANG, Jie ZHANG, Dan YANG, Ling TANG
Journal of Integrative Nursing    2022, 4 (4): 193-201.   doi: 10.4103/jin.jin_66_21
Abstract24)      PDF(pc) (697KB)(8)      

To understand the real experiences of patients with cancer-related fatigue and to promote quality of life, the researchers used computer searches of PubMed, EMbase, CINAHL, PsycINFO, Web of Science, and China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data, China Science and Technology Journal Database for relevant qualitative studies from the inception to November 1, 2021. The results showed that a total of 16 papers were included, and 57 outcomes were distilled into 9 categories, which were pooled into four integrated outcomes, such as somatic, psychological and social support and so on. It is concluded that patients with cancer-related fatigue are not only in the midst of multidimensional, unspeakable somatic experiences, and complex psychological experiences, they are also hindered in coping with fatigue symptom and social life. Therefore, healthcare professionals should provide health interventions and psychological support to those patients whenever possible.

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Dredging hand Yang meridians with deep tissue massage combined with neck movement in stiff‑neck syndrome: A randomized controlled trial
Xueguo SUN, Zonghua QI, Ying LIU, Yan LI, Xianli DOU, Lingyun ZHANG
Journal of Integrative Nursing    2022, 4 (4): 211-216.   doi: 10.4103/jin.jin_26_22
Accepted: 31 December 2022

Abstract23)      PDF(pc) (982KB)(5)      

Objective: The objective of this study is to observe the therapeutic effects of dredging hand Yang meridian with deep tissue massage combined with neck movement on stiff-neck syndrome.
Materials and Methods: This is a randomized controlled trial. The consecutive patients with the stiff-neck syndrome were randomly allocated into the intervention group and patch group (1:1) according to the random number table. The intervention group was treated with dredging hand Yang meridian with deep tissue massage combined with neck movement once a day for 3 days, while the patch group therapy was treated with a 3-patch therapy and every patch included 24-h patch and 24-h patch-free. A needle electromyogram would be exerted if the patients were at their willingness in different stages. The pain of patients was assessed by Visual Analog Scale in the two groups at every 24 h time point.
Results: Finally, 212 patients completed the trial, 106 in each group. The curative rate in the intervention group was higher than in the patch group (99.06% vs. 84.91%, χ2 = 0.890, P < 0.01). Repeated measures of the general linear model showed a significant difference in pain score within the subject-factors (factor of time F = 4548.577, P < 0.001; factor of time-group F = 490.034, P < 0.001). There was a significant difference between groups regarding pain score (F = 3016.315, P < 0.001).
Conclusion: Dredging hand Yang meridian with deep tissue massage combined with neck movement is better than patch therapy in stiff-neck syndrome, with a shorter duration and instant effects.

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Quality of life and psychological impact among chronic disease patients during the COVID-19 pandemic
Mohammed AL MAQBALI, Ahmad ALSAYED, Ibrahim BASHAYREH
Journal of Integrative Nursing    2022, 4 (4): 217-223.   doi: 10.4103/jin.jin_76_22
Abstract21)      PDF(pc) (602KB)(5)      

Objective: Patients diagnosed with chronic disease may experience psychological symptoms including depression, anxiety, insomnia, and fatigue, all of which may adversely affect their quality of life (QoL). The main objective of this study is to identify the level of QoL, to know the prevalence of these symptoms among chronic disease patients in Oman during the third wave of coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing factors.
Methods: A cross-sectional and descriptive correlational design was used. Convenience sampling was used to recruit participants. Data were collected using the Functional Assessment of Chronic Therapy (FACT)–General, Hospital Anxiety and Depression Scale, the Insomnia Severity Index, and the FACT–Fatigue subscale via Qualtrics? software. Linear regression analyses were used to explore factors that were associated with QoL.
Results: Of 990 patients with chronic disease who participated, the mean total QoL score was 67.7 (standard deviation = 16.1). Participants aged above 51, those with a basic education, those with heart disease, or those with more than one comorbidity had a significantly lower QoL. Linear regression revealed that the main factors associated with lower QoL included heart disease (β = 0.05, P = 0.02), diabetes (β = 0.12, P < 0.01), having taken one dose of COVID-19 vaccine (β = 0.05, P = 0.04), anxiety (β = -0.24, P < 0.01), depression (β = -0.31, P < 0.01), insomnia (β = -0.12, P < 0.01), and fatigue (β = 0.27, P < 0.01).
Conclusions: The COVID-19 pandemic has significantly reduced the individuals' level of QoL and affected the mental health of patients diagnosed with chronic diseases. Appropriate strategies to monitor psychological problems and interventions to prevent and reduce these among such patients are needed.

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Nursing perspective of expert consensus on the diagnosis and treatment of cerebral infarction with integrated traditional Chinese and Western medicine
Guiying LIU, Ling TANG, Shirong HU, Haiyan E, Yanyan ZHANG, Yu YANG, Jing ZHANG
Journal of Integrative Nursing    2022, 4 (3): 107-113.   doi: 10.4103/jin.jin_8_22
Abstract66)      PDF(pc) (509KB)(26)      
Cerebral infarction (CI) is also known as ischemic stroke. It is one of the most common cerebrovascular diseases, with high mortality and disability rate, which has seriously threatened human health. To better apply the diagnosis and treatment plan of integrated traditional Chinese and Western medicine to the treatment of patients with CI, the Chinese Association of Integrative Medicine issued the Expert Consensus on the Diagnosis and Treatment of Cerebral Infarction with the Integrated Traditional Chinese and Western Medicine in 2021. It involves etiology and pathogenesis of CI, diagnosis and treatment standards of Traditional Chinese Medicine (TCM) and Western Medicine, syndrome elements of TCM, as well as rehabilitation nursing of CI with integrated traditional Chinese and Western medicine during acute period and recovery period. This study interprets the consensus from routine nursing, dietary nursing, emotional nursing, complication nursing, rehabilitation nursing, and continuous nursing, aiming to provide evidence-based support for clinical TCM nursing practice.
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Does educational intervention change knowledge, attitude, and practice regarding pharmacovigilance among nursing officers in Central India? An interventional study
Chaitali Ashish CHINDHALORE, Ganesh Natthuji DAKHALE, Ashish Vijay GUPTA
Journal of Integrative Nursing    2022, 4 (3): 114-119.   doi: 10.4103/jin.jin_45_22
Abstract21)      PDF(pc) (643KB)(23)      
Objectives: To evaluate the impact of educational intervention on knowledge, attitude, and practice (KAP) regarding pharmacovigilance (PV) and adverse drug reaction (ADR) reporting among nursing officers.
Materials and Methods: A pre- and post-single-arm interventional study was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur from May 2021 to October 2021 among 48 nursing officers. Data related to KAP were obtained through validated questionnaires before and after 3 months of educational intervention.
Results: The mean knowledge score among nursing officers significantly improved from 11.05 ± 3.09 to 16.77 ± 2.07 after training session (P < 0.001). The mean score regarding attitude was significantly upgraded from 21.16 ± 5.6 to 23.79 ± 2.97 (P < 0.001). At baseline, the mean practice score was poor (2.41 ± 2.89), which was improved after training session, but the difference is not significant.
Conclusion: Educational intervention had a significant impact on knowledge and attitude toward ADR reporting. The practice of detecting and reporting an ADR to the treating consultant is improved, but it is not transformed into reporting an ADR to the PV center to a significant extent. Hence, it is recommended to streamline ADR reporting process by implementing such training modules more frequently.
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Research capacity and training needs of nurses’ in Shanghai, China: A multicenter, cross-sectional survey
Huajiao XU, Ying SHEN, Lingling WU, Weihong SHEN
Journal of Integrative Nursing    2022, 4 (3): 120-126.   doi: 10.4103/jin.jin_34_22
Accepted: 30 September 2022

Abstract74)      PDF(pc) (648KB)(32)      
Aims: The aim of this study is to investigate nurses' research capacity and related training needs in Shanghai to provide evidence to further nursing research training.
Materials and Methods: A cross-sectional design with a convenience sample of 1226 clinical registered nurses, including the Nursing Research Capacity of Self-Evaluation Questionnaire and Research Training Needs Form, was recruited from 14 public hospitals in Shanghai, China. And the influencing factors of nurses' research capacity were analyzed.
Results: The mean score of nurses' research capacity was (46.25 ± 22.90) in Shanghai, that was at a low-to-medium level. The influencing factors of nurses' research capacity including age (F = 15.983, P < 0.001), education (F = 20.738, P < 0.001), professional title (F = 6.993,
P = 0.001), working years (F = 7.803, P < 0.001), department (F = 8.545, P < 0.001), and position (F = ?3.354, P = 0.001). The most critical factor is the time to participate a study (P < 0.001). And what the nurses demanded were writing skills, special lectures, and participating in colleagues' projects mostly.
Conclusion: Nurse's scientific research capacity still needs to be improved in Shanghai. The key to improving this situation is the individualized scientific research training and education for nurses and the practice of more participation in scientific research projects.
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Nursing perspective of expert consensus for diagnosis and treatment of colorectal cancer with integrated traditional Chinese and Western medicine
Shuhong LIU, Ling TANG, Yanan ZHAO, Jingjing HUO, Yan ZHAO, Kang YAN, Baoya ZHAO
Journal of Integrative Nursing    2022, 4 (2): 49-58.   doi: 10.4103/jin.jin_1_22
Abstract114)      PDF(pc) (517KB)(152)      

As one of the most common malignant tumors in the world, colorectal cancer (CRC) is accompanied by a variety of symptoms in the process of disease development and treatment, which seriously affect the functional state and quality of life of patients. In China, comprehensive intervention measures of traditional Chinese medicine (TCM) play an indispensable role in the treatment and rehabilitation of CRC. In order to further standardize and improve the treatment and management of CRC by medical staff, the Chinese Association of Integrative Medicine issued the “Expert Consensus for Diagnosis and Treatment of Colorectal Cancer with Integrated Traditional Chinese and Western Medicine” in August 2021. This paper interprets this consensus in detail from the perspective of nursing, focusing on the common understanding of the pathogenesis of CRC, TCM diagnosis and syndrome differentiation, integrated traditional Chinese and Western medicine nursing, TCM characteristic therapies, etc., with a view to deepening the understanding and practical application of the consensus among clinical doctors and nurses and improving the level of diagnosis, treatment, and nursing of CRC.

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Treatment satisfaction and medication adherence among hypertensive patients in a teaching hospital in Ekiti State, Nigeria
Oluwaseyi Abiodun AKPOR, Florence Olutola OLOWOLAJU
Journal of Integrative Nursing    2022, 4 (2): 59-67.   doi: 10.4103/jin.jin_4_22
Abstract144)      PDF(pc) (557KB)(134)      
Objective: This study investigates treatment satisfaction and medication adherence among hypertensive patients attending the medical outpatient clinic of a teaching hospital in Ekiti State, Nigeria.
Materials and Methods: The study design was descriptive and cross-sectional using quantitative research strategy. A systematic sampling technique was used in selecting 270 participants; a structured questionnaire was used for data collection. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale, and treatment satisfaction was assessed using the 14-item Treatment Satisfaction Questionnaire for Medication.
Results: The study findings revealed that majority (73.7%) of the study participants had good knowledge of hypertension, while 44.4% had a good level of treatment satisfaction. Test of association of participants' sociodemographic characteristics revealed age (χ2 = 23.773, P = 0.003) and occupation (χ2 = 21.251, P = 0.019) to be significantly associated with treatment satisfaction. The level of medication adherence by the participants was observed to be relatively poor (50.4%). The educational status (χ2 = 23.914, P = 0.001) and monthly income (χ2 = 10.406, P = 0.034) of the participants showed significant association with medication adherence.
Conclusion: The study recommends that improving patients' understanding of their disease and treatment with subsidizing hypertensive medications by the government will enhance medication adherence.
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Midwives' utilization of nonpharmacological pain relief measures for labor pain management: A descriptive cross-sectional study
Idang Neji OJONG, Alberta David NSEMO, Mathias AGBA
Journal of Integrative Nursing    2022, 4 (2): 76-82.   doi: 10.4103/jin.jin_27_22
Abstract146)      PDF(pc) (528KB)(164)      
Objectives: This study sought to examine midwives' utilization of nonpharmacological pain relief measures in labor pain management and to test the relationship between midwives' knowledge and utilization of nonpharmacological pain relief measures for labor pain management in secondary health facility in Calabar, Cross River State, Nigeria.
Materials and Methods: A descriptive cross-sectional design was used for the study. The study was rooted in Katherine Kolcaba's Comfort theory. Totally, 67 participants were recruited for the study using the purposive sampling technique. A self-made structured questionnaire was used to obtain participants' information on knowledge, utilization, and predictors of nonpharmacological pain relief measures.
Results: Although 41 (61.2%) of the participants had knowledge about nonpharmacological pain relief measures, few did not know some of the cognitive-behavioral and environmental measures in labor pain management. There was 35.8% (24/67) for utilization of cognitive-behavioral measures and 55.2% (37/67) for psychological/emotional measures for labor pain management by respondents, respectively. Fifty (74.6%) of respondents agreed that predictors such as lack of knowledge, lack of updates and training, work experience, best practice guidelines, and equipment were hindrances to utilization. There was statistically significance in relationship between the level of knowledge and utilization of nonpharmacological pain relief measures (r = 0.6, P < 0.05).
Conclusion: The utilization of nonpharmacological measures for labor pain management is low, thus it is recommended that frequent education, training updates on effective labor pain management, provision of clinical guidelines on labor pain management, and enrichment of midwifery training curriculum are imperative to ensure quality labor pain management and positive health outcome.
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Nursing perspective of the expert consensus on diagnosis and treatment of integrated Chinese and Western medicine in lung cancer
Jing ZHANG, Tao MA, Shuhong LIU, Yan ZHAO, Ling TANG
Journal of Integrative Nursing    2022, 4 (1): 1-7.   doi: 10.4103/jin.jin_61_21
Abstract55)      PDF(pc) (511KB)(35)      
Lung cancer is a malignant tumor with the highest incidence and mortality in China, which seriously affects the quality of life of patients. Traditional Chinese medicine (TCM) plays a unique advantage in the treatment and rehabilitation of lung cancer. In order to standardize TCM diagnosis and treatment and disease management of clinical medical workers, the Chinese Association of Integrative Medicine issued the “Expert Consensus on the Diagnosis and Treatment of Lung Cancer by Integrated Traditional Chinese and Western Medicine” in August 2021. Experts' recommendations were made on the clinical staging and syndrome differentiation and classification of lung cancer, characteristic TCM therapies, and nursing care of integrated traditional Chinese and Western medicine. This article interpreted the Consensus on the above aspects from a nursing perspective, hoping to provide references for clinical medical workers in the treatment and nursing care of lung cancer.
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Skin damage due to personal protective equipment among nursing staff in a dedicated coronavirus disease‑2019 hospital of tribal India
Avatarkishan JAISINGHANI, Vikas GUPTA, Amanjot Kaur CHAUHAN
Journal of Integrative Nursing    2022, 4 (1): 8-14.   doi: 10.4103/jin.jin_42_21
Abstract57)      PDF(pc) (563KB)(34)      
Background: Nursing staff are at much greater risk of infection (Ebola virus diseases and severe acute respiratory syndrome) due to their exposure to highly infectious bodily fluids and droplet nuclei and the need for personal protective equipment (PPE) to reduce the transmission risk.
Aim: The present study was conducted to estimate the prevalence of skin injuries and their types due to PPE usage among nursing staff in tribal India.
Materials and Methods: This descriptive cross-sectional study was conducted in the dedicated coronavirus disease-2019 (COVID-19) hospital for a period of 4 months among 144 nursing staff wearing Grade 2 and 3 PPE kits. Study subjects were approached through social networking websites and survey questionnaires (Google forms) according to relevant guides, and research literature was used to collect the details regarding baseline, duty, and skin injury characterization. Chi-square test was used to find the association between skin injury and baseline or duty characteristics, and the association was significant at a P < 0.05.
Results: It was observed that 54.7% of nursing staff were working for 6 or more hours and 16.5% of subjects were wearing the PPE kit for 5 or more hours per day. Skin injury was reported by 86.3% of the subjects after using PPE. Skin injuries among nurses were statistically significant with their current place of stay and daily duty hours (P < 0.05).
Conclusion: In this study, it was found that 86.3% of subjects had suffered from skin injuries by using PPE while caring for COVID-19 patients during duty hours, so an effective preventive measure should be adopted.
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Omicron: Egyptian nurses’ knowledge and attitudes
Mostafa SHABAN, Marwa Mamdouh SHABAN, Osama RAMADAN, Huda Hamdy MOHAMMED
Journal of Integrative Nursing    2022, 4 (1): 15-19.   doi: 10.4103/jin.jin_63_21
Abstract42)      PDF(pc) (518KB)(20)      
Objective: The current study aimed to assess the knowledge and attitudes of nurses toward the current COVID-19 pandemic and Omicron variant.
Materials and Methods: A cross-sectional online survey was used. Totally 277 Egyptian nurses completed an electronic questionnaire comprising demographics with 5 items, nurses' knowledge on Omicron with 18 questions, and nurses' attitudes on Omicron with 5 questions. The data collected were expressed using numbers, percentages, and mean and standard deviation.
Results: The mean age of nurses was 27 ± 5 years, nearly 50% of the nurses were bachelor degrees. The total score of correct answers related to knowledge was 75%, showing the different degrees of knowledge about Omicron. The majority of nurses showed positive attitudes toward controlling and managing the COVID-19 pandemic.
Conclusions: Egyptian nurses have average knowledge about Omicron and a positive attitude toward controlling the COVID-19 pandemic. There should be scope for further assessment to enhance understanding about COVID-19. Moreover, health education programs should be developed for nursing staff to improve information, beliefs, behaviors, and attitudes towards the Omicron variant in particular and the COVID-19 pandemic in general.
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Insignificant small can still be mighty: Trend of chronic kidney disease in Nigeria
Oluwaseyi Abiodun AKPOR, Abigael Oluwaseyi ADEOYE, Blessing AWHIN, Olaolorunpo OLORUNFEMI
Journal of Integrative Nursing    2021, 3 (4): 141-147.   doi: 10.4103/jin.jin_43_21
Abstract104)      PDF(pc) (852KB)(181)      

The global burden of chronic kidney diseases (CKDs) kept increasing, and it is a leading cause of mortality and morbidity rate in most African countries. The burden of CKD is felt more in developing countries where there is no adequate social security system or health insurance to meet the huge financial demands the disease places on its sufferers and their families. It is also noted that this disease affects the economically productive age group unlike in developed countries where the elderly are more affected. The prevalence of CKD was found to be highly related to age, gender, hypertension, obesity, history of diabetes mellitus, use of herbal medicines, and prolonged use of nonsteroidal anti-inflammatory drugs in Nigeria. The majority of CKD cases were not clinically recognized promptly, mainly because of the lack of patients’ awareness about CKD and associated risk factors. Therefore, health awareness should be intensified by the nurses on lifestyle modification by individuals at risk of CKD, prompt management, good compliance with prescribed medications, avoidance of self-medication, and indiscriminate use of over-the-counter drugs. In addition to that, nurses also need to advocate for regular population screening, and efforts should be made at all levels of care to reduce the negative impact of the disease and complications on the patients.

 

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Moxibustion plus acupuncture improves the efficacy and quality of life of patients with polycystic ovary syndrome: A randomized controlled trial
Qian ZHANG, Li-Xiu LIU
Journal of Integrative Nursing    2021, 3 (4): 148-154.   doi: 10.4103/jin.jin_47_21
Abstract134)      PDF(pc) (543KB)(179)      
Objective: To observe the effect of moxibustion combined with acupuncture on the efficacy and quality of life of spleen-kidney-yang-deficiency patients with polycystic ovary syndrome (PCOS).
Materials and Methods: A total of 90 patients with PCOS of spleen-kidney yang deficiency type from January 2020 to March 2021 were selected and randomly divided into three groups, 30 patients each in the moxibustion group, acupuncture group, and moxibustion combined with acupuncture group (combined group). The changes of body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment-insulin resistance index (HOMA-IR), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), triglycerides (TG), total cholesterol (TC), traditional Chinese medicine (TCM) clinical symptom score, efficacy, and quality of life score in the three groups were observed before and 3 months after treatment.
Results: After treatment, (1) compared with the moxibustion and acupuncture groups, the combined group was more effective in reducing BMI (F = 5.274, P < 0.05) and WHR (F = 8.246, P < 0.05) in PCOS patients; (2) FINS, FPG, and HOMA-IR were reduced in all three groups, and the reduction in these three indicators was more pronounced in combined group (FINS: F = 5.637, P < 0.05, FPG: F = 4.915, P < 0.05, HOMA-IR: F = 3.817, P < 0.05); (3) The FSH, LH, and T levels of patients in the combined group were better than those in the remaining two groups (FSH: F = 4,163, P < 0.05, LH: F = 5.098, P < 0.05, T: F = 7.038, P < 0.05); (4) The TG and TC of patients in the combined group were lower than those in the remaining two groups (TG: F = 4.806, P < 0.05, TC: F = 3.828, P < 0.05); (5) The TCM clinical symptom score of the combined group was significantly lower than those of the moxibustion and acupuncture groups (F = 4.547, P < 0.05); (6) The quality of life of patients in the combined group improved more significantly than the moxibustion and acupuncture groups (F = 6.239, P < 0.05); (7) The total effective rate of the combined group was higher than that of the moxibustion and acupuncture groups (χ2 = 6.947, P = 0.031).
Conclusion: The combination of moxibustion and acupuncture can effectively reduce the BMI and WHR of PCOS patients, improve the endocrine function, sex hormone level, TCM symptoms and quality of life of patients, and has significant efficacy and high safety, which is worthy of wide clinical application.
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Relationship of demoralization with anxiety, depression, and demographics of Chinese dialysis patients
Cai-Lan ZHUANG, Juan-Lian ZHENG, Lei GAO, Ying-Ling HUANG, Wen-Jing HU
Journal of Integrative Nursing    2021, 3 (4): 155-160.   doi: 10.4103/jin.jin_46_21
Abstract80)      PDF(pc) (530KB)(176)      

Objective: The purpose of this study is to investigate the demoralization level of dialysis patients in China and analyze the influencing factors.
Materials and Methods: A convenience sample of 278 dialysis patients from a tertiary hospital participated in a cross-sectional descriptive study using a structured questionnaire including assessments of demographic data, Demoralization Scale-II (DS-II), and Hospital Anxiety and Depression Scale. The main analysis consisted of descriptive statistics, correlation coefficients, and multiple linear regression.
Results: The mean standard deviation DS-II score was 11.87 (7.72). Dialysis patients had a high level of demoralization. Findings from multiple linear regression indicated that demoralization was positively correlated with marital status (β = 0.141; P = 0.001), employment status (β = 0.113; P = 0.006), anxiety (β = 0.393; P < 0.001), and depression (β = 0.224; P < 0.001). These variables explained 57.1% of the variance in patient demoralization.
Conclusions: Demoralization is common in dialysis patients and is associated with marital status, employment status, anxiety, and depression. Health-care providers might regularly assess demoralization in dialysis patients, and develop related interventions to improve the quality of life.

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Self-management of cataract extraction among diabetes patients
Funke Elizabeth AKINTUNDE, Olaolorunpo OLORUNFEMI, Rasidi Akinade SALAWU, Mary Olabisi OYEKANMI, Babatunde Abdul-latef ADEYENI, Olawale Rasheed OLADAPO, Jeminat Omotade SODIMU
Journal of Integrative Nursing    2021, 3 (4): 170-175.   doi: 10.4103/jin.jin_39_21
Abstract109)      PDF(pc) (488KB)(185)      

Background: Diabetes-related cataract extraction is a minor surgery required to regain full vision. One of the recognized factors that can delay or prevent full-vision recovery is poor management, and most of this management is being carried out by patients themselves.
Objective: This study aimed to assess the knowledge of diabetes patients on self-management after cataract extraction in two tertiary hospitals in Osun State.
Methods: A cross-sectional descriptive design was conducted among 97 diabetes patients who underwent cataract extraction and were attending clinics and follow-up visits in Osun State. A self-structured questionnaire was used for data collection.
Results: Moderate knowledge was found among the participants on an appropriate diet (56.7%), prevention of injury risk (57.5%), prevention of infection risk (50.9%), and low knowledge on the technique of administration of eye drop (60.8%) after cataract extraction, whereas 74.7% of the total respondents were knowledgeable on the indication for follow-up visit after cataract extraction, these results were found to be below the expected knowledge level.
Conclusion: An intensive and comprehensive educational initiative by nurses should be tailored to meet the specific needs of diabetes patients with cataract surgery. Nurses also need to implement the use of checklist which will enhance learning and improve patient understanding of self-management after cataract extraction.

 

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Effect of a traditional Chinese medicine theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus: A randomized controlled trial
Huiwen XU, Yuan YUAN, Li YANG, En TAKASHI, Akio KITAYAMA
Journal of Integrative Nursing    2021, 3 (3): 97-105.   doi: 10.4103/jin.jin_19_21
Abstract154)      PDF(pc) (604KB)(238)      
Objective: The aim of this study was to evaluate the effect of the Traditional Chinese Medicine (TCM) theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus (T2DM) in China.
Materials and Methods: A randomized controlled trial was conducted. Ninety?seven patients with T2DM were enrolled and they were randomized into the control group and the experimental group. The control group was given usual diabetes education and follow-up with telephone call, while the experimental group was followed up by using the TCM theory-based mobile app. After 6-month intervention, the diabetic symptom scores, the blood glucose levels, and self?management ability of the two groups were compared. 
Results: Compared with intervention before, the levels of fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), and glycated hemoglobin (HbA1c) decreased in the control group (9.28 ± 3.05 vs. 8.26 ± 2.73 mmol/L, 12.65 ± 4.18 vs. 10.65 ± 3.79 mmol/L, and 8.78% ±1.76% vs. 7.96% ±1.47%, respectively, all P < 0.05) and also decreased in the experimental group (8.36 ± 2.64 vs. 7.35 ± 2.45 mmol/L, 11.50 ± 4.29 vs. 9.85 ± 2.71 mmol/L, and 8.64% ±2.04% vs. 7.29% ±1.56%, respectively, all P < 0.05) after 6?month intervention, while the summary of diabetes self-care activities (SDSCAs) scale scores after 6?month intervention increased significantly in the control group (35.20 ± 14.68 vs. 44.78 ± 10.21, P < 0.05) and the experimental group (32.16 ± 13.21 vs. 50.37 ± 10.06, P < 0.05). After 6-month intervention, the diabetic symptom scores (18.16 ± 2.74 vs. 22.18 ± 4.77) and HbA1c (7.29 ± 1.56% vs. 7.96% ±1.47%) were lower, and SDSCA scale scores (50.37 ± 10.06 vs. 44.78 ± 10.21) were higher in the experimental group than the control group (all P < 0.05). 

Conclusion: The mobile app based on TCM theory can effectively improve diabetes-related symptoms in patients with T2DM and help control their blood glucose as well as enhance their self-management ability.

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Comparison of in‑vial exhaust method versus conventional exhaust method in the injection of COVID‑19 vaccine
Jingjin XU, Hui ZHI, Ye LI, Jinjing LIU, Wen ZHENG, Ling TANG
Journal of Integrative Nursing    2021, 3 (3): 106-109.   doi: 10.4103/jin.jin_28_21
Abstract112)      PDF(pc) (752KB)(204)      
Objective: The objective of the study was to compare the application effects of in-vial exhaust method and conventional exhaust method in the process of coronavirus disease 2019 vaccine injection.
Materials and Methods: Using convenient sampling method, 102 vaccines were selected as experiment group during the process of vaccine injection, and the in-vial exhaust method was used. One hundred and five vaccines were selected as the control group and the conventional exhaust method was adopted. The incidence of vaccine solution spillage and exhausting time in the two groups during exhaust were observed.

Results: The incidence of solution spillage in the experiment group was lower than that in the control group (0 vs. 6.67%, P < 0.05). The exhausting time of the experiment group was shorter than that of the control group ([15.12 ± 4.43] s vs. [22.74 ± 6.53] s, P < 0.05). 

Conclusion: Implementing the in-vial exhaust method in the vaccine injection can effectively reduce the incidence of solution spillage, reduce nucleic acid contamination, and ensure that the vaccine is injected at the prescribed dose. Moreover, the operation is simple and easy, which improves the nurse’s vaccination efficiency, and has a higher promotion and application value.

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Analysis of licensure examination anxiety and its influencing factors among undergraduate nursing students
Doreen Asantewa ABEASI, Frank Bediako AGYEI
Journal of Integrative Nursing    2021, 3 (3): 110-106.   doi: 10.4103/jin.jin_33_21
Abstract230)      PDF(pc) (512KB)(326)      
Background: Examination anxiety is a concern for educational policymakers because of the impact it can have on the overall outcome of the performance of the candidates who partake in such examinations.

Aim: The aim of this study is to determine the examination anxiety level of students of Nursing and Midwifery College, Agogo, and Presbyterian University College and to evaluate the factors affecting them. 

Materials and Methods: A total of 160 undergraduate nursing students comprising 80 degree and 80 diploma students were conveniently sampled for the study. The study was conducted in September 2019 using a descriptive cross-sectional design. The Westside Test Anxiety Scale was used to measure examination anxiety among the participants. A researcher-designed questionnaire in which participants responded to a three-point Likert scale was used to assess factors influencing examination anxiety.

Results: The findings of the study showed that test anxiety was higher among the diploma candidates (M = 3.60) than the degree candidates (M = 2.95) and the difference was statistically significant (P = 0.024). Demographic characteristics such as age (P = 0.009), sex (P = 0.003), study hours per day (P = 0.001) were found to be significantly associated with test anxiety. The factors found to influence examination anxiety among students were volume of materials to study (P = 0.044), level of preparation (P = 0.005) perceived difficulty of the questions (P = 0.033) and myth about examinations (P = 0.000). The perceived importance of the examination (P = 0.057) and schedule of the exams (P = 0.68) did not influence examination anxiety.

Conclusion: Candidates for the licensure examination organized by the Nursing and Midwifery Council of Ghana should be assessed for test anxiety and offered the necessary psychological support where necessary.
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Discussion on optimizing nursing rounds model based on the inheritance of traditional Chinese medicine nursing
Xue‑Jian ZHANG, Ling TANG, Jing ZHANG, Yue TANG
Journal of Integrative Nursing    2021, 3 (2): 53-55.   doi: 10.4103/jin.jin_05_20
Abstract61)      PDF(pc) (409KB)(210)      
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Operations of school health program assessment at selected secondary schools in Egor Local Government Area, Benin City, Nigeria
Eunice Amaechi OSIAN, Osagumwenro IGBINOBA, Olaolorunpo OLORUNFEMI, Monday Ugiagbe AGBONKPOLOR
Journal of Integrative Nursing    2021, 3 (2): 56-61.   doi: 10.4103/jin.jin_5_21
Abstract109)      PDF(pc) (545KB)(221)      
Background: School health program (SHP) is the most cost-effective investment a nation can make to simultaneously improve education and health conditions of her citizen. In spite of this, the adoption of SHP in developing countries is still below set standard. Therefore, this study assesses the operations of SHP in secondary schools in Egor Local Government Area (LGA), Benin City, Nigeria.
Materials and Methods: A descriptive cross-sectional survey was conducted with accidental sampling method to select 56 school health teachers from secondary schools in Egor LGA. A self-structured instrument was used to collect data based on the research objectives. Data collected were analyzed using percentages, means, and standard deviation.
Results: This study showed that despite high level of the program awareness, the actualization of its objective was found to be poor, and this was found to be related with the lack of government support, lack of needed personnel and materials, lack of effective supervision of the program and inappropriate funding.
Conclusion: In-service training on SHP should be provided to enhance the skills needed for implementation of SHP. The government should provide needed materials and equipment and employ competent health personnel to take charge of the school health services, and other policymakers should mobilize and strengthen SHP and education activities at the state.
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Control effect of structured skin care plan of integrated Chinese and Western medicine in elderly patients with incontinence‑associated dermatitis
Jian‑Hua DENG, Xiu‑Li LI, Li‑Li NIU, Yuan‑Yuan LI, Jing ZHANG, Ling TANG
Journal of Integrative Nursing    2021, 3 (2): 62-66.   doi: 10.4103/jin.jin_013_20
Abstract147)      PDF(pc) (577KB)(247)      
Objective: The objective of this study is to explore the clinical effects of structured skin care plan of integrated Chinese and Western medicine in intervening elderly patients with incontinence-associated dermatitis (IAD).
Materials and Methods: Totally, 66 elderly patients with IAD were randomly divided into the experiment group (32 cases) and control group (34 cases). The control group was given routine nursing care, while the experiment group was given a structured skin care plan. The observational course was 2 weeks. The treatment efficiency and healing time were compared between the two groups.
Results: After 2-week intervention, the total effective rate of the experiment group was higher than that of the control group (97.1% vs. 78.1%, X2 = 3.913, P = 0.048). The skin assessment tool score of the experiment group was lower than that of the control group (0.56 ± 1.58 vs. 1.75 ± 2.46, Z = ?2.401, P = 0.016). The healing time of the experiment group was shorter than that of the control group (7.29 ± 4.76 days vs. 10.69 ± 6.36 days, Z = ?2.280, P = 0.026).
Conclusion: The structured skin care plan of integrated Chinese and Western medicine showed a good effect in elderly IAD patients, and provided a reference for clinical treatment and care of elderly patients with IAD.
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Analysis of risk factors for lymphedema of the lower limbs after endometrial cancer surgery and suggestions for prevention and treatment
Qian ZHANG, Li-Xiu LIU
Journal of Integrative Nursing    2021, 3 (2): 67-71.   doi: 10.4103/jin.jin_13_21
Abstract113)      PDF(pc) (580KB)(205)      
Objective: The objective of this study is to investigate the risk factors for the occurrence of lower limb lymphedema in patients with endometrial cancer after surgery and to make recommendations for prevention and treatment.
Materials and Methods: We retrospectively reviewed the clinical data of 135 patients with endometrial cancer treated in the Department of Gynecology of the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2013 to December 2019 and analyzed the risk factors of lower limb lymphedema in patients with endometrial cancer after surgery using single factor analysis and multi-factor logistic regression analysis.
Results: The incidence of postoperative lower limb lymphedema in patients with endometrial cancer was 11.11%. The results of one-way Chi-square test analysis showed that body mass index (BMI), surgical method, number of lymph node dissection, and radiotherapy were related to the occurrence of lower limb lymphedema, and multi-factor logistic analysis showed that BMI (odds ratio [OR] = 6.207), number of lymph node dissection (OR = 4.223), and radiotherapy (OR = 8.081) were the risk factors for lower limb lymphedema after endometrial cancer surgery.
Conclusion: Patients with endometrial cancer with BMI ≥25 kg/m2, high number of lymph node dissection, and postoperative radiotherapy are more likely to develop lower limb lymphedema, and they should be given priority attention and timely preventive and curative measures.

 

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Effect of structured education program on physiological and psychosocial outcomes in type 2 diabetes patients: A randomized controlled trial
Qianqian ZHOU, Xiaorong LIU, Jianing LI, Jinlan YAO, Qingqing LOU
Journal of Integrative Nursing    2021, 3 (2): 72-79.   doi: 10.4103/jin.jin_09_20
Abstract113)      PDF(pc) (659KB)(276)      
Objective: This study was conducted to compare the effect of structured education program versus traditional diabetes education on insulin injection technique as well as physiologically and psychosocially related outcomes in adults with Type 2 diabetes.
Materials and Methods: This study was a randomized controlled trial. Totally, 71 Type 2 diabetes patients of using the insulin pen were enrolled and randomly divided into the intervention group (n = 36) and the control group (n = 35) according to random number table method. Patients in the intervention group received structured education program, while patients in the control group received traditional diabetes education. The levels of glycosylated hemoglobin (HbA1c), blood glucose, and lipids were monitored before and 3 months after intervention, and the insulin injection techniques, diabetes distress, and diabetes self-management skills between groups were assessed after 3 months.
Results: Finally, 65 participants (intervention group: n = 33, control group: n = 32) finished the study. After the intervention, HbA1c was lower (7.42 ± 0.80 vs. 8.35 ± 1.40, P = 0.002), fasting blood glucose (FBG) was lower (7.27 ± 1.06 vs. 9.40 ± 3.16, P < 0.001), and postprandial blood glucose (PBG) was lower (10.33 ± 2.20 vs. 12.77 ± 4.94, P = 0.012) in the intervention group than in the control group. No statistically significance was identified between the two groups in scores of Diabetes Distress Scale and summary of diabetes self-care activities.
Conclusion: Patients with Type 2 diabetes received structured education program, with greater improvements achieved in HbA1c, FBG, PBG, and measures about insulin injection techniques compared to the traditional education group, but there was no significant difference in diabetes distress or self-management behavior between groups.
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Effect of health locus of control on the quality of life among hemodialysis patients
Mahdi MOSHKI, Jahanshir TAVAKOLIZADEH, Mohammad Vahedian SHAHROODI, Mahmoud NABIANSANI, Atefeh DEHNOALIAN
Journal of Integrative Nursing    2021, 3 (1): 5-11.   doi: 10.4103/jin.jin_56_20
Abstract171)      PDF(pc) (668KB)(271)      

Objective: The purpose of this study was to determine the effect of health locus of control on the quality of life on hemodialysis patients.

Materials and Methods: This study is a randomized controlled trial. Participants were 78 dialysis patients among 17–70 years old including 39 cases in the training program and 39 cases in control groups. Kidney disease quality of life-short form and the health locus of control scale-form A were used. Questionnaires were completed before and 8 weeks after the intervention by two groups.

Results: The results of the paired t-test showed that the mean scores of physical component summary, mental component summary, and components of renal disease in the test group increased significantly after the intervention. There was also a significant difference between the test and control groups only about powerful others.

Conclusion: The education based on health locus of control can have a positive effect on the life quality of hemodialysis patients.

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The impacts of resilience on the association between illness uncertainty and sleep quality among patients with type 2 diabetes mellitus
Xin‑Ge WANG, Yu‑Qiong WEN, Hui‑Bing KUANG, Li‑Xia LIN, Hong CUI
Journal of Integrative Nursing    2021, 3 (1): 12-18.   doi: 10.4103/jin.jin_59_20
Abstract173)      PDF(pc) (644KB)(278)      
Objective: The objective was to investigate the relationship between resilience, illness uncertainty, and sleep quality in patients with type 2
diabetes mellitus (T2DM).
Methods: This cross?sectional study was conducted from September 2019 to August 2020 from a tertiary hospital in Guangzhou, China. Totally, 205 participants completed questionnaires concerning demographic characteristics, Pittsburgh sleep quality index, Mishel uncertainty in illness scale (MUIS), and Connor–Davidson Resilience Scale (CD-RISR) were collected by convenience sampling. Multiple hierarchical regression
analysis was used to evaluate the interaction of illness uncertainty, resilience, and sleep quality. The mediating role of resilience was also tested.
Results: The total score of illness uncertainty was 94.68 ± 11.19 in T2DM patients, which was proved in the medium level. There was a significant negative correlation between the total CD-RISR score and total MUIS score (r = 0.716, P < 0.01); there was a significant negative
correlation between the total CD-RISR score and total PISQ score (r = 0.806, P < 0.01); total MUIS score was positively correlated with PISQ score (r = 0.872, P < 0.01). Psychological resilience could partially mediate the association between sleep quality and the level of illness uncertainty, and the mediating effect was 0.293, accounting for 34.20% of the total effect.
Conclusion: Patients with T2DM have a moderate level of illness uncertainty, and it was negatively correlated with mental resilience level and positively associated with sleep quality. Medical staff should strengthen psychological intervention for T2DM patients to reduce the sense of uncertainty.
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Scientific publications in nursing journals from East Asia: A survey of literature
Zhi-Chen LIU, Ya-Lou PU, Yong-Hua WANG, Li GAO, Jing WANG, Bao-Hua CAO
Journal of Integrative Nursing    2021, 3 (1): 19-24.   doi: 10.4103/jin.jin_51_20
Abstract142)      PDF(pc) (944KB)(189)      
Background: East Asia is one of the most important economy and research force in the world. However, the trend of published articles in various areas of East Asia has not been reported.
Methods: We used PubMed and Web of Science databases to search for articles published from China, South Korea, and Japan in 59 nursing journals, from January 2008 to December 2017.
Results: The results indicated that Journal of Clinical Nursing is the most popular journal in East Asia and the number of articles published in China has shown a steady upward trend, surpassing Japan and South Korea (from 204 in 2008 to 320 in 2017). South Korea has increased rapidly since 2013 (from 65 in 2013 to 144 in 2017).
Conclusion: We conclude that China is the most influenced country with the largest number of articles in the field of nursing in East Asia. It is worth noting that the number of articles published in Japan has been slowly declining since 2015.
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Mediating effect of undergraduate nursing students’ professional commitment on positive psychological capital and learning burnout
Huanze LI, Hongfang CHEN, Miaoqing ZHUANG, Yue LIU, Jiayi WANG, Luyu ZHANG
Journal of Integrative Nursing    2021, 3 (1): 25-29.   doi: 10.4103/jin.jin_01_20
Abstract184)      PDF(pc) (726KB)(310)      
Objective: The objective of this study is to explore the mediating role of professional commitment of undergraduate nursing students between positive psychological capital (PsyCap) and learning burnout.
Materials and Methods: A cluster sampling method was used to survey 442 students of a bachelor’s degree in freshman to the junior
in a medical college in Shaanxi Province.
Results: Professional commitment was positively related to positive PsyCap (= 0.487, P < 0.01), while positive PsyCap and professional commitment were negatively related to learning burnout (r = 0.456, r = 0.411, P all < 0.01). There are certain mediating effects of professional commitment in the relationship between positive PsyCap and learning burnout. The mediating effect value of professional commitment is - 0.065, accounting for 16.08% of the total effect.
Conclusion: Nursing educators in medical colleges and universities should focus on developing and training the positive PsyCap of undergraduate nursing students, thereby enhancing and stabilizing their professional commitment level and reducing the risk of learning burnout.
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Sleep disturbance in patients with cancer
Mohammed AL MAQBALI
Journal of Integrative Nursing    2020, 2 (4): 153-159.   doi: 10.4103/jin.jin_48_20
Abstract159)      PDF(pc) (493KB)(246)      
Patients diagnosed with cancer often experience sleep disturbance in the form of poor sleep patterns or insomnia that can start on diagnosis and continue until the end of the individual’s life. The aim of this review is to discuss current definitions and theories of sleep disturbance, its prevalence, the underlying physiological and psychological correlates, measurement scales, and possible intervention and management strategies. Equally important, regular assessment is worthwhile for sleep disturbance and quality of life among cancer patients. Therefore, it is advisable for health-care professionals to conduct regular assessment of sleep disturbance for cancer patients and provide appropriate management.
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Analysis of status quo and research progress in nursing care for different typed coronavirus disease 2019: A literature review
Bing‑Rui WEI, Dian Francis SAVELLANO, Cui‑Huan HU
Journal of Integrative Nursing    2020, 2 (4): 160-171.   doi: 10.4103/jin.jin_37_20
Abstract195)      PDF(pc) (546KB)(313)      
At present, patients with coronavirus disease 2019 (COVID-19) are showing a surge in the world, to explore the clinical characteristics, treatment, and care of different types of COVID-19. The authors reviewed the existing literature, selected, and analyzed the diagnosis and treatment records of 11 patients with COVID-19 who were initially cured, including patient information, clinical manifestations, auxiliary examination results, treatment principles, nursing evaluation, nursing goals, nursing diagnosis, and nursing measures, and found clinical similarities and differences in the care of different types of patients. Among them, nine patients recovered and discharged after receiving treatment, and two died. As there is no specific medicine, only symptomatic treatment and supportive treatment can be given. Eleven common nursing measures and special nursing measures of different levels were carried out for patients diagnosed with mild, common, severe, and critical illnesses, and different treatment methods were given according to the severity of signs and symptoms. By summarizing the similarities and differences of clinical nursing interventions, we hope to help improve the quality of care for patients diagnosed with COVID-19.
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Construction of nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19 (mild and common) in Beijing based on Delphi method
Jing ZHANG, Xue‑Ling MA, Jian‑Hua DENG, Jing LI, Zhi‑Yun ZHANG, Ling TANG
Journal of Integrative Nursing    2020, 2 (4): 172-178.   doi: 10.4103/jin.jin_54_20
Abstract134)      PDF(pc) (545KB)(308)      

Objective: The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID-19 (mild and common) in Beijing, to provide reference for clinical nursing of patients with COVID-19 (mild and common).

Methods: Through online communication meeting with nurses who are in the frontline of anti-epidemic, clinical investigation, literature research, and expert demonstration meeting are carried out to prepare the draft of the standard, and the Delphi method is applied to determine the standard of integrated traditional Chinese and Western medicine care for patients with COVID-19 (mild and common) in Beijing.

Results: The nursing standard of integrated traditional Chinese and Western medicine for patients with COVID-19 (mild and common) was established, which included 5 first-level indicators, 14 second-level indicators and 60 third-level indicators. After two rounds of Delphi method, the positive coefficients of experts were 96% and 83%, the authoritative coefficients of experts were 0.89 and 0.91, and the Kendalls coefficient of concordance (W) of experts were 0.12, 0.09, 0.10, 0.13 (P < 0.05) and 0.44, 0.43, 0.37, 0.39 (P < 0.05).

Conclusion: The standard of integrated traditional Chinese and Western medicine nursing for patients with COVID-19 (mild and common) in Beijing constructed by the Delphi method is scientific and practical, which provides a reference for clinical application of integrated traditional Chinese and Western medicine nursing to fight against COVID-19 infection.

 

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Assessing the reasons for increase in self‑medication and control measures among student nurses in University of Benin Teaching Hospital, Edo State, Nigeria
Olaolorunpo OLORUNFEMI, Sarah Olayinka FALEKE, Omotayo Mercy OLORUNFEMI, Vitalis OKAFOR, Uche Gift EMIARE
Journal of Integrative Nursing    2020, 2 (4): 179-185.   doi: 10.4103/jin.jin_46_20
Abstract216)      PDF(pc) (528KB)(296)      

Background: Self-medication among student nurses is the use of medicines without doctor’s prescription. This practice is a global phenomenon and potential contributor to human resistance to most drugs, associated with different types of health challenges. Despite the high knowledge on the complication of self-medication, studies showed that most student nurses still practice selfmedication.

Aims: The aim of this study was to assess the reasons for increase in selfmedication and and find ways on how to curbing the menace among student nurses in the School of Nursing, University of Benin Teaching Hospital, Edo State, Nigeria.

Materials and Methods: A descriptive crosssectional survey was conducted with stratified simple random sampling technique to select ninety student nurses from three different levels in the School of Nursing, University of Benin Teaching Hospital in Benin City, Edo State. A selfstructured questionnaire with opentype and Likerttype scale questions used as instrument to assess the reasons for increase in selfmedication and the possible control measures. Data collected were analyzed using tables, percentages, means, standard deviation, and t-test for inferential statistics at 0.05 level of significance, through Statistical Package for the Social Sciences software.

Results: The result showed the reasons for increase in selfmedication and how to reduce its occurrence. It also showed that the gender of the student nurses is statistically related to the reasons why they practice selfmedication (t = 6.82, P 0.001).

Conclusion: Selfmedication can be reduced among student nurses by empowering the law enforcement agencies against selfmedication, improving the availability of essential and quality drugs in school clinics, and inclusion of all student nurses in National Health Insurance Scheme (NHIS) program, where they can enjoy the benefit of paying only 10% of the treatment charges.

 

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Physical restraint using, autonomy, ethics among psychiatric patients in nursing practice in China
Jun-Fang ZENG, Hong-Tao CAI, Wei-Ming LI, Cai-Mei ZOU
Journal of Integrative Nursing    2020, 2 (3): 97-102.   doi: 10.4103/jin.jin_29_20
Abstract211)      PDF(pc) (501KB)(307)      
The application of physical restraint for patients represents ethical dilemmas for psychiatric nurses in terms of maintaining the safety of all (clients and staff) while at the same time curtailing the individual's autonomy. This article aimed to provide a sound knowledge of ethical positions and strategies for psychiatric nurses to address ethical issues of physical restraint according to the ethical principles of autonomy, beneficence, nonmaleficence, and ethical theories. Given that nursing workforce was limited and workload among psychiatric nurses was heavy, physical restraint was one of the coercive interventions managing aggressive behavior. In relation to address ethical dilemmas, it was proposed to acquire informed consent of physical restraint from the individuals and provide person-centered care. Effective communication and negotiation with patients could help to strike a balance between patients' autonomy and nurses' accountability when using physical restraint. In addition, guidelines and targeted intervention strategies need to be developed to regulate and reduce the implementation of restraint. Finally, a collaboration among nurses, psychiatrists, and families is essential to protect patients' autonomy concerning physical restraint use.
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The relationship between diabetes‑related distress and self‑management in empty‑nest elderly patients with type 2 diabetes mellitus: The mediating effect of self‑efficacy
Hui‑Wen XU, Yuan YUAN, Lin LIU, En TAKASHI, Kitayama AKIO, Xin LI
Journal of Integrative Nursing    2020, 2 (3): 103-109.   doi: 10.4103/jin.jin_11_20
Abstract232)      PDF(pc) (717KB)(398)      
Objective: The aim of this study is to investigate the mediating effect of self-efficacy between diabetes-related distress and self-management in empty-nest elderly patients with type 2 diabetes mellitus (T2DM).
Methods: A total of 347 empty-nest elderly patients with T2DM from Jiangsu Province Hospital of Chinese Medicine and Affiliated Hospital of Yangzhou University were investigated by a self-designed General Information Questionnaire, the Self-efficacy for diabetes, the Diabetes Distress Scale, and the summary of diabetes self-care activities. Diabetes-related distress and diabetes self-management were tested for correlation analysis with self-efficacy. Meditational analyses were conducted to test the hypothesized mediating effects of diabetes self-efficacy as an intervention variable between diabetes distress and self-management.
Results: About 68.59% of patients suffered from diabetes-related distress. The results of bivariate correlations revealed that self-efficacy was negatively correlated with diabetes-related distress (r =–0.627, P < 0.01) and positively correlated with self-management (r = 0.356, P < 0.01). The relationship effects of diabetes distress on self-management were fully mediated by self-efficacy.
Conclusions: Diabetes-related distress prevails in empty-nest elderly patients with T2DM. Self-efficacy plays a mediate role between diabetes-related distress and self-management. Psychological intervention is contributed to reducing diabetes-related distress.
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Impact of the emigration of nurses on health care delivery system in selected hospitals, Benin‑City, Edo State, Nigeria
Olaolorunpo OLORUNFEMI, David Idenyi AGBO, Omotayo Mercy OLORUNFEMI, Esther Odogho OKUPAPAT
Journal of Integrative Nursing    2020, 2 (3): 110-115.   doi: 10.4103/jin.jin_42_20
Abstract477)      PDF(pc) (579KB)(620)      
Background: Globally, there is a high demand for nurses, resulting in migration from low-to high-income countries. The emigration of nurses is the act of leaving one's own country to settle permanently in another country, leading to a shortage in the number of nurses in their home countries. Consequently, this study aims to assess the impact of the emigration of nurses on the health-care delivery system in Nigeria.
Materials and Methods: A descriptive cross-sectional survey was conducted with a stratified sampling technique to select 270 nurses from three selected hospitals in Benin-city Edo state. A self-structured questionnaire with open and Likert scale questions were used as an instrument to assess the Impact of the Emigration of nurses on the Health Care Delivery System. Data collected were analyzed using tables, percentages, means, standard deviation and t-test.
Results: The result showed a mean score of 1.59 ± 0.92 impacts of the emigration of nurses on health-care delivery system and identified how to reduce it. The study also showed that there is no significant difference between gender and reason for emigration among nurses (t = 3.84, P ≤ 0.001).
Conclusion: The emigration of nurses is severely affecting the health care delivery system in the country. Recently, the Nursing and Midwifery Council of Nigeria gave the directive for training schools to increase their training capacity and number of students' intake to cushion the effect, and this study shows that this palliative can only be a short time measure, and however will encourage more nurses traveling abroad on the long run. Therefore, the hospital managers and government should provide a conducive working environment, better remuneration, attractive retirement benefit, and other incentives as a push in factor for nurses to stay back in their home countries.
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A bibliometric analysis of nursing research in COVID‑19 in China
Ke PENG, Qiu‑Lu MAI, Mei‑Qi MENG, Dou WANG, Xiao‑Yan ZHANG, Yu‑Fang HAO
Journal of Integrative Nursing    2020, 2 (3): 116-122.   doi: 10.4103/jin.jin_32_20
Abstract184)      PDF(pc) (1228KB)(315)      
Objective: The objective of this study is to analyze the current status of nursing research in COVID-19 through literature metrology and provide ideas and references for further research.
Methods: The search terms such as “novel coronavirus/COVID-19” and “nursing” were used to search the nursing-related papers published in China National Knowledge Infrastructure, Wanfang Data, VIP Data, SinoMed, Web of Science, and PubMed from October 1, 2019, to March 30, 2020. The bibliometric methods and related software were used for analysis.
Results: A total of 234 articles were included from 48 journals, and core journals accounted for 61.1%. There were five nursing literature topics and 14 document types. There is a cooperative relationship between six institutions. Keywords include nursing staff, nursing management, and protection.
Conclusions: The opening of journal green channels and the establishment of database columns will help the spread of anti-epidemic academic results. The topics of nursing literature include clinical nursing, nursing management, prevention and control, nursing education, and social surveys. Nursing literature types focus on cross-sectional research and experience summary; the cooperation between researchers and research institutions has begun to take shape, and it is recommended to strengthen the research on iatrogenic injuries and nurse training in future nursing research.
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Effect of flapping-meridians combined with thunder-fire moxibustion on upper limb dysfunction after stroke
Feng‑Guang GUAN, Qiu‑Lu JI, Yue‑Qing JIANG, Zhuo‑Mei ZHUANG, Xiao‑Qin LIAN
Journal of Integrative Nursing    2020, 2 (3): 123-128.   doi: 10.4103/jin.jin_6_20
Abstract134)      PDF(pc) (1018KB)(263)      
Objective: The objective of the study is to explore the effect of flapping-meridians combined with thunder-fire moxibustion in the treatment of upper limb dysfunction after stroke.
Materials and Methods: This randomized, single-blind, controlled trial included 140 patients with stroke. According to the random number table, the patients were divided into four groups: the control group (receiving conventional nursing alone), the intervention group 1 (receiving conventional nursing combined with flapping-meridians), the intervention group 2 (receiving conventional nursing combined with thunder-fire moxibustion), and the intervention group 3 (receiving conventional nursing, flapping-meridians, and thunder-fire moxibustion). All four groups were intervened 4 weeks, 6 days a week. The outcome indicators (Fugl-Meyer Assessment of the upper extremity and body mass index of shoulder abduction, elbow extension, and wrist flexion) were assessed at the beginning and the end of treatment.
Results: The effect of the intervention group 3 was better than that of the intervention group 2, intervention group 1, and control group (P < 0.05).
Conclusion: The flapping-meridians combined with thunder-fire moxibustion can significantly improve the upper limb motor function and muscle strength of stroke patients with hemiplegia, and its effect is better than that of single treatment.
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The effects of health Qigong Baduanjin on the prevention, treatment, and recovery of COVID‑19
Yi‑Zhen HAN, Meng‑Wei FU, Zi‑Jie CHEN, Fei‑Hong REN, Dan‑Dan XIE, Jing‑Lei LI, Si‑Yu ZHAO, Qian SHEN
Journal of Integrative Nursing    2020, 2 (2): 33-39.   doi: 10.4103/jin.jin_27_20
Abstract324)      PDF(pc) (494KB)(484)      
To summarize the application and modern studies on health Qigong Baduanjin by domestic and foreign scholars, combined them with clinical practice of mobile hospital in Wuhan, we explore the prevention, treatment, and recovery of Baduanjin in the war against COVID 19. On the basis of studying ancient classics, such as Huangdi’s Internal Classic, and the concrete exercise methods of Baduanjin, we propose three ideas: prevention before disease onset, promoting healing during illness, and strengthening the body after recovery. We aimed to give full play to Baduanjin in the battle against COVID 19 to popularize correct prevention and health knowledge for the patients and the healthy as well as to provide a reference for medical workers to use Traditional Chinese Medicine to prevention and treatment.
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Traditional Chinese medicine nursing protocols for COVID-19
Mei‑Zhen LIN, Qiao‑Mei WU, Yu LIU, Zhong‑De ZHANG, Gang‑Yi PENG, Chang‑Xiu WAN, Xiao‑Pan WANG, Ying‑Rui MA, Ping XIONG, Hui‑Chao CHEN, Qiu‑Ying DENG, Li‑Li DENG, Ding‑Rong QIU, Lin WEI, Jiu‑Hong YOU, Yang‑Chen LIU, Guang‑Qing ZHANG, Li‑Xia KOU, Ming‑Ming XU, Yu‑Mei CHEN, Yin‑Qin ZHONG, Xiao‑Qin LU, Han‑Jiao LIU, Jin ZHOU, Hong YE, Xiao‑Zhen GONG, Shi‑Miao LUO, Xi‑Yan HU
Journal of Integrative Nursing    2020, 2 (2): 40-49.   doi: 10.4103/jin.jin_23_20
Abstract152)      PDF(pc) (553KB)(388)      
In order to facilitate nurses to understand the key points of COVID-19's common syndromes, master the key points of nursing with syndrome differentiation, use the advantages of traditional Chinese medicine (TCM) nursing characteristics, standardize TCM nursing behavior, and improve the TCM nursing effect, through the search of relevant information, combined with the clinical practice experience of more than 1 month of front-line anti-epidemic nursing staff, the TCM nursing protocols for COVID-19 (draft) were formed. After four rounds of expert consultation and discussion, and 15 times of collation and revision, the final version of TCM nursing protocols for COVID-19 was formed. The TCM nursing protocols for COVID-19 include the following five parts: key points of common syndromes, nursing for common symptoms/syndromes, TCM special nursing, healthy guidance, and difficulties in nursing; it is scientific and practical, and can provide clinical guidance for nursing of patients with COVID-19.
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The application of feedforward control in the nursing emergency management of COVID-19
Zhao Jia WANG, Yan Rong SUN, Jing ZHANG, Hui JU, Ling TANG
Journal of Integrative Nursing    2020, 2 (2): 50-54.   doi: 10.4103/jin.jin_17_20
Abstract298)      PDF(pc) (520KB)(316)      
Objective: To explore the application of feedforward control in the nursing emergency management of COVID-19.
Methods: The feedforward control theory was applied to the emergency management of COVID-19 nursing, including grasping the latest epidemic information, preparing for the early stage, formulating nursing workflow, implementing flexible management, standardizing isolation and protection measures, unifying nursing document record format, and implementing humanistic care.
Results: During the period of support to Wuhan, the nursing work in the isolated area was orderly, the nursing staff's job satisfaction was high, no nursing errors and hospital infections occurred.
Conclusion: Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.
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The psychological experience of Chinese nurses in support of COVID-19 frontline: A qualitative study
Ju‑Hong PEI, Hai‑Xia CHEN, Xing‑Lei WANG, Rui‑Ling NAN, Xin‑Man DOU, Xian PENG
Journal of Integrative Nursing    2020, 2 (2): 55-60.   doi: 10.4103/jin.jin_24_20
Abstract367)      PDF(pc) (522KB)(414)      
Objective: The objective of the study is to explore the real psychological experience of the frontline support nurses in fight against COVID-19, so as to provide a reference basis for targeted intervention and ensure the mental health of the frontline support nurses.
Methods: The objective sampling method was used to conduct semi-structured interviews with 9 frontline support nurses fighting COVID-19, and the interview contents were analyzed using Colaizzi's 7-step method.
Results: The psychological experience of frontline support nurses in fight against COVID-19 can be summarized into four themes: The coexistence of negative psychological experience and positive psychological experience (tension, anxiety, fear, and depression); psychological pressure; many factors that affect the negative psychological experience (the stimulation of the external environment, the care of family members, the guidance of network public opinion); and solid support system (good family support and rich social support).
Conclusion: Although frontline support nurses have negative emotions and bear great psychological pressure, they all have a high sense of professional responsibility. Therefore, managers should pay attention to their psychological experience and provide targeted assistance to them.

 

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Studies of nursing in acute mastitis in China: Bibliometric analysis
Hui JU, Ling TANG, Hong GUO
Journal of Integrative Nursing    2020, 2 (1): 1-6.   doi: 10.4103/jin.jin_1_20
Abstract295)      PDF(pc) (737KB)(427)      

Objective: To analyze the research hotspots of nursing related to lactation acute mastitis in China and provide guidance and reference for nursing researchers.

Methods: Papers from China National Knowledge Infrastructure, Wanfang Data, VIP Data, and SinoMed are collected. All papers were imported into Noteexpress software in the form of bibliography to check again and delete duplicate references. The remaining literature was screened by reading the title and abstract and finally included by reading the full text. The paper’s information was analyzed using SPSS 22.0.

Results: 1275 papers are searched and 531 papers are included at last. Periodical literature accounted for the highest proportion, 96.80%. Moreover, the journal with the largest number of entries is China Health Care and Nutrition. In 2007, the number of literatures related to acute mastitis nursing began to increase rapidly, and the most articles were published in Henan. Among the literature types, the majority are literatures expert experience. Only 18 literature reports were funded.

Conclusions: Papers on acute mastitis nursing are increasing year by year and gradually become a research hotspot. However, the development of this study is uneven in different regions, with little financial support, and randomized controlled trials are still to be carried out.

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Efficacy of compound Bai Yu San in treating diabetic skin ulcer
Yun-Xia GE, Xiao-Rong LIU, Bei WANG, Yong ZHANG, Jia-Jia TONG, Dou-Dou LI
Journal of Integrative Nursing    2020, 2 (1): 7-10.   doi: 10.4103/jin.jin_7_20
Abstract192)      PDF(pc) (586KB)(415)      

Objective: To assess the efficacy of compound Bai Yu San (CBYS) as a new treatment option, in healing diabetic skin ulcer.

Materials and Methods: A total of 64 diabetic patients with skin ulcer were enrolled and randomly assigned to experimental group (n = 33) and control group (n = 31). In the control group, normal saline (NS) was used to cleanse the wound. After debridement, the wound was dressed with modern materials. In the experimental group, the NS-cleansed wound was dressed with CBYS. The infection rate, healing rate, treatment cost, and patient satisfaction between the two groups were compared. Results: On the 35th day after treatment, the infection rate and healing rate showed no between-group difference (P > 0.05); the experimental group showed lower treatment cost and higher satisfaction than the control group (P < 0.05).

Conclusion: As a new treatment option for diabetes-induced skin ulcer, CBYS can effectively control the infection, promote the healing, reduce treatment cost, and increase patient satisfaction. Dressing with CBYS can be clinically replicated in the treatment of diabetic skin ulcer.

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Evaluation and analysis of the effect of continuing education on nurses’ physical restraint knowledge, attitude, and behavior
Luo YANG, Ling TANG, Hong GUO, Yan-Ling SHEN, Li LI, Qing-Xia LIU, Hai-Yan WANG, Yan-Juan LIU
Journal of Integrative Nursing    2020, 2 (1): 11-17.   doi: 10.4103/jin.jin_4_20
Abstract303)      PDF(pc) (630KB)(377)      

Objective: The objective of the study is to construct a training course for physical restraint (PR) evidence-based practice project and apply it to verify its effect.

Methods: A total of 162 nurses from five departments of a general hospital in Beijing were trained to compare the PR knowledge, attitudes, and behaviors of nurses before and after training.

Results: The nurses were satisfied with the overall curriculum; the total scores of PR’ knowledge, attitude and behavior of nurses after training were higher than before, and the difference was statistically significant (P < 0.05); the total scores of nurses who received evidence-related training before this training were higher than those of nurses who did not receive relevant training, and the difference was statistically significant (P < 0.05).

Conclusion: Continuing education can effectively improve nurses’ knowledge, attitude, and behavior level of PR, ensure patient safety, and promote physical and psychological rehabilitation of patients.

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Home-based treatment and nursing plan of a patient diagnosed with mild-to-common coronavirus disease 2019
Bing-Rui WEI, Dian Francis SAVELLANO, Cui-Huan HU
Journal of Integrative Nursing    2020, 2 (1): 27-31.   doi: 10.4103/jin.jin_8_20
Abstract312)      PDF(pc) (767KB)(444)      

To date, there are no known specific antiviral medicines recommended for coronavirus disease 2019 (COVID-19). The treatment mainly focuses on the improvement of the immunity of the individual and the application of palliative treatment. A case of a patient diagnosed with mild COVID-19 and then later developed common COVID-19 which was treated and closely monitored at home will be presented. The patient was advised for self-quarantine with several prescribed medications. Nursing home and self-care advice were given to the patient, including a change of lifestyle for the duration of the isolation, medication advice, symptomatic care, change of diet, how to monitor the progress of the disease, psychological care, and follow-up instructions. During the course of the nursing plan, the patient showed significant improvements, and normal life functions were restored. On February 05, 2020, novel coronavirus nucleic acid test showed negative after re-examination; the patient was cured. Therefore, providing adequate nursing plan for home-based self-care treatment can effectively cure mild and common cases of COVID-19.

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Analysis of Adaptation Process of Evidence-Based Interventions by Taking Post-Stroke Dysphagia Screening As an Example--Based on a Series of Empirical Studies
Xiao-Yan ZHANG, Jun-Qiang ZHAO, Shang-Qian GAO, Li-Jiao YAN, Xue-Jing LI, Jing-Ya MA, Yu-Fang HAO
Journal of Integrative Nursing    2019, 1 (3): 123-131.   doi: 10.35437/intnur.issn.2663-4481.2019.01.03.01
Accepted: 10 September 2019
Online available: 15 November 2019

Abstract377)      PDF(pc) (384KB)(595)      

Background: Evidence-based interventions (EBIs) are frequently adapted or modified during the implementation process to meet the needs of the target context, public health professionals, or health practitioners. However, little is known about how the EBIs of the same clinical problem at a different time (sustainability) and a different setting (scalability) should be adapted to facilitate implementation. To address this gap, this research aims to analyze the adaptations process of EBIs by taking post-stroke dysphagia screening as an example based on a series of empirical studies.

Methods: We reviewed three best practice implementation projects of post-stroke dysphagia identification and management in mainland China, and conducted a comparative analysis of three projects of dysphagia screening practical decision-making according to core elements of evidence-based nursing (EBN).

Results: We identified the core elements of EBN that influence decision-making in each best practice implementation project. The decision-making of screening time and tool for dysphagia in the three projects varied. Project 1: Post-stroke dysphagia was screened using Water Swallow Test (WST) before the first intake of liquid or food. Project 2: A sustainability study based on project 1, post-stroke dysphagia was screened using Standardized Swallowing Assessment (SSA) before the first intake of liquid or food, within 24 hours of admission. Project 3: A community scalability study based on project 2, post-stroke dysphagia was screened using Water Swallow Test (WST) before the first intake of liquid or food, within 24 hours after referral.

Conclusions: Adaption of EBIs needs to fully consider the best available external evidence from systematic research, clinical expertise, patient preferences, as well as context.

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