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Impact of COVID-19 pandemic on cardiology fellows academic training: beyond the clinical impact

Arch Cardiol Mex. 2021;91(Supl):18-24. doi: 10.24875/ACM.20000518.

ABSTRACT

OBJETIVO: Determinar la percepción de los médicos internos residentes (MIR) de cardiología de España sobre el efecto de la pandemia por COVID-19 en su formación y la adaptación realizada por sus servicios.

MÉTODOS: Estudio de corte transversal a través de una plataforma de encuesta digital con el objetivo de conocer la opinión individual de los MIR de cardiología sobre la influencia de la pandemia en su formación. Se realiza un análisis estadístico para determinar los factores que influyeron en la percepción de la formación afectada.

RESULTADOS: Participó un total de 180 MIR de las 17 comunidades autónomas (CA). Los MIR de tercer año fueron los más afectados, junto con los que rotaban en imagen cardíaca. Los residentes de las CA con una prevalencia >5 casos/1,000 habitantes fueron los que mayor probabilidad tuvieron de ser desplazados de sus servicios.

CONCLUSIONES: Según la opinión de los participantes, el efecto de la pandemia por COVID-19 en su formación fue más negativa en los residentes de tercer año y los que rotaban en imagen cardíaca.

OBJECTIVE: The objectives were to analyze the perception of the Cardiology Fellows in Training (FIT) of Spain about the impact of the COVID-19 pandemic on their academic training and to know the adaptative changes performed by their department.

METHODS: A cross-sectional study performed through a digital survey platform for Cardiology FIT. Chi2 analysis and logistic regression were performed to determine the factors that influenced on the perception of an affected training.

RESULTS: A total of 180 FIT from the 17 regions of Spain participated. Third year FIT and those rotating in cardiac imaging were the most affected with statistically significant difference. The residents of the regions with a prevalence of >5 cases/1,000 inhabitants were the most likely to be displaced from their departments.

CONCLUSIONS: According to the opinion of the participants, the impact of the COVID-19 pandemic on their academic training was more negative in third year FITs and those rotating in cardiac imaging.

PMID:34968379 | DOI:10.24875/ACM.20000518

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The Mediating Effect of Insecure Adult Attachment on the Relationship between Smartphone Addiction and Self-Directed Learning in University Students

Nurs Rep. 2020 Dec 1;10(2):124-134. doi: 10.3390/nursrep10020016.

ABSTRACT

(1) Purpose: This study aimed to explore the mediating effect of insecure adult attachment on the relationship between smartphone addiction and self-directed learning in university students. (2) Methods: In total, 235 university students participated in this study. Data analysis was carried out through a three-stage verification procedure: Sobel test using technical statistics, Pearson correlation, and multiple regression analysis. (3) Results: Smartphone addiction was positively correlated with insecure adult attachment, attachment anxiety, and self-directed learning, whereas self-directed learning had a significant negative correlation with insecure adult attachment and attachment anxiety. Insecure adult attachment had a mediating effect on the relationship between smartphone addiction and self-directed learning. (4) Conclusion: Higher levels of smartphone addiction indicated higher levels of insecure adult attachment and reduced self-directed learning ability. Therefore, while the prevention of smartphone addiction is critical for improving self-directed learning skills, programs should be developed to foster the formation of secure adult attachment among university students.

PMID:34968357 | DOI:10.3390/nursrep10020016

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Place of Work and Level of Satisfaction with the Lives of Polish Nurses

Nurs Rep. 2020 Nov 23;10(2):95-105. doi: 10.3390/nursrep10020013.

ABSTRACT

Practicing as a nurse may be a factor influencing the overall level of satisfaction with life. The aim of the study was to assess the level of satisfaction with nurses’ lives in relation to the place of employment. The research was conducted among nurses working in hospitals, primary health care, and outpatient specialist care. The study was carried out with the use of the satisfaction with life scale (SWLS) scale. Statistical analysis included a quantitative and qualitative approach to life satisfaction of the nurses surveyed. The impact of independent variables, measured on nominal (qualitative) scales on the results of the SWLS scale in quantitative terms, was assessed using one-way analysis of variance (ANOVA). Pairwise comparisons were assessed with the assumption of equality of variance with the Tukey honestly significant difference test. The level of satisfaction with life of the surveyed nurses was average. The place where nurses worked significantly influenced the level of life satisfaction. Nurses working in a hospital had a high level of satisfaction with life more so than nurses working in primary care or outpatient specialist care. The workplace is a factor that significantly differentiates the level of life satisfaction of the surveyed nurses.

PMID:34968354 | DOI:10.3390/nursrep10020013

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Impact of Nursing Methodology Training Sessions on Completion of the Virginia Henderson Assessment Record

Nurs Rep. 2020 Nov 25;10(2):106-114. doi: 10.3390/nursrep10020014.

ABSTRACT

The Virginia Henderson model, integrated in the computer application GACELA Care, helps to standardise the nursing assessment and establish precise and personalised nursing diagnoses. The aim was to determine the extent of completion of the initial patient assessment record after nurses following a training programme on nursing methodology. A quasi-experimental, retrospective, randomised, observational, single-group study was performed in two stages: pre-training and post-training. Voluntary training sessions were held for the nurses that work with GACELA Care. The completion of the initial patient assessment using the needs of Virginia Henderson and the Norton scale was evaluated before and after the training sessions. Completion of the needs of Virginia Henderson in the initial patient assessment increased from 94.2% to 100% (p = 0.014). Completion of “hygiene/skin” increased significantly from 83.3% to 95.8% (pre-training and post-training, respectively). The remaining needs did not show statistical significance. Recording of the Norton scale increased from 63.13% to 92.5% (p < 0.001). The training sessions on nursing methodology have improved the completion of records and inclusion of normal characteristics, defining characteristics and risk factors, and improving pressure ulcer risk assessment through the Norton scale.

PMID:34968355 | DOI:10.3390/nursrep10020014

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Healthcare Workers’ Experiences and Views of Using Surgical Masks and Respirators, and Their Attitudes on the Sustainability: A Semi-Structured Survey Study during COVID-19

Nurs Rep. 2021 Aug 7;11(3):615-628. doi: 10.3390/nursrep11030059.

ABSTRACT

A universal mask use was instituted in healthcare during COVID-19 pandemic in 2020. The extensive growth in the consumption of surgical masks and respirators brought new challenges. Healthcare workers had to get accustomed to wearing the facemasks continuously, raising concerns on the patient, occupational, and environmental safety. The aim of this study is to describe frontline healthcare workers and other authorities’ views and experiences on continuous use of surgical masks and respirators (facemasks) and their attitudes towards environmental and sustainability issues. A cross-sectional web-based survey was conducted in Finland during the COVID-19 pandemic in autumn 2020. The respondents(N = 120) were recruited via social media, and the data were collected using a purpose-designed questionnaire. Descriptive statistics and inductive content analysis were used to analyze the quantitative data and qualitative data, respectively. The healthcare workers perceived their own and patient safety, and comfortability of facemasks as important, but according to their experiences, these properties were not evident with the current facemasks. They considered protection properties more important than environmental values. However, biodegradability and biobased material were seen as desired properties in facemasks. Based on the results, the current facemasks do not meet users’ expectations well enough. Especially the design, breathability, and sustainability issues should be taken more into account.

PMID:34968337 | DOI:10.3390/nursrep11030059

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A Retrospective Cohort Study of the Impact of Nurse Practitioners on Hospitalized Patient Outcomes

Nurs Rep. 2021 Jan 6;11(1):28-35. doi: 10.3390/nursrep11010003.

ABSTRACT

The role of advanced practice providers has expanded in the hospital setting. However, little data exist examining the impact of these providers. Our purpose was to determine the effect of adding nurse practitioners in a complementary role on the quality and efficiency of care of hospitalized patients. A retrospective cohort study evaluated adult patients admitted by private physicians (without house staff or non-physician providers) to a general medical-surgical unit in an academic medical center. The admissions department allocated patients as beds became available and nurse practitioners were assigned to patients until their caseload was reached. Outcomes included length of hospital stay, in-hospital mortality, admission costs, 30-day readmissions, transfer to a more intensive care level, and discharge order time. Of the 382 patients included in this study, 263 were assigned to the nurse practitioner group. Hospital mortality was lower in the nurse practitioner group [OR 0.11 (95% CI 0.02-0.51)] as was transfer to more intensive care level [OR 0.39 (95% CI 0.20-0.75)]; however, the nurse practitioner group had longer length of stay (geometric mean = 5.80 days for nurse practitioners, 3.63 days for no nurse practitioners; p < 0.0001) and higher cost per patient (geometric mean = USD 6631 vs. USD 5121; p = 0.005). The results were unchanged when models were adjusted for potential confounders. Adding nurse practitioners can yield improved clinical outcomes (lower hospital mortality and fewer transfers to intensive care), but with a potential economic expense (longer hospital stays and higher costs).

PMID:34968309 | DOI:10.3390/nursrep11010003

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Evaluating Self-Efficacy among Patients Undergoing Dialysis Therapy

Nurs Rep. 2021 Mar 23;11(1):195-201. doi: 10.3390/nursrep11010019.

ABSTRACT

(1) Background: Perceived disease-related self-efficacy is considered a fundamental component of the successful self-management of chronic diseases. Prior studies have found that self-efficacy is associated with improvements in health behaviors and health status among people with chronic kidney disease (CKD). However, few studies have evaluated self-efficacy among patients undergoing dialysis. (2) Methods: This study was performed to evaluate CKD patients’ self-efficacy and to determine the factors that significantly affect self-efficacy among dialysis patients. This was a cross-sectional study using a convenience sample of 190 patients undergoing dialysis. The patients’ self-efficacy was measured using the CKD Self-Efficacy Scale. Inferential statistics were used to analyze the data. (3) Results: The mean age of the participants was 49.24 ± 13.15 years. Almost half of them were males (48.4%), and 75.3% were married. The majority of the patients (83%) were undergoing hemodialysis. The total score for self-efficacy was 192.57 ± 39.23. Only occupational status and the type of dialysis were significantly and positively correlated with patients’ perceived self-efficacy scores. (4) Conclusions: This study provides primary evidence of the perceived self-efficacy among CKD patients who are on dialysis. The results of this cross-sectional study showed that greater self-efficacy was associated with employment and peritoneal dialysis. Strategies to enhance self-efficacy among dialysis patients, especially those on hemodialysis, are needed.

PMID:34968324 | DOI:10.3390/nursrep11010019

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Brief Report: Hispanic Patients’ Trajectory of Cancer Symptom Burden, Depression, Anxiety, and Quality of Life

Nurs Rep. 2021 Jun 9;11(2):475-483. doi: 10.3390/nursrep11020044.

ABSTRACT

Background: Anxiety and depression symptoms are known to increase cancer symptom burden, yet little is known about the longitudinal integrations of these among Hispanic/Latinx patients. The goal of this study was to explore the trajectory and longitudinal interactions among anxiety and depression, cancer symptom burden, and health-related quality of life in Hispanic/Latinx cancer patients undergoing chemotherapy.

METHODS: Baseline behavioral assessments were performed before starting chemotherapy. Follow-up behavioral assessments were performed at 3, 6, and 9 months after starting chemotherapy. Descriptive statistics, chi-square tests, Fisher’s exact tests, and Mann-Whitney tests explored associations among outcome variables. Adjusted multilevel mixed-effects linear regression models were also used to evaluate the association between HADS scores, follow-up visits, FACT-G scale, MDASI scale, and sociodemographic variables.

RESULTS: Increased cancer symptom burden was significantly related to changes in anxiety symptoms’ scores (adjusted β^ = 0.11 [95% CI: 0.02, 0.19]. Increased quality of life was significantly associated with decreased depression and anxiety symptoms (adjusted β^ = -0.33; 95% CI: -0.47, -0.18, and 0.38 adjusted β^= -0.38; 95% CI: -0.55, -0.20, respectively).

CONCLUSIONS: Findings highlight the need to conduct periodic mental health screenings among cancer patients initiating cancer treatment.

PMID:34968222 | DOI:10.3390/nursrep11020044

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Fatalism, Social Support and Self-Management Perceptions among Rural African Americans Living with Diabetes and Pre-Diabetes

Nurs Rep. 2021 Apr 12;11(2):242-252. doi: 10.3390/nursrep11020024.

ABSTRACT

Diabetes is a public health problem and a major risk factor for cardiovascular disease, the leading cause of death in the United States. Diabetes is prevalent among underserved rural populations. The purposes of this study were to perform secondary analyses of existing clinical trial data to determine whether a diabetes health promotion and disease risk reduction intervention had an effect on diabetes fatalism, social support, and perceived diabetes self-management and to provide precise estimates of the mean levels of these variables in an understudied population. Data were collected during a cluster randomized trial implemented among African American participants (n = 146) in a rural, southern area and analyzed using a linear mixed model. The results indicated that the intervention had no significant effect on perceived diabetes management (p = 0.8), diabetes fatalism (p = 0.3), or social support (p = 0.4). However, the estimates showed that, in the population, diabetes fatalism levels were moderate (95% CI = (27.6, 31.3)), and levels of social support (CI = (4.0, 4.4)) and perceived diabetes self-management (CI = (27.7, 29.3)) were high. These findings suggest that diabetes fatalism, social support, and self-management perceptions influence diabetes self-care and rural health outcomes and should be addressed in diabetes interventions.

PMID:34968202 | DOI:10.3390/nursrep11020024

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Challenges of Pediatric Anesthesia Services and Training Infrastructure in Tertiary Care Teaching Institutions in Pakistan: A Perspective From the Province of Sindh

Anesth Analg. 2021 Dec 28. doi: 10.1213/ANE.0000000000005849. Online ahead of print.

ABSTRACT

BACKGROUND: Pakistan is a lower middle-income country located in South Asia with a population of nearly 208 million. Sindh is its second largest province. The aim of this survey was to identify the current setup of pediatric services, staffing, equipment, and training infrastructure in the teaching hospitals of Sindh.

METHODS: The survey was conducted between June 2018 and September 2018. A questionnaire was designed with input from experts and pretested. One faculty coordinator from each of 12 of the 13 teaching hospitals (7 government and 5 private) completed the form. Information was exported into Statistical Package for the Social Sciences (SPSS) version 22. Frequency and percentages were computed for all variables. Confidentiality was ensured by anonymizing the data.

RESULTS: Anesthesia services are provided by consultants with either membership or fellowship in anesthesia of the College of Physicians and Surgeons of Pakistan (CPSP). All drugs on the World Health Organization (WHO) essential medication list were available, although narcotic supply was often inconsistent. Weak areas identified were absence of standardization of practice regarding premedication, preoperative laboratory testing, pain assessment, and management. No national practice guidelines exist. Pulse oximeters and capnometers were available in all private hospitals but in only 86% and 44% of the government hospitals, respectively. Some training centers were not providing the training as outlined by the CPSP criteria.

CONCLUSIONS: Several gaps have been identified in the practice and training infrastructure of pediatric anesthesia. There is a need for national guidelines, standardization of protocols, provision of basic equipment, and improved supervision of trainees. One suggestion is to have combined residency programs between private and government hospitals to take advantage of the strengths of both. Recommendations by this group have been shared with all teaching hospitals and training bodies.

PMID:34968193 | DOI:10.1213/ANE.0000000000005849