Category: Statistics

Nurse Educ Pract. 2022 May 22;63:103370. doi: 10.1016/j.nepr.2022.103370. Online ahead of print.

ABSTRACT

AIM: The purpose of this paper is to describe an innovative educational approach for pre-licensure nursing students to learn and practice motivational interviewing skills in a telehealth simulation with standardized patients portraying pregnant women with substance use disorder.

BACKGROUND: Given the ongoing need for online delivery of both nursing education and clinical practice, providers must continue to find approaches to facilitate the provision of empathetic and personalized care to achieve optimal patient outcomes. Motivational interviewing integrates a person-centered approach with specific communication strategies to encourage and support patients’ commitment to change. Motivational interviewing skills can be implemented across a wide variety of patient situations, including mental health and primary nursing care.

DESIGN: The study followed a pre-/post-test cross-sectional observational design.

METHODS: After completing an online training course to learn motivational interviewing skills, students participated in an online simulation with a standardized patient portraying a woman with substance use disorder during pregnancy. Prior to the simulation, students completed the Caring Behaviors Inventory-24 and the Opening Minds Scale for Health Care Providers. After the simulation, students and standardized patients completed the Simulated Clinical Interview Rating Scale and a 5-item version of the Caring Behaviors Inventory-6.

RESULTS: Of the 252 students in the course, 85 (34%) participated in the study. Twenty-six student participants completed both pre- and post-simulation questionnaires; 40 completed only pre-simulation questionnaires; and 19 completed only post-simulation questionnaires. Prior to the simulated patient encounter, students rated themselves most favorably on ability to demonstrate assurance behaviors. After the training and simulation, students and standardized patients reported successful student demonstration of motivational interviewing skills and caring behaviors consistent with fundamental therapeutic communication and motivational interviewing knowledge. There was no statistically significant difference between self-reported student performance and the standardized patients’ observations.

CONCLUSIONS: Students attained and applied motivational skills and demonstrated caring behaviors in a virtual setting with standardized patients.

PMID:35623234 | DOI:10.1016/j.nepr.2022.103370

Am J Emerg Med. 2022 May 12;58:9-15. doi: 10.1016/j.ajem.2022.05.008. Online ahead of print.

ABSTRACT

BACKGROUND: Acute head and neck cancer (HNC) bleeding is a life-threatening situation that frequently presents to the emergency department (ED). The purpose of the present study was to analyze the risk factors for the 30-day mortality in patients with HNC bleeding.

METHODS: We included patients who presented to the ED with HNC bleeding (n = 241). Patients were divided into the survivor and nonsurvivor groups. Variables were compared, and the associated factors were examined with Cox’s proportional hazard model.

RESULTS: Of the 241 patients enrolled, the most common bleeding site was the oral cavity (n = 101, 41.9%). More than half of the patients had advanced HNC stage while 41.5% had local recurrence. The proportion of active bleeding was significantly higher in the nonsurvivor group (70.5% vs. 53.3%, p = 0.038). 42.3% received blood transfusion and 5.0% required inotropic support. In total, 21.2% of the patients experienced rebleeding, and 18.3% died within 30 days. Multivariate analyses indicated that a heart rate > 100 (beats/min) (HR = 2.42; Cl 1.15-5.06; p = 0.019) and inotropic support (HR = 3.00; Cl 1.14-7.89; p = 0.026) were statistically significant independent risk factors for 30-day mortality.

CONCLUSIONS: The results of this study may aid physicians in the evaluation of short-term survival in HNC bleeding patients and provide critical information for risk stratification and medical decisions.

PMID:35623184 | DOI:10.1016/j.ajem.2022.05.008

Eur J Obstet Gynecol Reprod Biol. 2022 May 20;274:88-95. doi: 10.1016/j.ejogrb.2022.05.012. Online ahead of print.

ABSTRACT

OBJECTIVE: Spontaneous preterm birth is the leading cause of infant morbidity and mortality in the developed world. Environmental socio-economic factors, such as neighborhood deprivation, are known to negatively affect birth outcomes, including overall preterm birth. However, the role of neighborhood deprivation in spontaneous preterm birth (SPTB) is unclear. The aim of the study is to 1) to determine the effect of neighborhood deprivation on SPTB birth and 2) to investigate the trend in rates of SPTB between 2010 and 2019 for each quintile of neighborhood deprivation.

STUDY DESIGN: Based on the national perinatal registry, we included 1,584,225 singleton pregnancies resulting in a birth from 22 to 42 completed weeks of gestation between 2010 and 2019 in the Netherlands. Deprivation scores per neighborhood were derived from the Netherlands Institute of Social Research and were linked to the perinatal registry data, using the woman’s home address. The scores were divided into quintiles (Q). Rates of SPTB were calculated, categorized into <37 weeks, <32 weeks and <28 weeks of gestation. We used logistic regression analysis to adjust for maternal age, parity and ethnicity.

RESULTS: Compared to the most affluent neighborhoods (Q1), women in all other quintiles had a statistically significant increased risk for SPTB. The largest effect was observed in the most deprived neighborhoods (Q5); adjusted odds ratio 1.16 (95% confidence interval 1.13 – 1.19). From 2010 to 2019, we observed an overall decrease of 0.21% in SPTB < 37 weeks (p < 0.0001). All quintiles showed a decrease in SPTBs < 37 weeks, but only in Q1, Q2 & Q5 this decline in SPTB was statistically significant.

CONCLUSIONS: Pregnant women in deprived neighborhoods in the Netherlands are more at risk for spontaneous preterm birth. From 2010 to 2019, the rate of spontaneous preterm birth decreased. Efforts should be made by both governmental and medical professionals to develop intervention programs to reduce spontaneous preterm birth in more deprived neighborhoods.

PMID:35623155 | DOI:10.1016/j.ejogrb.2022.05.012

Int J Nurs Stud. 2022 Apr 22;132:104259. doi: 10.1016/j.ijnurstu.2022.104259. Online ahead of print.

ABSTRACT

BACKGROUND: Elderspeak communication is typically viewed as patronizing and infantilizing by older adults and can lead to resistive behaviors in persons living with dementia. Little is known about the presence of elderspeak communication in hospitals in the United States. Understanding this phenomenon in the hospital setting is needed in order to improve hospital dementia care.

OBJECTIVES: The purpose of the Nurse Talk study was to (1) describe attributes of elderspeak use in hospital dementia care and to (2) determine what characteristics are associated with nursing staff use of elderspeak communication with hospitalized patients with dementia.

DESIGN: A cross-sectional observational study design was used to collect and analyze audio-recordings of nursing staff during care for hospitalized patients with dementia.

SETTING: Three hospital units in one Midwestern university hospital in the United States.

PARTICIPANTS: A convenience sample of 53 staff nurses and nursing assistants that provided direct care to 16 patients with mild or more severe dementia recruited from October 2019 through mid-March 2020.

METHODS: Eighty-eight care encounters were audio-recorded and coded for elderspeak communication using the Iowa Coding of Elderspeak scheme to determine the frequency and characteristics of elderspeak communication. A linear mixed effects model was used to determine what characteristics were associated with elderspeak and the frequency of elderspeak use by nursing staff to hospitalized patients with dementia.

RESULTS: Over a quarter (28.7%) of all nursing staff speech directed towards patients with dementia constituted elderspeak and nearly all (96.6%) care encounters included some elderspeak. Particularly common attributes of elderspeak were minimizing words and mitigating expressions, childish terms and phrases, and collective pronoun substitution. A statistically significant interaction was identified between staff role and age (95% CI: -0.02, -0.00, p = .008) in predicting the frequency of elderspeak use, indicating that elderspeak was used more often by older staff nurses, whereas the age of nursing assistants remained constant across elderspeak use. Statically significant effects for delirium and length of stay were also demonstrated. Elderspeak use was 12.5% higher with patients with delirium (95% CI: 0.02, 0.23, p = .025) and increased 1.5% for each additional day the patient with dementia was hospitalized (95% CI: 0.00, 0.03, p = .035).

CONCLUSIONS: Elderspeak is present and pervasive in the acute care setting. Interventions targeted towards older staff nurses and nursing staff from hospital units that care for patients with delirium and longer lengths of stay are needed.

TWEETABLE ABSTRACT: This study identified that nursing staff are frequently using elderspeak (infantilizing speech) with hospitalized patients with dementia. @claireshaw_phd @IowaNursing.

PMID:35623154 | DOI:10.1016/j.ijnurstu.2022.104259

Int J Nurs Stud. 2022 Apr 20;132:104255. doi: 10.1016/j.ijnurstu.2022.104255. Online ahead of print.

ABSTRACT

BACKGROUND: Insufficient self-care behaviors, low self-efficacy, depression, and poor illness perceptions are obstacles to the management of people with heart failure, leading to adverse patient outcomes. Self-care interventions are strategies used to support individuals in self-care. Currently, evidence on the effects of nurse-led self-care interventions on self-care behaviors and the correlates (self-efficacy, depression, and illness perceptions) in people with heart failure is scarce.

OBJECTIVES: This review aims to systematically synthesize current evidence to determine the effectiveness of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression, and illness perceptions among people with heart failure and identify the optimal characteristics of effective nurse-led heart failure self-care programs.

METHODS: MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, and PsycINFO were electrically searched for relevant articles from the inception to December 2021. Randomized controlled trials examining the effects of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression, and illness perceptions among people with heart failure published in the English language were included. The quality appraisal of included studies was performed using the revised Cochrane tool for assessment of the risk of bias in randomized controlled trials (RoB 2.0). The meta-analysis was conducted using statistical software R. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS: Twenty-four trials with 2488 participants were identified in this review. The results of our study revealed that nurse-led self-care interventions improved self-care maintenance (mean difference [MD]: 9.58, 95% confidence interval [CI]: 5.96 to 13.20, moderate certainty of evidence), self-care management (MD: 12.08, 95% CI: 8.05 to 16.11, high certainty of evidence), self-efficacy (standardized mean difference [SMD]: 0.98, 95% CI: 0.42 to 1.54, moderate certainty of evidence), and depression (SMD: 0.55, 95% CI: 0.34 to 0.77, high certainty of evidence) among people with heart failure. Moreover, subgroup analyses indicated that the ideal intervention duration to enhance self-care behaviors and self-efficacy was 1 to 3 months and to reduce depression was within 1 month.

CONCLUSIONS: This review revealed the beneficial effects of the nurse-led self-care interventions on self-care behaviors, self-efficacy, and depression among people with heart failure. The duration of the intervention is one of the factors that may affect the intervention effects. Further well-designed randomized controlled trials are recommended to strengthen the current evidence. Registration number (PROSPERO): CRD42022299754.

PMID:35623153 | DOI:10.1016/j.ijnurstu.2022.104255

Acta Psychol (Amst). 2022 May 24;227:103620. doi: 10.1016/j.actpsy.2022.103620. Online ahead of print.

ABSTRACT

This study aimed to confirm the status of body image perception by adolescents in South Korea and identify the associated factors using the data from the 14th Korea Youth Risk Behavior Survey (KYRBS) conducted in 2018. The KYRBS is a government-approved statistical survey performed annually and an anonymous self-administered online survey conducted in middle and high school students. The data for this study were downloaded from the KYRBS web site and analyzed through complex sample analysis. Body image distortion was found in 40.3% (under-perception 26.5%, over-perception 13.8%) of the boys and 39.7% (under-perception 14.4%, over-perception 25.3%) of the girls. The factors associated with body image distortion were school achievement, weight control, school, school type and exercise in school gym class in boys and school achievement, weight control, and economic status in girls. These results indicated that intervention programs for the accurate perception of body image should be provided to adolescents and these programs should consider gender difference in factors associated with adolescents’ body image distortion.

PMID:35623123 | DOI:10.1016/j.actpsy.2022.103620

Clin Neurol Neurosurg. 2022 Apr 27;218:107270. doi: 10.1016/j.clineuro.2022.107270. Online ahead of print.

ABSTRACT

PURPOSE: Levetiracetam (LEV) is an anti-seizure drug (ASD). A consensus has not been reached regarding its effects on bone health. This cross sectional study was planned to assess short, medium and long-term effects on bone density and blood parameters that are associated with bone metabolism.

METHODS: The sample consisted of 47 patients with epilepsy, who had been on LEV monotherapy for more than six months. All participants were over 18 years of age and had no other risk factors for osteoporosis. None of them used any other anti-seizure drug before. Bone mineral density (BMD) was evaluated with dual energy X-ray absorptiometry (DEXA) and biochemical markers associated with bone health were measured. Patients were divided into three groups depending on how long they had been on LEV for (Group A: <1 year; Group B: 1-5 years, Group C: >5 years) and compared with each other in terms of BMD scores and blood parameters.

RESULTS: The mean age of patients was 32. 6 ± 13.3 and 20 patients were female (42.5%). The mean onset age of epilepsy was 28.1 ± 13.4 years. Average LEV period of consumption was 2.7 ± 2.7 years and mean daily dose was 1041.7 ± 393.9 milligrams. Lumbar BMD scores of the group with LEV usage < 1 year were significantly lower than those of the group with LEV usage of 1-5 years (p < 0.05). Lumbar vertebra scores were found to be lower in group of LEV usage duration of < 1 year when compared with LEV usage duration > 5 years but the difference was not statistically significant.

CONCLUSION: We argue that LEV might have a negative effect on bone densitometry at the lumbar level in short-time usage for less than one year. Furthermore, no deleterious impact on bone metabolism was observed in long-term treatment. LEV seems as a rational drug for treatment of epilepsy patients, particularly for those with osteoporosis, since the comparative results of one year and longer than 5-years usage data did not show any statistically significant difference.

PMID:35623138 | DOI:10.1016/j.clineuro.2022.107270

J Pediatr Gastroenterol Nutr. 2022 May 27. doi: 10.1097/MPG.0000000000003479. Online ahead of print.

ABSTRACT

Blenderized tube feeding (BTF) refers to formula composed of whole foods and purees, blended to a consistency that can be administered through an enteral feeding device. BTFs have a higher viscosity than conventional enteral formulas and may be mixed with extra liquid to aid in administration via an enteral feeding device. This study compared changes in viscosity of commercially available blenderized tube feedings when stirred, shaken, or blenderized. The International Dysphagia Diet Standardisation Initiative (IDDSI) flow test was used to provide an objective level of viscosity. Our results indicate that the method chosen to thin BTFs results in significant differences in viscosity and varies depending on the percent of water by volume added to the formula as well as the presence of additional non-food ingredients such as synthetic supplements. We conclude that the method used to thin BTFs should be taken into account when a consistent viscosity level is desired. An infographic is available for this article at: http://links.lww.com/MPG/C836.

PMID:35623084 | DOI:10.1097/MPG.0000000000003479

J Med Internet Res. 2022 May 20. doi: 10.2196/38099. Online ahead of print.

ABSTRACT

BACKGROUND: Disease status-such as cancer stage-has been used in routine clinical practice to determine more accurate treatment plans. Health-related indicators, such as mortality, morbidity, and population group life expectancy, have also been used. However, few studies specifically focus on the comprehensive and objective measures of individual health status.

OBJECTIVE: The perspectives of the public toward 29 health indicators obtained from a literature review were analyzed to provide evidence for further prioritization of the indicators. The difference between health status and disease status should be considered.

METHODS: This study used a cross-sectional design. Online surveys were administered through Ohio University, ResearchMatch, and Clemson University, resulting in three samples. Participants included individuals aged ≥ 18 years. Participants rated the importance of the 29 health indicators. The rating results were aggregated, cleaned, and analyzed as follows: (1) to determine the agreement among the three samples regarding the importance of each indicator (IV = the three samples, DV = individual survey responses); (2) to examine the mean differences between the retained indicators with agreement across the three samples (IV = the identified indicators, DV = individual survey responses); and (3) to rank the groups of indicators into various levels after grouping the indicators with no mean differences (IV = the groups of indicators, DV = individual survey responses).

RESULTS: A total of 1,153 valid responses were analyzed. Descriptive statistics revealed that the top-five rated indicators were drug or substance abuse, smoking or tobacco use, alcohol abuse, major depression, and diet and nutrition. Among the 29 health indicators, the three samples agreed upon the importance of 13. Inferential statistical analysis indicated that some of the 13 indicators held equal importance. Therefore, the 13 indicators were categorized by rank into seven levels as follows: Level 1: blood sugar level and immunization/vaccination; Level 2: LDL cholesterol; Level 3: HDL cholesterol, blood triglycerides, cancer screening detection, and total cholesterol; Level 4: health literacy rate; Level 5: personal care needs and air quality index > 100; Level 6: self-rated health status and HIV testing; and Level 7: the supply of dentists. Levels 1-3 were rated significantly higher than Levels 4-7. Among the 13 health indicators, blood sugar level and immunization/vaccination status were the most important, and the supply of dentists was the least important.

CONCLUSIONS: This study provides a baseline for prioritizing 29 health indicators, which can be used by electronic health records or personal health record system designers or developers to determine what can be included in the systems to capture an individual’s health status. Currently, self-rated health status is used predominantly. Additionally, this study provides a foundation for tracking and measuring preventive healthcare services more accurately and developing an individual health status index.

PMID:35623051 | DOI:10.2196/38099

PLoS Biol. 2022 May 27;20(5):e3001663. doi: 10.1371/journal.pbio.3001663. eCollection 2022 May.

ABSTRACT

[This corrects the article DOI: 10.1371/journal.pbio.2006202.].

PMID:35623029 | DOI:10.1371/journal.pbio.3001663