-
Annals of Medicine and Surgery (2012) Nov 2023Patient satisfaction (PS) with nursing care is considered one of the most important predictors of satisfaction with hospital services. The current research was conducted...
INTRODUCTION
Patient satisfaction (PS) with nursing care is considered one of the most important predictors of satisfaction with hospital services. The current research was conducted to determine the level of PS with nursing care provided in hospitals in Iran.
METHODS
A comprehensive systematic search was conducted in various international electronic databases, such as PubMed, Scopus, Web of Science, and Persian electronic databases such as Iranmedex, and the Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as 'Patient satisfaction', 'Satisfaction', 'Nursing care', and 'Nurse' from the earliest to 27 January 2023. The risk of bias was assessed using the Joanna Briggs Institute (JBI) scale, and the analysis was performed in Stata software version 14. Subgroup and sensitivity analyses were performed to clarify the source of heterogeneity.
RESULTS
The results showed that the overall PS with nursing care in different hospitals was 0.83 (95% CI: 0.79-0.86). The proportions of complete satisfaction, partial satisfaction, and dissatisfaction were 0.38 (95% CI: 0.23-0.53), 0.45 (95% CI: 0.34-0.55), and 0.17 (95% CI: 0.12-0.21), respectively.
CONCLUSION
However, overall satisfaction was seen in four out of five patients admitted to hospitals in Iran, complete satisfaction with nursing care was 38%. Future studies should identify the effective factors related to PS with nursing care.
PubMed: 37915670
DOI: 10.1097/MS9.0000000000001309 -
Journal of Clinical Medicine Oct 2023Subarachnoid Hemorrhage (SAH) is one of the acute neurological conditions that is associated with high mortality and recovery failure rates. In recent years, due to the... (Review)
Review
Subarachnoid Hemorrhage (SAH) is one of the acute neurological conditions that is associated with high mortality and recovery failure rates. In recent years, due to the development of endovascular and classical techniques, the mortality rate after SAH has decreased. Currently, more research is focused on understanding the molecular mechanisms underlying SAH. Methods of treatment are investigated in order to obtain the best treatment result, not only survival. One of the drugs used in stroke, including SAH, is Cerebrolysin. It is a mixture of neuropeptides that has similar properties to neurotrophic factors. Its positive impact on strokes has been analyzed; however, there are no meta-analyses concerning only the subpopulation of patients diagnosed with SAH in the current literature. Therefore, we conducted a meta-analysis of available clinical trials to evaluate the effect of Cerebrolysin on the treatment outcome. The data suggest a positive effect of Cerebrolysin on the mortality of SAH patients. However, further randomized clinical trials with larger groups of patients are needed to draw final conclusions.
PubMed: 37892776
DOI: 10.3390/jcm12206638 -
Medical Archives (Sarajevo, Bosnia and... 2023Most patients with acute pancreatitis (AP) suffer from abdominal pain that requires immediate pain relief, and there are various medication choices available, with... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Most patients with acute pancreatitis (AP) suffer from abdominal pain that requires immediate pain relief, and there are various medication choices available, with opioids being the most prescribed analgesics.
OBJECTIVE
Our objective is to compare the use of opioids with other medications in emergency settings for managing pain in patients with AP.
METHODS
A systemic search was conducted in electronic databases (PubMed/Medline, Cochrane Library, Embase and Google Scholar) from inception to Feb 2023. All statistical analyses were conducted in Review Manager 5.4.1. The study's inclusion criteria was then selected. Only those Randomized Controlled Trials were involved that included patients having AP in an emergency setting. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the Odds Ratio (OR) and Mean Difference (MD) along with the corresponding 95% confidence interval (CI). Narrative analysis was conducted for those variables which did not have sufficient data be included in the quantitative analysis.
RESULTS
We include eight Randomized Controlled Trials in our study. The Pooled result showed non-significant differences in adverse effects between the two interventions (OR 1.42 [95% CI 0.62, 3.23]; p value= 0.40; I2= 20%). While overall, significantly additional drugs were used in the control group (OR 0.22 [95% CI 0.06, 0.85]; p value= 0.03; I2= 72%). Pain score and severity levels were also analyzed. We used a narrative approach to analyze the length of stay, mean time to reach significant decrease in pain, and mortality, which were all non-conclusive. We also narratively assessed the Pediatric population.
CONCLUSION
Opioids do not provide significant superiority over other medications and should be avoided due to their addictive nature.
Topics: Humans; Child; Analgesics, Opioid; Acute Disease; Pancreatitis; Pain; Pain Management; Randomized Controlled Trials as Topic
PubMed: 37876565
DOI: 10.5455/medarh.2023.77.281-287 -
Frontiers in Pediatrics 2023This systematic review aimed to evaluate the quality of clinical practice guidelines (CPGs) and recommendations for managing pain, sedation, delirium, and iatrogenic... (Review)
Review
A systematic review of clinical practice guidelines and recommendations for the management of pain, sedation, delirium and iatrogenic withdrawal syndrome in pediatric intensive care.
INTRODUCTION
This systematic review aimed to evaluate the quality of clinical practice guidelines (CPGs) and recommendations for managing pain, sedation, delirium, and iatrogenic withdrawal syndrome in pediatric intensive care (PICU). The objectives included evaluating the quality of recommendations, synthesizing recommendations, harmonizing the strength of the recommendation (SoR) and the certainty of evidence (CoE), and assessing the relevance of supporting evidence.
METHODS
A comprehensive search in four electronic databases (Medline, Embase.com, CINAHL and JBI EBP Database), 9 guideline repositories, and 13 professional societies was conducted to identify CPGs published from January 2010 to the end of May 2023 in any language. The quality of CPGs and recommendations was assessed using the AGREE II and AGREE-REX instruments. Thematic analysis was used to synthesize recommendations, and the GRADE SoR and CoE harmonization method was used to interpret the credibility of summary recommendations.
RESULTS
A total of 18 CPGs and 170 recommendations were identified. Most CPGs were of medium-quality, and three were classified as high. A total of 30 summary recommendations were synthesized across each condition, focused on common management approaches. There was inconsistency in the SoRs and CoE for summary recommendations, those for assessment showed the highest consistency, the remaining were conditional, inconsistent, inconclusive, and lacked support from evidence.
CONCLUSION
This systematic review provides an overview of the quality of CPGs for these four conditions in the PICU. While three CPGs achieved high-quality ratings, the overall findings reveal gaps in the evidence base of recommendations, patient and family involvement, and resources for implementation. The findings highlight the need for more rigorous and evidence-based approaches in the development and reporting of CPGs to enhance their trustworthiness. Further research is necessary to enhance the quality of recommendations for this setting. The results of this review can provide a valuable foundation for future CPG development.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=274364, PROSPERO (CRD42021274364).
PubMed: 37868267
DOI: 10.3389/fped.2023.1264717 -
The Turkish Journal of Pediatrics 2023To describe the existing pharmacological managements for Multisystem Inflammatory Syndrome in Children (MIS-C) in a systematic way, to identify the available... (Review)
Review
BACKGROUND
To describe the existing pharmacological managements for Multisystem Inflammatory Syndrome in Children (MIS-C) in a systematic way, to identify the available pharmacological managements in MIS-C, evaluate its safety and efficacy and identify the best treatment procedures for practice recommendation.
METHODS
A systematic search using six databases was conducted on August 18, 2021, updated in January 26th 2023. Terminologies that were used in this search are children, MIS-C/PIMS and SARS-CoV-2. A PRISMA flow diagram was used to report the study selection process. Quality analysis was done based on NOS and GRADE tools. Data synthesis was conducted by extracting the information on drugs used, efficacy and side effects.
RESULTS
From the 32 articles included, a total of 2331 children with MIS-C were studied. The main pharmacological approaches were immunomodulatory therapy, i.e., intravenous immunoglobulin (IVIG) (77.3%), steroids (60.5%), and a combination of IVIG and steroids (41.3%). IVIG and steroids were found to be potentially effective and safe treatments for MIS-C. Combination of IVIG and steroids was found favorable in severe cases with higher recovery rate. Refractory treatments include second dose of initial treatment and biological response modifier drugs like anakinra, tocilizumab, infliximab. A small number of studies investigating supportive treatment consisted of vasoactive, inotropic and anticoagulation. The mortality rate was 1.28% and only three studies reported side effects from the treatment. Evidence of outcome from GRADE were mostly at moderate, low and very low levels.
CONCLUSIONS
This review provides preliminary evidence to support the current standard treatment practices in managing MIS-C pharmacologically. However, comprehensive investigation is required using clinical trials to provide stronger outcome evidence.
Topics: Child; Humans; COVID-19; SARS-CoV-2; Immunoglobulins, Intravenous; Drug-Related Side Effects and Adverse Reactions; Steroids
PubMed: 37853964
DOI: 10.24953/turkjped.2022.765 -
BMC Medicine Oct 2023Breastfeeding has long been associated with numerous benefits for both mothers and infants. While some observational studies have explored the relationship between... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Breastfeeding has long been associated with numerous benefits for both mothers and infants. While some observational studies have explored the relationship between breastfeeding and mental health outcomes in mothers and children, a systematic review of the available evidence is lacking. The purpose of this study is to systematically evaluate the association between breastfeeding and mental health disorders in mothers and children.
METHODS
We systematically searched MEDLINE and EMBASE from inception to June 2, 2023. The inclusion criteria consisted of all studies evaluating links between breastfeeding and development of mental health disorders in children and mothers. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) while grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the certainty of evidence. A random-effects meta-analysis was used if possible, to estimate the odds ratio for the association between breastfeeding and mental health outcomes. The Mantel-Haenszel method was utilised for pooling ORs across studies. Study heterogeneity was assessed using the I statistic.
RESULTS
Our review identified twenty-one original study. Of these, 18 focused on the association between breastfeeding and child health, assessing depressive disorders, schizophrenia, anxiety disorders, eating disorders and borderline personality disorder. Three studies evaluated the associations between breastfeeding and maternal mental health disorders. Three studies looking at outcomes in children showed no significant association between breastfeeding and occurrence of schizophrenia later in life (OR 0.98; 95% CI 0.57-1.71; I = 29%). For depressive disorders (5 studies) and anxiety disorders (3 studies), we found conflicting evidence with some studies showing a small protective effect while others found no effect. The GRADE certainty for all these findings was very low due to multiple limitations. Three studies looking at association between breastfeeding and maternal mental health, were too heterogeneous to draw any firm conclusions.
CONCLUSIONS
We found limited evidence to support a protective association between breastfeeding and the development of mental health disorders in children later in life. The data regarding the association between breastfeeding and maternal mental health beyond the postnatal period is also limited. The methodological limitations of the published literature prevent definitive conclusions, and further research is needed to better understand the relationship between breastfeeding and mental health in mothers and children.
Topics: Infant; Female; Child; Humans; Breast Feeding; Mothers; Mental Health; Anxiety Disorders; Feeding and Eating Disorders
PubMed: 37840122
DOI: 10.1186/s12916-023-03071-7 -
Advances in Clinical and Experimental... Jun 2024Nowadays, there are a variety of viewpoints on problem-based learning (PBL) and mind mapping teaching outcomes in nursing education, but there are not many thorough... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nowadays, there are a variety of viewpoints on problem-based learning (PBL) and mind mapping teaching outcomes in nursing education, but there are not many thorough assessments that are pertinent.
OBJECTIVES
We performed a meta-analysis to evaluate the effect of the PBL method combined with mind mapping on nursing instruction.
MATERIAL AND METHODS
A systematic literature search up to July 2022 was performed, and 1765 related studies were evaluated. The chosen studies comprised 1473 nursing teaching participants as the trial's baseline, with 770 of them using the PBL model with mind mapping and 703 enrolled as controls. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (95% CIs) were calculated to assess the effect of the PBL method combined with mind mapping on nursing instructions using dichotomous and continuous methods with a random or fixed effect model. The study protocol was registered in PROSPERO (registration No. CRD 42022432130).
RESULTS
The PBL model with mind mapping reached a significantly higher results of nursing knowledge test (MD: 7.29, 95% CI: 6.88-7.71, p < 0.001) and pediatric practice test (MD: 9.89, 95% CI: 9.04-10.74, p < 0.001), as well as higher students' ability of independent learning (OR: 3.49, 95% CI: 2.11-5.76, p < 0.001) compared to the controls in nursing teaching.
CONCLUSION
The PBL model with mind mapping resulted in a significantly higher results of nursing knowledge test, pediatric practice test and students' ability of independent learning compared to controls in nursing teaching.
Topics: Humans; Problem-Based Learning; Education, Nursing; Students, Nursing
PubMed: 37831474
DOI: 10.17219/acem/170097 -
Nursing Open Dec 2023Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the... (Review)
Review
AIM
Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work.
DATA SOURCES
We conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar.
REVIEW METHODS
We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA-ScR Checklist. Inclusion criteria included full-text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial.
RESULTS
Out of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development.
CONCLUSION
Considering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country.
IMPACT
These competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.
Topics: Humans; Education, Nursing, Baccalaureate; Students, Nursing; Curriculum; Qualitative Research; Generalization, Psychological
PubMed: 37817394
DOI: 10.1002/nop2.2020 -
Atencion Primaria Jan 2024To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management.
OBJECTIVE
To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management.
DESIGN
Systematic review based on the PRISMA recommendations.
DATA SOURCES
Pubmed, Scopus, Cuiden, Web of Science and Google Scholar databases were reviewed.
STUDY SELECTION
Sixteen articles published between 2014 and 2021 were included, with access to full text, languages: English, French and Spanish and pediatric population: 0-18 years.
DATA EXTRACTION
Two thousand three hundred and thirteen children were participated. The variables analyzed were: level of care, type of intervention, correct performance of the inhalation technique, follow-up of the technique, delivery of written recommendations, professional-educator category, variables related to respiratory pathology, school absenteeism, quality of life and economic costs.
RESULTS
The health care level was primary, hospital and community care, where specialist doctors, nurses and pharmacists stood out as educators. The most prevalent educational interventions are on-site demonstration and delivery of recommendations or multimedia interventions. Several articles report that asthma education is not carried out correctly, others state that their technique improves after the intervention, but most of them highlight the importance of periodic review of the technique.
CONCLUSIONS
The authors report improvement in the inhalation technique in all of them, as well as greater self-management of the disease and adherence to treatment. It is necessary to intensify the education of patients in the correct handling of the devices, and the follow-up and subsequent review to optimize the control of the disease.
Topics: Child; Humans; Quality of Life; Asthma
PubMed: 37741186
DOI: 10.1016/j.aprim.2023.102721 -
The Journal of Hospital Infection Apr 2024The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention... (Meta-Analysis)
Meta-Analysis Review
The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis.
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
Topics: Humans; Surgical Wound Infection; Anti-Infective Agents; Digestive System Surgical Procedures; Surgical Wound; Sutures
PubMed: 37734678
DOI: 10.1016/j.jhin.2023.09.006