Acute and Critical Care

Original Article

Nursing
Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan: Khaldoun Mohammad Hamdan, Ahmad M. Al-Bashaireh, Mohammad Al-Dalahmeh, Ahmad Rajeh Saifan, Maha Alkaid Albqoor, Abeer M. Shaheen; Acute Crit Care. 2023;38(4):469-478. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00430

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Background
There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods
A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results
We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions
ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Citations

Citations to this article as recorded by

Investigation of the Relationship between Personality Traits of Intensive Care Nurses and Their Attitudes and Behaviours towards End-of-life Care
Fırat Demir, Cansu Polat Dünya, İlknur Özkan
Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2024; 6(3): 243. CrossRef
Knowledge and attitude towards palliative care and associated factors among nurse: a cross-sectional descriptive study
Saeedeh Rafiee, Ismail Azizi-Fini, Zahra-Sadat Banihashemi, Safoura Yadollahi
BMC Nursing.2024;[Epub] CrossRef

Review Article

Nursing
Theoretical definition of nurse–conscious mechanically ventilated patient communication: a scoping review with qualitative content analysis: Arezoo Mohamadkhani Ghiasvand, Meimanat Hosseini, Foroozan Atashzadeh-Shoorideh; Acute Crit Care. 2023;38(1):8-20. Published online February 27, 2023; DOI: https://doi.org/10.4266/acc.2022.01039

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Abstract PDF Supplementary Material

Providing critical nursing care for conscious mechanically ventilated patients is mediated via effective communication. This study aimed to identify and map the antecedents, attributes, consequences, and definition of nurse–conscious mechanically ventilated patient communication (N-CMVPC). This scoping review was conducted by searching the Cochrane Library and the CINAHL, EMBASE, PubMed, Web of Science, and Scopus databases, between 2001 and 2021. The keywords queried included "nurses," "mechanically ventilated patients," "mechanical ventilation," "intubated patients," "communication," "interaction," "relationships," "nurse–patient communication," "nurse–patient relations," "intensive care units," and "critical care." Studies related to communication with healthcare personnel or family members were excluded. The results indicated that N-CMVPC manifests as a set of attributes in communication experiences, emotions, methods, and behaviors of the nurse and the patient and is classified into three main themes, nurse communication, patient communication, and quantitative-qualitative aspects. N-CMVPC is a complex, multidimensional, and multi-factor concept. It is often nurse-controlled and can express itself as questions, sentences, or commands in the context of experiences, feelings, and positive or negative behaviors involving the nurse and the patient.

Citations

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Communication Methods Used with Conscious Intubated Patients: Scoping Review
Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said
The Open Nursing Journal.2024;[Epub] CrossRef
A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
The Application of Augmentative and Alternative Communication in Intubated Patients in the Intensive Care Unit: A Scoping Review
Mee-Kyung Shin, Hyejin Jeon
The Korean Journal of Rehabilitation Nursing.2023; 26(2): 97. CrossRef

Original Articles

Nursing
How do physicians and nurses differ in their perceived barriers to effective enteral nutrition in the intensive care unit?: Masoumeh Mirhosiny, Mansour Arab, Parvin Mangolian Shahrbabaki; Acute Crit Care. 2021;36(4):342-350. Published online November 16, 2021; DOI: https://doi.org/10.4266/acc.2021.00185

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Abstract PDF

Background
Patients hospitalized in intensive care units are susceptible to chronic malnutrition from changes in protein and energy metabolism in response to trauma. Therefore, nutritional support, especially enteral nutrition, is one of the most important treatment measures for these patients. However, there are several barriers in the hospitals in treating patients with enteral nutrition. This study was performed to compare the perceptions of care providers (physicians and nurses) on the barriers to enteral nutrition in intensive care units.
Methods
This was a cross-sectional descriptive and analytic study. This study included 263 nurses and 104 physicians in the intensive care units of XXXX southeast hospitals. A questionnaire of enteral nutrition barriers in intensive care units was used. IBM SPSS ver. 19 was used to analyze data.
Results
There was a significant difference between the two groups in the three subscales of intensive care units (P=0.034), dietician support (p=0.001>) and critical care provider attitudes and behavior (P=0.031). There was also a significant difference between having completed educational courses and the score of enteral nutrition barriers in the two groups (P<0.05); the people who received an educational course had a better perception of enteral nutrition barriers.
Conclusions
Physicians and nurses agreed with the perception of enteral nutrition barriers, but there was a difference in their perception on some barriers. Strategies such as in-service training and increasing the knowledge and skills of physicians and nurses can reduce these differences.

Citations

Citations to this article as recorded by

Nutrition practices in critically ill adults receiving noninvasive ventilation: A quantitative survey of Australian and New Zealand intensive care clinicians
Kaitlyn Page, Elizabeth Viner Smith, Mark P. Plummer, Emma J. Ridley, Kristy Burfield, Lee-anne S. Chapple
Australian Critical Care.2024; 37(1): 43. CrossRef
El hambre invisible en la Unidad de Cuidados Intensivos. Estrategias de Cuidado y Consideraciones Esenciales
Ignacio Zaragoza-García
Enfermería Intensiva.2024; 35(1): 1. CrossRef
Invisible hunger in the Intensive Care Unit: Care strategies and essential considerations
I. Zaragoza-García
Enfermería Intensiva (English ed.).2024; 35(1): 1. CrossRef
Evidence-Based Investigation of Nurses' Nutrition Interventions in Intensive Care Patients Regarding Enteral Nutrition
Mensure Turan, Zeliha Cengiz, Dilek Olmaz
Dimensions of Critical Care Nursing.2024; 43(3): 123. CrossRef
Contribution to the Validation of the Portuguese Version of the “Barriers to Enterally Feeding Critically Ill Patients” Questionnaire and Its Application in a Hospital Context
Mário Rui Abade, Noémia Lopes, José de Santo Amaro
Topics in Clinical Nutrition.2024; 39(3): 184. CrossRef
What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed‐methods systematic review
Jia Qi Li, Ting Sun, Jun Tao Zuo, Yao Xu, Li Na Cai, Heng Yu Zheng, Xiang Hong Ye
Journal of Advanced Nursing.2024;[Epub] CrossRef
Adequacy of protein and calorie delivery according to the expected calculated targets: a day‐by‐day assessment in critically ill patients undergoing enteral feeding
Adam Fabiani, Lorella Dreas, Enzo Mazzaro, Elena Trampus, Michela Zanetti, Antonella Calabretti, Giuseppe Gatti, Gianfranco Sanson
Journal of Human Nutrition and Dietetics.2023; 36(3): 697. CrossRef
Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs
Sara Zaher
Risk Management and Healthcare Policy.2022; Volume 15: 2357. CrossRef

Nursing
Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study: Leila Kargar, Zahra Khademian, Masoume Rambod; Acute Crit Care. 2021;36(2):118-125. Published online April 29, 2021; DOI: https://doi.org/10.4266/acc.2020.00752

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Abstract PDF

Background
Assessing and improving patient self-efficacy are among the major roles of nurses. Nurses are also responsible for providing direct patient care, and they play a major role in improving patient care quality. Therefore, it is essential to evaluate nurses’ care-giving behaviors. This study aimed to determine the association between caring behaviors and self-efficacy in patients with cardiovascular disease.
Methods
In this cross-sectional study, 400 patients with cardiovascular disease who were admitted to hospitals in Jahrom, southern Iran, were selected through a stratified sampling. The Caring Behaviors Inventory and the Strategies Used by People to Promote Health questionnaires were used to collect data. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test and Spearman correlation coefficient in SPSS ver. 22.
Results
Results showed significant relationships between perception of caring behaviors and self-efficacy (r=0.16, P=0.001) as well as subscales of respectful deference to others (r=0.12, P=0.01), assurance of human presence (r=0.12, P=0.02), and positive connectedness (r=0.18, P=0.001). Additionally, among the subscales of caring behaviors, “attentive to others’ experience,” with a mean of 5.17±1.10, was the highest priority and “positive connectedness,” with a mean of 4.81±1.31, was the lowest priority for patients. The mean self-efficacy score was 73.94±29.78, and 169 patients (43.2%) had low self-efficacy.
Conclusions
Given the positive relationship between perception of caring behaviors and self-efficacy in patients with cardiovascular disease, self-efficacy could be improved by paying more attention to patient care priorities and improving patient perception of caring behaviors.

Citations

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The relationship between psychological capital and humanistic caring ability among mental health nurses in Saudi Arabia
Atallah Alenezi, Fahad M. Alhowaymel, Abdulaziz F. Abaoud, Mona Hamdy Mostafa
BMC Nursing.2024;[Epub] CrossRef
Effectiveness of educational interventions for nurses caring for patients with chronic kidney disease in improving nurse outcomes: A systematic review
Yoke‐Yee Samantha Tai, Yu Hui Foo, Jeanette Ignacio
Journal of Clinical Nursing.2024; 33(3): 951. CrossRef
Self-efficacy in increasing physical activity of coronary heart disease patients: a cross-sectional study
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Patient Assessment of Care with Chronic Cardiovascular Disorders and Its Relationship with Self-Efficacy: A Cross-Sectional Study
Aidah Sanad Alqarni, Eddieson Pasay-An, Awad Eid Alshammari, Ferdinand Gonzales, Lorraine Estadilla, Kawther Eltayeb Ahmed, Lizy Sonia Benjamin, Andrew Ngo, Hanan Awad Moawad Elmashad, Dawlat Ahmed mahmoud Gharib, Salman Amish Alshammari
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Patient's perception of the quality of care in the Ambulatory Surgery Unit of the Polyclinic Hospital of the western area of the Metropolitan Area of Buenos Aires
Claudia Yanina Castillo
Salud, Ciencia y Tecnología.2023; 3: 504. CrossRef
A Scoping Review of Predictors Associated with Self-Efficacy Among Patients with Coronary Heart Disease
Firman Sugiharto, Aan Nuraeni, Yanny Trisyani, Azalia Putri, Nuraulia Armansyah, Asroful Zamroni
Vascular Health and Risk Management.2023; Volume 19: 719. CrossRef
The mediating role of psychological capital on the relationship between authentic leadership and nurses’ caring behavior: a cross-sectional study
Guowen Zhang, Wen Tian, Ying Zhang, Juanjuan Chen, Xiaohong Zhang, Wenfeng Lin, Huiping Li, Liqin Sun, Baozhen Cheng, Hui Ding, Guiqi Song
BMC Nursing.2023;[Epub] CrossRef
Clinical Effectiveness of Nursing Care Delivery Models for Patients Following Hip Elective Surgery: Comparative Study
Zhangrou Rao†, Hui Shi†*, Zhezhen Jiang†, Jing Hu, Lanping Hu, Manjuan Xu, Regis Ernest Mendame Ehya, Guy-Armel Bounda*
Trends in Medical Research.2023; 18(1): 161. CrossRef
The Effect of Education Based on Human Care Theory on Caring Behaviors and Job Involvement of Nurses in Intensive Care Units
Maasumeh Elahi, Parisa Mansouri, Zahra Khademian
Iranian Journal of Nursing and Midwifery Research.2021; 26(5): 425. CrossRef

Review Article

The Association of Nurse Staffing Levels and Patient Outcome in Intensive Care Units: Hyunjung Lee, Hongbeom Bae; Korean J Crit Care Med. 2013;28(2):75-79.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.75

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Abstract PDF

Nurses play a crucial role in providing high-quality care in intensive care units (ICU). Previous studies have shown an association between nurse staffing levels and outcome of critically ill patients. Increasing nurse staffing levels in ICU has been recommended to improve the outcome of critically ill patients. However, nursing staff shortages associated with decreased budgets may prevent adequate nurse-to-patient ratios although there lies increasing needs for critical care. Several studies have suggested that higher nurse staffing level is associated with favorable patient outcome, including mortality, length of stay, and infections, but some of studies did not find an association between nurse staffing and patient outcome. Although there are some controversies in the associations between nurse staffing levels and patient outcome, it is difficult to apply such effect as compared with other developed countries in North American and Europe as the nurse-to-patient ratio in Korea's ICU is relatively low. By studying the nurse staffing effects for patient outcome from the Korea ICU, it is found that higher nurse staffing level is associated with improved patient mortality. This finding may suggest that a shortage of nursing staff is currently a serious issue for caring of critically ill patients in Korea.

Citations

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Quantitative Evaluation of Evacuation Efficiency during Disasters according to the Operation of Human Resources in Medical Facilities
Junghyeon Kim, Moonsik Kim, Yongjoo Kim, Dongho Rie
Journal of the Korean Society of Hazard Mitigation.2024; 24(3): 97. CrossRef
A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
The Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study
Miok Park, Eunjin Yang, Mimi Lee, Sung-Hyun Cho, Miyoung Shim, Soon Haeng Lee
Journal of Korean Critical Care Nursing.2021; 14(2): 1. CrossRef
The Relationship between the Work Environment and Person-centered Critical Care Nursing for Intensive Care Nurses
Jiyeon Kang, Yun Mi Lim
Journal of Korean Critical Care Nursing.2019; 12(2): 73. CrossRef

Original Article

The Distribution of Medical Personnel and Medical Equipments in the Intensive Care Units in Korea: Shin Ok Koh, Pyung Hwan Park, Myoung Hoon Kong, Yong Lak Kim; Korean J Crit Care Med. 2001;16(2):138-143.

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Abstract PDF: BACKGROUND
Not much of the fund is invested in the intensive care unit (ICU) in Korean hospitals since the cost of ICU care is set too low compared to the other medical fields as well as to the other part of the world. This study is designed to support the base of an ICU standard guideline in Korea.
METHODS
The questionnaire were sent to 73 ICUs and 24 neonatal ICUs (NICU) of 30 hospitals. Twenty-two of them were teaching hospitals and 8 of them were general hospitals.
RESULTS
The ratios of ICU bed number to total bed number were 5.0% and 6.0% in teaching hospital and general hospital respectively. The ratios of NICU bed to total bed were 3.4% and 2.0% in teaching hospital and general hospital respectively. Intensivists were kept in 24.6% of ICU and 36.4% of NICU. Residents were kept in 43.1% of ICU and 45.5% of NICU. The utilization of ICU service was 90% for teaching hospital and 86% for general hospital. The utilization of NICU was 89% for teaching hospital and 3% of general hospital. Nurse to patient ratios varied widely. Most ICUs in teaching hospital showed the nurse to patients ratio of 1 : 4 which was about 32% of total ICU. Most NICUs in teaching hospital showed the nurse to patients ratio of 1 : 5 which was around 20% of total NICU. Most of the ICUs were equipped with central piping system for oxygen and compressed air supply, vacuum system and all the necessary medical gadgets such as mechanical ventilators, ECG monitors, defibrillators, pulse oximeters and infusion pumps.
CONCLUSIONS
The distribution of medical personnel as well as medical equipments were varied widely. The variation existed between teaching hospital and general hospital as well as within the teaching hospitals. We need to establish a standard, which grades the level of ICU according to the number of keeping physician, nurse-patients ratio, and the types of medical equipments they have.

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