Effects of progressive muscular relaxation and stretching exercises combination on blood pressure among farmers in rural areas of Indonesia: a randomized study†

Objective Maintaining blood pressure (BP) could improve the quality of life among farmers in agricultural health. The study aims to evaluate the effects of progressive muscular relaxation and stretching exercises (SEs) for BP in farmer subjects in rural areas. Methods A randomized controlled design was applied for this study. We performed a method, which is the combination of progressive muscle relaxation (PMR) and SEs for participants (30 in the control group and 60 in the intervention group). The intervention group self-practiced PMR and SEs through a video that providing instructions for 15 min. PMR practiced before going to sleeping in the night, and SEs practiced before going to farms in the morning per day for 3-months. Wilcoxon signed-rank test was performed to measure the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP) as one pre- and post-test comparison of baseline and 3 months data in control and intervention groups. Results There were no significant differences between SBP and DBP pre- and post-test in control group (P > 0.050). Meanwhile, there were significant differences in reducing SBP (M = 126.67; SD = 18.07; 95% CI = 120–147.5 mmHg) and DBP (M = 80.67; SD = 6.91; 95% CI = 80–90 mmHg) pre- and post-test combination of PMR and SEs in intervention group (P < 0.001). After 3-months of follow-up data, number type SBP and DBP still remained at the same levels of baseline and 3-month data in control group. While, there was an increased number of normal and prehypertension for SBP and DBP (10% vs. 10% and 20% vs. 31.6%) and reduced of hypertension stage I for SBP and DBP (30% vs. 41.6%). Conclusions This pilot study demonstrated effectively to reduce SBP and DBP among farmers using the combination of PMR and SEs in the agricultural health setting.

Factors associated with active aging in Chinese elderly in rural areas of Xiangtan County, China†

Objectives To explore the level of active aging and correlates among rural elderly in Xiangtan County, China. Methods A cross-sectional survey was conducted from July to November 2019. A total of 945 rural elderly from 3 towns in Xiangtan County, China, were investigated by using the positive aging evaluation questionnaire (PAEQ), the activity of daily living scale (ADL), and the depression in old-age scale (DIA-S). Results The average score in the PAEQ among the rural elderly of Xiangtan County was 72.81 (range = 21–105). A moderate negative correlation was found between the score in the PAEQ and those in the ADL (r = −0.361) and DIA-S (r = −0.495). Symptoms of depression (β: −0.321, P = 0.001), number of chronic diseases (β: −0.281, P = 0.001), subjective economic status (β: 0.239, P = 0.001), ADL (β: −0.196, P = 0.001), education (β: 0.126, P = 0.001), number of children (β: 0.097, P = 0.001), and marital status (β: −0.060, P = 0.001) were significantly associated with levels of active aging in rural elderly, whereas gender and age were not independently related to active aging. Conclusions The level of active aging is at a moderately high level in the Chinese elderly in rural areas in Xiangtan County. The focus group of active aging in rural areas should be elderly people suffering from chronic diseases, physical decline, poor education and economic conditions, childlessness, and those without partners.

Relationship between quality of professional life and organizational commitment in intensive care unit nurses

Objective The quality of professional life has attracted the attention of many managers owing to its importance, and organizational commitment differs according to work conditions in an organization. As the largest professional group in the healthcare system, nurses face many stressful factors that can endanger their quality of professional life and organizational commitment. Despite their huge importance, these 2 variables have rarely been addressed or evaluated in the nursing profession. The present study was conducted to determine the relationship between quality of professional life and organizational commitment in nurses working in the intensive care units (ICUs) and critical care units (CCUs). Methods The present descriptive–analytical study was conducted on 221 nurses working in the ICUs of hospitals affiliated to Shiraz University of Medical Sciences and selected through proportional stratified sampling. The data collection tools comprised demographic questionnaires, the quality of work-life questionnaire by Walton with 8 dimensions, and the valid and reliable organizational commitment scale by Meyer and Allen. The data were analyzed in SPSS, version 23 (IBM Corporation, Armonk, New York, United States), using descriptive and inferential statistical techniques, including Spearman correlation, Pearson correlation, the Kruskal–Wallis test, the Mann–Whitney U test, the χ2 test, and the independent t test. P < 0.050 was set as the level of statistical significance. Results The mean scores of quality of professional life and organizational commitment were 58.996 ± 14.427 and 93.840 ± 13.900, respectively, in the ICU nurses. The Pearson test showed positive and significant relationships between quality of professional life and organizational commitment (r = 0.392, P < 0.001). Conclusions Given the positive relationship found in the present study between organizational commitment and quality of professional life, it is recommended that organizational commitment be modified to improve the quality of professional life in nurses.

Rescue of a patient with a 50 cm broken PICC tube retracted and wrapped in pulmonary artery: a case report

Objective With the increasing use of a peripherally inserted central catheter (PICC) in clinical application, the breaking of the PICC is increasing as well, which would turn into the emboli and drift to the heart and pulmonary artery, causing severe consequences. However, few cases have been reported on the rescue of patients with a broken PICC. Patient concerns A 33-year-old man, diagnosed with chronic hepatitis B-related decompensated cirrhosis and cryptococcal meningitis, was treated with amphotericin B combined with flucytosine and fluconazole by means of PICC catheterization. The patient was discharged with a catheter; when he returned for re-examination, a 50cm length of PICC broke and slipped into the vein after his sudden dysphoria. First aid was immediately administered, and then the intervention therapy to extricate the tube, including pulmonary artery angiography and intravascular removal of foreign matter, was performed based on the consensus of the in-hospital vein treatment group. At last, the broken PICC fragment was successfully taken out of the vessel. Re-examination after surgery showed that he recovered well. Conclusions Once the catheter is broken, the X-ray examination should be performed at the first instance and re-examined frequently. Moreover, the involvement of a multidisciplinary team should be formed to decide the appropriate method of treatment to ensure a successful rescue.

Depressive symptoms and their associated factors in heart failure patients

Objectives Depressive symptoms are common in heart failure (HF) patients and they may exacerbate the progression of HF. Thus, identifying associations with depressive symptoms is essential to develop effective interventions to alleviate patients’ depressive symptoms. Therefore, this study aimed to explore the factors related to HF patients’ depressive symptoms. Methods Potential hospitalized patients were recruited from a university-affiliated hospital by convenience sampling. This study included 321 HF patients who had completed information about depressive symptoms, functional capacity, social support, dispositional optimism, self-care confidence, and health literacy. Descriptive statistics were used to characterize the sample. Independent group t-tests and one-way analysis of variance were used to assess the difference in depressive symptoms score in demographic and clinical characteristics, while Pearson's correlation was used to assess the associations among continuous variables. Results The scores for functional capacity, social support, dispositional optimism, self-care confidence, and health literacy were negatively associated with the score for depressive symptoms. The interaction effect between the functional capacity and the dispositional optimism on depressive symptoms was significant. Conclusions Interventions targeted improving the above-mentioned factors may be beneficial to reduce depressive symptoms in HF patients.

Relationship between clinical performance and professional self-concept in critical care nurses

Objective To determine the relationship between clinical performance and professional self-concept in critical care nurses. Methods This study was conducted on 308 critical care nurses. Data gathering instruments were nurses’ clinical performance questionnaire (NCPQ) and nursing professional self-concept measure (NPSCM). Independent sample t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficient were used for data analyses. Results The average age of the nurses was 33.74 ± 7.01 years. The clinical performance score of female nurses was significantly higher than male nurses. In the domain of clinical performance, clinical judgment and clinical inquiry had the highest and lowest scores, respectively. In the nurses’ professional self-concept, the highest and lowest scores were awarded to the subscales of self-confidence and staff relations, respectively. In addition, there was a significant positive correlation between self-concept and clinical performance of nurses. Conclusions Increasing professional self-concept improves the clinical performance of critical care nurses. Professional self-concept enhancement measures are recommended to improve the clinical performance of nurses in critical care units.

Clinical nursing competency assessment: a scoping review

Objective To ensure that only competent graduates are licensed to practice nursing, councils conduct licensing examinations, which may include among others clinical competency assessment. This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based, context-specific framework for clinical competency assessment in a sub-Saharan African (SSA) country. Methods A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted. Results Findings from 28 out of 1151 studies identified from Scopus, PubMed, CINAHL, Wiley Online Library, and ProQuest were included and synthesized. Results show that a good assessment system must be valid, reliable, transparent, feasible, fair, objective, and must provide feedback and continually improve to have an educational impact. Clinical competency assessment systems must be developed on sound empirical evidence, pilot tested, and involve thorough training and evaluation of the examiners. Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system. Only one of the included studies was conducted in Africa. Conclusions The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context. Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

Clarivate listed nursing journals in 2020: what they publish and how they measure use of social media

Objectives To investigate what the most common types of articles that nursing journals purport to publish are and what they actually publish. And to investigate the extent to which academic nursing journals listed by Clarivate track alternative metrics. Methods Journals included in the nursing Journal Citation Report (JCR) journal category in 2019 described as nursing were identified and considered suitable for inclusion in the analysis. Instructions for authors were reviewed online and mention of each type of article is identified. The tables of contents of each issue of each journal published during 2019 were examined and the types of articles published were extracted to a spreadsheet into permitted article types and published articles. Likewise, the use of alternative metrics by each journal was extracted to a spreadsheet. Pearson's and Spearman's correlation analysis was applied to investigate the relationship between articles permitted and articles published. Results In the 2020 JCR, 123 journals were listed. The most common article type permitted was original research (n = 117), followed by review papers (n = 116), and discussion papers (n = 63). Original research (n = 7045); review papers (n = 1268); discussion papers (n = 1225); editorials (n = 793) and commentaries (n = 776) were the most commonly published categories of the article. Of journals examined, 108 (96.8%) tracked mentions on social media and the Altmetric score was most commonly used (75%). There was a strong correlation (r = 0.73; P = 0.002) between the numbers of articles permitted and published and a strong correlation (ρ = 0.86; P < 0.001) in terms of the rankings of the permitted and published articles. Conclusions There is a relationship between the most frequently permitted article types and those published, especially for the most frequent categories of both. Original articles, review papers, and discussion papers are the backbone of academic publishing in nursing with original articles vastly outweighing review and discussion papers. Most Clarivate listed journals now use some method of tracking alternative metrics indicating how seriously publishers take their social media profiles.

Predictors of nurse's happiness: a systematic review

Objective An acute shortage of nurses exists all over the world. Part of this shortage appears to be due to nurses’ low job satisfaction, low retention, and high turnover. Happiness at work is identified as a contributing factor that determines the shortage of nurses across the world. This paper critically appraised the existing scientific articles that assessed the individual and organizational predictors of happiness among nurses. Methods The systematic review was conducted from August 2010 to August 2020 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific articles were searched in the electronic databases (Scopus, Medline, CINAHL, PsychINFO, and Pubmed Central) on the predictors of happiness among nurses. Results A total of 13 articles were selected following the literature search and a thematic analysis was done. This review provides updated evidence on the predictors of nurses’ happiness. Job-related predictors were identified as organizational predictors; and personal, psychological, family, social, and spiritual predictors were reported to be the individual predictors. Conclusions As both individual and organizational predictors determine the happiness of nurses, the authors recommend the need for future interventional studies to increase the nurses’ happiness, their mental health, and health-related quality of life.

Redefining the concept of professionalism in nursing: an integrative review

Objective In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics. Methods In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing. Results In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors. Conclusions Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.