RESUMO
Objective:To systematically evaluate and integrate the qualitative research of the practical experience and practical difficulties of advance care planning (ACP), so as to provide a reference for subsequent clinical nurses to better carry out ACP.Methods:PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang, VIP, Chinese Biomedical Literature Database were collected the qualitative research on the practical experience and practical difficulties of nurses′advance care planing, and the search time was the database establishment until August 1, 2022. Literature quality evaluation was conducted by the Joanna Briggs Institute (JBI) (2016), and the results were summarized using Meta integration method.Results:A total of 13 studies were included, and 39 studies were summarized into 11 new categories, forming 4 integrated results: nurses′ cognition of ACP practice, emotional experience of nurses′ ACP practice, personal factors that hinder ACP practice, and external environmental factors that hinder ACP practice.Conclusions:In ACP practice, nurses should be actively guided to have positive cognitive and emotional experience to improve their competence in ACP practice. At the same time, government departments should be united to support, integrate hospitals, society and other forces to formulate coping strategies against obstacles, so as to promote the development and practice of ACP.
RESUMO
Objective: To evaluate the dentinal tubular occlusion of nano-hydroxyapatite (nHAp) containing desensitizers and their influence on the dentin bonding performance of self-etch adhesive. Methods: Mid-coronal dentin specimens were prepared from 48 intact human third molars. They were immersed in 10 g/L of citric acid for 20 s to simulate sensitive teeth, and randomly divided into four groups. The control group received no desensitizing treatment. Three experimental groups were treated with two commercial nHAp containing desensitizing toothpastes (Biorepair and Dontodent) and an experimental pure nHAp paste, respectively. The effect of desensitizers on dentinal tubular occlusion was observed by the field-emission scanning electron microscope (FESEM). Each group was further bonded with Futurabond NR. The micro-tensile bond strength was tested and failure mode distribution was analyzed. Moreover, resin infiltration of the adhesive was evaluated under confocal laser scanning microscopy (CLSM). Results: FESEM revealed that all the desensitizers noticeably occluded the dentinal tubules. After application for 7 days, the penetration depth of desensitizing particles was obviously increased and the extent of occlusion was completer. The micro-tensile bond strength test showed no significant differences in bonding strength among the three desensitization groups and control group (P>0.05). CLSM demonstrated the similar morphology of resin tags was produced in the desensitized groups and control group. Conclusion: Nano-hydroxyapatite containing desensitizers could occlude dentinal tubules effectively. Meanwhile, the application of these nHAp desensitizers has no adverse effect on resin infiltration and dentin bond strength of Futurabond NR self-etch adhesive