Understanding relationships between general self-efficacy and the healthy ageing of older people: An integrative review.

AIMS AND OBJECTIVES: The aim of this integrative review was to investigate current literature exploring relationships between general self-efficacy and the healthy ageing of older people. BACKGROUND: Enhancing the health and well-being of older adults, while mitigating consequences of illness and frailty are important priorities in healthy ageing. General self-efficacy is closely associated with human behaviour and has been linked with improved health and well-being. DESIGN: An integrative review using the five-stage method described by Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546). METHODS: Academic databases CINAHL, MEDLINE and APA PsycInfo were searched between 2010 and 2020 for original, peer-reviewed papers, published in English that investigated general self-efficacy and factors associated with the healthy ageing of older people. Included papers were critically appraised using the Appraisal tool for Cross-Sectional Studies (AXIS tool) and Critical Appraisal Skills Programme, and underwent data abstraction and synthesis via a constant comparative method. This review was also evaluated using the PRISMA checklist. RESULTS: Twenty-one papers were included in this review. Two main themes emerged. The first highlights positive relationships between general self-efficacy and health and ageing perceptions, with subsequent influence on health behaviours. The second includes two sub-themes, which explores general self-efficacy's role in maintaining well-being through its effects on psychological health and overcoming physical decline through adaption to changing physical and health conditions. CONCLUSIONS: Promoting general self-efficacy has potential benefits for the healthy ageing of older people through positive effects on ageing and health perceptions, health behaviours, psychological health and overcoming physical decline. RELEVANCE TO CLINICAL PRACTICE: Understanding how general self-efficacy facilitates healthy ageing can guide nursing practices that reduce or mitigate consequences of illness and physical decline on the health and well-being of older people. Strategies aimed at increasing older people's general self-efficacy can help to facilitate subsequent positive effects on factors that promote healthy ageing.

Relationship between body mass index and fracture risk is mediated by bone mineral density.

The relationship between body mass index (BMI) and fracture risk is controversial. We sought to investigate the effect of collinearity between BMI and bone mineral density (BMD) on fracture risk, and to estimate the direct and indirect effect of BMI on fracture with BMD being the mediator. The study involved 2199 women and 1351 men aged 60 years or older. BMI was derived from baseline weight and height. Femoral neck BMD was measured by dual-energy X-ray absorptiometry (DXA; GE-LUNAR, Madison, WI, USA). The incidence of fragility fracture was ascertained by X-ray reports from 1991 through 2012. Causal mediation analysis was used to assess the mediated effect of BMD on the BMI-fracture relationship. Overall, 774 women (35% of total women) and 258 men (19%) had sustained a fracture. Approximately 21% of women and 20% of men were considered obese (BMI ≥ 30). In univariate analysis, greater BMI was associated with reduced fracture risk in women (hazard ratio [HR] 0.92; 95% confidence interval [CI], 0.85 to 0.99) and in men (HR 0.77; 95% CI, 0.67 to 0.88). After adjusting for femoral neck BMD, higher BMI was associated with greater risk of fracture in women (HR 1.21; 95% CI, 1.11 to 1.31) but not in men (HR 0.96; 95% CI, 0.83 to 1.11). Collinearity had minimal impact on the BMD-adjusted results (variance inflation factor [VIF] = 1.2 for men and women). However, in mediation analysis, it was found that the majority of BMI effect on fracture risk was mediated by femoral neck BMD. The overall mediated effect estimates were -0.048 (95% CI, -0.059 to -0.036; p < 0.001) in women and -0.030 (95% CI, -0.042 to -0.018; p < 0.001) in men. These analyses suggest that there is no significant direct effect of BMI on fracture, and that the observed association between BMI and fracture risk is mediated by femoral neck BMD in both men and women.

Management of intra-abdominal hypertension and abdominal compartment syndrome: a review.

UNLABELLED: Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). AIM: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function.

A review of the nursing role in central venous cannulation: implications for practice policy and research.

AIMS AND OBJECTIVES: The aim of this article is to review published studies about central vein cannulation to identify implications for policy, practice and research in an advanced practice nursing role. DESIGN: Modified integrative literature review. METHODS: Searches of the electronic databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, Embase, and the World Wide Web were undertaken using MeSH key words. Hand searching for relevant articles was also undertaken. All studies relating to the nurses role inserting central venous cannulae in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. RESULTS: Ten studies met the inclusion criteria for the review, all reported data were from the UK. There were disparate models of service delivery and study populations and the studies were predominantly non experimental in design. The results of this review need to be considered within the methodological caveats associated with this approach. The studies identified did not demonstrate differences in rates of adverse events between a specialist nurse and a medical officer. CONCLUSIONS: There were only a small number of studies found in the literature review and the limited availability of clinical outcome data precluded formal analysis from being generated. RELEVANCE TO CLINICAL PRACTICE: Central vein cannulation is potentially an emerging practice area with important considerations for policy practice and research. Training specialist nurses to provide such a service may facilitate standardising of practice and improving surveillance of lines, and possibly improve the training and accreditation process for CVC insertions for junior medical officers. For this to occur, there is a need to undertake well-conducted clinical studies to clearly document the value and efficacy of this advanced practice nursing role.