ABSTRACT
INTRODUCTION: The "paternalistic decision-making model" is no longer well suited to the modern clinical environment, and therefore, shared decision making (SDM) has emerged as a key approach. Although the benefits of SDM have been largely reported, several studies have reported low participation in SDM in coronary artery disease (CAD) patients. The theory of planned behavior (TPB) model is one of the most frequently employed theoretical frameworks for predicting human behaviors. According to the TPB, intention is influenced by attitude, subjective norm, and perceived behavioral control, while behavior is influenced by both intention and perceived behavioral control. Therefore, we propose a mixed methods study based on TPB to investigate the status of Chinese stable coronary artery disease (SCAD) patients' participation in SDM, understand their experiences of SDM, and explore the factors that influence their participation in SDM. MATERIALS AND METHODS: An explanatory sequential mixed methods design will be used to explore the study aims, including a quantitative phase, a subsequent qualitative phase, and the final integration study. The quantitative study will use convenient sampling from the Affiliated Hospital of Hangzhou Normal University to conduct a cross-sectional survey (n ≥ 252). The qualitative study will be sampled using the maximum difference sampling method from the quantitative study results, and then the data will be collected through semi-structured interviews (n = 10-20). This study will use descriptive statistics and test hypotheses while considering a p-value of <0.05, which will be considered statistically significant. DISCUSSIONS: The study employs a mixed method approach with an explanatory sequential design, incorporating qualitative and quantitative methods to comprehensively understand the factors influencing SCAD patients' participation in SDM. Furthermore, these findings can inform the design of future intervention studies and provide healthcare providers with targeted information and communication to help SCAD patients make the most appropriate decisions. Study participants will be recruited using convenience sampling from just one single clinical setting, which may limit the findings' generalizability. ETHICS AND DISSEMINATION: This study has been approved by the Ethical Committee of the School of Nursing, Hangzhou Normal University (Approval No.: 2024013). All the participants will sign an informed consent form before participating in the survey. The corresponding results and conclusions will be disseminated in journals and conferences after the completion of the study.
ABSTRACT
Objectives: To evaluate the effect of topical corticosteroids (TCS) in preventing acute radiation dermatitis in patients with breast cancer. Methods: An updated systematic review and meta-analysis were conducted following the preferred reporting items for systematic reviews and meta-analyses. Randomized controlled trials (RCTs) in six English databases (PubMed, Web of Science, Scopus, CINAHL, Cochrane Library, Embase), three Chinese databases (Sinomed, China National Knowledge Infrastructure, Cqvip), and two clinical trial registration platforms (CHICTR, Clinicaltrials.gov) were systematically searched from inception to 1 February 2024. Results: Thirteen RCTs were included, with 1172 patients in this updated review. Meta-analysis showed that TCS reduced the rate of moist desquamation (OR = 0.31; 95% CI = [0.22, 0.44]; P < 0.01), the incidence of Radiation Therapy Oncology Group ratings of grade 2 or higher (OR = 0.22; 95% CI = [0.14, 0.32]; P < 0.01), the incidence of Common Terminology Criteria for Adverse Events ratings of grade 2 or higher (OR = 0.56; 95% CI = [0.37, 0.84]; P < 0.01), the mean score of radiation dermatitis (SMD = -0.46; 95% CI = [-0.59, -0.34]; P < 0.01), skin erythema and hyperpigmentation readings, and improved subjective symptoms. Conclusions: TCS can effectively prevent acute radiation dermatitis in patients with breast cancer. Systematic review registration: Prospero (CRD42024507890).
ABSTRACT
BACKGROUND: Nursing professional skills training has undergone significant transformation due to the exponential growth of computer and medical technology. The innovative use of virtual reality (VR) in nursing education has emerged as a cutting-edge technical support technique that has gained attention as a highly effective method for improving nurse training quality. OBJECTIVE: This study aims to review the current status of VR technology in nursing professional skills training, research hotspots, and emerging trends in the last 15 years. METHODS: The Web of Science Core Collection database was used to search for literature on VR technology in nursing professional skills training covering the period from 2006 to 2022. Biblioshiny (K-Synth Srl) was used to import and convert the records to Bibliometrix (K-Synth Srl) for analysis, and R (R Core Team) was used for descriptive bibliometric analysis. VOSviewer (Leiden University) was used to cluster co-occurring keywords, and Scimago Graphica (version 1.0.16; Scimago Lab) was used to generate a geographical visualization of published countries and regions. RESULTS: A total of 1073 papers were analyzed, indicating a surge in research on the application of VR in nursing professional skills training in recent years, as evidenced by a positive trend in annual publication of relevant literature. The majority of studies were from the United States (n=340) and Canada (n=107), and Margaret Verkuyl was the most prolific author, leading the way with 9 publications. Furthermore, "Computerized Virtual Patients in Health Professions Education: a Systematic Review and Meta-Analysis" was the most frequently cited reference. Keywords such as education, simulation, skills, students, and care were most commonly used by researchers. CONCLUSIONS: The bibliometric analysis provides a comprehensive overview of the use of VR in nursing professional skills training, indicating that VR-based training is an effective means of improving the skills and competencies of nursing students and professionals alike. The COVID-19 pandemic has reinforced the importance of developing VR-based distance education, despite challenges such as integrating virtual and real-world training and mitigating safety risks.