Leadership training effectiveness for high-performing young nurses in a teaching hospital - A quasi-experimental study.

BACKGROUND: Good nursing leadership management positively correlates with patient care quality and an organization's performance. Plans to nurture top-notch talents and strengthen management functions are essential to retain key talents and achieve sustainability. The leadership training for nursing staff should begin early to cope with complex clinical situations. OBJECTIVES: To compare the impact of leadership training on high-performing young nurses' (young nursing elite) management functions and team behavior. SETTING: A public teaching hospital in Taipei, Taiwan. METHODS: This research implemented a longitudinal quasi-experimental study with a fixed time series design; the target subjects were youth nursing elites who received training, along with their direct managers and peers, for a total of 102 participants. The training course intervention included the classroom teaching of leadership management functions, arranging internships in the hospital's internal administrative units and professional nursing institutions, and the direct managers sharing their experiences during teaching. We measured the outcome indicators before the course intervention, at the end of the course intervention, and three months after using the management function and team behavior scales. RESULTS: The mean score of the direct managers' assessments regarding the youth nursing elite's pre-test team behavior was 4.18. This improved by 0.68 points (p < .001) after the program intervention and improved by 0.65 points (p < .001) three months after the program compared to the pre-test. There was no statistically significant difference between the two groups as analyzed using GEE. The mean score of the pre-test self-assessment management function of the young nursing elite was 3.27. This improved by 1.06 points (p < .001) after the program intervention and by 1.14 points (p < .001) three months after the program compared to the pre-test. There was no statistically significant difference between the three groups using GEE analysis. CONCLUSIONS: Leadership training enhances young nursing professionals' leadership function and team behavior.

Smart humancentric lighting system improves sleep efficiency of nursing home residents.

The global phenomenon of population aging presents a significant challenge, affecting both the increasing number of older individuals and their duration of living with disability. Tailored care services are crucial for improving the quality of life of older adults, particularly those with disabilities residing in nursing homes. However, ensuring personalized care and mitigating the risks associated with institutionalization are essential in optimizing care quality. One particular challenge in nursing homes is maintaining residents' personal routines and addressing sleep disturbances linked to neurodegenerative disorders. Non-pharmacological interventions are increasingly recognized as preventive and management strategies for behavioral and psychiatric symptoms in nursing home residents. Sleep disruptions, such as reduced duration and increased nocturnal awakenings, are prevalent among nursing home residents. Excessive nocturnal lighting and frequent caregiver interventions contribute to these disturbances. This study aimed to investigate the impact of implementing smart humancentric lighting on the sleep efficiency of nursing home residents. Data from pressure sensors embedded in mattresses were collected to assess sleep efficiency. The findings suggest that smart humancentric lighting can significantly reduce sleep disturbances and improve sleep quality in nursing home residents. Future research should delve into specific symptoms, care burden, and psychotropic agent utilization to validate the effectiveness of this intervention.

Psychosocial Adjustment Changes and Related Factors in Postoperative Oral Cancer Patients: A Longitudinal Study.

Disease and treatment-related symptoms and dysfunctions can interfere with the psychosocial adjustment of patients with oral cancer. Identifying factors influencing psychosocial maladjustment is important because at-risk individuals can be targeted for early intervention. This prospective longitudinal study investigated psychosocial adjustment changes and associated factors in postoperative oral cancer patients. Data on psychosocial adjustment, facial disfigurement, symptoms, and social support were collected before surgery (T1) at one month (T2), three months (T3), and five months after discharge (T4). Fifty subjects completed the study, and their data were included in the analysis. Psychosocial maladjustment was reported in 50%, 59.2%, 66%, and 62% of subjects at T1, T2, T3, and T4, respectively. The subjects' psychosocial adjustment deteriorated after surgery. Results from generalized estimating equations indicated that financial status, cancer stage, pain, speech problems, social eating problems, and less sexuality were significant predictors of changes in psychosocial adjustment. Patients with insufficient income, stage III/IV cancer, severe pain, speech problems, social eating problems, and less sexuality were at higher risk for postoperative psychosocial maladjustment. Continued psychosocial assessment and appropriate supportive measures are needed to strengthen the psychosocial adjustment of these high-risk groups.

Predictors of weight loss during and after radiotherapy in patients with head and neck cancer: A longitudinal study.

PURPOSE: Weight loss is a multifactorial condition that commonly affects patients receiving radiotherapy for head and neck cancers. The aims of this study were to 1) describe body weight changes over time in patients receiving radiotherapy for head and neck cancers and 2) explore the influence of pretreatment weight loss, body mass index (BMI) category, symptom burden, mucositis, and nutritional support on body weight changes over time. METHODS: Using a longitudinal design, this study investigated a consecutive cohort of head and neck cancer patients who were treated with radiotherapy between January 2015 to January 2016 in a Taiwan medical center (n = 128). Data regarding symptom burden, mucositis severity, and body weight were collected before radiotherapy (T1), one month after the initial radiotherapy (T2), at the completion of radiotherapy (T3), and one month after the completion of radiotherapy (T4). RESULTS: On average, the participants' body weight decreased by 3.09 kg (SD = 2.79) from T1 to T2, 1.72 kg (SD = 2.06) from T2 to T3, and continued to decrease by 1.04 kg (SD = 2.87) from T3 to T4. The results of a generalized estimating equation showed that BMI category, symptom burden, mucositis, and nutritional support were directly and independently related to body weight changes over time in patients with head and neck cancers. CONCLUSIONS: Head and neck cancer patients experience significant weight loss during and after radiotherapy. The study findings are relevant for assessing nutritional status and providing necessary support measures at critical moments for patients treated with radiotherapy.

Influences of facial disfigurement and social support for psychosocial adjustment among patients with oral cancer in Taiwan: a cross-sectional study.

OBJECTIVE: To explore the influences of facial disfigurement and social support for psychosocial adjustment in patients with oral cancer. DESIGN: A cross-sectional design was used for the study. PARTICIPANTS AND SETTING: A convenience sample of 77 patients with oral cancer was recruited from the otolaryngology and oral and maxillofacial surgery outpatient clinics of three general hospitals in Taiwan. MEASURES: Data were collected using the study questionnaires, including the Facial Disfigurement Scale, the Social Support Scale and the Psychosocial Adjustment to Illness Scale. RESULTS: The mean score on the Psychosocial Adjustment to Illness Scale was 413.01 (SD=32.32); 71.4% of the participants were maladjusted. Results of multiple regression analysis showed statistically significant main effects of tumour site (beta=0.37), facial disfigurement (beta=0.35) and social support (beta=-1.01), and the interaction effect of facial disfigurement and social support (beta=0.79) (all p<0.05) on psychosocial adjustment after controlling for other sociodemographic and clinical variables. All variables together explained 62% of the variance in psychosocial adjustment (F(16, 55)=14.98, p<0.001). CONCLUSIONS: The level of psychosocial adjustment in patients with oral cancer was suboptimal. Poorer psychosocial adjustment was reported by patients with more severe facial disfigurement and less social support. Patients with cancers in other areas of the oral cavity also reported poorer psychosocial adjustment than patients with cancers in the buccal mucosa. Medical professionals may use these variables to identify higher risk groups for early intensive intervention.

Comparing the efficacy of aquatic exercises and land-based exercises for patients with knee osteoarthritis.

AIMS: The study aims to compare changes over time among three study groups on the primary outcome, pain, as well as on the secondary outcomes, other symptoms, activities of daily living function, sport and recreation function, knee-related quality of life, knee range of motions and the six-minute walk test and to investigate whether aquatic exercises would be superior compared with land exercise on pain reduction. BACKGROUND: Osteoarthritis is a prevalent musculoskeletal disorder. Appropriate exercise may prevent osteoarthritis-associated disabilities and increase life quality. To date, research that compares the effects of different types of exercise for knee osteoarthritis has been limited. DESIGN: The study is a randomised trial. METHODS: Eighty-four participants with knee osteoarthritis were recruited from local community centres. Participants were randomly assigned to the control, aquatic or land-based exercise group. Exercise in both groups ran for 60 minutes, three times a week for 12 weeks. Data were collected at baseline, week 6 and week 12 during 2006-2007. The instruments included the Knee Injury and Osteoarthritis Outcome Score, a standard plastic goniometer and the six-minute walk test. Generalised estimation equations were used to compare changes over time among groups for key outcomes. RESULTS: Results showed statistically significant group-by-time interactions in pain, symptoms, sport/recreation and knee-related quality of life dimensions of Knee Injury and Osteoarthritis Outcome Score, knee range of motions and the six-minute walk test. However, the aquatic group did not show any significant difference from the land group at both weeks 12 and 6. CONCLUSIONS: Both aquatic and land-based exercise programmes are effective in reducing pain, improving knee range of motions, six-minute walk test and knee-related quality of life in people with knee osteoarthritis. The aquatic exercise is not superior to land-based exercise in pain reduction. RELEVANCE TO CLINICAL PRACTICE: Similar outcomes could be possible with the two programmes. Health care professionals may consider suggesting well-designed aquatic or land-based exercise classes for patients with osteoarthritis, based on their preferences and convenience.

Factors influencing heart failure patients' sleep quality.

AIM: The aim of the study was to describe the factors influencing the sleep quality of patients with heart failure. BACKGROUND: Sleep problems are common in patients with heart failure, and have a negative impact on their quality of life. Patients with heart failure often have difficulties in lying supine to sleep, falling asleep, and maintaining sleep, as well as waking up too early. METHODS: A predictive correlational design was used, with 101 patients with heart failure recruited from cardiology clinics in Taiwan. Patients completed questionnaires, and data were collected in 2007. Statistical analyses included descriptive statistics, t-tests, analysis of variance, Pearson product moment correlation coefficients, and multiple regression. RESULTS: The mean score for sleep quality was 10.78 (sd = 4.78), as measured by the Pittsburgh Sleep Quality Index. Overall, 81% of participants reported poor sleep quality, and 31% were unsatisfied with the quality of their sleep. Sleep efficacy and hours of sleep during the night were rated as the lowest among the dimensions of sleep quality. The most common reason for interruption of sleep was getting up to urinate at night. Stepwise multiple regression analysis showed that the factors related to sleep quality were gender, perceived health, depressive mood, and the number of comorbidities. These four variables explained 31% of the variance in the sleep quality of these patients. CONCLUSION: Patients with heart failure should be taught sleep hygiene and to increase leisure time activities, disease self-management, and emotional adjustment skills to improve their sleep quality. These patients should also be observed for night time safety risk due to nocturia.