Reflecting on ICU patient's dignity using Taylor's Emancipatory Reflection Model.

Intensive Care Unit (ICU) patients not only require life-sustaining treatments but also the preservation of their psychological well-being and dignity, and ICU nurses face heavy work pressure, focusing more on life-sustaining treatments for patients, while the patient's psychological experiences are often overlooked. This article aims to explore the issue of nurse-led patient dignity preservation in the ICU from China. Reflection is a process of deep thinking and examining one's actions, experiences, perspectives, or emotions. It involves retrospectively reviewing, analyzing, and evaluating past events to gain insights, understanding, and personal growth. Through reflection, individuals can consider whether their actions align with their values and goals and whether they can learn valuable lessons from them. This article discusses the preservation of patient dignity in the ICU from China based on Taylor's Emancipatory Reflection Model, which involves four steps: constructing, deconstructing, confronting, and reconstructing. The process of reflection incorporates theories such as Maslow's Hierarchy of Needs, Comfort Theory, and the style of Paternalistic Decision-making. This study is of great significance in enhancing Chinese nurse's attention to patient dignity, improving the inpatient experience of ICU patients, and enhancing the quality of nursing practice by critically examining current nursing practices in China and providing improvement recommendations.

Decision aids for shared decision-making and appropriate anticoagulation therapy in patients with atrial fibrillation: a systematic review and meta-analysis.

AIMS: Underuse of oral anticoagulants (OACs) is commonly observed among patients with atrial fibrillation (AF), which hinders stroke prevention in AF. Shared decision-making (SDM) can help enhance adherence by minimizing patients' misunderstanding of treatment and aligning care with their preferences. Decision aids (DAs) have been developed to facilitate the SDM process. This study aimed to: (i) evaluate the effects of DAs on AF patients' knowledge, decisional conflict, OAC uptake, and adherence and on the incidence of stroke and bleeding; and (ii) explore characterizing factors associated with enhanced DA effectiveness. METHODS AND RESULTS: Five databases were searched. Meta-analysis was conducted using RevMan 5.3 when data were available. Comparative analysis between effective and ineffective DAs was conducted to determine the DA designs associated with better effects. Ten studies were included. Pooling results indicated that DAs reduce decisional conflict related to warfarin use [mean difference = -0.10; 95% confidence interval (CI): -0.18 to -0.02; P = 0.01] and enhance OAC uptake [risk ratio: 1.03; 95% CI: 1.01-1.05; P = 0.004]. The effects of DAs on adherence and incidence of stroke and bleeding were unclear. Comparative analysis revealed that DAs with key elements of SDM (situation diagnosis, choice awareness, option clarification, benefits and disadvantages, and patient's preference) and pre-consultation delivery are more likely to be effective in promoting SDM and OAC uptake. CONCLUSIONS: DAs are promising in promoting SDM and OAC uptake in patients with AF. The evidence on adherence and incidence of stroke and bleeding remains uncertain. More trials with rigorous study design and longer follow-up are necessary to obtain evidence.

Sleep disturbance mediates the relationship between depressive symptoms and cognitive function in older adults with mild cognitive impairment.

This study examined whether and to what extent sleep disturbance mediates the effects of depressive symptoms on the cognition of individuals with mild cognitive impairment (MCI), who represent a high-risk group for developing dementia. Cross-sectional data were obtained from a sample of 204 Chinese community-dwelling older adults with MCI. MCI subjects were screened using the Montreal Cognitive Assessment, sleep quality was measured using the Pittsburgh Sleep Quality Index, and depressive symptoms were assessed using the Geriatric Depression Scale. Mediation analysis was conducted using the PROCESS macro with 10,000 bootstrap samples. The significant mediating effect of sleep quality on the association between depressive symptoms and cognition (Beta = -0.025; 95% CI, -0.054 to -0.007) explains 26% of the total effect of depressive symptoms on cognition and implies that the timely detection and management of sleep disturbance among the MCI population is highly important, especially for those with depressive symptoms.