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EditorialComment of Walker and Avant’s method of concept analysis
Liu Hui, Ling Dong-Lan, Su Irene
TMR Integrative Nursing    2018, 2 (1): 1-3.   https://doi.org/10.12032/TMRIN20180307
Abstract   HTML PDF (234KB)  
Self-management A concept analysis of self-management for cancer patients’ home-basedrehabilitation
Ling Dong-Lan, Yu Hong-Jing
TMR Integrative Nursing    2018, 2 (1): 4-11.   https://doi.org/10.12032/TMRIN20180308
Abstract   HTML PDF (376KB)  

Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-based rehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to develop self-management strategies and enables them to improve their ability in symptom self-management of home-based rehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management. Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation, problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge and social support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes and quality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Management scale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether this instrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thus further research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients to involve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management of home-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Adherence-A concept analysis in the context of cardiac rehabilitation
Liu Hui, Tian Xu
TMR Integrative Nursing    2018, 2 (1): 12-17.   https://doi.org/10.12032/TMRIN20180309
Abstract   HTML PDF (303KB)  

Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This concept analysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence to cardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept of adherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in the treatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributes of adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents of adherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors. Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standard instrument to measure adherence. Conclusion:Based on the concept analysis, in order to improve patients’ adherence to cardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan and promote patients’ self-efficacy and prevention relapse.

ICU Delirium: A concept analysis
Lian-Lian Tang
TMR Integrative Nursing    2018, 2 (1): 18-26.   https://doi.org/10.12032/TMRIN20180310
Abstract   PDF (448KB)  

Objective: To explore and analyze the concept of intensive care unit (ICU) delirium. Method: Walker and Avant’s strategy of analysis was adopted to this research. Results: ICU delirium is defined as the presence of an acute cognitive impairment, accompanied by a disturbance of consciousness with fluctuating inattention, and the array of dysfunctions only developed for a short period of time in ICU. The antecedents of ICU delirium include (1) the high severity of illness, (2) pain, (3) sedative use, (4) immobilization, (5) sleep deprivation and (6) unpleasant awareness. The consequences involve (1) promoting the risks of self-extubation and unplanned removal of catheters, (2) prolonging the length of ICU stay, (3) increasing the mortality of critical patients and (4) highly distressing the patients’ family members and caregivers. Some different ICU delirium assessment instruments are gathered. Confusion Assessment Method for Intensive Care Unit assessment tool (CAM-ICU) was the most popular diagnostic tool used by nurses. Conclusion: Concept analysis as an extension and development of nursing theory can create a linkage between practice and theory. It will create a knowledge foundation of ICU delirium and provide a theoretical basis to construct nursing theory. This study can help ICU nurses to understand and recognize ICU delirium. ICU nurses will be enlightened to develop effective interventions of ICU delirium to improve critical patients’ clinical outcomes.

Quality of life in head and neck cancer survivors: A concept analysis
Zeng Qiao-Miao, Liao Yao, Chen Wen-Feng
TMR Integrative Nursing    2018, 2 (1): 34-41.   https://doi.org/10.12032/TMRIN20180312
Abstract   HTML PDF (345KB)  

Objective: To identify and clarify the existing definitions of quality of life in head and neck cancer survivors. This concept analysis will inform healthcare professionals of promoting nursing care for head and neck cancer survivors and eventually improve their quality of life. Method: Concept analysis based on Walker and Avant’s framework. Results: Quality of life is a subjective and personally derived cognitive evaluation of global well-being by perceiving a feeling of overall life satisfaction in his/her own value, happiness, and the independence to manage daily activities and life experience. Three defining attributes for quality of life were identified: a feeling of overall life satisfaction in his/her value, global personal well-being, and independence. An improvement of quality of life means an improvement of clinical outcome. However, the variety of instruments for measuring life quality makes it difficult for healthcare professionals to select a standard one for head and neck cancer survivors. Conclusion: By proposing a comprehensive definition of the concept, this analysis contributes to the advancement of knowledge about quality of life in the context of head and neck cancer survivorship. Through a sound understanding of the phenomenon, healthcare professions will recognize or measure head and neck cancer survivors’ life conditions in a more accurate way and to implement intervention where necessary, eventually, improve patients’ life quality in survivorship.

Coping: a concept analysis in the cancer context
Yang Hua
TMR Integrative Nursing    2018, 2 (1): 27-33.   https://doi.org/10.12032/TMRIN20180311
Abstract   HTML PDF (368KB)  

Objectives: The aim of this paper is to analyse the concept of coping in the cancer context. This concept analysis will provide a theoretical framework for oncology nurses to help patients cope with the influences of cancer and adapt to their new situations. Methods: The concept analysis of coping was conducted according to Walker and Avant's method. Results: Coping is defined as a process of dealing with stressful events by means of cognitive appraisal, purposeful efforts, and use of available supports and resources in order to achieve physiological and psychological adjustment. Antecedents to coping involve stressful events, individual personality, individual experience, and available supports and resources. Different coping strategies based on patients’ responses to suffering from cancer bring about positive or negative results. Effective coping means being well-adapted, which is conducive to patients’ health and optimum quality of life. Roy’s middle range theory of coping and adaptation processing provides a theoretical framework for the study of coping.The Mental Adjustment to Cancer scale and the 15-item Coping and Adaptation Processing Scale are considered practical and effectual instruments to measure coping in the cancer context. Conclusions: This concept analysis contributes to understanding the process of coping with cancer. Oncology nurses should identify cancer patients’ coping patterns, provide timely and proper professional support and educate effective coping strategies in order to help patients adapt to their new situations both physiologically and psychologically.

Early enteral nutrition supplemented with probiotics improved the clinical outcomes in patients with severe head injury: protocol for a meta-analysis of randomized controlled trials
Li-Juan Yi, Xu Tian, Wei-Qing Chen, Li Ma, Huan He, Hui Chen, Cheng-Xiang Wu, Yuan-Ping Pi
TMR Integrative Nursing    2017, 1 (2): 30-35.   https://doi.org/10.12032/TMRIN20171202
Abstract   PDF (518KB)  

Abstract


Objective: The aim of this systematic review of randomized controlled trials (RCTs) is to determine the effects of early enteral nutrition supplemented with probiotics on clinical outcomes in patients with SHI.
Methods and analysis: A systematic search will be carried out in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), WanFang database, and Chinese Biomedical Literature (CBM) in order to identify the randomized controlled trials (RCTs) investigated the potential of early enteral nutrition supplemented with probiotics on patients with severe head injury, as well as we will also manually check the bibliographies of eligible studies and topic-related reviews. We will assign two investigators to independently search all potential citations, extracted data, and appraised risk of bias accordingly, and then STATA software version 12.0 will be used to statistically analyze all data.
Ethics and dissemination: The ethics approval and patient written informed consent will not be required because all analyses in the present study will be performed based on data from published studies. We will submit our systematic review to a peer-reviewed scientific journal for publication.
The effect of traditional Chinese medicine washing combined with massage for neonatal jaundice: a meta-analysis
Li Wang, Ting Shuai, Yun-Yun Wang, Hong Cao
TMR Integrative Nursing    2017, 1 (2): 36-44.   https://doi.org/10.12032/TMRIN20171203
Abstract   PDF (1398KB)  
Objective: To systematically assess the effect of traditional Chinese medicine washing (TCM washing) combined with massage for the treatment of neonatal jaundice.
Methods and analysis: Databases, including PubMed, the Cochrane Library, Embase, Web of Science, the Chinese Biomedical Literature Database (CBM), CNKI, and Wanfang Data were electronically searched for randomized controlled trials (from inception to July 2017). The methodological qualities of included trials were evaluated by the Cochrane risk of bias assessment tool. The meta-analysis was performed by using RevMan 5.3 software.
Results: Overall, thirteen trials with a total of 1998 participants were included. The results of meta-analysis indicated that TCM washing combined with massage group was significantly superior to the control group in the first meconium time (MD, -16.67; 95% CI, -24.59 to -8.74; P<0.001), time for transformation of meconium (MD, -15.44; 95% CI, -23.59 to -7.28; P<0.001), transcutaneous bilirubin index changes [after treating three days (MD, -1.99; 95% CI, -2.57 to -1.40; P<0.001), after treating four days (MD, -1.86; 95% CI, -2.77 to -0.95; P<0.001), after treating five days (MD, -2.44; 95% CI, -3.47 to -1.42; P<0.001), after treating six days (MD, -2.23; 95% CI, -3.30 to -1.16; P<0.001), and the changes of serum bilirubin levels [after treating five days (MD, -3.17; 95% CI, -5.83 to -0.50; P=0.02), after treating six days (MD, -1.63; 95% CI, -3.10 to -0.16; P=0.03), after treating fifteen days (MD,-1.20; 95% CI, -1.99 to -0.41; P=0.003).
Conclusions: TCM washing combined with massage may be an effective therapy for the treatment of neonatal jaundice. It can accelerate the excretion of meconium, shorten the time for transformation of meconium, and decrease transcutaneous bilirubin index and the level of serum bilirubin. But it should be careful to interpreting these findings. Well-designed RCTs are needed to further clarify the conclusion.
Treatment of perianal infection in acute leukemia hematopoietic stem cell transplantation with Xiongzhen ointment mixed with furacilin powder
Yang Song
TMR Integrative Nursing    2017, 1 (2): 45-49.   https://doi.org/10.12032/TMRIN20171204
Abstract   PDF (307KB)  
Objective: To investigate the effect of Xiongzhen ointment mixed with furaicillin powder on perianal care of patients with acute myeloid leukemia M2a hematopoietic stem cell transplantation.
Methods: A case of acute myeloid leukemia M2a hematopoietic stem cell transplantation was used as the research object. The method and effect of peristaltic nursing were recorded in the patients with hematopoietic stem cell transplantation by using Xiongzhen ointment mixed with furazolidone powder.
Results: After treatment with Xuelong ointment mixed with furacilin powder, the patients did not show obvious perianal infection during the transplantation process. After 24 days, the transplant was successfully transferred into the transitional ward.
Conclusion: In the perianal care of laminar flow chamber, the addition of Xiongzhen ointment mixed with furaicillin powder can reduce the incidence of perianal infection.
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