Nursing research
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The incidence rate of breast cancer is rising rapidly in Hong Kong. Lymphedema is a serious long-term complication of breast cancer surgery and radiation therapy. ⋯ Previous inflammation-infection and advanced age at axillary dissection are risk factors associated with the initiation of lymphedema. Previous inflammation-infection, operation on the side of the dominant hand, obesity, and aging are potential risk factors associated with the aggravation of lymphedema. Greater BMI is still a risk factor for lymphedema progression even in a lower BMI population.
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Time pressure and, occasionally, suboptimal assessment decisions are features of nursing in acute care. ⋯ Time pressure reduced nurses' ability to detect the need and the tendency to report intervening. Thus, there were more failures to report appropriate intervention under time pressure, and the positive effects of clinical experience were negated under time pressure. More and larger scale research on the effect on clinical outcomes of time pressured nursing choices is required.
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Research evidence suggests that nurse staffing influences patient outcomes. ⋯ Nurse and physician staffing and specialization of ICUs impacted patient mortality. Associations differed in tertiary and secondary hospitals. Further investigation of the impact of organizational environments in ICUs is needed.
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Translation of data collection instruments, paying careful attention to equivalency between the source and the target language, is important to obtain valid data collection instruments. ⋯ The findings for the psychometric properties of the Spanish version of the SDSCA questionnaire suggest that it has conceptual and content equivalency with the original English version and is valid and reliable. However, further testing with larger samples is required.
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Clinical Trial
Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention.
Studies show that patients who have higher self-efficacy and participate actively in their care have better disease management. Patient-provider Internet portals offer an exciting new venue for empowering and engaging patients in better management of chronic conditions. ⋯ The Internet-based coaching intervention departs substantially from usual nursing care but warrants further study given its potential to offer considerable benefits to large numbers of patients. Several challenges were identified to providing patient coaching and self-management support via the Internet, but this efficient and low-cost approach offers an innovative opportunity to improve patient-clinician partnerships in managing chronic conditions. As patients become more accustomed to electronic communication, nurses can play an important role, joining efforts to develop this new realm to promote patients as partners in managing their health conditions.