Recent research has reinforced the idea that haemodialysis (HD) patients should exercise to maintain their physical functioning and improve their quality of life. Some effective exercise programmes are available for HD patients. However, these programmes are not always completed by the patients who enrol in them, and therefore, these patients do not maintain long-term physical activity. In this study, a support programme based on the concepts of self-monitoring, verbal reinforcement and motivation was developed to encourage continued participation of HD patients in an exercise regimen. Intervention group participants were provided a support programme in addition to the exercise programme, whereas nonintervention group participants were only provided the exercise programme. The two groups were compared for 12 weeks. The intervention group participants showed a significantly higher rate of continuation of independent exercise than the nonintervention group participants.
Aim
To estimate diagnostic accuracy of ultrasonography for detecting aspiration and pharyngeal residue in patients with dysphagia.
Methods
A systematic search was conducted in MEDLINE (via PubMed), CINAHL, EMBASE, Ichushi‐Web, and Cochrane Library databases to identify articles that showed diagnostic accuracy of ultrasonography for detecting aspiration and residue published in English and Japanese until August 2019. Cross‐sectional studies, case–control studies, and cohort studies were included. The diagnostic accuracy results were extracted and the pooled estimated sensitivity and specificity were calculated. The risk of bias of the studies was assessed using the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies 2. The certainty of the evidence was assessed using the Grades of Recommendation Assessment, Development, and Evaluation methodology.
Results
Five studies were included in this review. The pooled estimated sensitivity and specificity for detecting aspiration were 0.82 (95% CI: 0.72–0.89) and 0.87 (95% CI: 0.81–0.92), respectively. One study was included that evaluated ultrasound assessments of pharyngeal residue. The sensitivity and specificity were 0.62 (95% CI: 0.32–0.86) and 0.67 (95% CI: 0.22–0.96), respectively. The certainty of the evidence was low and very low for the diagnostic accuracy of aspiration and pharyngeal residue, respectively.
Conclusion
Ultrasound is a non‐invasive method with good sensitivity and specificity in detecting aspiration as well as reference standards. While risk of bias and small number of studies limited the strength of this systematic review, our results suggested that ultrasound examination was useful as a bedside screening tool for detecting aspiration.
Findings from quality of life research provide nurses with valuable information for planning care. However, the instrument for measuring quality of life has to be carefully selected to ensure that it assesses accurately the impact on the patients' lives. The research tools reviewed in this article (QLI-H, and KDQOLTM) are well-established instruments that have contributed significantly to understanding issues surrounding quality of life in the end-stage renal disease population. This understanding will lead to improved patient care in the field of nephrology nursing practice.
The aim of the present study was to analyze the activity of the trapezius muscle, the
heart rate and the time pressure of Swiss and Japanese nurses during day and night shifts.
The parameters were measured during a day and a night shift of 17 Swiss and 22 Japanese
nurses. The observed rest time of the trapezius muscle was longer for Swiss than for
Japanese nurses during both shifts. The 10th and the 50th percentile of the trapezius
muscle activity showed a different effect for Swiss than for Japanese nurses. It was
higher during the day shift of Swiss nurses and higher during the night shift of Japanese
nurses. Heart rate was higher for both Swiss and Japanese nurses during the day. The time
pressure was significantly higher for Japanese than for Swiss nurses. Over the duration of
the shifts, time pressure increased for Japanese nurses and slightly decreased for those
from Switzerland. Considering trapezius muscle activity and time pressure, the nursing
profession was more burdening for the examined Japanese nurses than for Swiss nurses. In
particular, the night shift for Japanese nurses was characterized by a high trapezius
muscle activity and only few rest times for the trapezius muscle.
We found a significant time effect in heart rate similar to the known circadian rhythm under normal sleep-wake conditions while working in the studied shift work schedules. In the Japanese nurses, studied heart rate followed a circadian rhythm independently of the level of physical activity. Therefore, an activity profile following the circadian rhythm, especially a reduced workload from 2 to 4 a.m., is proposed. The proposed activity profile could be reached with an adapted work organization.
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