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Koontalay A, Botti M, Hutchinson A. Narrative synthesis of the effectiveness and characteristics of heart failure disease self-management support programmes. ESC Heart Fail 2024. [PMID: 38311880 DOI: 10.1002/ehf2.14701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/21/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024] Open
Abstract
A deeper understanding of the key elements that should be included in heart failure (HF) disease self-management support (DSMS) programmes is crucial to enhance programme effectiveness and applicability to diverse settings. We investigated the characteristics and effectiveness of DSMS programmes designed to improve survival and decrease acute care readmissions for people with HF and determine the generalizability and applicability of the evidence to low- and middle-income countries (LMICs). A narrative meta-synthesis approach was used, and systematic reviews of randomized controlled trials (RCTs) of DSMS programmes were included. The Cochrane Database of Systematic Reviews, MEDLINE, and Embase were searched without language restriction and guided by the adapted Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight high-quality systematic reviews were identified representing 250 studies, of which 138 were unique RCTs measuring the outcomes of interest. The findings revealed statistically significant reductions in HF readmissions [relative risk (RR) range 0.64-0.85, P < 0.5, five out of six reviews], all-cause readmissions (RR range 0.85-0.95, P < 0.5, five out of six reviews), and all-cause mortality (RR range 0.67-0.87, P < 0.5, five out of five reviews). Overall, 44.2% (n = 61) of RCTs reduced acute care readmission and improved survival. Studies were categorized according to intensity (low, moderate, moderate+, and high) based on the opportunity for immediate treatment of HF instability; 29.2% (14/48) of low-intensity, 63.6% (21/33) of moderate-intensity, 40% (6/15) of moderate+-intensity, and 47.6% (20/42) of high-intensity interventions were effective. Most effective programmes used moderate-intensity (39.4%, 48%, or 50%, respectively) or high-intensity (33.3%, 36%, and 43.7%, respectively) interventions. The majority of studies (90.6%) were conducted in high-income countries. Programmes that provided opportunities for early recognition and response to HF instability were more likely to reduce acute care readmission and enhance survival. Generalizability and applicability to LMICs are clearly limited. Tailoring HF DSMS programmes to accommodate cultural, resource, and environmental challenges requires careful consideration of intervention intensity, duration of follow-up, and feasibility in low-resource settings.
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Affiliation(s)
- Apinya Koontalay
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Anastasia Hutchinson
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research-Epworth HealthCare Partnership, Deakin University, Geelong, Victoria, Australia
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Koontalay A, Suksatan W, Prabsangob K. "I am afraid that others will feel scared and disgusted with me. So, I will keep it a secret until I die": A qualitative study among patients with tuberculosis receiving DOTS regimen in Thailand. Belitung Nurs J 2021; 7:516-521. [PMID: 37497292 PMCID: PMC10367973 DOI: 10.33546/bnj.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/12/2021] [Accepted: 10/06/2021] [Indexed: 07/28/2023] Open
Abstract
Background Tuberculosis (TB) has become a significant public health problem leading to a top ten morality. Directly Observed Therapy, Short-course (DOTS) is recommended as a critical element for curing and preventing TB. However, patients who have been living with TB often receive barriers and challenges, which may lead them to discontinue the DOTS treatment. Objective This study aimed to understand patients' experiences living with TB and receiving DOTS regimens. Methods A qualitative descriptive study was employed. Semi-structured interviews were done among twenty tuberculosis patients selected using convenience sampling from the slum community in Bangkok, Thailand. The thematic approach was used for data analysis. Results Two main themes were developed: (1) troublesome disease and (2) emotional challenges. The first theme comprises three subthemes: confronting death, accepting lifestyle change, and DOTS challenges. The second theme consists of two subthemes: isolation from others and stigma. Conclusion The findings could guide nurses and other healthcare professionals to develop the treatment guideline and the DOTS strategy using a holistic approach.
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Affiliation(s)
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Kantapong Prabsangob
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkhram, Thailand
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Koontalay A, Suksatan W, Prabsangob K, Sadang JM. Healthcare Workers' Burdens During the COVID-19 Pandemic: A Qualitative Systematic Review. J Multidiscip Healthc 2021; 14:3015-3025. [PMID: 34737573 PMCID: PMC8558429 DOI: 10.2147/jmdh.s330041] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/05/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The global healthcare system is continuing to confront major challenges during the current COVID-19 pandemic, with the second wave the deadliest one to date. This study aimed to identify and explore the challenges and burdens of frontline healthcare workers during the current pandemic, and to help prepare workforce support plans for them now and in the future. METHODS A qualitative systematic review method involving thematic synthesis without meta-analysis was used to analyze relevant studies from five databases from November 2020 to February 2021: MEDLINE via PubMed, CINAHL Complete, Embase through Ovid, Scopus, and Web of Science. The quality of the studies was evaluated using the Critical Appraisal Skills Program Qualitative Research Checklist appraisal tools. This systematic review was conducted in accordance with the PRISMA statement. The informants are healthcare workers working at the frontlines and providing care to COVID-19 patients. RESULTS Ten studies revealed the burden of healthcare providers during the COVID-19 pandemic, with having the related challenges experienced by 498 participants (doctors, nurses, pediatric nurses, paramedical staff, support staff, and physiotherapists). Our findings fell into four main themes as follows: inadequate preparedness; emotional challenges; insufficient equipment and information; and work burnout. CONCLUSION The study results demonstrate that the COVID-19 pandemic has had an impact on all aspects of life, especially for healthcare providers, who work on the frontlines. The pandemic has affected the frontline workers' physical and psychological health, causing them to experience emotional distress such as fear, anxiety, depression, and stress. In addition, the pandemic can increase posttraumatic stress disorder, leading to burnout and discontinuity of healthcare workloads to ensure the patients' safety and the high quality of care provided to the patients.
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Affiliation(s)
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
- Trudy Busch-Valentine School of Nursing, Saint Louis University, St. Louis, MO, USA
| | - Kantapong Prabsangob
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkram, Thailand
| | - Jonaid M Sadang
- College of Health Sciences, Mindanao State University, Marawi, Philippines
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Koontalay A, Suksatan W, Teranuch A. Early Enteral Nutrition Met Calories Goals Led by Nurse on Improve Clinical Outcome: A Systematic Scoping Review. Iran J Nurs Midwifery Res 2021; 26:392-398. [PMID: 34703776 PMCID: PMC8491827 DOI: 10.4103/ijnmr.ijnmr_421_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/24/2021] [Accepted: 05/08/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Critically ill patients face challenges in hypercatabolism due to crisis states, as it may lead to malnutrition. An early Enteral Nutrition (EN) within 24-48 h is recommended to use in order to improve clinical outcomes. This systematic scoping review is examined recently with the evidence of the early EN protocol led by nurses to drive and achieve the daily calorie target and improve clinical outcomes. MATERIALS AND METHODS The database of CINAHL, MEDLINE via PubMed and Scopus, Web of Science, and Embase through Ovid from January 2019 to September 2020, comprised of 221 articles which four articles are chosen and entered into the final analysis. RESULTS The findings show the benefits of the early EN to guide nurses to start the EN as soon as possible after admitted to the Intensive Care Unit or when hemodynamic is stable in order to achieve a daily calorie target regarding the reduced hospitalization, duration of mechanical ventilation, morbidity, and mortality. CONCLUSIONS The synthesized results show the early EN led by a nurse to address the specific needs and the vital role of nutritional support, and also drive the enteral feeding for critically ill patients to reach the calorie target goals in short times to enhance clinical outcomes.
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Affiliation(s)
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabron College of Medical Science, Chulaborn Royal Academy, Thailand
- Saint Louis University, Trudy Busch.Valentine School of Nursing, St.Louis, Missouri, USA
| | - Aumpornpun Teranuch
- Adult Nursing, Faculty of Nursing, Khon Kaen University, Acting Director, Research and Training Center for Enhancing Quality of Life of Working Age People, Thailand
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Posai V, Suksatan W, Choompunuch B, Koontalay A, Ounprasertsuk J, Sadang JM. Assessment of the Health-Promoting Behaviors of Hospitalized Patients with Non-Communicable Diseases During the Second Wave of COVID-19. J Multidiscip Healthc 2021; 14:2185-2194. [PMID: 34413651 PMCID: PMC8370493 DOI: 10.2147/jmdh.s329344] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has affected the health-related behaviors of patients with non-communicable diseases (NCDs). Thus, the factors predicting the health-promoting behaviors (HPBs) of hospitalized patients with NCDs during the second wave of COVID-19 should be examined. OBJECTIVE The aims of this study were to determine the relationships among the patients' characteristics, perceived self-efficacy, social support, perception of the benefits of and barriers, and HPBs, and to determine the predictive factors of HPBs among hospitalized patients with NCDs during the second wave of COVID-19. PATIENTS AND METHODS The study had a cross-sectional predictive correlational design and included 250 patients with NCDs 18 years of age or older hospitalized in a tertiary hospital in Thailand. Descriptive statistics, the chi-square test, the Pearson's correlation coefficient, and stepwise multiple linear regression were used for data analysis. RESULTS Most of the participants had a cardiovascular disease (34.0%). Followed by diabetes (28.8%), cancer (11.2%), hypertension (10.0%), heart disease (9.6%), or chronic obstructive pulmonary disease (6.4%) and had a moderate level of overall HPBs (M = 106.09; SD = 4.66). Among the six components of the HPBs, the participants achieved the moderate levels in nutrition, interpersonal relations, spiritual growth, and stress management, and low levels in physical-activity and health responsibility. The patients' perception of the benefits and barriers to the adoption of HPBs and perceived self-efficacy and social support were able to predict their HPBs, accounting for approximately 38.0% of the variance of such behaviors. CONCLUSION On the basis of our study's results, we suggest that researchers, multidisciplinary teams, the government, and policymakers establish effective interventions, guidelines, and policies for the development of HPBs to prevent and control the spread of COVID-19 particularly among patients with NCDs, and to improve their capacity for high-quality and continuing self-care.
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Affiliation(s)
- Vachira Posai
- Nursing Department, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | | | | | - Jatuporn Ounprasertsuk
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Bangkok, Samut Songkram Province, Thailand
| | - Jonaid M Sadang
- College of Health Sciences, Mindanao State University- Marawi, Marawi, Philippines
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Koontalay A, Suksatan W, Sadang JM, Prabsangob K. Optimal Nutritional Factors Influencing the Duration of Mechanical Ventilation Among Adult Patients with Critical Illnesses in an Intensive Care Unit. J Multidiscip Healthc 2021; 14:1385-1393. [PMID: 34140776 PMCID: PMC8203270 DOI: 10.2147/jmdh.s319553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aims to identify the impact of nutritional factors on mechanical ventilation duration for critical patients. Patients and Methods The current study was a single-center, prospective observational design which enrolled one-hundred critically ill patients who were admitted to an intensive care unit (ICU). It demonstrates purposive sampling and also performs the descriptive nutritional factors influencing the mechanical ventilation duration. Daily calories target requirement scale (DCRS), subjective global assessment form (SGA), dyspnea assessment form, and APACHE II have been used as methods in the study along with time to initial enteral nutrition (EN) after 24-hour admission and daily calories target requirement over 7 days to assess patients. Data is analyzed using the multiple regressions. Results As a result, nutritional status monitoring, time to initial EN, calories and target requirements are statistically positive significance associated with the mechanical ventilation duration respectively (R = 0.54, R = 0.30, R= 0.40, p < 0.05). However, age, illness severity, and dyspnea scales are not associated with the mechanical ventilation duration (p> 0.05). Therefore, the nutritional status, malnutrition scores and calorie target requirements can be used to significantly predict the mechanical ventilation duration. The predictive power is 58 and 28.0% of variance. The most proper influencer to predict the mechanical ventilation duration is nutritional status or malnutrition scores. Conclusion The research findings show that the nutritional status, time to initial EN, and calorie target requirement within 7 days of admission are associated with the mechanical ventilation duration in the critical patients. Therefore, it can be used to develop guidelines reducing the mechanical ventilation duration and to promote the ventilator halting for critical patients.
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Affiliation(s)
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jonaid M Sadang
- College of Health Sciences, Mindanao State University, Marawi, Philippines
| | - Kantapong Prabsangob
- College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkram, Thailand
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Suksatan W, Choompunuch B, Koontalay A, Posai V, Abusafia AH. Predictors of Health Behaviors Among Undergraduate Students During the COVID-19 Pandemic: A Cross-Sectional Predictive Study. J Multidiscip Healthc 2021; 14:727-734. [PMID: 33790571 PMCID: PMC8001725 DOI: 10.2147/jmdh.s306718] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected the health behaviors of university students. Thus, factors influencing students' health behaviors during the COVID-19 outbreak should be examined. PURPOSE To our knowledge, little is known about stress, adversity quotient, and health behaviors of university students in Thailand. Therefore, the aims of this study were to determine the relationships among socioeconomic factors, stress, and adversity quotient influencing university students' health behavior during the COVID-19 crisis. PATIENTS AND METHODS We conducted a cross-sectional predictive study; it was included 416 undergraduate students ≥18 years of age at a university in Thailand. We used descriptive statistics, chi-squared test, and stepwise multiple linear regression for data analysis. RESULTS The results indicated that most participants were women (71.90%), and the highest proportion of students were enrolled in College of Politics and Governance (25.24%). Most of the students had a high stress level (M = 3.54, SD = 0.53), high adversity quotient (M = 3.77, SD = 0.63), and good health behavior (M = 3.06, SD = 0.53). Adversity quotient, stress, and current faculty/college were significant predictors of health behaviors of undergrad students (total variance: 37.2%). CONCLUSION Total adversity quotient was the strongest predictor of health behavior, followed by stress and current faculty/colleges. On the basis of our results, we suggested that faculty members, caretakers, and interdisciplinary care teams should consider adversity quotient and stress in developing activities to encourage and promote students' physical and mental health behaviors, particularly during the COVID-19.
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Affiliation(s)
- Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
- Trudy Busch-Valentine School of Nursing, Saint Louis University, St. Louis, MO, USA
| | | | | | - Vachira Posai
- Nursing Department, Sunpasithiprasong Hospital, Ubon Ratchathani, Thailand
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Koontalay A, Sangsaikaew A, Khamrassame A. Effect of a Clinical Nursing Practice Guideline of Enteral Nutrition Care on the Duration of Mechanical Ventilator for Critically Ill Patients. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 14:17-23. [PMID: 31899383 DOI: 10.1016/j.anr.2019.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Early enteral nutrition (EN) can improve clinical outcomes in critically ill patients. This study aimed to evaluate the effects of this clinical nursing practice guideline (CNPG) of EN care on the duration of mechanical ventilator in critically ill patients to investigate whether it was able to improve clinical outcomes. METHODS This study compares a pretest-posttest design for the two groups, which was done before and after to determine the effects of a CNPG of EN care on the duration of a mechanical ventilator in critically ill patients. This study was performed on 44 critically ill patients admitted to the intensive care unit (ICU). The patients were divided into two groups according to EN. For the intervention group, CNPG started within the first 48 hours of admission to the ICU, and for the control group, they received standard nursing care. RESULTS After the implementation, it showed significant associations between the duration of mechanical ventilator in ICU. The intervention group who received the CNPG had significantly shorter starting time of EN and a reduced duration of mechanical ventilator than those in the control group (p < .001). CONCLUSION A CNPG for EN care reduced the duration of mechanical ventilator. This could possibly improve the delivery of target calories when compared with current standard practice and improve the outcome of critically ill patients.
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Affiliation(s)
- Apinya Koontalay
- College of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok, Thailand.
| | - Amornrat Sangsaikaew
- Boromarajonani College of Nursing NakhonPhanom, Nakhon Phanom University, Nakhon Phanom, Thailand
| | - Arunee Khamrassame
- Intensive Care Unit, Kuchinarai Crown Prince Hospital, Kalasin, Thailand
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