Maintaining the QOL of caregivers is important in their ability to provide the care required to keep family members with cancer in the community. Nurses must provide care to maintain caregivers' QOL.

In China, there is a lack of studies to generate pain intensity scales to the patients with CI and compare the pain scales in various age groups. Therefore, this study would compare the psychometric properties of the evidence-supported pain intensity scales consisting of the Verbal Descriptor Scale (VDS), the Numeric Rating Scale (NRS), the Faces Pain Scale (FPS), the Numeric Box-21 Scale (BS-21), and the Colored Analogue Scale (CAS) in Chinese postoperative adults varying in ages including the elderly with mild CI. This was a descriptive comparative study and 200 surgical patients were recruited purposively from a university-affiliated hospital with 50 for each group: young adults (age 20 -44 years), middle-aged adults (age 45 -59 years), elderly (age ≥ 60 years) without CI, and elderly (age ≥ 60 years) with mild CI.Participants rated the vividly remembered, current, worst, least, and average pain, and indicated scale preference and simplicity. Scale face validity, concurrent validity, convergent validity, and test-retest reliability at a 3-day interval were assessed. Fisher's exact tests were used to investigate whether face validity was related to different age iv groups and the levels of CI. One-way ANOVA and Kruskal-Wallis test were used to test the differences of concurrent validity, convergent validity, and test-retest reliability of each pain scale among the four groups. Regarding face validity, the FPS was ranked best across the subjects as nearly half of the patients selected it as both the most preferred and simplest and it had low errors; the VDS and the NRS were similar and ranked following the FPS; however, the BS-21 and the CAS were ranked last. The concurrent validity, convergent validity, and test-retest reliability of all five pain scales were supported in use with the four groups. The differences in psychometric properties among the four groups were only found in face validity. The findings support the psychometric properties of all five pain scales for pain assessment in Chinese adults including the elderly with mild CI. However, the FPS appears to be the best scale followed by the VDS and the NRS. ACKNOWLEDGEMENTSIt is impossible to finish this work without the continuous help and love from the people around me. I take this opportunity to give thanks to them for their willing to teach, guidance, help, and care during my master degree study.

Background: Pressure injury (PI) remains a critical health issue worldwide. The global incidence of hospital-acquired PI is 8.4%, and among intensive-care unit (ICU) patients, it is even higher, ranging from 6.60% to 36.80%. It is important to investigate ICU nurses' PI prevention knowledge, attitudes, and practices (KAP). Aim: The aim of this study was to describe the level of Chinese ICU nurses' knowledge, attitudes, and self-reported practices of PI prevention. Materials and Methods: From March 31 to April 30, 2019, we recruited a total of 510 ICU nurses into the current study using convenience sampling. The Modified Pressure Ulcer Knowledge Assessment Tool version 2.0, Attitudes toward Pressure Ulcer Prevention instrument, and Questionnaire to evaluate nurses' Adherence to Recommendations for Preventing Pressure Ulcers were used for data collection. We used one-way analysis of variance, Student's t-test, and the Mann-Whitney U-test to assess differences in knowledge, attitudes, and self-reported practices of PI prevention among ICU nurses, whom we categorized by their demographic characteristics. Results: Mean scores of participants' knowledge, attitude, and their self-report practice were 65. 82 ± 9.29, 76.65 ± 8.62, and 83.35 ± 13.55, respectively. Participants with bachelor's degrees or higher, who worked in tertiary hospitals, and who had received training on PI prevention over the last year had higher scored on PI prevention knowledge (all P < 0.05). Participants who had received training on PI prevention over the last year scored higher on attitude than those who had not received such training over the last year (P = 0.001). Conclusion: ICU nurses surveyed in this study did not demonstrate an acceptable level of knowledge about PI prevention, while their attitudes and self-reported practices were acceptable. Continuing education or in-service training should be provided to enhance ICU nurses' knowledge of PI prevention.

Most patients experience decreased physical, psychosocial, and spiritual comfort while receiving mechanical ventilation. Regarding the Muslim patients, diminished comfort might be associated with alterations in performing daily rituals, such as saying prayers (salat) and reciting the Holy Qur’an. This pilot study aimed to determine the effects of comfort care integrated with the Holy Qur’an recitation on comfort in Muslim patients being mechanically ventilated.Methods: This quasi-experimental study was performed on a group of participants using pretest-posttest design. The samples consisted of ten Muslim patients under mechanical ventilation who met the inclusion criteria. Each participant was provided with the comfort care integrated with the Holy Qur’an recitation for three days. A modified version of Shortened General Comfort Questionnaire was utilized to evaluate comfort of the participants. The data were analyzed by SPSS using paired t-test. Results: Mean score of total comfort increased significantly after receiving the comfort care integrated with recitation of the Holy Qur’an (t=11.42, p=0). In addition, mean score of each context of comfort (i.e. physical, psychospiritual, environmental, and sociocultural comforts) also augmented significantly post-intervention.Conclusion: This pilot study showed that the comfort care integrated with the Holy Qur’an recitation can be an effective way of enhancing comfort of Muslim patients under mechanical ventilation.

Introduction Community integration is an essential component for rehabilitation among traumatic brain injury (TBI) survivors, which yields positive outcomes in terms of social activities, community participation, and productive work. A factor that usually facilitates community integration among TBI survivors is social support, whereas physical environment and fatigue are most often found as barriers. Objectives This study aimed to (1) describe the level of community integration, fatigue, physical environment, and social support of persons after TBI, and (2) examine the relationship between community integration and these three factors. Methods This is a descriptive correlational study. One hundred and twenty TBI survivors living in the communities of Province Number Three, Nepal were enrolled using the stratified sampling technique. The data were collected using the Community Integration Questionnaire, Modified Fatigue Impact Scale, Craig Hospital Inventory of Environmental Factors, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics and Pearson’s correlation were used to analyze the data. Results Community integration, fatigue, and physical environment showed a moderate level, while social support revealed a high level. Fatigue was significantly correlated with overall community integration, whereas physical environment was found to correlate with two subscales of community integration, home integration and productive activities. Conclusion To enhance the level of community integration among TBI survivors, health care providers, in particular rehabilitation nurses and community nurses, should plan and implement strategies such as follow-up appointments or continued rehabilitation at home.

Background: The incidence of trauma has been high and has gained attention worldwide. The energy involved in trauma results in specific tissue damage. Such tissue damage generally leads to pain. The high pain intensity possibly is consequence of trauma due to transfer energy to the body from external force and absorbed in wide area. This pain affected patients’ physical and psychological function, in which well known as pain interference.Objective: The aim of this review is to describe the pain intensity and pain interference among trauma patients.Method: A systematic search of electronic databases (CINHAL, ProQuest, Science Direct, and Google scholar) was conducted for quantitative and qualitative studies measuring pain intensity and pain interference. The search limited to hospitalized trauma patients in adult age.Results: The search revealed 678 studies. A total of 10 descriptive studies examined pain intensity and pain interference and met inclusion criteria. The pain intensity and pain interference was assessed using Brief Pain Inventory (BPI). Pain intensity of hospitalized trauma patients were moderate to severe. These including 6 studies in orthopedic trauma, one study in musculoskeletal, two in studies in combinational between orthopedic and musculoskeletal, and two studies in burn injury. Moreover, the patients also reported pain was relentless & unbearable. In accordance, data showed that pain interference was moderate to severe from six studies. These studies result in vary of functional interference. However, those studies examined pain interference on sleep, enjoyment of life, mood, relationship with other, walking, general activity, and walking.Conclusion: The evidence from 10 studies included in this review indicates that hospitalized trauma patients perceived moderate to severe pain intensity and pain interference. Further research is needed to better evaluate the pain of hospitalized trauma patients.

Background & Aim: Most mechanically ventilated patients reported decreasing comfort during their treatments, especially in Muslim patients. Nursing comfort care needs to be addressed by integrating daily Islamic rituals to fulfill the spiritual need and promote holistic comfort of Muslim patients with mechanical ventilation. This study aimed to investigate the effect of nursing comfort care integrating with the daily Islamic rituals on comfort among mechanically ventilated Muslim patients. Methods & Materials: A pretest-postest with control group design was used. Fifty-six participants recruited from intensive care units of three public hospitals in Indonesia were randomly assigned into either the intervention group (n=28) or control group (n=28) by matching technique based on gender, age, and duration using a ventilator. Those in the intervention group received nursing comfort care developed based on Kolcaba’s Theory of Comfort integrating with the daily Islamic rituals, while those in the control group received usual care. Comfort was measured on the first day before receiving the intervention and on the second day after the intervention was completed by using Comfort Questionnaire for Mechanically Ventilated Patients (CQMVP). Results:  Data analysis using an independent t-test found no significant difference between the intervention and control groups at baseline (t = .134, p .894). The mean of comfort score of patients in the intervention group after receiving the intervention was significantly higher than those in the control group (t=6.70, p< .05).  Conclusion:  Nursing comfort care integrated with daily Islamic rituals increased comfort in Muslim patients while receiving mechanical ventilation. Thus, this nursing comfort care program can be recommended to use in practice.

Background: Comfort in patients receiving mechanical ventilation can be disturbed for many reasons. This condition may lead to negative impacts due to unmet comfort needs in patients with mechanical ventilation. Kolcaba's comfort theory described that patients' comfort may be enhanced, if the needs of comfort can be met in four contexts of comfort, including physical, psychospiritual, environmental, and sociocultural comfort. Therefore, there is a need to identify causative factors that may disturb comfort during mechanical ventilation and intervention to promote comfort while receiving mechanical ventilation. Objective: This study aimed at reviewing the literature concerning comfort in patients receiving mechanical ventilation. Methods: A literature review was conducted by analyzing 42 scholarly papers from year 2002 to 2016. The data were searched through Scopus, ProQuest, Elsevier/Science Direct, CINAHL, and PubMed based on PICO questions with keywords; 'comfort', 'discomfort', 'comfort need' 'patient', 'mechanical ventilation', and 'ventilator'. Relevant articles were appraised following the recommendation of the Joanna briggs institute for evidence-based nursing. Results: Overall, 116 articles were retrieved and 42 articles met the inclusion criteria. The results presented comfort needs of mechanically ventilated patients in physical, psychospiritual, environmental, and sociocultural contexts, and interventions to promote comfort during mechanical ventilation were divided to the following three categories, pharmacological interventions, nursing care interventions, and complementary and alternative interventions. Conclusion and Recommendation:The knowledge from this literature review can be useful for nurses and other healthcare providers to develop quality comfort care for patients dependent on mechanical ventilation.