Aim: The purpose of this study was to clarify the thoughts and attitudes of patients with type 1 diabetes during disasters. Methods: We conducted a qualitative descriptive study. The participants were 10 adult patients with type 1 diabetes who were selected through purposeful sampling. None of them had experienced a disaster. Data were collected through semi-structured interviews. Thematic analysis was used to analyze the data.Results: Type 1 diabetes patients described a variety of thoughts and attitudes regarding disaster and preparedness. Based on their experiences, 528 codes were extracted. The codes were categorized based on their patterns and similarities. Then, 11 sub-themes and three main themes were identified. The three main themes were (a) "being unprepared since one could not relate to disasters"; (b) "managing well with insulin and food"; and (c) "hiding the fact that one has diabetes." Conclusions: This study identified three important characteristics of the thoughts and attitudes of patients with type 1 diabetes toward disasters. These provide perspectives for education in pre-disaster preparation and support when disasters occur. Patients with type 1 diabetes are aware of the importance of insulin, food adjustment, and self-management on a daily basis. Therefore, it is necessary to educate them so that they can apply their knowledge in times of disaster. In addition, healthcare providers who provide support in times of disaster need to be aware that there are victims who cannot talk readily about their illness.
This study aimed to verify the construct validity of "Comfort Items in Critical Care" developed to clarify the comfort of critically ill patients. Methods: Data were collected through an online questionnaire between February and March of 2020 and analyzed with a confirmatory factor analysis. Participants were 120 certified nurse specialists in critical care nursing, certified nurses in intensive care, and certified nurses in emergency nursing, from Japan. "Comfort Items in Critical Care" comprises 34 items and is designed to measure 6 categories of comfort: "relief of symptoms", "independence", "calmness", "satisfaction", "stable physiological responses", and "calm behavior and asleep", Participants rated the appropriateness of each item using a 4-point Likert scale. Results: The "Comfort Items in Critical Care" scores ranged from a mean of 3.10 to 3.93. Item-total correlation coefficients ranged from ρ = .300 to .636. The standardized path coefficient for "being able to endure" (β = .15, p = .103) was eliminated because it was not significant. Confirmatory factor analysis supported a two-factor structure "comfort measured by patient subjectivity" and "comfort measured by nurse observation". That model fit met the reference values the path coefficient between the latent variables of .61. Conclusion: This study confirmed the construct validity of comfort in critical care nursing based on nursesʼ perceptions. The emphasis was on "calmness", "satisfaction", and "calm behavior and asleep". Each item in "Comfort Items in Critical Care" is an assessment perspective for providing comfort care to critically ill patients.
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