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Background The symptom network can provide a visual insight into the symptom mechanisms. However, few study authors have explored the multidimensional symptom network of patients with atrial fibrillation (AF). Objectives We aimed to identify the core symptom and symptom clusters of patients with AF by generating a symptom network. Furthermore, we wanted to identify multiple characteristics related to symptom clusters. Methods This is a cross-sectional study. A total of 384 patients with AF at Tianjin Medical University General Hospital were enrolled. The University of Toronto Atrial Fibrillation Severity Scale was used to assess AF symptoms. Network analysis was used to explore the core symptom and symptom cluster. Results Shortness of breath at rest (r s = 1.189, r c = 0.024), exercise intolerance (r s = 1.116), shortness of breath during physical activity (r s = 1.055, r c = 0.022), and fatigue at rest (r c = 0.020) have the top centrality for strength and closeness. The top 3 symptoms of bridge strength were shortness of breath at rest (r s = 0.264), dizziness (r s = 0.208), and palpitations (r s = 0.207). Atrial fibrillation symptoms could be clustered into the breathless cluster and the cardiac cluster. We have identified multiple factors such as mental health status, left ventricular ejection fraction, heart failure, sex, B-type natriuretic peptide, and chronic obstructive pulmonary disease as significant contributors within the breathless cluster, whereas sex, mental health status, and history of radiofrequency ablation were strongly associated with the cardiac cluster, holding promise in elucidating the underlying mechanisms of these symptoms. Conclusion Special attention should be given to shortness of breath at rest as its core and bridging role in patients' symptoms. Furthermore, both the breathless and cardiac clusters are common among patients. Network analysis reveals direct connections between symptoms, symptom clusters, and their influencing factors, providing a foundation for clinicians to effectively manage patients' symptoms.
Background The symptom network can provide a visual insight into the symptom mechanisms. However, few study authors have explored the multidimensional symptom network of patients with atrial fibrillation (AF). Objectives We aimed to identify the core symptom and symptom clusters of patients with AF by generating a symptom network. Furthermore, we wanted to identify multiple characteristics related to symptom clusters. Methods This is a cross-sectional study. A total of 384 patients with AF at Tianjin Medical University General Hospital were enrolled. The University of Toronto Atrial Fibrillation Severity Scale was used to assess AF symptoms. Network analysis was used to explore the core symptom and symptom cluster. Results Shortness of breath at rest (r s = 1.189, r c = 0.024), exercise intolerance (r s = 1.116), shortness of breath during physical activity (r s = 1.055, r c = 0.022), and fatigue at rest (r c = 0.020) have the top centrality for strength and closeness. The top 3 symptoms of bridge strength were shortness of breath at rest (r s = 0.264), dizziness (r s = 0.208), and palpitations (r s = 0.207). Atrial fibrillation symptoms could be clustered into the breathless cluster and the cardiac cluster. We have identified multiple factors such as mental health status, left ventricular ejection fraction, heart failure, sex, B-type natriuretic peptide, and chronic obstructive pulmonary disease as significant contributors within the breathless cluster, whereas sex, mental health status, and history of radiofrequency ablation were strongly associated with the cardiac cluster, holding promise in elucidating the underlying mechanisms of these symptoms. Conclusion Special attention should be given to shortness of breath at rest as its core and bridging role in patients' symptoms. Furthermore, both the breathless and cardiac clusters are common among patients. Network analysis reveals direct connections between symptoms, symptom clusters, and their influencing factors, providing a foundation for clinicians to effectively manage patients' symptoms.
This study aimed to explore the experiences of barriers and facilitators to the implementation of narrative nursing by junior nurses. Participants were recruited using purposive sampling. Semi-structured interviews were conducted from October 2023 to February 2024. Data were thematically analyzed using the Colaizzi seven-step method. Five barriers and 3 facilitators to the implementation of narrative nursing by junior nurses emerged in the study. Relevant barriers include lack of practical skills related to narrative nursing, neglect of the concept of humanistic care, negative events, high workload for junior nurses, restricted implementation environment. The facilitators contain patients’ and family members’ trust, training related to knowledge and skills, as well as harmonious and cooperative working atmosphere. There is still room for improvement in the implementation of narrative nursing for junior nurses, and the systematic training of narrative nursing knowledge and skills should be enhanced; the medical humanistic environment should be optimized; and the psychological resilience of junior nurses should be improved, so as to encourage them to actively implement narrative nursing at the early stage of their careers, and to deepen the high-quality development of nursing humanism.
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