Post-extubation dysphagia (PED) emerges as a frequent complication following endotracheal intubation within the intensive care unit (ICU). PED has been strongly linked to adverse outcomes, including aspiration, pneumonia, malnutrition, heightened mortality rates, and prolonged hospitalization, resulting in escalated healthcare expenditures. Nevertheless, the reported incidence of PED varies substantially across the existing body of literature. Therefore, the principal objective of this review was to provide a comprehensive estimate of PED incidence in ICU patients undergoing orotracheal intubation. We searched Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science, Technology Journal Database (VIP), and SinoMed databases from inception to August 2023. Two reviewers independently screened studies and extracted data. Subsequently, a random-effects model was employed for meta-statistical analysis utilizing the “meta prop” command within Stata SE version 15.0 to ascertain the incidence of PED. In addition, we performed subgroup analyses and meta-regression to elucidate potential sources of heterogeneity among the included studies. Of 4144 studies, 30 studies were included in this review. The overall pooled incidence of PED was 36% (95% confidence interval [CI] 29–44%). Subgroup analyses unveiled that the pooled incidence of PED, stratified by assessment time (≤ 3 h, 4–6 h, ≤ 24 h, and ≤ 48 h), was as follows: 31.0% (95% CI 8.0–59.0%), 28% (95% CI 22.0–35.0%), 41% (95% CI 33.0–49.0%), and 49.0% (95% CI 34.0–63.0%), respectively. When sample size was 100 < N ≤ 300, the PED incidence was more close to the overall PED incidence. Meta-regression analysis highlighted that sample size, assessment time and mean intubation time constituted the source of heterogeneity among the included studies. The incidence of PED was high among ICU patients who underwent orotracheal intubation. ICU professionals should raise awareness about PED. In the meantime, it is important to develop guidelines or consensus on the most appropriate PED assessment time and assessment tools to accurately assess the incidence of PED.

Purpose: This study systematically reviewed and elucidated the current status and key determinants of enteral nutrition interruption (ENI) in critically ill patients. By shedding light on these factors, we aimed to furnish compelling evidence to mitigate the occurrence of ENI in this critical setting.Methods: We embarked on a comprehensive search across seven prominent databases, PubMed, Embase, Web of Science, Cochrane Library, Scopus, EBSCO, and Ovid Medline, spanning from their inception to 27 May 2024. Two independent researchers meticulously screened and assessed the quality of the literature, extracting data on the current status and influencing factors of ENI. This rigorous approach culminated in a descriptive systematic review and analysis.Results: From an initial pool of 2,984 studies, 28 were deemed suitable for inclusion in this review, comprising 20 cross-sectional and eight cohort studies. Moreover, 16 studies highlighted ENI incidence rates ranging from 4.7% to a staggering 100%, with an overall average of 48.3%. Among 17 studies, a total of 4,890 ENI episodes were reported involving 2,008 critically ill patients, translating to an average of 2–3 episodes per patient. Four studies detailed the cumulative ENI duration in 327 critically ill patients, totaling 11037.2 h, with an individual average of 33.8 h per patient. The analysis revealed four primary factors influencing ENI: procedures, gastrointestinal events, feeding tube problems, and hemodynamic instability. Procedures accounted for 29.8%–85.0% of ENI frequency and 34.6%–81.2% of duration, with averages of 63.4% and 52.1%, respectively. Gastrointestinal events contributed to 9.4%–59.7% of ENI frequency and 11.5%–21.4% of duration, averaging 19.2% and 18.1%. Feeding tube problems ranged from 0.9% to 29.3% in frequency and 1.3%–25.6% in duration, with averages of 9.3% and 11.6%. Hemodynamic instability was responsible for 0.9%–20.0% of ENI frequency and 1.1%–5.1% of duration, averaging 3.9% and 2.6%.Conclusion: The incidence and frequency of ENI in critically ill patients are notably high, with interruptions lasting for extended durations. The primary culprits, procedures, gastrointestinal events, feeding tube problems, and hemodynamic instability, influenced ENI occurrence.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_recordphp?ID=CRD42024554417, identifier CRD42024554417.

This study aims to examine the relationship between dyadic coping (DC), intimate relationship, and quality of life (QOL), and to explore the mediating role of intimate relationship in patients with breast cancer (BC) and their spouses from a dyadic perspective. A cross-sectional design was used in this present study, and 205 dyads of BC patients and their spouses who completed a sociodemographic and clinical questionnaire and self-reported measures assessing their DC, intimate relationship, and QOL were recruited. The actor-partner interdependence mediation model (APIMeM) was adopted for dyadic distinguished data analysis. The paired t-test, Pearson's correlation coefficients, and the structural equation model were employed for data analysis by using SPSS 22.0 and Amos 24.0. The current study revealed that, for BC patients and their spouses, intimate relationship mediates completely the actor effect of DC on QOL. That is to say, DC was positively related to intimate relationship and then improved QOL. It was interesting to find that, for both patients and their spouses, the intimate relationship could exert a partner-actor complete mediation effect between DC and QOL. The DC perceived by both BC patients and their spouses has significant actor effects on QOL by improving the level of an intimate relationship. Furthermore, intimate relationship has significant actor-actor and partner-actor complete mediation effects for both patients and their spouses. Given the vital role of patient-spouse dyads, nursing staff should take patients' spouses into account when conducting related psychosocial interventions aiming to improve the QOL of BC patients and their spouses.

Objective: This study aimed to explore the turnover intention among male nurses and analyze the underlying mechanisms through the lens of the social cognitive theory to provide valuable insights for developing targeted intervention strategies to mitigate the turnover of male nurses. Methods: A cross‐sectional survey was conducted. Questionnaires were distributed to male nurses in Jiangsu Province, China, from September to December 2023, with the assistance of the nursing departments. The first part of the questionnaire collected the sociodemographic information. The second part included three instruments, i.e., the Turnover Intention Scale, the Chinese version of the Decent Work Perception Scale, and the Colleague Solidarity Scale for Nurses. Results: Of the 6630 male nurses who were solicited by email, 4227 provided a valid response, and the response rate was 63.76%. Their turnover intention score was 14.27 ± 4.34. According to path analysis, both head nurse support, colleague support, and decent work perception directly reduced turnover intention ( β = 0.19, 0.47, and −0.65, respectively, p < 0.001). However, head nurse support and colleague support indirectly increased turnover intention via decent work perception ( β = −0.27 and −0.09, respectively, p < 0.001). Conclusion: The male nurses in Jiangsu, China, had a high level of turnover intention, and decent work perception and colleague solidarity were key influencing factors. To effectively reduce the turnover intention of male nurses, nursing managers should focus on fostering career development opportunities and cultivating a supportive organizational environment.

Dysphagia-related safety incidents encompass near-miss events, no-harm occurrences, or harmful incidents associated with oral or enteral feeding methods. This systematic review and meta-analysis aimed to assess the incidence rates of dysphagia-related safety incidents in older adults across various feeding methods. A comprehensive literature search was conducted using PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases to identify studies reporting dysphagia-related safety incidents in older adults. The feeding methods analyzed included oral feeding, nasogastric (NG) tube feeding, and percutaneous endoscopic gastrostomy (PEG) tube feeding. Randomized controlled trials (RCTs), non-randomized studies, and cohort studies were included. The analysis adhered to the PRISMA guidelines, and meta-analytic outcomes were presented with 95% confidence intervals (CIs). A total of 30 studies satisfied the inclusion criteria. The overall incidence rates of safety incidents were 13.8% for oral feeding, 23.9% for NG tube feeding, and 26.5% for PEG tube feeding. Aspiration pneumonia emerged as the most prevalent safety incident across all feeding methods, with incidence rates of 12.0% for oral feeding, 20.6% for NG tube feeding, and 12.4% for PEG tube feeding. Tube feeding methods were associated with diarrhea and wound infection. Additionally, specialized safety incidents were observed for each feeding method: suffocation in oral feeding; gastroesophageal reflux in NG tube feeding; and tube blockage, tube dislodgment, tube leakage, vomiting, nausea, site pain, gastrointestinal hemorrhage, and peritonitis in PEG tube feeding. Dysphagia-related safety incidents in older adults demonstrated considerable variability in type and frequency across different feeding methods. Understanding these differences could provide healthcare professionals with valuable insights for targeted risk prediction and proactive management strategies to mitigate such incidents.

Background: The use of ultrasound (US) makes it convenient to identify dysphagia or swallowing impairment. The aim of the study was to evaluate the validity and reliability of US measurements for swallowing function. Methods: We conducted a systematic review and meta‐analysis. Embase, Medline, Cochrane Library, Web of Science, CINAHL, and Scopus databases were systematically searched from inception to July 22, 2024. Published studies on the validity and reliability of US measurements for assessing dysphagia or swallowing impairment in individuals aged 18 years and older were included. The review followed PRISMA guidelines and was evaluated using the QUADAS‐2 tool for diagnostic studies. Two authors independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. Data synthesis was conducted via random‐effects meta‐analysis using Stata software. Results: This review included 38 articles, assessing the value of using hyoid bone displacement, thyrohyoid approximation, and tongue muscle thickness change on US for identifying dysphagia. The pooled sensitivities were 0.64 (95% CI: 0.50–0.79), 0.89 (95% CI: 0.66–1.11), and 0.60 (95% CI: 0.44–0.76), respectively; with pooled specificities of 0.71 (95% CI: 0.64–0.78), 0.82 (95% CI: 0.76–0.88), and 0.69 (95% CI: 0.62–0.77), respectively. Additionally, the area under the summary receiver operating characteristic curve (SROC) for identifying dysphagia using masseter thickness was 0.74 (95% CI: 0.70–0.78). The correlation coefficient of 0.58 (95% CI: 0.20–0.81) was observed between displacement and swallowing function, whereas the correlation for swallowing muscle cross‐sectional area (CSA) was 0.26 (95% CI: 0.09–0.42). Meta‐analyses revealed intrarater reliability values of 0.88 (95% CI: 0.76–0.94) for displacement, 0.93 (95% CI: 0.87–0.96) for CSA, 0.77 (95% CI: 0.73–0.80) for swallowing muscle thickness, and 0.79 (95% CI: 0.74–0.84) for echo intensity. Interrater reliability values were 0.75 (95% CI: 0.55–0.87) for displacement, 0.89 (95% CI: 0.83–0.94) for CSA, and 0.68 (95% CI: 0.57–0.75) for swallowing muscle thickness. Conclusion: Data from this review suggested that US was a reliable and valid screening tool for assessing dysphagia and swallowing impairment. Future research could aim at proposing standardised and universal US protocols to promote comparability and reliability in clinical practice.