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.

Aim: To explore the cognitive representations and emotional responses to living with chronic heart failure of people receiving limited community disease management.Background: Individuals living with heart failure face self‐care and emotional challenges due to the overwhelming nature of adapting to lifestyle changes, particularly in subtropical areas.Design: Qualitative descriptive. We applied Leventhal's Common Sense Model of Self‐Regulation as the framework for interviews and analyses.Methods: Twenty patients with chronic heart failure were interviewed during a hospital admission for exacerbation of their condition in a tertiary hospital in Thailand.Results: Analysis of the components of Leventhal's model of cognitive representations of illness revealed two themes relating to Illness Identity: (1) lack of knowledge of the diagnosis and how to recognise symptoms of the disease, and (2) recognition of symptoms of an exacerbation of CHF was based on past experience rather than education. These resulted in delays responding to cardiac instability and confusion about the intent of treatment. Participants recognised the chronicity of their disease but experienced it as an unrelenting cycle of relative stability and hospitalisations. Perceived Controllability was low. Two themes were: (1) Low perceived trust in the efficacy of medical treatment and lifestyle changes, and (2) Low perceived trust in their ability to comply with recommended lifestyle changes. The Consequences were significant emotional distress and high burden of disease. The two themes of emotional responses were (1) Frustration and hopelessness with the uncertainty and unpredictability of the disease, and (2) Sense of loss of independence, functional capacity and participation in life's activities.Conclusion: Chronically ill patients need support to understand their illness and make better treatment and lifestyle decisions. Improving patients' self‐efficacy to manage treatment and symptom fluctuations has the potential to improve their mental well‐being and minimise the impact of their condition on suffering and participation in employment and community.Implications for the Profession and/or Patient Care: Leventhal's Common Sense Model of Self‐Regulation can be used to examine cognitive and emotional elements of illness perceptions, which link to individuals' ability to make informed decisions about disease management and influence health behaviours. Understanding illness perceptions underpins strategies for enhancing and sustaining self‐management behaviours.Impact: The study findings accentuate the need to establish long‐term condition support programs in low‐middle income countries where the burden of heart failure is increasing exponentially.Reporting Method: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used to explicitly and comprehensively report our qualitative research.Patient or Public Contribution: Patients contributed to the conduct of the study by participating in the data collection via face‐to‐face interviews.

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. 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. 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). 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.

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.

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.

Nurse-led interventions are tailored to the specific needs of heart failure (HF) patients, facilitating the transfer of knowledge in ways that are more feasible and applicable within the context of diverse healthcare settings. These programs emphasize comprehensive discharge planning, patient education on self-care practices, medication management, and early symptom recognition. The meta-analysis included 11 randomized controlled trials, selected from databases including MEDLINE, EBSCO, CINAHL, and the Cochrane Library. Quality assessment of the included studies was conducted independently by two reviewers. The overall pooled effect showed a relative risk (RR) of 0.69 (95% confidence interval [CI]: 0.54–0.89) for all-cause readmission and a RR of 0.80 (95% CI: 0.71–0.91) for combined outcomes of all-cause readmission and mortality in the nurse-led group compared to the control group. These results indicate that nurse-led transitional care interventions contribute substantially to reducing both readmission rates and mortality among HF patients. The review also explored the applicability of these interventions in low-resource settings, emphasizing their potential to be adapted and implemented effectively in lower-middle-income countries. This review highlights the pivotal role of nurse-led transitional care programs in addressing these challenges by providing close support to patients and their families. Leveraging existing resources and fostering interdisciplinary collaboration are essential in optimizing healthcare delivery in low-resource settings.