alturath Nursing Journal

Background: Systemic inflammation contributes to morbidity in mechanically ventilated ICU patients, yet the immunomodulatory effects of routine nursing interventions such as repositioning remain poorly understood.

Objective: To evaluate systematic 2-hourly repositioning effects on serum IL-6 and TNF-α in non-septic mechanically ventilated patients.

Methods: Parallel-group RCT (n=60) following CONSORT guidelines. Experimental group received systematic repositioning every 2 hours; control received routine care (mean 4.6-hourly). IL-6 and TNF-α measured via blinded ELISA at days 1, 3, and 7. Linear mixed-effects models with Bonferroni correction (α=0.025).

Results: IL-6 decreased 31% in experimental group versus 11% in control; Cohen's d=1.19 (95% CI: 0.64-1.74). TNF-α: d=0.82 (95% CI: 0.29-1.35). Respiratory failure patients showed larger effects (d=1.42) than post-operative patients (d=0.78).

Conclusion: Systematic repositioning significantly reduces pro-inflammatory cytokines in non-septic patients. Findings require validation in larger, multicenter trials including septic populations and powered for clinical endpoints.

Background: Effective diabetes education is essential for glycemic control, yet 40-50% of patients fail to achieve targets despite standard education. Objective: To compare teach-back method versus standard education on glycemic control and self-management in adults with type 2 diabetes. Methods: Pragmatic RCT (n = 80) at outpatient diabetes clinics. Teach-back group (n = 40) received four 60-minute sessions with comprehension verification; control (n = 40) received identical content via standard approach. Primary: HbA1c at 6 months. Analysis: Linear mixed-effects models, ITT. Results: Teach-back achieved clinically significant HbA1c reduction (8.82%→7.42% vs 8.88%→8.28%; difference: -0.80%; 95% CI: -1.18 to -0.42; p < .001; d = 0.94). The 0.80% improvement exceeds the 0.50% clinically meaningful threshold and approximates the magnitude achieved with adding a second-line oral hypoglycemic agent. DSMQ improved more in teach-back (d = 0.87). Lower education patients showed larger effects (d = 1.24 vs d = 0.64; interaction p = .031). Conclusion: Teach-back significantly improves glycemic control and self-management. Findings support integration into routine diabetes nursing practice

Background: Postpartum depression (PPD) affects 10–20% of mothers with significant consequences for maternal-infant dyads. HPA axis dysregulation represents a key neurobiological mechanism. Non-pharmacological interventions are often preferred by breastfeeding mothers. Objective: To evaluate a nurse-led mind-body intervention on biobehavioral outcomes (depressive symptoms and cortisol) among primiparous mothers with elevated PPD risk. Methods: Single-center parallel-group RCT with 1:1 allocation and assessor-blinded evaluation. Ninety primiparous mothers (aged 18–40) with EPDS 10–19 at 2 weeks postpartum. Mind-body group (n=45): Eight 90-minute weekly sessions combining mindfulness, slow breathing (6/min), yoga, and loving-kindness. Control (n=45): Standard postpartum care. Results: 84 participants (93.3%) completed follow-up. EPDS: 14.2→7.4 (mind-body) vs 14.5→11.8 (control); between-group difference −4.1 points (95% CI: −5.8 to −2.4; d=1.12; p<.001). Cortisol: 18.5→12.4 vs 18.2→16.5 nmol/L (d=0.89; p<.001). Cortisol mediated 28.4% of EPDS improvement (partial mediation). Remission: 82.2% vs 37.8% (NNT=2.3). Depression history was associated with larger effects (d=1.45; interaction p=.024). Conclusions: Nurse-led mind-body intervention produced clinically significant biobehavioral effects, with EPDS reductions within ranges reported for pharmacotherapy, supporting consideration as a first-line intervention option for at-risk postpartum mothers.

Background: Postpartum depression affects 10-20% of new mothers. Non-pharmacological interventions are preferred by breastfeeding mothers, yet evidence for mindfulness-based approaches remains limited. Objective: To evaluate nurse-delivered Mindfulness-Based Stress Reduction on depressive symptoms and stress biomarkers among primiparous mothers with elevated PPD risk. Methods: Single-center parallel RCT (n = 90). Mindfulness-Based Stress Reduction group (n = 45): eight 90-minute weekly sessions; Control (n = 45): standard postpartum care. Primary: EPDS at 12 weeks. Secondary: salivary cortisol, GAD-7, SF-12. Analysis: LMM, ITT. Results: Mindfulness-Based Stress Reduction achieved clinically significant EPDS reduction (14.2→7.4 vs 14.5→11.8; difference: -4.1; 95% CI: -5.8 to -2.4; p < .001; d = 1.12). The 4.1-point improvement approximates the clinical efficacy of first-line antidepressants, supporting MBSR as a viable alternative for breastfeeding mothers. Cortisol decreased more in MBSR (d = 0.89). Depression history mothers showed larger effects (d = 1.45; interaction p = .024). Remission rate: 82.2% vs 37.8% (NNT = 2.3). Conclusion: Nurse-delivered MBSR significantly reduces PPD symptoms and stress biomarkers. Findings support MBSR as a first-line non-pharmacological intervention.

Background: Effective nurse-patient communication is fundamental to quality healthcare delivery. Despite its recognized importance, variations in communication practices continue to affect patient outcomes across healthcare settings. Objective: This study aimed to examine the relationship between nurse-patient communication quality and patient outcomes, including patient satisfaction, medication adherence, length of hospital stay, and readmission rates in acute care settings. Methods: A cross-sectional descriptive study was conducted with 450 patients and 120 registered nurses across three acute care hospitals. Data were collected using validated instruments including the Communication Assessment Tool (CAT), Patient Satisfaction Questionnaire (PSQ-18), and hospital administrative records. Results: Significant positive correlations were found between communication quality scores and patient satisfaction (r = 0.72, p < 0.001). Units with higher communication ratings demonstrated 23% shorter average length of stay and 31% lower 30-day readmission rates. Patient-reported understanding of discharge instructions was significantly higher when nurses employed teach-back methods (M = 4.6 vs. M = 3.2, p < 0.001). Conclusion: Quality nurse-patient communication significantly impacts multiple patient outcome measures. Implementing structured communication training and standardized protocols can enhance patient safety and satisfaction while reducing healthcare costs.