Spirgienė, Lina

Įvadas LSMU Kauno klinikų Neonatologijos klinikos Naujagimių intensyviosios terapijos skyriuje (NITS) naujagimiai yra ne tik gydomi, bet ir nuosekliai auga bei vystosi, todėl hospitalizacijos trukmė dažnai yra ilgesnė – ji gali trukti vieną ar net kelis mėnesius. Klinika dirba pagal Skandinavų puoselėjamą – į šeimą orientuotos naujagimio priežiūros modelį. Palata turi suteikti tėvams svetingumo jausmą, o aplinka neturėtų atrodyti kaip ligoninė (Oude Maatman et al., 2020). Ankstyvasis tėvų ir naujagimio artumas yra labai svarbus, ypač neišnešiotų naujagimių. Tyrimai patvirtina į šeimą orientuotos priežiūros naudą Naujagimių intensyviosios terapijos skyriuje (Lee, 2024). Todėl naujagimiui augant ir gerėjant jo būklei, Naujagimių intensyviosios terapijos skyriuje tėvai vis labiau įtraukiami į naujagimio slaugą. Jiems patikimos sudėtingesnės slaugos procedūros ir didesnė atsakomybė už vaiko priežiūrą. Darbo tikslas Atskleisti mamų patirtis, įsitraukus į naujagimio medicinines procedūras Naujagimių intensyviosios terapijos skyriuje. Metodika Tyrimas atliktas Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų Naujagimių intensyviosios terapijos skyriuje. Tyrimas vyko 2025 m. gegužės-spalio mėn. Atliktas kokybinis tyrimas, pusiau struktūruotas interviu, dalyvavo 8 mamos. Tyrimui atlikti buvo gauti LSMU Bioetikos centro pritarimas (Nr. 2023-BEC2-0521, 2025-04-04) Rezultatai Analizuojant interviu, išsiskyrė 3 temos. Dalyvavimas slaugos procese. Išryškėjo mamų įsitraukimas į įvairias sergančio naujagimio slaugos ir medicinines procedūras. Mamos pasakojo apie savo dalyvavimą ruošiant vaistus, juos maišant su motinos pienu ir suleidžiant per maitinimo zondą: „<...su slaugytojos priežiūra galėjau atlikti ir pati”(Mama 1). Mamų patirtys atskleidė jų palaipsnį įsitraukimą į kvėpuojamosios terapijos priežiūrą: „<.. teko prisidėt kad pakeist kaukytę, ūsiukus ...>“(Mama 3), “ <...moku kaniules užsidėti, kaukę moku užsidėt...“ (Mama 5). Kita svarbi patirtis – dalyvavimas diagnostinių tyrimų metu. Mamos dažnai būdavo šalia, pačios procedūrų neatlikdavo, bet stengdavosi raminti, paguosti ir palaikyti savo naujagimį. Naujagimio būklės stebėjimas ir reagavimas. Viena dažniausių mamų atliekamų veiklų buvo SaO2 daviklio keitimas ir priežiūra. Mamos teigė, kad ši procedūra nebuvo sudėtinga išmokti ir atlikti. Tyrimo dalyvės teigė, kad laipsniškas įtraukimo procesas suteikė žinių ir pasitikėjimo vertinant savo naujagimio būklę. Išmoko pačios suprasti, įvertinti ir reaguoti į urgentines situacijas tokias kaip bradikardija, desaturacija ar apnėja: “<…> pakrenta viskas pavyzdžiui, kad reikėtų nugarytę glostyti, pėdutes, kad atsistatytų viskas, kad prisimintų, kaip reik kvėpuot”(Mama 3). Viena dažniausiai minimų strategijų – taktilinis kontaktas, apimantis švelnų prisilietimą, rankos uždėjimą ant galvytės ar kūno, apglėbimą bei laikymą už rankyčių ar kojyčių: “ <…>man sakydavo, kad ranką ant galvytės reikia padėti, mamą jaučia… ramesnis…”(Mama 2). Mamų mokymosi procesas. Pradiniu laikotarpiu dominuoja stiprios neigiamos emocijos – nerimas, baimė, vidinis diskomfortas bei gailestis vaikelio atžvilgiu. Tačiau laikui bėgant šie išgyvenimai virsta į didesnį emocinį stabilumą, susitaikymą ir aktyvesnį įsitraukimą į slaugos procesą. “Aš labai bijojau iš pat pradžių“(Mama 7). Tyrimo dalyvės pabrėžė, kad sveikatos priežiūros personalas informaciją perteikia suprantamai, struktūruotai ir prieinamai, o tai stiprina pasitikėjimą bei mažina nežinomybės keliamą nerimą. “Aš viską nuosekliai žinojau, labai labai aiškiai merginos viską papasakodavo…” (Mama 6). Mamų savarankiškumas naujagimio priežiūros procese Naujagimių intensyviosios terapijos skyriuje didėja palaipsniui ir yra glaudžiai susijęs su jų įgyjama patirtimi, pasitikėjimu savimi bei aktyviu įsitraukimu į kasdienę slaugą. Išvados Mamų patirtys atskleidė, jog praktinis mokymasis Naujagimių intensyviosios terapijos skyriuje vyko stebint ir palaipsniui įsitraukiant į medicinines procedūras. Ilgainiui mamos tapo gana autonomiškos ir galėjo atlikti kasdienines ir medicinines naujagimio priežiūros veiklas. Tėvams suteikiamos reikalingos žinios bei praktiniai įgūdžiai, leidžiantys saugiai ir užtikrintai dalyvauti naujagimio slaugos procese. Tokiu būdu stiprinamas jų pasitikėjimas gebėjimais, skatinamas aktyvus dalyvavimas ir ruošiama savarankiškai vaiko priežiūrai po išrašymo iš gydymo įstaigos.

Technological advancements have profoundly reshaped healthcare systems, transforming workflows, communication, and education. This paper explores the integration of digital health innovations, including electronic health records (EHRs), artificial intelligence (AI), and virtual reality (VR), within Lithuanian healthcare institutions, educational settings and research initiatives. It emphasizes the pivotal role of health care professionals and nursing informatics in adapting to digital transformation, while also addressing key challenges such as digital competence, system usability, and implementation costs.

At Lithuania’s largest hospital, Kaunas Clinics, digital systems such as Hospital Information Systems (HIS, AREST), and automated monitoring tools are enhancing care coordination and clinical decision-making. A case study from Kėdainiai District Hospital highlights disparities in digital competence between nurses and nursing assistants, underscoring the need for systematic and personalized training programs.

In healthcare education, the Lithuanian University of Health Sciences (LSMU) incorporates simulation technologies, VR, and AI to strengthen students’ clinical reasoning and technical skills in safe, immersive environments. The paper also presents a collaborative initiative with Kaunas University of Technology (KTU) to develop an AI-and XR (extended reality)-based educational model focused on critical clinical scenarios, such as the management of anaphylactic shock. Despite technical and linguistic barriers, innovations like GPU-accelerated speech recognition and AI-driven virtual patients offer promising solutions to enhance health care students’ critical thinking and decision-making in acute care settings.

The authors conclude that the integration of advanced digital technologies and interdisciplinary innovations in both healthcare practice and education not only improves clinical workflows and patient outcomes but also transforms medical training. This ensures future professionals are equipped with the skills and tools essential for delivering high-quality care in modern clinical environments. The paper further highlights the importance of interdisciplinary collaboration in research as a driving force shaping the future of digital health.

Introduction The integration of nursing students' theoretical knowledge into simulation training is an important teaching method (1). Simulation training provides students with a realistic, risk-free environment in which they can apply the skills they have learned in the classroom to clinical scenarios, improving their decision-making and clinical assessment skills (2). Simulation improves technical skills, but also strengthens students' self-confidence and communication skills, preparing them for the challenges of real-world patient care (3). Aim To describe the experiences of nursing students of integrating theoretical knowledge into simulation-based training. Methods A qualitative study was conducted using semi-structured interviews. The data was analyzed using thematic analysis. 11 first-year nursing students who are learning nursing skills through simulation-based training participated in the study. The study was conducted in February – March 2025 at the LSMU Faculty of Nursing. Approval to conduct the study was obtained from the LSMU Bioethics Center 2025-BEC2-0221. Results Simulation-based training helps students apply theoretical concepts like patient assessment, nursing interventions, and decision-making in a controlled, risk-free environment. Analyzing the experiences of nursing students, the following themes were identified: "we would not learn by studying theory," self-confidence, and an adapted environment. The following subthemes were identified: "theory is formal," practical mastery, high value, repetition helps with confidence, feeling more courageous, better mastery, real ward environment, mannequins adapted for manipulation. Simulation training is important and useful for nursing students ,, simulations have contributed greatly to better teaching." (student 03). In the students' opinion, "we would not learn by studying theory alone." Simulations make it easier for students to acquire theoretical knowledge. Repeating simulations is very important in the learning process. "By doing it several times, you learn much faster and better" (student 09). This helps them feel more confident and assured. These experiences are reinforced by the adapted learning environment and mannequins. "I like it best when you come into the classroom and it looks like a real ward." (student 11). Simulation encourages active participation and critical thinking, making theoretical knowledge more meaningful and easier to retain. Conclusions Nursing students positively evaluated the simulation-based training. The mannequins, realistic ward environment, repetition of nursing procedures allowed better integration of theoretical knowledge into practical skills. Nursing students gained more self-confidence after the simulation-based training.

Introduction Students' satisfaction and self-confidence while learning in simulation methods provides opportunity to acquire skills and helps to achieve better learning outcomes such as satisfaction, critical thinking and self-confidence [1]. Students with better results are commonly more selfconfident [2], more involved in tasks, enjoy the learning process, and are determined to reach their goals [3]. Aim To examine nursing students' opinions about students' satisfaction and self-confidence who learned nursing clinical skills through simulation-based methods. Methods The study involved 72 first year LSMU nursing students, who learned nursing clinical skills through simulation-based method. The study was conducted between March and April 2025. Inclusion criteria; first year LSMU nursing students, no exclusion criteria were applied. The study used a standardized scale ,,Student Satisfaction and Self-Confidence in learning scale“ [4]. Students rated each statement on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree). Permission to conduct the study was received from LSMU Bioethics center (Nr 2025- BEC2-0066). Numerical characteristics as mean, standard deviation values, Spearman correlation coefficient were used to describe sample data. Results Students evaluated as best statement that teaching methods used in this simulation were helpful and effective (mean= 4,26, SD= 7,12), the teaching materials used in this simulation were motivating and helped to learn (mean= 4,12, SD= 0,715), students mastered the content of the simulation activity, that was presented by lecturers (mean= 4,00, SD= 0,628), students were confident that they were developing the skills and obtaining the required knowledge from this simulation to perform necessary tasks in clinical setting (mean= 4,33, SD= 0,581). A negative, very weak, and statistically not significant correlation was found between satisfaction and mental effort invested (r=-0.033, p=0.783, n=72). Weak correlations were found between satisfaction and task interest and difficulty (accordingly, r=0.221, p=0.062, and r=0.025, p=0.837). A negative, very weak, and statistically insignificant correlation was found between self-confidence and mental effort invested (r=-0.011, p=0.927, n=72). Positive, weak, and statistically not significant correlations were found between self-confidence and task interest and difficulty (accordingly, r=0.191, p=0.108, and r=0.059, p=0.625. No statistically significant differences were found in this study. Conclusions The simulation method was evaluated by nursing students as useful and effective, which helps to perform nursing skills in clinical practice. Students' satisfaction and self-confidence while learning in simulation-based method was not significantly associated with effort, task interest and difficulty.

Introduction Patients’ expectations are a key factor shaping their perception of nursing care quality (1). They influence satisfaction, trust, and overall experience, and arise from previous encounters, personal beliefs, and sociocultural context (2). Clear communication, emotional support, and professional competence are central elements patients evaluate. Organizational factors such as workload, responsiveness, and ward environment also determine whether expectations are met (3,4). Aim To assess the relationships between hospitalized patients’ expectations of nursing care and selected hospitalization characteristics (number of hospitalizations, type of ward accommodation) as well as patients’ subjectively assessed health. Methods A cross-sectional study was conducted from April to September 2025 with 160 patients hospitalized in the Urology Department of the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics. Patients’ expectations of nursing care were assessed using the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), Laschinger HKS et al, 2005, (22 items, 7 subscales), permission is freely available. It was adapted to evaluate patients’ expectations. Subjectively assessed health and hospitalization characteristics were collected using additional questions. Internal consistency was high (Cronbach’s α = 0.929). Mann– Whitney U and Kruskal–Wallis H tests were applied (p < 0.05). Ethical approval of LSMU Bioethics Center (BEC2-0532) was obtained to conduct the study. Results Patients in a single-bed ward expected better information provision (mean 4.25±0.56). Patients sharing a ward had the highest expectations for comfort and privacy (4.09±0.63); however, no statistically significant differences were found. Patients hospitalized for the first time had higher expectations for overall nursing care than those hospitalized more times (4.16±0.56 vs. 3.78±0.57). Patients hospitalized ≥3 times had the lowest expectations for preparation of discharge (3.85±0.85), comfort, and privacy (3.78±0.81). Worse subjective health assessment was associated with higher expectations for information (4.28±0.66), family involvement (4.40±0.99), respect and care (4.36±0.56), and preparation of discharge (4.35±0.85). Excellent subjective health was associated with higher expectations for overall nursing care (4.26±0.42, 4.08±0.57, 3.87±0.61). Conclusions Patients’ expectations of nursing care were strongly associated with hospitalization characteristics and subjective health. Higher expectations were observed among first-time hospitalized patients and those reporting poorer subjective health, particularly in relation to information provision, respect and care, and discharge preparation. These findings highlight the importance of   recognizing patients’ expectations when planning and delivering nursing care in hospital settings.

Introduction Introduction. Anaesthesia nurses play a crucial role in the operating room, yet their contributions often remain insufficiently acknowledged (1). Interpersonal familiarity, psychological safety, and open communication are essential for effective teamwork and improved patient outcomes (2,3). Stress in the operating room negatively affects teamwork climate, and anaesthesia professionals are vulnerable to emotional strain and burnout (4,5). Aim The aim of this study was to explore the experiences of anaesthesia and intensive care nurses collaborating with operating room team members. Methods Methods. A qualitative study was conducted between May and December 2025 and included 14 anaesthesia and intensive care nurses. Data were collected through semi-structured individual interviews. All interviews were audio-recorded with participants’ informed consent and transcribed by the researcher. Data were analysed using reflexive thematic analysis. Ethical approval was obtained from the LSMU Bioethics Centre (No. 2025-BEC2-0672). Results Results. Four subthemes emerged from the data analysis. Hierarchy. Professional hierarchy was experienced as contributing to nurses’ invisibility in the workflow, and their work often remained unrecognized “…anaesthesiologists are often forgotten; everyone thanks each other, but a great deal depends on our team…” (N6). Motivation. Motivation was influenced by leadership communication and emotional support. Calm communication fostered a safer atmosphere “…the best motivation is a calm, non-commanding, non-raised tone” (N4). Mutual support and respect also enhanced motivation “…a positive attitude and a thank you, a kind word—that is what motivates the most” (N5). Feedback. A lack of systematic feedback was a common experience “…there are no team meetings where we discuss what we do or what mistakes occur” (N1). Feedback mainly focused on errors “…doctors mostly talk about mistakes; they rarely speak about good work” (N2). Emotional climate. The leader’s emotional state was experienced as shaping the emotional climate of the team “if the doctor runs in and starts panicking, that negative aura spreads around the OR” (N3). Calm behaviour supported smoother workflow, while personal characteristics sometimes increased stress “…some give clear instructions on what to do next, while others create additional stress…” (N6). Conclusions Conclusions. Anaesthesia and intensive care nurses experienced collaboration in the operating room as shaped by a strong professional hierarchy, which often left them feeling like unequal team members. They described greater motivation and emotional safety when leadership communication was calm, respectful, and acknowledged their work. Nurses also reported a lack of systematic feedback. In addition, they experienced leaders’ emotional regulation as central to shaping the emotional climate of the operating room.

Introduction The Neonatal Intensive Care Unit (NICU) is a specialized environment, where parental participation is important not only for the wellbeing of the newborn, but also for parents' own confidence and emotional health. Care in the medical facility often takes place in an environment filled with strict rules, which poses a big physical, emotional and psychological challenge not only for the patient’s parents, but also for the healthcare professionals (1). Parental involvement leads towards better newborn health indicators, stronger emotional bond, reduced stress, a more positive experience during treatment and lastly, more successful long term parenting (2). Aim To describe mothers’ experiences when it comes to their involvement towards daily care of the newborn in the NICU. Methods Study is a phenomenological semi-structured interview study conducted at the NICU of the Hospital of Lithuanian University of Health Sciences. Approval to conduct the study was obtained from the LSMU Bioethics Center (No. 2025-BEC2-0521). All mothers caring for their newborns at the NICU for at least one week between May and September 2025 were invited to participate. Mothers who did not speak Lithuanian or who did not wish to participate were excluded. In total, eight mothers were included in the study. Results Data analysis revealed the following result categories: Early engagement. Mothers while under the care of NICU stated that they were offered first contact with their newborn during the first day after giving birth, “ started participating pretty much on the very first day after birth…” (Mother 1). The mothers have also learned the required skills gradually. Further engagement. Mothers who ended up in the care of NICU had experienced complicated pregnancies or childbirth. “Once my health got better, I was instantly offered to take part towards the care” (Mother 8). While taking care of their newborns, mothers are gradually introduced to more responsibilities and tasks, gaining confidence in their abilities and having chance to stay with their newborns for longer periods. The father’s participation and adaptation in the environment of NICU highlights a practical and emotional support for the mother and their newborn. “The father was also fully integrated into all of the procedures, though he was quite scared in the beginning” (Mother 7). Emotions experienced by mothers. Mothers find close correlation of their emotions with the uncertainty that comes with taking care of their fragile newborn. “I mentioned that there was fear, lack of courage that you might do something wrong” (Mother 3). The opportunity to make contact with their newborn in the NICU strengthens motherhood and the emotional connection with the newborn. Conclusions Mothers are gradually introduced to the everyday procedures and care of their newborn. The involvement of mothers strengthens the bond with the newborn while building the foundation for their strong motherhood.

Tyrimo tikslas – nustatyti 50-60 amžiaus pacientų informuotumą ir dalyvavimą vėžio prevencinėse programose. Tyrimo metodika. 2023 m. gruodžio – 2024 m. vasario mėn. buvo atliktas kiekybinis tyrimas VšĮ Garliavos pirminės sveikatos priežiūros centre, naudojant tyrėjų sudarytą anoniminę anketą. Apklausti 50-60 amžiaus vyrai ir moterys, viso – 153 pacientai. Tyrimui vykdyti buvo gautas Lietuvos sveikatos mokslų universiteto Bioetikos centro pritarimas (Nr. 2023-BEC2-502). Rezultatai. Statistiškai reikšmingai daugiau vyrų buvo informuoti apie tai, kad Lietuvoje yra organizuojamas prostatos vėžio prevencinė programa (p=0,008). Moterų, statistiškai reikšmingai, daugiau žinojo apie gimdos kaklelio ir krūties vėžio prevencines programas (p< 0,001). Daugiausiai vyrų (85,7 proc.) dalyvavo prostatos vėžio prevencinėje programoje. Daugiausiai moterų (92,1 proc.) dalyvavo krūties vėžio prevencinėje programoje, kita dalis (86,8 proc.) dalyvavo gimdos kaklelio vėžio prevencinėje programoje. Labiausiai respondentus motyvavo lankytis vėžio prevencinėse programose nemokamos tyrimų paslaugos (85,0 proc.) bei noras pasitikrinti sveikatą (85,0 proc.), tačiau moteris (93,4 proc.) statistiškai reikšmingai labiau motyvavo noras pasitikrinti sveikatą nei vyrus (76,6 proc.). Labiausiai (80,4 proc.) respondentus skatino lankytis vėžio prevencinėse programose šeimos gydytojas. Kita dalis (71,2 proc.) teigia, kad juos skatino lankytis slaugytojas dirbantis šeimos klinikoje. Mažiausiai (39,9 proc.) respondentus skatino dalyvauti visuomenės sveikatos priežiūros specialistas (-ė). Išvados. Dauguma 50-60 amžiaus moterų ir vyrų žinojo, kad Lietuvoje yra organizuojamos vėžio prevencinės programos. Tačiau ne visi kviečiamo amžiaus dalyvauti vėžio prevencinėse programose pacientai jose dalyvavo, moterys dažniau dalyvavo vėžio programose nei vyrai. Iš sveikatos priežiūros specialistų dažniausiai apie programas informavo šeimos gydytojas, slaugytojai. Dalyvauti vėžio prevencinėse programose vyrus ir moteris labiausiai motyvavo nemokamos tyrimų paslaugos ir noras pasitikrinti sveikatą.

Šioje apžvalgoje nagrinėjama kritinė vyresnio amžiaus pacientų griuvimų problemą, pabrėžiant psichotropinių vaisių vartojimo, ypač pirminėje sveikatos priežiūroje, reikšmę. Senstanti populiacija ir su amžiumi susiję fiziologiniai pokyčiai didina griuvimų riziką, o tyrimai rodo, kad ilgalaikis psichotropinių medikamentų (benzodiazepinų, antidepresantų, vaistų nuo psichozės) vartojimas yra reikšmingas rizikos veiksnys, didinantis pusiausvyros, koordinacijos sutrikimus ir ortostazinės hipotenzijos tikimybę dėl pakitusios farmakokinetikos ir farmakodinamikos. Siekiant sumažinti šią riziką, būtina taikyti nuoseklią prevenciją ir tarpdisciplininį bendradarbiavimą. Išplėstinės praktikos slaugytojai atlieka esminį vaidmenį holistiškai vertindami paciento būklę, identifikuodami šalutinius vaistų poveikius, taikydami standartizuotus testus, edukuodami pacientus apie nefarmakologines alternatyvas (pvz., kognityvinę elgesio terapiją, fizinį aktyvumą) bei koordinuodami kompleksines priemones su kitais specialistais, taip užtikrinant pacientų saugumą, mobilumą ir gerinant gyvenimo kokybę.