Pub Date : 2025-12-23DOI: 10.1016/j.ijnsa.2025.100477
Jan Kottner, Ulrike Linstedt, Ahmed Tafesh, Monira El Genedy-Kalyoncu
Background
Pressure ulcer prevention and management belong to the core topics of nursing practice and research for decades. Numerous systematic reviews, clinical practice guidelines, and good practice documents are available, but pressure ulcer prevention and treatment may not be conducted following state-of-the-art methods in clinical practice.
Objectives
The overall objective was to describe and map the available evidence regarding pressure ulcer prevention and treatment practices in European hospitals.
Methods
A scoping review was conducted in the databases Embase and Medline (via OVID) and CINAHL including descriptive empirical studies published between 2014 and 2024. The population included all healthcare professionals, and context was hospitals in the European Union.
Results
Forty-six studies from 18 countries were included, describing 33 structure and 32 process aspects. The categories knowledge (n = 19) and attitudes (n = 11) were examined or identified by far the most frequently. Formal education and qualification were mentioned 10 times and personal interest and/or commitment 7 times. At the system level, the availability of and access to clear standards or protocols was mentioned most frequently. Most frequent process aspects included pressure ulcer risk assessment (n = 10), the type of risk assessment (n = 7), skin assessment (n = 10), repositioning (n = 9) and the use of support surfaces (n = 7).
Conclusion
More than 60 organizational, structural, and process characteristics were identified as potentially influencing pressure ulcer practice in European hospitals. Individual knowledge and attitudes and the availability of standards/protocols were most often investigated indicating a perceived priority in shaping pressure ulcer practice. Since all studies indicate knowledge deficits and a lack of implementation of basic prophylactic measures, there seems to be high potential to improve pressure ulcer prevention and enhance patient safety.
{"title":"Pressure ulcer practice in European hospitals: a scoping review","authors":"Jan Kottner, Ulrike Linstedt, Ahmed Tafesh, Monira El Genedy-Kalyoncu","doi":"10.1016/j.ijnsa.2025.100477","DOIUrl":"10.1016/j.ijnsa.2025.100477","url":null,"abstract":"<div><h3>Background</h3><div>Pressure ulcer prevention and management belong to the core topics of nursing practice and research for decades. Numerous systematic reviews, clinical practice guidelines, and good practice documents are available, but pressure ulcer prevention and treatment may not be conducted following state-of-the-art methods in clinical practice.</div></div><div><h3>Objectives</h3><div>The overall objective was to describe and map the available evidence regarding pressure ulcer prevention and treatment practices in European hospitals.</div></div><div><h3>Methods</h3><div>A scoping review was conducted in the databases Embase and Medline (via OVID) and CINAHL including descriptive empirical studies published between 2014 and 2024. The population included all healthcare professionals, and context was hospitals in the European Union.</div></div><div><h3>Results</h3><div>Forty-six studies from 18 countries were included, describing 33 structure and 32 process aspects. The categories knowledge (<em>n</em> = 19) and attitudes (<em>n</em> = 11) were examined or identified by far the most frequently. Formal education and qualification were mentioned 10 times and personal interest and/or commitment 7 times. At the system level, the availability of and access to clear standards or protocols was mentioned most frequently. Most frequent process aspects included pressure ulcer risk assessment (<em>n</em> = 10), the type of risk assessment (<em>n</em> = 7), skin assessment (<em>n</em> = 10), repositioning (<em>n</em> = 9) and the use of support surfaces (<em>n</em> = 7).</div></div><div><h3>Conclusion</h3><div>More than 60 organizational, structural, and process characteristics were identified as potentially influencing pressure ulcer practice in European hospitals. Individual knowledge and attitudes and the availability of standards/protocols were most often investigated indicating a perceived priority in shaping pressure ulcer practice. Since all studies indicate knowledge deficits and a lack of implementation of basic prophylactic measures, there seems to be high potential to improve pressure ulcer prevention and enhance patient safety.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100477"},"PeriodicalIF":3.1,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long-term caregiving for individuals with schizophrenia, who typically present with cognitive deficits and reduced emotional expression, can result in significant caregiver burden when adaptation to caregiving roles proves challenging.
Objective
To evaluate the effectiveness of a novel multichannel psychoeducation program in reducing caregiving burden among caregivers of individuals with schizophrenia.
Design
A randomized controlled trial study employing a pretest-posttest design with intervention and control groups.
Setting
Psychiatric outpatient department of Thammasat University Hospital in Pathum Thani, Thailand.
Participants
Initially, 50 caregivers of individuals with schizophrenia with mild to moderate caregiving burden (scores ≥11) without comorbidities were recruited. Five participants withdrew due to inconvenience and loss of contact, resulting in 45 completers (23 intervention, 22 control).
Methods
Participants were purposively selected based on inclusion criteria and matched in pairs according to caregiving burden scores, Brief Psychiatric Rating Scale scores of care recipients, age, and gender before random allocation. The intervention consisted of a seven-session multichannel psychoeducation program delivered over 3–4 weeks: one initial 60-minute face-to-face session followed by six 40-minute video conference sessions via the Line application. The control group received only usual care. Caregiving burden was assessed at baseline and one month post-intervention.
Results
The intervention group demonstrated significantly reduced caregiving burden scores from pre-test to post-test (t=10.278, p<0.001). Moreover, between-group comparison revealed significantly lower caregiving burden in the intervention group compared to the control group one month post-intervention (t=3.711, p=0.001). While both groups showed some reduction in burden, the intervention group achieved low burden levels, whereas the control group remained in the moderate range.
Conclusions
This innovative multichannel psychoeducation program shows promise in reducing caregiving burden among caregivers of people with schizophrenia. The integration of both face-to-face and digital delivery methods enhanced accessibility and appeared to support caregiver outcomes. While these findings are encouraging, the study design limits the strength of causal inferences. Further studies with more rigorous methodologies are recommended to confirm effectiveness and guide integration of this approach into standard care for caregivers in Thailand.
{"title":"Effect of a multichannel psychoeducation program on caregiving burden among caregivers of persons with schizophrenia: Randomized controlled trial","authors":"Anassaya Chueachalad , Chalinee Suvanayos , Patraporn Bhatarasakoon","doi":"10.1016/j.ijnsa.2025.100474","DOIUrl":"10.1016/j.ijnsa.2025.100474","url":null,"abstract":"<div><h3>Background</h3><div>Long-term caregiving for individuals with schizophrenia, who typically present with cognitive deficits and reduced emotional expression, can result in significant caregiver burden when adaptation to caregiving roles proves challenging.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of a novel multichannel psychoeducation program in reducing caregiving burden among caregivers of individuals with schizophrenia.</div></div><div><h3>Design</h3><div>A randomized controlled trial study employing a pretest-posttest design with intervention and control groups.</div></div><div><h3>Setting</h3><div>Psychiatric outpatient department of Thammasat University Hospital in Pathum Thani, Thailand.</div></div><div><h3>Participants</h3><div>Initially, 50 caregivers of individuals with schizophrenia with mild to moderate caregiving burden (scores ≥11) without comorbidities were recruited. Five participants withdrew due to inconvenience and loss of contact, resulting in 45 completers (23 intervention, 22 control).</div></div><div><h3>Methods</h3><div>Participants were purposively selected based on inclusion criteria and matched in pairs according to caregiving burden scores, Brief Psychiatric Rating Scale scores of care recipients, age, and gender before random allocation. The intervention consisted of a seven-session multichannel psychoeducation program delivered over 3–4 weeks: one initial 60-minute face-to-face session followed by six 40-minute video conference sessions via the Line application. The control group received only usual care. Caregiving burden was assessed at baseline and one month post-intervention.</div></div><div><h3>Results</h3><div>The intervention group demonstrated significantly reduced caregiving burden scores from pre-test to post-test (t=10.278, p<0.001). Moreover, between-group comparison revealed significantly lower caregiving burden in the intervention group compared to the control group one month post-intervention (t=3.711, p=0.001). While both groups showed some reduction in burden, the intervention group achieved low burden levels, whereas the control group remained in the moderate range.</div></div><div><h3>Conclusions</h3><div>This innovative multichannel psychoeducation program shows promise in reducing caregiving burden among caregivers of people with schizophrenia. The integration of both face-to-face and digital delivery methods enhanced accessibility and appeared to support caregiver outcomes. While these findings are encouraging, the study design limits the strength of causal inferences. Further studies with more rigorous methodologies are recommended to confirm effectiveness and guide integration of this approach into standard care for caregivers in Thailand.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100474"},"PeriodicalIF":3.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-17DOI: 10.1016/j.ijnsa.2025.100476
Christopher S. Lee , Marianna Antoniadou , Tiny Jaarsma , Barbara Riegel , Heleen Westland
Background
The efficacy of self-care interventions is not well understood in part because of variation in the domains of self-care being targeted as well as in modes of intervention delivery and behavioral change techniques used in trials.
Objective
The goal of this study was to synthesize the efficacy of comprehensive self-care interventions on relevant outcomes across six common chronic illnesses.
Design
Meta-analysis, meta-regression, and subgroup comparisons.
Methods
Data extraction focused on randomized controlled trials published between 2008 and 2022 designed to enhance comprehensive self-care interventions (i.e. those that focus on all three self-care domains of maintenance, monitoring, and management) in asthma, coronary artery disease, chronic obstructive pulmonary disease, type 2 diabetes mellitus, heart failure, and hypertension. Data were pooled using random-effects meta-analyses. Meta-regression and subgroup analyses were used to quantify the year of publication and both modes of delivery and behavioral change techniques on intervention efficacy, respectively.
Results
145 interventions tested in 140 trials involving 31,642 participants were included. The efficacy of comprehensive self-care interventions on improving outcomes was moderate in effect size and heterogeneous (g = 0.40 (95%CI=0.35–0.45), p < 0.001; χ2=898.7, p < 0.001, I2=83.9%). In meta-regression, the efficacy of interventions improved linearly between 2008 and 2022 (slope = 0.017 (95%CI=0.001–0.032); z = 2.08, p = 0.038). Interventions using individual face-to-face or telephone modes of delivery, and those employing behavioral feedback, social support or reminders were more efficacious compared with interventions that did not use these features (all p < 0.05).
Conclusions
Comprehensive self-care interventions have moderate efficacy in improving outcomes, especially those using certain modes of delivery and behavioral change techniques, and should be considered for adults with chronic illness.
自我护理干预的效果还没有被很好地理解，部分原因是自我护理领域的变化，以及在试验中使用的干预方式和行为改变技术。目的探讨综合自我保健干预对6种常见慢性疾病相关结局的影响。设计meta分析、meta回归和亚组比较。方法：数据提取集中于2008年至2022年间发表的随机对照试验，旨在加强哮喘、冠状动脉疾病、慢性阻塞性肺疾病、2型糖尿病、心力衰竭和高血压患者的综合自我保健干预（即关注所有三个自我保健领域的维持、监测和管理）。采用随机效应荟萃分析汇总数据。采用meta回归和亚组分析分别量化发表年份、交付方式和行为改变技术对干预效果的影响。结果140项试验共纳入145项干预措施，涉及31642名受试者。综合自我保健干预对改善预后的效果中等且具有异质性(g = 0.40 (95%CI= 0.35-0.45), p < 0.001；χ2=898.7, p < 0.001, I2=83.9%)。在meta回归中，干预措施的有效性在2008年至2022年间线性提高(斜率= 0.017 (95%CI= 0.001-0.032)；Z = 2.08, p = 0.038)。与不使用这些特征的干预相比，使用个人面对面或电话传递方式的干预以及使用行为反馈、社会支持或提醒的干预更有效（均p <； 0.05）。结论综合自我保健干预对改善预后有中等疗效，特别是使用某些交付方式和行为改变技术的干预，应考虑对成人慢性疾病患者进行干预。
{"title":"The comparative efficacy of comprehensive self-care interventions in chronic illness: An updated meta-analysis of randomized controlled trials","authors":"Christopher S. Lee , Marianna Antoniadou , Tiny Jaarsma , Barbara Riegel , Heleen Westland","doi":"10.1016/j.ijnsa.2025.100476","DOIUrl":"10.1016/j.ijnsa.2025.100476","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of self-care interventions is not well understood in part because of variation in the domains of self-care being targeted as well as in modes of intervention delivery and behavioral change techniques used in trials.</div></div><div><h3>Objective</h3><div>The goal of this study was to synthesize the efficacy of comprehensive self-care interventions on relevant outcomes across six common chronic illnesses.</div></div><div><h3>Design</h3><div>Meta-analysis, meta-regression, and subgroup comparisons.</div></div><div><h3>Methods</h3><div>Data extraction focused on randomized controlled trials published between 2008 and 2022 designed to enhance comprehensive self-care interventions (i.e. those that focus on all three self-care domains of maintenance, monitoring, and management) in asthma, coronary artery disease, chronic obstructive pulmonary disease, type 2 diabetes mellitus, heart failure, and hypertension. Data were pooled using random-effects meta-analyses. Meta-regression and subgroup analyses were used to quantify the year of publication and both modes of delivery and behavioral change techniques on intervention efficacy, respectively.</div></div><div><h3>Results</h3><div>145 interventions tested in 140 trials involving 31,642 participants were included. The efficacy of comprehensive self-care interventions on improving outcomes was moderate in effect size and heterogeneous (<em>g</em> = 0.40 (95%CI=0.35–0.45), <em>p</em> < 0.001; <em>χ<sup>2</sup>=</em>898.7, <em>p</em> < 0.001, <em>I</em><sup>2</sup>=83.9%). In meta-regression, the efficacy of interventions improved linearly between 2008 and 2022 (slope = 0.017 (95%CI=0.001–0.032); <em>z</em> = 2.08, <em>p</em> = 0.038). Interventions using individual face-to-face or telephone modes of delivery, and those employing behavioral feedback, social support or reminders were more efficacious compared with interventions that did not use these features (all <em>p</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>Comprehensive self-care interventions have moderate efficacy in improving outcomes, especially those using certain modes of delivery and behavioral change techniques, and should be considered for adults with chronic illness.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100476"},"PeriodicalIF":3.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.ijnsa.2025.100472
Chen Xin , Yubiao Gai , Yuhong Luo , Guixin Liu , Binru Han
<div><h3>Background</h3><div>Disease-related malnutrition is a prevalent condition among hospitalized patients and is closely linked to adverse clinical outcomes. Beyond malnutrition present at admission, various in-hospital factors can further deteriorate nutritional status. A particularly significant yet often underrecognized factor is the interruption of enteral nutrition, which may occur due to diagnostic or therapeutic procedures, gastrointestinal intolerance, or other clinical concerns. While this issue has been extensively studied in intensive care settings, its prevalence, underlying causes, and clinical impact in the general inpatient population remain poorly understood.</div></div><div><h3>Objective</h3><div>To investigate the prevalence and causes of enteral nutrition interruptions among inpatients in tertiary hospitals in China, and to explore the impact of enteral nutrition interruptions on inpatients.</div></div><div><h3>Design</h3><div>A sequential explanatory mixed-methods design was adopted.</div></div><div><h3>Setting(s)</h3><div>The study was conducted in two tertiary hospitals in Beijing and Qingdao, China. The cross-sectional survey included 2328 inpatients from nine departments, and qualitative interviews included 10 inpatients from seven departments.</div></div><div><h3>Methods</h3><div>Initially, a convenience sampling method was adopted to conduct cross-sectional surveys on two separate days in the two tertiary hospitals, aiming to investigate the prevalence and duration of enteral nutrition interruptions across various departments. Subsequently, an interpretative phenomenological analysis was conducted through one-on-one, semi-structured in-depth interviews with patients from different departments who had experienced enteral nutrition interruptions. The interviews aimed to explore patients’ personal experiences, perceived causes of the interruptions, and their physical and psychological impacts.</div></div><div><h3>Results</h3><div>A total of 2328 inpatients were surveyed, among whom 116 experienced enteral nutrition interruptions, with prevalence rates of 3.30 %, 7.01 %, and an overall prevalence of 4.98 %. We classified the causes of enteral nutrition interruptions into 11 categories, with surgery being the most common (73.28 %) and associated with a mean duration of 31.39 ± 24.74 h. Ten inpatients participated in qualitative interviews, which revealed that enteral nutrition interruptions resulted from various factors, some of which were avoidable, and had negative impacts on physical function, appetite, and psychological well-being.</div></div><div><h3>Conclusions</h3><div>Enteral nutrition interruptions were observed across different clinical departments in Chinese hospitals. Inpatients may experience multiple enteral nutrition interruptions during a single admission, caused by diverse factors, leading to adverse physical and psychological effects. Healthcare professionals could reduce the occurrence of enteral nutri
{"title":"Prevalence and causes for enteral nutrition interruptions in inpatients: A mixed-methods study","authors":"Chen Xin , Yubiao Gai , Yuhong Luo , Guixin Liu , Binru Han","doi":"10.1016/j.ijnsa.2025.100472","DOIUrl":"10.1016/j.ijnsa.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>Disease-related malnutrition is a prevalent condition among hospitalized patients and is closely linked to adverse clinical outcomes. Beyond malnutrition present at admission, various in-hospital factors can further deteriorate nutritional status. A particularly significant yet often underrecognized factor is the interruption of enteral nutrition, which may occur due to diagnostic or therapeutic procedures, gastrointestinal intolerance, or other clinical concerns. While this issue has been extensively studied in intensive care settings, its prevalence, underlying causes, and clinical impact in the general inpatient population remain poorly understood.</div></div><div><h3>Objective</h3><div>To investigate the prevalence and causes of enteral nutrition interruptions among inpatients in tertiary hospitals in China, and to explore the impact of enteral nutrition interruptions on inpatients.</div></div><div><h3>Design</h3><div>A sequential explanatory mixed-methods design was adopted.</div></div><div><h3>Setting(s)</h3><div>The study was conducted in two tertiary hospitals in Beijing and Qingdao, China. The cross-sectional survey included 2328 inpatients from nine departments, and qualitative interviews included 10 inpatients from seven departments.</div></div><div><h3>Methods</h3><div>Initially, a convenience sampling method was adopted to conduct cross-sectional surveys on two separate days in the two tertiary hospitals, aiming to investigate the prevalence and duration of enteral nutrition interruptions across various departments. Subsequently, an interpretative phenomenological analysis was conducted through one-on-one, semi-structured in-depth interviews with patients from different departments who had experienced enteral nutrition interruptions. The interviews aimed to explore patients’ personal experiences, perceived causes of the interruptions, and their physical and psychological impacts.</div></div><div><h3>Results</h3><div>A total of 2328 inpatients were surveyed, among whom 116 experienced enteral nutrition interruptions, with prevalence rates of 3.30 %, 7.01 %, and an overall prevalence of 4.98 %. We classified the causes of enteral nutrition interruptions into 11 categories, with surgery being the most common (73.28 %) and associated with a mean duration of 31.39 ± 24.74 h. Ten inpatients participated in qualitative interviews, which revealed that enteral nutrition interruptions resulted from various factors, some of which were avoidable, and had negative impacts on physical function, appetite, and psychological well-being.</div></div><div><h3>Conclusions</h3><div>Enteral nutrition interruptions were observed across different clinical departments in Chinese hospitals. Inpatients may experience multiple enteral nutrition interruptions during a single admission, caused by diverse factors, leading to adverse physical and psychological effects. Healthcare professionals could reduce the occurrence of enteral nutri","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100472"},"PeriodicalIF":3.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.ijnsa.2025.100471
Pernilla Dillner , Katarina E. Göransson , Mikael Norman , Maria Unbeck , Ulrika Förberg
Background
The development of neonatal intensive care has substantially reduced infant mortality, still, infants remain at high risk for adverse outcomes. Safe care relies on adequate nurse staffing and an appropriate skill mix, which is especially important in neonatal intensive care as infants are extremely vulnerable to harm when quality lapses occur. Although international guidelines recommend optimal nurse-to-patient ratios for neonatal care, these standards have not been fully implemented, leaving it unclear whether current staffing levels align with recommendations for safe staffing.
Objective
To benchmark the acuity-adjusted registered nurse staffing provision ratio in neonatal intensive care and determine the skill mix distribution and variation of nursing staff across shifts.
Method
This retrospective cohort study included infant data from a 16-week period in 2022 in three neonatal intensive care units with a common administration at a university hospital. Data were obtained from the hospital’s data repository and the Swedish Neonatal Quality Register, including 609 neonatal admissions and 345 nursing staff members working 1008 shifts. Infants’ daily acuity levels were assessed using an adapted version of the British Association of Perinatal Medicine’s guideline, classifying infants into three levels: intensive care, high dependency care, and special care. Staffing provision was measured as the number of worked hours per shift, staff category, and unit. The registered nurse provision ratio was defined as the number of registered nurse hours provided divided by the recommended hours. A ratio below 1.0 indicates understaffing.
Results
The population’s total in-hospital days were 4674, and the mean birth weight was 2843 g (SD 1029), with 57.0 % being boys. The proportion of registered nurses relative to nursing assistants ranged from 22.2 % to 85.7 %, with a median of 46.5 %. Registered nurses with specialist education accounted for a median of 73.0 % of total registered nurse hours. Within each unit, the mean acuity-adjusted number of registered nurses recommended by the British Association of Perinatal Medicine’s standard was relatively consistent across shift types and between weekdays and weekends. However, the required number of registered nurses between individual shifts showed considerable variation, ranging from 2.5 to 10.3. During the inclusion period, 81.2 % of the shifts had a registered nurse provision ratio below 1.0, suggesting that most shifts did not meet the recommendations for staffing levels.
Conclusions
This study highlights a shortfall in registered nurse staffing relative to recommended levels. Ensuring adequate registered nurse staffing levels is crucial for maintaining high-quality neonatal care and improving infant outcomes.
新生儿重症监护的发展大大降低了婴儿死亡率，然而，婴儿仍然处于不良后果的高风险中。安全护理依赖于充足的护士人员配备和适当的技能组合，这在新生儿重症监护中尤其重要，因为婴儿在发生质量失误时极易受到伤害。尽管国际指南建议新生儿护理的最佳护士与患者比例，但这些标准尚未得到充分实施，目前的人员配备水平是否符合安全人员配备的建议尚不清楚。目的对新生儿重症监护注册护士配备比例进行基准测试，确定护理人员的技能组合分布和不同班次的变化。方法本回顾性队列研究纳入了2022年在一所大学医院的三个新生儿重症监护病房进行的为期16周的婴儿数据。数据来自医院的数据存储库和瑞典新生儿质量登记册，包括609名新生儿入院和345名轮班1008次的护理人员。婴儿的日常视力水平是根据英国围产期医学协会的指南进行评估的，该指南将婴儿分为三个级别：重症监护、高度依赖护理和特殊护理。工作人员供应以每班工作时数、工作人员类别和单位来衡量。注册护士供应比率定义为提供的注册护士时数除以推荐时数。比率低于1.0表示人手不足。结果总住院天数4674天，平均出生体重2843 g (SD 1029)，男婴占57.0%。注册护士相对于护理员的比例介乎22.2%至85.7%，中位数为46.5%。专科教育注册护士占注册护士总时数的中位数为73.0%。在每个单位内，英国围产期医学协会标准推荐的经急性调整后的注册护士平均人数在轮班类型和工作日与周末之间相对一致。然而，每班所需的注册护士人数有相当大的差异，由2.5至10.3不等。在纳入期内，81.2%的班次的注册护士供应比率低于1.0，显示大部分班次不符合建议的人员编制水平。结论：本研究突出了注册护士人员配备相对于推荐水平的不足。确保足够的注册护士配备水平对于维持高质量的新生儿护理和改善婴儿结局至关重要。
{"title":"Nurse staffing skill mix and acuity-adjusted provision ratios in Swedish neonatal care: A cohort benchmark study","authors":"Pernilla Dillner , Katarina E. Göransson , Mikael Norman , Maria Unbeck , Ulrika Förberg","doi":"10.1016/j.ijnsa.2025.100471","DOIUrl":"10.1016/j.ijnsa.2025.100471","url":null,"abstract":"<div><h3>Background</h3><div>The development of neonatal intensive care has substantially reduced infant mortality, still, infants remain at high risk for adverse outcomes. Safe care relies on adequate nurse staffing and an appropriate skill mix, which is especially important in neonatal intensive care as infants are extremely vulnerable to harm when quality lapses occur. Although international guidelines recommend optimal nurse-to-patient ratios for neonatal care, these standards have not been fully implemented, leaving it unclear whether current staffing levels align with recommendations for safe staffing.</div></div><div><h3>Objective</h3><div>To benchmark the acuity-adjusted registered nurse staffing provision ratio in neonatal intensive care and determine the skill mix distribution and variation of nursing staff across shifts.</div></div><div><h3>Method</h3><div>This retrospective cohort study included infant data from a 16-week period in 2022 in three neonatal intensive care units with a common administration at a university hospital. Data were obtained from the hospital’s data repository and the Swedish Neonatal Quality Register, including 609 neonatal admissions and 345 nursing staff members working 1008 shifts. Infants’ daily acuity levels were assessed using an adapted version of the British Association of Perinatal Medicine’s guideline, classifying infants into three levels: intensive care, high dependency care, and special care. Staffing provision was measured as the number of worked hours per shift, staff category, and unit. The registered nurse provision ratio was defined as the number of registered nurse hours provided divided by the recommended hours. A ratio below 1.0 indicates understaffing.</div></div><div><h3>Results</h3><div>The population’s total in-hospital days were 4674, and the mean birth weight was 2843 g (SD 1029), with 57.0 % being boys. The proportion of registered nurses relative to nursing assistants ranged from 22.2 % to 85.7 %, with a median of 46.5 %. Registered nurses with specialist education accounted for a median of 73.0 % of total registered nurse hours. Within each unit, the mean acuity-adjusted number of registered nurses recommended by the British Association of Perinatal Medicine’s standard was relatively consistent across shift types and between weekdays and weekends. However, the required number of registered nurses between individual shifts showed considerable variation, ranging from 2.5 to 10.3. During the inclusion period, 81.2 % of the shifts had a registered nurse provision ratio below 1.0, suggesting that most shifts did not meet the recommendations for staffing levels.</div></div><div><h3>Conclusions</h3><div>This study highlights a shortfall in registered nurse staffing relative to recommended levels. Ensuring adequate registered nurse staffing levels is crucial for maintaining high-quality neonatal care and improving infant outcomes.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100471"},"PeriodicalIF":3.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.ijnsa.2025.100473
Vincenza Giordano , Teresa Rea , Andrea Chirico , Gianluigi Comparone , Luigi Chianese , Plinio Cirillo , Assunta Guillari
Background
Nurses are the touch point for different aspects of patient care, particularly in identifying early prodromal symptoms of acute myocardial infarction in women. Although there is increasing awareness of women-specific symptoms like fatigue, anxiety, and sleep disturbances, acute myocardial infarction is frequently underdiagnosed or recognized too late in women. Instruments such as the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey have demonstrated effectiveness in identifying these prodromal symptoms. However, no validated Italian tool exists to assess prodromal symptoms and predict myocardial infarction; developing one would help nurses detect symptoms early and improve outcomes in women.
Aim
The study aims to validate an Italian version of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, and to evaluate the predictive ability of prodromal symptoms toward acute myocardial infarction in women, to secondarily test a potential cut-off score for easier implementation of the tool in screening contexts, and to identify prodromal symptom clusters in women with AMI.
Materials
A multicenter study was conducted from October 2023 to January 2025, including women with ischemic heart disease and healthy women. Both groups completed the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, a structured questionnaire. Data analysis relied on test-re-test, regression models, and Receiver Operating Characteristic curve analysis to identify key prodromal symptoms of Acute Muocardial Infarction.
Results
The study involved 125 women with a mean age of 59.9 years. Women with acute myocardial infarction most commonly experienced chest pain, unusual fatigue, sleep disturbances, and anxiety. In contrast, healthy women reported fewer prodromal symptoms, with chest pain and unusual fatigue being less frequent. Reliability analysis showed excellent consistency in the tool (Cronbach’s α ≥0.90), with strong test-retest correlations (r = 0.973, p < 0.001). Logistic regression identified significant chest symptoms and general ones associated with acute myocardial infarction. Receiver Operating Characteristic curve analysis indicated excellent discriminative ability, defining a cut-off score with high sensitivity and specificity.
Conclusions
Results showed different identifying symptoms such as chest, back, neck/throat, and left arm pain, fatigue, shortness of breath, loss of appetite, arm weakness, and headache. The results suggest that it can be used as an effective screening tool to identify women at risk of acute myocardial infarction.
护士是患者护理不同方面的接触点，特别是在识别女性急性心肌梗死的早期前体症状方面。尽管人们越来越意识到女性特有的症状，如疲劳、焦虑和睡眠障碍，但女性急性心肌梗死经常被误诊或发现得太晚。McSweeney急性和前驱心肌梗死症状调查等仪器已经证明在识别这些前驱症状方面是有效的。然而，没有经过验证的意大利工具来评估前驱症状和预测心肌梗死；开发一种方法可以帮助护士及早发现症状并改善妇女的治疗效果。目的：本研究旨在验证意大利版的McSweeney急性和前驱心肌梗死症状调查，评估前驱症状对女性急性心肌梗死的预测能力，其次测试潜在的临界值，以便更容易地在筛查背景下实施该工具，并确定AMI女性的前驱症状群。材料一项多中心研究于2023年10月至2025年1月进行，包括患有缺血性心脏病的女性和健康女性。两组都完成了McSweeney急性和前体心肌梗死症状调查，这是一份结构化问卷。数据分析依靠检验-再检验、回归模型和受试者工作特征曲线分析来确定急性心肌梗死的关键前驱症状。研究对象为125名平均年龄为59.9岁的女性。急性心肌梗死的女性最常见的症状是胸痛、异常疲劳、睡眠障碍和焦虑。相比之下，健康女性报告的前驱症状较少，胸痛和不寻常的疲劳较少出现。信度分析显示，该工具具有良好的一致性（Cronbach 's α≥0.90），具有很强的重测相关性（r = 0.973, p < 0.001）。Logistic回归确定了与急性心肌梗死相关的显著胸部症状和一般症状。受试者工作特征曲线分析显示具有良好的判别能力，定义了具有高灵敏度和特异性的截止评分。结论结果显示不同的识别症状，如胸部、背部、颈部/喉咙和左臂疼痛、疲劳、呼吸短促、食欲不振、手臂无力和头痛。结果表明，它可以作为一种有效的筛查工具来识别有急性心肌梗死风险的女性。
{"title":"Translation, validation, predictive analysis of the Italian version of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey and symptom cluster characterization in women","authors":"Vincenza Giordano , Teresa Rea , Andrea Chirico , Gianluigi Comparone , Luigi Chianese , Plinio Cirillo , Assunta Guillari","doi":"10.1016/j.ijnsa.2025.100473","DOIUrl":"10.1016/j.ijnsa.2025.100473","url":null,"abstract":"<div><h3>Background</h3><div>Nurses are the touch point for different aspects of patient care, particularly in identifying early prodromal symptoms of acute myocardial infarction in women. Although there is increasing awareness of women-specific symptoms like fatigue, anxiety, and sleep disturbances, acute myocardial infarction is frequently underdiagnosed or recognized too late in women. Instruments such as the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey have demonstrated effectiveness in identifying these prodromal symptoms. However, no validated Italian tool exists to assess prodromal symptoms and predict myocardial infarction; developing one would help nurses detect symptoms early and improve outcomes in women.</div></div><div><h3>Aim</h3><div>The study aims to validate an Italian version of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey, and to evaluate the predictive ability of prodromal symptoms toward acute myocardial infarction in women, to secondarily test a potential cut-off score for easier implementation of the tool in screening contexts, and to identify prodromal symptom clusters in women with AMI.</div></div><div><h3>Materials</h3><div>A multicenter study was conducted from October 2023 to January 2025, including women with ischemic heart disease and healthy women. Both groups completed the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey<strong>,</strong> a structured questionnaire. Data analysis relied on test-re-test, regression models, and Receiver Operating Characteristic curve analysis to identify key prodromal symptoms of Acute Muocardial Infarction.</div></div><div><h3>Results</h3><div>The study involved 125 women with a mean age of 59.9 years. Women with acute myocardial infarction most commonly experienced chest pain, unusual fatigue, sleep disturbances, and anxiety. In contrast, healthy women reported fewer prodromal symptoms, with chest pain and unusual fatigue being less frequent. Reliability analysis showed excellent consistency in the tool (Cronbach’s α ≥0.90), with strong test-retest correlations (r = 0.973, p < 0.001). Logistic regression identified significant chest symptoms and general ones associated with acute myocardial infarction. Receiver Operating Characteristic curve analysis indicated excellent discriminative ability, defining a cut-off score with high sensitivity and specificity.</div></div><div><h3>Conclusions</h3><div>Results showed different identifying symptoms such as chest, back, neck/throat, and left arm pain, fatigue, shortness of breath, loss of appetite, arm weakness, and headache. The results suggest that it can be used as an effective screening tool to identify women at risk of acute myocardial infarction.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100473"},"PeriodicalIF":3.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-09DOI: 10.1016/j.ijnsa.2025.100469
Hélder Cunha , Patrício Costa , José Miguel Padilha
Background
Chronic obstructive pulmonary disease is a major global cause of death, marked by frequent exacerbations, high healthcare use, and reduced quality of life. Its progressive nature requires continuous self-care and symptom management. Understanding how individuals make self-care decisions is key to developing patient-centered nursing interventions. This study validates a theory-based instrument designed to assess core self-care domains in individuals living with chronic obstructive pulmonary disease, addressing gaps in existing tools that insufficiently capture behavioral aspects of disease management.
Objective
To translate and adapt the Self-care in Chronic Obstructive Pulmonary Disease Inventory to the Portuguese context and to test its psychometric properties on a sample of patients with chronic obstructive pulmonary disease in Portugal.
Design
A methodological study focused on the validation of an instrument.
Setting(s)
A Local Health Unit and its aggregated primary care centers from a municipality in the north region of Portugal.
Participants
196 patients met the inclusion criteria and accepted to participate in the study.
Methods
Construct validity was assessed using confirmatory factor analysis and hypothesis testing, while internal consistency reliability was evaluated using Cronbach’s alpha and McDonald’s omega.
Results
A convenience sample of 196 chronic obstructive pulmonary disease patients was recruited from September 2023 to February 2024. The instrument consists of four scales: Self-Care Maintenance, Self-Care Monitoring, Self-Care Management and Self-Care Self-Efficacy. Confirmatory factor analysis was assessed on all four dimensions of the inventory producing acceptable model fit indices. The hypotheses presumed to evaluate the convergent and discriminant validity were confirmed. Internal consistency was adequate with Cronbach’s alpha values ranging from 0.673 to 0.893 across the four scales.
Conclusions
The Portuguese version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory demonstrated acceptable psychometric properties. Some differences were observed compared to the original instrument. Further validation studies are needed to confirm its psychometric characteristics in the Portuguese population.
{"title":"Translation, cross-cultural adaptation and psychometric evaluation of the Portuguese version of the self-care in chronic obstructive pulmonary disease inventory","authors":"Hélder Cunha , Patrício Costa , José Miguel Padilha","doi":"10.1016/j.ijnsa.2025.100469","DOIUrl":"10.1016/j.ijnsa.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease is a major global cause of death, marked by frequent exacerbations, high healthcare use, and reduced quality of life. Its progressive nature requires continuous self-care and symptom management. Understanding how individuals make self-care decisions is key to developing patient-centered nursing interventions. This study validates a theory-based instrument designed to assess core self-care domains in individuals living with chronic obstructive pulmonary disease, addressing gaps in existing tools that insufficiently capture behavioral aspects of disease management.</div></div><div><h3>Objective</h3><div>To translate and adapt the Self-care in Chronic Obstructive Pulmonary Disease Inventory to the Portuguese context and to test its psychometric properties on a sample of patients with chronic obstructive pulmonary disease in Portugal.</div></div><div><h3>Design</h3><div>A methodological study focused on the validation of an instrument.</div></div><div><h3>Setting(s)</h3><div>A Local Health Unit and its aggregated primary care centers from a municipality in the north region of Portugal.</div></div><div><h3>Participants</h3><div>196 patients met the inclusion criteria and accepted to participate in the study.</div></div><div><h3>Methods</h3><div>Construct validity was assessed using confirmatory factor analysis and hypothesis testing, while internal consistency reliability was evaluated using Cronbach’s alpha and McDonald’s omega.</div></div><div><h3>Results</h3><div>A convenience sample of 196 chronic obstructive pulmonary disease patients was recruited from September 2023 to February 2024. The instrument consists of four scales: Self-Care Maintenance, Self-Care Monitoring, Self-Care Management and Self-Care Self-Efficacy. Confirmatory factor analysis was assessed on all four dimensions of the inventory producing acceptable model fit indices. The hypotheses presumed to evaluate the convergent and discriminant validity were confirmed. Internal consistency was adequate with Cronbach’s alpha values ranging from 0.673 to 0.893 across the four scales.</div></div><div><h3>Conclusions</h3><div>The Portuguese version of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory demonstrated acceptable psychometric properties. Some differences were observed compared to the original instrument. Further validation studies are needed to confirm its psychometric characteristics in the Portuguese population.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100469"},"PeriodicalIF":3.1,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-09DOI: 10.1016/j.ijnsa.2025.100470
Meng-Yao Liang , Jin-Rui Cui , Xin Fan , Jun-Jie Zhang , Xiao-Ling Liu , Dong-Gui Liu
<div><h3>Background</h3><div>Frailty is prevalent among the elderly population and can lead to multiple negative health consequences.</div></div><div><h3>Objective</h3><div>This study compares the effects of digital interventions versus either non-digital interventions with the same content or routine treatment/care alone (or both) on improving physical function and frailty status in older adults, and clarifies the formal advantages and comprehensive benefits of digital interventions.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>Systematic searches of the PubMed, Embase, Web of Science, CINAHL, PsycINFO, the Cochrane Library, and CNKI for publications archived in the database between its launch and January 16, 2025. The meta-analysis was performed using stata 15.0 and 16.0. We used the 2019 Revised version of the Cochrane risk-of-bias tool (RoB 2.0) to evaluate the study’s quality.</div></div><div><h3>Results</h3><div>23 studies were conducted from 2007 to 2024 in 5 continents that investigated 3426 frail elderly participants were included in the review.The meta-analytic findings indicated superior efficacy in older adults with frailty for digital health interventions over control group on measures of the frailty scores (standardized mean difference (SMD)= -0.42, 95 % confidence intervals (CI) [-0.72, -0.12]; <em>P</em> = 0.006), grip strength (weighted mean difference (WMD)= 1.11, 95 % CI [0.09, 2.14]; <em>P</em> = 0.034), cognitive function (SMD= 0.12, 95 % CI [0.01, 0.24]; <em>P</em> = 0.038), and quality of life (SMD= 0.30, 95 % CI [0.11, 0.50]; <em>P</em> = 0.003). Subgroup analysis stratified by control group type revealed that the digital intervention combined with exercise group significantly improved frailty status (SMD= -0.52, 95 % CI[-0.96, -0.08]; <em>P</em> = 0.020), grip strength (WMD= 1.82, 95 % CI[0.53, 3.12]; <em>P</em> = 0.006), and cognitive function (SMD= 0.20, 95 % CI[0.04, 0.37]; <em>P</em> = 0.015) in elderly patients to a greater extent compared with the usual care group. There were no significant differences between digital health interventions and control groups on any of the remaining 5 comparisons: Timed Up and Go Test (WMD= -0.73, 95 % CI [-1.52, 0.06]; <em>P</em> = 0.07), gait speed (WMD= 0.02, 95 % CI [-0.05, 0.09]; <em>P</em> = 0.55), Short Physical Performance Battery (WMD = -0.17, 95 % CI [-1.14, 0.79]; <em>P</em> = 0.724), Sit-to-Stand Test (WMD = 0.19, 95 % CI [-0.69, 1.07]; <em>P</em> = 0.67), and depression (SMD = -0.21, 95 % CI [-0.47, 0.05]; <em>P</em> = 0.107). Meta-regression analyses revealed that covariates including sex distribution, country of origin, care setting, intervention type, intervention duration, and assessment methodology exhibited no significant moderating effects on grip strength, cognitive function, or quality of life outcomes.</div></div><div><h3>Conclusions</h3><div>The study results showed
背景：虚弱在老年人中普遍存在，并可能导致多种负面健康后果。目的比较数字干预与具有相同内容的非数字干预或单独的常规治疗/护理（或两者兼有）对改善老年人身体功能和虚弱状态的影响，并阐明数字干预的形式优势和综合效益。设计随机对照试验的系统评价和荟萃分析。方法系统检索PubMed、Embase、Web of Science、CINAHL、PsycINFO、Cochrane Library和CNKI数据库，检索自该数据库开通至2025年1月16日的文献。meta分析采用stata 15.0和16.0进行。我们使用2019年修订版Cochrane风险偏倚工具（RoB 2.0）来评估研究的质量。研究人员从2007年到2024年在五大洲进行了23项研究，调查了3426名体弱老年人。meta分析结果显示，数字健康干预对虚弱老年人的疗效优于对照组(标准化平均差(SMD)= -0.42, 95%可信区间（CI） [-0.72, -0.12]；P = 0.006)，握力(加权平均差(WMD)= 1.11, 95% CI [0.09, 2.14]；P = 0.034)、认知功能（SMD= 0.12, 95% CI [0.01, 0.24]; P = 0.038）和生活质量（SMD= 0.30, 95% CI [0.11, 0.50]; P = 0.003）。按对照组类型分层的亚组分析显示，与常规护理组相比，数字干预联合运动组更显著地改善了老年患者的虚弱状态（SMD= -0.52, 95% CI[-0.96, -0.08]; P = 0.020）、握力（WMD= 1.82, 95% CI[0.53, 3.12]; P = 0.006）和认知功能（SMD= 0.20, 95% CI[0.04, 0.37]; P = 0.015）。没有明显差异数字卫生干预和控制在任何剩余的5组比较:定时去测试(大规模杀伤性武器= -0.73,95% CI [-1.52, 0.06]; P = 0.07),步速(大规模杀伤性武器= 0.02,95% CI [-0.05, 0.09]; P = 0.55),短的物理性能电池(大规模杀伤性武器= -0.17,95% CI [-1.14, 0.79]; P = 0.724), Sit-to-Stand测试(大规模杀伤性武器= 0.19,95% CI [-0.69, 1.07]; P = 0.67),和抑郁(SMD = -0.21, 95% CI [-0.47, 0.05]; P = 0.107)。meta回归分析显示，包括性别分布、原籍国、护理环境、干预类型、干预持续时间和评估方法在内的协变量对握力、认知功能或生活质量结果没有显著的调节作用。研究结果表明，接受数字健康干预的体弱老年人的虚弱状态、握力、认知功能和生活质量得到改善。此外，与常规护理组相比，数字运动干预组在改善体弱老年人握力、虚弱状态和认知功能方面表现出更优的效果，提示在临床实践中应优先采用“数字干预与运动相结合”的模式来管理老年虚弱。未来的研究应进行更多大样本、同质、高质量的临床试验，以更准确地验证核心数字模块对老年人虚弱和身体功能的影响。注册号crd42024614928（普洛斯彼罗）。
{"title":"The effect of digital health interventions in older adults with frailty: a systematic review and meta-analysis","authors":"Meng-Yao Liang , Jin-Rui Cui , Xin Fan , Jun-Jie Zhang , Xiao-Ling Liu , Dong-Gui Liu","doi":"10.1016/j.ijnsa.2025.100470","DOIUrl":"10.1016/j.ijnsa.2025.100470","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is prevalent among the elderly population and can lead to multiple negative health consequences.</div></div><div><h3>Objective</h3><div>This study compares the effects of digital interventions versus either non-digital interventions with the same content or routine treatment/care alone (or both) on improving physical function and frailty status in older adults, and clarifies the formal advantages and comprehensive benefits of digital interventions.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>Systematic searches of the PubMed, Embase, Web of Science, CINAHL, PsycINFO, the Cochrane Library, and CNKI for publications archived in the database between its launch and January 16, 2025. The meta-analysis was performed using stata 15.0 and 16.0. We used the 2019 Revised version of the Cochrane risk-of-bias tool (RoB 2.0) to evaluate the study’s quality.</div></div><div><h3>Results</h3><div>23 studies were conducted from 2007 to 2024 in 5 continents that investigated 3426 frail elderly participants were included in the review.The meta-analytic findings indicated superior efficacy in older adults with frailty for digital health interventions over control group on measures of the frailty scores (standardized mean difference (SMD)= -0.42, 95 % confidence intervals (CI) [-0.72, -0.12]; <em>P</em> = 0.006), grip strength (weighted mean difference (WMD)= 1.11, 95 % CI [0.09, 2.14]; <em>P</em> = 0.034), cognitive function (SMD= 0.12, 95 % CI [0.01, 0.24]; <em>P</em> = 0.038), and quality of life (SMD= 0.30, 95 % CI [0.11, 0.50]; <em>P</em> = 0.003). Subgroup analysis stratified by control group type revealed that the digital intervention combined with exercise group significantly improved frailty status (SMD= -0.52, 95 % CI[-0.96, -0.08]; <em>P</em> = 0.020), grip strength (WMD= 1.82, 95 % CI[0.53, 3.12]; <em>P</em> = 0.006), and cognitive function (SMD= 0.20, 95 % CI[0.04, 0.37]; <em>P</em> = 0.015) in elderly patients to a greater extent compared with the usual care group. There were no significant differences between digital health interventions and control groups on any of the remaining 5 comparisons: Timed Up and Go Test (WMD= -0.73, 95 % CI [-1.52, 0.06]; <em>P</em> = 0.07), gait speed (WMD= 0.02, 95 % CI [-0.05, 0.09]; <em>P</em> = 0.55), Short Physical Performance Battery (WMD = -0.17, 95 % CI [-1.14, 0.79]; <em>P</em> = 0.724), Sit-to-Stand Test (WMD = 0.19, 95 % CI [-0.69, 1.07]; <em>P</em> = 0.67), and depression (SMD = -0.21, 95 % CI [-0.47, 0.05]; <em>P</em> = 0.107). Meta-regression analyses revealed that covariates including sex distribution, country of origin, care setting, intervention type, intervention duration, and assessment methodology exhibited no significant moderating effects on grip strength, cognitive function, or quality of life outcomes.</div></div><div><h3>Conclusions</h3><div>The study results showed","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100470"},"PeriodicalIF":3.1,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-06DOI: 10.1016/j.ijnsa.2025.100467
Raquel Navarro Maldonado , Antonio R. Moreno-Poyato , Nuria María Albacar Rioboó
Background
Perinatal mental health problems affect one in five women during pregnancy and the first postpartum year, negatively impacting maternal and infant health. Despite its importance, healthcare remains focused on physical aspects, whereas mental health is neglected, highlighting the need for comprehensive and effective approaches.
Aim
To explore the current status of perinatal mental healthcare from the perspective of women and midwives, and to identify needs, challenges, and potential solutions to improve comprehensive care during pregnancy and the postpartum period.
Methods
An exploratory qualitative study in which 20 midwives from different care settings and 30 women at different stages of pregnancy and postpartum participated in individual semi-structured interviews. Reflexive thematic analysis assisted by Nvivo12 was used for data analysis.
Results
Four main themes emerged from the data analysis: (I) Challenges in Emotional Care: Cultural stigma identified as a significant barrier. Culturally sensitive care and strong therapeutic relationships highlighted as essential for emotional support. Need for dedicated time and safe spaces to facilitate emotional openness. (II) Significance of Perinatal Mental Health: Importance widely recognized but rarely addressed effectively. Mental health closely linked to emotional well-being, yet often neglected in daily practice. (III) Training-related challenges: Midwives report feeling unprepared. Need for ongoing, specific mental health training and standardized assessment tools. (IV) Challenges in Clinical Practice: Absence of clear protocols. High workloads hinder emotional care. Inconsistent approaches contribute to fragmented care.
Conclusions
This study highlights key priorities to improve perinatal mental healthcare: including culturally sensitive training, validated and standardised assessment tools, clear clinical protocols, and sufficient time for emotional support. Strengthening therapeutic relationships between midwives and pregnant and postpartum women emerged as essential for effective care. Findings support implementing structured support groups, multidisciplinary collaboration, and a more responsive, holistic care model.
{"title":"Women' and midwives' experiences of perinatal mental health care: A qualitative study","authors":"Raquel Navarro Maldonado , Antonio R. Moreno-Poyato , Nuria María Albacar Rioboó","doi":"10.1016/j.ijnsa.2025.100467","DOIUrl":"10.1016/j.ijnsa.2025.100467","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal mental health problems affect one in five women during pregnancy and the first postpartum year, negatively impacting maternal and infant health. Despite its importance, healthcare remains focused on physical aspects, whereas mental health is neglected, highlighting the need for comprehensive and effective approaches.</div></div><div><h3>Aim</h3><div>To explore the current status of perinatal mental healthcare from the perspective of women and midwives, and to identify needs, challenges, and potential solutions to improve comprehensive care during pregnancy and the postpartum period.</div></div><div><h3>Methods</h3><div>An exploratory qualitative study in which 20 midwives from different care settings and 30 women at different stages of pregnancy and postpartum participated in individual semi-structured interviews. Reflexive thematic analysis assisted by Nvivo12 was used for data analysis.</div></div><div><h3>Results</h3><div>Four main themes emerged from the data analysis: (I) Challenges in Emotional Care: Cultural stigma identified as a significant barrier. Culturally sensitive care and strong therapeutic relationships highlighted as essential for emotional support. Need for dedicated time and safe spaces to facilitate emotional openness. (II) Significance of Perinatal Mental Health: Importance widely recognized but rarely addressed effectively. Mental health closely linked to emotional well-being, yet often neglected in daily practice. (III) Training-related challenges: Midwives report feeling unprepared. Need for ongoing, specific mental health training and standardized assessment tools. (IV) Challenges in Clinical Practice: Absence of clear protocols. High workloads hinder emotional care. Inconsistent approaches contribute to fragmented care.</div></div><div><h3>Conclusions</h3><div>This study highlights key priorities to improve perinatal mental healthcare: including culturally sensitive training, validated and standardised assessment tools, clear clinical protocols, and sufficient time for emotional support. Strengthening therapeutic relationships between midwives and pregnant and postpartum women emerged as essential for effective care. Findings support implementing structured support groups, multidisciplinary collaboration, and a more responsive, holistic care model.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100467"},"PeriodicalIF":3.1,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The experience of nurses migrating abroad to work clinically can have a significant impact on their mental health. Stress factors can include adjusting to a new work system, language challenges, and adaptation.
Purpose
The aim was to analyse the stress, distress, and coping conditions of Indonesian nurses returning home after working abroad.
Methods
This was a qualitative descriptive and interpretative phenomenological approach with 30 nurses who returned home after working abroad, recruited using snowball sampling. Data collection was carried out in Indonesia through semi-structured interviews with the participants. Interviews were conducted in Indonesian and lasted approximately 60 minutes. The data were analysed using reflective thematic analysis.
Results
There were three themes. The first was feeling stressed with the work, consisting of sub-themes feeling a high mental burden, experiences that made one cry, difficulty in adapting, overwork in the field, and feeling alone in a foreign country. The second theme was mental health and its impact on life, with the sub-themes of feeling afraid, feeling traumatised, thinking about losing weight, inability to express feelings, and often being a victim of bullying. The third theme was coping mechanisms while working abroad, consisting of the sub-themes of coping was not good enough, feeling relieved to return to Indonesia, surrendering to the situation, being able to manage oneself and one’s mentality, always having to be ready to learn, relieving stress with entertainment, finding a place to express feelings, and strengthening commitment and planning.
Conclusions
Indonesian nurses working abroad faced a number of complex challenges as migrant nurses.
{"title":"Indonesian immigrant nurses' stress, distress, and coping: A qualitative study","authors":"Mundakir Mundakir , Ferry Efendi , Hema Malini , Reliani Reliani , Diah Priyantini , Chlara Yunita Prabawati , Rifky Octavia Pradipta","doi":"10.1016/j.ijnsa.2025.100466","DOIUrl":"10.1016/j.ijnsa.2025.100466","url":null,"abstract":"<div><h3>Background</h3><div>The experience of nurses migrating abroad to work clinically can have a significant impact on their mental health. Stress factors can include adjusting to a new work system, language challenges, and adaptation.</div></div><div><h3>Purpose</h3><div>The aim was to analyse the stress, distress, and coping conditions of Indonesian nurses returning home after working abroad.</div></div><div><h3>Methods</h3><div>This was a qualitative descriptive and interpretative phenomenological approach with 30 nurses who returned home after working abroad, recruited using snowball sampling. Data collection was carried out in Indonesia through semi-structured interviews with the participants. Interviews were conducted in Indonesian and lasted approximately 60 minutes. The data were analysed using reflective thematic analysis.</div></div><div><h3>Results</h3><div>There were three themes. The first was feeling stressed with the work, consisting of sub-themes feeling a high mental burden, experiences that made one cry, difficulty in adapting, overwork in the field, and feeling alone in a foreign country. The second theme was mental health and its impact on life, with the sub-themes of feeling afraid, feeling traumatised, thinking about losing weight, inability to express feelings, and often being a victim of bullying. The third theme was coping mechanisms while working abroad, consisting of the sub-themes of coping was not good enough, feeling relieved to return to Indonesia, surrendering to the situation, being able to manage oneself and one’s mentality, always having to be ready to learn, relieving stress with entertainment, finding a place to express feelings, and strengthening commitment and planning.</div></div><div><h3>Conclusions</h3><div>Indonesian nurses working abroad faced a number of complex challenges as migrant nurses.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100466"},"PeriodicalIF":3.1,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号