International Journal of Nursing Studies Advances最新文献

{"title":"Potential diagnostic tools for intensive care unit acquired weakness: A systematic review","authors":"Chen Xin , Yubiao Gai , Lili Wei , Yanqiu Wang , Yuhong Luo , Binru Han","doi":"10.1016/j.ijnsa.2025.100301","DOIUrl":"10.1016/j.ijnsa.2025.100301","url":null,"abstract":"<div><h3>Background</h3><div>Intensive care unit-acquired weakness is a prevalent complication among critically ill patients, associated with heightened mortality rates, extended durations of mechanical ventilation and hospital stays, as well as diminished mobility and unfavorable prognoses. Early diagnosis of intensive care unit-acquired weakness and identification of its subcategories are essential for early implementation of targeted interventions and care strategies. Nevertheless, there remains a significant gap in the availability of widely accepted, accurate, and user-friendly diagnostic tools for intensive care unit-acquired weakness.</div></div><div><h3>Objective</h3><div>The aim of this research was to conduct a comprehensive review of pertinent studies on diagnostic tools for intensive care unit-acquired weakness in critically ill patients, summarizing their diagnostic efficacy and constraints to aid healthcare professionals in choosing suitable diagnostic tools for intensive care unit-acquired weakness.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement were utilized to direct the literature search, bias risk assessment and data extraction. The search databases included PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL. The search period was from the inception of the database to 1 July 2024. Different types of risk bias assessment tools were used for different types of studies. Due to the heterogeneity of the data, solely a narrative synthesis of the intensive care unit-acquired weakness diagnostic tool was performed in this study.</div></div><div><h3>Results</h3><div>A total of 38 observational studies were included in the study. In the included studies, the gold standard for intensive care unit-acquired weakness diagnosis include the Medical Research Council score, muscle biopsy and electrophysiologic testing, potential diagnostic tools include the manual muscle test, electrophysiologic testing, imaging, serum inflammatory markers, neuromuscular ultrasound, and other parameters. In various studies, the diagnostic accuracy of intensive care unit-acquired weakness diagnostic tools has been inconsistent, with each tool possessing its own set of advantages and disadvantages. At present, no single tool is available for the definitive diagnosis of intensive care unit-acquired weakness, necessitating the combined use of multiple methods, each with inherent limitations. Manual muscle test is inexpensive and straightforward to perform, but it requires the patient to be conscious and cooperative. Muscle biopsy is invasive and rarely utilized. Electrophysiological testing can help differentiate whether intensive care unit-acquired weakness is caused by neural or muscular alterations, thereby aiding in the classification of its subtypes. However, it is moderately invasive, costly, and operator-dependent. Other diagnostic modalities, such as imaging and respira","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100301"},"PeriodicalIF":3.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143241966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy aging in frail older adults: Active aging project of a national survey","authors":"Jisu Seo ,&nbsp;Kyungok Joo ,&nbsp;Yuelin Li ,&nbsp;Nayoung Kim ,&nbsp;Eunna Oh ,&nbsp;Lkhagvajav Gansukh ,&nbsp;Rhayun Song","doi":"10.1016/j.ijnsa.2025.100302","DOIUrl":"10.1016/j.ijnsa.2025.100302","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is a growing concern among the aging population. Due to their vulnerability and reduced physiological reserves, frail older adults face an increased risk of functional decline and loss of independence. In frail older adults, the concept of healthy aging emphasizes maintaining independence, functionality, and a high quality of life despite frailty and other age-related challenges.</div></div><div><h3>Objective</h3><div>Grounded in the multidimensional model of healthy aging and aging-related resilience theory, we aimed to propose and test a hypothesized model. The model included exogenous variables (cognitive and physical function, perceived health) and mediators (resilience, social support, and daily activity) as influencing factors of healthy aging among frail older adults.</div></div><div><h3>Methods</h3><div>The cross-sectional study was conducted in South Korea using a national survey of 505 frail older adults living in the community. The sample was representative across age groups, sex, and regional distributions. A structural equation modeling was employed to test a hypothesized model, examining both direct and indirect effects of influencing factors on healthy aging. Data were collected between October and December 2023 and analyzed using IBM SPSS 26.0 and AMOS 26.0.</div></div><div><h3>Results</h3><div>A total of 505 frail older adults with an average age of 74 participated in the study. The hypothesized model demonstrated a good fit with the data. The exogenous variables and mediators accounted for 43 % of the variance in healthy aging. Resilience, cognitive function, and perceived health had significant direct and indirect effects on healthy aging. Daily activity also had a significant direct effect on healthy aging. Social support, while not directly affecting healthy aging, exerted a significant indirect effect through daily activity. Similarly, physical function influenced healthy aging indirectly via daily activity. The model was tested after controlling for age, sex (ref=male), economic status, and years of education. Among these confounding variables, economic status was a significant influencing factor in healthy aging (β = 0.14, <em>p</em> = 0.016).</div></div><div><h3>Conclusion</h3><div>Cognitive and physical function, alongside resilience and social support as mediators, significantly associated with healthy aging in frail older adults through daily activity. Health promotion strategies could focus on resilience and social support to empower individuals and strengthen social connectedness, thereby supporting independence in daily life and healthy aging. Further, we need to explore diverse social and cultural activities associated with healthy aging in this population to expand the definition of active aging.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100302"},"PeriodicalIF":3.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural perinatal nursing in Canada: A hermeneutic literature review","authors":"Lela V. Zimmer ,&nbsp;Martha L.P. MacLeod ,&nbsp;Amanda De Smit ,&nbsp;Steinunn Jónatansdóttir","doi":"10.1016/j.ijnsa.2025.100300","DOIUrl":"10.1016/j.ijnsa.2025.100300","url":null,"abstract":"<div><h3>Background</h3><div>Nurses working in rural and remote settings are central to the delivery of perinatal services, often as the initial providers to assess and manage patients. Although policies and guidelines dictate nurses’ responsibilities, little research focuses on rural perinatal nursing practice. Articulation of nurses’ actual and significant involvement in rural perinatal care is needed as increasingly sustaining rural perinatal services is in jeopardy.</div></div><div><h3>Objective</h3><div>The study aimed to answer the question, “How are nurses understood to be involved in the delivery of rural perinatal care?”</div></div><div><h3>Design</h3><div>A hermeneutic literature review</div></div><div><h3>Setting</h3><div>Rural and remote Canada</div></div><div><h3>Methods</h3><div>A hermeneutic literature review was conducted through a two-phase, interpretive process of evaluation and deliberation for relevance and meaning carried out through dialogue and questioning with the selected texts and among members of the research team. This process provided deepened understanding of rural perinatal nursing practice and the contexts in which it takes place, highlighting not only what was evident in the texts, but also what was missing regarding nurses’ involvement in the provision of perinatal care.</div></div><div><h3>Results</h3><div>Seven of 38 grey literature documents, and 25 research articles out of 800 were selected as relevant to the research question. Rural nurses’ perinatal practice was found to be largely invisible in the literature. Only a few studies focused on nurses, demonstrating their autonomy and agency to benefit patients, other providers, and system functioning, despite many contextual and health system constraints. Rural nurses’ experiences and insights were found rarely to be represented in perinatal policy and guidelines.</div></div><div><h3>Conclusions</h3><div>Rural nurses voices and practices are rarely represented in the research and grey literature relevant to rural perinatal services. Nurses’ insights and experiences are essential to ensure that policies and practices in healthcare organizations foster the sustainability of rural perinatal care for rural/remote childbearing families and the retention of nurses in rural practice.</div></div><div><h3>Tweetable abstract</h3><div>Canadian rural perinatal nurses’ practices are largely invisible in research and grey literature. Their voices and recognition of their contributions to care are needed to sustain rural maternity services.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100300"},"PeriodicalIF":3.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of video-based trauma-informed care training for nursing staff on seclusion and restraint of psychiatric inpatients: A non-randomized controlled study","authors":"Michi Miyake ,&nbsp;Megumi Hazumi ,&nbsp;Kentaro Usuda ,&nbsp;Takahiro Kawashima ,&nbsp;Maiko Fukasawa ,&nbsp;Hisateru Tachimori ,&nbsp;Daisuke Nishi","doi":"10.1016/j.ijnsa.2025.100297","DOIUrl":"10.1016/j.ijnsa.2025.100297","url":null,"abstract":"<div><h3>Background</h3><div>Trauma-informed care, based on the belief that past traumatic experiences induce problematic behavior, is being promoted through various initiatives in the United States and other countries. The specific effect of training that focuses solely on trauma-informed care for reducing seclusion and restraint in psychiatric settings remains unknown. In this non-randomized controlled trial, we examined the effectiveness of a video-based trauma-informed care training program for nursing staff, with seclusion and restraint times as the outcome.</div></div><div><h3>Methods</h3><div>Six of the 11 participating hospitals interested in trauma-informed care training were allocated to the intervention group, while the remaining five were assigned to the control group.The intervention ran from November 2021 to January 2022 in Japan. Data were collected using a specialized psychiatric monitoring system from April 2020 to October 2021 pre-intervention and from February 2022 to January 2023 post-intervention. The difference-in-differences analysis compared seclusion and restraint times between the groups.</div></div><div><h3>Results</h3><div>During the data collection period, one hospital in the intervention group was excluded due to a change in ward function. Patients admitted to the remaining hospitals (5,050 in the intervention group and 4,830 in the control group) were included in the analysis. The analysis showed that the estimated difference-in-differences coefficient of average restraint time decreased significantly by -0.24 (<em>p</em> = 0.01) at 6 months post-intervention, although seclusion time was not significantly decreased.</div></div><div><h3>Conclusions</h3><div>From the results of this non-randomized controlled trial, we found that video training focused solely on trauma-informed care may effectively reduce restraint time for inpatients. This accessible approach has the potential for broader adoption in clinical practice and may help reduce the use of coercive measures.</div></div><div><h3>Trial registration</h3><div>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry on 31 October 2021 (UMIN-CTR ID: UMIN000045879).</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100297"},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-viewing the concept of saturation in qualitative research","authors":"Bonnie Mowinski Jennings,&nbsp;Katherine A. Yeager","doi":"10.1016/j.ijnsa.2025.100298","DOIUrl":"10.1016/j.ijnsa.2025.100298","url":null,"abstract":"<div><div>The term saturation is used ubiquitously in reports of qualitative research. The term is often used, however, as a throw-away line, sans definition, rationale, or explanation of the process. Consequently, there remains a question about what is meant when saturation is used.</div><div>The concept of saturation originated in grounded theory. Achieving theoretical saturation is one of the tenets of grounded theory. Over time, this specific and singular term has migrated to a general term that reflects various types of saturation such as code, data, theme, and meaning saturation. There is a lack of clarity among saturation types and a lack of transparency in reporting what is meant by saturation and how it was achieved. There is also a question about the relevance of saturation to qualitative methodologies outside grounded theory.</div><div>In seeking to raise awareness of the issues surrounding the term saturation, in this discussion paper we offer a synopsis of the history and evolution of the term saturation, address the current conundrum about saturation in qualitative research, and examine the use of saturation in qualitative articles published in the six nursing journals with the highest journal impact factors. This re-view reflects the need to critically assess the status of saturation as it is used in nursing journals. Better definitions of terms are needed to assure consistency in language that will enhance understanding for the end user of qualitative research reports. Those conducting and assessing qualitative inquiries need clear understanding of what is appropriate for each qualitative methodology—saturation does not apply to some qualitative approaches.</div><div>Mentorship and teaching are at the heart of the saturation issue. Finding a mentor who is a solid methodologist may require nurses to reach out to individuals in other disciplines such as sociology, psychology, or anthropology. In the absence of a mentor, investigators conducting qualitative inquiry are urged to become well-versed in the methodology they believe is best suited to their question by turning to original sources written by well-trained methodologists. It is imperative that students who may become educators or researchers who then become reviewers and perhaps journal editors have a solid understanding of key qualitative concepts such as saturation.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100298"},"PeriodicalIF":3.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of nurses and patient representatives on the morally competent nurse: An international focus group study","authors":"Chris Gastmans ,&nbsp;Evelyne Mertens ,&nbsp;Alvisa Palese ,&nbsp;Brian Keogh ,&nbsp;Francesca Apolloni ,&nbsp;Johanna Wiisak ,&nbsp;Catherine Mc Cabe ,&nbsp;Maria Dimitriadou ,&nbsp;Alessandro Galazzi ,&nbsp;Michael Igoumenidis ,&nbsp;Nikos Stefanopoulos ,&nbsp;Paraskevi Charitou ,&nbsp;Evridiki Papastavrou ,&nbsp;Riitta Suhonen ,&nbsp;Stefania Chiappinotto ,&nbsp;Promocon Consortium","doi":"10.1016/j.ijnsa.2025.100296","DOIUrl":"10.1016/j.ijnsa.2025.100296","url":null,"abstract":"<div><h3>Background</h3><div>Across the world, healthcare systems have become increasingly complex, making it more difficult for nurses to act ethically when faced with moral dilemmas. The COVID-19 pandemic in particular revealed ethical challenges, highlighting the need for nurses to attain high levels of moral competence. Nurses who attain moral competency provide superior patient care because they have integrated clinical competence with sensitivity to moral values. Understanding what comprises moral competence in nursing is crucial to stimulate and support consistent ethical behaviour. However, most studies to date on moral competence in nursing have been conducted at a national level and only from a particular stakeholders’ perspective, thereby limiting their utility.</div></div><div><h3>Objective</h3><div>To explore and document the characteristics of the morally competent nurse from the perspectives of nurses and patient representatives practicing in Europe.</div></div><div><h3>Design</h3><div>A descriptive qualitative study was conducted.</div></div><div><h3>Methods</h3><div>Semi-structured focus group discussions were conducted to collect data. Data were analysed with a descriptive thematic method.</div></div><div><h3>Participants</h3><div>A purposive sample of 38 nurses and 35 patient representatives was recruited. They were geographically spread across six European countries.</div></div><div><h3>Results</h3><div>The overarching characteristic of a morally competent nurse that emerged from our thematic analyses of group discussions is that they are person-centred. This person-centred quality is expressed on intrapersonal and interpersonal levels. The theme ‘main components of moral competence in nurses’ can be divided into three subthemes: knowledge, skills, and attitudes.</div></div><div><h3>Conclusions</h3><div>This study provided a deeper understanding of moral competency in nurses, from both the perspective of nurses and patient representatives in Europe. Morally competent nurses are person-centred and possess the requisite knowledge, skills, and attitudes that foster positive relationships with patients and their families, as well as with their nursing colleagues. Pedagogically, the results should be useful for teaching how moral competence can be supported in practice and how nurses can be better prepared to deal with ethically sensitive care practices in constantly evolving healthcare systems.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100296"},"PeriodicalIF":3.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal midwifery care demand in a tertiary hospital: A time-series analysis","authors":"Luisa C. Eggenschwiler ,&nbsp;Giusi Moffa ,&nbsp;Valerie Smith ,&nbsp;Michael Simon","doi":"10.1016/j.ijnsa.2025.100299","DOIUrl":"10.1016/j.ijnsa.2025.100299","url":null,"abstract":"<div><h3>Introduction</h3><div>The chronic shortage of registered midwives and nurses is a serious global problem. However, current recommendations regarding midwifery staffing do not address operational staffing difficulties that arise from wide variations in care demand. The aim of this study was to describe shift-level care demand and available staffing resources in a tertiary hospital's maternity department.</div></div><div><h3>Methods</h3><div>This single-centre retrospective longitudinal study investigated a four-year timeframe (2019–2022). All registered midwives and nurses working a three-shift pattern in the prenatal unit, labour ward, or postnatal unit were included. To determine care demand, we approached it in a novel way, accounting for both the number of women on each unit and each case's expected complexity. Any unmet care demand was calculated in relation to pre-specified nurse-to-patient ratios for each care area by subtracting demand hours from available staff hours per shift.</div></div><div><h3>Results</h3><div>In total, 17,558 cases were included and 13,149 worked shifts analysed. The match of staffing resources with care demand was different for each analysed unit. In the prenatal and postnatal units, demand was generally met; however, the labour ward had a shortfall of at least one midwife on 32% of all shifts. Adjusted for care complexity, the deficiency prevalence rose to 55% of shifts for this ward.</div></div><div><h3>Conclusion</h3><div>Alongside the inclusion of care complexity in assessing care demand, shift- and unit-level analyses showed that average staffing numbers obscure the actual volume of unmet care demand. Staffing in labour wards needs greater flexibility to cope with the clustering of births over short periods.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100299"},"PeriodicalIF":3.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the experiences of birthing care during COVID-19: A qualitative systematic review","authors":"Danielle Macdonald ,&nbsp;Kristen Bigelow-Talbert ,&nbsp;Amanda Ross-White ,&nbsp;Erna Snelgrove-Clarke ,&nbsp;Leah Sookhoo","doi":"10.1016/j.ijnsa.2025.100295","DOIUrl":"10.1016/j.ijnsa.2025.100295","url":null,"abstract":"<div><h3>Background</h3><div>The Covid-19 pandemic was a challenging time for people who sought health care and for health care providers. Throughout the pandemic women and birthing people, families, and health care providers adapted to ongoing changes, restrictions, and new information to ensure that babies were born safely. There was a strong policy focus on safety and the reduction of infection, however this focus did not account for how the changes to birthing care practice would influence the experiences of the people most continuously sharing space during birth – women and birthing people, midwives, and nurses.</div></div><div><h3>Objective</h3><div>To explore and understand the birthing care experiences of women and birthing people, midwives, and nurses.</div></div><div><h3>Methods</h3><div>We used the JBI methodology and methods to conduct our qualitative review. We included studies with participants who were women or birthing people, nurses, and midwives who received or provided birthing care during the Covid-19 global pandemic. Studies published between January 2020 and February 2023 were included. Studies had to report qualitative data.</div></div><div><h3>Results</h3><div>A total of 5694 studies were identified for this review. After duplications were removed, screening and critical appraisal, 26 studies were included. Following meta-aggregation, 3 synthesized findings and 9 categories were created. The synthesized findings are 1) Navigating a pandemic and the chaos of constant changes 2) Striving for business as usual during a pandemic and 3) Amplifying variations in birthing care experiences.</div></div><div><h3>Conclusions</h3><div>The experiences and needs of people who provide and receive birthing care must be prioritized in all spaces. Midwives, nurses, women, and birthing people must be included in decision making for changes to practices and policies at all levels, especially during uncertain times. Birth experiences must be respected and supported to ensure that health and wellness outcomes are optimized for families at all stages of the intrapartum, postpartum and early parenting journeys.</div></div><div><h3>Registration</h3><div>Registered with Prospero CRD42021292832. An a priori protocol published, Macdonald, D., Snelgrove-Clarke, E., Ross-White, A., &amp; Bigelow-Talbert, K. (2022). The experiences of birthing care during Covid-19: A systematic review protocol. <em>JBI Evidence Synthesis. 20</em>(5): 1353–1360<em>.</em> <span><span>https://doi.org/10.11124/JBIES-21–00300</span><svg><path></path></svg></span></div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100295"},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing ethical self-efficacy among dementia caregiver staff: A mixed-methods feasibility study of the care programme","authors":"Sigurd Lauridsen ,&nbsp;Sofie Smedegaard Skov ,&nbsp;Lucca-Mathilde Thorup Ferm ,&nbsp;Marie-Eva Berg ,&nbsp;Anna Paldam Folker ,&nbsp;Peter Simonsen ,&nbsp;Frederik Schou-Juul","doi":"10.1016/j.ijnsa.2025.100294","DOIUrl":"10.1016/j.ijnsa.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>The global population living with dementia is rapidly increasing, with projections estimated at 78 million by 2030 and 132 million by 2050 due to ageing demographics. Despite the increasing prevalence of dementia, effective treatments remain limited. High-quality care is critical, but it presents complex ethical challenges, including balancing autonomy with best interests, addressing the needs of individuals with dementia and their caregivers, and equitably allocating resources. To address these challenges, we introduced the CARE programme, a systematic approach to ethics work, in nursing homes to enhance the ethical self-efficacy of nursing home staff.</div></div><div><h3>Objective</h3><div>This study assessed the feasibility of the CARE programme in a community-based Danish nursing home setting. Using the framework of Bowen et al. and a mixed-methods research design, we conducted six face-to-face focus group interviews with nursing home staff, two telephone interviews with nursing home managers, and a survey among 90 participants. Data were collected in the spring and fall of 2022.</div></div><div><h3>Method</h3><div>Quantitative data were analysed using STATA for descriptive statistics, while qualitative data were processed using a six-step template analysis framework.</div></div><div><h3>Results</h3><div>The results indicate high feasibility and acceptance of the CARE programme among the nursing home staff. To a high/some degree, 97 % expressed satisfaction, 95 % found the programme relevant to their work, 90 % believed it would improve dementia care, and 82 % felt better equipped to handle ethical dilemmas. Both the management and staff acknowledged the programme's effectiveness in filling the critical gap in ethics training in nursing homes. Appreciation for external facilitation, participation from multiple nursing homes, and cross-institutional group work emphasised the value of the programme.</div></div><div><h3>Conclusion</h3><div>The quantitative results indicate high levels of satisfaction and relevance, with the majority of participants believing that the program improves care and enhances their ability to manage ethical issues. Qualitative insights further emphasize the program's success in meeting the need for ethics training, facilitated by external researchers and cross-institutional collaboration. Full implementation of the CARE programme requires a cultural shift in nursing homes that advocates for universal staff involvement in ethics training and promotes open dialogue about ethical issues. Moreover, policy changes may be necessary to secure funding and establish minimum training standards for nursing home staff.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100294"},"PeriodicalIF":3.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teamwork between registered nurses and unlicensed assistive personnel in acute care settings: A scoping review","authors":"Kang Lynn Wong ,&nbsp;Wei Ling Chua ,&nbsp;Peter Griffiths ,&nbsp;Qin Ling Pearlyn Goh ,&nbsp;Kye Wern Chelsea Low ,&nbsp;Jia Qi Apphia Tan ,&nbsp;Sok Ying Liaw","doi":"10.1016/j.ijnsa.2025.100293","DOIUrl":"10.1016/j.ijnsa.2025.100293","url":null,"abstract":"<div><h3>Background</h3><div>Unlicensed assistive personnel are increasingly employed to support the nursing workforce in providing bedside care.</div></div><div><h3>Aim</h3><div>To scope the literature on the factors influencing teamwork between registered nurses and unlicensed assistive personnel in acute care settings</div></div><div><h3>Methods</h3><div>A scoping review was conducted using the Arksey and O'Malley (2005) framework. Eight electronic databases were searched from inception of each database to August 2024 to locate studies that reported issues relating to teamwork between registered nurses and unlicensed assistive personnel on patient care in general wards of acute care settings. Two reviewers independently screened titles, abstracts, and full text for eligibility. The data were extracted, analysed, and synthesised using the data-based convergent qualitative synthesis</div></div><div><h3>Results</h3><div>Thirty-eight studies were included. Five themes were generated: (1) role clarity, (2) delegation, (3) communication, (4) ward culture and practice, and (5) interpersonal relationships. Challenges in registered nurses–unlicensed assistive teamwork include unclear roles and responsibilities, ineffective delegation, and communication barriers. Work culture that excludes unlicensed assistive personnel from shift handovers were found to hinder shared goals for patient care. The importance of interpersonal relationships between registered nurses and unlicensed assistive personnel was highlighted to aid in the power disparity between them.</div></div><div><h3>Conclusions</h3><div>This review found suboptimal teamwork between registered nurses and unlicensed assistive personnel. Teamwork between registered nurses and unlicensed assistive personnel can be improved through clearly defined roles and responsibilities, better delegation practices, effective communication, and improved interpersonal relationships. Future research should focus on optimising communication processes and enhancing registered nurses’ delegation skills through education.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100293"},"PeriodicalIF":3.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143134424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}