Pub Date : 2024-11-04DOI: 10.1016/j.ijnsa.2024.100263
Rebecka Nilsson , Ami Hommel
Purpose
Effective nurse-patient communication is demanding and essential when patients’ treatment changes from curative to palliative approach. We aimed to illustrate nurses’ experiences communicating with patients who have undergone end-of-life breakpoint communication.
Method
Six nurses from both haematology and oncology wards at a hospital in southern Sweden were interviewed. The data were analysed using content analysis.
Result
Three themes with a total of eight categories were identified: Nurses were excluded from the end-of-life breakpoint communication, which impacted the following communication and the dialogue between nurses and patients afterwards; the importance of communication, where the experience of following-up patients, supporting patients and having existential conversations was highlighted; the nurses’ strategies in the communication, included experience of using tools, the need for more information and education, and to be human.
Conclusion
Nurses in today's healthcare system need education to provide the care and the communication that patients ask for and are obligated to receive regarding support and information. In the results, nurses suggest and relate their strategies for effective patient communication, which would also aid nurses working in areas other than palliative care. For example, they propose collaborating more with physicians to facilitate better information flow and patient contact. Moreover, reflective tutorials, including spiritual leaders to aid patients’ existential concerns, are beneficial. The need for further research in this area is crucial for the growth and development of nurse-patient communication.
{"title":"Registered nurses’ experiences of communication with patients after the end-of-life breakpoint communication: A pilot interview study","authors":"Rebecka Nilsson , Ami Hommel","doi":"10.1016/j.ijnsa.2024.100263","DOIUrl":"10.1016/j.ijnsa.2024.100263","url":null,"abstract":"<div><h3>Purpose</h3><div>Effective nurse-patient communication is demanding and essential when patients’ treatment changes from curative to palliative approach. We aimed to illustrate nurses’ experiences communicating with patients who have undergone end-of-life breakpoint communication.</div></div><div><h3>Method</h3><div>Six nurses from both haematology and oncology wards at a hospital in southern Sweden were interviewed. The data were analysed using content analysis.</div></div><div><h3>Result</h3><div>Three themes with a total of eight categories were identified: <em>Nurses were excluded from the end-of-life breakpoint communication</em>, which impacted the following communication and the dialogue between nurses and patients afterwards; <em>the importance of communication,</em> where the experience of following-up patients, supporting patients and having existential conversations was highlighted; <em>the nurses’ strategies in the communication</em>, included experience of using tools, the need for more information and education, and to be human.</div></div><div><h3>Conclusion</h3><div>Nurses in today's healthcare system need education to provide the care and the communication that patients ask for and are obligated to receive regarding support and information. In the results, nurses suggest and relate their strategies for effective patient communication, which would also aid nurses working in areas other than palliative care. For example, they propose collaborating more with physicians to facilitate better information flow and patient contact. Moreover, reflective tutorials, including spiritual leaders to aid patients’ existential concerns, are beneficial. The need for further research in this area is crucial for the growth and development of nurse-patient communication.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100263"},"PeriodicalIF":3.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652498","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}
Pub Date : 2024-11-01DOI: 10.1016/j.ijnsa.2024.100252
Manal Kleib , Elizabeth Mirekuwaa Darko , Oluwadamilare Akingbade , Megan Kennedy , Precious Majekodunmi , Emma Nickel , Laura Vogelsang
Background
The past decade has witnessed a surge in the development of artificial intelligence (AI)-based technology systems for healthcare. Launched in November 2022, ChatGPT (Generative Pre-trained Transformer), an AI-based Chatbot, is being utilized in nursing education, research and practice. However, little is known about its pattern of usage, which prompted this study.
Objective
To provide a concise overview of the existing literature on the application of ChatGPT in nursing education, practice and research.
Methods
A rapid review based on the Cochrane methodology was applied to synthesize existing literature. We conducted systematic searches in several databases, including CINAHL, Ovid Medline, Embase, Web of Science, Scopus, Education Search Complete, ERIC, and Cochrane CENTRAL, to ensure no publications were missed. All types of primary and secondary research studies, including qualitative, quantitative, mixed methods, and literature reviews published in the English language focused on the use of ChatGPT in nursing education, research, and practice, were included. Dissertations or theses, conference proceedings, government and other organizational reports, white papers, discussion papers, opinion pieces, editorials, commentaries, and published review protocols were excluded. Studies involving other healthcare professionals and/or students without including nursing participants were excluded. Studies exploring other language models without comparison to ChatGPT and those examining the technical specifications of ChatGPT were excluded. Data screening was completed in two stages: titles and abstract and full-text review, followed by data extraction and quality appraisal. Descriptive analysis and narrative synthesis were applied to summarize and categorize the findings.
Results
Seventeen studies were included: 15 (88.2 %) focused on nursing education and one each on nursing practice and research. Of the 17 included studies, 5 (29.4 %) were evaluation studies, 3 (17.6 %) were narrative reviews, 3 (17.6 %) were cross-sectional studies, 2 (11.8 %) were descriptive studies, and 1 (5.9 %) was a randomized controlled trial, quasi-experimental study, case study, and qualitative study, respectively.
Conclusion
This study has provided a snapshot of ChatGPT usage in nursing education, research, and practice. Although evidence is inconclusive, integration of ChatGPT should consider addressing ethical concerns and ongoing education on ChatGPT usage. Further research, specifically interventional studies, is recommended to ascertain and track the impact of ChatGPT in different contexts.
{"title":"Current trends and future implications in the utilization of ChatGPT in nursing: A rapid review","authors":"Manal Kleib , Elizabeth Mirekuwaa Darko , Oluwadamilare Akingbade , Megan Kennedy , Precious Majekodunmi , Emma Nickel , Laura Vogelsang","doi":"10.1016/j.ijnsa.2024.100252","DOIUrl":"10.1016/j.ijnsa.2024.100252","url":null,"abstract":"<div><h3>Background</h3><div>The past decade has witnessed a surge in the development of artificial intelligence (AI)-based technology systems for healthcare. Launched in November 2022, ChatGPT (Generative Pre-trained Transformer), an AI-based Chatbot, is being utilized in nursing education, research and practice. However, little is known about its pattern of usage, which prompted this study.</div></div><div><h3>Objective</h3><div>To provide a concise overview of the existing literature on the application of ChatGPT in nursing education, practice and research.</div></div><div><h3>Methods</h3><div>A rapid review based on the Cochrane methodology was applied to synthesize existing literature. We conducted systematic searches in several databases, including CINAHL, Ovid Medline, Embase, Web of Science, Scopus, Education Search Complete, ERIC, and Cochrane CENTRAL, to ensure no publications were missed. All types of primary and secondary research studies, including qualitative, quantitative, mixed methods, and literature reviews published in the English language focused on the use of ChatGPT in nursing education, research, and practice, were included. Dissertations or theses, conference proceedings, government and other organizational reports, white papers, discussion papers, opinion pieces, editorials, commentaries, and published review protocols were excluded. Studies involving other healthcare professionals and/or students without including nursing participants were excluded. Studies exploring other language models without comparison to ChatGPT and those examining the technical specifications of ChatGPT were excluded. Data screening was completed in two stages: titles and abstract and full-text review, followed by data extraction and quality appraisal. Descriptive analysis and narrative synthesis were applied to summarize and categorize the findings.</div></div><div><h3>Results</h3><div>Seventeen studies were included: 15 (88.2 %) focused on nursing education and one each on nursing practice and research. Of the 17 included studies, 5 (29.4 %) were evaluation studies, 3 (17.6 %) were narrative reviews, 3 (17.6 %) were cross-sectional studies, 2 (11.8 %) were descriptive studies, and 1 (5.9 %) was a randomized controlled trial, quasi-experimental study, case study, and qualitative study, respectively.</div></div><div><h3>Conclusion</h3><div>This study has provided a snapshot of ChatGPT usage in nursing education, research, and practice. Although evidence is inconclusive, integration of ChatGPT should consider addressing ethical concerns and ongoing education on ChatGPT usage. Further research, specifically interventional studies, is recommended to ascertain and track the impact of ChatGPT in different contexts.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100252"},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652028","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}
Pub Date : 2024-10-31DOI: 10.1016/j.ijnsa.2024.100262
Hyunmin Yu , April J. Ancheta , Dalmacio Dennis Flores , Stephen Bonett , Steven Meanley , Seul Ki Choi , José A. Bauermeister
Background
Discrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems.
Methods
Twenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation.
Results
Nurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices.
Conclusion
Implementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.
{"title":"Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: A qualitative descriptive study","authors":"Hyunmin Yu , April J. Ancheta , Dalmacio Dennis Flores , Stephen Bonett , Steven Meanley , Seul Ki Choi , José A. Bauermeister","doi":"10.1016/j.ijnsa.2024.100262","DOIUrl":"10.1016/j.ijnsa.2024.100262","url":null,"abstract":"<div><h3>Background</h3><div>Discrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems.</div></div><div><h3>Methods</h3><div>Twenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation.</div></div><div><h3>Results</h3><div>Nurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices.</div></div><div><h3>Conclusion</h3><div>Implementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100262"},"PeriodicalIF":3.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578425","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}
Presenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves.
Objective
We aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences.
Design
We performed an integrative review.
Methods
We searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews.
Results
The results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32 % and 94 %. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes.
Conclusion
This review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.
背景旷工是指员工在身体或精神受到限制的情况下仍然参加工作的一种现象,在护士中普遍存在,对患者、医疗机构和护士自身都有负面影响.ObjectiveWe aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences.DesignWe performed an integrative review.Methods我们检索了数据库中2018年至2024年期间发表的关于护理人员旷工的研究。本综述纳入了 44 项符合纳入标准的研究,具体包括 38 项定量研究、4 项定性研究和 2 项综述。结果结果表明,表现出旷工症状的护士的患病率在 32 % 到 94 % 之间。影响因素包括工作量、团队文化、年龄、育儿责任、工作不安全感和领导方法。旷工可导致严重的个人和组织后果,如增加护士的健康问题、降低病人护理质量和增加医疗成本。大多数研究主要针对在医院工作的护士,只有一项研究针对在养老院工作的护士。这突出表明,有必要提高护士和管理团队对解决旷工问题重要性的认识并加强相关培训。需要在养老院和门诊护理等环境中开展进一步研究,以了解这些环境中的独特挑战和影响。工作重点应放在改善工作条件、培养支持性的组织文化和实施有效的领导实践上,以减轻旷工的负面影响。
{"title":"Presenteeism among nurses: An integrative review","authors":"Maisa Gerlach , Sabine Hahn , Celine Rossier , Franziska Geese , Jan Hamers , Ramona Backhaus","doi":"10.1016/j.ijnsa.2024.100261","DOIUrl":"10.1016/j.ijnsa.2024.100261","url":null,"abstract":"<div><h3>Background</h3><div>Presenteeism, a phenomenon in which employees attend work despite physical or mental limitations, is prevalent among nurses and has negative implications for patients, healthcare organizations, and nurses themselves.</div></div><div><h3>Objective</h3><div>We aimed to present the current state of knowledge on presenteeism in nursing, focusing on prevalence rates, reasons, influencing factors, and consequences.</div></div><div><h3>Design</h3><div>We performed an integrative review.</div></div><div><h3>Methods</h3><div>We searched databases for studies on presenteeism in the nursing workforce published between 2018 and 2024. This review included 44 studies that met the inclusion criteria, specifically 38 quantitative studies, 4 qualitative studies, and 2 reviews.</div></div><div><h3>Results</h3><div>The results indicated that the prevalence of nurses exhibiting symptoms of presenteeism varies between 32 % and 94 %. The influencing factors include workload, team culture, age, childcare responsibilities, job insecurity, and leadership practices. Presenteeism can lead to significant individual and organizational consequences such as increased health issues among nurses, decreased quality of patient care, and higher healthcare costs. Most studies were focused on nurses who work in hospitals, with only one study addressing nurses who work in nursing homes.</div></div><div><h3>Conclusion</h3><div>This review highlights the high prevalence of presenteeism among nurses and its multifaceted causes and effects. This underscores the need for increased awareness and training of both nurses and management teams regarding the importance of addressing presenteeism. Further research is needed in settings such as nursing homes and outpatient care to understand the unique challenges and impacts in these environments. Efforts should focus on improving working conditions, fostering supportive organizational cultures, and implementing effective leadership practices to mitigate the negative effects of presenteeism.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100261"},"PeriodicalIF":3.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652030","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}
Pub Date : 2024-10-30DOI: 10.1016/j.ijnsa.2024.100259
Thao Thi Phuong Nguyen , Hai Bui Hoang , Huyen Thi Thanh Vu
Background
In Vietnam, early screening and intervention for post-stroke mental health are limited, with rising demand for home-based rehabilitation due to the scarcity of inpatient programs.
Objectives
We aimed to evaluate the effectiveness of multifaceted interventions, including Motivational Interviewing and home-based rehabilitation, in improving the mental and physical health of stroke patients.
Design
A randomized controlled trial at the Vietnam National Geriatric Hospital assessed a multi-intervention approach for stroke survivors from 2021 to 2022. Ninety-two participants (aged over 45 with a stroke diagnosis) were randomly assigned to an intervention group (Motivational Interviewing and home-based rehabilitation) or a control group (standard care), with 46 participants in each group. Outcomes for mental health (Patient Health Questionnaire-9, Fatigue Severity Scale, Mini-Mental State Examination) and physical health (Barthel Index) were measured at baseline and after 1, 3, and 6 months. Statistical analyses used t-tests, Cohen's d, and repeated measures ANOVA.
Results
Over 6 months, 37 participants completed the intervention program. Baseline characteristics were similar except for age, lesion locations, and National Institutes of Health Stroke Scale scores. The intervention group showed significant improvements in mental health and physical function. Patient Health Questionnaire-9 scores decreased from 9.1 to 1.8, and Fatigue Severity Scale scores dropped from 28.5 to 17.8, while Barthel Index scores improved from 58.8 to 68.8 (p < 0.001).
Conclusions
We found that participants who underwent Motivational Interviewing therapy and home-based rehabilitation were more likely than those receiving standard care to experience substantial improvements in both mental and physical health metrics.
Registration
The research protocol was registered on ClinicalTrials.gov on August 1, 2021 (Identifier: NCT04941482, link: https://clinicaltrials.gov/study/NCT04941482).
背景在越南,脑卒中后心理健康的早期筛查和干预非常有限,由于住院治疗项目的稀缺,对家庭康复的需求不断增加。92名参与者(45岁以上,确诊为中风)被随机分配到干预组(动机访谈和家庭康复)或对照组(标准护理),每组46人。在基线和 1、3、6 个月后测量心理健康结果(患者健康问卷-9、疲劳严重程度量表、迷你精神状态检查)和身体健康结果(巴特尔指数)。统计分析采用 t 检验、Cohen's d 和重复测量方差分析。除年龄、病变部位和美国国立卫生研究院卒中量表评分外,其他基线特征相似。干预组在心理健康和身体功能方面有明显改善。患者健康问卷-9评分从9.1分降至1.8分,疲劳严重程度量表评分从28.5分降至17.8分,而巴特尔指数评分从58.8分提高至68.8分(p < 0.001)。结论我们发现,与接受标准护理的患者相比,接受动机访谈疗法和家庭康复治疗的患者更有可能在心理和身体健康指标方面获得实质性改善。注册该研究方案于2021年8月1日在ClinicalTrials.gov上注册(标识符:NCT04941482,链接:https://clinicaltrials.gov/study/NCT04941482)。
{"title":"Effectiveness of multifaceted interventions including motivational interviewing and home-based rehabilitation program for improving mental and physical health in stroke patients: A randomized controlled trial","authors":"Thao Thi Phuong Nguyen , Hai Bui Hoang , Huyen Thi Thanh Vu","doi":"10.1016/j.ijnsa.2024.100259","DOIUrl":"10.1016/j.ijnsa.2024.100259","url":null,"abstract":"<div><h3>Background</h3><div>In Vietnam, early screening and intervention for post-stroke mental health are limited, with rising demand for home-based rehabilitation due to the scarcity of inpatient programs.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate the effectiveness of multifaceted interventions, including Motivational Interviewing and home-based rehabilitation, in improving the mental and physical health of stroke patients.</div></div><div><h3>Design</h3><div>A randomized controlled trial at the Vietnam National Geriatric Hospital assessed a multi-intervention approach for stroke survivors from 2021 to 2022. Ninety-two participants (aged over 45 with a stroke diagnosis) were randomly assigned to an intervention group (Motivational Interviewing and home-based rehabilitation) or a control group (standard care), with 46 participants in each group. Outcomes for mental health (Patient Health Questionnaire-9, Fatigue Severity Scale, Mini-Mental State Examination) and physical health (Barthel Index) were measured at baseline and after 1, 3, and 6 months. Statistical analyses used <em>t</em>-tests, Cohen's <em>d</em>, and repeated measures ANOVA.</div></div><div><h3>Results</h3><div>Over 6 months, 37 participants completed the intervention program. Baseline characteristics were similar except for age, lesion locations, and National Institutes of Health Stroke Scale scores. The intervention group showed significant improvements in mental health and physical function. Patient Health Questionnaire-9 scores decreased from 9.1 to 1.8, and Fatigue Severity Scale scores dropped from 28.5 to 17.8, while Barthel Index scores improved from 58.8 to 68.8 (<em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>We found that participants who underwent Motivational Interviewing therapy and home-based rehabilitation were more likely than those receiving standard care to experience substantial improvements in both mental and physical health metrics.</div></div><div><h3>Registration</h3><div>The research protocol was registered on ClinicalTrials.gov on August 1, 2021 (Identifier: NCT04941482, link: <span><span>https://clinicaltrials.gov/study/NCT04941482</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100259"},"PeriodicalIF":3.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652031","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}
Pub Date : 2024-10-28DOI: 10.1016/j.ijnsa.2024.100256
Annick Stolze , Tara N.M. Woolley-Hendriks , Yara Bassa , Ralph de Vries , Christa Boer , Peter G. Noordzij
Background
An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.
Methods
This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799. PubMed, Embase.com, CINAHL (Ebsco) and Wiley/Cochrane Library were searched from inception up to 20-06-2023 for randomized controlled trials and non-randomized studies of interventions. Studies were eligible for inclusion if the effect of an early warning scoring system using spot check monitoring was studied.
Results
Eight articles were included, of which two were randomised controlled trials. The overall risk of bias was high. A statistically significant decrease in mortality was seen in three studies. Two studies reported a decrease in cardiopulmonary arrests, and three studies found a decrease in ICU-admissions. There was heterogeneity among studies regarding the types of complications that were reported.
Conclusions
The evidence in favor of an early warning scoring system to reduce complications and mortality in surgical patients is low, mainly due to a limited number of studies and poor study design. Well-designed trials are needed to investigate whether an early warning scoring system improves outcome in surgical patients.
{"title":"The effect of early warning scoring systems on adverse outcome in surgical patients: A systematic review","authors":"Annick Stolze , Tara N.M. Woolley-Hendriks , Yara Bassa , Ralph de Vries , Christa Boer , Peter G. Noordzij","doi":"10.1016/j.ijnsa.2024.100256","DOIUrl":"10.1016/j.ijnsa.2024.100256","url":null,"abstract":"<div><h3>Background</h3><div>An early warning scoring system aims to detect clinical deterioration at an early stage and prevent failure-to-rescue in hospitalized patients. In this systematic review we studied the effect of an early warning scoring system on adverse outcome in surgical patients.</div></div><div><h3>Methods</h3><div>This review was conducted and reported according to PRISMA and the protocol of this review is registered at PROSPERO, under the registration number CRD42018107799. PubMed, Embase.com, CINAHL (Ebsco) and Wiley/Cochrane Library were searched from inception up to 20-06-2023 for randomized controlled trials and non-randomized studies of interventions. Studies were eligible for inclusion if the effect of an early warning scoring system using spot check monitoring was studied.</div></div><div><h3>Results</h3><div>Eight articles were included, of which two were randomised controlled trials. The overall risk of bias was high. A statistically significant decrease in mortality was seen in three studies. Two studies reported a decrease in cardiopulmonary arrests, and three studies found a decrease in ICU-admissions. There was heterogeneity among studies regarding the types of complications that were reported.</div></div><div><h3>Conclusions</h3><div>The evidence in favor of an early warning scoring system to reduce complications and mortality in surgical patients is low, mainly due to a limited number of studies and poor study design. Well-designed trials are needed to investigate whether an early warning scoring system improves outcome in surgical patients.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100256"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652029","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}
Pub Date : 2024-10-28DOI: 10.1016/j.ijnsa.2024.100253
Boitumelo Setlogelo, Champion N Nyoni
Background
Nursing students engage with the complex health system for competence development. These students are exposed to nerve-wrecking experience in addition to their everyday personal and social challenges. Non-cognitive attributes, namely grit, resilience and mindset can influence students’ ability to overcome complexities as they become nurses resulting in academic success and well-being. Insights into the state of non-cognitive attributes among undergraduate nursing students are essential in developing tailor-made educational programmes to enhance their grit, resilience, and mindset.
Objectives
To describe the undergraduate nursing students’ grit, academic resilience, and mindset at a university in South Africa
Design
A quantitative descriptive cross-sectional design.
Setting
A School of Nursing at a public multi-campus university in South Africa.
Participants
All students (N = 315) registered for the undergraduate nursing programme were invited to participate, and 70 % (N = 221) chose to participate.
Methods
Data were collected using self-administered questionnaires that included a 7-item demographic survey, the 30-item Academic Resilience Scale (ARS-30) that measures affective, cognitive, and behavioural responses in an educational context, the 16-item Dweck Mindset Scale (DMI) that measures a personal belief about whether intelligence and talent are fixed or amenable to change, and the 8-item Grit-S scale measuring passion for long term goals and perseverance. The collected quantitative data were analysed statistically through the Statistical Analysis Software Version 9.4 computer programme.
Findings
The findings revealed that the participants have normal grit and a growth mindset, but low academic resilience.
Conclusions
Tailor-made educational programmes that target non-cognitive attributes must integrate interventions that are focused on enhancing academic resilience for undergraduate nursing students.
{"title":"Grit, academic resilience, and mindset of nursing students: A cross-sectional study","authors":"Boitumelo Setlogelo, Champion N Nyoni","doi":"10.1016/j.ijnsa.2024.100253","DOIUrl":"10.1016/j.ijnsa.2024.100253","url":null,"abstract":"<div><h3>Background</h3><div>Nursing students engage with the complex health system for competence development. These students are exposed to nerve-wrecking experience in addition to their everyday personal and social challenges. Non-cognitive attributes, namely grit, resilience and mindset can influence students’ ability to overcome complexities as they become nurses resulting in academic success and well-being. Insights into the state of non-cognitive attributes among undergraduate nursing students are essential in developing tailor-made educational programmes to enhance their grit, resilience, and mindset.</div></div><div><h3>Objectives</h3><div>To describe the undergraduate nursing students’ grit, academic resilience, and mindset at a university in South Africa</div></div><div><h3>Design</h3><div>A quantitative descriptive cross-sectional design.</div></div><div><h3>Setting</h3><div>A School of Nursing at a public multi-campus university in South Africa.</div></div><div><h3>Participants</h3><div>All students (N = 315) registered for the undergraduate nursing programme were invited to participate, and 70 % (N = 221) chose to participate.</div></div><div><h3>Methods</h3><div>Data were collected using self-administered questionnaires that included a 7-item demographic survey, the 30-item Academic Resilience Scale (ARS-30) that measures affective, cognitive, and behavioural responses in an educational context, the 16-item Dweck Mindset Scale (DMI) that measures a personal belief about whether intelligence and talent are fixed or amenable to change, and the 8-item Grit-S scale measuring passion for long term goals and perseverance. The collected quantitative data were analysed statistically through the Statistical Analysis Software Version 9.4 computer programme.</div></div><div><h3>Findings</h3><div>The findings revealed that the participants have normal grit and a growth mindset, but low academic resilience.</div></div><div><h3>Conclusions</h3><div>Tailor-made educational programmes that target non-cognitive attributes must integrate interventions that are focused on enhancing academic resilience for undergraduate nursing students.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100253"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573389","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}
Pub Date : 2024-10-28DOI: 10.1016/j.ijnsa.2024.100258
Raimund M. Kovacevic , Doris A. Behrens , Walter Hyll
Background
Community health nursing was introduced in Austria in 2022. Information about nurses' activities, their alignment with established public health frameworks, and their relationship to existing care services is crucial for understanding the role's implementation and potential impact.
Objective
This study examines the activities of the first cohort of Austrian Community Health Nurses, focusing on their alignment with the Public Health Intervention Wheel and the Nursing Intervention Classification. An important aspect comes from the question, whether these new services complement or substitute existing direct care services. In this process, we also address heterogeneity across urbanization levels.
Design
Cross-sectional survey.
Setting(s)
An online survey (April to June 2023) among Community Health Nurses captured their perception of activity frequencies based on the Public Health Intervention Wheel and Nursing Intervention Classification.
Participants
130 nurses (59 %, N = 220) answered >6 (out of 33) questions, 98 nurses (45 %, N = 220) provided all required information.
Methods
The analysis used descriptive statistics, statistical tests, and hierarchical cluster analysis, employing Excel®, Stata® and R.
Results
Austrian Community Health Nurses implement many principles of the Public Health Intervention Wheel, with a focus on counselling, consultation, and health teaching. Direct care interventions (according the Nursing Intervention Classification) are rarely performed. Findings indicate that community health nurses complement rather than substitute existing direct care and home nursing services. However, unlike international practices, activities are primarily at the individual level, with limited engagement at community and systems levels.
Conclusions
Community health nursing in Austria demonstrates a public health focus and therefore complements existing care services. However, it focuses primarily at the individual level, which differs from international norms where activities span individual, community, and systems levels.
Tweetable abstract
First Austrian Community Health Nurses implement public health intervention principles mainly on individual level.
{"title":"Nursing interventions in a newly established community health nursing system: A cross sectional survey","authors":"Raimund M. Kovacevic , Doris A. Behrens , Walter Hyll","doi":"10.1016/j.ijnsa.2024.100258","DOIUrl":"10.1016/j.ijnsa.2024.100258","url":null,"abstract":"<div><h3>Background</h3><div>Community health nursing was introduced in Austria in 2022. Information about nurses' activities, their alignment with established public health frameworks, and their relationship to existing care services is crucial for understanding the role's implementation and potential impact.</div></div><div><h3>Objective</h3><div>This study examines the activities of the first cohort of Austrian Community Health Nurses, focusing on their alignment with the Public Health Intervention Wheel and the Nursing Intervention Classification. An important aspect comes from the question, whether these new services complement or substitute existing direct care services. In this process, we also address heterogeneity across urbanization levels.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting(s)</h3><div>An online survey (April to June 2023) among Community Health Nurses captured their perception of activity frequencies based on the Public Health Intervention Wheel and Nursing Intervention Classification.</div></div><div><h3>Participants</h3><div>130 nurses (59 %, <em>N</em> = 220) answered >6 (out of 33) questions, 98 nurses (45 %, <em>N</em> = 220) provided all required information.</div></div><div><h3>Methods</h3><div>The analysis used descriptive statistics, statistical tests, and hierarchical cluster analysis, employing Excel®, Stata® and R.</div></div><div><h3>Results</h3><div>Austrian Community Health Nurses implement many principles of the Public Health Intervention Wheel, with a focus on counselling, consultation, and health teaching. Direct care interventions (according the Nursing Intervention Classification) are rarely performed. Findings indicate that community health nurses complement rather than substitute existing direct care and home nursing services. However, unlike international practices, activities are primarily at the individual level, with limited engagement at community and systems levels.</div></div><div><h3>Conclusions</h3><div>Community health nursing in Austria demonstrates a public health focus and therefore complements existing care services. However, it focuses primarily at the individual level, which differs from international norms where activities span individual, community, and systems levels.</div></div><div><h3>Tweetable abstract</h3><div>First Austrian Community Health Nurses implement public health intervention principles mainly on individual level.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100258"},"PeriodicalIF":3.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554494","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}
Given the diverse roles and responsibilities expected of academic nurse educators, it is essential that they acquire relevant nursing educator competencies. Early career nursing faculty often struggle to engage in their tasks. Therefore, systematic support is crucial in developing the necessary capacities for early career nursing faculty. In organizational sociology, the positive interaction between organizational and individual resources enhances the competence of nurse educators. Psychological safety enhances organizational members' ability to cope with challenges and perform effectively. It may also foster a high sense of coherence, linked to improved job performance and competence in nursing faculty. Both psychological safety and coherence promote work engagement, further boosting nurse educator competence.
Aim
This study explored the relationships between psychological safety, sense of coherence, work engagement, and competence of nurse educators among assistant professors and assistants in nursing education.
Design
A cross-sectional survey design was used. Data were collected from 164 early career nursing faculty using an anonymous self-administered web-based questionnaire. The study measured the psychological safety, sense of coherence, work engagement, and competence of academic nurse educators. The mediating effects of a sense of coherence and work engagement on the relationship between psychological safety and competency were assessed using the PROCESS macro model. Bootstrapping with 5,000 re-samples was used to determine the significance of the mediating effects.
Setting
The study was conducted from October 1 to December 31, 2022, at nursing universities in Japan.
Results
Positive correlations were identified among psychological safety, sense of coherence, work engagement, and the competence of nurse educator. The sense of coherence and work engagement indirectly mediated the relationship between psychological safety and the competence of nurse educator. A serial multiple mediation model demonstrated that psychological safety indirectly influenced the competence of nurse educator through a sense of coherence and work engagement.
Conclusions
Supportive organizational environments foster a sense of coherence, enabling effective resource utilization and the competence of nurse educator development. While structured intervention programs such as faculty development are vital, establishing supportive systems that nurture adaptable qualities and use various resources is also essential. A positive work environment can create a cycle of increasing competency through positive attitudes toward work.
{"title":"Psychological safety in enhancing the competence of nurse educators among early career nursing faculty in Japan: A cross-sectional study","authors":"Miho Satoh , Naoko Sato , Noriko Tamura , Akiko Fujimura","doi":"10.1016/j.ijnsa.2024.100254","DOIUrl":"10.1016/j.ijnsa.2024.100254","url":null,"abstract":"<div><h3>Background</h3><div>Given the diverse roles and responsibilities expected of academic nurse educators, it is essential that they acquire relevant nursing educator competencies. Early career nursing faculty often struggle to engage in their tasks. Therefore, systematic support is crucial in developing the necessary capacities for early career nursing faculty. In organizational sociology, the positive interaction between organizational and individual resources enhances the competence of nurse educators. Psychological safety enhances organizational members' ability to cope with challenges and perform effectively. It may also foster a high sense of coherence, linked to improved job performance and competence in nursing faculty. Both psychological safety and coherence promote work engagement, further boosting nurse educator competence.</div></div><div><h3>Aim</h3><div>This study explored the relationships between psychological safety, sense of coherence, work engagement, and competence of nurse educators among assistant professors and assistants in nursing education.</div></div><div><h3>Design</h3><div>A cross-sectional survey design was used. Data were collected from 164 early career nursing faculty using an anonymous self-administered web-based questionnaire. The study measured the psychological safety, sense of coherence, work engagement, and competence of academic nurse educators. The mediating effects of a sense of coherence and work engagement on the relationship between psychological safety and competency were assessed using the PROCESS macro model. Bootstrapping with 5,000 re-samples was used to determine the significance of the mediating effects.</div></div><div><h3>Setting</h3><div>The study was conducted from October 1 to December 31, 2022, at nursing universities in Japan.</div></div><div><h3>Results</h3><div>Positive correlations were identified among psychological safety, sense of coherence, work engagement, and the competence of nurse educator. The sense of coherence and work engagement indirectly mediated the relationship between psychological safety and the competence of nurse educator. A serial multiple mediation model demonstrated that psychological safety indirectly influenced the competence of nurse educator through a sense of coherence and work engagement.</div></div><div><h3>Conclusions</h3><div>Supportive organizational environments foster a sense of coherence, enabling effective resource utilization and the competence of nurse educator development. While structured intervention programs such as faculty development are vital, establishing supportive systems that nurture adaptable qualities and use various resources is also essential. A positive work environment can create a cycle of increasing competency through positive attitudes toward work.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100254"},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560791","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}
Pub Date : 2024-10-24DOI: 10.1016/j.ijnsa.2024.100251
Thora Gunnlaugsdóttir , Rannveig J. Jónasdóttir , Kristín Björnsdóttir , Marianne Elisabeth Klinke
<div><h3>Background</h3><div>Families are an important part of the intensive care unit (ICU) team. Being a family member in the ICU can be distressing due to interacting factors, such as the critical condition of the patient, the responsibility of acting as the patient's advocate, and partaking in decision-making related to treatment. Nurses need to be aware of the family's well-being throughout the patient's ICU stay.</div></div><div><h3>Objective</h3><div>To synthesize reviews of family members' experiences and needs during patients' ICU admission and develop recommendations to support nurses in strengthening their relationships with families.</div></div><div><h3>Design</h3><div>Systematic review of qualitative and mixed method reviews.</div></div><div><h3>Data sources</h3><div>Extensive searches without time limits identified systematic reviews published until June 27, 2024 in CINAHL, PubMed, Scopus, and Web of Science. Reviews were eligible if they provided knowledge required to inform high-quality on-site family care during the patient's ICU admission.</div></div><div><h3>Review methods</h3><div>Quality appraisal adhered to the Joanna Briggs Institute checklist for systematic reviews and research syntheses. Themes were generated by integrating review results and narratively summarizing the main contents. Finally, findings were translated into clinical practice recommendations by using the four-component GRADE-CERQual assessment (low to high recommendation grades). Recommendations were backtracked to primary research studies for validation. All recommendations were critically reflected upon with an expert panel of ICU nurses.</div></div><div><h3>Results</h3><div>The nine included reviews were built on 124 original studies published between 1995 and 2021. One central theme, “Emotional limbo and extreme moments”, mirrored the core of families' experiences characterized by waiting time, i.e., for the patient to get better or worse, and overwhelming emotions and confusion brought about by the patient's critical illness. Three sub-themes reflected actions to counterbalance emotional challenges: a) Responding to family members' existential needs, b) Establishing optimal grounds for reciprocal communication, and c) Enhancing a humanizing approach and atmosphere in the ICU. The meta-synthesis resulted in 11 aggregated recommendations. The findings highlighted that nurses should proactively address emotional issues to help preserve families' ability to keep going, allow families to be present and function as a part of the team, and inform families of the patient's situation and how they can practically help.</div></div><div><h3>Conclusions</h3><div>Nurses should use multiple adjustable approaches to alleviate family's burden during an ICU stay. Findings help nurses to prioritize care and make physical and emotional space for family caregivers. Results emphasize the need to facilitate the agency of family caregivers and reinforce their strengths throug
{"title":"How can family members of patients in the intensive care unit be supported? A systematic review of qualitative reviews, meta-synthesis, and novel recommendations for nursing care","authors":"Thora Gunnlaugsdóttir , Rannveig J. Jónasdóttir , Kristín Björnsdóttir , Marianne Elisabeth Klinke","doi":"10.1016/j.ijnsa.2024.100251","DOIUrl":"10.1016/j.ijnsa.2024.100251","url":null,"abstract":"<div><h3>Background</h3><div>Families are an important part of the intensive care unit (ICU) team. Being a family member in the ICU can be distressing due to interacting factors, such as the critical condition of the patient, the responsibility of acting as the patient's advocate, and partaking in decision-making related to treatment. Nurses need to be aware of the family's well-being throughout the patient's ICU stay.</div></div><div><h3>Objective</h3><div>To synthesize reviews of family members' experiences and needs during patients' ICU admission and develop recommendations to support nurses in strengthening their relationships with families.</div></div><div><h3>Design</h3><div>Systematic review of qualitative and mixed method reviews.</div></div><div><h3>Data sources</h3><div>Extensive searches without time limits identified systematic reviews published until June 27, 2024 in CINAHL, PubMed, Scopus, and Web of Science. Reviews were eligible if they provided knowledge required to inform high-quality on-site family care during the patient's ICU admission.</div></div><div><h3>Review methods</h3><div>Quality appraisal adhered to the Joanna Briggs Institute checklist for systematic reviews and research syntheses. Themes were generated by integrating review results and narratively summarizing the main contents. Finally, findings were translated into clinical practice recommendations by using the four-component GRADE-CERQual assessment (low to high recommendation grades). Recommendations were backtracked to primary research studies for validation. All recommendations were critically reflected upon with an expert panel of ICU nurses.</div></div><div><h3>Results</h3><div>The nine included reviews were built on 124 original studies published between 1995 and 2021. One central theme, “Emotional limbo and extreme moments”, mirrored the core of families' experiences characterized by waiting time, i.e., for the patient to get better or worse, and overwhelming emotions and confusion brought about by the patient's critical illness. Three sub-themes reflected actions to counterbalance emotional challenges: a) Responding to family members' existential needs, b) Establishing optimal grounds for reciprocal communication, and c) Enhancing a humanizing approach and atmosphere in the ICU. The meta-synthesis resulted in 11 aggregated recommendations. The findings highlighted that nurses should proactively address emotional issues to help preserve families' ability to keep going, allow families to be present and function as a part of the team, and inform families of the patient's situation and how they can practically help.</div></div><div><h3>Conclusions</h3><div>Nurses should use multiple adjustable approaches to alleviate family's burden during an ICU stay. Findings help nurses to prioritize care and make physical and emotional space for family caregivers. Results emphasize the need to facilitate the agency of family caregivers and reinforce their strengths throug","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100251"},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573390","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}