International Journal of Nursing Studies Advances最新文献

{"title":"Realigning identity: Nurse executives' experiences within a new socio-professional group – A classic grounded theory study","authors":"Cora Lunn ,&nbsp;Claire O’ Donnell ,&nbsp;Sarah MacCurtain ,&nbsp;Alice Coffey","doi":"10.1016/j.ijnsa.2025.100367","DOIUrl":"10.1016/j.ijnsa.2025.100367","url":null,"abstract":"<div><h3>Background</h3><div>Nurse executives play a crucial role in adapting to the evolving needs of healthcare communities. Existing research demonstrates the positive impact of nursing leadership practices on workforce retention, job satisfaction and overall well-being. The complexities surrounding role transitioning for nurse executives remains under explored.</div></div><div><h3>Objective</h3><div>This study aims to deepen the understanding of how nurse executive leaders navigate the intricate process of role transitioning, providing insights into their experiences and challenges.</div></div><div><h3>Design</h3><div>This study was conducted using Glaser's classic grounded theory.</div></div><div><h3>Setting</h3><div>This study was carried out in acute hospital settings at seven different sites in the Republic of Ireland.</div></div><div><h3>Participants</h3><div>Participants were 12 nurse executives who were working in the Republic of Ireland, with additional reflective diary notes gathered from conversations with six international nurse executives.</div></div><div><h3>Methods</h3><div>Data were collected through unstructured interviews conducted between January 2020 and September 2022. The process of data collection and analysis occurred simultaneously, with the data being analysed based on the principles of classic grounded theory.</div></div><div><h3>Results</h3><div>This study introduces the theory of Identity Realigning, which describes the leadership development of nurse executives through three stages: identity earning, role transitioning, and self-integrating. Identity Earning involves forming a new identity within a new socio-professional group. Role transitioning is the psychological process of moving from one role to another, encompassing various stages. Self-Integrating refers to the extent of assimilation into the new role and socio-professional group. Factors such as organisational design and resources were identified as contextual conditions that can either facilitate or impede success for nurse executives.</div></div><div><h3>Conclusion</h3><div>The theory of Identity Realigning provides significant insights for educators, leaders, and policymakers by explaining the intricate process of role transitioning for nurse executives. It establishes a clear link between shifts in professional identity and the processes of role transitioning and integration. This connection underscores the critical importance of developing executive skills and highlights the necessity for tailored professional development strategies for this cohort.</div><div>Identity realigning theory; Nurse executive; Identity earning; Role transition; Self-integration</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100367"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument for individuals with heart failure","authors":"Daniele Cristina Bosco Aprile ,&nbsp;Karina Aparecida Lopes da Costa ,&nbsp;Renata Eloah de Lucena Ferretti-Rebustini ,&nbsp;Vinicius Batista Santos ,&nbsp;Mirian Ueda Yamaguchi ,&nbsp;Camila Takáo Lopes","doi":"10.1016/j.ijnsa.2025.100391","DOIUrl":"10.1016/j.ijnsa.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.</div></div><div><h3>Objective</h3><div>To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.</div></div><div><h3>Design</h3><div>A psychometric study analyzing internal structure validity and reliability.</div></div><div><h3>Settings</h3><div>The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.</div></div><div><h3>Participants</h3><div>Outpatients with heart failure who used the internet.</div></div><div><h3>Methods</h3><div>The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett’s test should have <em>p</em> &lt; 0.05. Target explained variance was approximately 60 %, with factor loadings &gt;0.3 and communalities &gt;0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05–0.08. Reliability was measured using ordinal alpha and McDonald’s omega (&gt;0.9).</div></div><div><h3>Results</h3><div>A unidimensional model emerged. Five items were removed due to factor loadings &lt;0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy &gt;0.75, explained variance = 59 %, factor loadings 0.53–0.86, and communalities 0.28–0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.</div></div><div><h3>Conclusions</h3><div>The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100391"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in shift patterns due to the COVID-19 pandemic: a prospective cohort study of the intensive care nursing staff in hospitals in Stockholm","authors":"Emma Brulin ,&nbsp;Emelie Thunqvist ,&nbsp;Per Gustavsson ,&nbsp;Carolina Bigert ,&nbsp;Tove Nilsson ,&nbsp;Seth Addo ,&nbsp;Abid Lashari","doi":"10.1016/j.ijnsa.2025.100408","DOIUrl":"10.1016/j.ijnsa.2025.100408","url":null,"abstract":"<div><h3>Background</h3><div>It is well known that the COVID-19 pandemic placed pressure on healthcare, leading to increased job demands for intensive care unit (ICU) nursing staff and possibly also longer working hours. Potential changes in shift patterns for ICU nursing staff are important to study as numerous studies collectively indicate that certain shift patterns, especially night shifts, increase the risk of developing various diseases, such as diabetes, cardiovascular diseases, and preterm birth among nursing staff.</div></div><div><h3>Objective</h3><div>To inform crisis planning, the aim was to investigate potential changes in shift patterns among ICU nursing staff working in public hospitals in Stockholm during the pandemic (March 1, 2020-May 31, 2022). Specifically, we investigated changes in the number of day, evening, night, and long shifts; quick returns from evening and night shifts; and mean monthly work hours corresponding to each peak of COVID-19.</div></div><div><h3>Design</h3><div>A prospective cohort study</div></div><div><h3>Setting</h3><div>ICU in four public hospitals in Stockholm</div></div><div><h3>Participants</h3><div>Nursing staff, i.e., nurses, specialist nurses, and assistant nurses working in the ICU (<em>n</em> = 1208) between 1 January 2017 and 31 May 2022.</div></div><div><h3>Method</h3><div>Data were obtained from a computerised administrative employee register in Region Stockholm, which includes detailed information on hours worked. Interrupted time series regressions, modelled with three interruptions, one for each peak of COVID-19 patient influx, were used to investigate whether COVID-19 had an impact on shift patterns.</div></div><div><h3>Results</h3><div>Results showed that the first peak of COVID-19 led to an immediate increase in the number of night shifts by 673.15 shifts (95 % confidence interval (CI): 487.25–859.04), quick returns from night shifts by 443.44 (CI 265.03–621.85) and ≥3 consecutive night shifts by 201.51 (CI 116.57–286.46). Following the first peak, both the number of night shifts and quick returns from night shifts declined. At peak two, the number of night shifts and quick return from night shifts increased by 450.01 (CI 285.85–614.18) and 397.45 (CI 220.43–574.46), respectively. At the third peak, there was an immediate decrease in the number of working days in a row. However, from the second month, a statistically significant upward trend was observed in both the number of night shifts and quick return from night shifts.</div></div><div><h3>Conclusions</h3><div>During the COVID-19 pandemic, (ICU nursing staff experienced an increase in both the number of night shifts and quick returns from night shifts. These types of shifts may lead to adverse health effects and should be minimised. Healthcare organisations should prepare for shift schedules during times of strain to prevent an increase in hazardous shifts.</div></div><div><h3>Study registration</h3><div>Not registered</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100408"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses’ challenges and strategies for safeguarding care quality and safety: A qualitative study on situated resilience","authors":"Mariëlle Van Mersbergen-de Bruin ,&nbsp;Catharina Van Oostveen ,&nbsp;Anne Marie Weggelaar-Jansen","doi":"10.1016/j.ijnsa.2025.100365","DOIUrl":"10.1016/j.ijnsa.2025.100365","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Most healthcare delivery succeeds in safeguarding high-quality care and safety. This is largely due to the adaptive capacity and situated resilience work of healthcare professionals as nurses who keeps things on track&lt;em&gt;.&lt;/em&gt; However, much of their situated resilience work in complex everyday practice remains hidden or is done behind the scenes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To explore situated resilience in everyday nursing practice and shed light on the often invisible efforts of nurses as they manage immediate challenges and navigate complex processes to ensure care quality and safety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A qualitative design.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting(s)&lt;/h3&gt;&lt;div&gt;The surgical and an ambulatory care team of an urban, 600-bed Dutch teaching hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Nurses (&lt;em&gt;N&lt;/em&gt; = 37), nurse practitioners (&lt;em&gt;N&lt;/em&gt; = 2), managers (&lt;em&gt;N&lt;/em&gt; = 5),&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data were collected through 80 hours of non-participant non-participant observations, three semi-structured interviews with nurses and one monodisciplinary (i.e. nurses) focus group. Thereafter, two multidisciplinary focus groups were conducted. Data were analysed using thematic analysis. The research protocol was approved by the ethical review board of Erasmus University Rotterdam under number ETH2122-0079.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Nurses are dedicated providing the high-quality care that ensures patient safety. In daily practice they face challenges that require them to make changes to system standards. We identified three key triggers for change and emerging strategies to handle these triggers: 1) when standard risk assessment does not fit nursing practice, nurses a) seem to comply with the system, b) adopt an investigative, attentive approach. 2) when protocols and guidelines do not align with daily practices, nurses a) proactively identify potential and actual changes, b) find the \"golden mean\" through relational negotiation and patient advocacy. 3) when nurses and other healthcare professionals hold differing values on care quality and safety, nurses a) find allies, and b) applied various indirect means.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our study reveals that situated resilience in nursing is not only a television series of actions to fix misalignments or to deal with unexpected change. It unfolds as a relational process in which nurses adapt their behaviour intuitively according to a patient’s unique situation, values, and interests. By balancing the individual patient’s needs and values with organizational systemic demands nurses exhibit situated resilience. By recognizing and supporting situated resilience practices, organizations not only enhance the quality of daily practice but also structurally strengthen their adaptive and resilient capacities. Further research into the role of nurses in system-level resilience and the impact of experience o","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100365"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do job resources buffer the harmful effects of job demands on burnout complaints? A 1-year cohort study of Swedish healthcare professionals","authors":"Britta E Gynning ,&nbsp;Elin Karlsson ,&nbsp;Kevin Teoh ,&nbsp;Per Gustavsson ,&nbsp;Filip Christiansen ,&nbsp;Emma Brulin","doi":"10.1016/j.ijnsa.2025.100397","DOIUrl":"10.1016/j.ijnsa.2025.100397","url":null,"abstract":"<div><h3>Background</h3><div>The job demands-resources model posits that job resources buffer the effects of job demands on subsequent strain. However, empirical support for this is inconclusive, with some studies suggesting this may be context- or even profession-specific.</div></div><div><h3>Objective</h3><div>To investigate the buffering effect in the job demands-resources model within the Swedish healthcare sector and the impact of professional differences on this effect</div></div><div><h3>Method</h3><div>Data were drawn from a 1-year cohort called the <em>Longitudinal occupational health survey for healthcare in Sweden,</em> utilising the 2022 and 2023 waves. The study sample consisted of Swedish healthcare professionals who at baseline were 69 years or younger, who participated in both survey waves. In total, the study included 4132 healthcare professionals (1649 physicians, 1631 registered nurses, and 852 nurse assistants). Descriptive statistics and ordinary least squares regression moderation analysis were carried out.</div></div><div><h3>Results</h3><div>The experience of control at work buffered the impact of several job demands, including quantitative demands (Beta coefficients [<em>B</em>] =−0.034, 95 % confidence interval [CI] [−0.05; −0.01]), illegitimate work tasks (<em>B</em>=−0.018, 95 % CI [−0.04;−0.01]), effort-reward imbalance (<em>B</em> = −0.050, 95 % CI [−0.08; −0.01]), and work-life Interference (<em>B</em> = −0.023, 95 % CI [−0.04; −0.004]) on subsequent burnout complaints. Collegial support buffered the effect of emotional demands (<em>B</em> = −0.025, 95 % CI [−0.04; −0.01]). Physicians reported a greater buffering effect from control compared with nurse assistants on the effect of illegitimate work tasks (<em>B</em> = 0.084, 95 % CI [0.01;0.16]) and effort reward imbalance (<em>B</em> = 0.120, 95 % CI [0.02;0.22]) towards subsequent burnout complaints.</div></div><div><h3>Conclusions</h3><div>We have contributed to the application of the job demands-resources model by emphasising the critical role of the type of profession in the buffering effect of resources. We have underlined the importance of profession-specific job demands and resources in understanding burnout among Swedish healthcare professionals and in other settings.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100397"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the ability of the interRAI communication collaborative action plan to identify individuals with sensory challenges: A retrospective cohort study","authors":"Nicole Williams ,&nbsp;Walter Wittich ,&nbsp;M.Kathleen Pichora-Fuller ,&nbsp;Joseph B. Orange ,&nbsp;Dawn M. Guthrie","doi":"10.1016/j.ijnsa.2025.100424","DOIUrl":"10.1016/j.ijnsa.2025.100424","url":null,"abstract":"<div><h3>Background</h3><div>The current study evaluated the performance of the interRAI communication collaborative action plan (CAP) to flag individuals with sensory impairments who could benefit from intervention. Investigators also examined how the CAP can help facilitate client-centered care planning and service delivery by exploring three unique case studies.</div></div><div><h3>Method</h3><div>This retrospective cohort study utilized secondary data collected using the Resident Assessment Instrument for Home Care (RAI-HC) across Canada. The sample included individuals aged 65 years or older who had two RAI-HC assessments completed between 2008 and 2020 (n=508,856). At time 1, individuals were categorized into three mutually exclusive groups based on their CAP triggering level: not triggered, triggered to facilitate improvement, or triggered to prevent decline. The three groups were compared across demographic characteristics, sensory impairments, cognitive challenges, and disease diagnoses. Transitions between triggering levels from time 1 and time 2 were analyzed using Sankey diagrams. Three case studies were examined to identify the reasons why someone may no longer trigger on the CAP at time 2.</div></div><div><h3>Results</h3><div>The median time between an individual’s intake and most recent assessment was 21 months (standard deviation=24.7 months). The majority of individuals did not trigger on the CAP at time 1 (77.7 %; n=395,309), while 9.5 % (n=48,263) triggered to facilitate improvement and 12.5 % (n=65,284) triggered to prevent decline. For each of the sensory impairments, the majority of individuals were more likely to fall into the triggered to facilitate improvement group.</div></div><div><h3>Conclusions</h3><div>The communication CAP was robust in flagging individuals with sensory impairments as these individuals are more likely to fall into the triggered to facilitate improvement group. The three case studies highlight the importance of assessing all aspects of communication (e.g., cognitive, and sensory challenges, receptive and expressive communication), as they are all necessary components when considering decision-support tools and next steps.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100424"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a decision-making support framework on nurse burnout and quality of end-of-life care: A before-and-after study in intensive care units","authors":"Yoshihiko Takahashi ,&nbsp;Shu Utsumi ,&nbsp;Kenji Fujizuka ,&nbsp;Hiroyuki Suzuki ,&nbsp;Yumiko Takadera ,&nbsp;Mitsunobu Nakamura","doi":"10.1016/j.ijnsa.2025.100438","DOIUrl":"10.1016/j.ijnsa.2025.100438","url":null,"abstract":"<div><h3>Background</h3><div>The high incidence of burnout syndrome among intensive care unit nurses highlights the need for effective prevention strategies. Poor decision-making in end-of-life care contributes to nurse burnout syndrome through a decline in the quality of end-of-life care; however, the effects of enhancing decision-making support remain unclear.</div></div><div><h3>Objectives</h3><div>To examine the relationship between enhanced decision-making support in end-of-life care, nurse burnout syndrome, and the quality of end-of-life care.</div></div><div><h3>Methods</h3><div>A before-and-after intervention study was conducted in a 24-bed mixed intensive care unit at a tertiary emergency medical center in Japan. In September 2022, a decision-making support framework, developed through an international Delphi meeting in 2020, was introduced. Pre- and post-intervention questionnaires (August 2022, 2023) assessed nurse burnout syndrome using the Maslach Burnout Inventory and nurses' evaluation of end-of-life care using the Quality of Dying and Death scale. Univariate analysis used <em>t</em>-tests or Mann–Whitney U tests for continuous variables and chi-squared or Fisher’s exact tests for categorical variables. Multivariate analysis used multiple regression, adjusting for nurses' age, sex, and intensive care unit experience.</div></div><div><h3>Results</h3><div>Among the 70 nurses, 51 (73%) completed pre- and post-intervention surveys. While the Maslach Burnout Inventory showed no statistically significant change (15 vs. 11, p = 0.177), the subscales of emotional exhaustion (15 vs. 14, p = 0.089) and depersonalization (12 vs. 10, p = 0.087) showed trends toward improvement. No significant subgroup differences were observed based on sex, age, or intensive care unit experience. However, the Quality of Dying and Death scale showed a significant improvement (33 vs. 27, p = 0.002), which remained significant in the multivariate analysis (β = 5.015, p = 0.02). Subgroup analysis revealed more pronounced improvements in the Quality of Dying and Death scale among female nurses, those under 30, and nurses with less than five years of intensive care unit experience.</div></div><div><h3>Conclusions</h3><div>The decision-making support framework was associated with a non-significant reduction in burnout syndrome but a significant improvement in nurses' evaluation of end-of-life care. This suggests that factors contributing to burnout syndrome in end-of-life care may have improved. Further large-scale, multicenter studies are required to determine whether this intervention ultimately contributes to mitigating burnout syndrome.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100438"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A balancing act: Primary care midwives screening for fetal growth restriction- a focus group study","authors":"Mariëlle van Roekel ,&nbsp;Dominique Kramer ,&nbsp;Ank de Jonge ,&nbsp;Arie Franx ,&nbsp;Jens Henrichs ,&nbsp;Corine J. Verhoeven","doi":"10.1016/j.ijnsa.2025.100439","DOIUrl":"10.1016/j.ijnsa.2025.100439","url":null,"abstract":"<div><h3>Background</h3><div>Fetal growth restriction in low-risk pregnancies often remains undetected, despite its association with perinatal morbidity and mortality. While technical improvements in screening have been widely studied, little is known about how autonomous midwives in primary care settings navigate screening for fetal growth restriction in daily practice.</div></div><div><h3>Aim</h3><div>To better understand how midwives in low-risk settings navigate the screening process for fetal growth restriction, and to identify opportunities for improvement.</div></div><div><h3>Methods</h3><div>An interpretative qualitative study was conducted based on five online focus groups with 21 participants, including midwives and senior midwifery students across the Netherlands. Reflexive thematic analysis was carried out by a multidisciplinary team.</div></div><div><h3>Findings</h3><div>Midwives described screening for fetal growth restriction as a balancing act shaped by diagnostic uncertainty, ambiguous guidelines, interprofessional mistrust and moral responsibility. Five themes were identified: managing screening uncertainty, adapting to women’s care needs, coping with a lack of trust in collaboration with secondary care, balancing tradition and innovation within professional identity, and maintaining professional confidence.</div></div><div><h3>Conclusion</h3><div>Screening for fetal growth restriction is not only a technical act but also a relational and value-laden practice. Midwives’ practices reflect a continuous negotiation between societal reliance on technology, the limitations of current tools and guidelines, interprofessional tensions, and the relational and moral responsibilities of care. Improving screening therefore requires more than technical solutions: it calls for clear guidelines, respectful collaboration, and supportive structures that enable midwives to practice with confidence and trust.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100439"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a behaviour change intervention to increase care home staff influenza vaccination uptake","authors":"Amrish Patel ,&nbsp;Sion Scott ,&nbsp;Alys Wyn Griffiths ,&nbsp;David Wright","doi":"10.1016/j.ijnsa.2025.100387","DOIUrl":"10.1016/j.ijnsa.2025.100387","url":null,"abstract":"<div><h3>Background</h3><div>To protect care home residents the World Health Organisation recommends that 75 % of care home staff are vaccinated for influenza. In the UK this value is less than 30 %. Previously reported interventions have not been informed by theory and usually only addressed one or two known barriers to uptake. Using behavioural science, we worked with care home staff to develop an intervention which addressed all barriers at both individual and care home level.</div></div><div><h3>Methods</h3><div>We developed an online questionnaire, derived from the literature, asking staff about barriers and facilitators of flu vaccination. These were prioritised (based on frequency and distinctiveness), then mapped to the Theoretical Domains Framework. Relevant behaviour change techniques were identified. Care home staff selected and designed behaviour change techniques according to affordability, practicability, effectiveness, acceptability, safety and equity (APEASE) via an online questionnaire and workshop.</div></div><div><h3>Results</h3><div>The prioritised barriers were: lack of time to get vaccinated; insufficient vaccine supplies; vaccination costs; a lack of peers getting vaccinated and beliefs that staff do not need vaccination and that it is ineffective. Six behaviour change techniques were selected and developed into a multi-component intervention: (behaviour change technique 1, Restructure of the physical environment) Free, in care home vaccination clinics for staff; (behaviour change techniques 2–4, Information about health consequences, Salience of consequences and information about others’ approval) information campaign featuring care home staff highlighting non-vaccination risks, (behaviour change techniques 5–6, Information about health consequences and Credible source) information campaign featuring primary care doctor challenging misconceptions.</div></div><div><h3>Conclusions</h3><div>We developed the first theory and evidence-based intervention specifically to facilitate care home staff flu vaccination uptake. Feasibility and acceptability testing of the intervention followed by definitive trial to assess efficacy in care homes is necessary to inform policy decision-making.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100387"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Function focused care in hospital among nurses and patients from geriatric and neurology wards: A mixed method process evaluation","authors":"Selma Kok ,&nbsp;Elke G.E. Mathijssen ,&nbsp;Lisette Schoonhoven ,&nbsp;Carolien Verstraten ,&nbsp;Silke F. Metzelthin ,&nbsp;Nienke Bleijenberg ,&nbsp;Janneke M. de Man-van Ginkel","doi":"10.1016/j.ijnsa.2025.100401","DOIUrl":"10.1016/j.ijnsa.2025.100401","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Function Focused Care is a promising approach stimulating physical activity of patients admitted to hospital. In studying the effectiveness, patients receiving Function Focused Care in Hospital were admitted 3.3 days shorter than patients receiving usual care. However, no differences were found in functional status. Process evaluations alongside an effect studies create an understanding implementation fidelity, of mechanisms of impact, contextual factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;to gain insight into the experiences of nurses and patients, and to give insight into implementation fidelity, mechanisms of impact, and contextual factors while implementing Function Focused Care in Hospital on geriatric and neurologic hospital wards.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;convergent parallel mixed-methods study, alongside a stepped wedge clinical trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting(s)&lt;/h3&gt;&lt;div&gt;four hospital wards of two Dutch hospitals&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;nurses, nursing students and care assistants (&lt;em&gt;n&lt;/em&gt; = 123), and patients (&lt;em&gt;n&lt;/em&gt; = 24).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data for the process evaluation was collected before the implementation of Function Focused Care in Hospital (T0), directly after implementation (T1), and four months after implementation (T2). Data was obtained from patient interviews, focus group interviews with nurses, questionnaires, observations, screening of electronic patients’ records, and logbook notes. For the qualitative data thematic analyses and for quantitative data descriptive statistics were used. The results of these analyses were synthesized into overarching findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Findings from the observations showed the care delivery according to the Function Focused Care in Hospital principles increased from 60 % in the control condition to 75 % in the intervention condition. Moreover, nurses stated that patients were only assisted when needed and nurses often asked about their abilities to perform ADL and then encouraged them to do as much as they could themselves. Nevertheless, patients don’t recognize Function Focused Care in Hospital. The results suggest that the implementation fidelity was influenced by different working mechanisms and contextual factors which led to different experiences from nurses, coaches and patients in promoting patient engagement and functional independence. The synthesized findings show that lessons can be learned with regards to continuity of the care provided in the interprofessional collaboration, the challenge in providing personalized care given the current time constraints, the phenomenon of being unconscious incompetent observed in the nurses, and difficulties in demonstrating nursing leadership and autonomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Implementation of Function Focused Care in Hospital improved care delivery but highlighted challenges in personalized care, interpro","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100401"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}