International Journal of Nursing Studies Advances最新文献

{"title":"Conceptualizing end-of-life communication by nursing staff as part of advance care planning with older people: A multiple discipline focus group study","authors":"Fran B.A.L. Peerboom ,&nbsp;Jolanda H.H.M. Friesen-Storms ,&nbsp;Jenny T. van der Steen ,&nbsp;Daisy J.A. Janssen ,&nbsp;Judith M.M. Meijers","doi":"10.1016/j.ijnsa.2025.100436","DOIUrl":"10.1016/j.ijnsa.2025.100436","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the fundamentals of end-of-life communication by nursing staff as part of advance care planning with older people and their family caregivers can enhance nurse education, research, and practice in end-of-life communication. We developed a preliminary theoretical framework based on previous studies, incorporating literature and perspectives from nursing staff, older people, and family caregivers. Reflection and discussion from these groups— as well as from physicians and spiritual caregivers with whom nursing staff most often collaborate in advance care planning—should be included to ensure accuracy and enrich the framework.</div></div><div><h3>Objective</h3><div>To enrich and provide a multiple discipline perspective on a preliminary theoretical framework for end-of-life communication by nursing staff as part of advance care planning with older people.</div></div><div><h3>Methods</h3><div>Five semi-structured focus group interviews were conducted. Four focus groups were discipline-specific, and one included various disciplines. Data were analyzed using framework analysis; the five overarching themes and twenty fundamentals from the preliminary theoretical framework served as the coding structure.</div></div><div><h3>Results</h3><div>Ten nursing staff members, eight physicians, seven spiritual caregivers, and eight patient-family caregiver representatives participated. The interview results enriched the framework and understanding of end-of-life communication. Participants emphasized the importance of prioritizing mutual trust over a long-term relationship, distinguishing between feeling able and being able to talk about the end of life, not having an intended outcome for the conversation other than seeking connection, and prioritizing silence over speaking to ensure that older people and family caregivers feel seen and heard.</div></div><div><h3>Conclusion</h3><div>Nursing staff, typically very proactive professionals, may need to step back, reflect, remain silent, and sit down to connect with older people and family caregivers. The revised theoretical framework can help nursing staff become aware of, learn from, prepare for, engage in, and evaluate person-centered end-of-life communication that respects the values, needs, and preferences of the older person, their family caregivers, and themselves.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100436"},"PeriodicalIF":3.1,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424321","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":"The quality and applicability of clinical practice guidelines for falls prevention, assessment and management across the lifespan: A systematic review","authors":"Amber Harnett ,&nbsp;Lyndsay Howitt ,&nbsp;Vithusa Kumarasamy ,&nbsp;Christine Buchanan ,&nbsp;Amy Burt ,&nbsp;Nafsin Nizum ,&nbsp;Shanoja Naik","doi":"10.1016/j.ijnsa.2025.100442","DOIUrl":"10.1016/j.ijnsa.2025.100442","url":null,"abstract":"<div><h3>Background</h3><div>The burden of falls across the lifespan is substantial. Given the variety of clinical practice guidelines available for falls management, it is useful to understand the quality and clinical applicability of guidelines and their recommendations.</div></div><div><h3>Objective</h3><div>To assess the quality and applicability of clinical practice guidelines for falls prevention, assessment and management across the lifespan.</div></div><div><h3>Design</h3><div>Systematic review, reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</div></div><div><h3>Data Sources</h3><div>CINAHL, Cochrane, Embase, MEDLINE, PsycINFO and grey literature databases were searched from January 2016 to April 2025.</div></div><div><h3>Methods</h3><div>Two investigators assessed the methodological quality of the guidelines and recommendations based on the eligibility criteria established a priori. Scaled domain scores were calculated for AGREE II and AGREE-REX.</div></div><div><h3>Results</h3><div>Eleven guidelines met the eligibility criteria and were included for analysis. Most provided recommendations for older adults with only two guidelines focused on adults. AGREE II scores ranged from 32 % to 83 %, while AGREE-REX scores ranged from 39 % to 56 %. Three guidelines were of high quality (≥70 %): (1) 2017 Registered Nurses’ Association of Ontario, (2) 2025 National Institute for Health and Care Excellence, and (3) 2022 World Falls Guideline.</div></div><div><h3>Conclusion</h3><div>This systematic review identified gaps in evidence-based guidelines for falls prevention, particularly for individuals under 65. Variations in guideline quality suggest the need for refined development processes, emphasizing stakeholder involvement and applicability. Despite limitations in the current evidence, this review offers a foundation for future guideline development, highlighting the importance of developing inclusive, evidence-based guidelines to address falls for children and adults under the age of 65.</div></div><div><h3>Registration</h3><div>The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration CRD42023446557).</div></div><div><h3>Tweetable Abstract</h3><div>Gaps in fall prevention, assessment, and management guidelines emphasize the need for evidence-based recommendations for children and adults under the age of 65.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100442"},"PeriodicalIF":3.1,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424324","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":"2025-10-23","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":"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":"2025-10-22","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":"The mediating role of caregiver guilt in the relationship between stroke patients’ functional status and caregiver burden: A correlational study","authors":"Le Zhou ,&nbsp;Yaofeng Zhu ,&nbsp;Shuo Liu ,&nbsp;Lisha Tang ,&nbsp;Wenya He ,&nbsp;Huihong Zhong ,&nbsp;Min Tian ,&nbsp;Ru Tian ,&nbsp;Ping Li","doi":"10.1016/j.ijnsa.2025.100437","DOIUrl":"10.1016/j.ijnsa.2025.100437","url":null,"abstract":"<div><h3>Background</h3><div>Stroke, a leading cause of disability, significantly burdens caregivers. Increased patient dependency correlates with higher caregiver burden, potentially exacerbated by guilt. We examined the interplay between patient self-care, caregiver guilt, and burden to guide intervention strategies.</div></div><div><h3>Objective</h3><div>To investigate the mediating role of caregiver guilt in the relationship between activities of daily living and caregiver burden in stroke patients.</div></div><div><h3>Design</h3><div>Cross-sectional descriptive study.</div></div><div><h3>Methods</h3><div>From July 2024 to February 2025, 312 pairs of stroke patients and caregivers were recruited from three medical centers in the Wuling Mountain region in China. Data collection utilized questionnaires, including the Barthel Index for Activities of Daily Living (Chinese adaptation), the Caregiver Guilt Scale (Chinese version), and the Zarit Caregiver Burden Scale.</div></div><div><h3>Results</h3><div>Activities of daily living scores negatively correlated with caregiver guilt and burden (<em>p</em>&lt;0.05). Caregiver guilt positively correlated with burden and partially mediated the relationship between the ability to perform activities of daily living and caregiver burden, with an effect size of 62.56%.</div></div><div><h3>Conclusions</h3><div>The patient's ability to perform activities of daily living was associated with caregiver burden through caregiver guilt. Interventions might consider targeting the caregiver's guilt while promoting the patient's activities of daily living recovery. A dual \"patient-caregiver\" evaluation approach may mitigate guilt and reduce caregiver burden.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100437"},"PeriodicalIF":3.1,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424420","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":"Effects of interventions to reduce clinical placement-related psychological distress among nursing students: A systematic review with meta-analysis","authors":"Ka Yan Ko ,&nbsp;Jed Ray Montayre ,&nbsp;Pak Lung Chiu ,&nbsp;Timothy Kam Hung Lai ,&nbsp;Kitty Chan ,&nbsp;Harry Ho Tin Chan","doi":"10.1016/j.ijnsa.2025.100435","DOIUrl":"10.1016/j.ijnsa.2025.100435","url":null,"abstract":"<div><h3>Background</h3><div>Clinical placements are essential in nursing education but often cause significant psychological distress, affecting students' well-being, learning outcomes, and patient safety. This systematic review and meta-analysis evaluate the effectiveness of interventions aimed at reducing psychological distress during clinical placements for nursing students.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across databases including CINAHL, PsycINFO, PubMed, EMBASE, Web of Science, Cochrane Library, ERIC, China National Knowledge Infrastructure, and Wan Fang Data. The review adhered to PRISMA guidelines and used Joanna Briggs Institute (JBI) tools for quality appraisal. Meta-analysis employed a random-effects model for outcomes reported in at least three studies.</div></div><div><h3>Results</h3><div>From 2,680 citations, 14 studies met inclusion criteria, comprising five randomized controlled trials and nine quasi-experimental designs. Quality appraisal indicated low to moderate risk of bias. Most interventions were delivered before clinical placements and focused on stress and anxiety coping strategies (n=7), knowledge and psychomotor skills reinforcement (n=5), or mixed approaches (n=2). Coping strategies included cognitive-behavioral therapy, art therapy, and mindfulness. Outcomes primarily assessed stress and anxiety. Meta-analysis showed that pre-clinical interventions significantly reduced stress (SMD = -0.54, 95 % CI: -0.92 to -0.17, p = 0.005) and anxiety (SMD = -0.65, 95 % CI: -0.92 to -0.38, p &lt; 0.001), with moderate effect sizes but high heterogeneity due to varied measurement tools.</div></div><div><h3>Conclusions</h3><div>Current interventions effectively alleviate clinical placement-related psychological distress in nursing students despite outcome variability. Future research should incorporate theoretical frameworks, systematically assess student stressors, and standardize assessment tools. Additionally, interventions should address clinical mentors’ needs and provide adequate support to enhance their role in nursing education.</div><div>Registration: The review protocol was registered on OSF (Open Science Framework) with the following registration number: DOI: <span><span>https://doi.org/10.17605/OSF.IO/QWXF6</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100435"},"PeriodicalIF":3.1,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474103","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":"Health and health related outcomes of Chinese adult surgical patients managed by a nurse-led discharge service: A meta-analysis","authors":"Mei Lin ,&nbsp;Shi Lan Liu","doi":"10.1016/j.ijnsa.2025.100434","DOIUrl":"10.1016/j.ijnsa.2025.100434","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patients’ discharge from the hospital is a major factor for the continuous normal functioning of the inpatient health care service. A nurse-led discharge service for surgical patients in China refers to the fact where, with the advice of the treating doctor, a senior trained nurse takes the main responsibility to prepare and manage a post-operative patient’s discharge from the hospital, rather than solely depending on the corresponding physician to handle the discharge process. However, conclusions from individual studies are often controversial. Meta-analyses provide more precise estimates of the effect size compared to that of any single study that could have been achieved, reducing the uncertainty of results thereby generating a more efficient overall estimate of the effect providing a single, synthesized conclusion with high level evidence that could be used to develop clinical practice guidelines and inform decision-making in various fields. Therefore, because of the several positive aspects of meta-analyses compared to a single individual study, we aimed to systematically show the health and health related outcomes of Chinese adult surgical patients managed by a nurse-led discharge service through a meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;MEDical Literature Analysis and Retrieval System Online, Web of Science, Excerpta Medica dataBASE, the Cochrane library, Google scholar and &lt;span&gt;&lt;span&gt;http://www.Clinicaltrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; were the search databases. In this meta-analysis, the statistical work was carried out by the RevMan software version 5.4. For dichotomous data, risk ratios (RR) with 95% confidence intervals (CI) were used to represent the results following the meta-analysis. For continuous data, mean and standard deviation were the inputs, and weighted mean differences (WMD) with 95% CI were used to represent the results following the meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total number of 1059 participants were included in this meta-analysis whereby 504 patients were assigned to the nurse-led discharge group whereas 555 patients were assigned to the control group. Most of the studies were randomized trials and participants were enrolled from year 2001 to 2024. All the participants were of Chinese origin and were from mainland China, Hong Kong or Taiwan. Results of this meta-analysis showed that this nurse-led discharge service in Chinese adult surgical inpatients was associated with a significantly lower risk of re-admission with RR: 0.46, 95% CI: 0.30 – 0.70; &lt;em&gt;P&lt;/em&gt; = 0.0003. However, the risk of mortality was not significantly different (RR: 0.67, 95% CI: 0.31 – 1.44; &lt;em&gt;P&lt;/em&gt; = 0.31. Moreover, the mean length of hospital stay with WMD: [-0.57; 95% CI: (-2.09 – 0.96); &lt;em&gt;P&lt;/em&gt; = 0.47] and quality of life with WMD [5.48, 95% CI: (-1.92 – 12.88); &lt;em&gt;P&lt;/em&gt; = 0.15] were similarly manifested.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Based on t","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100434"},"PeriodicalIF":3.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361001","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":"Stroke coordinators perceived roles, responsibilities, & resources: Florida Stroke Registry insights","authors":"Joy Sessa ,&nbsp;Lauri Bishop ,&nbsp;Carolina M. Gutierrez ,&nbsp;Hannah Gardener ,&nbsp;Judith Krigman ,&nbsp;Christina Ampie ,&nbsp;Valynncea Butler ,&nbsp;Ashley Bolling ,&nbsp;Farya Fakoori ,&nbsp;Tara Hylton ,&nbsp;Evie Sobczak ,&nbsp;Negar Asdaghi ,&nbsp;Tatjana Rundek ,&nbsp;Jose G. Romano ,&nbsp;Gillian Gordon Perue ,&nbsp;Florida Stroke Registry","doi":"10.1016/j.ijnsa.2025.100432","DOIUrl":"10.1016/j.ijnsa.2025.100432","url":null,"abstract":"<div><h3>Background</h3><div>Optimization of stroke care plays a critical role in post-stroke outcomes. The stroke coordinator role includes leadership of stroke care teams, education of staff, patients, and emergency personnel, and stroke care quality improvement initiatives. The current study aimed to characterize Florida stroke coordinator responsibilities, stroke coordinators roles, and resources available and job satisfaction through a statewide hospital survey.</div></div><div><h3>Methods</h3><div>We report on a 20-item Stroke Coordinator Roles and Responsibility Survey that was administered to stroke coordinators from participating Florida hospitals. Topics included description of stroke center (i.e., size and type); experience of stroke coordinator; roles/responsibilities (data abstraction details, number of sites covered, description of additional duties); resources available; adequacy of training; satisfaction with compensation. We characterized various roles and resources available to coordinators and examined their variations by center type, size, and additionally by years in current position using the Chi square test.</div></div><div><h3>Results</h3><div>Surveys were deployed to 148 stroke coordinators covering 180 stroke hospitals from August to December 2023. A total of 55 responses (response rate 37 %) were available for analysis from 25 comprehensive/thrombectomy capable and 24 primary stroke centers with some coordinators covering multiple sites. Stroke coordinators who have been in their current role &gt;5 years were more likely to work in large (63 % vs 29 %, <em>p</em> = 0.02), comprehensive (75 % vs 33 % <em>p</em> = 0.03) stroke centers. Coordinators reported spending on average 45 to 60 min per chart for data abstraction, which was unrelated to center type (<em>p</em> = 0.57), size (<em>p</em> = 0.99) or coordinator experience (<em>p</em> = 0.81). The longer the stroke coordinator was in their role (&gt;5 years vs. &lt;5 years) the more likely they had additional duties (&gt;2 additional duties, 69 % vs 49 %, <em>p</em> = 0.04), and less likely to have extra resources (88 % vs 67 % <em>p</em> = 0.05). The majority (61 %) of stroke coordinators indicated dissatisfaction with their training and compensation.</div></div><div><h3>Conclusions</h3><div>Stroke coordinators face challenges with chart abstraction workload, fulfilling multiple roles, and limited available resources. Dissatisfaction is present with perceptions of inadequate training and compensation. Organizations should focus on addressing these concerns to stabilize and strengthen the stroke coordinator role, enhancing the quality and performance of the stroke program.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100432"},"PeriodicalIF":3.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332297","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":"Self-care practice and associated factors among hypertensive patients in Ethiopia: Umbrella review of systematic review and meta-analysis studies","authors":"Sefineh Fenta Feleke ,&nbsp;Anteneh Mengist Dessie ,&nbsp;Atitegeb Abera Kidie ,&nbsp;Muluemebet Kassa ,&nbsp;Tesfaye Engdaw Habtie ,&nbsp;Natnael Amare Tesfa ,&nbsp;Zenebe Daniel Getachew ,&nbsp;Tadele Emagneneh ,&nbsp;Wagaw Abebe","doi":"10.1016/j.ijnsa.2025.100433","DOIUrl":"10.1016/j.ijnsa.2025.100433","url":null,"abstract":"<div><h3>Background</h3><div>Self-care practices are vital for managing high blood pressure. Four systematic reviews and meta-analysis in Ethiopia have shown inconsistent prevalence rates and varying quality scores for hypertensive self-care. This umbrella review aims to unify these findings into a comprehensive document for better comparison. It is the first of its kind in Ethiopia and seeks to support clinicians and policymakers in preventing hypertension-related complications.</div></div><div><h3>Methods</h3><div>This umbrella review incorporated four systematic reviews and meta-analyses identified through a literature search across PubMed, ScienceDirect, Web of Science, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects, specifically targeting systematic reveiw and meta-analysis) studies on hypertension self-care practices in Ethiopia<strong>.</strong> Data from the included systematic review and meta-analysis studies were extracted using a standardized data abstraction form created in an Excel spreadsheet. The quality of all relevant systematic reviews and meta-analyses was assessed using the AMSTAR-2 (Assessment of Multiple Systematic Reviews) tool. R software version 4.3.2 was used to perform overall data synthesis and statistical analysis. The overall pooled prevalence and effect sizes were analyzed using a random-effects model.</div></div><div><h3>Results</h3><div>Four studies with 21,479 hypertensive patients were included. The overall pooled prevalence of good self-care practice among hypertensive patients in Ethiopia is 41 % (95 % CI 38 %, 44 %, I² =96 %, <em>P</em> = 0.001). Attending formal education (OR=1.56, 95 % CI: 1.23, 2.74), good knowledge of hypertension (OR=1.98, 95 % CI: 1.45, 3.01) were significantly associated with self-care practice among hypertensive patients in Ethiopia.</div></div><div><h3>Conclusions</h3><div>This umbrella review revealed low self-care practices among hypertensive patients in Ethiopia, with the poorest adherence in physical activity and the highest in smoking cessation. Education and knowledge about hypertension were key influences on self-care. The review suggests promoting physical activity, targeted education, and integrating these strategies into public health policies, alongside conducting nationwide studies to improve interventions.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100433"},"PeriodicalIF":3.1,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265286","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":"The effectiveness of a pupillary dilation reflex as an analgesia indicator: A protocol for a randomised multicentre trial in critically ill patients","authors":"Yolanda López_de_Audícana_Jimenez_de_Aberasturi ,&nbsp;Ana Vallejo_De_la_Cueva ,&nbsp;Naiara Parraza_Diez","doi":"10.1016/j.ijnsa.2025.100431","DOIUrl":"10.1016/j.ijnsa.2025.100431","url":null,"abstract":"<div><h3>Background</h3><div>Effective pain management in sedated, mechanically ventilated patients is essential in intensive care, particularly before invasive procedures. The relationship between pain and biological stress is well established, but its manifestation depends on the patient's clinical state, calling for individualised and effective interventions. The Pupillary Dilation Reflex (PDR) has emerged as a potential objective tool for assessing nociceptive responses and guiding preemptive analgesia (Pre-A) before interventions.</div></div><div><h3>Objective</h3><div>To evaluate the PDR as a physiological indicator of pain and its utility in guiding Pre-A before endotracheal aspiration (ETA) in sedated and ventilated ICU patients. We compare the incidence of pain, measured using PDR by video pupillometry, the Behavioural Pain Scale (BPS), and the Pain Indicator Behavioural Scale (ESCID), as well as the proportion of patients receiving Pre-A, between a pupillometry-guided group and a control group receiving standard care.</div></div><div><h3>Methods</h3><div>In this multicenter, randomised controlled study, 82 critically ill, sedated patients with an estimated 10% oversampling to compensate for possible attrition will be enrolled and randomised (1:1) into intervention or control groups. In the intervention group, PDR will be measured after a 20 mA stimulus. Patients exhibiting a PDR ≥ 11.5%, a threshold indicating insufficient analgesia, as determined in precursor study (López de Audícana-Jimenez de Aberasturi Y et al., 2024a), will receive Pre-A according to established ICU protocols. The control group will receive Pre-A based on routine clinical assessment. Pain will be assessed using PDR by video pupillometry and behavioural pain scales (BPS and ESCID) after ETA by blinded researchers. Only the pupillometry researcher will be aware of the Pre-A decision. Group differences will be analysed using Chi-square and bivariate statistical methods to explore associations between pain and related clinical variables.</div></div><div><h3>Results</h3><div>The primary outcome will be post-intervention pain, assessed by pupillometry as well as BPS and ESCID scale scores. The second outcome will be the proportion of patients requiring Pre-A in the groups.</div></div><div><h3>Conclusion</h3><div>Pupillometry-guided analgesia may offer a simple and effective bedside method for individualised pain management in sedated, mechanically ventilated ICU patients, potentially reducing pain-related complications.</div></div><div><h3>Clinical trial registration number</h3><div>Phase 2 of the project PUPIPAIN <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier: NCT04078113</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100431"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332298","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}