Pub Date : 2024-04-08DOI: 10.1016/j.ijnsa.2024.100197
Mia Blaabjerg , Anne Sophie Ågård , Marianne Lisby
Background
Being a relative to a trauma patient may be a dramatic experience. Often, trauma centre nurses do not feel they have the competences needed to meet relatives experiencing a crisis. Therefore, a need exists to enhance their crisis management competencies.
Objective
To investigate relatives' experiences of a nursing crisis management intervention on information, inclusion and support, including the importance of these needs in two Danish trauma centres.
Design
A prospective intervention study based on interrupted time series. The intervention, conducted in 2020–2021, consisted of a crisis management training programme.
Setting(s)
The Trauma Centre of the Aarhus University Hospital and Aalborg University Hospital in Denmark.
Participants
Relatives (18+ years) of critically ill or injured patients (n = 293).
Methods
Data were collected using a 32-item questionnaire. The primary outcome was relatives’ overall experience of the quality of the information, inclusion and support measured on a visual analogue scale (VAS) (0–10). Secondary outcomes were changes in risk ratios and scores between the periods for each of the three main variables. The outcome was measured as weighted and non-weighted scores, taking into account the importance of each variable. Besides use of interrupted time series, predictive and weight-adjusted analyses were performed. Time series comprised a before-period (6 months), an implementation period (3 months) and an after-period (6 months). Due to ceiling effect, the predictive analysis was dichotomized using the median scores for information, inclusion and support.
Results
Overall, no differences were observed between the participants' characteristics in each of the three periods. Comparing the implementation period with the after-period revealed a statistically significant positive difference between the relatives’ assessment of crisis management [p = 0.009]. Additionally, the probability of scoring >8 from before to after the intervention increased statistically significantly [Risk ratio 1.21, 95 % confidence interval 1.16–1.27]. The secondary outcomes showed that the greatest change over time was inclusion of relatives [Risk ratio, 1.25 95 % confidence interval 1.15–1.35]. Information had the greatest effect on relatives’ experience of nurses’ provision of crisis management and was also the needs area that relatives considered most important. However, information was also the needs area that evolved least during the study.
Conclusions
Based on the selected cut-off levels, the intervention appeared to have a positive effect on relatives’ experiences – especially inclusion of relatives. In the weighted analyses, information was considered most important and also had the greatest effect on rel
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Researchers have found that mindfulness-based interventions can reduce stress and improve mental health in healthcare professionals, as well as support relationship building, communication, and compassionate care. However, few researchers have systematically examined what determines successful implementation in hospital settings, which is essential for integrating research in clinical practice.
Objectives
The aim of this study was to synthesize qualitative data regarding healthcare professionals’ experiences of factors affecting implementation of mindfulness in hospital settings and outline recommendations for clinical practice.
Design
A systematic review and meta-synthesis of qualitative studies.
Data sources
A systematic search was conducted in six databases; Scopus, PubMed, CINAHL, PsycINFO (Ovid), Web of Science, and ProQuest Dissertations and Theses Global. The inclusion criteria were: 1) Healthcare professionals engaged in patient care in hospital settings, 2) Mindfulness-based interventions defined by Crane and colleagues’, and 3) Primary studies using a qualitative design.
Review methods
Multiple researchers were engaged in screening, quality assessment, data extraction, and interpretation of the results. Thematic synthesis described by Thomas and Harden guided the data analysis. Reporting followed Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ).
Results
Eighteen studies were included. We identified three overall themes of importance for successful implementation: 1) Buying In, 2) Allocating time and space, and 3) Keeping it going. The results revealed that cultural values, held beliefs about mindfulness, inter-professional relationships, and context-related factors such as time and space could affect implementation of mindfulness in hospital settings.
Conclusion
Based on the results, we formulated eight recommendations to guide stakeholders and hospital management in planning implementation of mindfulness in hospital settings. However, to confirm the results, more research where mindfulness implementation is the primary aim is needed.
背景研究人员发现，以正念为基础的干预措施可以减轻医护专业人员的压力并改善其心理健康，还可以支持关系建设、沟通和爱心护理。本研究旨在综合医护人员对影响正念在医院环境中实施的因素的体验的定性数据，并概述对临床实践的建议。数据来源在六个数据库中进行了系统检索：Scopus、PubMed、CINAHL、PsycINFO (Ovid)、Web of Science 和 ProQuest Dissertations and Theses Global。纳入标准为综述方法多名研究人员参与了筛选、质量评估、数据提取和结果解释工作。Thomas 和 Harden 所描述的主题综合法指导了数据分析。报告遵循《提高定性研究综合报告的透明度》（ENTREQ）。我们确定了成功实施的三个重要主题：1) 认同，2) 分配时间和空间，3) 坚持下去。结果表明，文化价值观、对正念的信念、跨专业关系以及时间和空间等与环境相关的因素都会影响正念在医院环境中的实施。结论根据研究结果，我们提出了八项建议，以指导利益相关者和医院管理层规划在医院环境中实施正念。然而，为了证实这些结果，还需要进行更多的以正念实施为主要目标的研究。
{"title":"Factors affecting implementation of mindfulness in hospital settings: A qualitative meta-synthesis of healthcare professionals' experiences","authors":"Randi Karkov Knudsen , Sine Skovbjerg , Elna Leth Pedersen , Camilla Littau Nielsen , Marie Højriis Storkholm , Connie Timmermann","doi":"10.1016/j.ijnsa.2024.100192","DOIUrl":"10.1016/j.ijnsa.2024.100192","url":null,"abstract":"<div><h3>Background</h3><p>Researchers have found that mindfulness-based interventions can reduce stress and improve mental health in healthcare professionals, as well as support relationship building, communication, and compassionate care. However, few researchers have systematically examined what determines successful implementation in hospital settings, which is essential for integrating research in clinical practice.</p></div><div><h3>Objectives</h3><p>The aim of this study was to synthesize qualitative data regarding healthcare professionals’ experiences of factors affecting implementation of mindfulness in hospital settings and outline recommendations for clinical practice.</p></div><div><h3>Design</h3><p>A systematic review and meta-synthesis of qualitative studies.</p></div><div><h3>Data sources</h3><p>A systematic search was conducted in six databases; Scopus, PubMed, CINAHL, PsycINFO (Ovid), Web of Science, and ProQuest Dissertations and Theses Global. The inclusion criteria were: 1) Healthcare professionals engaged in patient care in hospital settings, 2) Mindfulness-based interventions defined by Crane and colleagues’, and 3) Primary studies using a qualitative design.</p></div><div><h3>Review methods</h3><p>Multiple researchers were engaged in screening, quality assessment, data extraction, and interpretation of the results. Thematic synthesis described by Thomas and Harden guided the data analysis. Reporting followed Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ).</p></div><div><h3>Results</h3><p>Eighteen studies were included. We identified three overall themes of importance for successful implementation: 1) <em>Buying In</em>, 2) <em>Allocating time and space,</em> and 3) <em>Keeping it going</em>. The results revealed that cultural values, held beliefs about mindfulness, inter-professional relationships, and context-related factors such as time and space could affect implementation of mindfulness in hospital settings.</p></div><div><h3>Conclusion</h3><p>Based on the results, we formulated eight recommendations to guide stakeholders and hospital management in planning implementation of mindfulness in hospital settings. However, to confirm the results, more research where mindfulness implementation is the primary aim is needed.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000195/pdfft?md5=7f866f79b15c720d57d9e61714ef9228&pid=1-s2.0-S2666142X24000195-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140404968","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 : 2024-03-27DOI: 10.1016/j.ijnsa.2024.100194
Sara Melander , Oili Dahl , Ann-Charlotte Falk , Veronica Lindström , Erik Andersson , Petter Gustavsson , Ann Rudman
Background
Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients.
Objective
To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents.
Design
Cross sectional study.
Setting(s)
The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden.
Participants
A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation).
Methods
The data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups.
Results
The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high.
Conclusions
This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses’ pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.
{"title":"Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic: A cross-sectional study","authors":"Sara Melander , Oili Dahl , Ann-Charlotte Falk , Veronica Lindström , Erik Andersson , Petter Gustavsson , Ann Rudman","doi":"10.1016/j.ijnsa.2024.100194","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2024.100194","url":null,"abstract":"<div><h3>Background</h3><p>Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients.</p></div><div><h3>Objective</h3><p>To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents.</p></div><div><h3>Design</h3><p>Cross sectional study.</p></div><div><h3>Setting(s)</h3><p>The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden.</p></div><div><h3>Participants</h3><p>A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation).</p></div><div><h3>Methods</h3><p>The data were analyzed using descriptive statistics, unpaired <em>t</em>-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups.</p></div><div><h3>Results</h3><p>The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high.</p></div><div><h3>Conclusions</h3><p>This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses’ pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000213/pdfft?md5=ee7a6f822b76b9f6593c803a10a0e4d6&pid=1-s2.0-S2666142X24000213-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140342367","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}
Nurses faced with multiple demands in hospitals are often compelled to prioritize nursing care. Knowledge of missed nursing care provides insight into whether necessary nursing care is delivered, what is missed, and the reasons for missed nursing care. This insight is essential to support evidence-based policy and practice to improve patient care, enhance nursing practice, and optimize the work environment. Research on factors influencing missed nursing care is imperative to implement targeted strategies. However, studies investigating work experience as a predictor are inconclusive, and no identified studies have examined how nurses’ work experience is associated with different elements of missed nursing care.
Objectives
To investigate the prevalence and reasons for missed nursing care and whether nurses' work experience was associated with missed nursing care.
Design
The design was cross‐sectional, using the Danish version of the MISSCARE survey.
Setting
The study was conducted at a public Danish university hospital with 1,150 beds and approximately 10,350 employees.
Participants
Across 34 surgical, medical, and mixed bed wards for adults, 1,241 nurses were invited by email to respond anonymously to the Danish MISSCARE survey. Of these nurses, 50.3% responded, and 42.6% fully completed the questionnaire.
Methods
A total score mean and a mean score were calculated and then compared between experience (≤5 years/>5 years) in a linear regression model adjusting for unequally distributed variables.
Results
More than two thirds of the nurses reported that emotional support, patient bathing, ambulation, mouth care, interdisciplinary conferences, documentation, and assessing effectiveness of medication were frequently missed elements of nursing care. The most significant reasons for missed nursing care were an inadequate number of nurses, an unexpected rise in patient volume, urgent patient situations, heavy admission, and discharge activity. Nurses with work experience of less than 5 years reported more missed nursing care, especially within fundamental care.
Conclusions
Nursing elements to avoid potentially critical situations and nursing related to treatment observations were rarely missed, while nursing care elements visible only to the patient and the nurse were most often missed. By increasing transparency and explicitness within nursing care, the results enable critical evaluation of prioritization of nursing care elements. The number of staff not balancing the number and acuity of patients was the main reason for missed nursing care. The perception of missed nursing care was most pronounced in less experienced nurses. The study contributes to the global research community to achieve a broader understanding of missed nursing care.
{"title":"Prevalence of missed nursing care and its association with work experience: A cross-sectional survey","authors":"Hanne Mainz , Randi Tei , Karen Vestergaard Andersen , Marianne Lisby , Merete Gregersen","doi":"10.1016/j.ijnsa.2024.100196","DOIUrl":"10.1016/j.ijnsa.2024.100196","url":null,"abstract":"<div><h3>Background</h3><p>Nurses faced with multiple demands in hospitals are often compelled to prioritize nursing care. Knowledge of missed nursing care provides insight into whether necessary nursing care is delivered, what is missed, and the reasons for missed nursing care. This insight is essential to support evidence-based policy and practice to improve patient care, enhance nursing practice, and optimize the work environment. Research on factors influencing missed nursing care is imperative to implement targeted strategies. However, studies investigating work experience as a predictor are inconclusive, and no identified studies have examined how nurses’ work experience is associated with different elements of missed nursing care.</p></div><div><h3>Objectives</h3><p>To investigate the prevalence and reasons for missed nursing care and whether nurses' work experience was associated with missed nursing care.</p></div><div><h3>Design</h3><p>The design was cross‐sectional, using the Danish version of the <em>MISSCARE</em> survey.</p></div><div><h3>Setting</h3><p>The study was conducted at a public Danish university hospital with 1,150 beds and approximately 10,350 employees.</p></div><div><h3>Participants</h3><p>Across 34 surgical, medical, and mixed bed wards for adults, 1,241 nurses were invited by email to respond anonymously to the Danish MISSCARE survey. Of these nurses, 50.3% responded, and 42.6% fully completed the questionnaire.</p></div><div><h3>Methods</h3><p>A total score mean and a mean score were calculated and then compared between experience (≤5 years/>5 years) in a linear regression model adjusting for unequally distributed variables.</p></div><div><h3>Results</h3><p>More than two thirds of the nurses reported that emotional support, patient bathing, ambulation, mouth care, interdisciplinary conferences, documentation, and assessing effectiveness of medication were frequently missed elements of nursing care. The most significant reasons for missed nursing care were an inadequate number of nurses, an unexpected rise in patient volume, urgent patient situations, heavy admission, and discharge activity. Nurses with work experience of less than 5 years reported more missed nursing care, especially within fundamental care.</p></div><div><h3>Conclusions</h3><p>Nursing elements to avoid potentially critical situations and nursing related to treatment observations were rarely missed, while nursing care elements visible only to the patient and the nurse were most often missed. By increasing transparency and explicitness within nursing care, the results enable critical evaluation of prioritization of nursing care elements. The number of staff not balancing the number and acuity of patients was the main reason for missed nursing care. The perception of missed nursing care was most pronounced in less experienced nurses. The study contributes to the global research community to achieve a broader understanding of missed nursing care.</p><","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000237/pdfft?md5=6c107fd7ea70ee420a1a8691dbce2e18&pid=1-s2.0-S2666142X24000237-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402226","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}
The shortage of nurses worldwide is a well-known issue that has changed the health and social workforce picture. Increased recruitment and migration of internationally educated nurses in the health and social care workforce pose many risks to successful integration into the healthcare system. Understanding the barriers and enablers affecting their integration in their host countries is imperative.
Objective
To critically and systematically review the current literature to explore the transitioning experiences of internationally educated nurses to understand the enabling influences affecting their workforce integration into their host countries.
Design
A narrative systematic literature review was conducted. This study was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD42023401090). The study results were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Methods
A comprehensive literature search using the search engines CINAHL, MEDLINE, PsycINFO, Academic Search, and PubMed was conducted. Only peer-reviewed papers written in the English language were included. Primary research studies published between 2019 and 2023, which explored the lived experiences of internationally educated nurses, were considered for review.
Results
Seventeen studies (16 qualitative and one quantitative) were included in the review. Three main themes were developed: (1) push and pull factors that mediated internationally educated nurses' migration experiences, (2) one-way integration logic, and (3) expectations versus reality.
Conclusions
There is a need for a comprehensive and collaborative organisational approach to enhance the integration experiences of internationally educated nurses into their host countries. This can also ensure their contribution is recognised and will help them fulfil the responsibilities of their role and become influential team members within their organisations. This comprehensive and collaborative approach is also required to tackle discrimination, racism, communication and language barriers. Addressing these challenges can improve internationally educated nurses' job satisfaction and, thereby, improve retention.
Tweetable abstract
A new systematic review study explores barriers and enablers for optimising internationally educated nurses' experiences of working in their host country @cathy_Henshall @clairmerriman9 @annemarieraffer
{"title":"Transitioning experiences of internationally educated nurses in host countries: A narrative systematic review","authors":"Aasia Rajpoot , Clair Merriman , Anne-Marie Rafferty , Catherine Henshall","doi":"10.1016/j.ijnsa.2024.100195","DOIUrl":"10.1016/j.ijnsa.2024.100195","url":null,"abstract":"<div><h3>Background</h3><p>The shortage of nurses worldwide is a well-known issue that has changed the health and social workforce picture. Increased recruitment and migration of internationally educated nurses in the health and social care workforce pose many risks to successful integration into the healthcare system. Understanding the barriers and enablers affecting their integration in their host countries is imperative.</p></div><div><h3>Objective</h3><p>To critically and systematically review the current literature to explore the transitioning experiences of internationally educated nurses to understand the enabling influences affecting their workforce integration into their host countries.</p></div><div><h3>Design</h3><p>A narrative systematic literature review was conducted. This study was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD42023401090). The study results were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p></div><div><h3>Methods</h3><p>A comprehensive literature search using the search engines CINAHL, MEDLINE, PsycINFO, Academic Search, and PubMed was conducted. Only peer-reviewed papers written in the English language were included. Primary research studies published between 2019 and 2023, which explored the lived experiences of internationally educated nurses, were considered for review.</p></div><div><h3>Results</h3><p>Seventeen studies (16 qualitative and one quantitative) were included in the review. Three main themes were developed: (1) push and pull factors that mediated internationally educated nurses' migration experiences, (2) one-way integration logic, and (3) expectations versus reality.</p></div><div><h3>Conclusions</h3><p>There is a need for a comprehensive and collaborative organisational approach to enhance the integration experiences of internationally educated nurses into their host countries. This can also ensure their contribution is recognised and will help them fulfil the responsibilities of their role and become influential team members within their organisations. This comprehensive and collaborative approach is also required to tackle discrimination, racism, communication and language barriers. Addressing these challenges can improve internationally educated nurses' job satisfaction and, thereby, improve retention.</p></div><div><h3>Tweetable abstract</h3><p>A new systematic review study explores barriers and enablers for optimising internationally educated nurses' experiences of working in their host country @cathy_Henshall @clairmerriman9 @annemarieraffer</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000225/pdfft?md5=b41ae0ecdfb6a14f9e23dd54192164a2&pid=1-s2.0-S2666142X24000225-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402233","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 : 2024-03-25DOI: 10.1016/j.ijnsa.2024.100193
Jie Zou , Jiao Xie , Jinyong Zhang , Hangdi Zhao , Pingjing Lu
Background
: The number of individuals undergoing maintenance haemodialysis has continued to increase in recent years. This treatment method can lead to social isolation, which has a significant impact on an individual's health. Unfortunately, research on this issue is insufficient, and no effective interventions have been developed. Moreover, existing research lacks attention to and understanding of patient aspirations—a critical area that warrants further exploration.
Objectives
: We aimed to reveal the natural coping trajectory of individuals undergoing maintenance haemodialysis in the context of social isolation to provide a useful reference for further research and the development of effective interventions.
Design
: This was a descriptive qualitative study.
Setting (s)
This study was conducted at a haemodialysis centre in a provincial capital city of northern China.
Participants
Using maximum variant and purposive sampling, we recruited 15 patients undergoing maintenance haemodialysis.
Methods
: The interviews were transcribed verbatim, and data were analysed using deductive content analysis.
Results
Three themes were identified: (a) prerequisites for coping with social isolation; (b) maintaining the bond between coping and social isolation; and (c) the results of coping with social isolation. These themes revealed the natural trajectory of individuals undergoing maintenance haemodialysis in dealing with social isolation.
Conclusion
: We interpreted the findings to mean that it was necessary to establish a three-way linkage among family, hospitals, and society to develop multicomponent and multilevel intervention measures.
Tweetable abstract
: A study of the response of individuals undergoing maintenance haemodialysis to social isolation revealed their coping trajectory and conveyed their aspirations.
{"title":"Coping trajectory of social isolation in individuals with maintenance haemodialysis: A descriptive qualitative study","authors":"Jie Zou , Jiao Xie , Jinyong Zhang , Hangdi Zhao , Pingjing Lu","doi":"10.1016/j.ijnsa.2024.100193","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2024.100193","url":null,"abstract":"<div><h3>Background</h3><p>: The number of individuals undergoing maintenance haemodialysis has continued to increase in recent years. This treatment method can lead to social isolation, which has a significant impact on an individual's health. Unfortunately, research on this issue is insufficient, and no effective interventions have been developed. Moreover, existing research lacks attention to and understanding of patient aspirations—a critical area that warrants further exploration.</p></div><div><h3>Objectives</h3><p>: We aimed to reveal the natural coping trajectory of individuals undergoing maintenance haemodialysis in the context of social isolation to provide a useful reference for further research and the development of effective interventions.</p></div><div><h3>Design</h3><p>: This was a descriptive qualitative study.</p></div><div><h3>Setting (s)</h3><p>This study was conducted at a haemodialysis centre in a provincial capital city of northern China.</p></div><div><h3>Participants</h3><p>Using maximum variant and purposive sampling, we recruited 15 patients undergoing maintenance haemodialysis.</p></div><div><h3>Methods</h3><p>: The interviews were transcribed verbatim, and data were analysed using deductive content analysis.</p></div><div><h3>Results</h3><p>Three themes were identified: (a) prerequisites for coping with social isolation; (b) maintaining the bond between coping and social isolation; and (c) the results of coping with social isolation. These themes revealed the natural trajectory of individuals undergoing maintenance haemodialysis in dealing with social isolation.</p></div><div><h3>Conclusion</h3><p>: We interpreted the findings to mean that it was necessary to establish a three-way linkage among family, hospitals, and society to develop multicomponent and multilevel intervention measures.</p></div><div><h3>Tweetable abstract</h3><p>: A study of the response of individuals undergoing maintenance haemodialysis to social isolation revealed their coping trajectory and conveyed their aspirations.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000201/pdfft?md5=c4abf2c7e55d05e6974fc71fc64172e0&pid=1-s2.0-S2666142X24000201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308966","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 : 2024-03-23DOI: 10.1016/j.ijnsa.2024.100191
Ali Dehghani
Background
Clinical judgment is one of the most important competencies required for safe care, decision-making, and diagnosis in nursing profession. Therefore, it is necessary to examine clinical judgment in nursing care. Existing a standard questionnaire based on cultural and social conditions can accurately evaluate clinical judgment in nurses.
Objective
The present study aimed to develop and validate clinical judgment capability questionnaire in nurses.
Design
The current research was a sequential exploratory mixed method study.
Setting
The teaching hospitals affiliated to Jahrom University of Medical Sciences in the South of Iran in 2023.
Participants
Twelve clinical nurses were included in the qualitative part and 181 nurses in the quantitative part.
Methods
The study was conducted in two parts: one qualitative and one quantitative. In the qualitative part, the concept of clinical judgment was explored using qualitative content analysis. Then, the initial pool of items was generated to develop a questionnaire. In the quantitative part, psychometric properties of the questionnaire were evaluated including face, content, and structure validity and reliability (internal consistency and stability).
Results
After examining the psychometric properties, 22 items were developed for the final questionnaire. The results of factor analysis led to the extraction of four factors, including noticing, interpreting, responding, and reflecting. The internal consistency of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.95 and its stability with an intraclass correlation coefficient of 0.84.
Conclusion
The developed 22-item questionnaire is a valid and reliable tool for assessment of clinical judgment capability in nurses.
{"title":"Development and validation of the clinical judgment capability questionnaire in nurses: A sequential exploratory mixed method study","authors":"Ali Dehghani","doi":"10.1016/j.ijnsa.2024.100191","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2024.100191","url":null,"abstract":"<div><h3>Background</h3><p>Clinical judgment is one of the most important competencies required for safe care, decision-making, and diagnosis in nursing profession. Therefore, it is necessary to examine clinical judgment in nursing care. Existing a standard questionnaire based on cultural and social conditions can accurately evaluate clinical judgment in nurses.</p></div><div><h3>Objective</h3><p>The present study aimed to develop and validate clinical judgment capability questionnaire in nurses.</p></div><div><h3>Design</h3><p>The current research was a sequential exploratory mixed method study.</p></div><div><h3>Setting</h3><p>The teaching hospitals affiliated to Jahrom University of Medical Sciences in the South of Iran in 2023.</p></div><div><h3>Participants</h3><p>Twelve clinical nurses were included in the qualitative part and 181 nurses in the quantitative part.</p></div><div><h3>Methods</h3><p>The study was conducted in two parts: one qualitative and one quantitative. In the qualitative part, the concept of clinical judgment was explored using qualitative content analysis. Then, the initial pool of items was generated to develop a questionnaire. In the quantitative part, psychometric properties of the questionnaire were evaluated including face, content, and structure validity and reliability (internal consistency and stability).</p></div><div><h3>Results</h3><p>After examining the psychometric properties, 22 items were developed for the final questionnaire. The results of factor analysis led to the extraction of four factors, including noticing, interpreting, responding, and reflecting. The internal consistency of the questionnaire was confirmed with a Cronbach's alpha coefficient of 0.95 and its stability with an intraclass correlation coefficient of 0.84.</p></div><div><h3>Conclusion</h3><p>The developed 22-item questionnaire is a valid and reliable tool for assessment of clinical judgment capability in nurses.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000183/pdfft?md5=bdc022b89c1d1c78f0b71136bf3d2d6d&pid=1-s2.0-S2666142X24000183-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543887","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 : 2024-03-12DOI: 10.1016/j.ijnsa.2024.100190
Mélanie Lavoie-Tremblay , Kathleen Boies , Christina Clausen , Julie Frechette , Kimberley Manning , Christina Gelsomini , Guylaine Cyr , Geneviève Lavigne , Bruce Gottlieb , Laurie N. Gottlieb
Background
Development of nursing leadership is necessary to ensure that nurse leaders of the future are well-equipped to tackle the challenges of a burdened healthcare system. In this context, the Strengths-Based Nursing and Healthcare Leadership program was delivered to 121 participants from 5 organizations in Canada in 2021 and 2022. To date, no study used a qualitative approach to explore nursing leaders’ perceptions of a leadership Strengths-Based Nursing and Healthcare Leadership program three months post training.
Objective
To describe nursing leaders’ perceptions of the impact of the Strengths-Based Nursing and Healthcare Leadership program three months post training.
Methods
Qualitative descriptive design was used with individual semi-structured interviews. A convenient sample of nurse leaders (n = 20) who had participated in the leadership program were recruited for an individual interview three months post training. The data generated by interviews were analyzed using a method of thematic content analysis.
Results
Three themes emerged from the qualitative data analysis related to the leadership program that stayed with participants three months post training: 1) mentorship: a lasting relationship, 2) human connections through Story-sharing, and 3) focus on strengths. Two other themes emerged related to the changes that they have made since attending the program: 1) seeking out different perspectives to work better as a team and 2) create a positive work environment and to show appreciation for their staff.
Conclusion
The present study offers evidence of the impact of the Strengths-Based Nursing and Healthcare Leadership program three months post training.
Implication
This study reinforces the importance of training using a Strengths-Based Nursing and Healthcare Leadership lens when tackling leadership.
{"title":"Nursing leaders’ perceptions of the impact of the Strengths-Based Nursing and Healthcare Leadership program three months post training","authors":"Mélanie Lavoie-Tremblay , Kathleen Boies , Christina Clausen , Julie Frechette , Kimberley Manning , Christina Gelsomini , Guylaine Cyr , Geneviève Lavigne , Bruce Gottlieb , Laurie N. Gottlieb","doi":"10.1016/j.ijnsa.2024.100190","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2024.100190","url":null,"abstract":"<div><h3>Background</h3><p>Development of nursing leadership is necessary to ensure that nurse leaders of the future are well-equipped to tackle the challenges of a burdened healthcare system. In this context, the Strengths-Based Nursing and Healthcare Leadership program was delivered to 121 participants from 5 organizations in Canada in 2021 and 2022. To date, no study used a qualitative approach to explore nursing leaders’ perceptions of a leadership Strengths-Based Nursing and Healthcare Leadership program three months post training.</p></div><div><h3>Objective</h3><p>To describe nursing leaders’ perceptions of the impact of the Strengths-Based Nursing and Healthcare Leadership program three months post training.</p></div><div><h3>Methods</h3><p>Qualitative descriptive design was used with individual semi-structured interviews. A convenient sample of nurse leaders (<em>n</em> = 20) who had participated in the leadership program were recruited for an individual interview three months post training. The data generated by interviews were analyzed using a method of thematic content analysis.</p></div><div><h3>Results</h3><p>Three themes emerged from the qualitative data analysis related to the leadership program that stayed with participants three months post training: 1) <em>mentorship: a lasting relationship</em>, 2) <em>human connections through Story-sharing</em>, and 3) <em>focus on strengths</em>. Two other themes emerged related to the changes that they have made since attending the program: 1) <em>seeking out different perspectives to work better as a team</em> and 2) <em>create a positive work environment and to show appreciation for their staff.</em></p></div><div><h3>Conclusion</h3><p>The present study offers evidence of the impact of the Strengths-Based Nursing and Healthcare Leadership program three months post training.</p></div><div><h3>Implication</h3><p>This study reinforces the importance of training using a Strengths-Based Nursing and Healthcare Leadership lens when tackling leadership.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000171/pdfft?md5=cbd538442805412c8f2e33b2505455d8&pid=1-s2.0-S2666142X24000171-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140162726","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 : 2024-03-06DOI: 10.1016/j.ijnsa.2024.100189
Peter W.A. Reniers , Karin Hediger , Ine J.N. Declercq , Marie-José Enders-Slegers , Roeslan Leontjevas , Debby L. Gerritsen
Objective
The relevance of pets in long-term home care is increasingly recognised because of their effects on health outcomes in clients and the rising number of clients receiving long-term care at home (further referred to as clients receiving home care). Currently, there is a lack of supportive materials that address pet-related challenges within home care. This study aimed to develop a toolkit for clients receiving home care with pets, their family, and professional caregivers using a participatory research approach.
Methods
We used the Experience-Based Co-Design method involving clients receiving home care, family caregivers, and professional caregivers to create tools that are based on both theory and practice. This approach consists of four phases: 1) Exploring topics of emotional significance requiring attention (i.e., key moments) from the perspective of clients receiving home care, family caregivers, and professional caregivers; 2) Collaboratively prioritising these topics, through prioritisation meetings; 3) Developing and refining Toolkit materials through a co-design process; and 4) Evaluating the quality and feasibility of these materials.
Results
Based on the results of a previously-conducted systematic review and individual interviews, we developed a preliminary information booklet and conversation cards. Subsequently, we conducted a total of 28 semi-structured interviews and seven focus groups, including one with representatives of animal interest organisations, such as veterinarians. This process led to the PET@home Toolkit which includes various materials to support pet ownership in home care settings, such as leaflets with advice on communication and animal welfare and an infographic.
Conclusion
The PET@home Toolkit can support professional caregivers and their pet-owning clients receiving home care, family caregivers, and their pets. It may be a valuable addition to providing person-centred care in long-term care at home for clients with pets. The PET@home Toolkit and future updates will be readily available and free to download from May 2024 via the University Knowledge Network for Older Adult Care Nijmegen (www.ukonnetwerk.nl).
Tweetable abstract
The PET@home Toolkit: Supporting pet ownership in long-term care at home.
{"title":"The development of the PET@home toolkit: An experience-based co-design method study","authors":"Peter W.A. Reniers , Karin Hediger , Ine J.N. Declercq , Marie-José Enders-Slegers , Roeslan Leontjevas , Debby L. Gerritsen","doi":"10.1016/j.ijnsa.2024.100189","DOIUrl":"10.1016/j.ijnsa.2024.100189","url":null,"abstract":"<div><h3>Objective</h3><p>The relevance of pets in long-term home care is increasingly recognised because of their effects on health outcomes in clients and the rising number of clients receiving long-term care at home (further referred to as clients receiving home care). Currently, there is a lack of supportive materials that address pet-related challenges within home care. This study aimed to develop a toolkit for clients receiving home care with pets, their family, and professional caregivers using a participatory research approach.</p></div><div><h3>Methods</h3><p>We used the Experience-Based Co-Design method involving clients receiving home care, family caregivers, and professional caregivers to create tools that are based on both theory and practice. This approach consists of four phases: 1) Exploring topics of emotional significance requiring attention (i.e., key moments) from the perspective of clients receiving home care, family caregivers, and professional caregivers; 2) Collaboratively prioritising these topics, through prioritisation meetings; 3) Developing and refining Toolkit materials through a co-design process; and 4) Evaluating the quality and feasibility of these materials.</p></div><div><h3>Results</h3><p>Based on the results of a previously-conducted systematic review and individual interviews, we developed a preliminary information booklet and conversation cards. Subsequently, we conducted a total of 28 semi-structured interviews and seven focus groups, including one with representatives of animal interest organisations, such as veterinarians. This process led to the PET@home Toolkit which includes various materials to support pet ownership in home care settings, such as leaflets with advice on communication and animal welfare and an infographic.</p></div><div><h3>Conclusion</h3><p>The PET@home Toolkit can support professional caregivers and their pet-owning clients receiving home care, family caregivers, and their pets. It may be a valuable addition to providing person-centred care in long-term care at home for clients with pets. The PET@home Toolkit and future updates will be readily available and free to download from May 2024 via the University Knowledge Network for Older Adult Care Nijmegen (<span>www.ukonnetwerk.nl</span><svg><path></path></svg>).</p></div><div><h3>Tweetable abstract</h3><p>The PET@home Toolkit: Supporting pet ownership in long-term care at home.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X2400016X/pdfft?md5=1eb71baba6c6b0d36064a7bc0974693d&pid=1-s2.0-S2666142X2400016X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085309","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 : 2024-02-24DOI: 10.1016/j.ijnsa.2024.100186
Kristy A Bolton , Penny Fraser , Steven Allender , Rohan Fitzgerald , Susan Brumby
Background
The COVID-19 pandemic has amplified the need to understand the health and wellbeing of healthcare workers in hospital settings. Crises like the COVID-19 pandemic create poor health outcomes for healthcare workers, yet little is understood about underlying patterns of modifiable health determinants.
Objective
The aim of the study was to examine the health and wellbeing data of healthcare workers before and during the COVID-19 pandemic and inform future healthy intervention activities within the workplace.
Design
Repeat cross-sectional study pre-2018 and mid-COVID-19 2020.
Setting(s)
Rural health service in Victoria, Australia.
Participants
All 800 healthcare workers within the health service were invited; of these, 184 (23%) participated at Time 1 and 87 (11%) at Time 2.
Methods
Diet, physical activity, sleep behaviours, and psychological distress were collected via online survey in Qualtrics. Pre-COVID-19 pandemic, anthropometry (height, weight, waist circumference, blood pressure), and type 2 diabetes risk were collected by a trained practitioner. However, to reduce burden on healthcare workers mid-COVID-19 pandemic, only self-reported anthropometry was collected.
Results
The majority of participants were Australian-born females (84% at both timepoints) with half over the age of 45 (63% Time 1, 53% Time 2). Around half worked part-time (49% Time 1, 54% Time 2), over a third full-time (39% Time 1, 36% Time 2), and the majority reported working regular day shifts in the past 3 months (70% Time 1, 65% Time 2). Among this sample, there were few smokers (9% Time 1, 7% Time 2), and two thirds of participants were living with overweight or obesity (64% Time 1, 67% Time 2). Across both time points, compliance with health guidelines was low; 41% (Time 1) and 42% (Time 2) met fruit, 17% (Time 1) and 12% (Time 2) met vegetable, and just under 50% met physical activity guidelines at both time points. Those reporting moderate to very high levels of psychological stress increased from 42% (Time 1) to 59% (Time 2) (p< 0.05). At Time 1, >80% were at intermediate (39%) or high (33%) risk of developing type 2 diabetes within the next 5 years; and a third (32%) were hypertensive. Reasons for physical inactivity at work included already exercising out-of-work hours (28%), living too far from work (18%), available time (9%), and inflexible work hours (8%).
Conclusions
Several high-risk health areas along with opportunities for supporting improved wellbeing were identified in this group of healthcare workers. Psychological distress of healthcare workers urgently needs to be addressed, and this is reinforced by the need to understand the longitudinal impact of COVID-19 on the health and wellbeing of healthcare workers. Workplace settings, such a
{"title":"How healthy are the healthcare staff in a rural health service? A cross-sectional study","authors":"Kristy A Bolton , Penny Fraser , Steven Allender , Rohan Fitzgerald , Susan Brumby","doi":"10.1016/j.ijnsa.2024.100186","DOIUrl":"https://doi.org/10.1016/j.ijnsa.2024.100186","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has amplified the need to understand the health and wellbeing of healthcare workers in hospital settings. Crises like the COVID-19 pandemic create poor health outcomes for healthcare workers, yet little is understood about underlying patterns of modifiable health determinants.</p></div><div><h3>Objective</h3><p>The aim of the study was to examine the health and wellbeing data of healthcare workers before and during the COVID-19 pandemic and inform future healthy intervention activities within the workplace.</p></div><div><h3>Design</h3><p>Repeat cross-sectional study pre-2018 and mid-COVID-19 2020.</p></div><div><h3>Setting(s)</h3><p>Rural health service in Victoria, Australia.</p></div><div><h3>Participants</h3><p>All 800 healthcare workers within the health service were invited; of these, 184 (23%) participated at Time 1 and 87 (11%) at Time 2.</p></div><div><h3>Methods</h3><p>Diet, physical activity, sleep behaviours, and psychological distress were collected via online survey in Qualtrics. Pre-COVID-19 pandemic, anthropometry (height, weight, waist circumference, blood pressure), and type 2 diabetes risk were collected by a trained practitioner. However, to reduce burden on healthcare workers mid-COVID-19 pandemic, only self-reported anthropometry was collected.</p></div><div><h3>Results</h3><p>The majority of participants were Australian-born females (84% at both timepoints) with half over the age of 45 (63% Time 1, 53% Time 2). Around half worked part-time (49% Time 1, 54% Time 2), over a third full-time (39% Time 1, 36% Time 2), and the majority reported working regular day shifts in the past 3 months (70% Time 1, 65% Time 2). Among this sample, there were few smokers (9% Time 1, 7% Time 2), and two thirds of participants were living with overweight or obesity (64% Time 1, 67% Time 2). Across both time points, compliance with health guidelines was low; 41% (Time 1) and 42% (Time 2) met fruit, 17% (Time 1) and 12% (Time 2) met vegetable, and just under 50% met physical activity guidelines at both time points. Those reporting moderate to very high levels of psychological stress increased from 42% (Time 1) to 59% (Time 2) (<em>p</em> <em><</em> 0.05). At Time 1, >80% were at intermediate (39%) or high (33%) risk of developing type 2 diabetes within the next 5 years; and a third (32%) were hypertensive. Reasons for physical inactivity at work included already exercising out-of-work hours (28%), living too far from work (18%), available time (9%), and inflexible work hours (8%).</p></div><div><h3>Conclusions</h3><p>Several high-risk health areas along with opportunities for supporting improved wellbeing were identified in this group of healthcare workers. Psychological distress of healthcare workers urgently needs to be addressed, and this is reinforced by the need to understand the longitudinal impact of COVID-19 on the health and wellbeing of healthcare workers. Workplace settings, such a","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000134/pdfft?md5=b9c79e8fabb92645d093c583c1ea36f8&pid=1-s2.0-S2666142X24000134-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140067280","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}
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