Pub Date : 2025-09-19DOI: 10.1016/j.ijnsa.2025.100426
Signe Østrem , Anna Strömberg , Kari Hanne Gjeilo , Marianne Storm , Ingvild M. Morken
<div><h3>Background</h3><div>Effective self-care, including symptom monitoring and treatment adherence, is essential for individuals with heart failure. It can enhance quality of life, improve survival, and reduce hospital admissions. The home is the primary setting where individuals with heart failure perform self-care. However, many struggle to recognize symptoms that indicate worsening of their condition. Remote patient monitoring allows nurses to track symptoms, weight, and blood pressure while supporting self-care behaviours that help prevent exacerbations. A clearer understanding of these interventions is needed, particularly regarding how they influence patients’ views on self-care over time.</div></div><div><h3>Objective</h3><div>This study explored short- and long-term experiences of self-care among individuals with heart failure after a six-week, nurse-assisted remote patient monitoring intervention.</div></div><div><h3>Setting</h3><div>Twelve participants were recruited from the intervention group in a randomised controlled trial. Clinical trial ID 301472.</div></div><div><h3>Methods</h3><div>This study employed a qualitative longitudinal approach. Eleven semi-structured interviews were conducted at two time points: at time one, immediately after participants had completed the nurse-assisted remote patient monitoring intervention; and at time two, six months post-discharge. One participant did not respond to the second interview, resulting in 23 interviews in total. A qualitative content analysis was undertaken to explore the evolving self-care process over time.</div></div><div><h3>Results</h3><div>‘Transition from digital dependence to independent self-care management’ emerged as the overarching theme describing participants’ experiences at both time points. This theme was illustrated by four subthemes identified at time one: (1) guidance to interpret symptoms and bodily signs; (2) establishing a daily routine in monitoring vital signs; (3) support for changes in lifestyle and medication adherence; and (4) sense of security. At time two, three subthemes were identified: (1) increased confidence in bodily awareness and symptom monitoring; (2) recognition of self-care routines; and (3) feeling in control due to prior feedback from a previous nurse navigator.</div></div><div><h3>Conclusions</h3><div>Individuals with heart failure experienced self-care as an evolving process. This was demonstrated by their transition from reliance on digital support from nurses and the remote patient monitoring intervention to increased independence and proactivity in managing their self-care. There is an urgent need to respond to the pressures facing overburdened health-care systems. These findings highlight the importance of developing a digital environment that supports sustainable transitional care from hospital to home for individuals with heart failure.</div></div><div><h3>Registration</h3><div>The main randomised controlled trial project, “eHealth
{"title":"The process of self-care in patients with heart failure after nurse-assisted remote patient monitoring: A qualitative longitudinal approach","authors":"Signe Østrem , Anna Strömberg , Kari Hanne Gjeilo , Marianne Storm , Ingvild M. Morken","doi":"10.1016/j.ijnsa.2025.100426","DOIUrl":"10.1016/j.ijnsa.2025.100426","url":null,"abstract":"<div><h3>Background</h3><div>Effective self-care, including symptom monitoring and treatment adherence, is essential for individuals with heart failure. It can enhance quality of life, improve survival, and reduce hospital admissions. The home is the primary setting where individuals with heart failure perform self-care. However, many struggle to recognize symptoms that indicate worsening of their condition. Remote patient monitoring allows nurses to track symptoms, weight, and blood pressure while supporting self-care behaviours that help prevent exacerbations. A clearer understanding of these interventions is needed, particularly regarding how they influence patients’ views on self-care over time.</div></div><div><h3>Objective</h3><div>This study explored short- and long-term experiences of self-care among individuals with heart failure after a six-week, nurse-assisted remote patient monitoring intervention.</div></div><div><h3>Setting</h3><div>Twelve participants were recruited from the intervention group in a randomised controlled trial. Clinical trial ID 301472.</div></div><div><h3>Methods</h3><div>This study employed a qualitative longitudinal approach. Eleven semi-structured interviews were conducted at two time points: at time one, immediately after participants had completed the nurse-assisted remote patient monitoring intervention; and at time two, six months post-discharge. One participant did not respond to the second interview, resulting in 23 interviews in total. A qualitative content analysis was undertaken to explore the evolving self-care process over time.</div></div><div><h3>Results</h3><div>‘Transition from digital dependence to independent self-care management’ emerged as the overarching theme describing participants’ experiences at both time points. This theme was illustrated by four subthemes identified at time one: (1) guidance to interpret symptoms and bodily signs; (2) establishing a daily routine in monitoring vital signs; (3) support for changes in lifestyle and medication adherence; and (4) sense of security. At time two, three subthemes were identified: (1) increased confidence in bodily awareness and symptom monitoring; (2) recognition of self-care routines; and (3) feeling in control due to prior feedback from a previous nurse navigator.</div></div><div><h3>Conclusions</h3><div>Individuals with heart failure experienced self-care as an evolving process. This was demonstrated by their transition from reliance on digital support from nurses and the remote patient monitoring intervention to increased independence and proactivity in managing their self-care. There is an urgent need to respond to the pressures facing overburdened health-care systems. These findings highlight the importance of developing a digital environment that supports sustainable transitional care from hospital to home for individuals with heart failure.</div></div><div><h3>Registration</h3><div>The main randomised controlled trial project, “eHealth","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100426"},"PeriodicalIF":3.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424326","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}
Pub Date : 2025-09-18DOI: 10.1016/j.ijnsa.2025.100425
Stefan Lukac , Viktoria Maria Kässens , Anne Barzel , Tabea Kloss , Ina Mayer , Wolfgang Janni , Katharina Hancke , Davut Dayan
Background
Like other chronic diseases, endometriosis also requires long-term, individualized and multidisciplinary care. The integration of specialized nursing care has already been proven in other chronic diseases, but it is unclear whether and in which areas the integration of an endometriosis nurse specialist (EndoNurse) would be welcomed by patients with endometriosis.
Objective
The aim of this study is to identify the need and acceptance of an integration of a nurse specialist into the care of patients with endometriosis and possible counselling topics.
Design
Cross-sectional study in Germany.
Setting and Participants
844 German-speaking patients with diagnosed endometriosis completed an online survey distributed via official platforms and social media.
Methods
The current satisfaction and needs of patients with endometriosis were evaluated in five dimensions (Physical and psychological symptoms, therapy, lifestyle, sexuality, partnership, fertility, treatment wishes) similar to the Endometriosis Impact Questionnaire. In addition, questions regarding the need for optimalization along with acceptance and preferred areas of care by an EndoNurse were included. The evaluation was based on the 5-point Likert-scale.
Results
844 participants were included in the final analysis. Only 138 (16.4 %) of them described their current care as good or very good. Fewer than one in five patients felt well or very well informed concerning the topics symptoms (200; 23.7 %), therapy (209; 24.8 %), sexuality and family planning (124; 14.7 %) as well as sport and nutrition (111; 13.1 %). 774 (91.7 %) of the participants would accept an integration of an EndoNurse in their treatment, particularly regarding the following topics: pain management (594; 70.4 %), nutrition (570; 67.5 %), sports and physiotherapy (567; 67.2 %), coping with everyday life (558; 65.8 %) and therapy options (547; 64.8 %). 474 (56.2 %) of the patients named physicians as their preferred source of information. Specially trained medical staff (EndoNurse) followed with 159 (18.8 %) votes, ahead of the internet (88; 10.4 %), self-help groups (41; 4.9 %), apps (37; 4.4 %) and others.
Conclusions
Our study demonstrates a significant need for improvement in supportive endometriosis care. The involvement of a specialised nurse, EndoNurse, into care of patients with endometriosis is a concept that is useful and desirable for those affected in all evaluated areas.
Registration
The study was approved by the Ethical Committee of the University of Ulm Nr. 364/23 and registered in the German Register of Clinical Studies under Nr. DRKS00033078.
{"title":"Evaluation of the need for the integration of a nurse specialist (EndoNurse) into the interdisciplinary care of patients with endometriosis: Cross-sectional study","authors":"Stefan Lukac , Viktoria Maria Kässens , Anne Barzel , Tabea Kloss , Ina Mayer , Wolfgang Janni , Katharina Hancke , Davut Dayan","doi":"10.1016/j.ijnsa.2025.100425","DOIUrl":"10.1016/j.ijnsa.2025.100425","url":null,"abstract":"<div><h3>Background</h3><div>Like other chronic diseases, endometriosis also requires long-term, individualized and multidisciplinary care. The integration of specialized nursing care has already been proven in other chronic diseases, but it is unclear whether and in which areas the integration of an endometriosis nurse specialist (EndoNurse) would be welcomed by patients with endometriosis.</div></div><div><h3>Objective</h3><div>The aim of this study is to identify the need and acceptance of an integration of a nurse specialist into the care of patients with endometriosis and possible counselling topics.</div></div><div><h3>Design</h3><div>Cross-sectional study in Germany.</div></div><div><h3>Setting and Participants</h3><div>844 German-speaking patients with diagnosed endometriosis completed an online survey distributed via official platforms and social media.</div></div><div><h3>Methods</h3><div>The current satisfaction and needs of patients with endometriosis were evaluated in five dimensions (Physical and psychological symptoms, therapy, lifestyle, sexuality, partnership, fertility, treatment wishes) similar to the Endometriosis Impact Questionnaire. In addition, questions regarding the need for optimalization along with acceptance and preferred areas of care by an EndoNurse were included. The evaluation was based on the 5-point Likert-scale.</div></div><div><h3>Results</h3><div>844 participants were included in the final analysis. Only 138 (16.4 %) of them described their current care as good or very good. Fewer than one in five patients felt well or very well informed concerning the topics symptoms (200; 23.7 %), therapy (209; 24.8 %), sexuality and family planning (124; 14.7 %) as well as sport and nutrition (111; 13.1 %). 774 (91.7 %) of the participants would accept an integration of an EndoNurse in their treatment, particularly regarding the following topics: pain management (594; 70.4 %), nutrition (570; 67.5 %), sports and physiotherapy (567; 67.2 %), coping with everyday life (558; 65.8 %) and therapy options (547; 64.8 %). 474 (56.2 %) of the patients named physicians as their preferred source of information. Specially trained medical staff (EndoNurse) followed with 159 (18.8 %) votes, ahead of the internet (88; 10.4 %), self-help groups (41; 4.9 %), apps (37; 4.4 %) and others.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates a significant need for improvement in supportive endometriosis care. The involvement of a specialised nurse, EndoNurse, into care of patients with endometriosis is a concept that is useful and desirable for those affected in all evaluated areas.</div></div><div><h3>Registration</h3><div>The study was approved by the Ethical Committee of the University of Ulm Nr. 364/23 and registered in the German Register of Clinical Studies under Nr. DRKS00033078.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100425"},"PeriodicalIF":3.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265289","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}
Pub Date : 2025-09-13DOI: 10.1016/j.ijnsa.2025.100424
Nicole Williams , Walter Wittich , M.Kathleen Pichora-Fuller , Joseph B. Orange , Dawn M. Guthrie
Background
The current study evaluated the performance of the interRAI communication collaborative action plan (CAP) to flag individuals with sensory impairments who could benefit from intervention. Investigators also examined how the CAP can help facilitate client-centered care planning and service delivery by exploring three unique case studies.
Method
This retrospective cohort study utilized secondary data collected using the Resident Assessment Instrument for Home Care (RAI-HC) across Canada. The sample included individuals aged 65 years or older who had two RAI-HC assessments completed between 2008 and 2020 (n=508,856). At time 1, individuals were categorized into three mutually exclusive groups based on their CAP triggering level: not triggered, triggered to facilitate improvement, or triggered to prevent decline. The three groups were compared across demographic characteristics, sensory impairments, cognitive challenges, and disease diagnoses. Transitions between triggering levels from time 1 and time 2 were analyzed using Sankey diagrams. Three case studies were examined to identify the reasons why someone may no longer trigger on the CAP at time 2.
Results
The median time between an individual’s intake and most recent assessment was 21 months (standard deviation=24.7 months). The majority of individuals did not trigger on the CAP at time 1 (77.7 %; n=395,309), while 9.5 % (n=48,263) triggered to facilitate improvement and 12.5 % (n=65,284) triggered to prevent decline. For each of the sensory impairments, the majority of individuals were more likely to fall into the triggered to facilitate improvement group.
Conclusions
The communication CAP was robust in flagging individuals with sensory impairments as these individuals are more likely to fall into the triggered to facilitate improvement group. The three case studies highlight the importance of assessing all aspects of communication (e.g., cognitive, and sensory challenges, receptive and expressive communication), as they are all necessary components when considering decision-support tools and next steps.
{"title":"Examining the ability of the interRAI communication collaborative action plan to identify individuals with sensory challenges: A retrospective cohort study","authors":"Nicole Williams , Walter Wittich , M.Kathleen Pichora-Fuller , Joseph B. Orange , Dawn M. Guthrie","doi":"10.1016/j.ijnsa.2025.100424","DOIUrl":"10.1016/j.ijnsa.2025.100424","url":null,"abstract":"<div><h3>Background</h3><div>The current study evaluated the performance of the interRAI communication collaborative action plan (CAP) to flag individuals with sensory impairments who could benefit from intervention. Investigators also examined how the CAP can help facilitate client-centered care planning and service delivery by exploring three unique case studies.</div></div><div><h3>Method</h3><div>This retrospective cohort study utilized secondary data collected using the Resident Assessment Instrument for Home Care (RAI-HC) across Canada. The sample included individuals aged 65 years or older who had two RAI-HC assessments completed between 2008 and 2020 (n=508,856). At time 1, individuals were categorized into three mutually exclusive groups based on their CAP triggering level: not triggered, triggered to facilitate improvement, or triggered to prevent decline. The three groups were compared across demographic characteristics, sensory impairments, cognitive challenges, and disease diagnoses. Transitions between triggering levels from time 1 and time 2 were analyzed using Sankey diagrams. Three case studies were examined to identify the reasons why someone may no longer trigger on the CAP at time 2.</div></div><div><h3>Results</h3><div>The median time between an individual’s intake and most recent assessment was 21 months (standard deviation=24.7 months). The majority of individuals did not trigger on the CAP at time 1 (77.7 %; n=395,309), while 9.5 % (n=48,263) triggered to facilitate improvement and 12.5 % (n=65,284) triggered to prevent decline. For each of the sensory impairments, the majority of individuals were more likely to fall into the triggered to facilitate improvement group.</div></div><div><h3>Conclusions</h3><div>The communication CAP was robust in flagging individuals with sensory impairments as these individuals are more likely to fall into the triggered to facilitate improvement group. The three case studies highlight the importance of assessing all aspects of communication (e.g., cognitive, and sensory challenges, receptive and expressive communication), as they are all necessary components when considering decision-support tools and next steps.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100424"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-13DOI: 10.1016/j.ijnsa.2025.100423
Juan Roldan-Merino , Carmen Jerez-Molina , Olga Mestres-Soler , Lucia Muñoz-Narbona , Montserrat Gutiérrez-Juarez , Ainoa Biurrun-Garrido , Jéssica Gutiérrez-Martínez , Jurema Lopez-Monreal , Clara Expósito-Guanter , Martí Boix-Coll , Lucia Peñarrubia-San-Florencio , Ramon Mir-Abellan
Background
Maintaining dignity in hospitalized patients is fundamental in nursing care and healthcare quality. In Spain, there is no validated tool to quantitatively assess patient dignity during hospitalization. The Inpatient Dignity Scale has been developed and validated in other countries, but its cross-cultural adaptation and psychometric evaluation in Spanish have not yet been conducted.
Objective
To perform cross-cultural adaptation and psychometric validation of the Inpatient Dignity Scale in Spanish, evaluating its factorial structure, reliability, and validity.
Methods
A methodological study was conducted in two phases: (1) translation and cross-cultural adaptation following international standards, and (2) psychometric validation through confirmatory factor analysis and assessment of internal consistency using Cronbach's alpha (α) and McDonald's omega (Ω) coefficients. The sample included 553 hospitalized patients from four hospitals in Barcelona, Spain.
Results
The confirmatory factor analysis confirmed the original four-factor structure of the Inpatient Dignity Scale, maintaining the dimensions of respect as a human being, respect for personal feelings and time, respect for privacy, and respect for autonomy. Model fit indices were adequate (χ²/df = 5.7 for expectations, 4.3 for satisfaction; CFI ≥ 0.90; RMSEA ≤ 0.08). Internal consistency was high across all dimensions (α ≥ 0.88, Ω ≥ 0.92), indicating robust reliability.
Conclusions
The Spanish version of the Inpatient Dignity Scale in Spanish is a valid and reliable instrument for assessing expectations and satisfaction with dignity in hospitalized patients. Its use can facilitate research on dignity in healthcare and contribute to improving patient-centered care.
{"title":"Adaptation and validation of Spanish version of the Inpatient Dignity Scale in hospitalized patients: a psychometric study","authors":"Juan Roldan-Merino , Carmen Jerez-Molina , Olga Mestres-Soler , Lucia Muñoz-Narbona , Montserrat Gutiérrez-Juarez , Ainoa Biurrun-Garrido , Jéssica Gutiérrez-Martínez , Jurema Lopez-Monreal , Clara Expósito-Guanter , Martí Boix-Coll , Lucia Peñarrubia-San-Florencio , Ramon Mir-Abellan","doi":"10.1016/j.ijnsa.2025.100423","DOIUrl":"10.1016/j.ijnsa.2025.100423","url":null,"abstract":"<div><h3>Background</h3><div>Maintaining dignity in hospitalized patients is fundamental in nursing care and healthcare quality. In Spain, there is no validated tool to quantitatively assess patient dignity during hospitalization. The Inpatient Dignity Scale has been developed and validated in other countries, but its cross-cultural adaptation and psychometric evaluation in Spanish have not yet been conducted.</div></div><div><h3>Objective</h3><div>To perform cross-cultural adaptation and psychometric validation of the Inpatient Dignity Scale in Spanish, evaluating its factorial structure, reliability, and validity.</div></div><div><h3>Methods</h3><div>A methodological study was conducted in two phases: (1) translation and cross-cultural adaptation following international standards, and (2) psychometric validation through confirmatory factor analysis and assessment of internal consistency using Cronbach's alpha (α) and McDonald's omega (Ω) coefficients. The sample included 553 hospitalized patients from four hospitals in Barcelona, Spain.</div></div><div><h3>Results</h3><div>The confirmatory factor analysis confirmed the original four-factor structure of the Inpatient Dignity Scale, maintaining the dimensions of respect as a human being, respect for personal feelings and time, respect for privacy, and respect for autonomy. Model fit indices were adequate (χ²/df = 5.7 for expectations, 4.3 for satisfaction; CFI ≥ 0.90; RMSEA ≤ 0.08). Internal consistency was high across all dimensions (α ≥ 0.88, Ω ≥ 0.92), indicating robust reliability.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the Inpatient Dignity Scale in Spanish is a valid and reliable instrument for assessing expectations and satisfaction with dignity in hospitalized patients. Its use can facilitate research on dignity in healthcare and contribute to improving patient-centered care.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100423"},"PeriodicalIF":3.1,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104557","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}
Pub Date : 2025-09-12DOI: 10.1016/j.ijnsa.2025.100420
Tania Martins, Sarah N. Musy, Michael Simon
Introduction
Although shift work is inevitable in hospitals, some shift patterns and staffing levels are suggested to influence nurses’ workload more than others, which in turn can impact nurses’ health, quality of care, and patient safety. Despite the importance of workload in nursing practice, studies focusing on nurses’ work schedules, staffing levels and perceived workload are rare. The aims of this study were to describe key characteristics of nurses’ shift work patterns in acute care hospitals, and to investigate the association of shift work patterns and staffing levels with perceived workload.
Methods
This was a secondary analysis of an observational, cross-sectional, multicentre study conducted in 26 acute care hospitals in Switzerland. Registered nurses from 158 units completed the survey, covering questions about nurse staffing, the work environment and quality of care. We used sequenced data analysis to visualise nurses’ work schedules over the last seven days and identify shift characteristics and transitions. Clustering using Optimal Matching allowed us to group nurses with similar shift sequences and identify shift patterns. An observed-over-expected patient-to-nurse ratio (including patient acuity measures) was computed to assess staffing exposure. Perceived workload was measured with the NASA-Task Load Index instrument. A linear-mixed model was used to explore the association between identified shift work patterns, staffing and perceived workload.
Results
We analysed surveys of 1962 registered nurses. The sequence analysis identified 732 different sequences resulting in three clusters of different shift patterns. Backward rotations, quick returns and working more than five consecutive days were rare. Workload perception was on average 66.5 points (possible range 6–120). Low staffing (β=3.1, 95 % CI [0.5–5.6]), overtime in the last shift (β=8.8, 95 % CI [7.2–10.4]), higher percentage of days worked overtime in the previous seven days (β=3.9, 95 % CI [1.3–6.3]), number of days worked (β=6.4, 95 % CI [2.5–10.1]), last shift worked being a day shift (β=3.8, 95 % CI [1.8–5.8]), and longer shift length (β=1.4, 95 % CI [0.5–2.2]) were associated with higher perceived workload.
Conclusions
This study highlights the contribution of staffing and scheduling practices to nurses’ perceived workload. To reduce nurses’ perceived workload and improve healthcare performance—as previous research suggests—staffing and scheduling decisions must be increasingly prioritized by decision makers. The results suggest that avoiding or reducing e.g., overtime, reducing shift length and increasing staffing may be effective first strategies to reduce the perceived workload. Further research would benefit from analysing shift patterns using electronic rosters, real-time staffing measures, and repeated assessment of nurses’ workload perceptions.
{"title":"Nurse shift patterns, staffing and their association with perceived workload: Sequence analysis of multicentre data","authors":"Tania Martins, Sarah N. Musy, Michael Simon","doi":"10.1016/j.ijnsa.2025.100420","DOIUrl":"10.1016/j.ijnsa.2025.100420","url":null,"abstract":"<div><h3>Introduction</h3><div>Although shift work is inevitable in hospitals, some shift patterns and staffing levels are suggested to influence nurses’ workload more than others, which in turn can impact nurses’ health, quality of care, and patient safety. Despite the importance of workload in nursing practice, studies focusing on nurses’ work schedules, staffing levels and perceived workload are rare. The aims of this study were to describe key characteristics of nurses’ shift work patterns in acute care hospitals, and to investigate the association of shift work patterns and staffing levels with perceived workload.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of an observational, cross-sectional, multicentre study conducted in 26 acute care hospitals in Switzerland. Registered nurses from 158 units completed the survey, covering questions about nurse staffing, the work environment and quality of care. We used sequenced data analysis to visualise nurses’ work schedules over the last seven days and identify shift characteristics and transitions. Clustering using Optimal Matching allowed us to group nurses with similar shift sequences and identify shift patterns. An observed-over-expected patient-to-nurse ratio (including patient acuity measures) was computed to assess staffing exposure. Perceived workload was measured with the NASA-Task Load Index instrument. A linear-mixed model was used to explore the association between identified shift work patterns, staffing and perceived workload.</div></div><div><h3>Results</h3><div>We analysed surveys of 1962 registered nurses. The sequence analysis identified 732 different sequences resulting in three clusters of different shift patterns. Backward rotations, quick returns and working more than five consecutive days were rare. Workload perception was on average 66.5 points (possible range 6–120). Low staffing (β=3.1, 95 % CI [0.5–5.6]), overtime in the last shift (β=8.8, 95 % CI [7.2–10.4]), higher percentage of days worked overtime in the previous seven days (β=3.9, 95 % CI [1.3–6.3]), number of days worked (β=6.4, 95 % CI [2.5–10.1]), last shift worked being a day shift (β=3.8, 95 % CI [1.8–5.8]), and longer shift length (β=1.4, 95 % CI [0.5–2.2]) were associated with higher perceived workload.</div></div><div><h3>Conclusions</h3><div>This study highlights the contribution of staffing and scheduling practices to nurses’ perceived workload. To reduce nurses’ perceived workload and improve healthcare performance—as previous research suggests—staffing and scheduling decisions must be increasingly prioritized by decision makers. The results suggest that avoiding or reducing e.g., overtime, reducing shift length and increasing staffing may be effective first strategies to reduce the perceived workload. Further research would benefit from analysing shift patterns using electronic rosters, real-time staffing measures, and repeated assessment of nurses’ workload perceptions.</div></div><","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100420"},"PeriodicalIF":3.1,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265290","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}
Pub Date : 2025-09-11DOI: 10.1016/j.ijnsa.2025.100422
Marcel Schmucker , Andreas Küpper , Laura Hahn , Cornelia Mahler , Astrid Elsbernd
Background
Care dependency and mobility restrictions often go hand in hand, increasing the risk of falls. Rollators are essential assistive devices that support individuals’ mobility and functioning, with globally varying usage rates. While overall user satisfaction is rated high, usability challenges persist. Beyond advocating for user needs, nursing science should also address the role of rollators in enabling individuals to remain at home despite care needs, ensuring safety, and shaping informal and formal care settings.
Purpose
This study examined usability aspects with a strong user-centred emphasis on subjective rollator satisfaction, using Amazon rollator reviews as data source. The aim was to validate previously found aspects and to explore unknown elements of human-rollator interaction.
Methods
A total 1.026 rollator reviews from three price categories (200 €) were analysed. A Qualitative Content Analysis was employed, combining deductive and inductive coding methods. Deductive analysis was conducted based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). Inductive analysis was based on the Grounded Theory Method to identify themes that were not fully considered in the deductive coding.
Results
A total of 2243 deductive codes were assigned, with Ease of Use (489) and Comfort (458) being the most frequently coded categories. The inductive analysis revealed that users' expectations differ depending on the objectives of the primary and secondary users, who often make the purchasing decisions. Aesthetic appeal influenced rollator acceptance and reducing stigma. Usability has been shown to evolve over time, with experience, adaptation, and wear affecting long-term satisfaction and maintenance needs.
Conclusions
This study highlights the complexity of rollator usability, shaped by material and non-materialistic user needs. Amazon reviews offer valuable insights, including secondary user perspectives. Nurses can play a key role in training and advising on rollator, contributing to better provision. As rollators shape care situations, it is essential for nursing science to address assistive technology to improve usability, safety, and overall quality of care.
{"title":"Rollator usability from a nursing science perspective: A parallel qualitative content analysis of customer reviews on Amazon","authors":"Marcel Schmucker , Andreas Küpper , Laura Hahn , Cornelia Mahler , Astrid Elsbernd","doi":"10.1016/j.ijnsa.2025.100422","DOIUrl":"10.1016/j.ijnsa.2025.100422","url":null,"abstract":"<div><h3>Background</h3><div>Care dependency and mobility restrictions often go hand in hand, increasing the risk of falls. Rollators are essential assistive devices that support individuals’ mobility and functioning, with globally varying usage rates. While overall user satisfaction is rated high, usability challenges persist. Beyond advocating for user needs, nursing science should also address the role of rollators in enabling individuals to remain at home despite care needs, ensuring safety, and shaping informal and formal care settings.</div></div><div><h3>Purpose</h3><div>This study examined usability aspects with a strong user-centred emphasis on subjective rollator satisfaction, using Amazon rollator reviews as data source. The aim was to validate previously found aspects and to explore unknown elements of human-rollator interaction.</div></div><div><h3>Methods</h3><div>A total 1.026 rollator reviews from three price categories (200 €) were analysed. A Qualitative Content Analysis was employed, combining deductive and inductive coding methods. Deductive analysis was conducted based on the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). Inductive analysis was based on the Grounded Theory Method to identify themes that were not fully considered in the deductive coding.</div></div><div><h3>Results</h3><div>A total of 2243 deductive codes were assigned, with Ease of Use (489) and Comfort (458) being the most frequently coded categories. The inductive analysis revealed that users' expectations differ depending on the objectives of the primary and secondary users, who often make the purchasing decisions. Aesthetic appeal influenced rollator acceptance and reducing stigma. Usability has been shown to evolve over time, with experience, adaptation, and wear affecting long-term satisfaction and maintenance needs.</div></div><div><h3>Conclusions</h3><div>This study highlights the complexity of rollator usability, shaped by material and non-materialistic user needs. Amazon reviews offer valuable insights, including secondary user perspectives. Nurses can play a key role in training and advising on rollator, contributing to better provision. As rollators shape care situations, it is essential for nursing science to address assistive technology to improve usability, safety, and overall quality of care.</div></div><div><h3>Study Registration</h3><div>Not registered.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100422"},"PeriodicalIF":3.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104556","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}
Psychological well-being is an important topic in mental health. It is known that university students have a high prevalence of stress and psychological distress, especially students in health sciences fields such as nursing. Despite the growing emergence of this public health issue, research on the factors affecting the mental health of nursing students is limited.
Objective
To estimate the global psychological health and well-being of Spanish nursing students and its associations with sociodemographic and lifestyle factors.
Methods
A cross-sectional study was conducted among nursing students. Descriptive analysis, bivariate analysis, and binary regression models were performed.
Results
A total of 235 students participated, of which 49.4 % had poor psychological well-being and 51.5 % reported high levels of detrimental emotional symptoms. The main factors related to these unfavorable outcomes were smoking (OR > 5, 95 % C.I. 2–16.30), frequent consumption of fast food (OR > 5, 95 % C.I. 2–16.30), sleeping <7 h (OR > 2.5, 95 % C.I. 1.46–5.09), and being in the third year of the University study program (OR 2.13, 95 % C.I. 1.051–4.331).
Conclusions
These results highlight healthy lifestyle habits as the main factors related to psychological well-being. Additionally, they underscore the need to create psychological support strategies for nursing students.
{"title":"Factors related to well-being and psychological health in nursing students: A cross-sectional survey","authors":"Beatriz Calderón-Cruz , Uxía García-Sánchez , Jacinto Luis González-Oya , Ángela Prieto-Campo","doi":"10.1016/j.ijnsa.2025.100421","DOIUrl":"10.1016/j.ijnsa.2025.100421","url":null,"abstract":"<div><h3>Background</h3><div>Psychological well-being is an important topic in mental health. It is known that university students have a high prevalence of stress and psychological distress, especially students in health sciences fields such as nursing. Despite the growing emergence of this public health issue, research on the factors affecting the mental health of nursing students is limited.</div></div><div><h3>Objective</h3><div>To estimate the global psychological health and well-being of Spanish nursing students and its associations with sociodemographic and lifestyle factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among nursing students. Descriptive analysis, bivariate analysis, and binary regression models were performed.</div></div><div><h3>Results</h3><div>A total of 235 students participated, of which 49.4 % had poor psychological well-being and 51.5 % reported high levels of detrimental emotional symptoms. The main factors related to these unfavorable outcomes were smoking (OR > 5, 95 % C.I. 2–16.30), frequent consumption of fast food (OR > 5, 95 % C.I. 2–16.30), sleeping <7 h (OR > 2.5, 95 % C.I. 1.46–5.09), and being in the third year of the University study program (OR 2.13, 95 % C.I. 1.051–4.331).</div></div><div><h3>Conclusions</h3><div>These results highlight healthy lifestyle habits as the main factors related to psychological well-being. Additionally, they underscore the need to create psychological support strategies for nursing students.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100421"},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117967","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}
Pub Date : 2025-09-08DOI: 10.1016/j.ijnsa.2025.100417
Mathulada Chaimee , Jutharat Attawet , Yunjing Qiu , Thomas J Hugh , Pauline Murray-Parahi , Amanda Wilson
<div><h3>Background</h3><div>Delayed discharge is a global challenge that strains healthcare systems and affects patient outcomes. In gastrointestinal surgery patients, delays often result from a continuum, clinical complications prolong the acute stay and create additional care needs, such as rehabilitation and specialised homecare, which lead to further delays. However, existing literature provides limited insight into this patient group, as most studies generalise the issue. A focused integrative review is therefore needed to synthesise the causes, impacts, and strategies of delayed discharge and to inform more effective discharge planning.</div></div><div><h3>Objective</h3><div>This review aims to synthesise evidence related to delayed discharge in patients undergoing gastrointestinal surgery. Specifically, it seeks to: (1) identify multi-level contributing factors (patient, clinical, and healthcare system); (2) evaluate significant clinical and economic impacts on patients, family, healthcare staff and healthcare system; and (3) identify and describe effective interventions implemented to promote timely and safe discharge in this population.</div></div><div><h3>Method</h3><div>A literature search was conducted across CINAHL, Medline, Scopus, Cochrane, and PsycINFO databases for studies published from 2000 to January 2025. Keywords used included “delayed discharge,” “factors,” “impact,” “gastrointestinal surgery,” and “intervention.” Inclusion criteria focused on peer-reviewed studies involving adult gastrointestinal surgery patients in acute hospital settings. Two authors independently screened titles, abstracts, and full texts using the Joanna Briggs Institute SUMARI software. The methodological quality of studies was assessed using the Joanna Briggs Institute critical appraisal tools. Data extraction focused on study characteristics, factors, impacts, and interventions, followed by a deductive narrative analysis to identify patterns and relationships.</div></div><div><h3>Results</h3><div>Of the 572 articles identified, 20 met inclusion criteria: 17 cohort studies (12 retrospective, five prospective), one analytic cross-sectional study, and two clinical trials. The findings encompassed the length of stay and delayed discharge rate, contributing factors, impacts, and potential interventions. Delayed discharge stemmed from patient, surgical, and system-related factors, affecting patients and hospital efficiency. Targeted interventions, like nurse-led stoma education and streamlined discharge criteria, significantly reduced delays (<em>p</em> < 0.0001).</div></div><div><h3>Conclusion</h3><div>Delayed discharge in gastrointestinal surgery patients stems from a complex interplay of patient, surgical, and systemic factors, affecting both individual and healthcare system. Evidence supports nurse-led and multidisciplinary approaches in mitigating delays, improving outcomes and enhancing healthcare efficiency. Future research should employ qualit
{"title":"Improving delayed discharge in gastrointestinal surgery patients: An integrative review","authors":"Mathulada Chaimee , Jutharat Attawet , Yunjing Qiu , Thomas J Hugh , Pauline Murray-Parahi , Amanda Wilson","doi":"10.1016/j.ijnsa.2025.100417","DOIUrl":"10.1016/j.ijnsa.2025.100417","url":null,"abstract":"<div><h3>Background</h3><div>Delayed discharge is a global challenge that strains healthcare systems and affects patient outcomes. In gastrointestinal surgery patients, delays often result from a continuum, clinical complications prolong the acute stay and create additional care needs, such as rehabilitation and specialised homecare, which lead to further delays. However, existing literature provides limited insight into this patient group, as most studies generalise the issue. A focused integrative review is therefore needed to synthesise the causes, impacts, and strategies of delayed discharge and to inform more effective discharge planning.</div></div><div><h3>Objective</h3><div>This review aims to synthesise evidence related to delayed discharge in patients undergoing gastrointestinal surgery. Specifically, it seeks to: (1) identify multi-level contributing factors (patient, clinical, and healthcare system); (2) evaluate significant clinical and economic impacts on patients, family, healthcare staff and healthcare system; and (3) identify and describe effective interventions implemented to promote timely and safe discharge in this population.</div></div><div><h3>Method</h3><div>A literature search was conducted across CINAHL, Medline, Scopus, Cochrane, and PsycINFO databases for studies published from 2000 to January 2025. Keywords used included “delayed discharge,” “factors,” “impact,” “gastrointestinal surgery,” and “intervention.” Inclusion criteria focused on peer-reviewed studies involving adult gastrointestinal surgery patients in acute hospital settings. Two authors independently screened titles, abstracts, and full texts using the Joanna Briggs Institute SUMARI software. The methodological quality of studies was assessed using the Joanna Briggs Institute critical appraisal tools. Data extraction focused on study characteristics, factors, impacts, and interventions, followed by a deductive narrative analysis to identify patterns and relationships.</div></div><div><h3>Results</h3><div>Of the 572 articles identified, 20 met inclusion criteria: 17 cohort studies (12 retrospective, five prospective), one analytic cross-sectional study, and two clinical trials. The findings encompassed the length of stay and delayed discharge rate, contributing factors, impacts, and potential interventions. Delayed discharge stemmed from patient, surgical, and system-related factors, affecting patients and hospital efficiency. Targeted interventions, like nurse-led stoma education and streamlined discharge criteria, significantly reduced delays (<em>p</em> < 0.0001).</div></div><div><h3>Conclusion</h3><div>Delayed discharge in gastrointestinal surgery patients stems from a complex interplay of patient, surgical, and systemic factors, affecting both individual and healthcare system. Evidence supports nurse-led and multidisciplinary approaches in mitigating delays, improving outcomes and enhancing healthcare efficiency. Future research should employ qualit","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100417"},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104604","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}
Pub Date : 2025-09-07DOI: 10.1016/j.ijnsa.2025.100418
Yu Chen , Ying Lin , Xinyue Dong , Yan Xue , Dong Wu
Background
Self-care is crucial for improving the quality of life of patients with chronic heart failure. Self-care behaviors change over time, and the trajectories differ among patients with varying characteristics. However, the trajectories of self-care behaviors in older adults with chronic heart failure have not been fully studied.
Objective
This study aimed to identify the trajectory patterns of self-care behaviors over 3 months after hospital discharge in Chinese older adults with chronic heart failure, as well as the factors influencing these patterns.
Methods
A prospective observational study was conducted from October 2022 to July 2023, involving 255 older adults with chronic heart failure recruited from a tertiary hospital in Shanghai, China. Demographic and clinical information, self-care behaviors, self-care confidence, illness perception, self-efficacy, social support, and heart failure knowledge were investigated using a validated questionnaire and electronic health records at baseline, 2 weeks, 4 weeks, 2 months, and 3 months post-discharge. Growth mixture modeling was used to identify the trajectory patterns of self-care behaviors. Logistic regression was used to determine the influencing factors of different trajectory patterns.
Results
The best-fit growth mixture modeling revealed a 2-class model for self-care maintenance: “sustained good” group and “poor-gradually improving” group; a 3-class model for symptom perception: “gradually decreasing”, “persistently poor”, and “poor-gradually improving” groups; and a 3-class model for self-care management: “poor-gradually improving”, “sustained good”, and “early boost then decline” groups. Self-care confidence, heart failure knowledge, economic level, and the source of medical expenses were determinants of the different trajectory patterns in self-care behaviors.
Conclusion
This study enhances the understanding of the diverse behavioral trajectory patterns exhibited by Chinese older adults with chronic heart failure, as well as the factors that influence these patterns. Tailored interventions that focus on the unique needs of diverse groups should be developed to sustain satisfactory self-care behaviors.
{"title":"Trajectories and influencing factors of self-care behaviors in Chinese older adults with chronic heart failure: A prospective observational study","authors":"Yu Chen , Ying Lin , Xinyue Dong , Yan Xue , Dong Wu","doi":"10.1016/j.ijnsa.2025.100418","DOIUrl":"10.1016/j.ijnsa.2025.100418","url":null,"abstract":"<div><h3>Background</h3><div>Self-care is crucial for improving the quality of life of patients with chronic heart failure. Self-care behaviors change over time, and the trajectories differ among patients with varying characteristics. However, the trajectories of self-care behaviors in older adults with chronic heart failure have not been fully studied.</div></div><div><h3>Objective</h3><div>This study aimed to identify the trajectory patterns of self-care behaviors over 3 months after hospital discharge in Chinese older adults with chronic heart failure, as well as the factors influencing these patterns.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted from October 2022 to July 2023, involving 255 older adults with chronic heart failure recruited from a tertiary hospital in Shanghai, China. Demographic and clinical information, self-care behaviors, self-care confidence, illness perception, self-efficacy, social support, and heart failure knowledge were investigated using a validated questionnaire and electronic health records at baseline, 2 weeks, 4 weeks, 2 months, and 3 months post-discharge. Growth mixture modeling was used to identify the trajectory patterns of self-care behaviors. Logistic regression was used to determine the influencing factors of different trajectory patterns.</div></div><div><h3>Results</h3><div>The best-fit growth mixture modeling revealed a 2-class model for self-care maintenance: “sustained good” group and “poor-gradually improving” group; a 3-class model for symptom perception: “gradually decreasing”, “persistently poor”, and “poor-gradually improving” groups; and a 3-class model for self-care management: “poor-gradually improving”, “sustained good”, and “early boost then decline” groups. Self-care confidence, heart failure knowledge, economic level, and the source of medical expenses were determinants of the different trajectory patterns in self-care behaviors.</div></div><div><h3>Conclusion</h3><div>This study enhances the understanding of the diverse behavioral trajectory patterns exhibited by Chinese older adults with chronic heart failure, as well as the factors that influence these patterns. Tailored interventions that focus on the unique needs of diverse groups should be developed to sustain satisfactory self-care behaviors.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100418"},"PeriodicalIF":3.1,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104553","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}
Pub Date : 2025-09-01DOI: 10.1016/j.ijnsa.2025.100416
Linglong Liu , Xiaoping Fang , Xinbo Wang , Xiaoyan Wang , Yehua Xie , Yaoyao Cai , Lei Cui , Tianying Yao , Xiaoxuan Li , Qian Li , Mingxia Chen
Background
Family caregivers ('carers') bear the highest care burden during the postoperative survivorship period of pancreatic cancer, given its poor prognosis. Most carers report unmet needs when taking on caregiving responsibilities during this period. Thoroughly investigating carers' needs is essential for helping families address practical care challenges. However, this important topic remains underexplored.
Objective
To assess the need levels and identify need subgroups among carers of patients with pancreatic cancer 6 months after surgery and demographic predictors contributing to heterogeneity.
Design
Cross-sectional study.
Setting(s)
Participants were recruited from the pancreas centres of four tertiary A-level comprehensive hospitals in Jiangsu Province, China.
Participants
240 patients with pancreatic cancer and their carers ('dyads') participated in the survey.
Methods
Carers completed the Comprehensive Needs Assessment Tool in Cancer for Carers, the Activities of Daily Living Scale for patients, and the General Demographic Information Questionnaire for dyads. Latent profile analysis (LPA) was used to categorise carers' needs. Non-parametric and chi-square tests were used to examine differences in need scores and sociodemographic characteristics among subgroups. Multiple logistic regression (MLR) was used to analyse sociodemographic impacts.
Results
Six months post-surgery, the total carers' need score was 41.83 ± 22.65 points, indicating a moderate level, with the highest needs reported for healthcare personnel, information and knowledge, and facilities and services. The LPA results revealed that carers were divided into five distinct subgroups based on differing levels of need across the domains assessed by the Comprehensive Needs Assessment Tool in Cancer for Carers, with proportions of 8.8 %, 22.5 %, 8.3 %, 55 %, and 5.4 %. Subgroup membership was predicted by four factors: carers' sex (odds ratio [OR]: 11.08, 95 % confidence interval [CI]: 1.64, 74.99, p = 0.01), carers' education levels (OR: 3.92, 95 % CI: 1.04, 14.72, p = 0.04), patients' treatment after surgery (OR: 0.10, 95 % CI: 0.01, 0.84, p = 0.04) and activities of daily living levels (OR: 14.63, 95 % CI: 1.97, 108.77, p < 0.01).
Conclusions
We have highlighted the complex individualised needs of carers of patients with pancreatic cancer. Through LPA and MLR, we identified distinct need subgroups and their predictors. Healthcare professionals may be able to improve dyads’ health by tailoring support to each subgroup’s specific needs and issues.
Registration
Registration number: ChiCTR2400079415, registered 03/01/2024, first recruitment 04/02/2024.
背景：由于胰腺癌预后不良，在其术后生存期，家庭照顾者（“照顾者”）承担着最高的照顾负担。大多数护理人员报告说，在这一时期承担照顾责任时，需求未得到满足。彻底调查护理人员的需求对于帮助家庭应对实际护理挑战至关重要。然而，这一重要话题仍未得到充分探讨。目的评估胰腺癌患者术后6个月护理人员的需求水平，确定需求亚组，以及导致异质性的人口统计学预测因素。DesignCross-sectional研究。参与者从中国江苏省四所三级甲等综合医院的胰腺中心招募。参与者：240名胰腺癌患者及其护理人员（“二人组”）参与了这项调查。方法护理人员完成《癌症护理人员综合需求评估工具》、《患者日常生活活动量表》和《一般人口统计信息问卷》。使用潜在特征分析（LPA）对照顾者需求进行分类。采用非参数检验和卡方检验检验亚组间需求得分和社会人口学特征的差异。采用多元逻辑回归（MLR）分析社会人口统计学影响。结果术后6个月护理人员需求总分为41.83±22.65分，处于中等水平，其中护理人员需求、信息知识需求和设施服务需求最高。LPA结果显示，根据护理人员癌症综合需求评估工具评估的不同领域需求水平，护理人员被分为五个不同的亚组，比例分别为8.8%,22.5%,8.3%，55%和5.4%。亚组成员由四个因素预测：护理者性别（比值比[OR]: 11.08, 95%可信区间[CI]: 1.64, 74.99, p = 0.01），护理者教育水平（OR: 3.92, 95% CI: 1.04, 14.72, p = 0.04），患者术后治疗（OR: 0.10, 95% CI: 0.01, 0.84, p = 0.04）和日常生活活动水平（OR: 14.63, 95% CI: 1.97, 108.77, p < 0.01）。结论我们强调了胰腺癌患者护理人员复杂的个性化需求。通过LPA和MLR，我们确定了不同的需求亚群及其预测因子。医疗保健专业人员可以根据每个子群体的具体需求和问题定制支持，从而改善二人组的健康状况。报名编号：ChiCTR2400079415, 2024年3月1日报名，2024年2月4日首次招聘。
{"title":"Family caregivers' needs at 6 months after pancreatic cancer surgery: A latent profile analysis","authors":"Linglong Liu , Xiaoping Fang , Xinbo Wang , Xiaoyan Wang , Yehua Xie , Yaoyao Cai , Lei Cui , Tianying Yao , Xiaoxuan Li , Qian Li , Mingxia Chen","doi":"10.1016/j.ijnsa.2025.100416","DOIUrl":"10.1016/j.ijnsa.2025.100416","url":null,"abstract":"<div><h3>Background</h3><div>Family caregivers ('carers') bear the highest care burden during the postoperative survivorship period of pancreatic cancer, given its poor prognosis. Most carers report unmet needs when taking on caregiving responsibilities during this period. Thoroughly investigating carers' needs is essential for helping families address practical care challenges. However, this important topic remains underexplored.</div></div><div><h3>Objective</h3><div>To assess the need levels and identify need subgroups among carers of patients with pancreatic cancer 6 months after surgery and demographic predictors contributing to heterogeneity.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting(s)</h3><div>Participants were recruited from the pancreas centres of four tertiary A-level comprehensive hospitals in Jiangsu Province, China.</div></div><div><h3>Participants</h3><div>240 patients with pancreatic cancer and their carers ('dyads') participated in the survey.</div></div><div><h3>Methods</h3><div>Carers completed the Comprehensive Needs Assessment Tool in Cancer for Carers, the Activities of Daily Living Scale for patients, and the General Demographic Information Questionnaire for dyads. Latent profile analysis (LPA) was used to categorise carers' needs. Non-parametric and chi-square tests were used to examine differences in need scores and sociodemographic characteristics among subgroups. Multiple logistic regression (MLR) was used to analyse sociodemographic impacts.</div></div><div><h3>Results</h3><div>Six months post-surgery, the total carers' need score was 41.83 ± 22.65 points, indicating a moderate level, with the highest needs reported for healthcare personnel, information and knowledge, and facilities and services. The LPA results revealed that carers were divided into five distinct subgroups based on differing levels of need across the domains assessed by the Comprehensive Needs Assessment Tool in Cancer for Carers, with proportions of 8.8 %, 22.5 %, 8.3 %, 55 %, and 5.4 %. Subgroup membership was predicted by four factors: carers' sex (odds ratio [OR]: 11.08, 95 % confidence interval [CI]: 1.64, 74.99, <em>p</em> = 0.01), carers' education levels (OR: 3.92, 95 % CI: 1.04, 14.72, <em>p</em> = 0.04), patients' treatment after surgery (OR: 0.10, 95 % CI: 0.01, 0.84, <em>p</em> = 0.04) and activities of daily living levels (OR: 14.63, 95 % CI: 1.97, 108.77, <em>p</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>We have highlighted the complex individualised needs of carers of patients with pancreatic cancer. Through LPA and MLR, we identified distinct need subgroups and their predictors. Healthcare professionals may be able to improve dyads’ health by tailoring support to each subgroup’s specific needs and issues.</div></div><div><h3>Registration</h3><div>Registration number: ChiCTR2400079415, registered 03/01/2024, first recruitment 04/02/2024.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100416"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009964","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}
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