Nursing Reports最新文献

Background: Patients are the most frequent perpetrators of physical violence against nurses. In the United States, most states have established laws designating assault against nurses a felony, or serious crime. It is unknown what reasons nurses have for pressing charges or not pressing charges against patients. Purpose: The purpose of this study was to examine nurses' decisions regarding pressing charges when patients exhibit violent behavior. Methods: This study used a mixed-method, cross-sectional, descriptive design. Three unfolding case studies were presented in an electronic survey. Twelve versions of the survey were randomly assigned to participants. Each described an adolescent, adult, and geriatric patient. The narrative descriptions were identical, but the visual representations of the patients differed. Results: A total of 499 nurses from seven hospitals in the western United States responded. Most nurses indicated that they would not press charges against any of the hypothetical patients. An injury occurring and an assumption of intentionality contributed to nurses' decisions to press charges. Participants were more likely to press charges against the adolescent and adult patients than the geriatric patient. The hypothetical adolescent and geriatric patients were more likely to have charges pressed against them if presented as female than if presented as male. The hypothetical adult patient was more likely to have charges pressed against them if presented as white than if presented as black. Conclusions: There is no consensus regarding when a nurse ought to pursue legal action against a patient who exhibits violent behavior. In addition to the presence of injury and the assumption of intentionality, it is possible that implicit bias may also play a role in these decisions. More investigation into this is needed.

Background/Objectives: Nurses are at high risk for burnout. Identification of biomarkers associated with early manifestations of distress is essential to support effective intervention efforts. Methods: Fifty nurses from a large hospital system participated in a 30-day study of biopsychosocial factors that may contribute to burnout. Nurses wore an Oura ring that collected behavioral data and they completed a self-report burnout questionnaire at baseline and the end of the study period. Machine learning models were developed to evaluate whether objective measures could predict burnout states and changes at the end of the study period. Analyses were exploratory and hypothesis-generating for future work. Results: Data for 45 participants were included in the analyses. Participants with burnout had significantly higher sleep variability. Sleep measures provided 75.75% accuracy in ability to discriminate between burnout states. Heart rate-based measures better modeled changes in symptomatic components of burnout (Emotional Exhaustion, Depersonalization) over time. Heart rate-based measures provided a R-squared value of 0.13 (p < 0.05) (RMSE of 7.41) in a regression model of changes in Emotional Exhaustion evaluated in a leave-one-participant-out cross-validation. Conclusions: Sleep measures' association with a state of burnout may reflect the longer-term manifestations of chronic exposure to workplace stress. Short-term changes in burnout symptoms are associated with disturbances in heart rate measures. Wearable technology may support monitoring/early identification of those at risk for burnout.

According to the WHO, a clinical trial is defined as "any research study that prospectively assigns human participants or groups of humans to one or more health-related interventions to evaluate the effects on health outcomes" [...].

Background: Narrative Medicine (NM) has emerged as a strategy to support reflective clinical practice and emotional resilience among nurses. This study examined relationships between NM practices and well-being among registered nurses (RNs) and nurse practitioners (NPs). Methods: A national sample of RNs and NPs was recruited using snowball sampling. Participants completed a NM practice survey and the Mayo Clinic Well-Being Index (WBI) survey. Data were analyzed using descriptive statistics and Pearson correlation coefficients. Results: A total of 3167 responses were analyzed (1934 RNs and 1233 NPs). Among RNs, strong statistically significant correlations were found between NM practices and well-being scores (p < 0.001). Among NPs, moderate correlations appeared in select NM practice dimensions (p < 0.05). Conclusions: Engagement in narrative Medicine practices is associated with improved well-being among nurses and nurse practitioners. NM may present a promising strategy to reduce burnout and strengthen professional resilience.

Background/Objectives: Self-care is central to chronic illness management and is particularly relevant in osteoporosis to prevent complications and improve quality of life. Grounded in Riegel's middle-range theory of self-care of chronic illness, the study sought to understand the contextual, emotional, and structural influences shaping self-care in people living with osteoporosis. Aim: The aim of this study was to explore patient-reported barriers and facilitators to self-care behaviors among individuals living with osteoporosis. Methods: A qualitative descriptive design was conducted using in-depth, semi-structured interviews with 20 patients with osteoporosis recruited via convenience sampling. Data were coded deductively and analyzed using Mayring's qualitative content analysis with a deductive approach. Results: Participants identified several factors related to both barriers and facilitators of self-care behaviors. Four barrier sub-themes emerged: ineffective coping strategies, difficulties in osteoporosis management, inadequate physical activity, and ineffective self-efficacy. Six facilitator sub-themes were identified: self-care management strategies, osteoporosis management after a fracture, osteoporosis control, osteoporosis treatment, exercise, and confidence in one's ability. Main barriers included fear of falling, ineffective self-efficacy, and poor care continuity, whereas key facilitators included support networks, motivation, and tailored care. Conclusions: Self-care behaviors in individuals with osteoporosis are influenced by emotional, contextual, and structural factors. Person-centered interventions integrating emotional and educational components may strengthen patients' engagement and enhance self-care behaviors in osteoporosis. Identifying barriers and facilitators enables nurses to design empathetic, tailored strategies that enhance empowerment and disease management. Understanding these factors can improve autonomy for patients and adherence, promoting long-term health outcomes across clinical and community settings.

Background/Objectives: Given the critical role of vaccinations and venipunctures in disease prevention and health monitoring, it is concerning that over half of children ages 4 to 8 experience some level of needle fear. Higher levels of fear result in longer procedure times, ineffective pain management, distressing memories of needles, and ultimately, healthcare avoidance. Exposure-based therapy with a therapist is recommended for high levels of fear. However, access is limited due to cost, wait times, clinician shortages, system barriers, and social stigma. Thus, there is a need for an evidence-informed, caregiver-directed educational resource for management of moderate to high needle fear in young children. Methods: To address this gap, such a resource was drafted which included a caregiver guide and an illustrated children's book. The current objective was to gather key user feedback on this initial version of the resource. Participants reported their perceptions of the content, coping strategies, design, organization, and accessibility of the resource through semi-structured interviews and limited quantitative ratings. Participants were children with moderate to high levels of needle fear (N = 6), their caregivers (N = 6), and healthcare professionals (N = 6; including needle providers, child life specialists, and mental health clinicians). Interviews were coded with inductive content analysis; descriptive statistics were calculated for quantitative ratings. Results: Participants reported satisfaction with the e-resource and highlighted strengths (e.g., CARD^TM system, children's book) and improvement areas (e.g., length, language). Conclusion: Feedback informed revisions to the e-resource in preparation for further evaluation in a follow-up study.

Background/Objectives: Heel pressure ulcers are a relevant complication in critically ill patients and may negatively affect recovery after ICU discharge. This study investigated health-related quality of life (HRQoL) and mobility levels one year after ICU discharge in survivors who developed heel pressure ulcers. Methods: A prospective observational study was conducted in the ICU of an academic tertiary-level hospital in Milan (Italy) from 1 January 2023 to 31 December 2024. Adult survivors were enrolled, and HRQoL was assessed using the EQ-5D-5L questionnaire. Functional status at ICU discharge was evaluated using the Manchester Mobility Score and Barthel Index. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results: Among 3144 ICU admissions, 52 survivors were enrolled. At ICU discharge, functional status was markedly impaired: only 15 patients (28.9%) were able to stand upright according to the Manchester Mobility Score, and none achieved even moderate levels of independence. At one year, 47 patients (90.4%) completed the follow-up, and 15 of them (31.9%) continued to report moderate-to-severe mobility limitations. The mean EQ-5D index value was 0.75 (SD 0.27), representing a significant reduction compared with Italian population norms (p < 0.001). Conclusions: ICU survivors who developed heel pressure ulcers exhibit reduced HRQoL at one year after discharge. These findings emphasize the need for structured post-ICU rehabilitation and targeted follow-up.

We built a system that measures what is easy-not what matters [...].

Background: Palliative care addresses not only physical symptoms but also the social, psychological, and spiritual needs of patients. Nurses play a key role in identifying and responding to these needs, yet their perceptions and preparedness may vary. Objectives: This study aimed to explore nurses' perspectives on the psychological, social, and spiritual needs of palliative patients, assess how well these needs are being met, and examine the influence of nurses' self-assessed education levels on their evaluations. Methods: A cross-sectional survey was conducted among 237 registered nurses with palliative care experience in Split-Dalmatia County, Croatia. Two validated questionnaires were used to assess the perceived importance of 53 patient needs and the extent to which these needs were satisfied. Results: Findings revealed significant discrepancies between the perceived importance and satisfaction of nearly all psychological, social, and spiritual needs (p < 0.001), particularly regarding fear of death, suffering, and future uncertainty. Only 38.4% of nurses considered themselves adequately trained in palliative care, though most had some educational exposure to it. No statistical differences were found in need assessment based on nurses' self-rated education. Most nurses reported emotional exhaustion (72.6%) and supported interdisciplinary care (95.8%), while 90.3% noted that responsibility for care often falls on families. Conclusions: Nurses recognize critical unmet needs in palliative patients and feel insufficiently prepared to address them. These findings underscore the need to improve palliative care education, provide emotional support for nurses, and implement systemic healthcare reforms to ensure comprehensive, dignified care.

Background/Objectives: Our previous study showed that the dietary structure is imbalanced in a majority of colorectal cancer patients receiving chemotherapy. These patients had higher risk of developing malnutrition. In the present study, we aimed to identify factors associated with nutritional risk in this cohort of patients. Methods: We performed a secondary analysis of a dataset that was originally collected to identify the factors that are associated with an imbalanced dietary structure in patients receiving chemotherapy for colorectal cancer. Nutritional risk was evaluated by using an NRS-2002 form. Binary logistic regression was used for multivariate analysis. Results: Among the 178 CRC patients enrolled in this study, 60 (33.7%) had nutritional risk. Patients with nutritional risk exhibited lower intake of grains, potatoes, vegetables, fruits, beans, nuts, and oils compared to those without risk. Multivariate analysis showed that non-surgery (95% CI: 0.130-0.914, p = 0.032) and high dietary structure score (95% CI: 0.808-0.944, p = 0.001) are associated with lower nutritional risk in CRC patients receiving chemotherapy. Conclusions: CRC patients receiving chemotherapy have moderate risk of developing malnutrition. Dietary structure score and surgery are associated with malnutrition in CRC patients receiving chemotherapy. Education on proper dietary structure is a potential strategy to mitigate nutritional risk in CRC patients undergoing chemotherapy. These findings highlight the need for personalized nutritional support to optimize patient outcomes.