Nursing Reports最新文献

Background/Objectives: Limited health literacy among older adults with noncommunicable diseases (NCDs) remains a major challenge in community and primary-care settings. This action research aimed to develop and evaluate a community-based health literacy training model for volunteer caregivers for the elderly (VCEs) to support the prevention and control of diabetes and hypertension among older adults in the community. Materials and Methods: This study was conducted in a primary care-based community setting and comprised two phases: Phase 1 (model development) and Phase 2 (implementation and evaluation). The primary analytic sample consisted of 38 volunteer caregivers for the elderly, each providing home-based health education to one older adult (n = 38). The intervention combined structured health literacy education based on the K-shape framework (Knowledge, Comprehension, Thoughtful Inquiry, Decision-making, and Implementation) with SKT meditation/exercise. The program was delivered weekly over 8 weeks. Outcomes included health literacy (20-item scale) and disease prevention and control behaviors (12-item scale), assessed at baseline, immediately post-intervention, and 1 month after program completion. Results: Among VCEs, mean health literacy scores increased significantly from baseline to post-intervention and were further improved at 1-month follow-up (p < 0.001), indicating sustained gains in health literacy. Preventive behavior scores also increased significantly from baseline to post-intervention (p < 0.001); however, no additional improvement was observed at 1 month compared with immediately after the program (p > 0.05). The magnitude of improvement suggested a meaningful effect of the intervention on health literacy, while behavioral changes appeared to plateau after program completion. Conclusions: The community-based training model effectively and sustainably improved health literacy among volunteer caregivers for the elderly. Although preventive health behaviors improved immediately after the intervention, no further gains were observed at 1 month, suggesting that ongoing reinforcement may be required to sustain behavioral change. This model supports the role of community participation in primary care-based NCD prevention among older adults.

Background: The humanization of care is increasingly recognized as a core component of healthcare quality; however, its meaning remains complex and strongly shaped by organizational, professional, and educational contexts. Nursing students, as future healthcare professionals, play a crucial role in the development and transmission of humanized care values, making their representations of the humanized hospital particularly relevant for understanding how these values are constructed during professional education. Aim: To explore how undergraduate nursing students conceptualize the humanized hospital. Methods: A qualitative exploratory study was conducted involving 742 undergraduate nursing students enrolled in a Bachelor of Science in Nursing program in Italy. Data were collected through a single open-ended written question inviting students to describe how they imagine a humanized hospital. Textual data were analyzed using Automatic Analysis of Textual Data within an Exploratory Multidimensional Data Analysis framework, enabling the identification of shared lexical patterns, discursive clusters, and latent semantic dimensions within a large textual corpus. Findings: Students articulated the humanized hospital as an integrated and system-oriented care environment in which relational, organizational, professional, and holistic dimensions are deeply interconnected. Humanization was associated not only with empathy, respect, and emotional engagement, but also with organizational functioning, teamwork, adequate resources, and professional competence. Two latent dimensions structured these representations: the first highlighted organizational systems as enabling conditions for person-centered care, while the second framed professional operability and technical competence as foundations for a holistic understanding of patients' physical, psychological, and social well-being. Conclusions: Undergraduate nursing students' discourse revealed an articulated and multidimensional representation of hospital humanization, conceptualizing it as an emergent property of healthcare environments rather than as a function of individual attitudes alone. These findings underscore the importance of addressing hospital humanization simultaneously at relational, educational, and organizational levels and highlight the need for nursing education programs and healthcare institutions to foster structural and professional conditions that sustainably support humanized care in clinical practice.

Background: Burnout and job satisfaction are widely studied phenomena within the field of occupational health, particularly among nursing professionals exposed to high work demands. Work engagement has been identified as a potential mediator that may buffer the negative effects of burnout on job satisfaction. However, in the Peruvian context, empirical evidence on this relational dynamic remains limited. Objective: The objective of this study is to examine the mediating role of work engagement in the relationship between burnout and job satisfaction among Peruvian nurses using a structural equation modeling (SEM) approach. Methods: An explanatory study was conducted with a sample of 230 Peruvian nurses (M = 41.22, SD = 11.65). Data were analyzed using structural equation modeling. Results: Burnout showed significant negative correlations with work engagement (r = -0.47, p < 0.01) and job satisfaction (r = -0.41, p < 0.01), while work engagement was positively associated with job satisfaction (r = 0.79, p < 0.01). The structural model demonstrated a good fit (CFI = 0.96, TLI = 0.95, RMSEA = 0.06, and SRMR = 0.04). The model also indicated solid overall fit and revealed a significant indirect effect of burnout on job satisfaction through engagement, accounting for approximately 24% of the variance in engagement and 80% of the variance in job satisfaction. Conclusions: The findings confirm that work engagement fully mediates the relationship between burnout and job satisfaction among Peruvian nurses, serving as a key protective psychosocial resource. These results reinforce the Job Demands-Resources (JD-R) model and highlight the importance of implementing organizational interventions aimed at strengthening work engagement as a strategy to improve satisfaction and well-being in demanding healthcare settings.

Background: Frailty markedly increases risk of unplanned readmission, 30-day mortality, and discontinuity of care during the transition from hospital to home. Although this transition represents a critical period for patient safety and recovery, the specific needs perceived by individuals with frailty and their caregivers at the time of discharge remain insufficiently understood. Aim: The aim of this study was to explore and synthesize qualitative evidence of perceived needs by individuals with frailty and their caregivers during the transition from hospital to home. Methods: A qualitative systematic review will be conducted following the Joanna Briggs Institute (JBI) methodological guidance. Systematic searches will be performed in PubMed, CINAHL, Web of Science (WoS), Biblioteca Virtual de Salud (BVS), Scopus, and Google Scholar. All primary qualitative and mixed-methods studies with a qualitative component, published in any language and without date restrictions, will be eligible. Methodological quality will be appraised using the JBI Critical Appraisal Checklist for Qualitative Research. A meta-aggregative approach will be applied to extract and synthesize findings using JBI SUMARI software. Confidence in the synthesized findings will be assessed using the ConQual approach. Expected results: The results will describe the perceived needs of this population and their caregivers and will support the development of practical recommendations for transitional care. Conclusions: The findings are expected to inform person-centered transitional care practices and support the development of clinical strategies to improve continuity of care.

Background: Trauma-informed education (TIE) has become commonplace in nursing education; however, little is known about students' experience of this and its impact on their practice. Aim: This study aimed to evaluate and explore mental health nursing students' perspectives on TIE, and its impact on their practice, to contribute to the knowledge and evidence base that informs nursing and broader healthcare education. Methods: This qualitative, phenomenological study used a conversation café approach to focus group interviews (n = 3) with final year mental health nursing students (n = 11), reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Analysis: The data generated was analysed using reflective thematic analysis. Findings: Three themes were identified: 1. a compass for practice; 2. mental health nursing: between paradigms; and 3. supporting personal development and wellbeing. Integrating TIE within nursing education can support students to adopt the principles of trauma-informed care (TIC) both personally and in their practice. Improved self-awareness, recognition of trauma and adopting self-care strategies were valuable in supporting personal resilience and wellbeing and in managing the challenges of mental health practice. Conclusions/Recommendations: TIE has the potential to have a positive impact on wellbeing; therefore, its integration should be considered for all healthcare programmes. Further interprofessional research is needed to establish the longer-term impact of TIE as students progress into their nursing careers.

Background: Adults on maintenance hemodialysis experience multiple physical and psychological symptoms that can affect confidence in self-management and perception of care received from healthcare providers. Understanding the interplay between symptom burden, self-management self-efficacy, and perceptions about care received is essential to inform patient-centered nephrology nursing. Aim: This cross-sectional study aimed to describe dialysis symptom burden, self-efficacy to manage chronic disease, and satisfaction with nursing care, and to examine associations among these variables in adults undergoing maintenance hemodialysis in Oman. Methods: A cross-sectional study using consecutive sampling was conducted among 232 adults on maintenance hemodialysis at two dialysis units in Muscat, Oman. Data were collected using the Dialysis Symptom Index, the nursing care satisfaction questionnaire, and the self-efficacy scale. Descriptive, correlation, and multivariable linear regression analysis were used to summarize the findings. Results: The mean age was 55.9 years and the most common comorbidities were diabetes (58.2%) and hypertension (74.1%). Symptom burden was substantial, with over half reporting muscle soreness, anxiety, sleep disturbance, dry mouth, pruritus, appetite loss, and dyspnea, although severity was generally mild-moderate (1.1-1.6/4). Satisfaction with nursing care was high (90.2%), while self-efficacy was moderate (mean 30.52/44). Patient satisfaction correlated positively with self-efficacy (r = 0.25, p < 0.001), but not with symptom burden (r = 0.08, p = 0.24); Self-efficacy showed a small positive correlation with dialysis symptom burden (r = 0.14, p = 0.03), suggesting that patients who were more aware of and reported more symptoms also perceived themselves as more actively engaged in managing their illness. In multivariable analysis, higher satisfaction and more favorable laboratory indicators independently predicted higher self-efficacy. Conclusions: Adults on hemodialysis reported high satisfaction with nursing care but continued to experience multiple physical and psychological symptoms and had only moderate self-efficacy to manage their condition. There is a need to integrate structured symptom assessment and targeted, nurse-led self-management support intervention into routine dialysis care to reduce symptom burden and enhance patients' confidence in managing their illness.

Background/Objectives: Domestic violence against women is a widespread global health issue profoundly affecting victims, their families, and society. This study aimed to assess the prevalence, patterns, risk factors, and health sequelae of domestic violence among females during reproductive age in Sharkia governorate, Egypt. Methods: A cross-sectional descriptive study was conducted from April to December 2024. A total of 379 females of reproductive age (15-49 years) were recruited using simple random sampling from secondary schools and Maternal and Child Health centers affiliated with the Ministry of Health. Data were collected using a structured interview questionnaire covering sociodemographic characteristics, violence exposure (physical, psychological, economic, and sexual), risk factors, causes, severity, perpetrators, and consequences. Results: The overall prevalence of domestic violence was 88%. Psychological violence was the most common form (78%), followed by physical violence (63%), and economic violence (43%). Insults were the predominant form of verbal abuse, while slapping and beating were the most common manifestations of physical violence. Husbands were identified as the primary perpetrators across all violence types. Major risk factors included cigarette use by the abuser (47%), alcohol and drug use (14%), and psychological problems (11%). The most frequently reported consequences were anxiety, fear, and depression (82%), followed by insomnia (55%) and seeking separation (49%). Conclusions: Domestic violence against women of reproductive age is highly prevalent in the study setting, with significant physical and psychological consequences. Comprehensive interventions, including awareness campaigns, legal enforcement, women empowerment programs, and healthcare provider training, are urgently needed to address this critical public health issue.

Background/Objectives: The global nursing workforce shortage has heightened concerns about burnout, workload, and nurse retention, with an increasing intention to leave the profession and the unit, especially in the post-pandemic context. Although intention to leave has been widely studied, limited attention has been paid to nurses who continue to provide high-quality care and persist despite expressing a desire to leave. This study aimed to explore the reasons for persistence among nurses who intend to leave the organization and the profession. Methods: A descriptive qualitative study was conducted involving frontline nurses and nurse managers working in a large university healthcare trust in Northern Italy. Data were collected through three focus groups, using a semi-structured interview, until data saturation was achieved. Data were analyzed using inductive content analysis. Findings were reported in accordance with COnsolidated criteria for REporting Qualitative research guidelines. Results: Thirty-two participants were included. Overall, two main themes emerged: 'Reasons that are inside of me' and 'Reasons that are outside of me but influence my decisions to stay', with eight and six subthemes respectively. Internal reasons included professional passion, commitment, autonomy, perceived usefulness, and supportive collegial relationships. External reasons included organizational flexibility, opportunities for internal mobility and professional development, responsiveness to nurses' expectations, and, in some cases, limited external employment alternatives. Conclusions: Persistence represents a distinct and underexplored dimension within the intention-to-leave continuum. While internal reasons reflect deeply rooted professional identity, external organizational reasons are modifiable and play a critical role in promoting retention. Organizational strategies aligned with nurses' values, expectations, and professional development needs may enhance workforce stability and inform more targeted retention interventions.

Background/Objectives: Workplace violence (WPV) is a major occupational concern in psychiatric settings, where mental health nurses (MHNs) are consistently identified as a high-risk professional group. Within this context, sexual violence (SV) remains understudied as a distinct phenomenon and is often embedded within aggregated measures of WPV. This systematic review aimed to synthesize the available evidence on SV against MHNs working in inpatient settings by: (1) describing its prevalence, forms, and characteristics; (2) examining psychological, occupational, and physical outcomes; and (3) identifying associated risk factors. Methods: This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251103606). A literature search was performed across PubMed, CINAHL, Scopus, Web of Science, and PsycInfo, supplemented by reference list checking and citation tracking. Peer-reviewed quantitative and qualitative studies published in English or Italian were eligible if they involved MHNs working in inpatient settings and addressed SV. Study selection, data extraction, and risk-of-bias assessment were conducted independently by two reviewers. A narrative synthesis following SWiM guidance was undertaken, and the certainty of evidence for statistically significant outcomes was assessed using the GRADE approach. Results: Twenty-five studies published between 2003 and 2025 were included. Definitions of SV varied substantially. Reported prevalence ranged from 0% to 68%, with verbal sexual harassment ranging from 19.5% to 53.4%, physical sexual harassment ranging from 14% to 42.9%, and sexual assault up to 18.6%. Evidence indicated associations between SV exposure and poorer quality of life, burnout, and days lost from work. The main risk factors included gender, age, education, work experience, employment type, acute psychiatric settings, night shifts, normalization of violence, and history of physical and sexual violence. Conclusions: SV against MHNs represents a relevant issue in psychiatric settings. Findings suggest significant psychological and occupational consequences. Standardized definitions and measurement, longitudinal research, and intervention studies are needed to inform effective prevention strategies and organizational responses.

Background. Virtual reality (VR) is emerging as a non-pharmacological tool to support rehabilitation and self-management. Evidence of its effectiveness, however, remains fragmented. This umbrella review synthesized systematic reviews and meta-analyses on VR interventions in chronic conditions. Methods. Following the Joanna Briggs Institute Manual for Evidence Synthesis, comprehensive searches were conducted in MEDLINE, CINAHL, Cochrane Database, Web of Science, and Scopus. Eligible studies were systematic reviews and meta-analyses assessing VR interventions. Two reviewers independently performed screening, quality appraisal, and data extraction. Results. Seventeen reviews, including 229 primary studies, were analyzed. Stroke and chronic obstructive pulmonary disease were most frequently investigated. VR tools ranged from web- and smartphone-based systems to wearable devices and interactive games. Significant improvements were reported in respiratory outcomes, functional mobility, balance, and psychological symptoms. Cognitive effects were mixed. Reported adverse events, mainly cybersickness and dizziness, were mild. Conclusions. VR may improve physical, respiratory, psychological, and selected cognitive outcomes in chronic conditions. Despite study heterogeneity, evidence supports its integration into chronic care. Future work should standardize protocols, assess long-term effects, broaden target populations, and address equity and ethical issues to fully realize VR's potential as a person-centered tool.