Nursing Reports最新文献

Background: Narration of care (NOC) refers to a nurse's ability to explain the purposes, goals, and objectives of nursing tasks. In this project, narration of care (NOC) refers to real-time verbal explanation of nursing tasks and should not be confused with the Nursing Outcomes Classification, which uses the same acronym. Although NOC is recognized as a critical skill, little research exists on how to teach it or evaluate its use. A companion article describes the development of a NOC framework. This article focuses on implementation and observed changes during rollout. Objective: We aimed to describe the implementation of a discussion-based course designed to teach nurses and patient care assistants (PCAs)-collectively referred to as nursing staff-how to effectively narrate care, and to assess changes observed during the implementation period. Methods: We used a mixed-methods, pre- and post-implementation design across seven hospitals over six months (February-August 2023). Quantitative data included pre-post comparisons of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores (baseline: 2022; follow-up: 2024) and structured observations of nurse-patient interactions. Qualitative data from free-text course evaluations were thematically analyzed to contextualize quantitative findings. Integration occurred by comparing themes with observed practice gaps and patient experience trends. Results: Course Evaluations: In total, 7341 staff completed the course; 4185 evaluations were submitted. Ninety-five percent reported increased knowledge and rated the course highly. Common strategies cited included teach-back, reducing anxiety through NOC, active listening, and building personal connections. HCAHPS Comparisons: Five domains improved significantly post-implementation: care transitions (4.6, p = 0.001), cleanliness (3.9, p = 0.024), communication about medications (2.3, p = 0.042), discharge communication (2.7, p = 0.002), and restfulness (2.5, p = 0.015). Practice Observations: In total, 1281 observations were conducted. Observations indicated frequent use of several NOC-aligned behaviors and opportunities to improve narration of the environment and resolution of patient concerns. Conclusions: Improvements in patient experience measures and observed practices coincided with the course rollout. However, given the pre-post, uncontrolled design, causality cannot be inferred.

The rise in ICU survival rates has introduced new challenges related to the long-term effects of intensive care, known as Post-Intensive Care Syndrome (PICS). Nurses play a key role in these clinics; however, the nature and outcomes of their interventions remain insufficiently understood. Objectives: This review aims to identify nursing interventions for PICS in follow-up clinics. Methods: Using the JBI scoping review methodology, we searched PubMed, Web of Science and CINAHL (via EBSCOhost) in March 2025, and examined grey literature in RCAAP and Open Dissertations (through B-ON). Inclusion criteria, based on JBI's PCC (Population, Concept, Context), focused on nursing interventions for PICS for patients and families in follow-up. Studies involving children, adolescents, pregnant women, and those receiving end-of-life care were excluded. Results: Encompassing studies from 2005 to 2022 across multiple countries, this review highlights nursing interventions for post-ICU recovery. A total of 394 articles that met our search criteria were found, resulting from searches in the mentioned databases. These were initially exported to Rayyan, and 115 duplicates were removed. The 21 articles that met our inclusion criteria were fully analyzed, and those that effectively answered our questions and met our inclusion criteria were selected. In the end, 9 articles were selected, to which, after an individual analysis of their bibliographic references, 3 more were added, totaling 12 articles submitted to the final analysis. Conclusions: For patients, interventions ranged from debriefing, PICS symptom evaluation, ICU re-visits, health education, cognitive-behavioral therapy and support groups, complemented by home-based physical rehabilitation and virtual reality. Family-focused interventions centered on appointment involvement, educational sessions, patient diary review, and emotional support. These assessments and interventions address the consequences of ICU admission, with the goal of facilitating physical, mental, and emotional rehabilitation of ICU survivors. This review emphasizes the critical role of follow-up consultations in the recovery of both patients and families. A comprehensive assessment using PICS scales and the integration of families into care plans are crucial for optimizing intervention outcomes. Implications for Clinical Practice: The development of evidence-based guidelines for implementation of follow-up clinics for SPICI appointments is necessary.

Background/Objectives: Hyperbaric Oxygen Therapy (HBOT) involves breathing oxygen at pressures greater than atmospheric levels and is used to treat diverse clinical conditions. However, little is known about the lived experiences and perceived needs of patients undergoing scheduled treatment in multiplace hyperbaric chambers, where nurses play a key role in support, safety, and communication. This study aimed to explore the perceptions, expectations, and needs of patients receiving scheduled HBOT sessions in a multiplace chamber in a hospital setting. Methods: A qualitative phenomenological design was used. Participants were recruited consecutively among adults who had completed at least 10 HBOT sessions and demonstrated adequate cognitive function. Individual semi-structured interviews were conducted between January and March 2023 in locations chosen by participants. Interviews were audio-recorded, transcribed, and validated by participants. Results: Twelve participants (eight men, four women; aged 25-84 years) were included. Four thematic areas emerged: (1) Biopsychosocial lived experiences, including initial uncertainty, physical discomfort such as ear pressure or mask-related issues, and progressive recognition of therapeutic benefits. (2) Interpersonal relationships, highlighting trust, security, and emotional support provided mainly by nurses. (3) Communication experiences, with participants expressing satisfaction but requesting clearer, earlier information on procedures, risks, and expected sensations. (4) Structural and organizational factors, where transportation logistics and treatment scheduling were significant sources of fatigue and discomfort. Conclusions: Patients valued HBOT and perceived notable health improvements, while identifying specific unmet informational and organizational needs. These findings suggest the importance of nurse-led educational interventions to enhance preparation, reduce anxiety, and optimize patient experience during HBOT.

Background/Objectives: Challenging behaviour post-stroke can complicate care and disrupt rehabilitation, yet its presentation and management are underreported. This study explored how such behaviours were documented in clinical records and managed in stroke settings, and how care delivery and discharge outcomes were documented in this context. Methods: A retrospective chart review was conducted across two NHS stroke units, covering all admissions between March and April 2022. Patient records were reviewed to capture demographic, clinical, and behavioural information, together with details relating to management and discharge. Challenging behaviour was identified retrospectively from clinical documentation during routine care. Descriptive statistics were used to summarise the data. Results: Forty-eight stroke admissions were examined, with challenging behaviour documented in thirteen patients (27%). Eleven had ischaemic stroke, with moderate severity common (n = 6), while inattention/neglect (n = 5) and infection (n = 4) were also documented. Behaviours were commonly recorded as confusion or agitation, and predominantly by nursing staff. Challenges to care delivery were documented in six of these patients, and additional professional input was provided for seven. Discharge delays were documented in patients with challenging behaviour, and the median length of stay was notably longer for this group (19 days compared with 7). Documentation of cognitive or delirium screening was uncommon. Conclusions: Challenging behaviour was documented in over a quarter of acute stroke admissions and was documented alongside greater care complexity and longer hospital stays. These preliminary descriptive findings from a small sample indicate a need for further exploration to better characterise challenging behaviour following stroke and its implications for care.

Background/Objectives: This study examined the reasons and sociodemographic drivers behind delays in seeking medical care among participants in the All of Us Research Program. Methods: A cross-sectional study was conducted using data collected between 2018 and 2024. The primary outcome was the prevalence of reasons for delayed medical care (DMC). Descriptive statistics were used to calculate the prevalence of the various reported reasons for delayed medical care. Binary logistic regression was applied to examine the association between sociodemographic characteristics and each reported reason for delayed medical care. Results: Out of a total of 633,000 All of Us participants, 300,820 participants had complete data on the healthcare utilization and access survey and were eligible for final analysis. The most common reported reasons for DMC were out-of-pocket expenses (16.68%), nervousness about seeing a provider (14.18%), and inability to get time off work (11.04%). Females had significantly higher odds of DMC due to out-of-pocket costs (OR = 1.31, 95% CI: 1.28-1.33). Black (OR = 0.81, 95% CI: 0.78-0.84) and Asian (OR = 0.94, 95% CI: 0.89-0.99) individuals had lower odds of DMC due to out-of-pocket costs. Married individuals had more than twice the odds of DMC due to childcare responsibilities (OR = 2.45, 95% CI: 2.33-2.56). Conclusions: A significant proportion of participants reported DMC due to various reasons, with financial, medical visit anxiety, and work-related reasons being the most common. These findings highlight actionable intervention targets, including nurse-led cost navigation and financial counseling, flexible scheduling/telehealth to reduce work-related delays, and patient-centered communication and outreach strategies to reduce visit-related anxiety and support caregiving and transportation needs.

Background: Health literacy and eHealth literacy are core competencies for nursing students, yet their distribution across training pathways remains insufficiently explored. Objective: This study aimed to examine HL and eHL levels among nursing students across different years of the educational programme and identify distinct subgroups of students. Methods: A cross-sectional study was conducted among undergraduate nursing students enrolled in all years of a single Italian university programme. Literacy profiles were assessed using validated questionnaires. A Two-Step Cluster Analysis was applied to identify homogeneous literacy profiles. Group differences were examined using appropriate statistical tests. Results: Four distinct clusters were identified, showing heterogeneous patterns of literacy profiles across the training course. Significant differences emerged in demographic and educational variables across clusters. Conclusions: The findings highlight the coexistence of diverse literacy profiles among nursing students and suggest the need for tailored educational strategies. Due to the cross-sectional design, causal inferences cannot be drawn.

Background: Individuals with mental health conditions frequently experience stigmatization and discrimination. Among the primary objectives in the fight against stigma is to examine groups that play a crucial role in addressing it, such as healthcare professionals. Although research has examined stigma among healthcare professionals, few studies have specifically addressed how nurses perceive and contribute to the stigmatization of individuals with mental health conditions. Objective: The aim of this review was to compile and compare the scientific literature addressing nurses' stigma toward individuals with mental health conditions. Methods: Following the methodological guidelines of the Joanna Briggs Institute and in accordance with the PRISMA 2020 guidelines, an integrative review was conducted of MEDLINE (PubMed), EMBASE, APA PsycInfo (EBSCO), and CINAHL Complete (EBSCO). Database-specific indexing terms were combined with the Boolean operators AND/OR. Studies with quantitative or qualitative methodologies, published in Spanish or English and without restrictions by year of publication, were included. Two independent reviewers selected the studies and performed the critical appraisal. Results: The search retrieved 4256 records, of which 32 articles were finally included. A content analysis of the selected studies was conducted. Most studies used validated questionnaires to assess stigma and its associations with various variables, while only a limited number employed qualitative designs. Across the 32 studies (n = 6283 nurses from 29 countries), stigma was observed across settings but tended to be lower among mental health specialists. Insufficient training and limited contact were consistently associated with higher levels of stigma, whereas specialization and positive contact were linked to lower levels. Associative stigma emerged as a recurrent theme with implications for psychiatric nursing identity. Conclusions: Nurses working in mental health settings generally demonstrate more positive attitudes toward individuals with mental health conditions compared with those in other clinical areas; however, stigma persists across all settings. Associative stigma may be influencing the development and advancement of psychiatric nursing. Specific academic training, capacity building, and specialization in mental health are essential to counteract stigma. Further qualitative research is required to achieve a deeper understanding of this phenomenon.

Background: The nursing profession is currently facing a critical challenge with a noticeable decline in interest among young people to pursue nursing as a career. Objectives: This study examined academics' perceptions of factors driving low enrollment in Greek baccalaureate nursing programs and explored incentives that could motivate young people to pursue nursing careers. Methods: We performed a cross-sectional study. We collected our data during October 2025 through an anonymous questionnaire. Source population included all academics in the nine nursing departments in Greece. Response rate was 54.2% (90 out of 166). Results: We classified the factors contributing to the low interest in baccalaureate nursing education programs into four groups: (a) poor working conditions, (b) negative social and cultural perceptions, (c) educational constraints, and (d) impact of the COVID-19 pandemic. Academics identified negative social and cultural perceptions of nursing and poor working conditions as the primary drivers of low interest in baccalaureate nursing programs. The COVID-19 pandemic was viewed as having a moderate influence on young people's career choices, while educational constraints were considered least important overall. Academics in nursing departments based in Greece's capital perceived the pandemic's impact as more substantial than colleagues outside the capital and attributed greater importance to educational constraints. Respondents without prior clinical nursing experience emphasized educational barriers more strongly. To attract students, academics prioritized improving working conditions, increasing salaries, and expanding scholarships and support. Conclusions: Academics reported that unfavorable nursing work environments, intensified during COVID-19, influence students' career choices, underscoring the need for urgent policy and organizational actions informed by this study and existing evidence.

Background: Peristomal leakage is one of the most troublesome complications of living with a stoma, affecting skin integrity, quality of life, and healthcare costs. However, definitions, measurement methods, and prevalence estimates remain heterogeneous. This scoping review aimed to (i) map the international prevalence of peristomal leakage across stoma subtypes; (ii) identify associated or correlated factors; and (iii) describe the tools used to assess leakage. Methods: A scoping review was performed following the Joanna Briggs Institute (JBI) guidelines. MEDLINE, CINAHL, Scopus, Embase, and the Cochrane Library were searched, with publication language restricted to English and Italian. Primary studies and evidence syntheses addressing peristomal leakage were included. Results: Twenty-seven studies were included, most of which were primary observational studies conducted in Europe, North America, and the Nordic countries. Ileostomy was the most frequently investigated stoma type, followed by colostomy and urostomy. Across settings, peristomal leakage was highly prevalent, with most period or lifetime prevalence estimates exceeding 50%. Reported determinants clustered into anatomical, surgical, device-related, behavioral, care-related and psychosocial factors. Multiple tools were used, including leakage-specific and broader stoma questionnaires, but definitions and leakage grading were inconsistent. Conclusions: Peristomal leakage is a common, multifactorial, and largely preventable complication with substantial clinical, psychosocial and economic consequences. Clinical practice should prioritize early detection, validated assessment tools, patient education, specialized stoma nursing and structured follow-up. Future research should establish consensus definitions, robustly validate leakage-specific instruments, include under-represented regions and conduct high-quality economic evaluations to guide equitable, cost-effective care models.

Objective: This study aimed to examine the association between family cohesion and disease identity in adolescents and young adults (AYAs) with type 1 diabetes mellitus (T1DM) and to test the mediating role of perceived social support in this relationship. Methods: From January 2025 to June 2025, a total of 222 AYA patients with T1DM were recruited from the Department of Endocrinology and Department of Pediatrics of four tertiary-level hospitals in Zhengzhou, Henan Province, China. The Disease Identity Questionnaire for AYA patients with T1DM, Family Cohesion Scale, and Perceived Social Support Scale were used. Results: Family cohesion was positively correlated with perceived social support and disease identity, and perceived social support was positively correlated with disease identity. Perceived social support played a partial mediating role in the association between family cohesion and disease identity (β = 0.391, p < 0.001), accounting for 63.6% of the total effect. Conclusions: Family cohesion is positively associated with perceived social support and disease identity in AYA patients with T1DM, with perceived social support playing a partial mediating role. This indicates that family cohesion shows both direct and indirect associations with patients' disease identity. The study suggests that interventions aimed at enhancing family cohesion and perceived social support may inform strategies to improve patients' disease identity, thereby potentially facilitating their psychosocial adaptation.