Nursing Reports最新文献

Background/Objectives: Workplace violence (WV) against healthcare workers (HCWs) is a major hazard all over the world. Prevention requires a reliable risk assessment. The rate of HCWs reporting a violent event varies considerably across multi-year retrospective studies compared to periodic surveys. We conducted a rapid observational study to demonstrate that data collection methods are more important than socio-cultural and healthcare organizational differences in determining the frequency of reported violence. Methods: In June 2025, in a cross-sectional observational comparison, we examined a total of 236 nurses divided into three groups: the first two were recruited online from Brescia (Italy) and Trollhättan (Sweden), while the third group was composed of Latium (Italy) nurses participating in a sleep health promotion program who answered the same questions on WV online. All the workers reported the frequency of violent incidents experienced in the previous 12 months using the Violent Incident Form (VIF), occupational stress using the Effort/Reward Imbalance questionnaire (ERI), and work ability via the Work Ability Score (WAS). Results: In the three samples, WV was correlated positively with stress and inversely with work ability (p < 0.01), while no significant difference was found between Italian and Swedish nurses in relation to the spot surveys. The nurses questioned directly about WV were significantly younger and reported significantly higher rates of physical aggression (28% vs. 5%, p < 0.001) and all forms of violence (73% vs. 20%, p < 0.001) than those questioned indirectly during the census of all the HCWs. In a multivariate linear regression model, the WV experienced and poor work ability were highly significant predictors of work-related stress (p < 0.001). Nurses who had experienced WV in the previous year had an increased odds ratio (OR = 8.94; Confidence Interval 95% = 4.43; 18.01) of reporting a state of distress. Conclusions: Experience has shown that specific questioning about violence-the commonest method used-encourages respondents to report violent events and may induce overreporting. This method also tends to involve younger workers who are more exposed to WV. On the other hand, prospective studies based on official reports may be influenced by underreporting. Monitoring WV during health promotion interventions included in occupational health surveillance could minimize both phenomena. Systematic studies and meta-analyses which rely mainly on "ad hoc" studies may be biased.

Background/Objectives: Workplace violence in the healthcare sector is a growing global concern. Defined as incidents where staff are abused, threatened, or assaulted in work-related contexts, this issue affects over half of healthcare personnel worldwide, with nurses being particularly vulnerable. The consequences are far-reaching, leading to diminished service quality, workforce turnover, reduced healthcare access, and increased costs. Despite its physical and psychological impact, workplace violence remains underreported, especially in its psychological forms, which have historically been underestimated. Methods: This study applies Per Isdal's typology of violence to analyze incident reports from a hospital setting. By doing so, it offers a structured framework for understanding the multifaceted nature of workplace violence. By categorizing and examining how different forms of violence co-occur and manifest in daily professional interactions, the study aims to contribute to more systematic documentation and theoretical understanding of the field. Results: In total, 247 incidents were analyzed. Physical violence was the most frequently reported type with 167 incidents, followed by psychological violence with 125 cases. Material violence accounted for 28 reports, sexual violence for 10, and latent violence for 4, indicating that physical and psychological aggression dominates the spectrum of workplace violence in this context. Conclusions: The prevalence and complexity of violent incidents targeting healthcare personnel highlight the pressing need for actionable policies and evidence-based interventions that prioritize staff safety and psychological well-being. Establishing clear definitions of violence, alongside fostering a culture of reporting, is essential to create safer and more resilient healthcare environments.

Background/Objectives: Shift-working healthcare professionals are exposed to high psychophysiological demands associated with occupational stress, anxiety, and depressive symptoms. Salivary chromogranin A (sCgA) and secretory immunoglobulin A (sIgA) are non-invasive biomarkers reflecting sympathetic nervous system activation and mucosal immune function, respectively, and are increasingly used to assess biological stress responses. This study examined changes in these biomarkers and their associations with anxiety and depression. Methods: This cross-sectional comparative observational study was conducted among healthcare professionals working 12-h shifts (n = 95) and non-shift-working controls (n = 95) and included a within-shift pre-post assessment, with saliva samples collected before and after the work shift. Salivary biomarkers were determined using ELISA methods. Anxiety and depression were assessed using the State-Trait Anxiety Inventory and the Zung Self-Rating Depression Scale. Data were analyzed with t-tests, correlation, and multiple linear regression. Statistical analyses included between- and within-group comparisons, correlation analyses, and multiple linear regression models to examine independent associations between salivary biomarkers and psychological outcomes. Results: After a 12-h shift, healthcare professionals showed increased sCgA (3.82 ± 0.95 vs. 4.68 ± 1.02 ng/mL; p < 0.001) and decreased sIgA (165.3 ± 32.4 vs. 142.6 ± 29.8 mg/dL; p < 0.001). Psychological scores were higher in healthcare professionals than in controls (p < 0.001). Salivary sCgA correlated positively with anxiety and depression (r = 0.41 to 0.45), while sIgA correlated negatively (r = -0.29 to -0.36). Regression analysis confirmed occupational group (healthcare professionals vs. controls) as the strongest predictor, with independent contributions of sCgA and sIgA to psychological scores. Conclusions: A 12-h work shift in healthcare professionals leads to increased salivary chromogranin A, indicating sympathetic activation, and decreased secretory IgA, reflecting reduced mucosal immune activity. The combined assessment of sCgA and sIgA provides a sensitive and non-invasive approach for monitoring occupational stress and identifying early risks of anxiety and depressive symptoms among shift-working healthcare professionals.

Background: Many nurses and physicians report difficulties with breaking bad news to their patients due to the lack of adequate skills and training. This study aimed to explore the communication skills, knowledge, and self-perceived difficulties of healthcare professionals working in oncology and hematology settings in Italy, in relation to their self-perceived stress levels when communicating bad news. Methods: An "ad hoc" questionnaire and the Perceived Stress Scale were administered online to both physicians and nurses registered by two important professional associations between October 2023 and September 2024. Results: A total of 221 Italian physicians and nurses were enrolled in the study. Most participants reported learning how to conduct difficult conversations from a mentor (61.1%) or through specific courses (56.6%). However, many of the recruited subjects declared having difficulty in giving bad news to the patient and family members (84.2%), and many of them did not know the SPIKES method (63.8%). A moderate level of stress was perceived by the great majority of participants, and the stress level was significantly increased in healthcare professionals who had difficulties in using evidence-based tools (e.g., SPIKES) for bad news communication. Moderate stress was "often" experienced by participants when presenting themselves during the first approach (p = 0.006), when attempting to anticipate the patient's reactions (p = 0.044), when the patient refused to receive information (p = 0.006), when they had to remain assertive and confident regardless of the patient's response (p = 0.013), and when managing post-communication consequences (p = 0.012). Conclusion: The limited knowledge and application of specific tools for bad news communication could exacerbate stressful conditions at this sensitive time among healthcare providers. The present findings could be used by health institutions to develop ad hoc training programs for both physicians and nurses, as well as to strengthen their organizational culture.

Background/Objectives: The nursing profession is experiencing a global shortage of nurses. Early-Career Nurses (ECNs) assist in addressing the shortage; however, a significant number are leaving their workplaces and the profession. The aim of the review is to explore the factors that impact early-career nurses thriving at work, including their motivation and intention to stay in employment and the profession. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. The objectives, analysis, and inclusion and exclusion criteria were informed by PRISMA for Scoping Reviews (PRISMA-ScR) to ensure accurate and complete reporting of findings. The target population were ECNs who are in the first five years of practice. Databases including CINAHL, PubMed, PsycINFO, Scopus, and Web of Science were searched to identify the literature on ECN thriving between 1985 and 2025. Titles, abstracts, and full texts of the identified studies were screened by two independent reviewers, and thematic analysis was undertaken to analyse the data. Results: A total of 190 studies was initially identified, and after screening and review, a total of 16 articles met the inclusion criteria and explored factors related to thriving and retention. Key themes identified within the literature that contribute to ECNs thriving at work encompass the work environment, work-life balance, and education, where generational differences may also create unique nuances between ECNs. Conclusions: ECNs encounter many challenges in the early stages of their nursing career. Organisational support may be responsive and provide conducive work environments that nurture growth, career development, and thriving for ECNs. However, future research is needed to further confirm drivers of thriving, along with understanding the impact of targeted interventions to better support ECN thriving and retention. Future search will include stakeholders to validate the findings.

For those of you who adhere to the Gregorian calendar, December marks the end of the year and a time for celebration and some well-earned rest [...].

Background/Objectives: This review aimed to explore the pathways of nursing and midwifery education in Tanzania and compare them with global perspectives. The goal was to identify similarities, differences, and areas for potential improvement to align with international standards. Methods: A narrative literature review was carried out through databases with published studies in nursing and gray literature. The database search included Medline, PubMed, Google Scholar, EBSCO, PsycINFO, clinical nursing, and gray literature from January 2014 up to December 2024. The search process was carried out by the authors with the following key words: admission, pathway to nursing profession, delivery mode, generative dynamic, and learning models. The search strategy included studies from selected countries in East Africa, Europe, North America, Australia, and Asia. The inclusion criteria were (1) published papers or reviews addressing the review topics; (2) studies published in the English language; (3) gray literature on the reviewed topics; (4) studies originating from Tanzania, East Africa, Europe, Asia, Australia, and North America. The selected countries served as a source for comparison of nursing and midwifery education in Tanzania with the globe. Results: A total of 758 articles were reviewed from the selected databases. Finally, 27 studies and 11 gray literature sources were included. In Tanzania, the overall duration of nursing education from primary education to a bachelor's degree for diploma graduates is relatively long. Students complete approximately 14 years of schooling from primary education to the completion of a diploma, including three years at the diploma level. To enroll in a degree program, candidates are required to have two years of professional experience, followed by four years of academic training and a mandatory one-year internship. Globally, the duration of educational programs is generally decreasing due to generational shifts and advancements in technology. Conclusions: Whilst nursing and midwifery education is regulated in Tanzania, the current admission criteria and duration of the program do not align with the global standards. Future studies that provide the comparison of curriculums among universities in Tanzania with global standards would provide a deep understanding of the competencies, teaching models, learning environment, duration, and desired learning outcomes for nursing and midwifery education.

Background: Hospital In The Home (HITH), also called Hospital at Home or Virtual Hospital, delivers hospital-level care in patients' homes to enhance outcomes and reduce hospital bed occupancy. Despite widespread implementation, strategic guidance for managing HITH initiatives remains limited. Methods: Following PRISMA 2020 guidelines, we conducted a systematic review (protocol not registered) searching ScienceDirect and Scopus (inception to December 2023) using the terms "hospital in the home," "HITH," "hospital at home," "virtual care" AND "lesson," "management," "governance." Peer-reviewed studies reporting lessons learned, best practices, or governance strategies for HITH programs with sufficient implementation detail were included; we excluded studies focusing solely on clinical effectiveness without organizational aspects, conference abstracts, and editorials. Two researchers independently screened records, extracted data, and conducted thematic analysis. Quality assessment used the Mixed Methods Appraisal Tool (MMAT). Sixteen studies (12 high-quality, 3 moderate, 1 low) were included. The studies were moderate overall, based on predominantly observational program evaluations and case studies. Results: Forty-two lessons were identified and classified into nine categories: combining care modalities, technology integration, impact on patient outcomes, training and specialized knowledge, care coordination, governance structures, financial sustainability, cross-sector collaboration, and patient selection. These categories fall under four themes: care delivery models; staffing and team dynamics; governance and financial sustainability; and patient selection and safety. Conclusions: This framework provides healthcare executives and program managers with evidence-based guidance for implementing and enhancing HITH programs, addressing a critical gap in governance and management literature.

Background/Objectives: Sex trafficking is a form of modern-day slavery still present in our societies. Health professionals are in a key position to identify and support victims, but adequate training is required. The aim of this study was to analyze the impact of a structured educational intervention on knowledge, perceived professional role, and attitudes toward sex trafficking of women among undergraduate nursing students at the University of Seville, Spain. Methods: A cluster randomized pilot educational trial with a pre-test-post-test control group design and one-year follow-up was conducted. A two-hour educational session addressed key concepts related to sex trafficking, health professionals' responsibilities, and survivor support. Knowledge and attitudes were assessed at baseline, immediately after the intervention, and at one-year follow-up. Results: 199 students participated. Significant post-intervention improvements were observed in knowledge and attitudes, with sustained impact after one year despite some knowledge decay. Conclusions: This pilot educational intervention appears to improve knowledge and attitudes toward sex trafficking among undergraduate nursing students and may represent a useful strategy for sensitizing and training future health professionals in this area.

Background/Objectives: Low-income compared to high-income women have a higher incidence of and mortality from cervical cancer (CC) due to lower screening rates (under/never-screened). Home-based screening for CC via mailed "self-collection" for human papillomavirus (HPV) testing is an alternative to traditional, provider-collected screening that may be more acceptable to low-income women. Theoretically, adoption of a recent technology, in this case, mailed return of self-collection, is related to the Diffusion of Innovations concepts of advantages and complexity. The purpose of this study was to develop and psychometrically test scales to measure advantages and complexity of self-collection in a low-income, under/never-screened population. Methods: Low-income women (n = 168) were recruited in person from food pantries and online using Facebook in the Midwest U.S. After a baseline survey, women were mailed a self-collection kit. We assessed reliability with item analysis and Cronbach's α and evaluated validity with exploratory factor analysis and t-tests, using mailed kit return as the independent variable. Results: Two scales were developed: (1) advantages (Cronbach's α = 0.84), item-total correlation = 0.51 to 0.69, and (2) complexity (Cronbach's α = 0.82), item-total correlation = 0.45 to 0.64. Exploratory factor analysis supported items factoring on their respective scales, and t-tests supported a relationship between each scale and mailed return of kits. Conclusions: Both the advantages and complexity scales demonstrated reliability and validity among low-income women. Future studies should evaluate these scales in a larger, more diverse population. Nurses could use these scales to assess preferences and difficulties associated with self-collection and aid patients with CC screening decision-making.