Nursing Reports最新文献

Background/objectives: The use of coercive measures (CMs) and security technologies (STs) in mental healthcare continues to raise ethical and practical concerns, affecting both patient and staff well-being. Mental health nurses (MHNs) and nursing students (NSs) play a key role in the decision-making process regarding these interventions. However, their attitudes, particularly toward STs, remain underexplored in Italy. This study protocol aims to introduce a new conceptual framework and investigate Italian MHNs' and NSs' attitudes toward CMs and STs in mental health settings. Additionally, it will explore the influence of sociodemographic and psychological factors, including stress, anxiety, depression, stigma, and humanization on these attitudes.

Methods: The research will be conducted in two phases. Phase 1 involves a national survey of a convenience sample of MHNs and NSs to assess their attitudes and related factors. Phase 2 includes qualitative interviews with a purposive sample of MHNs and NSs to explore participants' perspectives on STs in more depth. Quantitative data will be analyzed using descriptive and inferential statistics, while qualitative data will be examined through thematic analysis.

Conclusions: This study protocol seeks to enhance our understanding of MHNs' and NSs' attitudes toward the use of CMs and STs in mental health settings, identifying key factors influencing these attitudes. The findings aim to inform policy development, education programs, and clinical practices in both the Italian and international panoramas. Additionally, the proposed conceptual framework could guide future research in this field.

Background/objectives: Caring for patients at the end of life can involve issues that are ethically and legally fraught: withholding or withdrawing artificial nutrition and hydration, pain control that could hasten death, aggressive treatment that is continued when it seems only to be prolonging suffering, patients who request medical assistance in dying, and so forth. Clinicians may find that their deeply held ethical principles conflict with law, institutional policy, or patients' choices. In these situations, they may consider either refusing to participate in procedures that they find morally abhorrent (conscientious refusal) or providing care that they believe to be ethically obligatory despite being contrary to law or policy (conscientious commitment).

Methods: This paper reviews the ethical issues involved.

Results: Each of the usual policies for handling conscientious refusals faces serious challenges.

Conclusions: Healthcare providers who refuse to provide medical services should be expected to explain their reasons, make prompt referrals, and bear some of the resulting costs or burdens.

Background/Objectives: Extensive research has emphasised the persistent challenges and failures in providing hospitalised patients with fundamental evidence-based nursing care, often resulting in grave consequences for patient safety. Recommendations from implementation research indicate that a tailored theory- and research-based implementation strategy targeting contextual determinants can optimise the implementation of evidence-based clinical practice for the benefit of patients. This study evaluated the feasibility of an implementation strategy designed to improve the quality of nursing care by targeting behavioural and environmental barriers in a hospital setting. Methods: Proctor's conceptual model for implementation was applied to evaluate the strategy based on eight outcomes: adoption, acceptability, appropriateness, fidelity, feasibility, penetration, sustainability, and costs. Data collection methods included field observations, informal and focus group interviews, registrations, and audits of electronic patient records. Results: The strategy was adoptive, acceptable, appropriate, and feasible in targeting complex environmental and behavioural determinants (at the individual, team, and management level), enabling successful implementation of fundamental evidence-based nursing care. However, fidelity, feasibility, and sustainability were challenged by competing organisational demands and time constraints. Conclusions: The tailored, multifaceted strategy proved effective in addressing complex environmental and behavioural determinants across multiple levels, facilitating the implementation of fundamental evidence-based nursing care in a clinical practice. Further testing and larger-scale studies is needed to assess the strategy's transferability and its impact on nursing-sensitive patient outcomes in different clinical settings.

Background: Preventing postoperative infection and promoting patient safety are essential responsibilities of the operating room nurse. In some hospitals, splash basins are used to rinse instruments during surgery, although previous studies emphasise the risk of bacterial contamination. A recent systematic review calls for further investigation into surgical teams' use of splash basins. Objectives: Our objective was to investigate bacterial contamination in splash basins and to identify the variables that may have an influence on this contamination. Methods: This prospective observational pilot study involved collecting, cultivating, and analysing water samples obtained from splash basins during operations performed in the thoracic and neurosurgical departments. The ventilation systems, length of surgery, number of instruments in the splash basin, number of persons present in the operating room, frequency of door openings during surgery, and type of bacteria were observed. Results: Bacterial growth was found in 44% of the final water samples: 41% from the thoracic surgical department, which had laminar airflow ventilation systems/unidirectional airflow ventilation, and 47% from the neurosurgical department, which had conventional ventilation systems/turbulent mixing ventilation. However, the binary logistic regression analysis revealed no significant correlation between bacterial growth and the ventilation systems, length of surgery, number of instruments in the splash basin, number of people in the operating room, or frequency of door openings. The most common types of bacteria found were coagulase-negative staphylococci and Micrococcus luteus. Conclusions: Splash basins become contaminated with bacteria during surgery. Therefore, using splash basins with sterile water is not recommended. Further research is needed to determine the best evidence-based practice for rinsing instruments perioperatively.

Background: Ageism refers to the presence of stereotypes, prejudices, and discrimination against older adults based on their age. In healthcare settings it negatively impacts opportunities for treatment, rehabilitation, and cure opportunities. This study aims to assess the presence of ageism among healthcare workers toward older patients and to identify the associated sociodemographic, personal, and work-related factors. Methods: A systematic review of the literature was performed using PubMed, Embase, CINAHL, and Scopus. Studies that assessed the presence of ageism among healthcare professionals through a quantitative or mixed methodology and published between 2014 and 2024 were included. Results: Fifteen articles met the inclusion criteria. Healthcare workers generally exhibited low rates of ageism; however, results varied across studies. Although the available literature is limited, workers with less knowledge about aging and less experience, especially in geriatric units, showed higher ageism scores. Intergenerational contact and a wish to work with older people appeared to be important factors for promoting a positive relationship with older adults. Other sociodemographic and sociocultural factors, such as age and sex, were not related to ageism. Workload and work-related factors, such as stress or lack of personnel, might be associated with ageism, but few studies were found to be available to confirm these results. Conclusions: Ageism scores among professionals were low. Gerontological education and clinical and family experience could help reduce ageist attitudes toward older patients among health professionals.

Background/objectives: To identify and analyze what is known about the psychosocial factors affecting the wellbeing and sources of support of young adult (YA) cancer survivors.

Methods: The search strategy included Neoplasms, young adults, psycho* or emotional well* or mental health. The OVID Medline and CINAHL databases were searched. Included were cancer survivors (YA) ages 18-39 at the time of the study. The studies included qualitative and quantitative designs, written in English, and published between January 2016 and October 2024. The results were recorded according to PRISMA-ScR guidelines.

Results: Thirteen studies with 4992 participants found psychosocial factors to be the most important influence on life satisfaction with social support the most decisive factor. This expands the results of previous reviews by including a variety of study designs and data collection tools to provide a comprehensive understanding of the YA experience. Psychosocial concerns affecting wellbeing led to social isolation, low connectedness with family and friends, and significant distress. Consistent with previous reviews, the greatest challenges to wellbeing were psychosocial needs, which included seeking and delivering information that is easy to understand but detailed, which can decrease frustration and anger, and needs to be readily available and accessible. Unlike older adult cancer survivors, YA survivors are more likely to have reduced psychosocial functioning compared to their peers and suffer from higher distress than their adult peers and non-YA cancer survivors with anxiety as the most reported symptom.

Conclusions: Interventions need to be developed that lessen the impact of a cancer diagnosis and cancer treatments. The specific needs of YAs must be further researched and evaluated to determine specific interventions and the support needed during this crucial stage of cancer survivorship. Future research must also increase the focus on the racial and ethnic diversity of participants as well as prioritizing underserved populations and the impact of the COVID-19 pandemic.

Background/objectives: The COVID-19 pandemic has put nurses under extreme pressure, especially affecting them by significantly increasing their workload and compromising their well-being. The lack of balance between work and personal life has caused greater stress and burnout in these professionals, deteriorating their quality of life and the care they provide. This study aims to synthesize the scientific evidence on the relationship between work-family balance and the perceived quality of life of nurses during the COVID-19 pandemic.

Methods: A scoping review was carried out based on the Joanna Briggs Institute methodology, following the PRISMA-ScR guidelines in the PubMed, CINAHL, SCOPUS, WOS, Cochrane Library, and PsycINFO databases. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results: Five studies involving 1641 nurses from Spain, India, Jordan, South Korea, and Turkey focused on three key areas: (1) work-life balance, (2) quality of life, and (3) factors associated with quality of life during the COVID-19 pandemic.

Conclusions: The pandemic exacerbated pre-existing challenges related to work-life balance and quality of life, particularly for nurses with rigid and extended work hours, increasing stress and negatively impacting their well-being. The study emphasizes the need for flexible labor policies, psychological support, and strong social networks to prevent burnout and improve nurses' quality of life.

Objective: Nursing students' experiences about clinical practice tutoring in a public university from southern Spain and at its two attached educational centres were analysed.

Methods: A cross-sectional observational study was carried out. The population was comprised of nursing students attending their fourth year of university during the 2023/2024 academic period, with a final sample of 179 subjects. Sociodemographic data were collected and a validated questionnaire on opinions about the figure of clinical practice tutors was applied, with 34 closed questions offering five answer options. The questions were categorized into 17 dimensions. A question on the students' satisfaction with tutoring of the practices was included, in addition to an open question to gather the students' comments and/or suggestions in relation to clinical practice tutoring. The analysis was performed through a data matrix in SPSS. The Kruskal-Wallis test was used to compare the centres according to the questionnaire dimensions, considering p-values < 0.05 to establish statistically significant differences. The open question was analysed using Atlas.ti.

Results: Most of the students were women, with an approximate mean age of 23 years old. Significant differences were detected among the centres in almost all dimensions from the questionnaire. High satisfaction levels were obtained in the three centres. A total of 83 verbatims were collected in the open question and grouped into eight categories.

Conclusion: Nursing students place significant importance on the role of the clinical tutor. Clinical tutors who demonstrate enthusiasm for teaching, foster a positive environment based on active listening, respect, and the encouragement of autonomy, are essential to enhancing the students' experience during clinical placements.

Background: Cardiac rehabilitation (CR) is an intervention to improve health and quality of life in patients undergoing percutaneous coronary intervention (PCI). The use of digital technology for healthcare promotion, such as telemedicine, has received growing attention in recent years due to the possibility of offering remote and individualized cardiac rehabilitation to patients undergoing coronary interventions. However, the impact of cardiac telerehabilitation on health-related quality of life (HRQoL) is not fully understood. This systematic review aims to analyze through meta-analyses and synthesized comments the current knowledge on the effectiveness of cardiac telerehabilitation in improving HRQoL in patients undergoing PCI.

Objectives: This manuscript presents a protocol for a systematic review to assess the effects of cardiac telerehabilitation on HRQoL in cardiac patients after PCI. Furthermore, the systematic review will explore the different modalities of remote rehabilitation documented in scientific literature.

Methods: The literature review protocol was developed according to the PRISMA guidelines for systematic reviews. Search terms were structured according to the PIO (Population-Intervention-Outcome) framework. All relevant available studies will be identified using the main databases (PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library) and included in the review. Methodological quality and risk of bias will be evaluated using the Crowe Critical Appraisal Tool (CCAT). This review protocol has been registered on PROSPERO (No. CRD42024582933).

Conclusions: This systematic review will comprehensively investigate the effects of cardiac telerehabilitation on QoL improvements in patients after PCI.

Background and aims: The COVID-19 pandemic significantly impacted the mental health of healthcare professionals, especially those working in Psychosocial Care Centers (CAPS), which are crucial services in the Brazilian mental health system. This study aimed to investigate the association between job satisfaction, workload, and psychological distress among CAPS professionals during the pandemic.

Methods: A cross-sectional study was conducted with 53 professionals from seven CAPS. The Workload Impact Scale (IMPACTO-BR) and Job Satisfaction Scale (SATIS-BR), the General Health Questionnaire (GHQ-12), and a sociodemographic questionnaire were used. Descriptive and analytical statistical analyses were performed. Multiple linear regression analysis was conducted to examine the relationship between job satisfaction, workload, and psychological distress.

Results: Professionals reported moderate satisfaction (3.67 ± 0.45) and mild workload (1.82 ± 0.63). One-third of the sample showed scores indicative of psychological distress. Multiple linear regression analysis revealed that workload (p = 0.0025) and low job satisfaction (p = 0.0495) were significantly associated with psychological distress.

Conclusions: Low job satisfaction and high professional workload were predictive variables of psychological distress. These findings highlight the need for investments in promoting the quality of life at work for mental health professionals, especially during crises. The implications for human resource management and public policy development emphasize the importance of an integrated approach that considers the well-being of professionals for the effectiveness and sustainability of the psychosocial care model.