Nursing Research and Practice最新文献

Aim: To evaluate intra- and interoperator reliability and accuracy of the third-generation tympanic thermometer (GeniusTM3) and to explore the relationship between measurement error and calibration intervals of the tympanic thermometer.

Design: Open-label, pragmatic multicenter cross-sectional study.

Methods: The study was carried out in intensive care units and operating theaters across five hospitals in Northern Italy. Patients of any age admitted to intensive care units or undergoing surgical procedures in operating theaters between December 2023 and October 2024 were enrolled. Two trained nurses independently took the temperature three consecutive times using the same tympanic thermometer. Core temperature was measured using one of the gold standard methods. The measurement error was calculated as the difference between the gold standard measurement and the measurement made with the tympanic temperature.

Results: A total of 550 patients were enrolled. The precision of the tympanic thermometer was shown to be excellent in both intraobserver and interobserver reliability. The tympanic thermometer consistently underestimated body temperature, with a mean measurement error of 0.3°C and a limits of agreement of ±1.3°C. The generalized linear model (GLM) showed calibration interval, recruiting hospital, and the variable defined by their interaction as factors that were independently and statistically significant predictors of accuracy variation.

Conclusions: The third-generation tympanic thermometer (GeniusTM3) represents a reliable tool for ensuring high accuracy in terms of both intraoperator and interoperator concordance. However, the accuracy of the device has been significantly affected by the timing of the calibration: a calibration interval of more than 6 months results in a significant deterioration in accuracy.

Background: Early childhood developmental delays are a major concern in low- and middle-income countries (LMICs), where gaps often exist between developmental surveillance and follow-up support. In Thailand, the Developmental Surveillance and Promotion Manual (DSPM) provides a national framework for screening and promotion; however, practical models for integrating DSPM guidance into daily classroom and home routines in community daycare settings remain limited.

Aim: To compare two brief nurse-facilitated implementation models-teacher coaching using practice-based coaching (PBC) and a parent-implemented intervention (PII)-and examine their effects on adult practices and short-term developmental outcomes in preschool children at risk of delay.

Methods: A quasi-experimental, two-group pretest-posttest study was conducted in two community daycare centers. Forty-nine at-risk children and primary caregivers were enrolled (PBC: 26 dyads; PII: 23 dyads), along with 17 teachers (PBC: 8; PII: 9). Each center implemented one model over a 4-week intervention period with follow-up assessment approximately 4 weeks later. Outcomes included teacher developmental knowledge, teacher and caregiver developmental-promotion behaviors, and child pass/fail status across five DSPM domains. Continuous outcomes were analyzed using 2 × 2 mixed-design repeated-measures ANOVA; within-center domain changes used exact McNemar's tests.

Results: Teacher knowledge improved over time, and the magnitude of improvement differed between models (group-by-time interaction), with larger gains in the PII center than the PBC center. Teacher and caregiver developmental-promotion behaviors improved significantly from pre to post (main effects of time), while group-by-time interactions were not significant, indicating comparable behavioral gains across pathways. Within-center DSPM analyses suggested short-term reductions in delayed status in selected domains in both centers.

Conclusion: Both PBC and PII were feasible in community daycare settings and associated with meaningful short-term improvements in adult developmental-promotion practices and selected DSPM domains. Child domain patterns should be interpreted descriptively because DSPM changes were analyzed within centers rather than as between-model contrasts to inform service planning and scale-up. Trial Registration: Thai Clinical Trials Registry (TCTR): TCTR20250106003.

Shared decision-making (SDM) in intensive care units (ICUs) aids family decision-making and mental health; its impact on emergency management knowledge, anxiety, and mental health is unclear. In a quasi-experimental pre-post study at a teaching hospital in southern Taiwan, 60 family members of terminally ill ICU patients (30 SDM, 30 control) were enrolled. The SDM group received a three-talk model intervention (choice, options, decision talk); the control group received usual care. Emergency management knowledge, anxiety, and mental health were assessed via self-administered questionnaires before and after the intervention. Data were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests and multivariable linear regression. In the SDM group, emergency management knowledge increased from a pretest mean of 16.87 (SD 3.45) to a post-test mean of 19.33 (SD 1.49), albeit statistically significant (p < 0.05). Anxiety scores rose in the SDM group (post-test mean 47.13, SD 4.77) versus a slight decrease in controls (post-test mean 43.63, SD 6.56), with no significant intergroup difference (p = 0.284). Mental health scores (a secondary outcome) declined in both groups, indicating persistent emotional distress. After adjusting for confounders, the SDM intervention remained a significant predictor of increased knowledge. SDM enhanced knowledge of emergency management but did not alleviate anxiety or improve mental health among ICU family members. Integrating targeted emotional support into SDM models warrants exploration.

Objective: This study aims to analyze adolescents' family interaction experiences and social dynamics in the context of social distancing measures during the COVID-19 pandemic.

Methods: This study uses a qualitative methodological approach based on symbolic interactionism, with convenience sampling. It involved students aged 10 to 19 from two public schools, using semistructured remote interviews analyzed through inductive thematic analysis.

Results: The study included 22 adolescents, predominantly female. The themes were as follows: "Caught by surprise": break with the world and the (re)discovery of home; the new routine at home: conflicts and tensions; opportunities to reflect and be grateful: between fears, worries, and gratitude; learning through adversity: times of reconciliation and resignification. The adolescents who participated faced a significant routine disruption, spending more time at home, which reshaped family interactions. This adjustment phase involved coping with new household responsibilities and reduced privacy, sparking intrafamily conflicts necessitating dialogue and reconciliation efforts.

Conclusion: The COVID-19 pandemic reshaped the family interactions and daily routines of adolescents, requiring them to adopt new roles and coping strategies to navigate emotional, social, and financial challenges. Despite moments of conflict and loss, the experience also fostered personal growth, resilience, and a renewed appreciation for family support during adversity.

Aim: To explore the factors influencing the Family and Community Nurse (FCN) role implementation within the local health authority (LHA) of Biella, Italy.

Design: Qualitative single embedded case study.

Methods: Twenty-two participants (18 FCNs and 4 managers) were interviewed using in-depth semistructured interviews and timeline elicitation. Observational data were recorded in field notes. Data were analyzed using the Framework Analysis approach and organized through the Consolidated Framework for Implementation Research.

Results: At the outer setting level, alignment with national policy and population needs supported adoption, although public awareness of the role was initially low. Within the inner setting, organizational flexibility enabled role adaptation, especially regarding project participation and time allocation. However, fragmented coordination with existing services and the persistence of task-based workflows limited integration. At the individual level, FCNs expressed strong motivation and professional identification, but also reduced confidence linked to limited preparation for community-based and educational activities. The process was supported by reflective leadership and the progressive tailoring of strategies to local needs and staff competencies.

Conclusion: Implementing the FCN role is a dynamic process shaped by structural conditions, professional boundaries, and stakeholder engagement. Sustainability requires system-level support, cross-sector collaboration, and a clearly defined scope of practice.

Impact: This study highlights key organizational and contextual conditions required to support the sustainable integration of FCNs. These insights may guide health service managers and policymakers in strengthening community-based care models, improving interprofessional coordination, and investing in role-specific education to meet the needs of aging populations.

Reporting method: The study adhered to the Standards for Reporting Qualitative Research.

Patient or public contribution: None.

Aim: To investigate the current status of treatment burden in stroke patients and analyze its associated factors, thereby providing a theoretical basis for clinical interventions.

Design: This study used a convergent parallel mixed-methods design.

Methods: For the quantitative phase, a questionnaire survey was conducted among hospitalized stroke patients using convenience sampling from April to October 2024. Univariate analysis, correlation analysis, and multiple regression analysis were used to identify the associated factors of treatment burden. For the qualitative phase, purposive sampling was adopted, and the Colaizzi seven-step method with NVivo 11 software was used to analyze the specific manifestations and experiences of treatment burden in stroke patients. The quantitative and qualitative results were finally integrated and triangulated for joint presentation.

Results: A total of 237 valid questionnaires were retrieved. Multiple linear indicated that depression (β ^' = 0.431, p < 0.001), self-management efficacy (β ^' = -0.235, p = 0.047), age (β ^' = -0.213, p = 0.001), objective support (β ^' = -0.171, p = 0.001), and diet control (β ^' = -0.163, p = 0.001) were the main associated factors of treatment burden of stroke patients. Seventeen stroke patients were interviewed for the qualitative phase, from which 8 themes and 27 subthemes were extracted. Integration of quantitative and qualitative results yielded a comprehensive, multidimensional understanding of treatment burden in stroke patients.

Conclusion: Treatment burden in stroke patients is associated with multiple factors, involving psychological, behavioral, and social support dimensions. This finding emphasizes the necessity for healthcare professionals to adopt a holistic approach to stroke patient care.

Implications for clinical practice and patient care: This study suggests that clinical practice should strengthen psychological interventions for stroke patients, improve their self-efficacy, provide individualized guidance, and refine support systems, so as to effectively alleviate treatment burden.

Introduction: The cultural backgrounds of Australian populations are increasingly diverse due to trends in globalisation and migration. Specifically, within healthcare environments, the rapid growth of multicultural individuals necessitates a change in nursing practice. Healthcare professionals require culturally competent knowledge, skills, and attitudes to accommodate individualised healthcare needs of a diverse population. Therefore, preparing student nurses with an adequate level of cultural competence remains essential in nursing education.

Background: Previous studies indicated that the meaning of cultural competence is ambiguous. Additionally, there is a paucity of research examining the definitions of cultural competence among students with heterogeneous cultural backgrounds. Thus, this study aims to explore undergraduate nursing students' perceptions and learning experiences of cultural competence, with attention to the personal and educational factors that shape their understanding.

Materials and methods: An explanatory sequential mixed-methods research design was used, and data collection included a survey followed by a series of interviews with undergraduate students. A total of 25 nursing students had completed a full set of Cultural Competence Assessment Tool questionnaires, with five participating in a one-on-one interview. Both descriptive and inferential statistical methods were used to analyse the survey data, while the interviews were analysed using a thematic analysis.

Results: Overall, students have a moderate level of cultural competence and scored low on cultural sensitivity. Additionally, three recurring themes were identified in the qualitative results and encompassed understanding cultural competence is a lifelong journey, factors influencing students' interpretations of cultural competence, and learning cultural competence.

Conclusion: The findings highlight intercultural communication barriers and social segregation as contributing factors to demographic differences in cultural competence. The insights gained may benefit cultural content development in higher education curricula, specifically in nursing contexts. Future research may explore the benefits of alternative pedagogical strategies in enhancing students' cultural competency.

Objective: In pandemic conditions, paying attention to the facilities and amenities nurses need while caring for patients is important. In this regard, this study aimed to explore the challenges and problems faced by nurses regarding the use of personal protective equipment during the COVID-19 pandemic.

Methods: This is a qualitative study with conventional content analysis using Granheim and Landman's approach. In this study, 12 participants were selected by purposive sampling, considering the inclusion criteria. Data were collected through in-depth semistructured interviews. Ethical considerations were applied to all stages of the study. MAXQDA 20 software was used to manage and organize the data.

Results: About 59% of the participants (7/12) were female. The mean age of the participants was 37 years, and work experience ranged from 7 to 22 years. One main theme includes "Unfavorable management of personal protective equipment," and seven categories emerged from the data analysis.

Conclusion: Nurses face numerous challenges and problems in epidemics and pandemics, such as the COVID-19 pandemic. As these people are on the front lines of the fight against the pandemic, they always need various equipment and facilities, including qualified and standard personal protective equipment. Therefore, special attention should be paid to these members of the healthcare team through providing practical approaches to mitigate their challenges about using personal protective equipment.

Background: The COVID-19 pandemic highlighted the critical role of community health services, yet little is known about how nursing students perceive and engage with public health centers during their community nursing practicums in this evolving landscape.

Purpose: To explore the community nursing practicum experiences of Korean nursing students at public health center after the COVID-19 pandemic.

Methods: This qualitative study was conducted in the Republic of Korea. It employed purposive sampling and thematic analysis to examine the practicum experiences of 29 nursing students. The data were collected using daily reflective journals written by students during their practicum, with research consent obtained after all grades were finalized.

Results: Three themes were identified: (a) Understanding and engagement with public health centers, including limited prior awareness of community health services and expanded recognition of diverse public health initiatives. (b) Practicing and overcoming challenges in community nursing involves understanding the role of community nurses in preventive care, experiencing visiting nursing services, enhancing knowledge and skills, and clarifying career options. (c) Leading health promotion projects as a nursing professional entails roles as community health assessors, specialized practitioners, and collaborating with other experts.

Conclusions: This study highlights how community nursing practicum experiences after the COVID-19 pandemic contributed to enhancing students' understanding of public health roles and practical skills, influencing some students' career choices. To maximize outcomes, programs should implement prepracticum preparation and strengthen site collaboration for active student engagement in assessments. Through well-designed practicum experiences, nurses might be better prepared to address future community health challenges as health assessors and collaborators within multidisciplinary teams.

Background: The global nursing shortage has become a critical issue, worsened by poor working conditions, demographic shifts, and the COVID-19 pandemic. Understanding nursing students' preferences and expectations is crucial for improving workforce retention, guiding decision-making, and enhancing job satisfaction. This study aimed to explore nursing students' preferences and expectations regarding working environment dimensions and analyze differences by gender and generation.

Methods: A quantitative descriptive cross-sectional study was conducted using an online survey targeting 1277 nursing students from Catalan universities between March 27 and June 26, 2023. Convenience sampling was applied. Preferences and expectations for all items were recorded on a scale from 0 (minimum) to 10 (maximum), and responses were regrouped into three categories: low (0-4), moderate (5-7), and high (8-10). Data analysis was conducted using R (version 4.3.0) under RStudio (version 2023.03.0). The Kolmogorov-Smirnov test confirmed non-normal distribution of continuous variables. Comparisons by gender and generation were made using chi-square tests, with significance set at p < 0.05. Cronbach's alpha was used to assess internal consistency for the questionnaire items, confirming the reliability of the survey dimensions.

Results: A significant gap was found in high category (scores 8-10) between nursing students' preferences, which exceeded 80% for all working environment dimension items and their expectations, which remained below 50% in all cases, indicating a noticeable disparity.

Conclusions: The study highlights a significant discrepancy between nursing students' high preferences (> 80%) for working environment dimensions and their low expectations (< 50%) of achieving them. This gap suggests that improving work conditions and recognition could stabilize the nursing workforce.