Nursing Research and Practice最新文献

Background: Evidence-based nursing leads to improved care quality and patient outcomes; however, challenges with implementation prevent that from being achieved. In hospitals, nurses are well positioned across multiple organizational levels to influence the adoption of evidence-based practices (EBP). A better understanding of the roles of those who are serving as implementers of EBP changes in the hospital is needed.

Purpose: This narrative review sought to answer: In hospitals, who (i.e., what roles) are the implementers of nursing-related EBP changes and what are the attributes of those EBP projects? This review aimed to describe (1) the roles and the organizational level of those implementing EBP changes in the hospital for nurses and (2) the attributes of the projects including, its location, the model used to guide the project, and the evaluation measures.

Methods: An iterative, two-phased literature review was conducted. Categorical data were analyzed to achieve the aims.

Findings: Across 158 articles, numerous roles, mostly nursing roles, spanning multiple organizational levels were described. The majority of articles described teams representing multiple levels (n = 132; 84%), implementers positioned in unit-level roles (n = 37; 23%), and projects occurring at the unit-level (n = 127, 80%), using the Joanna Briggs Institute model (n = 97, 61%) and an evaluation of process measures (n = 77; 49%).

Conclusion: This review identified the implementers of nursing-related practice changes and the attributes of the projects, which provides a rich description of some contextual elements that shape how EBP changes occur in hospitals. This new foundational knowledge can stimulate a systematic approach for improvement and optimization of the implementation process, both in practice and through research. This review highlights the need for tailored and role-specific skills, education, and competencies to equip implementers to lead collaborative and effective teams across hospital systems and maximize the impact of implementation.

Objective: To determine participants' pre- and post-training competence in perinatal bereavement care, along with evaluation of the training.

Methods: A quasi-experimental study with a pre-post design was conducted in two phases. The training on coping with perinatal loss (TCPL) was first delivered entirely online to a cohort of students in 2022(N = 56). To enhance the initial intervention, a second cohort of students in 2023(N = 44) received the TCPL with an added on-site scenario simulation component. Questionnaires of Perinatal Bereavement Care Competence Scale, Self-Competence in Death Work Scale, Jefferson Scale of Empathy, Chinese version of the Stress-Related Growth Scale-Short Form, and the evaluation of scenario simulation were used to evaluate the effectiveness of the training.

Results: Including 52 junior undergraduate midwifery students in 2022 and 44 in 2023 completed the questionnaires. We observed higher post-training scores for perinatal bereavement care competence and stress-related growth, and a high degree of satisfaction in the scenario of simulations.

Conclusions: The results support the feasibility of the training and are consistent with short-term improvements; confirmatory controlled studies are warranted.

Trial registration: Chinese Registry of Clinical Trials: ChiCTR2200066048.

Aims: To explore the perspectives and needs of people with HIV in terms of social support from the three perspectives of healthcare professionals, peer volunteers, and people with HIV.

Background: Progress in ART has pushed HIV treatment to improve the quality of life of infected people, and UNAIDS has promoted the "95" goal, emphasizing good quality of health. Social support is critical to HIV health management and is strongly associated with multiple health outcomes. The current research on social support in HIV field is mostly based on traditional classification and requires deeper exploration of multidimensional influences.

Methods: During the period from January to March 2024, face-to-face, semistructured, in-depth interviews were conducted at Beijing You'an Hospital. The data were analyzed using an inductive thematic analysis.

Results: A total of six people with HIV, three peer volunteers, and seven medical professionals were interviewed. Inductive analysis of the purposive samples revealed that the social support needs of people with HIV encompass five dimensions: informational support, instrumental support, emotional support, affiliational social support, and appraisal social support.

Conclusions: The social support required by people with HIV is multidimensional in nature. In clinical practice, it is essential to pay full attention to the individual characteristics of people with HIV and develop personalized support plans to ensure that people with HIV receive comprehensive social support.

Introduction: Ensuring that home-visiting nurses (HVNs) possess adequate skills for providing appropriate care is crucial in the context of increasing service demand with advanced care needs. However, current quality assurance relies on mentors' subjective assessments during accompanying visits, which are burdensome and rater-dependent. This study aimed to develop and evaluate the inter- and intrarater reliability and concurrent validity of objective video-based assessment (VBA) checklists for HVNs' nursing skills, focusing on peripheral intravenous catheter placement, pressure injury care, defecation care, and skin tear care to reduce the burden of skill assessment at home and ensure valid skill assessments.

Methods: The checklists were developed through a literature review, focus group interviews, and a group meeting using the nominal group technique to ensure content validity. The inter- and intrarater reliabilities and concurrent validity of the checklists were evaluated using videos of nurses providing care to simulated patients. Five nursing researchers with experience in mentoring nurses assessed the videos twice using checklists with a washout period. The inter- and intrarater reliabilities were analyzed using Gwet's AC1 statistics. Concurrent validity was evaluated with sensitivity and specificity of assessment using checklists against raters' subjective assessments, with expertise in nursing skills as the gold standard.

Results: The checklists demonstrated substantial to almost perfect inter- and intrarater reliabilities (AC1: 0.63-1.00) for each item. The overall assessments also showed more than substantial inter- and intrarater reliabilities (AC1: 0.72-1.00). The sensitivity and specificity of the checklists were both above 0.90, indicating high concurrent validity.

Conclusion: The checklists were reliable and valid for objectively assessing HVNs' skills. The VBA suggests feasible and cost-effective methods for quality assurance, potentially improving the quality of home care. Further studies with patients in diverse clinical settings are required to enhance the generalizability of the results.

Background: Thirst is a common symptom of severe discomfort in awake patients with transoral tracheal intubation in the intensive care units (ICUs), which affects their physical and mental health. Due to the presence of transoral tracheal intubation, patients are unable to express their thirst needs in a timely manner through words, and nurses are prone to ignore their thirst symptoms. At present, there is a lack of systematic intervention protocols for managing thirst symptoms in awake patients undergoing transoral tracheal intubation in the ICU. Therefore, there is an urgent need to construct systematic intervention protocols for this group of patients.

Design: A stepwise multimethod study was conducted. The intervention protocol was developed through qualitative research, evidence synthesis, and the Delphi method.

Methods: Guided by symptom management theory, first, qualitative research methods were used to explore patients' thirst experience and nursing needs. Second, evidence-based methods were used to summarize the best evidence for thirst intervention in patients. Based on the results of qualitative research and evidence summary, a preliminary intervention protocol was formed. Finally, the Delphi method was used to consult 21 experts, soliciting their opinions and revising the protocol accordingly to form the final version.

Results: The expert enthusiasm of the two rounds of expert consultation was 95.45% and 100%, respectively, the expert authority coefficient was 0.89, the Kendall harmony coefficient of item importance was 0.442 and 0.581, and the Kendall harmony coefficient of item feasibility was 0.363 and 0.509, respectively (p < 0.001). A final draft, including three aspects of thirst assessment, intervention strategies, and effectiveness evaluation, was developed.

Conclusion: The thirst intervention program for awake patients with transoral tracheal intubation in ICU constructed in this study demonstrates sound scientific validity and can provide effective guidance for addressing patients' thirst symptoms while improving oral moisture and comfort levels.

Introduction: Diabetes affects more than 25% of elderly residents in nursing homes in Cádiz, Spain. Historically, therapeutic diets in these centers have included restrictions on calories, fats, and sugars, which may reduce food intake and increase the risk of malnutrition. In recent years, more flexible dietary approaches have emerged, aiming to improve both nutritional status and quality of life.

Objective: To explore the perceptions and experiences of nurses in nursing homes regarding dietary management and meal schedules for residents with diabetes.

Methods: A qualitative study was conducted with in-depth interviews of 18 nurses from nursing homes in Cádiz. Data were analyzed thematically.

Results: Three major positions emerged: (1) Support for dietary flexibility, reported by 8 out of 18 nurses, who emphasized the positive effects of relaxed dietary restrictions on residents' quality of life and emotional well-being. (2) Preference for strict diabetic diets, supported by 4 nurses, highlighting the importance of sugar-free and low-carbohydrate alternatives for glycemic control. (3) Criticism of current institutional meal schedules, expressed by 6 nurses, which were seen as rigid, contributing to long fasting periods and increased risk of nocturnal hypoglycemia. Nurses also noted that these schedules prioritize staff convenience over resident-centered care.

Conclusions: Dietary management and institutional meal schedules pose significant challenges to diabetes care in nursing homes. Incorporating greater dietary flexibility and adapting meal schedules to residents' individual needs may enhance both glycemic control and overall well-being.

Background: Self-care agency is crucial for the management of diabetes patients. The Appraisal of Self-Care Agency Scale-Revised (ASAS-R) is a reliable and brief measure of diabetic patients' SCA. In the MENA region, there is currently no Arabic version of the ASAS-R scale available.

Aim: To evaluate the psychometric properties of the Arabic version of the ASAS-R among Arabic patients with DM.

Methods: This study utilized a descriptive cross-sectional design. Exploratory factor analysis was used to test the scale's construct validity. Pearson correlation was used to test for its criterion-related and convergent validity.

Results: Participants' ASAS-R total scores significantly correlated with diabetes self-efficacy (r = 0.543, p ≤ 0.001) and diabetes self-care management (r = 0.566, p ≤ 0.001) but did not correlate with their demographics. Factor analysis revealed a 2-factor solution that retained all items and explained a variance of 46.3%. Cronbach's alpha was 0.775 for the total scale and 0.691-0.851 for subscales indicating a high internal consistency. Also, no item redundancy was noted with the maximum interitem correlation of 0.695.

Conclusion: The ASAS-R was found to be a psychometrically sound measure to evaluate self-care agency among Arabic patients with Type 1 diabetes mellitus, for which future studies interested in self-care among patients with diabetes are invited to use the ASAS-R to validate its psychometric properties.

The transition process for newly graduated registered nurses (NGN) entering hospital work is critical in managing challenges like insecurity and stress, while also supporting role navigation, learning, job satisfaction and retention. This study aimed to explore NGNs' perceptions and experiences during their first four months transitioning to hospital work. A cross-sectional survey with Likert-scale questions and two open-ended free text questions was conducted with NGNs enrolled in a regional transition program at five Swedish hospitals, gathering data from 216 nurses between September 2021 and September 2022. Descriptive statistics and qualitative content analysis were used to assess the data. The findings revealed that 61% of NGNs felt well prepared by their undergraduate nursing education, and 85% enjoyed their profession as nurses. Most reported they were integrated into their teams, satisfied with their support, and understood their responsibilities. However, only 28% reported feeling fully recovered for work, and 44% expressed fear of making mistakes. Qualitative responses highlighted feelings of unpreparedness for the workload, pace and ward-specific routines, although opportunities for learning, building relationships and validating their skills were viewed positively. The transition experience was influenced by individual, social, and organisational factors. Ongoing improvement in transition processes requires shared responsibility between nurses, educational institutions and hospitals.

Aim: This paper explores the impact of a Spaced Retrieval and Montessori-based activity (SPREMON) intervention on mealtime independence, mealtime engagement and affect (mood), and the nutritional status of people with dementia living in nursing homes.

Methods: Quasi-experimental pilot study design. The SPREMON intervention consisted of 20 sessions delivered over 7 weeks. Data were collected at baseline, postintervention, and at 3-month follow-up, using the Edinburgh Feeding Evaluation in Dementia Scale, the Engagement of a Person with Dementia Scale, and the Mini Nutritional Assessment Short Form. Descriptive and inferential statistics were used to analyze the data.

Results: Of the 20 consumer participants enrolled, 8 (40%) completed the intervention. The completed groups had significantly lower eating difficulty, significantly higher engagement and affect scores, and fewer comorbidities and polypharmacy than the dropouts at baseline. Engagement and affect and drink consumption changed significantly from pre- to postintervention. While positive trends were observed in eating difficulties and nutritional status scores within the completed group, these changes did not reach statistical significance.

Conclusions: Delivering the SPREMON intervention via this pilot study demonstrates its feasibility and potential benefits, given the positive trends in eating independence, engagement, affect, and nutrition. Larger studies are needed to confirm these findings, assess who benefits most, and explore scalability.

Implications: Combining SPREMON may improve eating independence, engagement and affect, and nutrition outcomes in people with dementia.

Impact: SPREMON shows promise as a person-centered approach to enhance mealtime outcomes in dementia care, informing practice for health professionals, researchers, and care managers.

Patient or public contribution: This intervention was co-designed with aged care professionals and consumer participants.

Trial registration: Australian New Zealand Clinical Trial Registry: 12623001031651.

Background: Disasters create an environment characterized by chaos and uncertainty, often leaving nurses feeling unsupported by their management. Despite this, nurses play a crucial role in the healthcare system's response during such crises. Therefore, this study aims to explore the perspectives of experts on human resource management in nursing during disasters and emergencies.

Methods: This study employed a conventional qualitative content analysis design. Purposive sampling was used to recruit 21 experts and disaster managers in Iran between February and April 2025. Data were collected through semistructured interviews, which were audio recorded with participants' consent, transcribed verbatim into Word documents, and imported into MAXQDA software (Version 2020) for systematic organization and analysis. The data were analyzed using Graneheim and Lundman's (2020) qualitative content analysis method.

Results: The analysis of the findings resulted in one main theme, poor nursing human resource management in disasters, and five subthemes, ineffective command process, passive presence and withdrawal, ineffective employment of volunteer nursing, insufficient attention to safety, and insufficient reinforcement of motivation.

Conclusion: Given our ongoing observations of nurses' capabilities during disasters and emergencies, it is expected that the results of this study will aid planners, policymakers, and health sector managers in effectively allocating nursing manpower in potential future disasters. This will improve the quality of services offered to injured individuals and their families during such events.