Journal of Research in Nursing最新文献

Background: Annual asylum applications in Europe have exceeded one million, highlighting asylum seekers' unique health needs and the increasing importance of refugee health nursing practices. In Finland, all asylum seekers are offered a free and voluntary initial health assessment conducted by nurses at reception centres.

Aim: To identify good practices and challenges in asylum seekers' initial health assessment from nurses' perspectives.

Methods: Participants were selected via purposive sampling. Between January and February 2019, we conducted 14 semi-structured interviews with reception centre nurses performing the initial health assessment. Data underwent thematic analysis.

Results: Three themes were identified: (1) building a relationship of trust between nurse and client, (2) interprofessional collaboration, and (3) continuity of care. Each theme included a client-centred approach. The findings reflect client, professional, and system levels, which can be located on a timeline from first contact to follow-up care.

Conclusion: Building trust is a foundational step, achieved through a client-centred approach, tailored interactions, and the provision of information. Clarifying the nurses' role benefits both interprofessional collaboration and professionals' well-being. Due to fragmented health records, precise documentation is essential for ensuring continuity of care. These findings can inform service development and professional training.

Background: The Nursing Interventions Classification (NIC) is a comprehensive, researched-based classification of 614 interventions whose responses can be influenced by a complex range of physiological, psychological, social and cultural conditions which present a challenge to establishing a specific level of evidence when findings are from studies using varied research contexts and methods.

Aims: To develop criteria for establishing evidence levels for interventions included in the NIC according to research designs commonly used in nursing.

Methods: A Design Science Research (DSR) approach was developed in four stages: (a) problem awareness, (b) solution suggestion, (c) artefact development, and (d) conclusion with presentation of the solution.

Results: Six criteria were established to determine the quality information produced by each paper: level of analysis, study design, temporality, unit of analysis, information capture strategy, and comparison strategy. An evidence level classification for the NIC based on the accumulation of qualified information identified for an intervention was established in relation to the four levels, each with four sublevels.

Conclusions: This study develops criteria and a classification system to assess evidence levels for the NIC, enhancing knowledge on the reliability and effectiveness of interventions in clinical practice and patient care.

Background: Patients receiving parenteral nutrition (PN) are often thought to be at higher risk of catheter-related blood stream infections (CRBSIs) than patients receiving other infusions. Nursing practice in the administration of PN has focused on traditional aseptic/sterile techniques using sterile gloves because of this perceived risk.

Aims: To identify the evidence base for current aseptic practice in the administration of PN and association with incidence of CRBSI.

Methods: A systematic review was conducted. MEDLINE, EMBASE, CINAHL Plus, and Cochrane Library databases were searched for studies reporting aseptic technique used/taught in administration of PN.

Results: Thirty-nine papers were identified. After title, abstract, and full text screening six studies were included. All studies were low-quality evidence, observational or quasi-experimental designs; no relevant controlled trials were identified. Evidence did not support the use of any one aseptic technique when administering PN. A structured approach to education and standardisation appeared to improve technique and reduce CRBSI. Use of sterile gloves versus non-sterile gloves did not appear to impact on CRBSI.

Conclusions: There is no evidence to support the use of aseptic/sterile technique over other techniques in nurse administration of PN. However, there is a need for higher quality research in this area.

Background: Moral distress occurs when individuals are unable to act according to their ethical values and beliefs due to constraints. It is a prevalent issue in healthcare settings, particularly among nurses. Critical care nurses (CCNs) confront challenges such as high rates of patient mortality, intense stressors, and end-of-life discussions and decisions, which make them more prone to experience moral distress.

Aim: To synthesise the existing literature pertaining to the consequences of moral distress among CCNs.

Methods: An integrative review of empirical literature was performed across three online databases: PubMed, CINAHL and PsycINFO using search terms related to nurses, critical care, moral distress, and ethical dilemmas. A total of 366 papers were retrieved. After applying the eligibility criteria and assessing the quality of the included studies using the Johns Hopkins Nursing Evidence-Based Practice tool, nine papers were included in this review and synthesised using content analysis.

Results: Reviewing the included papers revealed three main themes of moral distress consequences: impacts on nurses' well-being and job satisfaction, impact on patient care, and impact on turnover intention and burnout rate.

Conclusions: All studies reported negative consequences of moral distress among CCNs, highlighting the need for further research and organisational efforts to support nurse well-being.

Background: Promoting health self-management is an essential component of nursing care for maintaining quality of life in individuals with cardiovascular conditions.

Aims: This systematic review aimed to identify aetiological factors associated with ineffective health self-management (IHSM) in adults with cardiovascular conditions.

Method: Systematic review of aetiological factors. Databases: Medline, Web of Science, CINAHL, Scopus, and LILACS in July 2024. Combined key terms: adult, health risk behaviours, self-management, and cardiovascular diseases (CVDs). Inclusion criteria: adults with cardiovascular conditions and aetiological factors for IHSM. Exclusion criteria: acute disease exacerbations, intensive, palliative, or immediate post-surgical settings. All included studies were critically appraised for bias using the relevant assessment tools. Data were synthesised according to the theory of causation and validation of nursing diagnoses, and a meta-analysis was performed.

Results: Forty-five studies were included, predominantly cross-sectional studies, clinical trials, and cohort studies. The most common cardiovascular conditions addressed were systemic arterial hypertension and congestive heart failure. Thirty-five potential factors associated with IHSM were identified and categorised in factors: predisposing, disabling, precipitating, and reinforcing.

Conclusions: The identified factors provide insights for nursing practice when caring for patients with cardiovascular conditions and contribute to scientific knowledge by highlighting patient self-management needs.

Implications for nursing practice: This review identifies novel aetiological factors that should be integrated into nursing care plans for patients with CVD. It also validates and expands upon related factors within the NANDA-I taxonomy. Critically, our findings underscore the value of using theory to clarify the origins of a nursing diagnosis, enabling nurses to identify more precisely the root causes of ineffective health self-management.