Nursing Open最新文献

Aim: Spiritual care is vital to patient-centred care, yet gaps persist in nursing and midwifery education. This study presents the self-assessed spiritual care competencies of Slovenian nursing and midwifery students.

Design: A cross-sectional design was used.

Methods: A non-experimental, cross-sectional design was applied to a purposive sample of 319 undergraduate and graduate nursing and midwifery students. Data were collected based on the Spiritual Care Competency Self-Assessment Tool.

Results: The results showed that 51.7% (n = 165) of students demonstrated a moderate level of spiritual care competence, 40.4% (n = 129) achieved a good level and only 5.3% (n = 17) attained a high level. Nursing students scored significantly higher than midwifery students (p < 0.05), particularly in intrapersonal and interpersonal spirituality. Female students reported higher competence in spiritual care planning and interpersonal spirituality compared with males (p < 0.05). No significant differences were found regarding study format, year of study, or religious affiliation.

Conclusions: The findings highlight the need for targeted educational interventions to improve spiritual care training, ensuring all healthcare students develop the necessary competencies to provide holistic, patient-centred care.

Patient or public contribution: Nursing and midwifery students participated in this study.

Background: In clinical environments, nursing students encounter a variety of stressors, which can significantly impact their well-being, learning outcomes and the quality of care they provide to patients.

Aims: To develop and validate the Nursing Students' Clinical Practice Stress Scale (NSCPSS) to measure clinical practice stressors in nursing students in Sri Lanka.

Design: An exploratory sequential mixed methods design.

Methods: The study was conducted in two phases. The NSCPSS items were developed in the qualitative phase based on data gathered through focus group interviews and a literature review. The quantitative phase focused on the psychometric evaluation of the scale, assessing its face, content, construct, convergent, discriminant validity and reliability using data from 183 nursing undergraduate students.

Results: Four factors were extracted from 30 items through exploratory factor analysis: (1) lack of knowledge, skills and experience, (2) lack of academic communication and support systems, (3) challenges in managing academic and clinical demands and (4) challenges in the clinical learning environment. These four factors collectively explained 57.0% of the total variance. The confirmatory factor analysis demonstrated the acceptable goodness-of-fit indices. All factors showed reliability, with internal consistency and composite reliability indices > 0.6.

Conclusion: The NSCPSS is a valid and reliable instrument to measure the clinical stressors experienced by undergraduate nursing students.

Implications for practice: The development and validation of the NSCPSS is a key step toward identifying stressors that undergraduate nursing students experience during clinical practice. It contributes to enhancing effective learning during clinical practice and students' well-being and develops a resilient future nursing workforce capable of delivering high-quality patient care.

Reporting method: Good Reporting of a Mixed Methods Study (GRAMMS) checklist.

Patient or public contribution: No patient or public contribution.

Aim: To conduct an in-depth concept analysis of exnovation, exploring its significance, conceptual mechanisms and impacts in administration, business and healthcare, particularly emphasising its relevance to nursing.

Background: Exnovation is applicable in diverse fields, including information technology, manufacturing, business, education and cultural contexts; however, its utilisation in nursing and healthcare is limited and not widely adopted.

Data sources: The literature for this concept analysis was retrieved from two databases, PubMed and Scopus. A systematic search approach was employed across studies from business, administration and health care, specifically without restriction based on the year of publication.

Review methods: The article utilised Walker and Avant's 8-step approach to concept analysis, which entailed identifying the applications of the concept in various settings, its fundamental conceptual characteristics and developing model, borderline, related and contradictory instances. Additionally, the antecedents, consequences and empirical references of exnovation in nursing were established.

Results: The analysis revealed both onomasiological approaches to elucidate the evolution of innovation terminology and a semasiological approach to explain the concept across various contexts. Moreover, it identified antecedents to innovation in nursing, such as technological advancements and the adoption of evidence-based practices (EBPs), while also delineating consequences primarily focused on enhancing quality patient care and job satisfaction.

Conclusion: As exnovation emerges as a novel concept in nursing and medical practice, further research is warranted to tackle the recognised limitations and formulate practical guidelines for effectively integrating exnovation within nursing and healthcare settings.

Aim: To explore the lived experiences of Thai participants of public mass shooting during the COVID-19 pandemic.

Design: A phenomenographic research approach was used.

Methods: Fifteen participants were recruited using purposive and snowball sampling. Data were collected through dialogical interviews and analysed using thematic analysis within a Heideggerian interpretive framework. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Results: Through a hermeneutic lens, five interpretive themes were identified: dwelling in the shadow of threat, bearing witness to collective rupture, embodied echoes of trauma, grounding the self through everyday rituals and yearning for attuned care. These themes illuminate survivors' meaning-making amid dual crises and reflect the complex interplay of somatic, psychological and social adaptation.

Conclusion: The narratives of survivors underscore the urgent need for trauma-informed, relationally grounded nursing care in the aftermath of mass shooting incidents. The five emergent themes-ranging from embodied fear to the yearning for attuned care-highlight the complex interplay of psychological, social and existential dimensions of trauma. These findings emphasise the importance of holistic, context-sensitive interventions that not only validate survivors' emotional experiences but also foster adaptive coping and social reintegration. By recognising the embodied nature of fear and addressing survivors' multifaceted needs, healthcare professionals can play a pivotal role in facilitating recovery and promoting long-term well-being.

Patient or public contribution: Fifteen individuals with firsthand experience of mass shootings during the COVID-19 pandemic contributed personal narratives that informed the study's thematic analysis and nursing implications.

Aim: The study explored the lived experiences in the utilisation of NANDA International Inc. (NANDA-I) classification in the documentation of nursing care among nursing students in a selected Public University.

Design: A qualitative phenomenological approach was adopted, guided by a constructivist paradigm and Benner's Novice to Expert theory.

Methods: Qualitative approach was explored in this study. The second to fifth year nursing students, of similar age groups, and ward postings were included in the study. Those on part-time and first year nursing students were excluded. This was done in one phase with the use of a focus group discussion guide (FGDs). Participants were engaged in FGDs. Ethical approval was obtained from the ethical review committee, and informed consent was taken from the participants. Data were collected for 2 months and analysed using themes with independent coding by multiple researchers to ensure inter-coder reliability. The Consolidated criteria for reporting qualitative research "COREQ" was used.

Results: The study involved 20 participants, 15 of whom were female, with a mean age of 23 years (±2.0). Two (2) themes with various subthemes were extracted showing participants' lived experiences. These include (i) personal reflections, subthemes (Universality, Completeness, Uniformity, Decision making, and accurate documentation). (ii) Difficulty domain, subthemes (Comprehending terminologies and concepts, prioritising diagnoses, keeping up with updates and revisions of NANDA-I, and selecting appropriate 'related factor').

Patient or public contribution: Nursing students and nurses increase usage of the NANDA-I diagnoses, improve coordinated patient care, and should result in better quality of care.

Aim: Healthcare workers face significant occupational exposure risks from biological and non-biological hazards, with needlestick injuries being the most common hazard. This study aimed to assess the extent of occupational exposure among various healthcare workers.

Design: A descriptive cross-sectional study.

Methods: This study was conducted from 2018 to 2023 in a south-western Chinese tertiary hospital. The data about occupational exposure to blood and other body fluids were collected, including characteristics of healthcare workers and source patients, characteristics of such exposure and circumstances leading to such exposure.

Results: There were 675 occupational exposure events from 2018 to 2023, predominantly involving female (78.81%) and individuals under 30 years old (62.81%). All of the individuals had received training (100.00%) and 58.52% had received vaccination against hepatitis B. The most common occupational exposure to blood and other body fluids was needlestick and sharps injuries (83.56%), with HBV being the primary disease associated with the exposure (22.96%). The incidence rate peaked in 2019 (60.38 per 1000 person-years) and declined thereafter, with medical students, cleaning staffs and nurses experiencing the highest rate of exposure. The majority of incidents occurred in hospital wards (50.07%) and operating rooms (18.52%), often involving fingers (76.30%), and happened during patient care (17.63%), needle withdrawal (17.19%), and surgery operation (14.37%). Despite the high number of exposures, no medical staff contracted diseases from such exposure over the 6-year period, as confirmed by a 6-month serological follow-up.

Public contribution: The highest incidence rate was observed in 2019, followed by a decline. Medical students, cleaning staffs and nurses had the highest occupational exposure incidence rates. The majority of the exposures occurred in hospital wards and operating rooms, primarily on the fingers and were most commonly caused by syringe needles or scalp needles. These results highlight the need for continued vigilance and targeted interventions to reduce the risk of occupational exposure among these groups, particularly in locations where such exposures are most common.

Aim: This study sought to elucidate the conditions associated with sarcopenia among older, formerly homeless people residing in supportive housing in Thailand.

Design: This study employed a qualitative design.

Methods: Eight comprehensive interviews (n = 8) and four focus group discussions (n = 20) were conducted. The data collection spanned from March 2024 to June 2024 and was subsequently analysed utilising content analysis methodologies.

Results: All participants (age range: 31-83 years, female participants: 52.38%) were selected from a shelter for the economically disadvantaged in Nonthaburi. The analysis revealed two overarching themes: (1) insufficiency, encompassing five subthemes: deficient knowledge, limited dietary intake, poor oral health, insufficient physical activity and substandard sarcopenia care system and (2) the price of plenty, which includes four subthemes: carbohydrate consumption, poorly prepared food (characterised by hard, undercooked, or burnt items and excessive salt and spice usage), comorbid health conditions and excessive periods of inactivity.

Implications for the profession: Absence of nursing roles in supportive housing limits the delivery of people-centred care for formerly homeless older adults. Integrating nurses into these settings is essential to meet complex health needs and improve care quality.

Patient or public contribution: This represents the inaugural Thai research conducted within a shelter for the impoverished, underserved and marginalised population. The rich insights from this study provided a foundation for understanding and guiding the management, local policy formulation and prevention strategies related to sarcopenia for this population.

Aim: To analyse the extent of caregiver burden and psychological stress experienced by caregivers of liver transplant recipients, the relationship between caregiver burden and psychological distress, and whether gender moderates this relationship.

Design: This was a descriptive correlational cross-sectional study.

Methods: Convenience sampling was performed to recruit participants between February and September 2020. The Chinese version of the "Zarit Burden Interview Family Caregiver Burden Scale" was used to measure caregiving burden, and the Chinese version of the "Depression Anxiety Stress Scales-21" was used to measure psychological distress. Finally, the PROCESS moderation model was used to analyse the moderating effect of gender.

Results: Ninety-one caregivers participated in this study. Their median age was 50.88 years (interquartile range [IQR] = 18), and 73 patients were women (80.2%). Caregiver burden scores ranged from 0 to 40 (median = 20, IQR = 11), whereas depression scores ranged from 0 to 20 (median = 14.00, IQR = 8), anxiety scores from 0 to 28 (median = 14.00, IQR = 6), and stress scores from 0 to 34 (median = 14.00, IQR = 6). Male caregivers experienced a lower caregiver burden than their female counterparts, whereas female caregivers experienced higher levels of depression, anxiety, and stress than male caregivers. Further, gender's moderating effect on caregiver burden was significant for depression (coefficient = 0.480, p = 0.021) and stress (coefficient = 0.429, p = 0.040). With every 1-point increase in caregiver burden, depression increased by 0.48, and stress increased by 0.429 in men compared to women. Finally, the correlation between caregiver burden and anxiety did not differ between genders.

Conclusions: The results of this study indicate that although women have a higher care burden and psychological distress when the care burden increases, the psychological distress experienced by men increases more than that experienced by women. Hence, healthcare professionals should be sensitive to the different demands of caregivers of different genders.

Clinical relevance: The impact of caregiver burden on psychological distress differed by gender. Therefore, healthcare professionals should provide gender-friendly care. The priority and suitability of transplant care tasks for family caregivers should be tuned according to the different demands of care to reduce care burden, provide skills readiness, enhance stress relaxation skills, and seek resources.

Background: Cardiovascular diseases, with their high mortality rates, significantly impact patients' quality of life, contribute to disability, and impose a substantial financial burden on society.

Aims and objectives: This study aimed to illuminate patients' experiences before undergoing cardiac surgery during the COVID-19 pandemic.

Design: This is a qualitative interview study.

Methods: A purposive sampling technique was employed, with participants recruited from Department Cardiovascular surgery and interviewed to explore their experiences. An inductive thematic analysis was conducted, and reporting adhered to the EQUATOR guideline: COREQ.

Results: The study identified numerous challenges faced by patients during the preoperative period. Consequently, two prominent themes emerged from the patients' experiences while awaiting cardiac surgery during the COVID-19 pandemic: the feeling of loneliness and the feeling of losing oneself.

Conclusions: The psychological vulnerability of patients during the perioperative phase, intensified by circumstances such as a pandemic, can lead to emotional and behavioural instability, significantly impacting the patient negatively.

Relevance to clinical practice: Prioritising the patient's experience is crucial in fortifying presurgical care. Delving into the nuanced perspectives of patients fosters a comprehensive understanding that transcends conventional approaches. This research underscores the significance of giving prominence to the patient perspective, offering opportunities for healthcare professionals to elevate the standard of patient care. Recognising and addressing the challenges faced by patients awaiting cardiac surgery can contribute to a more holistic and patient-centered approach in clinical practice.

Patient or public contribution: Patients contributed by sharing their experiences during interviews, providing first-hand insights that are presented in the study results.

Objective: This study aims to investigate the relationship between perceived stress and depressive symptoms among caregivers of children with enterostomy, as well as the mediating role of resilience and the moderating effect of perceived social support. The findings are anticipated to provide a scientific basis for promoting the rehabilitation of children, enhancing the mental health status of caregivers of children and developing clinical psychological nursing interventions.

Methods: A convenience sampling method was utilised to recruit 236 caregivers of children who had undergone enterostomy surgery and returned for follow-up visits. Various assessment scales were employed, including the Perceived Stress Scale, Connor-Davidson Resilience Scale, Depression Screening Scale and Perceived Social Support Scale. Pearson correlation analysis was performed to explore relationships among variables, while Process version 4.1 was applied to test mediation and moderation effects.

Results: A highly significant positive correlation was identified between perceived stress and depression among caregivers (r = 0.450, p < 0.01). Conversely, a conspicuously negative correlation was detected between perceived stress and resilience (r = -0.352, p < 0.01). Both resilience (r = -0.774, p < 0.01) and perceived social support (r = -0.416, p < 0.01) demonstrated significant negative correlations with levels of depression. Furthermore, resilience functioned as a mediator in the relationship between perceived stress and depression, with the mediating effect accounting for 47.2% (95% CI: 0.140, 0.323). Additionally, perceived social support moderated the pathway from resilience to depression within the mediation model (β = -0.206, p < 0.01; 95% CI: -0.411, -0.003).

Conclusion: Elevated levels of resilience and enhanced perceived social support from the environment may serve as effective strategies for mitigating perceived stress and depression. Additionally, these factors contribute to improving mental well-being among caregivers of children with enterostomy.

Patient/public contributions: The caregivers of children with enterostomy were surveyed to collect relevant data.