Nursing Open最新文献

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 identify and map the breadth of available evidence on nurses' perspectives of the facilitators and barriers to relatives' involvement in the care continuum of patients with acquired brain injury or malignant brain tumour.

Background: The involvement of relatives in care and treatment may have a significant positive impact on the quality of care and treatment, leading to higher satisfaction with hospitalisation for patients, relatives and healthcare professionals. Nurses play an important role in nurturing a trusting and facilitating relatives' involvement. However, involving relatives seems complex and multifaceted, with many possible facilitators and barriers to consider.

Design: This scoping review was conducted in accordance with the Joanna Briggs Institute's methodology for scoping reviews and a published a priori protocol.

Data sources: A comprehensive literature search was conducted in MEDLINE (PubMed), CINAHL (EBSCO) and Embase (OVID). Reference lists of included studies, Google Scholar and Web of Science were also searched. Literature published in the English, German or Scandinavian languages since 2010 was included.

Results: The search identified 4330 studies, of which 18 were included. No studies including involvement of relatives to patients with Malignant Brain Tumour was found. Nurses' perspectives of the facilitators and barriers to relatives' involvement of patients with acquired brain injury indicates that several facilitators and barriers contribute to or hinder relatives' involvement. The facilitators for involvement were mostly related to nursing tasks within the healthcare system, acknowledging relatives in their own rights, building a trusting relationship and using communication as a tool. Contrary, barriers were organisational factors, when the patient was seen as a primary focus of care, and informational challenges.

Conclusions: The results illustrate the complex nature of involvement from the perspective of nurses. The results indicate a paradox because several of the identified aspects are not mutually exclusive but rather represent aspects of involvement that range along a continuum.

Implication for the profession: Nurses' involvement of relatives in the care continuum is important, however evidence suggests that the relationships between relatives and nurses need to be strengthened to individualise the level of involvement. We suggest that the organisational and contextual factors that shape relative involvement need to be studied further.

Report method: PRISMA-ScR.

Patient or public contribution: No Patient or Public Contribution. However, the review findings were shared and discussed with a panel of nurses from the neurosurgical speciality who validated and nuanced the findings into a Danish context.

Background: The United States (US) declared drug overdose a public health emergency in 2017. Despite this, two million people reported having an opioid use disorder (OUD) in 2018. However, following the beginning of COVID-19 there was a 53% increase in overdose deaths, with American Indian/Alaska Native (AI/AN) individuals experiencing the highest rates of all racial groups. In response to the COVID-19 pandemic and OUD treatment access challenges, OUD treatment policies were changed to improving access to care.

Purpose: This review examines how the state- and federal-level policies impacted access to medications for opioid use disorder (MOUD) during the COVID-19 pandemic. Due to the devastating impact of overdose and COVID-19 on AI/AN communities, as a secondary aim, we examined the inclusion of these populations in the samples of the included studies.

Methods: We completed a narrative review using a data-based convergent synthesis design.

Results: Forty-four studies met the inclusion criteria. Most of the studies were quantitative descriptive studies (n = 25). Only two studies offer AI/AN as a category for ethnicity and both had less that 4% of the sample that identified as an AI/AN individual.

Conclusion and implications: Telehealth OUD treatment increased initiation and retention for patients taking buprenorphine. No increase in overdose rates was associated with allowing for additional take-home doses of methadone. However, access to treatment, even telehealth, remains difficult for individuals due to a lack of OUD treatment providers and access to the internet. More needs to be done to address the opioid overdose crisis, especially among AI/AN communities. Research focused on cultural strategies to address this health disparity is desperately needed. We included nursing implications in response to this health disparity among AI/AN individuals.

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.

Background and aims: To explore literature in relation to the physical healthcare environment and person-centred care to understand how it can be better supported at the system level.

Methods: An integrative review using the work of Whittmore and Knafl. The review was designed around problem identification, literature search, data evaluation, data analysis and presentation of stages.

Data sources: CINAHL, Embase, PubMed and Scopus databases were searched, and 29 articles were included.

Findings: Articles were considered in relation to their context, and themes for each were generated. These were: Aged care (The 'Safety Gaze', Reconciling safety to support an environment of personhood and Nature and stimulation); Paediatrics and Neonatal (Supporting parenthood, Person-centred care (un)supported through control and Satisfaction and expertise); Maternity (Sterility versus person-centred care and Controlling the birth experience); Acute care (Participation in the environment, First and foremost a healing environment, Decentralised nurses station and single rooms); Mental Health (Safety versus person-centred care and Calming the environment); and Outpatient (Genuine access to information). The review found perceptions of safety and risk, and the idea of 'hotel culture', a negative connotation for healthcare staff. While person-centred design in hospitals makes for a more aesthetically pleasing environment and positive experience, it is argued these elements are superficial in nature, rather than authentic.

Conclusion: While described as person-centred, many design elements were more about satisfaction than engagement and shared decision-making. Healthcare policymakers, accreditors and leaders must move beyond satisfaction and consider environmental changes that genuinely engage people in their care and promote shared decision-making.

Implications for the profession and/or patient care: What is already known? Person-centred care is a requirement of health services. Person-centred environmental changes have recently occurred to the healthcare environment. What this article adds? Many healthcare designs are more about satisfaction rather than genuine partnership. While aesthetics are important for experience, we must move beyond satisfaction to ensure that systems and environments supports person-centred care.

Reporting method: PRISMA.

Patient or public contribution: No Patient or Public Contribution.

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.

Objectives: The aim of this study was to investigate the living space mobility among people with and without dementia and the influence of liberty-depriving measures on living space mobility.

Design: This empirical quantitative study used a longitudinal design.

Methods: Residents in five inpatient long-term care facilities were examined over a period of 6 months, including individuals with and without dementia. Data were collected at three time points between October 2023 and July 2024. Living space mobility was assessed by nursing staff using the Heidelberg Instrument for Assessing the Quality of Life of People with Dementia (H.I.L.D.E.), and the liberty deprivation measures were assessed by analysing medical records. The data were statistically analysed to obtain frequencies and to examine group differences.

Results: There was a significant correlation between living space mobility and dementia diagnosis: residents with dementia mainly stayed within their living area, whereas residents without dementia had a greater range of movement, including outside the facility. A significant correlation between liberty deprivation measures and dementia diagnosis could not be established. However, living space mobility was significantly associated with the use of liberty deprivation measures regardless of dementia status.

Conclusion: The results highlight the importance of living space mobility for residents with dementia and emphasise the influence of liberty deprivation measures. Further longitudinal studies with larger samples and alternative survey methods are necessary to investigate these relationships in greater depth.

Implications for the profession and/or patient care: For professional care, it is important to promote the mobility and well-being of residents, regularly review freedom of movement and implement strategies for participation and autonomy in order to increase the quality of care.

Impact: The results emphasise the importance of mobility promotion in dementia care and the critical reflection of liberty deprivation measures in long-term inpatient care. Larger longitudinal studies are recommended to clarify the causal relationships.

Reporting method: The methods and results of this study were reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Patient or public contribution: The study participants were recruited after being informed about the study and providing their consent.

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.