Nursing Open最新文献

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.

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.

Aim: To describe critical care nurses' perceptions and experiences of the organ donation process.

Design and methods: A systematic review with a literature search in CINAHL, PubMed, and PsycINFO was conducted between 2009-2024 and reported by the PRISMA guidelines. 14 qualitative studies were assessed for relevance and methodological quality. Data were extracted by two of the researchers. A quality appraisal was performed according to a review template, first individually and then discussed in the research group. The analysis followed an interpretative synthesis, in three steps: coding, developing descriptive themes and generating analytical themes.

Results: Four themes were identified: lack of knowledge, work environment, meeting with relatives and nurse's challenges. The nurses described that caring for a potential organ donor was complex. The nurses' general lack of knowledge about organ donation led to stress and feelings of uncertainty, which in turn created limitations in the donation process. Nurses identified several challenges with the organ donation process.

Conclusion: The staff found the organ donation process challenging on various levels. There was a significant need for crisis processing for all professionals involved in the donation process.

Implications: Addressing the knowledge gap through clear guidelines and internal training to enhance the organ donation process. Providing time for debriefing can help manage strain on professionals.

Impact: This study highlights the critical need for improved education and emotional support for critical care nurses. Implementing these changes can lead to more efficient and compassionate organ donation processes.

Introduction: This study aims to explore the relationship between work readiness and vocational belonging among newly graduated nurses-(NGNs).

Methods: The study employed a descriptive, correlational, and cross-sectional design. It was conducted with 415 NGNs working at a city hospital in Istanbul, Türkiye. The Work Readiness Scale-Newly Graduated Nurses-(WRS-NGN) and the Vocational Belonging Scale-(VBS) were used for data collection. The data obtained from the study were analysed using the SPSS.22.0 statistical software. For data analysis, descriptive statistics such as frequency, percentage, and mean were calculated, and inferential statistics including t-tests, ANOVA, Pearson correlation, and regression analysis were performed.

Results: The mean WRS-NGN score of the participants was 347.29 ± 55.37, while the mean VBS score was 121.81 ± 35.45. A positive and moderate correlation was found between the work readiness and vocational belonging levels of NGNs (r = 0.607, p < 0.01).

Conclusions: Work readiness was found to explain 36.8% of the variance in vocational belonging levels. The findings of the study revealed that NGNs were well-prepared for work and exhibited a moderate level of vocational belonging. It was also determined that the work readiness of NGNs influenced their level of vocational belonging.

Patient or public contribution: No Patient or Public Contribution.

Aim: To explore how internationally qualified ('foreign') nurses adapt to their professional and personal everyday life in Iceland, using the Cross-Cultural Adjustment Model (CCAM) reflecting general, interactional and work-related domains.

Design: Qualitative focus group study.

Background: The global nurse migration has created multicultural workforces, with foreign nurses facing significant challenges that may affect their well-being, sense of professional belonging and retention.

Methods: A CCAM-informed, semi-structured guide was used. Audio-recorded discussions were analysed in two stages: (1) content analysis to derive data-close categories; and (2) interpretive description to identify practice-relevant themes and cross-domain patterns of adaptation. Five focus group interviews were conducted with 30 foreign nurses.

Results: An overarching theme, Interplay between self and system, described reciprocal adaptation, where nurses both learn from the system and also shape it through peer mentoring, advocating for translated patient materials and modelling culturally sensitive practices. Three subthemes captured participants' multifaceted experiences: (1) Workplace dynamics and discrimination, (2) An uphill professional and personal adaptation process and (3) Need for systemic support and training. Across themes, participants called for structured onboarding, consistent mentorship and leadership that embeds inclusion in everyday practice.

Conclusions: Findings highlight the importance of culturally responsive leadership and systemic initiatives in supporting adaptation. Leveraging the skills of foreign nurses is essential for fostering inclusive, sustainable work environments.

Implications for the profession: Nurse leaders and educators should prioritise culturally and linguistically responsive onboarding, mentorship and inclusive feedback cultures to support sustainable workforce adaptation.

Impact: By applying the CCAM to a small, linguistically distinct Nordic system, this study identifies actionable, cross-domain levers to improve adaptation and inclusion of foreign nurses. Findings inform leaders on how to strengthen support structures, improve retention and foster inclusion.

Reporting method: The Consolidated Criteria for Reporting Qualitative Research.

No patient or public contribution: This study involved healthcare professionals only.

Aim: This scoping review aimed to map and synthesise the available evidence on the perioperative management of patients undergoing anorectal surgery in a day-surgery setting. This study creates the first unified, evidence-based framework for day-surgery anorectal care. It addresses gaps by integrating existing recommendations and establishing new protocols for positioning and postoperative care (diet, activity, bowels) tailored for rapid discharge. By standardising workflows for the day-surgery setting, it aims to reduce complications and unplanned admissions.

Design: A scoping review methodology was employed.

Methods: A systematic search of relevant literature was conducted across 25 databases guided by the '6S' model of evidence-based resources. Two reviewers, trained in evidence-based systems, independently performed study selection. A rigorous quality assessment process was applied to all included studies, followed by a detailed extraction, refinement and integration of the evidence.

Results: A total of 8 studies were included, comprising 2 clinical decision aids, 3 guidelines and 3 expert consensuses. We summarised 45 pieces of best evidence across six areas: preoperative education, preoperative assessment, preoperative preparation, intraoperative management, postoperative management and discharge management.

Patient or public contribution: It will increase the quality of care provided by nurses and patient satisfaction.