Nursing Open最新文献

Aim: The Registered Undergraduate Students of Nursing (RUSON) employment model was implemented to recruit nursing students for the purpose of assisting with care and increasing clinical exposure. This study explored experiences of RUSONS working in this capacity.

Design: An exploratory descriptive qualitative design was employed using semi-structured focus group interviews.

Methods: Nine students working as RUSONs were interviewed. Thematic analysis was employed to uncover overarching themes. The consolidated criteria for reporting qualitative research (COREQ) were utilised to inform the study.

Results: Qualitative thematic analysis identified three themes: (i) A mutually beneficial relationship, (ii) Understanding a RUSON and (iii) The difference of a RUSON. Participants believed their role optimised time with patients, cemented their value as active agents in care delivery, and triggered a sense of gratefulness. The role contributed to learning, exposed students to nursing culture and enriched sense of belonging. The positive impact of being a RUSON on students' experience of increased clinical exposure was highlighted. Students' confidence in skills improved and opportunities to put theory into practise and develop their professional identity in readiness to transition to the workforce. Challenges were attributed to a lack of understanding of the role intricacies by nurses or patients. This study has implications for the promotion of future employment models similar to the RUSON model, which has the potential to enhance nursing students' learning experience, and subsequently patients and reduce the workload of registered nurses. A RUSON work model can foster a context where students can effectively transition to practise.

Patient and public contribution: Student nurses working as RUSONs contributed to this study.

Objectives: To analyse risk factors for postoperative delirium (POD) in patients after total hip arthroplasty and develop a visual clinical prediction model.

Design: A Retrospective Cohort Study.

Methods: This study included 457 patients who received total hip arthroplasty. The clinical prediction model was developed based on the results of univariate and multivariate logistic regression analyses. The performance of the model was assessed through measures of discrimination, calibration and decision curve analysis. The final model was visualised as a nomogram. This study followed the TRIPOD checklist.

Results: A nomogram was developed based on age, total protein, fall risk and catheterisation. The model demonstrated strong discriminative power, with an AUC of 0.867. There was a strong agreement between predicted and observed outcomes, as shown by calibration analysis, while DCA supported the model's favourable clinical applicability.

Conclusions: The predictive model developed in this study showed good discriminative performance and may support early clinical risk assessment of POD in patients undergoing total hip arthroplasty.

Relevance to clinical practice: The importance of this research lies in shedding light on the significant impact of delirium on the health outcomes of patients after total hip arthroplasty, particularly in the short term. Guide clinical workers to identify risk factors early and improve the prognosis in patients after total hip arthroplasty.

Patient or public contribution: No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Age, fall risk and catheterisation were independent risk factors for POD in patients after total hip arthroplasty; total protein levels were protective against it. This study offers nursing staff a visual, non-invasive and simple nomogram for calculating the risk probability of POD in patients underwent total hip arthroplasty. This study will help nursing staff to predict POD in patients at an early stage, and give personalised intervention measures to improve the prognosis.

Aim: The existing literature typically reports an association between Gaming Disorder (GD) and psychopathological outcomes. However, evidence linking positive psychological attributes with the risk of GD is rarely explored. The present study aimed to investigate the associations between resilience, positive mental health and self-compassion and the risk of GD in young adults.

Design: The study was cross-sectional, collecting data online in four cities across China and one city in Thailand.

Methods: Potential participants were recruited through social media, gaming platforms and tertiary institutions or universities. The online survey sought information on demography, gaming behaviours, risk of GD, level of self-compassion, resilience and positive mental health. A General Linear Model was used to compute the associations between the study variables. A p value less than 0.05 is regarded as statistically significant.

Results: A total of 1750 young adults were recruited. The results showed that self-compassion and positive mental health were negatively associated with GD but that was not the case for resilience. Young adult gamers with lower levels of self-compassion and moderate mental health had a greater risk of gaming addiction as compared to those with a higher level of self-compassion and flourishing mental health. This is the first study to report the association between GD and three positive psychological factors. The preliminary findings suggest that self-compassion and positive mental health could be protective mechanisms against GD. Primary healthcare professionals could include self-compassion and positive mental health in health screening for the early identification of gamers at risk of GD before they manifest psychopathological symptoms. Future studies of GD should explore the effect of positive psychological factors in managing GD in addition to the psychopathological approach.

Patient or public contribution: No patient or public contribution.

Purpose: Development of a measurement scale to assess the safe disposal of insulin pen needles in patients with diabetes.

Methods: In the preliminary stage, a pool of 35 items in four areas was generated through literature analysis, research group discussions and preliminary qualitative research. A Delphi study was then used. Experts in the relevant fields were invited to participate in a consultation, assessing each item's representativeness and clarity, after which the expert opinions were synthesised. The content of the items analysed was modified in order to finalise the prediction scale.

Results: 18 experts participated in the first round and 17 in the second round. Items of the scale were added, deleted, and amended based on experts' recommendations, statistical analysis, and study group discussions. After the second Delphi round, the experts reached a consensus on 26 items within four dimensions. In the two rounds of expert correspondence, the return rate of the questionnaire was 81.80% and 94.44%, respectively; the authority coefficients of the experts were 0.922 and 0.947, respectively; the Kendall coordination coefficients of the two rounds of the scale were 0.147 and 0.200, respectively (p < 0.05).

Conclusion: The Safe Disposal of Insulin Pen Needles Scale for Patients with Diabetes has been shown to have adequate content validity. In the future, further analysis of the scale's validity and reliability is necessary to prove its value in managing insulin pen needles.

Relevance to clinical practice: Using assessment tools for safely disposing of insulin pen needles has practical implications. The development of this scale can be used to assess the disposal behaviour of patients with diabetes towards discarded needles and provide a basis for intervention by health care professionals.

Aim: This study aimed to investigate associations between the nurse practice environment and nurse-sensitive patient outcomes in Hong Kong.

Design: This was a 4-wave repeated cross-sectional study.

Methods: The sample comprised 71 adult general medical, surgical and orthopaedic wards recruited from four public hospitals. Data on nurses' practice environment and nurse-sensitive patient outcomes were collected quarterly from each hospital over a one-year period from January 2016 to December 2018. The number of participating nurses per survey wave ranged from 604 to 865. Measures comprised the Practice Environment Scale of the Nursing Work Index and four nurse-sensitive patient outcomes identified from the National Quality Forum-endorsed nursing-sensitive care measure set. The associations between each outcome and the practice environment were examined using multiple regression analysis.

Results: Nurse practice environments were rated favourably. The 'Nursing foundations for quality of care' subscale received the highest score (59.6) while the 'Staffing and resource adequacy' subscale received the lowest score (36.7). Though no significant associations were found between the overall practice environment and nurse-sensitive patient outcomes, the subscale of 'Staffing and resource adequacy' was significantly associated with the incidence of inpatient falls and catheter-associated urinary tract infections.

Conclusions: Our findings suggest that staffing is a core nurse workplace concern which impacts the outcomes of inpatient falls and catheter-associated urinary tract infections. However, the overall nurse practice environment was not significantly associated with any patient outcomes, and further studies are needed to corroborate these results. Additional mediating factors such as nurse resilience, which may potentially affect patient outcomes, should also be explored.

No patient or public contribution: Patients or the general public were not involved in the design, analysis, or interpretation of the data in this study.

Aims: To explore the perceptions and experiences of parents raising children with special educational needs, focusing on the impact of the COVID-19 pandemic and its aftermath.

Design: A descriptive qualitative approach was conducted using a photovoice design.

Methods: Individual interviews were conducted with 17 parents of children with special educational needs. These parents were asked to take photos that reflected their caring experiences of their children, especially during the COVID-19 pandemic, and to add captions to each photo. Data were analysed using an inductive thematic analysis.

Results: The analysis revealed four themes: flashbacks of COVID-19 memories, impacts that last beyond the pandemic, lessons learnt, and services needed. Our findings suggested that the experience of life under lockdown during the pandemic has created lasting memories for parents. It has had positive and negative impacts on family relationships and children's learning, extending beyond the pandemic's immediate effects. Despite their numerous challenges, parents expressed gratitude for discovering their own solutions, recognising the importance of quality time spent with their children, and acknowledging the growth experienced by both their children and themselves. However, they also emphasised the crucial need for comprehensive and continuous psychological support and services to be provided to them.

Conclusions: This study sheds light on the unique caregiving experiences of parents raising children with special educational needs, particularly during the challenging times of the COVID-19 pandemic and its aftermath. It revealed both positive and negative aspects of their experiences, offering a new perspective on their caregiving journeys and highlighting their ongoing needs.

Implications for the profession and/or patient care: It suggests the need to consider the well-being and needs of parents who engage in complex caregiving-children interactions at home.

Impacts: Insights gained from this study serve as a foundation for community service planning and developing supportive interventions that recognise the unique needs of parents of children with special care needs, ultimately improving the overall quality of life for parents and their children.

Reporting method: The study followed the Consolidated Criteria for Reporting Qualitative Research guideline.

Patient or public contribution: No patient or public contribution.

Aim: This study aimed to investigate the information needs for artificial intelligence chatbot-based interventions on prenatal care among pregnant women of advanced maternal age.

Design: This study employed a qualitative research method using thematic analysis.

Methods: Participants were pregnant women of advanced maternal age aged 35 and older who attended childbirth classes or used midwifery services in three cities. Participants were recruited through purposive sampling from September 23, 2023, to February 24, 2024, until saturation was reached. Semi-structured interviews were conducted with a total of 13 participants. The analysis was conducted in accordance with Braun and Clarke's six phases of thematic analysis: familiarisation with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report.

Results: Four central themes were identified that described prenatal care information needs for AI chatbots, as follows: (1) Information needs for an AI chatbot supporting advanced maternal age pregnancy; (2) childcare; (3) postpartum recovery; and (4) breastfeeding promotion.

Conclusion: These findings highlight the importance of developing an accessible, interactive, and empathetic AI chatbot-based prenatal care application that can provide reliable information and support to improve maternal and fetal health among women of advanced maternal age.

Implications for the profession and/or patient care: The themes identified in this study offer concrete guidance for developing an AI chatbot that delivers relevant support for postpartum recovery, breastfeeding, newborn emergencies, and child health management among pregnant women of advanced maternal age.

Reporting method: The study follows the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Patient or public contribution: No patient or public contribution.

Aim: This study aimed to investigate the mediating role of perceived insider status and organisational identification between authentic leadership and job embeddedness among Chinese nurses.

Background: Previous studies have explored the influence of authentic leadership on job embeddedness in the nursing profession. However, the chain-mediating effect of perceived insider status and organisational identification between authentic leadership and job embeddedness has not been clarified among nurses.

Design: A cross-sectional study.

Methods: A structural equation model was utilised to examine the proposed hypothesis regarding job embeddedness in Chinese clinical nurses and to investigate potential mediating factors influencing nurses' job embeddedness.

Results: There were positive correlations among authentic leadership, perceived insider status, organisational identification, and job embeddedness. Moreover, authentic leadership exerted a noteworthy influence on job embeddedness through three significant indirect pathways: the separate mediating effect of perceived insider status and organisational identification, and the chain mediating effect of perceived insider status and organisational identification.

Conclusion: Nursing managers aiming to enhance nurses' job embeddedness. Recognising the crucial role of perceived insider status and organisational identification as mediators between authentic leadership and job embeddedness, our findings suggest actionable strategies. Elevating authentic leadership creates a supportive environment, positively impacting nurses' commitment and reducing turnover.

Patient or public contribution: We would like to thank the clinical nurses from three hospitals in Wuhan who participated in the study and the hospital managers who supported this study. This study distributed survey links in the WeChat groups of three hospitals, and collected research data under the principle of ensuring anonymity and informed consent.

Objective: To examine the psychosocial impact and parental stress associated with severe neurological disorders and intellectual disabilities in children, with a particular focus on the relationships between parental response styles and family stress and impact.

Design: A descriptive, cross-sectional, prospective study was conducted.

Methods: The study included parents of children with neurological disorders and intellectual disabilities. Participants completed the Family Management Style Framework, Parenting Stress Index, and Parental Response Style Questionnaire. In addition, clinical characteristics related to psychological or psychiatric problems and conduct disorders were collected via parent-reported questionnaire items and analysed as categorical variables.

Results: One hundred parents participated in the survey, with data from 100 children analysed. Discomfort and Stress showed positive and significant relationships with all the factors of the Parental Response Style Questionnaire, except for Overprotection, while the Family Management Style Framework subscales did so with the Apathy/dysphoria. The presence and clinical complexity of psychological or psychiatric problems and conduct disorders were significantly associated with higher levels of parental stress and family impact.

Conclusions: Families of children with intellectual disabilities face substantial challenges that affect family functioning and daily activities. The presence and clinical complexity of psychological or psychiatric problems and conduct disorders emerged as key clinical characteristics associated with increased parental stress and family impact. Given the cross-sectional design of the study, these findings should be interpreted as associative, and no causal, directional, or temporal inferences can be drawn.

Impact: Parents provided critical insights into the challenges of caring for children with severe neurological disorders and intellectual disabilities, contributing to a better understanding of family dynamics and stress-related factors. Identifying relevant clinical characteristics may help nurses and other health professionals tailor family-centred interventions.

Reporting method: This paper is reported according to the STROBE Statement.

Patient or public contribution: Parents of children with severe neurological disorders and intellectual disabilities were the subjects of data collection for this study and participated in the survey after providing voluntary consent to participate.