Nursing Open最新文献

Aim: To examine burnout prevalence and associated factors among academic faculty across graduate-level health professions disciplines.

Design: Cross-sectional survey of a national sample of faculty from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs conducted between May and September 2022.

Review methods: Quantitative analysis included descriptive statistics, burnout profiles based on the Maslach Burnout Inventory, and logistic regression by faculty characteristics. Qualitative analysis used content analysis of open-ended responses.

Data sources: Survey responses collected via online questionnaire during May-September 2022.

Results: Underrepresented minority faculty were substantially more likely to report high emotional exhaustion and feelings of being overextended compared to non-underrepresented minority colleagues. Qualitative findings highlighted occupational stressors such as insufficient leadership support, institutional insularity, workload demands, and bias in evaluation and tenure processes. Suggested strategies included improving leadership accountability, clarifying roles, promoting well-being and work-life balance, and fostering collegiality.

Conclusion: Burnout among faculty in health professions education is influenced by structural and cultural factors, with underrepresented minority faculty at greater risk. Addressing faculty burnout is critical in retaining a thriving and diverse faculty and workforce.

Aim: This study aims to investigate the mediating role of professional identity in the relationship between psychological empowerment and moral courage among nursing students.

Research design: This study employed a cross-sectional descriptive survey design.

Methods: Between March and April 2022, 394 nursing students were selected using purposive sampling. Participants completed a questionnaire that included sections on general information, professional identity, psychological empowerment and moral courage. Descriptive statistics summarised the levels of the main variables, while Pearson correlation and SEM were used to examine relationships and pathways among psychological empowerment, professional identity and moral courage.

Results: Professional identity was positively associated with psychological empowerment and moral courage. Psychological empowerment also demonstrated a significant mediating effect on the relationship between professional identity and moral courage. The SEM showed a good fit with the data.

Conclusion: Strengthening professional identity and psychological empowerment may enhance moral courage in nursing students. These findings highlight the importance of integrating professional development and empowerment strategies in nursing education. Future research should investigate the effectiveness of targeted educational interventions and explore cross-cultural differences in the cultivation of moral courage.

Patient or public contribution: No patient or public contribution.

Aim: Pressure ulcers (PUs) and falls are two major issues following patient hospitalisation. They result in a series of complications affecting patients, families, and healthcare. Many factors can lead to PUs and falls. The absence of proper assessments of their etiologies exacerbates these issues. Mapping the road to effective assessment is crucial for the right interventions to be implemented according to each patient's needs. This study aims to provide an overall estimate of nurse compliance with PU and fall risk assessments on hospital admission and indicate the degree of variation in compliance rates across different hospital units.

Methods: Following the STROBE guidelines a retrospective descriptive design was utilised and included all patients for 2022.

Results: The results showed the general compliance with PU and fall risk assessments and indicated that intensive care units (medical/surgical and burn units) had the highest rate of compliance, which exceeded 97% with the PU assessment. Male wards (surgical and orthopaedic) wards demonstrated low compliance with the PU assessment (69% and 80.6%, respectively). Regarding the fall risk assessment, the surgical, orthopaedic, and medical wards had the lowest rates of compliance with an average of 69%, but the neurosurgery ward had a 95.6% compliance rate.

Patient or public contributions: Incidences of PUs and falls are essential quality indicators. This research highlights units' characteristics and their compliance with the assessments. Hospital-based assessment is crucial for identifying gaps in assessment and implementing proper interventions. Proper interventions not only improve patient outcomes but also enhance the overall quality of care within the healthcare system. By regularly evaluating these assessments, hospitals can better allocate resources and streamline processes to address patient needs more effectively.

Aims: This study explored factors influencing clinical nurses' adoption of digital nursing technologies (DNT) and examined their perceptions and behavioural intentions using the Theory of Planned Behaviour (TPB).

Design: A qualitative content analysis was conducted, guided by the TPB framework.

Methods: In depth interviews were conducted with 21 clinical nurses between March and April 2023. Data were analysed using qualitative content analysis to identify themes related to DNT perceptions and experiences.

Results: Seven main themes and 23 subthemes emerged. Nurses recognised benefits such as reduced workload, improved accuracy, enhanced efficiency, and expanded nursing services. Challenges included learning difficulties, limited perceived usefulness, data security concerns, and technical errors. Facilitators of adoption included supportive colleagues, role models, structured training, user-friendly technologies, adequate resources, positive prior experiences, and patient-centered design, while cultural resistance, lack of managerial support, and unclear regulatory guidance impeded use.

Conclusion: Effective adoption of DNT requires targeted educational programs to enhance nurses' digital competencies, user-friendly technology interfaces, and clear institutional policies. Addressing both individual and organisational factors is critical for safe and sustainable integration of digital technologies into nursing practice.

Reporting method: This study adhered to the consolidated criteria for reporting qualitative research (COREQ) guidelines.

Patient or public contribution: No patient or public involvement.

Aim: To describe the quality of life in patients with chronic heart failure and coexisting obstructive sleep apnoea, and to examine the effect of common sleep-disordered breathing treatments on quality of life, functional capacity and cardiac outcomes.

Design: Systematic review.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO (CRD42025634352).

Data sources: A comprehensive search was conducted in PubMed, CINAHL, Scopus and Web of Science up to March 2024. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklists.

Results: Fourteen studies were included, involving 2048 patients with chronic heart failure and sleep-disordered breathing, including obstructive and central sleep apnea. Sleep-disordered breathing was associated with reduced quality of life, physical capacity and cardiac function. Continuous positive airway pressure improved respiratory events, sleep quality, left ventricular function and exercise performance. Adaptive servo-ventilation reduced central respiratory events but was associated with increased mortality in patients with reduced left ventricular function. Nocturnal oxygen therapy improved some respiratory parameters but did not affect quality of life. Structured exercise programs showed benefits for functional status and quality of life.

Conclusion: Obstructive sleep apnea negatively affects the quality of life in people with chronic heart failure. Continuous positive airway pressure is beneficial in selected patients, while adaptive servo-ventilation should be used cautiously. Personalised approaches are needed.

Implications for the profession and/or patient care: Systematic screening and individualised care plans, including nurse-led management, are key to improving quality of life and outcomes in this population.

Impact: What problem did the study address? The insufficient understanding of how obstructive sleep apnea influences quality of life in chronic heart failure. What were the main findings? Some interventions improved quality of life, while others showed safety concerns. Where and on whom will the research have an impact? The findings guide clinical care for adults with chronic heart failure and coexisting sleep-disordered breathing.

Reporting method: We have adhered to the EQUATOR guidelines according to PRISMA.

Patient or public contribution: No patient or public contribution.

Aim: This study aimed to adapt the Nurse Professional Competence Scale-Short Form (NPC-SF) into Turkish and evaluate its validity and reliability study for nursing students.

Design: A methodological study was designed.

Methods: The study was conducted with 181 senior nursing students using a convenience sampling method from March 2021 to November 2021. Language adaptation was conducted using translation and back-translation. Content validity was assessed using expert approval. Construct validity was assessed using confirmatory factor analysis. Convergent and discriminant validity were applied. Reliability was assessed using Cronbach's alpha, the test-retest reliability and Bland-Altman Method.

Results: The mean Content Validity Index of the items in the total scale was 0.98. Confirmatory factor analysis identified 21 items, which could be categorised under five factors (Nursing Care, Value-based Nursing Care, Medical and Technical Care, Documentation and Administration of Nursing Care, Development, Leadership and Organization of Nursing Care). The scale preserved its original structure, but one sub-dimension (Care Pedagogy) was removed from the scale. The fit indices of TR-NPC-SF are χ²/SD 1.928, GFI 0.928, NFI 0.964, NNFI 0.956, CFI 0.964, RMSEA 0.072 and SRMR 0.040. The five-factor model achieved a good fit according to confirmatory factor analysis. The Cronbach's alpha reliability coefficient of the Turkish version of the NPC-SF (TR-NPC-SF) was 0.974.

Conclusion: TR-NPC-SF is a valid and reliable tool with good psychometric properties. This scale can be used to evaluate nursing students' self-assessed professional competence. Nurse managers and educators can also use TR-NPC-SF to improve nurses' competence and identify their competence gaps.

Patient or public contribution: No patient or public contribution.

Aims: To analyse the performance of the simulation-based hemofiltration knowledge and skills competition and provide a reference for continuously improving clinical nursing skills to reform the teaching methods.

Methods: Based on the guidelines, combined with the clinical practical problems and nursing quality control records of the department, the simulation-based hemofiltration knowledge and skills competition was created. The competition consists of two parts: a theoretical knowledge part and a skills part, each accounting for 50% of the total score. The final score is the sum of the scores from both parts. The theoretical knowledge part includes required questions, quick answer questions, and challenge questions, with a base score of 100 points. The skills part evaluates the performance in the whole operation process of continuous venovenous hemofiltration (CVVH) from pre-flushing to the end of the treatment, with a full score of 100 points. Structured scoring criteria were used to analyse the main points deducted in nurses' theoretical and practical parts.

Results: A total of 15 nurses participated in the competition and were divided into five teams with 3 nurses in each team. Each group's theoretical competition part (including the basic score of 100 points) has a minimum score of 130 points and a maximum score of 210 points. The pre-flushing and installation time of the skills competition part is 25.60 ± 2.51 min, which is significantly improved from 35.00 ± 1.58 min before the competition (p < 0.01). The main points lost in the theoretical competition part, were pathophysiological knowledge of anticoagulation, characteristics of different hemofiltration modes, acid-base imbalance in regional citrate anticoagulation in CRRT, handling of special alarms and complications associated with repeated catheterization. The main points lost in the skills competition part were touching or interfering with the weighing scales during the startup self-test, incomplete preparation of reinfusion materials, and timeout.

Conclusion: The simulation-based hemofiltration knowledge and skills competition improves the hemofiltration skills of ICU nurses and provides the data for analyses of the relevant shortcomings from the competition results and points lost, which may promote the reform of teaching methods, thus providing a reference for the department to continuously improve specialised nursing knowledge and skills in the future and promote the continuous improvement of nursing quality.

Patient or public contribution: No Patient or Public Contribution.

Aim: To identify the characteristics of parents with poor adherence to guidelines around introduction of solid foods and supplementation with Vitamin D, and to assess the role of different sources of information in adherence to these guidelines.

Design: A cross-sectional survey which was part of a birth cohort study following pregnant mothers and their infants in a UK city.

Methods: 390 parents who had consented to take part in a birth cohort study were sent a postal questionnaire when their infant was around 6 months old. 220 parents completed this questionnaire about their infants' diet and the sources of information they had used to make decisions about introducing complementary foods to their infant.

Results: Around half (54%) of parents adhered to current guidelines to delay the introduction of solid foods until after their infants were 24 weeks, and adherence to guidelines was positively associated with maternal age and education level as well as with the use of formal information sources such as a Health Visitor or leaflets. Vitamin D supplementation rates of infants by exclusively breastfeeding mothers were low (35%) but increased over time. The internet was a particularly significant source of information used by parents to make feeding decisions for their infants.

Conclusion: In this sample, adherence to guidance around the introduction of solid foods and Vitamin D supplementation was low. Health professionals must develop strategies to communicate these guidelines more effectively.

Patient or public involvement: Members of a PPI group were involved in the study design and development of study materials, including marketing materials.

Aim: To evaluate the impact of emotional labor on job burnout among young nurses and investigate the mediating roles of social support and emotional regulation.

Design: A cross-sectional survey.

Methods: The cross-sectional study recruited 1103 young nurses using convenience sampling from six tertiary-level hospitals in Henan Province, China. Data were collected through an online questionnaire survey, which included a self-administered socio-demographic questionnaire, the Emotional Labor Scale (ELS), the Social Support Scale (SSS), the Emotion Regulation Questionnaire (ERQ) and the Maslach Burnout Inventory Scale (MBI). Statistical analyses were performed using IBM SPSS Statistics 25.0 and AMOS 26.0.

Results: Job burnout had a significant effect on emotional labor, social support and emotional regulation. Mediation analysis revealed that social support and emotional regulation partially mediated the predictive relationship between emotional labor and job burnout. The findings suggest that emotional labor among young nurses indirectly influences their job burnout through social support and emotional regulation. This study provides nursing administrators and healthcare policymakers with a resource to build a supportive environment to increase young nurses' emotional regulation abilities and to decrease their job burnout.

Patient or public contribution: No patient or public contribution.