BMC Nursing最新文献

Background: Enhancing nursing undergraduates' sense of coherence is crucial for the growth of the nursing workforce. Yet, existing research primarily examines the aggregate level of sense of coherence among nursing undergraduates and its correlations with other variables, overlooking the individual heterogeneity in nursing undergraduates' sense of coherence in nursing. This study aimed to identify different subgroups of nursing undergraduates' sense of coherence and explore the influencing factors pertinent to each subgroup.

Methods: A cross-sectional study was conducted from May to June 2020 among 1,251 nursing undergraduates using convenience sampling. Latent profile analysis was employed to identify subgroups of nursing undergraduates' sense of coherence, and multiple logistic regression was utilized to analyze the factors associated with each subgroup.

Results: Four potential subtypes of nursing undergraduates' sense of coherence were identified: low sensitivity-low coping group (25.7%), high sensitivity-high coping group (29.7%), moderate sensitivity-moderate coping group (17.8%), and high sensitivity-low coping group (26.8%). Multiple logistic regression analysis revealed that factors influencing nursing undergraduates' sense of coherence included family financial situation, high school subject choice, religious beliefs, belief in having good interpersonal relationships, meaning in life, and professional identity.

Conclusion: The heterogeneity of nursing undergraduates' sense of coherence suggests that nursing educators should provide targeted intervention guidance according to the potential category characteristics of nursing undergraduates' sense of coherence; at the same time, they should strengthen the cultivation of nursing undergraduates' meaning of life and professional identity to improve their level of sense of coherence, so as to promote the growth of the nursing workforce.

Background: Self-care practices among people with heart failure (HF) remain suboptimal. Nurse-led self-care interventions hold promise in managing this condition. The Common-Sense Model (CSM) of Self-Regulation is a widely adopted theoretical framework that promotes behavior change and improves disease prognosis among patients. Therefore, this study aimed to describe the development and pilot testing of a nurse-led CSM of Self-Regulation-based self-care intervention among people with HF.

Methods: Intervention development was informed by a comprehensive review of the relevant literature, the CSM of self-regulation, international and national guidelines, and findings from our previous systematic reviews. The pilot study utilized a single-blinded, two-arm, parallel group, randomized controlled trial (RCT) design, adhering to the CONSORT Statement. Eligible participants were randomly assigned at a 1:1 ratio to either the intervention group or the control group. Data were collected at baseline and immediately after the intervention, with a focus on evaluating feasibility, acceptability, and potential effects.

Results: We developed and validated a nurse-led, theory-driven, evidence-based, and need-oriented HF self-care program. A total of 26 participants were enrolled in the pilot study, achieving an eligibility of 79.4%, a recruitment rate of 96.3%, and a retention rate of 92.3%. Most participants (83.3%) recognized the benefits of the intervention. The intervention significantly improved illness perceptions, self-care self-efficacy, and self-care behaviors among people with HF.

Conclusion: The nurse-led CSM of Self-Regulation-based self-care intervention is feasible, acceptable, and potentially beneficial for people with HF. A full-scale mixed-method RCT is recommended to further examine the intervention's effectiveness.

Trial registration: Chinese Clinical Trial Registry (No., ChiCTR2300068156; February 9, 2023).

Background: The nursing profession plays a crucial role in the quality of healthcare services. While nurses face occupational injury challenges globally, mental workload, which is often overlooked, plays a significant role in these injuries. Understanding nurses' coping strategies can help develop effective interventions. The study examined the influence of mental workload on occupational injuries and coping strategies among nurses.

Methods: A multi-centre cross-sectional study was conducted in selected hospitals in the Eastern Region of Ghana. Using a stratified sampling technique, 317 nursing staff from 6 hospitals participated in the study. A researcher-developed occupational injury questionnaire, NASA Task Load Index and Brief COPE scale were used to measure occupational injury, mental workload and coping strategies among nurses. Descriptive statistics, Pearson moment-product correlations, and regression analysis were used to analyse the data at a statistical significance of 0.05.

Results: Needle pricks, injuries from sharps, exposure to blood and other body fluids, and back pain and injury from patient handling tasks were shared among participants in the past year. The study also revealed a high level of mental workload among participants. A significant correlation was observed between mental workload and various occupational injuries. The participants adopted different coping strategies in dealing with the mental workload, with active coping and instrumental support being the most used coping strategies.

Conclusion: The findings underscore the importance of addressing mental workload in nursing to reduce occupational injuries. To achieve this, nurses must be provided with appropriate coping strategies and support to minimise mental stress.

Implication: Providing accessible and effective coping strategies tailored to nurses' needs can significantly improve their well-being and job performance. Healthcare administrators and policymakers should consider these results when designing interventions to support the nursing workforce.

Background: Innovative Behavior (IB) is a key prerequisite for nurses in solving clinical problems. However, existing research on IB among clinical nurses is relatively limited.

Objective: To identify profiles and characteristics of IB among clinical nurses and explore the associated predictors, as well as the relationships with research outputs.

Methods: A multicenter cross-sectional study was conducted on 354 clinical nurses in Shanghai from April 2023 to May 2023 (response rate 98.06%). IB was measured by the Innovative Behavior Scale for Nurses (IBSN), future time perspective was measured by the Future Time Perspective Scale (FTPS), and work engagement was measured by the Utrecht Work Engagement Scale-9 (UWES-9). Socio-demographic and professional data and research output indicators were measured by a self-designed questionnaire. We used latent profile analysis (LPA) by Mplus 7.0 to identify latent classes of IB. Ordinal logistic regression analysis was used to analyze the relevant predictors on the different profiles. And then Pearson's chi-squared was used to analyze the association between IB level and research output.

Results: Among the respondents, individuals aged 25 to 35 accounted for 55.9%, and females comprised 94.6%. IB of clinical nurses can be identified into 3 groups: low-level (n = 108, 30.51%), moderate-level (n = 149, 42.09%), and high-level (n = 97, 27.40%) groups. Based on the results of LPA, marital status, education level, work experience, monthly income, night shifts, future time perspective scores, and work engagement scores can be the predictors of IB among different profiles. Statistically significant associations were found between IB level and research productivity, including publishing academic papers (χ² = 15.307, p < 0.001), registering patents (χ² = 17.163, p < 0.001), and winning Sci. & Tech awards (χ² = 27.814, p < 0.001).

Conclusion: According to our research, clinical nurses have three unique IB profiles. The current level is predominantly at a moderate level, with less than 30% demonstrating a high level of innovation. It revealed that better socio-demographic status and professional characteristics, future time perspective, and work engagement positively influenced innovative behavior among clinical nurses. The findings also highlight the potentially important role of IB in contributing to nurses' research output.

Practical implications: As far as we know, it might be the first study to employ LPA to clarify the heterogeneity in the levels of IB and their specific distribution among nurses. Our findings may provide a new viewpoint for promoting IB among clinical nurses. Nursing administrators should pay attention to IB of clinical nurses and develop targeted interventions to enhance their IB levels.

Background: Supervisor-subordinate relationship is high relevant in dealing with work-related stress and providing a compassionate, high-quality, and safe nursing care while meeting the needs of the hospital. Our aim was to assess the predisposing risk and resilience factors of the stress of nursing staff as well as to explore the common and distinctive perceptions of these factors between nurses without a managerial position (nursing staff) and employees in a supervising position (nurse managers, ward nurses).

Design: Generic qualitative study using half-standardized interviews.

Methods: Fifty nurses and supervisors from different departments from a German hospital of maximum medical care participated in this study between August and November 2018. Nineteen face-to-face interviews and five focus groups were conducted. Transcripts were subjected to structured qualitative content analysis.

Results: Systematised in Lazarus's transactional model, nurses, and supervisors mentioned similar risk and resilience factors of stress. Disagreement in suggested responsibility for nurses' stress or health and an evaluation of implemented measures meeting the nurses' needs are discussed.

Conclusion: Nursing staff and supervisors should enforce exchange to reduce disagreements in perceptions and to improve mutual understanding. Furthermore, measures to meet nurses' needs to minimize stress and to improve collaboration and job satisfaction should be developed in close coordination with the target group. The focus should be placed on restructuring training and education programs with supplementation of self-responsibility promotion.

Trail registration: The study was registered with the German Register for Clinical Studies (DRKS 00013482) on 09 March 2018.

Background: Older adults receiving home care often face significant safety risks related to medication management due to their chronic diseases and complex health needs. Despite the increasing reliance on home healthcare services, the specific factors contributing to medication safety risks in this demographic remain inadequately explored.

Objective/aim: This study aims to explore the key factors involved in medication safety risks among older adults with chronic diseases receiving home healthcare in Iran.

Methods: Qualitative research employing conventional content analysis was conducted using Graneheim and Lundman's approach. was conducted in three home care centers in Tehran (Iran) from August 2020 to July 2022. Data were collected through semi-structured interviews with 7 nurses, 2 supervisors, 2 nursing assistants (experts in non-nursing careers), 1 home care inspector (expert of the Deputy of Treatment), and 3 family caregivers in home settings, along with four participatory observations and visual methods (narrative photography) focusing on medication safety challenges. The trustworthiness of the research was evaluated using Lincoln and Guba's four criteria for qualitative studies.

Findings: Factors associated with medication safety risks were found to rely on its major components Patients' attribution, Families' characteristics, Home care centers' condition, Health caregivers' characteristics, and the Homes' situations, where these factors all account for various medication safety risks. Indeed, a medication safety risk can be attributed to more than one of the factors associated with medication safety risk by participants at home.

Conclusion: As a result, the analysis of factors associated with medication safety risks highlights a complex interplay among various elements, including patients, families, home care centers, health caregivers, and the home environment. These interconnected factors are crucial for identifying the diverse medication safety challenges faced by participants in home settings. A comprehensive understanding of these dynamics is essential for improving medication safety protocols and enhancing health outcomes for this vulnerable population.

Background: Mild cognitive impairment (MCI) is prevalent in older adults with chronic pain, making early detection crucial for dementia prevention and healthy aging. This study aimed to determine MCI risk factors in older patients with chronic pain and to develop 9 machine learning models to identify MCI risk.

Methods: A total of 612 older patients with chronic pain were recruited between October 2023 and July 2024. Data collected included patients' general information, cognitive function, pain level, depression, and sleep quality. The dataset was randomly divided into training set and testing set, and processed by Min-Max Normalization and SMOTETomek comprehensive sampling. SVM-RFE and LASSO regression were used for variable selection. We then developed machine learning models and interpreted them by SHAP.

Results: Age, education level, number of pain sites, pain duration, pain level, depression and sleep quality were risk factors of MCI in older patients with chronic pain. The Extreme Gradient Boosting (XGBoost) model performed best (AUC 0.925), with pain level, age, and depression as the most important variables.

Conclusions: We successfully developed 9 machine learning models to identify MCI risk. These models provide a tool for nurses to detect MCI risk early. We recommend that nurses integrate machine learning techniques into clinical nursing practice for managing MCI. However, these findings require validation with longitudinal data to confirm predictive validity for MCI progression.

Background: Nurses face significant professional challenges arising from global pandemics, inadequate welfare protection, and declining social status. In this context, the decent working conditions for nurses are not adequately safeguarded. This study examines decent work status among Chinese nurses and its links work engagement, and compassion fatigue.

Methods: This study is a cross-sectional research. Through the method of convenience sampling, five reputable hospitals in Hangzhou, China, were selected, and a total of 838 nurses were surveyed. Data collection was conducted from April to May 2023. We employed a comprehensive set of assessment tools, including an evaluation of demographic characteristics, the Decent Work Perception Scale (DWPS), the Chinese version of the Compassion Fatigue Short Scale (C-CFSS), and the Gallup Q12 survey scale.

Results: The findings of this study demonstrated that compassion fatigue was significantly negatively correlated with both decent work (r = -0.482, p < 0.001) and engagement (r = -0.461, p < 0.001). Additionally, decent work was significantly positively correlated with engagement (r = 0.811, p < 0.001). Mediation analysis revealed that compassion fatigue had a direct negative effect on decent work (β = -0.05, p < 0.001), while engagement partially mediated the relationship between compassion fatigue and decent work (β = -0.14, p < 0.001).

Conclusion: This study found that compassion fatigue and engagement significantly influence nurses' perception of decent work, with engagement mediating this relationship. Future research should explore these mechanisms further and develop interventions to enhance engagement and reduce compassion fatigue, improving nurses' perception of decent work.

Background and purpose: When caring for patients hospitalized with cerebrovascular disease, a caring phenomenon occurs between the patient's family and the nurse, and according to Hohashi's Family Care/Caring Theory, the family and the nurse achieve self-actualization. However, the contents of self-actualization through specific care/caring are unclear. The purpose of this integrative review was to clarify the self-actualization of the nurse as an outcome of family care/caring, and the self-actualization of other individuals (that is, the family) who are supported by nurses.

Methods: A search conducted on 23rd December, 2023, using Ichushi-Web, CiNii and J-STAGE, which are extensive Japanese literature databases, identified 1,061 original articles using the keywords "cerebrovascular disease AND nurse." The quality of the articles was assessed according to the Joanna Briggs Institute critical appraisal checklists. We conducted an integrative review of 11 articles describing transactions between nurses and families according to Toronto and Remington. Self-actualization of the nurse and self-actualization of other individuals were classified as subcategories and then as categories. Exclusion criteria included no description of family members, no practice by nurses, and not patients with cerebrovascular disease.

Results: Of the 11 studies utilized, 10 were qualitative studies and one was a quantitative descriptive study. Eight categories were identified for self-actualization of families with a cerebrovascular patient by nurses, including "Families can realize their hopes through the provision of an environment by nurses." Three categories of self-actualization of the nurse were identified, including "Nurses can obtain a sense of satisfaction from the family."

Conclusion: During the recovery process after hospitalization for cerebrovascular disease, a caring phenomenon occurs between the patient's family and nurses, which can be understood using Family Care/Caring Theory. The family's self-actualization and the nurse's self-actualization were achieved through reciprocal concern between the two.