Nursing & Health Sciences最新文献

This study aimed to examine the opportunities and risks of sustainable business models in AI-integrated nursing, as perceived by nurses, nursing educators, nurse researchers, administrators, and policymakers. A qualitative design grounded in an interpretivist paradigm was adopted. Data were collected through 41 semi-structured interviews and three focus groups. Transcripts were thematically analyzed following Braun and Clarke's framework. The analysis generated four overarching themes: (1) opportunities for sustainable nursing practice, (2) patient-centered sustainability benefits, (3) organizational and economic dimensions, and (4) risks and challenges to sustainable AI models. Participants highlighted AI's role in reducing administrative burden, improving patient safety, supporting professional growth, and strengthening institutional resilience. However, concerns were raised about data security, ethical dilemmas, resistance related to professional identity, and financial or infrastructural barriers. AI has strong potential to support sustainable nursing systems when accompanied by robust governance, policy alignment, and workforce empowerment. Addressing ethical, cultural, and infrastructural challenges is vital to ensure AI integration enhances rather than disrupts nursing practice and contributes to equitable, patient-centered care.

Existing instruments have limitations in comprehensively capturing multimorbidity treatment burden. This study aimed to develop and validate a new measure, the Treatment Burden for Multimorbidity Scale (TBMS). We developed preliminary items based on the literature review and existing instruments. Content validity was evaluated with experts and patients. A longitudinal survey design was used for psychometric testing, with data collected at baseline (n = 503) and at 6-month follow-up (n = 313). We examined reliability, construct validity, and responsiveness of the TBMS. One item was deleted after the content validity evaluation, resulting in 12 items. Factor analyses revealed two domains (healthcare tasks and impacts) aligned with the conceptual definition. Cronbach's alpha for the total scale was 0.93. TBMS scores significantly correlated with scores of the disease burden, an existing multimorbidity treatment burden measure, and self-care as hypothesized. Changes in TBMS scores over 6 months were associated with changes in self-care, depressive symptoms, physical function, and self-rated health. The TBMS demonstrates sound reliability, validity, and responsiveness, making it a valuable tool for assessing multimorbidity treatment burden in clinical practice.

To promote community-based health, it is important to develop a practical model that integrates the perspectives of both public health nurses (PHNs) and community health workers (CHWs). This study explored collaboration and empowerment between PHNs and CHWs and used the findings to construct a collaborative model. Using empowerment and collaboration as the research framework, qualitative interviews were conducted with five PHNs and 24 CHWs from five municipalities in Japan. Individual interviews were held with PHNs, and group interviews (4-6 participants) were conducted with CHWs. An inductive qualitative analysis was performed. The data were organized into 7 themes. PHNs recognized CHWs' roles in supporting residents' lifestyles, building trust, promoting discussion, and collaborating. CHWs formed connections within their communities, communicated within their organizations, and found meaning in their work. These findings informed the creation of a collaborative model. The proposed model can help enhance the practical skills of health professionals involved in community health promotion and support effective collaboration between PHNs and CHWs.

End-of-life care enhances quality of life and alleviates suffering in patients with life-limiting illnesses, and its practice is shaped by cultural contexts. With East Asia comprising more than one-fifth of the global population, research in this region is essential. This scoping review explored nurses' experiences of providing end-of-life care in East Asia between 2015 and 2024. A total of 49 studies published in English or Chinese were selected from seven electronic databases, based on criteria involving direct care by registered nurses, and the review followed standard scoping methodology. Three themes were identified-requirements, transformation, and culture-encompassing seven categories: readiness, patient-centered, challenges, emotion, coping, transformation, and culture. A conceptual map was developed to visually present the findings. This review highlights the complexity of end-of-life care in East Asia and offers key insights into the real-world challenges and needs of nurses. Collectively, our results show that end-of-life care requires enhanced clinical readiness, recognition of nurses' emotional and professional transformation, and sensitivity to cultural and family-centered values. These findings highlight priorities for advancing training, emotional support, and culturally aligned care strategies in East Asia.

Aging population and growing shortage of specialists present increasing challenges to anesthetic care. In Switzerland, advanced practice nurses in anesthesia are not yet integrated, despite their potential to contribute to innovative care models. This qualitative study explored current gaps in anesthetic care and assessed the potential role of advanced practice nursing in anesthesia. Semi-structured interviews were held with 46 participants, including patients, nurse anesthetists, and anesthesiologists. Data were analyzed using Mayring's summarizing content analysis. Patients emphasized "Information and Preparation Needs," "pain," and "recurrent hospital stays." Nurse anesthetists highlighted gaps in "making nursing care visible," "(interprofessional) practice development," and "pain therapy." Anesthesiologists identified challenges in "changes in anesthesia," the "treatment process," and "pain management." The results reveal relevant deficits in perioperative care, underscoring the need for sustainable solutions. Integrating advanced practice nurses into anesthesia could address these gaps by providing patient-centered preoperative support, fostering interprofessional practice development in the operating room, and providing clinical leadership in the postoperative recovery room and pain management. Advanced practice nursing in anesthesia is a promising strategy to sustainably improve the quality of perioperative health care.

This study explores the intersection of masculinities, care, and aging through in-depth interviews with 12 men employed in nursing in the Czech Republic. Using a qualitative design grounded in inductive grounded theory, data were transcribed verbatim and analyzed through thematic analysis in ATLAS.ti, following COREQ guidelines. The analysis identified two contrasting strategies of performing masculinity within a feminized profession: the adaptation of hegemonic masculinity through the incorporation of caring elements, and the re-masculinization of care through relationality, emotional openness, and the rejection of dominance. The findings also show that physical strength operates as an ambivalent resource-granting younger men legitimacy and status while becoming a source of vulnerability with age. By conceptualizing care as a universal human skill rather than a gendered role, the study contributes to critical research on men and masculinities. It expands the framework of caring masculinities by integrating the perspective of aging. Men in nursing thus appear "man enough to care," while their practices both reinforce and challenge the gender order.

The Caribbean faces significant nursing and midwifery workforce challenges. A 2023 PAHO policy advises Member States to develop and implement strategies to strengthen their health workforce, including "promoting decent work conditions." Caribbean nurses' work conditions have not been described. The country's chief nurse has responsibility for policy development. The study purpose was to describe the Caribbean country chief nurses' concerns about nurses' work environments, strides made and polices implemented to support nurse work environments and quality care. Chief nurses of 20 Caribbean countries were surveyed. Inductive content analysis was done. Five concerns represented: (1) physical environment; (2) staffing and workload; (3) safety and security; (4) professional development; and (5) nurses' well-being. Improvements and policies reflected similar themes. The predominant work environment concerns center on inadequate physical environment, nurse staffing and workloads, and inconsistent security. The sporadic improvements and few policies initiated in several countries may warrant coordinated regional effort to achieve broader improvement in working conditions. To optimize patient care and a healthy, safe nursing workforce, policymakers should consider the priorities of government chief nurses to improve working conditions.

Women undergoing assisted reproductive technology (ART) often experience depression linked to treatment-related uncertainty. This study examined whether perceived stigma mediates the relationship between uncertainty and depression and whether spousal support moderates this effect. PROCESS Macro Model 14 was used, controlling for miscarriage experience, counseling history, and spousal proactiveness. Conditional indirect effects and the moderated mediation index were assessed using bootstrapping with 95% confidence intervals. Uncertainty significantly predicted perceived stigma (β = 0.56, p < 0.001) and depression (β = 0.54, p = 0.002). Perceived stigma also significantly affected depression (β = 0.61, p < 0.001). However, spousal support (β = -0.09, p = 0.617) and its interaction with stigma (β = 0.02, p = 0.913) were not significant. While indirect effects remained significant at all spousal support levels, the moderated mediation index was nonsignificant (95% CI: -0.15 to 0.21). Perceived stigma mediates the effect of uncertainty on depression, but spousal support does not moderate this pathway. Interventions should target uncertainty and stigma reduction to improve mental health in women undergoing ART.