Journal of Clinical Nursing最新文献

Aim: To analyse predictors of burnout in nursing professionals during and after the COVID-19 pandemic.

Design: Cohort study.

Method: A two-phase study conducted during the COVID-19 pandemic's peak (2020) and post-vaccination period (2022). Data from nursing professionals of four hospitals in southern Brazil included sociodemographic, occupational, lifestyle, and health variables, and Maslach Burnout Inventory responses. Multivariate logistic and linear regression analyses were used to identify independent predictors of burnout syndrome. The study was approved by the Research Ethics Committee (approval no. 4.152.027).

Results: A sample of 163 participants were assessed at two distinct time points. In 2020, 9.2% of nursing professionals experienced burnout syndrome, decreasing slightly to 7.4% in 2022. As for the burnout dimensions, emotional exhaustion was reported by 27% of professionals in 2020 and 26.4% in 2022. Depersonalisation affected 28.2% during the pandemic and 25.2% afterward. Low professional accomplishment was identified in 29.4% of professionals in 2020, increasing to 30.1% in 2022. Distinct predictors were identified for overall burnout and its specific dimensions. The main predictors included: perceiving a mental health impact from the pandemic, previous mental health issues, recent medical leave, and working directly with COVID-19 patients.

Conclusions: Burnout syndrome remained stable post-pandemic. Key predictors were identified, highlighting the need for preventive mental health interventions.

Relevance for clinical practice: Identifying predictors of burnout in nursing professionals supports the development of targeted interventions to protect mental health, improve job satisfaction, and enhance the quality of patient care during and after health crises.

Impacts: This study fills a gap in post-pandemic research by identifying predictors of burnout in nursing professionals. It supports the development of policies and interventions to protect mental health and improve working conditions in Brazilian hospitals.

Reporting method: STROBE guidelines for cohort studies.

Patient or public contribution: Participants contributed only through data collection.

Background: Ample evidence has shown the benefit of high-fidelity simulation (HFS) in promoting learning in pre-licensure nursing students, but the evidence for practising registered nurses has not been synthesised.

Objective: To evaluate the effects of HFS training on learning outcomes and satisfaction in practising registered nurses.

Methods: In this systematic review and meta-analysis, we searched PubMed, CINAHL, ERIC, Cochrane Library, Web of Science and China National Knowledge Infrastructure (CNKI) for studies published in English or Chinese from database inception to 31 May 2023 (updated on 20 April 2025). All randomised controlled trials (RCT) or quasi-experiments that compared HFS training with traditional methods (e.g., lecture) for practising registered nurses and reported learning outcomes and satisfaction were included. Risk of bias was assessed by the Cochrane risk-of-bias tool for randomised trials (RoB 2) and non-randomised trials (ROBINS-I). Inverse-variance random-effect models were used to calculate standardised mean differences (SMDs) with 95% confidence interval (CI). We followed the PRISMA 2020 guideline.

Results: Of 1404 records, eight eligible studies (five RCTs and three quasi-experiments) involving 275 practising nurses were identified. Two RCTs had high risk of bias, while others showed some concerns or moderate risk of bias. Meta-analyses showed that HFS could promote knowledge acquisition (SMD = 0.65, 95% CI, [0.35, 0.95], p < 0.01, I² = 0%), professional skills (SMD = 0.72, 95% CI, [0.41, 1.04], p < 0.01, I² = 0%) and learning satisfaction (SMD = 1.24, 95% CI, [0.35, 2.13], p < 0.01; I² = 67%), compared with traditional methods. The pooled effect on self-confidence was marginally insignificant (SMD = 0.59, 95% CI, [-0.04, 1.22], p = 0.07; I² = 67%).

Conclusion: Compared with traditional training methods, HFS is effective in promoting knowledge acquisition, professional skills and learning satisfaction and may enhance self-confidence among practising nurses. To strengthen the evidence base, more rigorous RCTs with larger sample sizes, adequate reporting of HFS design, and standardised outcome measures are warranted.

Protocol registration: PROSPERO (CRD42022358717). No Patient or Public Contribution.

Aim: To explore community dwelling adults' lived experiences of participating in death café in Singapore.

Design: A descriptive phenomenological study with Photovoice.

Methods: A purposive sample of community dwelling adults who participated in a community-based death café was recruited for this study. Data was collected through online individual semi-structured interviews. The Colaizzi's six-step descriptive phenomenological analysis was conducted for data analysis.

Results: Twenty community dwelling adults who participated in a death café were recruited. Participants' experiences of the death café were expounded in four themes: appeals of attending death cafés, enabling features of death café, engaging in die-logues, and perceived impacts of death café on everyday lives. The participants were attracted to death cafés for various reasons including curiosity and grief. A comfortable environment, accompanied by open dialogues and refreshments, was credited as enablers for death conversations. Through these 'die-logues', the participants had a deeper understanding of death and began engaging in advance planning.

Conclusions: Death cafés provide a supportive environment for individuals to engage in death-related conversations that may not easily occur in daily life. By engaging in conversations about mortality within death cafés, participants are encouraged to take proactive steps towards advance planning.

Implications for the profession and/or patient care: Findings from this study can guide the development of community-based interventions by highlighting the essential components required for a death café tailored to the Asian context.

Impact: This study describes the community dwelling adults' lived experiences of participating in a death café. The findings from this study underscore the role of informal conversations about death as a tool to promote population health based palliative care initiatives such as overcoming death taboos and stimulating advance care planning among community dwelling adults.

Reporting method: The Consolidated Criteria for Reporting Qualitative Studies was used.

Patient and public contribution: Community-dwelling adults participated in the interviews.