Journal of Clinical Nursing最新文献_第9页

The Mediation Impact of Compassion Competence on the Link Between Mindfulness and Job Burnout in Nurses: A Cross‐Sectional Study 护士的同情心能力对正念与工作倦怠之间联系的中介影响：一项横断面研究

IF 4.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-09-17 DOI: 10.1111/jocn.17435

Jiaoyue Li, Fengling Wang, Xiao Zhang, Hongqiang Zhang, Mengfei Lan, Shuya Chen, Jiacheng Su, Li Yang

AimsThis study explores the link between mindfulness, compassion competence and job burnout among nurses, and analyses the mediating role that compassion competence plays in this relationship.BackgroundUnderstanding nurses' mindfulness, compassion competence and job burnout is important, which could help devise interventions to relieve burnout in clinical nurses.MethodsThis study adopts convenience sampling method and descriptive design quantitative research. A cross‐sectional study of 513 nurses was conducted from June to October 2023 in mainland China. The Socio‐demographic Questionnaire, Mindful Attention Awareness Scale, Maslach Burnout Inventory‐Human Service Survey and Compassion Competence Scale for the Nurses were utilised to gather basic demographic information on nurses and to evaluate their level of mindfulness, compassion competence and job burnout. Descriptive statistics, Spearman's correlation analyses and structural equation model were used to analyse the data.ResultsFive hundred and thirteen valid questionnaires were gathered. Spearman's correlation analysis revealed a strong negative link between mindfulness and job burnout, and between compassion competence and burnout, and a significant positive correlation between mindfulness and compassion competence. The results of the mediation analysis revealed that the relationship between mindfulness and job burnout was partially mediated by compassion competence, and the mediating effect accounted for 18.6% of the total effect.ConclusionCompassion competence performed as a partial mediator between mindfulness and job burnout among nurses. Nursing managers could enhance nurses' mindfulness level and compassion competence through Mindfulness interventions and Compassion training to reduce their burnout.Relevance to Clinical PracticeThis study offers a fresh viewpoint on enhancing clinical nurses' compassion competence and reducing job burnout. Healthcare organisations and medical institutions can mitigate nurses' job burnout by improving their mindfulness levels and compassion competence.Reporting MethodThe study used the STROBE checklist for reporting.Patient or Public ContributionAll participants were nurses who completed an electronic questionnaire related to this study.

背景了解护士的正念、同情能力和工作倦怠具有重要意义，有助于制定干预措施以缓解临床护士的工作倦怠。于 2023 年 6 月至 10 月在中国大陆对 513 名护士进行了横断面研究。采用社会人口学问卷、正念注意意识量表、马斯拉克职业倦怠量表-人类服务调查和护士同情心胜任力量表收集护士的基本人口学信息，并对其正念水平、同情心胜任力和工作倦怠进行评价。数据分析采用了描述性统计、斯皮尔曼相关分析和结构方程模型。斯皮尔曼相关分析表明，正念与工作倦怠之间、同情能力与工作倦怠之间存在密切的负相关，正念与同情能力之间存在显著的正相关。中介分析结果显示，正念与工作倦怠之间的关系部分由同情心能力中介，中介效应占总效应的 18.6%。护理管理者可通过正念干预和慈悲训练来提高护士的正念水平和慈悲能力，以减少其工作倦怠。医疗组织和医疗机构可以通过提高护士的正念水平和同情能力来减轻其工作倦怠。报告方法本研究采用 STROBE 检查表进行报告。

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引用次数: 0

Nurses' acceptance of nursing information systems: A multi‐center cross‐sectional study in China 护士对护理信息系统的接受程度：中国多中心横断面研究

IF 4.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-09-17 DOI: 10.1111/jocn.17406

Danni He, Jiani Yao, Wenhao Qi, Shihua Cao, Yanfei Chen, Xiaohong Zhu, Xiajing Lou, Xiaomin Chen, Xin Lin, Yaping Feng, Xiaoli Fu, Li Ning, Shuyuan Wang, Yan Liu

BackgroundIn China, nursing information systems (NIS) implementation can face numerous barriers to acceptance, including the attitudes of potential users. However, few studies have evaluated this acceptance.ObjectiveThe aim of this study was to explain the acceptance of NIS utilizing a survey based on unified theory of acceptance and use of technology.MethodsA multi‐center cross‐sectional study utilizing an online survey was conducted. SPSS AMOS was used to conduct a structural equation modelling analysis. This research followed the STROBE Checklist.ResultsA total of 3973 Nurses participated in the study between January 2023 and March 2023. The acceptance of NIS among nurses was overall moderate to high. The proposed model has been rigorously tested and validated using empirical data, ensuring its credibility and dependability. Performance expectancy (PE), social influence (SI), and attitude significantly and positively affected intentions to use NIS. Effort expectancy (EE) did not show any significant effects in the sample. Facilitating conditions (FCs) was found to have a negative relationship with the intention to use NIS. There was a statistically significant difference BI between the different age groups, working years, and computer training experience. The model demonstrates a good fit with the observed data.ConclusionsThis study identified PE, SI, and attitude as facilitators of nurses' intentions to use NIS. The findings about EE indicates that the ease of using NIS does not seem to be a concern among nurses. Moreover, high FC might be perceived as indicative of a complex system or extensive usage, that can lead to increased workload and reduced behavioural intention (BI). The significant differences in BI among various demographic groups highlight the need for more studies understanding the preferences and barriers faced by different, levels of experience and training backgrounds.Patient or Public ContributionNo patient or public contribution.

背景在中国，护理信息系统（NIS）的实施可能面临许多障碍，包括潜在用户的态度。本研究的目的是根据技术接受和使用的统一理论，通过调查来解释对 NIS 的接受程度。采用 SPSS AMOS 进行结构方程建模分析。结果 2023 年 1 月至 2023 年 3 月期间，共有 3973 名护士参与了研究。护士对 NIS 的接受程度总体上处于中等偏上水平。所提出的模型已利用经验数据进行了严格的测试和验证，确保了其可信度和可靠性。绩效预期（PE）、社会影响（SI）和态度对使用 NIS 的意愿有显著的积极影响。在样本中，努力期望（EE）没有显示出任何明显的影响。研究发现，便利条件（FCs）与使用 NIS 的意愿呈负相关。不同年龄组、工作年限和计算机培训经验之间的 BI 差异具有统计学意义。本研究发现 PE、SI 和态度是护士使用 NIS 意向的促进因素。关于 EE 的研究结果表明，护士似乎并不关心 NIS 的易用性。此外，高 FC 可能被视为系统复杂或使用广泛的标志，这会导致工作量增加和行为意向（BI）降低。不同人口群体在行为意向（BI）方面的显著差异突出表明，有必要开展更多研究，以了解不同经验水平和培训背景的护士的偏好和面临的障碍。

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引用次数: 0

Effectiveness of Horticultural Therapy in Older Patients With Dementia: A Meta‐Analysis Systemic Review 园艺疗法对老年痴呆症患者的疗效：元分析系统综述

IF 4.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-09-14 DOI: 10.1111/jocn.17444

Min Wang, Ying Qian, Xiaoyun Yu, Yubo Xing

AimOur study aims to assess the effectiveness of horticultural therapy in improving outcomes in older patients with dementia.DesignA systematic review and meta‐analysis.MethodsThe included studies comprised randomised controlled trials (RCTs) that aimed to assess the effectiveness of horticultural therapy on cognitive function in older patients with dementia. The study design and data extraction were independently conducted by two investigators, who also evaluated the risk of bias using RoB 2.0. The meta‐analysis was carried out using Stata 15.1 software.Data SourcesOn November 2023, we searched relevant English and Chinese publications in PubMed, Web of Science, Cochrane Library, Embase, CNKI and Wanfang databases.ResultsThe meta‐analysis included a total of 9 RCTs, involving 655 older patients diagnosed with dementia. The findings from these studies demonstrated that horticultural therapy had a significant positive impact on various aspects of the patients' well‐being when compared to conventional care. Specifically, it was found to improve cognitive function scores, alleviate symptoms of depression, enhance daily activities and enhance overall quality of life. When conducting a subgroup analysis, it was observed that horticultural therapy had a statistically significant effect on cognitive function in older patients with dementia when the intervention frequency was at least two times per week. Furthermore, interventions with a duration of less than 6 months were found to be more effective than those lasting 6 months or longer. Additionally, outdoor horticultural therapy was found to be superior to indoor interventions. Moreover, structured interventions were observed to yield better outcomes compared to non‐structured interventions.ConclusionMore high‐quality studies are needed to further corroborate these findings due to the low quality of the included studies. Horticultural therapy has been found to have a significantly positive impact on the cognitive function, depression status, ADL, and quality of life of older patients with dementia.Implications for the Profession and/or Patient CareWe provide references for non‐pharmacologic treatment of older patients with dementia.What Problem Did the Study Address?This study aimed to measure the efficacy of horticultural therapy in older patients with dementia across four dimensions: cognitive function, depression levels, daily living activities and overall quality of life.What Were the Main Findings?In older patients with dementia, horticultural therapy has been proven to have a significant positive impact on cognitive function, depressive status, activities of daily living and quality of life.Where and on Whom Will the Research Have an Impact?This study will inform non‐pharmacological interventions for older patients with dementia worldwide.Patient or Public ContributionNo Patient or Public Contribution.

方法纳入的研究包括随机对照试验（RCT），旨在评估园艺疗法对老年痴呆症患者认知功能的有效性。研究设计和数据提取由两名研究人员独立完成，他们还使用 RoB 2.0 评估了偏倚风险。数据来源2023年11月，我们在PubMed、Web of Science、Cochrane Library、Embase、CNKI和万方数据库中检索了相关的中英文文献。这些研究结果表明，与传统护理相比，园艺疗法对患者各方面的健康状况都有显著的积极影响。具体来说，研究发现园艺疗法能够改善认知功能评分、缓解抑郁症状、增强日常活动能力并提高整体生活质量。在进行分组分析时发现，当干预频率为每周至少两次时，园艺疗法对老年痴呆症患者认知功能的影响具有统计学意义。此外，还发现持续时间少于 6 个月的干预比持续时间为 6 个月或更长时间的干预更有效。此外，还发现室外园艺疗法优于室内干预。结论由于纳入的研究质量不高，因此需要更多高质量的研究来进一步证实这些发现。园艺疗法对老年痴呆症患者的认知功能、抑郁状况、日常生活能力和生活质量有显著的积极影响。对行业和/或患者护理的意义我们为老年痴呆症患者的非药物治疗提供了参考。该研究将对哪些地方和哪些人产生影响？该研究将为全球老年痴呆症患者的非药物干预提供参考。

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引用次数: 0

Clinical Validation of the Nursing Diagnosis ‘Inadequate Health Self‐Efficacy’ in People With Hypertension 高血压患者 "健康自我效能感不足 "护理诊断的临床验证

IF 4.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-09-13 DOI: 10.1111/jocn.17418

Reinaldo Gutiérrez Barreiro, Marcos Venícios de Oliveira Lopes

AimsTo test the clinical validity of clinical indicators and causal relationships of aetiological factors of the new nursing diagnosis of inadequate health self‐efficacy in people with hypertension.BackgroundThe diagnosis of inadequate health self‐efficacy has both theoretical and content validity. However, a clinical validation study is needed to establish an appropriate framework for distinguishing individuals who manifest this unique human response.DesignThe study adopts a cross‐sectional clinical validation approach, adhering strictly to the STROBE guidelines throughout its design and implementation.MethodsNaturalistic sampling was used to identify 302 adults diagnosed with hypertension. Their data were subjected to latent class analysis, which facilitated the identification of a comprehensive set of clinical indicators that demonstrated better diagnostic accuracy and established posterior probabilities to guide the inference of inadequate health self‐efficacy. In addition, logistic regression analysis was used to assess the magnitude of the impact of aetiological factors.ResultsThe prevalence of inadequate health self‐efficacy was 76.61%. Among the 13 indicators examined, seven demonstrated notable sensitivity: ‘risk‐prone health behaviour’, ‘failure to take action that prevents health problems’, ‘inadequate self‐control’, ‘avoidance behaviours’, ‘negative health self‐perception’, ‘inadequate health‐related quality of life’ and ‘difficulty feeling good about adopting a healthy lifestyle’. Additionally, two indicators showed high specificity: ‘difficulty feeling good about adopting a healthy lifestyle’ and ‘inadequate adherence to treatment regimen’. Notably, 15 aetiological factors were identified as significantly associated with an increased risk of inadequate health self‐efficacy.ConclusionsA clinical framework consisting of eight clinical indicators and 15 aetiological factors was developed to characterise inadequate health self‐efficacy in individuals with hypertension.Relevance to PracticeClinical validation provides insight into the precision of clinical indicators and the magnitude of the effect of putative causal elements, thereby facilitating identification and tailored intervention for individuals with hypertension and inadequate health self‐efficacy.

目的检验高血压患者健康自我效能不足这一新护理诊断的临床指标的临床有效性和病因关系。背景健康自我效能不足的诊断具有理论和内容的有效性。本研究采用横断面临床验证方法，在整个设计和实施过程中严格遵守 STROBE 准则。对他们的数据进行了潜类分析，从而确定了一整套临床指标，这些指标显示出较好的诊断准确性，并建立了后验概率以指导健康自我效能不足的推断。结果健康自我效能不足的患病率为 76.61%。在研究的 13 个指标中，有 7 个指标显示出显著的敏感性："易发生风险的健康行为"、"未能采取预防健康问题的行动"、"自我控制能力不足"、"回避行为"、"消极的健康自我认知"、"与健康相关的生活质量不足 "和 "难以对采取健康的生活方式产生良好的感觉"。此外，有两个指标显示出高度的特异性："难以对采取健康的生活方式感到满意 "和 "对治疗方案的依从性不足"。值得注意的是，有15个病因因素被认为与健康自我效能不足的风险增加有显著关联。结论建立了一个由8个临床指标和15个病因因素组成的临床框架，用于描述高血压患者健康自我效能不足的特征。对实践的意义临床验证有助于深入了解临床指标的精确性和假定病因因素的影响程度，从而有助于识别高血压患者和健康自我效能不足患者，并为其提供有针对性的干预。

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引用次数: 0

Bibliometric Analyses: Do They Contribute to Knowledge? 文献计量分析：它们对知识有贡献吗？

IF 4.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-09-12 DOI: 10.1111/jocn.17423

Roger Watson, Mark Hayter

引用次数: 0

Frail Older Adults' Needs and Preferences for Mobile Health Exercise Interventions Guided by Nudge Theory: AQualitative Analysis. 在推力理论指导下，体弱老年人对移动健康锻炼干预的需求和偏好：定性分析。

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-08-30 DOI: 10.1111/jocn.17419

Ruotong Peng, Zeng Cao, Shaolong Hu, Xinzhou Liu, Yongzhen Guo, Xiaoyang Li, Chi Zhang, Hui Feng

Aim: To explore frail older adults' preferences and needs regarding mobile health (mHealth) exercise interventions in China. Additionally, it sought to identify the nudge strategies necessary for initiating and sustaining exercise behaviours among frail older adults.

Design: A qualitative study.

Method: The semi-structured interviews were conducted between April and May 2024 from two communities in Changsha, China. The data were analysed using a deductive framework analysis aligned to nudge theory, and an inductive thematic analysis to gather relevant needs and preferences.

Results: This study involved 14 participants with pre-frailty or frailty, aged 60-82 years (median age of 64 years). While participants were generally receptive to new technologies, lower levels of health literacy and competing priorities often hindered their participation. Three primary functionality requirements were as follows. (1) Profession engagement: tailored exercise prescription, professional and timely feedback and guidance; (2) personalised knowledge encompassing pain management, successful cases and inspiration; (3) beneficial, tailored, dynamic, fragmented, challenging exercise courses. Participants showed positive attitudes towards simplification nudges, gamification nudges, social nudges, trustworthy nudges, reminder nudges, economic nudges, feedback nudges and pre-commitment nudges. Addressing privacy concerns was essential to build trust and acceptance among older adults.

Conclusion: These findings emphasised the importance of designing mHealth interventions that address frail older adults' specific needs and preferences while incorporating effective nudge strategies to promote engagement and adherence. Future researchers should explore wearables, ChatGPT language models, virtual coaching assistants, exercise snack to further optimise the experience and analyse the effects of nudges in mHealth exercise interventions among older adults.

Implication for the profession and/or patient care: Exercise systems or app development for frail older adults should meet three basic functionality and essential nudge strategies.

Reporting method: The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting.

Patient or public contribution: Older adults' engagement and interview data contribute a lot.

目的：探讨中国体弱老年人对移动医疗（mHealth）运动干预的偏好和需求。此外，该研究还试图确定启动和维持体弱老年人运动行为所需的诱导策略：设计：定性研究：半结构式访谈于 2024 年 4 月至 5 月在中国长沙的两个社区进行。采用与督促理论相一致的演绎框架分析法和归纳主题分析法对数据进行分析，以收集相关需求和偏好：本研究涉及 14 名虚弱前期或虚弱期的参与者，年龄在 60-82 岁之间（中位年龄为 64 岁）。虽然参与者普遍乐于接受新技术，但较低的健康知识水平和相互竞争的优先事项往往阻碍了他们的参与。三个主要功能需求如下(1）专业参与：量身定制的运动处方、专业及时的反馈和指导；（2）个性化知识，包括疼痛管理、成功案例和启发；（3）有益的、量身定制的、动态的、碎片化的、具有挑战性的运动课程。参与者对简化提示、游戏化提示、社交提示、可信提示、提醒提示、经济提示、反馈提示和预先承诺提示持积极态度。解决隐私问题对于建立老年人的信任和接受度至关重要：这些研究结果强调了设计移动医疗干预措施的重要性，这些干预措施既要满足体弱老年人的特殊需求和偏好，又要结合有效的劝导策略，以促进老年人参与和坚持治疗。未来的研究人员应探索可穿戴设备、ChatGPT 语言模型、虚拟教练助手、运动零食，以进一步优化体验，并分析移动医疗运动干预对老年人的影响：针对体弱老年人的运动系统或应用程序开发应满足三项基本功能和必要的诱导策略：报告方法：采用定性研究报告综合标准（COREQ）指南进行报告：老年人的参与和访谈数据功不可没。

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引用次数: 0

The Relationship Between Moral Sensitivity, Missed Nursing Care and Moral Distress Among New Nurses: A Cross-Sectional Study. 新护士的道德敏感性、护理遗漏和道德压力之间的关系：一项横断面研究

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-08-29 DOI: 10.1111/jocn.17420

Xiaobing Xu, Yan Wang, Juntong Meng, Xiaolin Xia, Wanlu Cao, Ye Liu

Moral sensitivity, missed nursing care and moral distress among healthcare professionals have received considerable attention in recent years. These factors represent important healthcare challenges for new nurses (graduation to 2 years of work experience). However, studies on the relationships among these variables in the context of new nurses in China remain lacking.

Aims: To explore the relationships among moral sensitivity, missed nursing care and moral distress in the context of new nurses in China.

Research design: A cross-sectional descriptive survey was conducted.

Participants and research context: A total of 228 new nurses were recruited from three tertiary hospitals in Qingdao, Shandong Province, China. Participants provided their sociodemographic and professional information and completed the Chinese Moral Sensitivity Questionnaire-Revised Version, the Chinese Missed Nursing Care Survey Version and the Chinese Moral Distress Scale-Revised Version. The data were analysed using Spearman's correlation analysis and multiple linear regression analysis.

Results: The means and standard errors of moral sensitivity, missed nursing care and moral distress were 40.71 (0.39), 9.82 (0.78) and 34.87 (2.41), respectively. The variable of missed nursing care exhibited a significant negative relationship with moral sensitivity and a significant positive relationship with moral distress. Regression analysis revealed that the main factors influencing new nurses' moral distress were educational background, nature of job, current unit, frequency of night shifts and the dimensions of moral strength and responsibility. These factors can explain 14.9% of the total variation.

Conclusion: The findings revealed that higher rates of missed nursing care were associated with lower moral sensitivity and greater moral distress among new nurses. Therefore, developing interventions to reduce missed nursing care may be a promising strategy for improving moral sensitivity and preventing moral distress among new nurses.

Implications for the profession and/or patient care: In hospitals, moral distress can be improved by focusing on modifiable factors such as staffing resources, leading to better promoting new nurses' health and improving the quality of care. This study can highlight practices accounting for moral sensitivity and missed nursing care in nursing research and training programmes.

Reporting method: Strengthening the reporting of observational studies in epidemiology (STROBE) statement.

Patient or public contribution: No patient or public contribution.

近年来，医护人员的道德敏感性、护理失误和道德困扰受到了广泛关注。这些因素对于新护士（毕业至工作经验满 2 年）来说是重要的医疗挑战。目的：探讨中国新入职护士的道德敏感性、护理遗漏和道德困扰之间的关系：研究设计：采用横断面描述性调查：从中国山东省青岛市的三家三级医院共招募了 228 名新护士。参与者提供了他们的社会人口学和职业信息，并填写了《中国道德敏感性问卷-修订版》、《中国护理失误调查表-修订版》和《中国道德压力量表-修订版》。数据采用斯皮尔曼相关分析和多元线性回归分析进行分析：结果：道德敏感度、护理遗漏和道德困扰的均值和标准误差分别为 40.71（0.39）、9.82（0.78）和 34.87（2.41）。护理遗漏变量与道德敏感度呈显著负相关，与道德困扰呈显著正相关。回归分析显示，影响新护士道德困扰的主要因素是教育背景、工作性质、目前所在科室、夜班频率以及道德力量和责任感维度。这些因素可以解释 14.9%的总差异：研究结果表明，新护士较高的护理遗漏率与较低的道德敏感性和较大的道德困扰有关。因此，制定干预措施以减少护理遗漏可能是提高新护士道德敏感性和预防道德困扰的有效策略：在医院中，可通过关注人员配置资源等可改变的因素来改善道德困扰，从而更好地促进新护士的健康并提高护理质量。本研究可强调在护理研究和培训计划中考虑道德敏感性和错过的护理护理的做法：报告方法：加强流行病学观察性研究报告（STROBE）声明：无患者或公众贡献。

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引用次数: 0

Nurses' Beliefs About Pain Assessment in Dementia: A Qualitative Study Informed by the Theory of Planned Behaviour. 护士对痴呆症患者疼痛评估的信念：以计划行为理论为指导的定性研究。

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-08-29 DOI: 10.1111/jocn.17417

Madushika Wishvanie Kodagoda Gamage, Lihui Pu, Michael Todorovic, Wendy Moyle

Aim: To explore registered nurses' beliefs regarding pain assessment in people living with dementia.

Design: A descriptive exploratory qualitative study informed by the Theory of Planned Behaviour.

Methods: Online semi-structured in-depth interviews were conducted from January to April 2023 with a purposive sample of 15 registered nurses caring for people with dementia. Following transcription, data were analysed using direct content analysis.

Findings: Registered nurses believe pain assessment improves the well-being of people with dementia and informs and evaluates practice. However, there is a possibility of misdiagnosing pain as agitation or behavioural problems, leading to inaccurate pain management. Interpersonal factors, such as registered nurses' knowledge and experience, beliefs and motivation to improve care provision, were the primary facilitators of pain assessment. Physical and behavioural dimensions of the pain of the dementia syndrome were the most reported barriers to pain assessment. Registered nurses reported that multidisciplinary team members expect them to do pain assessments. Most did not experience disapproval when performing pain assessments.

Conclusion: Registered nurses hold beliefs about pain assessment benefits, consequences, enablers, barriers, approvals and disapprovals regarding dementia. The findings could inform interventions to enhance pain assessment practices.

Implications for the profession and/or patient care: Policymakers should provide education opportunities for registered nurses to improve their knowledge, skills and beliefs about pain assessment in dementia. Future research should develop and implement multidisciplinary, multifaceted pain assessment protocols to enhance the accuracy of pain assessment practices.

Impact: Pain is underassessed in dementia, and this could stem from registered nurses' beliefs about pain assessment in dementia. The findings could inform interventions to enhance pain assessment beliefs and practices.

Reporting method: This study adhered to the COREQ criteria.

Patient or public contribution: Registered nurses caring for people living with dementia participated as interview respondents.

目的：探讨注册护士对痴呆症患者疼痛评估的看法：方法：从 2023 年 1 月到 4 月，对 15 名特定样本的痴呆症患者进行了在线半结构式深度访谈：2023 年 1 月至 4 月，对 15 名护理痴呆症患者的注册护士进行了在线半结构式深度访谈。转录后，采用直接内容分析法对数据进行分析：注册护士认为疼痛评估可以改善痴呆症患者的福祉，并为实践提供信息和评估。但是，也有可能将疼痛误诊为躁动或行为问题，导致疼痛管理不准确。人际因素，如注册护士的知识和经验、信念和改善护理服务的动机，是疼痛评估的主要促进因素。据报告，痴呆综合症疼痛的身体和行为方面是疼痛评估的最大障碍。注册护士报告说，多学科团队成员希望他们进行疼痛评估。大多数人在进行疼痛评估时没有遇到不认可：注册护士对痴呆症进行疼痛评估的益处、后果、促进因素、障碍、认可和不认可的信念。这些发现可为加强疼痛评估实践的干预措施提供依据：政策制定者应为注册护士提供教育机会，以提高她们对痴呆症疼痛评估的知识、技能和信念。未来的研究应开发和实施多学科、多方面的疼痛评估方案，以提高疼痛评估实践的准确性：影响：痴呆症患者的疼痛评估不足，这可能源于注册护士对痴呆症患者疼痛评估的信念。研究结果可为加强疼痛评估信念和实践的干预措施提供参考：本研究符合 COREQ 标准：护理痴呆症患者的注册护士作为访谈对象参与了研究。

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引用次数: 0

Comment on 'prevalence and determinants of insufficient physical activity in elderly nursing homes: A cross-sectional study based on the COM-B model'. 对 "养老院老年人体育活动不足的普遍性和决定因素：基于 COM-B 模型的横断面研究 "的评论。

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-08-27 DOI: 10.1111/jocn.17409

Shu-Yuan Shi, Yu-Jie Guo

引用次数: 0

Exploring the barriers, facilitators and needs to use patient outcomes in district nursing care: A multi-method qualitative study. 探索在地区护理中使用患者结果的障碍、促进因素和需求：多方法定性研究。

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing

Pub Date : 2024-08-23 DOI: 10.1111/jocn.17407

Jessica Desirée Veldhuizen, Frans Van Wijngaarden, Misja Chiljon Mikkers, Marieke Joanne Schuurmans, Nienke Bleijenberg

Aim and objectives: To provide an in-depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care.

Background: As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation.

Design: A multi-method qualitative study.

Methods: Open-ended questions of a survey study (N = 132) were supplemented with in-depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis.

Results: Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient-centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care.

Conclusions: The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation.

Relevance to clinical practice: This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient-centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.

Reporting method: Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Patient of public contribution: No patient or public contribution.

目的和目标深入了解地区护士和护士助理在地区护理中使用患者疗效的障碍、促进因素和需求：背景：随着医疗保健需求的增长，尤其是地区护理需求的增长，我们亟需了解如何在这一环境中系统地衡量和改善患者疗效。需要进一步调查以确定有效实施的障碍和促进因素：设计：多方法定性研究：调查研究中的开放式问题（N = 132）辅以深入的在线焦点小组访谈，访谈对象包括荷兰的地区护士和护士助理（N = 26）。采用主题分析法对数据进行了分析：结果：确定了不同的障碍、促进因素和需求，并将其归纳为在地区护理中使用成果的 16 个先决条件。这些先决条件被归纳为六大主题：遵循学习型医疗保健系统的步骤；提供以患者为中心的护理；促进专业人员的自主性、态度、知识和技能；加强组织边界内外的责任分担和合作；优先考虑并投资于成果的使用；促进地区护理的团结和赞赏：本研究中确定的先决条件对于护士、护理提供者、政策制定者和支付者在地区护理实践中使用患者疗效至关重要。要想成功实施，就必须进一步探索适当的策略：这项研究标志着在地区护理中使用患者疗效方面迈出了重要一步。大多数研究都集中在医院和全科医生的环境中，而本研究则侧重于地区护理的需求。通过确定以患者为中心的护理、专业自主和团结等主题的 16 个关键先决条件，研究结果为整合学习型医疗保健系统提供了有价值的指导，该系统优先考虑衡量和持续改进地区护理中的患者疗效：报告方法：定性研究报告综合标准（COREQ）指南：无患者或公众贡献。

{"title":"Exploring the barriers, facilitators and needs to use patient outcomes in district nursing care: A multi-method qualitative study.","authors":"Jessica Desirée Veldhuizen, Frans Van Wijngaarden, Misja Chiljon Mikkers, Marieke Joanne Schuurmans, Nienke Bleijenberg","doi":"10.1111/jocn.17407","DOIUrl":"https://doi.org/10.1111/jocn.17407","url":null,"abstract":"Aim and objectives: To provide an in-depth insight into the barriers, facilitators and needs of district nurses and nurse assistants on using patient outcomes in district nursing care.Background: As healthcare demands grow, particularly in district nursing, there is a significant need to understand how to systematically measure and improve patient outcomes in this setting. Further investigation is needed to identify the barriers and facilitators for effective implementation.Design: A multi-method qualitative study.Methods: Open-ended questions of a survey study (N = 132) were supplemented with in-depth online focus group interviews involving district nurses and nurse assistants (N = 26) in the Netherlands. Data were analysed using thematic analysis.Results: Different barriers, facilitators and needs were identified and compiled into 16 preconditions for using outcomes in district nursing care. These preconditions were summarised into six overarching themes: follow the steps of a learning healthcare system; provide patient-centred care; promote the professional's autonomy, attitude, knowledge and skills; enhance shared responsibility and collaborations within and outside organisational boundaries; prioritise and invest in the use of outcomes; and boost the unity and appreciation for district nursing care.Conclusions: The preconditions identified in this study are crucial for nurses, care providers, policymakers and payers in implementing the use of patient outcomes in district nursing practice. Further exploration of appropriate strategies is necessary for a successful implementation.Relevance to clinical practice: This study represents a significant step towards implementing the use of patient outcomes in district nursing care. While most research has focused on hospitals and general practitioner settings, this study focuses on the needs for district nursing care. By identifying 16 key preconditions across themes such as patient-centred care, professional autonomy and unity, the findings offer valuable guidance for integrating a learning healthcare system that prioritises the measurement and continuous improvement of patient outcomes in district nursing.Reporting method: Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.Patient of public contribution: No patient or public contribution.","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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