International Journal of Nursing Studies最新文献

{"title":"Key drivers of nurse burnout and work engagement in Europe: A cross-sectional dominance analysis","authors":"Dorothea Kohnen ,&nbsp;Hans De Witte ,&nbsp;Wilmar B. Schaufeli ,&nbsp;Simon Dello ,&nbsp;Luk Bruyneel ,&nbsp;Linda H. Aiken ,&nbsp;Walter Sermeus","doi":"10.1016/j.ijnurstu.2025.105251","DOIUrl":"10.1016/j.ijnurstu.2025.105251","url":null,"abstract":"<div><h3>Background</h3><div>Following the Job Demands-Resources model, job resources are key drivers of work engagement, while excessive job demands and insufficient job resources are linked to job strain and burnout. Yet, little is known about the relative importance of different job demands and resources in comparison to one another.</div></div><div><h3>Objective</h3><div>Using dominance analysis, this study aimed to investigate the relative importance of specific job demands and job resources for burnout and work engagement among direct care nurses in Europe.</div></div><div><h3>Design</h3><div>A cross-sectional survey study.</div></div><div><h3>Setting</h3><div>64 general acute care hospitals in Belgium (13), Germany (20), Ireland (15), Norway (1), Sweden (4), and England (11).</div></div><div><h3>Participants</h3><div>Direct care nurses (n = 5023).</div></div><div><h3>Methods</h3><div>Data were collected between May 2022 and August 2022. To evaluate the measurement model, structural equation modeling was performed in the pooled sample and within each country. Due to model misfit (Tucker Lewis Index &lt;<!--> <!-->0.89), Norway and Sweden were excluded from further analysis, resulting in a final sample of 4591 nurses. Multiple-group confirmatory factor analysis was used to test configural and metric measurement invariance across countries. In the next step, the main propositions of the Job Demands-Resources model were tested, followed by dominance analysis to determine the relative importance of specific job demands and job resources on overall work engagement and burnout.</div></div><div><h3>Results</h3><div>In line with the Job Demands-Resources model, job demands contributed to burnout (β = 0.681, p &lt; 0.001), while job resources were positively linked to work engagement (β = 0.614, p &lt; 0.001) and negatively associated with burnout (β = −<!--> <!-->0.258, p &lt; 0.001). These relationships were consistent across countries. Dominance analyses further revealed that skill utilization was the strongest predictor of work engagement, explaining between 27.4 % and 41.9 % of the variance, while emotional dissonance (%R² = 17.0 %–23.8 %) and emotional demands (%R² = 17.3 %–20.8 %) were the strongest predictors of burnout. Overall, these findings were consistent across countries.</div></div><div><h3>Conclusions</h3><div>This study adds to existing research on Job Demands-Resources theory by uncovering the relative importance of specific job demands and resources for burnout and work engagement among European nurses. The findings can guide hospitals in prioritizing policies and practices to enhance nurses' well-being.</div></div><div><h3>Trial registration</h3><div>The study described herein is funded under the European Union's Horizon 2020 Research and Innovation programme from 2020 to 2024 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105251"},"PeriodicalIF":7.1,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of non-pharmacological interventions on fatigue in people with multiple sclerosis: A systematic review and network meta-analysis","authors":"Hui Chang ,&nbsp;Xuexue Wang ,&nbsp;Yanru Shi","doi":"10.1016/j.ijnurstu.2025.105250","DOIUrl":"10.1016/j.ijnurstu.2025.105250","url":null,"abstract":"<div><h3>Background</h3><div>Fatigue is a common symptom of multiple sclerosis (MS) that adversely affects patients' health and quality of life and increases the burden on healthcare systems. Although non-pharmacological therapies are effective alternatives to pharmacological treatments, it remains unclear which non-pharmacological interventions are most effective in alleviating fatigue in people with MS.</div></div><div><h3>Aims</h3><div>To compare the effectiveness of non-pharmacological interventions in reducing fatigue among people with MS.</div></div><div><h3>Methods</h3><div>We searched seven databases from their inception to May 2024. After literature screening and data extraction, the Cochrane Bias Assessment Tool 2.0 version of randomized controlled trials (RCTs) was used to evaluate literature quality. A network meta-analysis was performed to evaluate the relative efficacy of non-pharmacological interventions on fatigue. Statistical analysis was performed using STATA 17.0 software.</div></div><div><h3>Results</h3><div>A total of 73 RCTs involving nine non-pharmacological interventions were included. The results of the network meta-analysis showed that exercise therapy (SMD = −<!--> <!-->0.53, 95 % CI [−<!--> <!-->0.74, −<!--> <!-->0.33]), cognitive-behavioral therapy (SMD = −<!--> <!-->0.64, 95 % CI [−<!--> <!-->1.05, −<!--> <!-->0.22]), acupuncture or massage therapy (SMD = −<!--> <!-->0.67, 95 % CI [−<!--> <!-->1.28, −<!--> <!-->0.06]), eHealth interventions (SMD = −<!--> <!-->0.42, 95 % CI [−<!--> <!-->0.66, −<!--> <!-->0.18]), and combined interventions (SMD = −<!--> <!-->0.79, 95 % CI [−<!--> <!-->1.27, −<!--> <!-->0.31]) were more effective than the control group in improving MS fatigue. Among them, combined interventions may be the most effective non-pharmacological intervention to improve fatigue in people with MS.</div></div><div><h3>Conclusion</h3><div>This network meta-analysis found that combined interventions, acupuncture or massage therapy, cognitive-behavioral therapy, exercise therapy, and eHealth interventions can improve fatigue in people with MS. These findings provide evidence-based data to support clinical decision-making.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105250"},"PeriodicalIF":7.1,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the work life of clinical nurse educators in Canadian hospitals through the Job Demands-Resources Model: A descriptive qualitative study","authors":"Emily Read ,&nbsp;Kateryna Metersky ,&nbsp;Linda Matthews ,&nbsp;Rachel MacLean","doi":"10.1016/j.ijnurstu.2025.105249","DOIUrl":"10.1016/j.ijnurstu.2025.105249","url":null,"abstract":"<div><h3>Background</h3><div>Clinical nurse educators play a vital role in supporting nursing staff development, clinical competency, and quality of care in acute care hospitals. Despite their importance, limited research has examined the demands and resources that shape their work life and effectiveness.</div></div><div><h3>Objective</h3><div>This study explored the job demands and resources influencing clinical nurse educators' experiences in two Canadian provinces, using the Job Demands-Resources (JD-R) model as a guiding framework.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design was used, involving in-depth, semi-structured interviews with 24 clinical nurse educators employed in acute care hospitals in Ontario and New Brunswick. Thematic analysis was conducted to identify patterns in participants' descriptions of their roles, responsibilities, challenges, and supports. Codes were developed inductively and organized deductively using the JD-R framework, distinguishing between challenge demands, hindrance demands, job-related resources, and personal resources.</div></div><div><h3>Results</h3><div>Clinical nurse educators experienced a range of challenge demands, including administrative responsibilities, educational duties, continuous professional learning, and leadership. These aspects of the role provided opportunities for growth but were often accompanied by hindrance demands such as role ambiguity, interpersonal conflict, excessive workload, and lack of recognition. Participants reported feeling undervalued and overextended, with role expectations varying widely across organizations. Despite these challenges, clinical nurse educators drew on job-related resources including supportive colleagues, positive workplace culture, and collaborative teams and personal resources such as coping strategies, motivation, professional development, and social support. When resources were insufficient, clinical nurse educators reported frustration, burnout, and intentions to leave the role. The findings align with the JD-R model, highlighting how imbalance between demands and resources can trigger the health impairment pathway.</div></div><div><h3>Conclusions</h3><div>Clinical nurse educators' effectiveness and retention are shaped by a complex interplay of job demands and resources. While challenge demands can be motivating, hindrance demands contribute to stress and burnout, particularly when not buffered by adequate support. Addressing role ambiguity, enhancing recognition, and investing in both structural and interpersonal resources are critical to sustaining the clinical nurse educator workforce in hospital settings.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105249"},"PeriodicalIF":7.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of non-pharmacological interventions for relieving thirst in intensive care unit patients: A network meta-analysis","authors":"Xing Shu ,&nbsp;Shuang Li ,&nbsp;Zewen Pan ,&nbsp;Hao Peng ,&nbsp;Jiayi Zhou ,&nbsp;Can Wang ,&nbsp;Mingfang Xiang","doi":"10.1016/j.ijnurstu.2025.105245","DOIUrl":"10.1016/j.ijnurstu.2025.105245","url":null,"abstract":"<div><h3>Background</h3><div>Thirst is a prevalent and clinically significant symptom among intensive care unit patients. However, the comparative effectiveness of various non-pharmacological interventions for relieving thirst remains largely unclear.</div></div><div><h3>Objectives</h3><div>To evaluate the comparative effectiveness of non-pharmacological interventions for thirst alleviation in intensive care unit patients through a synthesis of direct and indirect evidence.</div></div><div><h3>Design</h3><div>A systematic review and network meta-analysis.</div></div><div><h3>Data sources</h3><div>A comprehensive search of sixteen electronic databases and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> was conducted for randomized controlled trials from inception to November 20, 2024.</div></div><div><h3>Review methods</h3><div>Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. The primary analysis utilized random-effects network meta-analysis to assess the effectiveness of non-pharmacological interventions in reducing thirst intensity. The quality of evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA) online tool. This study was registered in PROSPERO (CRD42024606388).</div></div><div><h3>Results</h3><div>A total of 14 studies, encompassing 1642 critically ill patients, met the inclusion criteria and evaluated 13 non-pharmacological interventions for thirst alleviation. Compared to routine oral care, the following interventions showed statistically significant efficacy (all <em>P</em> &lt; 0.05), ordered by their surface under the cumulative ranking curve (SUCRA): mint liquid spray (82.4 %), room temperature water spray (82.3 %), menthol lozenge (81 %), lemon liquid spray (78.8 %), drinking a little ice-cold water (65.3 %), and ice-cold water spray (51.3 %). The CINeMA assessment indicated that the overall certainty of the evidence remained low.</div></div><div><h3>Conclusions</h3><div>This network meta-analysis suggests that mint liquid spray may appear to offer benefits for relieving thirst among ICU patients, indicating that spray-based moisturization is a promising strategy. We advocate for comprehensive ICU oral care, emphasizing tailored interventions and the integration of low-temperature and menthol adjuncts into standard care protocols. Such strategies may help alleviate thirst-related distress and optimize critical care outcomes. However, further high-quality, standardized studies are required to verify these findings.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105245"},"PeriodicalIF":7.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Effects of three peripherally inserted central catheters insertion techniques on catheterization outcomes: A randomized controlled trial” [Int. J. Nurs. Stud. 172 (2025) 105209]","authors":"Lan Li ,&nbsp;Xinlei Wu ,&nbsp;Lihui Lin ,&nbsp;Zhiyun Cai ,&nbsp;Xijun Ye ,&nbsp;Yufeng Lin ,&nbsp;Yajiao Wang ,&nbsp;Liu Yang","doi":"10.1016/j.ijnurstu.2025.105237","DOIUrl":"10.1016/j.ijnurstu.2025.105237","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"172 ","pages":"Article 105237"},"PeriodicalIF":7.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, trends and distribution of dementia among older adults from 1990 to 2023 in China: A comprehensive systematic review and meta-analysis","authors":"Jing-hong Liang ,&nbsp;Rui-xia Jia ,&nbsp;Ying-quan Wang ,&nbsp;Sheng Qian ,&nbsp;Lu Lin ,&nbsp;Yong Xu","doi":"10.1016/j.ijnurstu.2025.105247","DOIUrl":"10.1016/j.ijnurstu.2025.105247","url":null,"abstract":"<div><h3>Objective</h3><div>Dementia among the older adults represents a significant public health challenge in China, particularly in light of the country's evolving socioeconomic conditions and demographic transformations. This meta-analysis of recent research focuses on quantifying the prevalence of dementia among older adults in China between 1990 to 2023. Additionally, it explores the prevalence of dementia within specific demographic groups.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search of the PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases was conducted from their inception until September 2024. The search used terms like “dementia”, “prevalence” and “China”, combined with specific filters. Studies were included if they reported dementia prevalence data among adults in China. Two reviewers independently extracted data on study characteristics, total sample size, and dementia cases, and assessed study quality using predefined criteria. The overall dementia prevalence was calculated by pooling estimates with 95 % CIs. Subgroup analyses were performed based on age, sex, region, and study quality.</div></div><div><h3>Results</h3><div>A total of 132 studies involving 681,074 participants and 35,141 people with dementia from 32 provinces in China were identified. The overall pooled prevalence of dementia was found to be 4.76 %. Furthermore, the pooled prevalence of dementia exhibited a gradual increase from 1990 (2.43 %) to 2023 (5.74 %). Notably, when classified into different subgroups by economic development level, individuals residing in underdeveloped regions exhibited a prevalence of 5.82 %. In contrast, when categorized by geographical location, those in the Northeast demonstrated a prevalence of 13.66 %. The prevalence was notably higher among females, recorded at 7.94 %, in contrast to males, which stood at 4.00 %. Additionally, individuals aged over 90 years exhibited a prevalence of 32.92 %, significantly higher than those in the 60–70 age group (2.07 %), 70–80 age group (5.26 %), and 80–90 age group (14.03 %).</div></div><div><h3>Conclusions</h3><div>The prevalence of dementia in China is considerable, currently estimated at 4.76 % with an upward trend since 1990. It affects nearly one-third of those aged 90 and older, with clear disparities by sex, age, and region. These findings highlight the need for targeted prevention and early detection among high-risk groups.</div></div><div><h3>Registration</h3><div>INPLASY2024120073.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105247"},"PeriodicalIF":7.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of plastic cannulae in haemodialysis: A scoping review","authors":"Monica Schoch ,&nbsp;Debra Kerr ,&nbsp;Vicki Smith ,&nbsp;Rochelle Wynne","doi":"10.1016/j.ijnurstu.2025.105246","DOIUrl":"10.1016/j.ijnurstu.2025.105246","url":null,"abstract":"<div><h3>Background</h3><div>Metal needles have traditionally been used for cannulation of arteriovenous fistula and grafts in haemodialysis. Plastic cannulae have emerged as a potential alternative, particularly for patients with newly formed arteriovenous fistula or graft, or those that require more arm mobility during dialysis. Despite the potential for improved clinical outcomes, the introduction of plastic cannula into haemodialysis units globally has been variable. Empirical evidence related to the clinical advantages of plastic cannula in haemodialysis remains limited.</div></div><div><h3>Aim</h3><div>To map the existing literature to gain an understanding of global trends in the use of plastic cannula for arteriovenous fistula and arteriovenous grafts in patients with end-stage renal disease requiring haemodialysis.</div></div><div><h3>Methods</h3><div>A review of literature from published 1990 to May 2025 is reported. MEDLINE Complete, CINAHL Complete, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials, ProQuest, Trove, and Google Scholar were searched. English language articles describing the use of plastic cannula in adults for haemodialysis in any setting were eligible for inclusion. Two reviewers independently assessed title, abstract relevant full text papers. Data were analysed using narrative synthesis.</div></div><div><h3>Results</h3><div>Papers (N = 45) reporting randomised controlled trials, non-randomised experimental, cohort and cross-sectional studies, case reports, cost analyses, or literature reviews from Australia, Europe, the United States, Canada, New Zealand, and Asia met the inclusion criteria. Findings indicate increasing adoption of plastic cannulae in haemodialysis practice worldwide. Key barriers included the higher initial unit cost, and procedural complexities associated with implementing a new technique. Despite this, long-term cost-effectiveness was demonstrated, due to reductions in clinical interventions resulting from adverse outcomes. Plastic cannulae were linked to improved clinical outcomes such as less catastrophic tissue damage due to failed cannulations, lack of aborted haemodialysis sessions, and higher levels of patient comfort.</div></div><div><h3>Conclusion</h3><div>There is a growing global interest in plastic cannulae for haemodialysis vascular access. Although emerging evidence points to potential clinical and economic advantages, widespread adoption remains limited due to logistical challenges and higher initial costs. Robust, high-quality trials comparing metal needles versus plastic cannulae are required to accurately determine relative effectiveness. Trial design must accommodate an appropriate period of plastic cannulae practice integration.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105246"},"PeriodicalIF":7.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The second victim of adverse events in health care: A systematic review of qualitative research","authors":"Yinhui Deng ,&nbsp;Binbin Mo ,&nbsp;Baohong Xu ,&nbsp;Lili Wang ,&nbsp;Jialiang Lai ,&nbsp;Changhong Zhao","doi":"10.1016/j.ijnurstu.2025.105248","DOIUrl":"10.1016/j.ijnurstu.2025.105248","url":null,"abstract":"<div><h3>Background</h3><div>Adverse medical events not only harm patients, but also create second victims among healthcare professionals, causing significant psychological trauma and professional challenges. A critical issue confronting healthcare systems worldwide is that over two-thirds of healthcare professionals encounter such trauma during their careers.</div></div><div><h3>Objectives</h3><div>The purpose of this study is to examine the impact of the second victim phenomenon on individuals and organizations, as well as their reciprocal interactions.</div></div><div><h3>Design</h3><div>A qualitative systematic review.</div></div><div><h3>Data source</h3><div>Medline, Web of Science, Cochrane, Science Direct, CINAHL, and PsycINFO were searched from January 2015 until April 2025.</div></div><div><h3>Review methods</h3><div>Two individuals independently performed the literature screening, as well as the extraction and evaluation of information. Quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument for Qualitative Research, and data were integrated and summarized using the inductive analysis method.</div></div><div><h3>Results</h3><div>Three analytical themes emerged from 19 studies: (1) The double-helix emotional response mode, which highlights the dynamic game between emotional contraction and emotional expansion. (2) The dilemma of organizational support, focusing on the gap between the symbolic and substantive aspects of resource provision. (3) The systematic feedback of the second victim phenomenon, which explores the transition from personal post-traumatic growth to systemic evolution.</div></div><div><h3>Conclusions</h3><div>This study advances theoretical understanding of the second victim phenomenon by analyzing the double-helix emotional response mode, the dilemma of organizational support and the systematic feedback mechanism. It also offers innovative insights and practical approaches for enhancing and continuously optimizing healthcare quality.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105248"},"PeriodicalIF":7.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sterile water injections for managing abdominal labour contraction pain: A randomised double blind placebo-controlled trial","authors":"Nigel Lee ,&nbsp;Lena B. Mårtensson ,&nbsp;Yu Gao ,&nbsp;Leonie Callaway ,&nbsp;Belinda Barnett ,&nbsp;Sania Hellyer ,&nbsp;Lauren Kearney ,&nbsp;Sue Kildea","doi":"10.1016/j.ijnurstu.2025.105244","DOIUrl":"10.1016/j.ijnurstu.2025.105244","url":null,"abstract":"<div><h3>Background</h3><div>Sterile water injections have been demonstrated to effectively manage back pain experienced during labour with no side effects other than the administration pain. Abdominal labour pain differs to back pain in location and likely physiological derivation. It is not known if sterile water injections would be efficacious in the relief of abdominal labour contraction pain.</div></div><div><h3>Objective</h3><div>To assess the efficacy of sterile water injections to reduce abdominal labour contraction pain.</div></div><div><h3>Design</h3><div>A two-arm superiority randomised placebo-controlled trial.</div></div><div><h3>Setting</h3><div>A referral maternity hospital in Brisbane, Australia.</div></div><div><h3>Participants</h3><div>Women in spontaneous or induced labour at term requesting analgesia.</div></div><div><h3>Methods</h3><div>Between April 2022 and November 2023 consenting participants were assigned (1:1) by an independently generated randomisation schedule to injections of either sterile water or saline placebo. The primary outcome was the difference between groups in self-reported visual analogue pain score at 30 min following allocated treatment. Secondary outcomes included use of pharmacologic analgesia following allocation. Analysis was by intention to treat.</div></div><div><h3>Results</h3><div>160 women were randomised to sterile water injections (n = 81) or injections of saline placebo (n = 79). Seven participants withdrew prior to treatment. Primary outcome data was provided by 68 women (intervention) and 64 (placebo). The mean visual analogue scores at 30 min were: intervention: 52.13 mm (with 100 mm indicating worst conceivable pain) and placebo: 71.14 mm; mean difference: −<!--> <!-->19.00 mm (95 % Confidence interval (CI) −<!--> <!-->26.10 to −<!--> <!-->11.91). Pain scores in the secondary repeated measures model at 60 min post treatment were (61.28 mm vs.76.15 mm) −<!--> <!-->14.84 (95 % CI −<!--> <!-->22.23 to −<!--> <!-->7.46). There was no difference in pain scores at 90 min, use of other pharmacological analgesia, or maternal or neonatal outcomes.</div></div><div><h3>Conclusion</h3><div>Sterile water injections provided a statistically significant reduction in pain when compared to a placebo for up to 60 min following treatment. However, the use of other pharmacological analgesia such as epidural did not differ between groups.</div></div><div><h3>Trial registration</h3><div>The trial is registered at the Australian and New Zealand Clinical Trials Registry (Trial ID: ACTRN12621001036808). Registration date 5/08/2021. First recruitment 29th April 2022.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105244"},"PeriodicalIF":7.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional support powered by artificial intelligence in healthcare settings: A scoping review of technologies, contents, and outcomes","authors":"Yingjia Qian ,&nbsp;Wenjuan Tang ,&nbsp;Tingting Xu ,&nbsp;Daqiao Zhu ,&nbsp;Wenzhe Hua","doi":"10.1016/j.ijnurstu.2025.105243","DOIUrl":"10.1016/j.ijnurstu.2025.105243","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, the application of artificial intelligence technologies for emotional support in healthcare settings has increased. However, less is known about the quality and effectiveness of artificial intelligence-based emotional support.</div></div><div><h3>Objectives</h3><div>This scoping review aimed to investigate the characteristics, supporting content, and outcomes (usability, acceptability, and effectiveness) of artificial intelligence-based emotional support in healthcare settings.</div></div><div><h3>Methods</h3><div>The scoping review followed the five-stage framework proposed by Arksey and O'Malley and the reporting standards established in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. In July 2025, literature searches were conducted across 10 databases without restrictions on study design. The Mixed Methods Appraisal Tool was used to assess quality. Results were synthesized narratively.</div></div><div><h3>Results</h3><div>A total of 20 studies involving 4703 participants were included. Some studies exhibited methodological limitations, including insufficient blinding and inadequate control of confounding factors. Artificial intelligence-based emotional support systems varied in their technical characteristics, with cognitive-behavioral therapy and mindfulness being the most common foundation for the design of supportive content. Among patients, caregivers, and healthcare providers, these systems demonstrated a degree of usability and acceptability and were effective in improving a range of emotional states and emotion-related capacities. However, limitations persisted regarding technology, supportive content, specific emotional indicators, and sustained effectiveness.</div></div><div><h3>Conclusion</h3><div>This review identified substantial heterogeneity in the technologies and supportive content of artificial intelligence-based emotional support in healthcare settings. While these systems show promising potential, their limitations must be carefully considered in practice. Future research should adopt more rigorous experimental designs and increase nurse involvement in both technology development and study implementation. This review can help nursing professionals better understand and utilize artificial intelligence to provide emotional support and improve patients' emotional well-being.</div></div><div><h3>Registration</h3><div>This review has been registered in PROSPERO (CRD42025645966).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"172 ","pages":"Article 105243"},"PeriodicalIF":7.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}