Pub Date : 2026-01-29DOI: 10.1016/j.ijnurstu.2026.105363
Marina Bogiatzis, Wendy Smyth, Mariann Hadland, Laura Irving, Cate Nagle
{"title":"Patient and nurse perceptions of electronic medical records in an acute setting: A multi-method qualitative study","authors":"Marina Bogiatzis, Wendy Smyth, Mariann Hadland, Laura Irving, Cate Nagle","doi":"10.1016/j.ijnurstu.2026.105363","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105363","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"23 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071688","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}
Pub Date : 2026-01-26DOI: 10.1016/j.ijnurstu.2026.105361
Albert Westergren
{"title":"Measuring what matters, family-centred interventions, person-level outcomes, and the value of Modern Test Theory","authors":"Albert Westergren","doi":"10.1016/j.ijnurstu.2026.105361","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105361","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"36 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047856","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}
Pub Date : 2026-01-26DOI: 10.1016/j.ijnurstu.2026.105358
Jessica Longhini, Federica Canzan, Erika Bassi, Alberto Dal Molin, Beatrice Albanesi, Tatiana Bolgeo, Anna Brugnolli, Sara Campagna, Valerio Dimonte, Alvisa Palese, Elisa Ambrosi, Workgroup, Fabio Vicariotto, Giulia Randon, Maria Grazia Cengia, Sonia Bogotto, Claudio Maliziola, Katia Moffa, Sabrina Contini, Luisella Canta, Stefano Toccoli
Family involvement in care has been shown to improve patient outcomes and reduce family caregiver burden. However, nurses' attitudes toward family participation vary widely and are influenced by multiple individual and contextual factors. Despite international evidence, there is a lack of data in relation to individual psycho-emotional and organizational predictors across settings.
{"title":"Which individual and organizational factors shape nurses' attitudes toward family involvement in nursing care? A multicenter cross-sectional study","authors":"Jessica Longhini, Federica Canzan, Erika Bassi, Alberto Dal Molin, Beatrice Albanesi, Tatiana Bolgeo, Anna Brugnolli, Sara Campagna, Valerio Dimonte, Alvisa Palese, Elisa Ambrosi, Workgroup, Fabio Vicariotto, Giulia Randon, Maria Grazia Cengia, Sonia Bogotto, Claudio Maliziola, Katia Moffa, Sabrina Contini, Luisella Canta, Stefano Toccoli","doi":"10.1016/j.ijnurstu.2026.105358","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105358","url":null,"abstract":"Family involvement in care has been shown to improve patient outcomes and reduce family caregiver burden. However, nurses' attitudes toward family participation vary widely and are influenced by multiple individual and contextual factors. Despite international evidence, there is a lack of data in relation to individual psycho-emotional and organizational predictors across settings.","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"1 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047858","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}
Pub Date : 2026-01-26DOI: 10.1016/j.ijnurstu.2026.105362
Koen Milisen , Sining Zeng , Ellen Bruynseraede , Anke Ceusters , Geert Verbeke , Kelu Yang , Steffen Rex , Marieke Schuurmans , Elke Detroyer
Background
Delirium is associated with increased mortality and morbidity, prolonged hospital stays, and a heightened risk of developing dementia, while its complete prevention remains challenging. Therefore, an efficient and time-saving screening tool is essential for the timely detection of delirium, enabling prompt intervention and reducing the associated healthcare burden. The original 13-item Delirium Observation Screening Scale (DOSS) is widely used and well-validated, but its relatively high workload leaves room for simplification.
Objective
This study aimed to develop and validate a shortened version of the DOSS (s-DOSS) to reduce screening burden while maintaining diagnostic accuracy.
Methods
The s-DOSS was developed in two phases. First, the content validity index (CVI) of the original 13-item DOSS was assessed through ratings from 14 delirium experts. Second, psychometric properties were assessed using 16,110 routine DOSS assessments from hospitalized patients. Item response theory parameters, classical test theory indices, and inter-item correlations were examined to inform item retention or deletion. A refined factor structure of the s-DOSS was subsequently evaluated. Finally, psychometric validation of the s-DOSS was conducted via secondary analysis of a prospective study, comparing its diagnostic performance to the Confusion Assessment Method (CAM) in 113 paired patient assessments.
Results
Four items were removed from the original DOSS. “Attention to conversation” was excluded due to conceptual redundancy, a low collected item-total correlation, and limited information contribution. The items ‘remembers events’, ‘pulls tubes’, and ‘sudden emotional’ were removed because of poor content validity, redundancy or local dependence, and weak internal coherence with the remaining items. The resulting 9-item s-DOSS demonstrated an average scale-level CVI (S-CVI/Ave) of 0.833 and a Cronbach's α of 0.853. Using a cutoff point of two, s-DOSS achieved a sensitivity of 90.9% (95% CI: 62–98), a specificity of 92.2% (95% CI: 85–96), and an overall diagnostic accuracy of 92.0% (95% CI: 86–96). The area under the ROC curve (AUC) was 0.935 (95% CI: 0.822–1.000).
Conclusion
The first validation of the 9-item s-DOSS suggests that it is a reliable and efficient tool for delirium screening, maintaining high diagnostic accuracy while reducing workload. Further adequately powered, multi-site validation studies are required to confirm the robustness of the cut-off and diagnostic performance across clinical settings.
{"title":"Development of a short version of the Delirium Observation Screening Scale (s-DOSS): A psychometric validation study","authors":"Koen Milisen , Sining Zeng , Ellen Bruynseraede , Anke Ceusters , Geert Verbeke , Kelu Yang , Steffen Rex , Marieke Schuurmans , Elke Detroyer","doi":"10.1016/j.ijnurstu.2026.105362","DOIUrl":"10.1016/j.ijnurstu.2026.105362","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is associated with increased mortality and morbidity, prolonged hospital stays, and a heightened risk of developing dementia, while its complete prevention remains challenging. Therefore, an efficient and time-saving screening tool is essential for the timely detection of delirium, enabling prompt intervention and reducing the associated healthcare burden. The original 13-item Delirium Observation Screening Scale (DOSS) is widely used and well-validated, but its relatively high workload leaves room for simplification.</div></div><div><h3>Objective</h3><div>This study aimed to develop and validate a shortened version of the DOSS (s-DOSS) to reduce screening burden while maintaining diagnostic accuracy.</div></div><div><h3>Methods</h3><div>The s-DOSS was developed in two phases. First, the content validity index (CVI) of the original 13-item DOSS was assessed through ratings from 14 delirium experts. Second, psychometric properties were assessed using 16,110 routine DOSS assessments from hospitalized patients. Item response theory parameters, classical test theory indices, and inter-item correlations were examined to inform item retention or deletion. A refined factor structure of the s-DOSS was subsequently evaluated. Finally, psychometric validation of the s-DOSS was conducted via secondary analysis of a prospective study, comparing its diagnostic performance to the Confusion Assessment Method (CAM) in 113 paired patient assessments.</div></div><div><h3>Results</h3><div>Four items were removed from the original DOSS. “Attention to conversation” was excluded due to conceptual redundancy, a low collected item-total correlation, and limited information contribution. The items ‘remembers events’, ‘pulls tubes’, and ‘sudden emotional’ were removed because of poor content validity, redundancy or local dependence, and weak internal coherence with the remaining items. The resulting 9-item s-DOSS demonstrated an average scale-level CVI (S-CVI/Ave) of 0.833 and a Cronbach's α of 0.853. Using a cutoff point of two, s-DOSS achieved a sensitivity of 90.9% (95% CI: 62–98), a specificity of 92.2% (95% CI: 85–96), and an overall diagnostic accuracy of 92.0% (95% CI: 86–96). The area under the ROC curve (AUC) was 0.935 (95% CI: 0.822–1.000).</div></div><div><h3>Conclusion</h3><div>The first validation of the 9-item s-DOSS suggests that it is a reliable and efficient tool for delirium screening, maintaining high diagnostic accuracy while reducing workload. Further adequately powered, multi-site validation studies are required to confirm the robustness of the cut-off and diagnostic performance across clinical settings.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105362"},"PeriodicalIF":7.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047855","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}
Pub Date : 2026-01-23DOI: 10.1016/j.ijnurstu.2026.105351
Shengzhang Chen , Binyan Chen , Jiaxin Shao , Miwen Zou , Jinghao Zhou , Jiayi Teng , Fuman Cai , Pan Huang
Background
Cognitive decline is a major public health concern in aging populations. Emerging evidence suggests that Internet engagement may provide mental stimulation and slow cognitive aging, but longitudinal cross-national evidence remains limited.
Objective
This study aimed to examine how first time Internet use relates to cognitive trajectories in middle-aged and older people, comparing cognitive performance before and after Internet adoption in two cohorts.
Design
A longitudinal analysis was conducted using data from two cohort studies: the English Longitudinal Study of Aging (ELSA) and the China Health and Retirement Longitudinal Study (CHARLS).
Methods
Participants were aged ≥ 45 years and had repeated cognitive assessments using the Mini-Mental State Examination. Global cognition and episodic memory were the primary outcomes, orientation, attention and calculation were also measured. First time Internet use was a time varying exposure. Linear mixed effects models were used to compare cognitive slopes before versus after Internet adoption within individuals, adjusting for age, education, and other covariates. Beta coefficients (β) with 95% confidence intervals (CI) were reported.
Results
At baseline, Internet users had higher cognitive scores than non-users, particularly for episodic memory in ELSA (β = 0.607, 95% CI 0.528–0.686) and global cognition in CHARLS (β = 0.402, 95% CI 0.365–0.439). After Internet adoption, cognitive trajectories improved mainly in global cognition and episodic memory. In ELSA, post-adoption slopes were more favorable for global cognition (β = 0.110, 95% CI 0.061–0.159) and episodic memory (β = 0.410, 95% CI 0.378–0.442). In CHARLS, episodic memory also improved after adoption (β = 0.044, 95% CI 0.025–0.063), while the post-adoption change in global cognition was not statistically significant (β = 0.013, 95% CI − 0.001–0.027). Orientation, attention and calculation showed no consistent post-adoption benefits across cohorts. The protective effect of Internet use was greater in ELSA than in CHARLS, and it varied by age group. Younger participants benefited more in ELSA, whereas in CHARLS the effect was greatest in those aged ≥ 65 years.
Conclusions
Initiating Internet use in mid-to-later life was associated with a slower decline in cognitive function, especially memory. The effects varied by cognitive domain and age, suggesting that digital engagement may support brain health in aging. Encouraging Internet use among older people could help maintain cognitive function in later life.
认知能力下降是老龄化人群中一个主要的公共卫生问题。新出现的证据表明，互联网参与可能提供精神刺激和减缓认知老化，但纵向跨国证据仍然有限。目的本研究旨在探讨首次使用互联网与中老年人认知轨迹的关系，比较两组人群在使用互联网前后的认知表现。采用英国老龄化纵向研究（ELSA）和中国健康与退休纵向研究（CHARLS）两项队列研究的数据进行纵向分析。方法参与者年龄≥45岁，使用简易精神状态检查重复进行认知评估。整体认知和情景记忆是主要结果，取向、注意力和计算能力也被测量。第一次使用互联网是一个时变暴露。线性混合效应模型用于比较个体在采用互联网之前和之后的认知斜率，调整了年龄、教育和其他协变量。报告了β系数（β）和95%置信区间（CI）。结果在基线上，互联网用户的认知得分高于非互联网用户，特别是在ELSA的情景记忆（β = 0.607, 95% CI 0.528-0.686）和CHARLS的整体认知（β = 0.402, 95% CI 0.365-0.439）。采用互联网后，认知轨迹的改善主要在全局认知和情景记忆方面。在ELSA中，收养后斜坡对整体认知（β = 0.110, 95% CI 0.061-0.159）和情景记忆（β = 0.410, 95% CI 0.378-0.442）更有利。在CHARLS中，收养后情景记忆也有所改善（β = 0.044, 95% CI 0.025-0.063），而收养后整体认知的变化无统计学意义（β = 0.013, 95% CI - 0.001-0.027）。取向、注意力和计算能力在收养后没有一致的益处。互联网使用的保护作用在ELSA中比在CHARLS中更大，并且因年龄组而异。年轻的受试者在ELSA中获益更多，而在CHARLS中，年龄≥65岁的受试者获益最大。在中老年开始使用互联网与认知功能，特别是记忆功能的较慢下降有关。影响因认知领域和年龄而异，这表明数字参与可能有助于老年人的大脑健康。鼓励老年人使用互联网有助于在以后的生活中保持认知功能。
{"title":"Internet use and cognitive trajectories in middle-aged and older people: A longitudinal mixed effects analysis of two cohorts","authors":"Shengzhang Chen , Binyan Chen , Jiaxin Shao , Miwen Zou , Jinghao Zhou , Jiayi Teng , Fuman Cai , Pan Huang","doi":"10.1016/j.ijnurstu.2026.105351","DOIUrl":"10.1016/j.ijnurstu.2026.105351","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive decline is a major public health concern in aging populations. Emerging evidence suggests that Internet engagement may provide mental stimulation and slow cognitive aging, but longitudinal cross-national evidence remains limited.</div></div><div><h3>Objective</h3><div>This study aimed to examine how first time Internet use relates to cognitive trajectories in middle-aged and older people, comparing cognitive performance before and after Internet adoption in two cohorts.</div></div><div><h3>Design</h3><div>A longitudinal analysis was conducted using data from two cohort studies: the English Longitudinal Study of Aging (ELSA) and the China Health and Retirement Longitudinal Study (CHARLS).</div></div><div><h3>Methods</h3><div>Participants were aged ≥<!--> <!-->45 years and had repeated cognitive assessments using the Mini-Mental State Examination. Global cognition and episodic memory were the primary outcomes, orientation, attention and calculation were also measured. First time Internet use was a time varying exposure. Linear mixed effects models were used to compare cognitive slopes before versus after Internet adoption within individuals, adjusting for age, education, and other covariates. Beta coefficients (β) with 95% confidence intervals (CI) were reported.</div></div><div><h3>Results</h3><div>At baseline, Internet users had higher cognitive scores than non-users, particularly for episodic memory in ELSA (β = 0.607, 95% CI 0.528–0.686) and global cognition in CHARLS (β = 0.402, 95% CI 0.365–0.439). After Internet adoption, cognitive trajectories improved mainly in global cognition and episodic memory. In ELSA, post-adoption slopes were more favorable for global cognition (β = 0.110, 95% CI 0.061–0.159) and episodic memory (β = 0.410, 95% CI 0.378–0.442). In CHARLS, episodic memory also improved after adoption (β = 0.044, 95% CI 0.025–0.063), while the post-adoption change in global cognition was not statistically significant (β = 0.013, 95% CI −<!--> <!-->0.001–0.027). Orientation, attention and calculation showed no consistent post-adoption benefits across cohorts. The protective effect of Internet use was greater in ELSA than in CHARLS, and it varied by age group. Younger participants benefited more in ELSA, whereas in CHARLS the effect was greatest in those aged ≥<!--> <!-->65 years.</div></div><div><h3>Conclusions</h3><div>Initiating Internet use in mid-to-later life was associated with a slower decline in cognitive function, especially memory. The effects varied by cognitive domain and age, suggesting that digital engagement may support brain health in aging. Encouraging Internet use among older people could help maintain cognitive function in later life.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105351"},"PeriodicalIF":7.1,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032880","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}
Pub Date : 2026-01-22DOI: 10.1016/j.ijnurstu.2026.105349
Rose Lin, Sara Laureen Bartels, Jing Jing Su
{"title":"Experience of living with mild cognitive impairment: A meta-synthesis and conceptual integration of dynamic cognitive, psychological, and social dimensions","authors":"Rose Lin, Sara Laureen Bartels, Jing Jing Su","doi":"10.1016/j.ijnurstu.2026.105349","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105349","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"43 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032881","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}
Pub Date : 2026-01-21DOI: 10.1016/j.ijnurstu.2026.105348
K. Mikkonen , M. Tomietto , J.J. Lee , F. Ye , P. Mandysova , J. Pekara , J. Kommusaar , M. Kangasniemi , X. Liao , G. Cicolini , V. Simonetti , J. Unsworth , M.F. Vizcaya-Moreno , M. Domingo-Pozo , M.F. Liu , M. Yamakawa , M. Utsumi , F. Domeisen Benedetti , A. Fringer , T.A. Hanssen , E. Jarva
Background
The worldwide acceleration of digital transformation in healthcare underscores the need for professionals to continuously adapt and sustain robust digital health competence, shaped not only by individual characteristics and institutional environments but also by broader social, cultural, and geopolitical factors.
Objective
This study aimed to identify distinct clusters of digital health competence among healthcare professionals across 19 diverse countries and regions, and to examine the factors influencing the development and distribution of these competence clusters.
Methods
A cross-sectional international survey study was conducted between 2023 and 2024, using a validated survey instrument measuring digital health competence and its influencing factors. Data were collected from healthcare professionals in 19 countries and regions (n = 6440; n = 5945 used for this study), following a harmonised protocol with shared demographic templates and instruments. K-means cluster analysis was employed to derive digital competence profiles, with comparative analyses conducted to investigate associations between the identified clusters and individual characteristics (e.g., age, education, professional experience).
Results
Five distinct clusters of digital health competence were identified: (1) Beginners, (2) Developing Professionals, (3) Emerging Users, (4) Proficient Practitioners, and (5) Pioneers. Higher competence clusters (4 and 5) were associated with younger age, higher education, hospital-based work, and stronger perceived support from management, organisational structures, and colleagues. In contrast, lower-performing clusters reported limited digital engagement and minimal support. Perceived leadership influence, particularly managerial commitment to digital change, was a key differentiator across clusters.
Conclusions
The findings demonstrate substantial variation in digital health competence across healthcare professionals internationally. Cluster-specific strategies, such as targeted upskilling, peer mentoring, and leadership engagement, are needed to address competence gaps. The results provide a foundation for policy development and workforce training frameworks aimed at strengthening digital readiness in global healthcare systems. Future research should explore longitudinal competence development and evaluate targeted interventions.
{"title":"Digital health competence among healthcare professionals: A cross-sectional cluster analysis across 19 countries and regions","authors":"K. Mikkonen , M. Tomietto , J.J. Lee , F. Ye , P. Mandysova , J. Pekara , J. Kommusaar , M. Kangasniemi , X. Liao , G. Cicolini , V. Simonetti , J. Unsworth , M.F. Vizcaya-Moreno , M. Domingo-Pozo , M.F. Liu , M. Yamakawa , M. Utsumi , F. Domeisen Benedetti , A. Fringer , T.A. Hanssen , E. Jarva","doi":"10.1016/j.ijnurstu.2026.105348","DOIUrl":"10.1016/j.ijnurstu.2026.105348","url":null,"abstract":"<div><h3>Background</h3><div>The worldwide acceleration of digital transformation in healthcare underscores the need for professionals to continuously adapt and sustain robust digital health competence, shaped not only by individual characteristics and institutional environments but also by broader social, cultural, and geopolitical factors.</div></div><div><h3>Objective</h3><div>This study aimed to identify distinct clusters of digital health competence among healthcare professionals across 19 diverse countries and regions, and to examine the factors influencing the development and distribution of these competence clusters.</div></div><div><h3>Methods</h3><div>A cross-sectional international survey study was conducted between 2023 and 2024, using a validated survey instrument measuring digital health competence and its influencing factors. Data were collected from healthcare professionals in 19 countries and regions (n = 6440; n = 5945 used for this study), following a harmonised protocol with shared demographic templates and instruments. K-means cluster analysis was employed to derive digital competence profiles, with comparative analyses conducted to investigate associations between the identified clusters and individual characteristics (e.g., age, education, professional experience).</div></div><div><h3>Results</h3><div>Five distinct clusters of digital health competence were identified: (1) Beginners, (2) Developing Professionals, (3) Emerging Users, (4) Proficient Practitioners, and (5) Pioneers. Higher competence clusters (4 and 5) were associated with younger age, higher education, hospital-based work, and stronger perceived support from management, organisational structures, and colleagues. In contrast, lower-performing clusters reported limited digital engagement and minimal support. Perceived leadership influence, particularly managerial commitment to digital change, was a key differentiator across clusters.</div></div><div><h3>Conclusions</h3><div>The findings demonstrate substantial variation in digital health competence across healthcare professionals internationally. Cluster-specific strategies, such as targeted upskilling, peer mentoring, and leadership engagement, are needed to address competence gaps. The results provide a foundation for policy development and workforce training frameworks aimed at strengthening digital readiness in global healthcare systems. Future research should explore longitudinal competence development and evaluate targeted interventions.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105348"},"PeriodicalIF":7.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014631","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}
Pub Date : 2026-01-20DOI: 10.1016/j.ijnurstu.2026.105350
Ying Xin Li , Yan Ling Hu , Han Mei Peng , Yuan Li , Xing Li Wan , Yue Li , Wen Qian Su , Li Ming Yang , Xi Huang , Qiong Chen
<div><h3>Background</h3><div>In China, preterm infants are commonly cared for in neonatal intensive care units, where parent-infant separation disrupts bonding and causes parental distress. Kangaroo mother care can restore this bond, but its adoption in Chinese neonatal intensive care units remains limited. Although cultural norms and institutional practices are shown to influence its implementation, little is known about how these factors shape parents' gendered experiences.</div></div><div><h3>Objective</h3><div>This study integrated the views of healthcare professionals, fathers, and mothers to explore: (1) The influence of sociocultural norms and gender roles on kangaroo mother care practices; (2) Parents' perceptions of gendered responsibilities and roles in kangaroo mother care; (3) Gender-specific barriers and facilitators to participation; and (4) The transformative effects of kangaroo mother care on parents and infants.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design was adopted. Between March and June 2025, purposive sampling was used to recruit 32 participants—including healthcare professionals (n = 11), fathers (n = 9), and mothers (n = 12) of preterm infants—from a tertiary hospital in Sichuan, China. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Based on interviews with 32 participants (11 healthcare professionals, 9 fathers, and 12 mothers), four themes were identified: (1) The influence of sociocultural norms and gender roles on participation in kangaroo mother care: Parents experienced tensions between traditional gender expectations and emerging egalitarian ideals of parenting; (2) Parental perceptions of appropriateness and unique contributions in kangaroo mother care: Mothers showed sensitivity in emotional interaction, while fathers fostered bonding and provided support, rendering their roles complementary and irreplaceable; (3) Gendered challenges and facilitators of kangaroo mother care: Fathers were constrained by work and limited paternity leave, while mothers faced postpartum restrictions; however, supportive environments and targeted guidance facilitated participation and individual traits sometimes shaped experiences beyond gender; and (4) The transformative effects of kangaroo mother care on parents and infants: Kangaroo mother care reinforced parental identity and strengthened parent–infant bonding.</div></div><div><h3>Conclusion</h3><div>Kangaroo mother care participation in Chinese neonatal intensive care units is shaped by gender norms, institutional constraints, and individual factors. To promote equitable parental involvement, policy actions such as more flexible and extended paternity leave are needed, alongside father-inclusive, gender-sensitive clinical support and standardized guidance from healthcare professionals. Strengthening nursing education to build skills in gender-sensitive family-c
{"title":"Gender perspectives on experiences of kangaroo mother care for preterm infants in neonatal intensive care unit in China: A qualitative study","authors":"Ying Xin Li , Yan Ling Hu , Han Mei Peng , Yuan Li , Xing Li Wan , Yue Li , Wen Qian Su , Li Ming Yang , Xi Huang , Qiong Chen","doi":"10.1016/j.ijnurstu.2026.105350","DOIUrl":"10.1016/j.ijnurstu.2026.105350","url":null,"abstract":"<div><h3>Background</h3><div>In China, preterm infants are commonly cared for in neonatal intensive care units, where parent-infant separation disrupts bonding and causes parental distress. Kangaroo mother care can restore this bond, but its adoption in Chinese neonatal intensive care units remains limited. Although cultural norms and institutional practices are shown to influence its implementation, little is known about how these factors shape parents' gendered experiences.</div></div><div><h3>Objective</h3><div>This study integrated the views of healthcare professionals, fathers, and mothers to explore: (1) The influence of sociocultural norms and gender roles on kangaroo mother care practices; (2) Parents' perceptions of gendered responsibilities and roles in kangaroo mother care; (3) Gender-specific barriers and facilitators to participation; and (4) The transformative effects of kangaroo mother care on parents and infants.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design was adopted. Between March and June 2025, purposive sampling was used to recruit 32 participants—including healthcare professionals (n = 11), fathers (n = 9), and mothers (n = 12) of preterm infants—from a tertiary hospital in Sichuan, China. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis.</div></div><div><h3>Results</h3><div>Based on interviews with 32 participants (11 healthcare professionals, 9 fathers, and 12 mothers), four themes were identified: (1) The influence of sociocultural norms and gender roles on participation in kangaroo mother care: Parents experienced tensions between traditional gender expectations and emerging egalitarian ideals of parenting; (2) Parental perceptions of appropriateness and unique contributions in kangaroo mother care: Mothers showed sensitivity in emotional interaction, while fathers fostered bonding and provided support, rendering their roles complementary and irreplaceable; (3) Gendered challenges and facilitators of kangaroo mother care: Fathers were constrained by work and limited paternity leave, while mothers faced postpartum restrictions; however, supportive environments and targeted guidance facilitated participation and individual traits sometimes shaped experiences beyond gender; and (4) The transformative effects of kangaroo mother care on parents and infants: Kangaroo mother care reinforced parental identity and strengthened parent–infant bonding.</div></div><div><h3>Conclusion</h3><div>Kangaroo mother care participation in Chinese neonatal intensive care units is shaped by gender norms, institutional constraints, and individual factors. To promote equitable parental involvement, policy actions such as more flexible and extended paternity leave are needed, alongside father-inclusive, gender-sensitive clinical support and standardized guidance from healthcare professionals. Strengthening nursing education to build skills in gender-sensitive family-c","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105350"},"PeriodicalIF":7.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146014635","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}
Pub Date : 2026-01-19DOI: 10.1016/j.ijnurstu.2026.105347
Emma S. Hock , Bryony Waters-Harvey , Alys Wyn Griffiths , Emily Fisher , Tamara Backhouse , Iria Cunha , Sion Scott , Clarissa Giebel , Liz Jones , Jignasa Mehta , Karen Spilsbury , Andrew Booth , Reena Devi , Mary Gemma Cherry
<div><h3>Objectives</h3><div>Wandering is a common behaviour among people with dementia living in care homes, driven by various factors such as enjoyment, a sense of purpose, lifelong habits, and social interaction. These elements can bring both physical and mental benefits, highlighting the need for strategies that enable safe wandering while respecting individual autonomy. This realist synthesis aimed to explore these strategies and the conditions under which they lead to successful outcomes.</div></div><div><h3>Methods</h3><div>This realist synthesis involved scoping the literature to develop initial theoretical explanations for how different strategies could support safe wandering. From this literature, we developed context-mechanism-outcome configurations, which we combined into initial programme theories. Systematic searches were then used to test and refine these programme theories. Studies were prioritised for inclusion based on criteria of relevance and richness. We extracted data pertinent to the initial programme theories and documented relevance, richness, and rigour. We synthesised data into five refined programme theories. At each stage of the process, we collaborated with stakeholders to develop and validate the strategies.</div></div><div><h3>Results</h3><div>The review included 79 evidence sources, leading to five refined programme theories. 1) <strong>Personalised Care:</strong> Emphasising the importance of staff practicing person-centred care by understanding residents, their reasons for wandering, and their life histories. 2) <strong>Monitoring:</strong> Effective monitoring requires good visual access or technological solutions that enable staff to observe residents, and detect when residents need support to walk while also enabling resident freedom and independence. 3) <strong>Navigation:</strong> Navigation is facilitated by dementia-friendly design features and environmental cues, which help minimise the challenges residents face due to diminished orientation and wayfinding abilities. 4) <strong>Managing access:</strong> Involving balancing residents' safety and autonomy. Strategies may include restricting access to unsafe areas by locking doors or using technology and camouflage, while ensuring access to safe spaces. 5) <strong>Hydration and nutrition:</strong> Hydration and nutrition (e.g., suitable snacks) is provided to prevent weight loss for residents who wander and may not stay seated during meals. These theories provide insight into supporting safe wandering, leading to improved wellbeing for both residents and staff, enhanced safety and autonomy for residents, and reduced staff anxiety.</div></div><div><h3>Discussion</h3><div>Strategies that create a supportive environment, provide physical assistance, and support hydration and nutrition enabled residents to wander safely. Identified strategies improved wellbeing for both residents and staff. However, the same strategies also led to ethical concerns around digita
{"title":"Strategies to support safe wandering in care homes for older adults – what works, for whom, and in which circumstances?: A realist synthesis","authors":"Emma S. Hock , Bryony Waters-Harvey , Alys Wyn Griffiths , Emily Fisher , Tamara Backhouse , Iria Cunha , Sion Scott , Clarissa Giebel , Liz Jones , Jignasa Mehta , Karen Spilsbury , Andrew Booth , Reena Devi , Mary Gemma Cherry","doi":"10.1016/j.ijnurstu.2026.105347","DOIUrl":"10.1016/j.ijnurstu.2026.105347","url":null,"abstract":"<div><h3>Objectives</h3><div>Wandering is a common behaviour among people with dementia living in care homes, driven by various factors such as enjoyment, a sense of purpose, lifelong habits, and social interaction. These elements can bring both physical and mental benefits, highlighting the need for strategies that enable safe wandering while respecting individual autonomy. This realist synthesis aimed to explore these strategies and the conditions under which they lead to successful outcomes.</div></div><div><h3>Methods</h3><div>This realist synthesis involved scoping the literature to develop initial theoretical explanations for how different strategies could support safe wandering. From this literature, we developed context-mechanism-outcome configurations, which we combined into initial programme theories. Systematic searches were then used to test and refine these programme theories. Studies were prioritised for inclusion based on criteria of relevance and richness. We extracted data pertinent to the initial programme theories and documented relevance, richness, and rigour. We synthesised data into five refined programme theories. At each stage of the process, we collaborated with stakeholders to develop and validate the strategies.</div></div><div><h3>Results</h3><div>The review included 79 evidence sources, leading to five refined programme theories. 1) <strong>Personalised Care:</strong> Emphasising the importance of staff practicing person-centred care by understanding residents, their reasons for wandering, and their life histories. 2) <strong>Monitoring:</strong> Effective monitoring requires good visual access or technological solutions that enable staff to observe residents, and detect when residents need support to walk while also enabling resident freedom and independence. 3) <strong>Navigation:</strong> Navigation is facilitated by dementia-friendly design features and environmental cues, which help minimise the challenges residents face due to diminished orientation and wayfinding abilities. 4) <strong>Managing access:</strong> Involving balancing residents' safety and autonomy. Strategies may include restricting access to unsafe areas by locking doors or using technology and camouflage, while ensuring access to safe spaces. 5) <strong>Hydration and nutrition:</strong> Hydration and nutrition (e.g., suitable snacks) is provided to prevent weight loss for residents who wander and may not stay seated during meals. These theories provide insight into supporting safe wandering, leading to improved wellbeing for both residents and staff, enhanced safety and autonomy for residents, and reduced staff anxiety.</div></div><div><h3>Discussion</h3><div>Strategies that create a supportive environment, provide physical assistance, and support hydration and nutrition enabled residents to wander safely. Identified strategies improved wellbeing for both residents and staff. However, the same strategies also led to ethical concerns around digita","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105347"},"PeriodicalIF":7.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000614","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}
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