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Comment on Liu et al. (2024) 'Patient preferences and willingness to pay for central venous access devices in breast cancer: A multicenter discrete choice experiment' 评Liu et al. (2024)乳腺癌患者对中心静脉通路装置的偏好和支付意愿:一项多中心离散选择实验
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-14 DOI: 10.1016/j.ijnurstu.2025.105002
Wanchen Zhao, Hui Zhang
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引用次数: 0
Comment on Fajarini et al. (2024) ‘Effects of advanced practice nurses on health-care costs, quality of care, and patient well-being: A meta-analysis of randomized controlled trials’
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-13 DOI: 10.1016/j.ijnurstu.2025.105001
Xiao Weiwei , Zhang Ping
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引用次数: 0
Evaluating quick return restrictions on sickness absence in healthcare employees: A difference-in-differences study 评估医疗保健员工病假的快速返回限制:差异中的差异研究。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-10 DOI: 10.1016/j.ijnurstu.2025.104996
Jarno Turunen , Kati Karhula , Annina Ropponen , Rahman Shiri , Kari Hämäläinen , Jenni Ervasti , Aki Koskinen , Olli Haavisto , Mikael Sallinen , Jaakko Pehkonen , Mikko Härmä

Background

Short intervals between shifts, known as quick returns, have been linked to adverse health effects, and increased risk of occupational accidents, particularly among healthcare employees. To safeguard employee health, the 2020 reform of Working Time Act in Finland limited rest periods under 11 h in irregular shift work.

Objective

To evaluate the changes in quick returns following the 2020 reform of the Working Time Act in Finland and their association with sickness absence among public healthcare employees.

Design and methods

This observational longitudinal study, analysed as a quasi-experiment used a difference-in-differences regression analysis with unit and time fixed effects and robust standard errors. We assessed changes in sickness absence from 2019 to 2021 across hospital work units. The study compared units mandated to limit quick returns (Treatment group; 416 units, over 20,500 employees, 72 % in nursing) with units that had low levels of quick returns prior the reform and did not need to limit quick returns (Control group; 37 units, over 1700 employees, 70 % in nursing). The analysis considered local agreements permitting quick returns, using both intention-to-treat and per-protocol approaches. Sensitivity analysis included regression models with unit level covariates and inverse probability weighting to adjust for initial differences.

Results

The per-protocol approach and simple regression analysis with fixed effects for unit and time over 2019–2020 showed a less pronounced increase in sickness absence by − 0.7 percentage points (95 % confidence interval [CI]: − 1.3 to − 0.1) for the treatment group compared to the control group, indicating a 13 % lower rate of sickness absence. For the period 2019–2021, the estimate was − 0.5 percentage points (95 % CI: − 1.0 to 0.0). When incorporating covariates and inverse probability weighting, the estimates were more substantial with narrower confidence intervals: − 0.9 percentage points (95 % CI: − 1.4 to − 0.3) for 2019–2020, and − 0.6 percentage points (95 % CI: − 1.2 to − 0.1) for 2019–2021. The estimates from the intention-to-treat approach were consistent with the per-protocol results.

Conclusion

The Working Time Act reform reduced quick returns, and after the reform, the reduction was associated with a smaller increase in sickness absence among healthcare employees. Policymakers and nursing managers should evaluate and adjust the frequency of quick returns to achieve the potential effects on employee well-being, health, and operational efficiency, which in this study was indicated by the reduction in sickness absence.
背景:轮班间隔短,被称为快速返回,与不利的健康影响和职业事故风险增加有关,特别是在医疗保健雇员中。为了保障员工健康,芬兰2020年的《工作时间法》改革将不定期轮班工作的休息时间限制在11小时以下。目的:评估芬兰2020年《工作时间法》改革后快速回报的变化及其与公共医疗保健员工病假的关系。设计和方法:这项观察性的纵向研究,作为准实验进行分析,采用单位和时间固定效应和稳健标准误差的差中差回归分析。我们评估了2019年至2021年各医院工作单位病假缺勤情况的变化。该研究比较了强制限制快速回报的单位(治疗组;416个单位,超过20,500名员工,72%为护理人员),改革前快速回报水平较低且不需要限制快速回报的单位(对照组;37个单位,1700多名员工,其中70%是护理人员)。分析考虑了允许快速回报的本地协议,使用了意向处理和协议处理两种方法。敏感性分析包括采用单位水平协变量的回归模型和逆概率加权来调整初始差异。结果:在2019-2020年的单位和时间内,按方案方法和具有固定效应的简单回归分析显示,与对照组相比,治疗组的缺勤率增加了-0.7个百分点(95%置信区间[CI]: -1.3至-0.1),这表明缺勤率降低了13%。对于2019-2021年期间,估计为-0.5个百分点(95% CI: -1.0至0.0)。当纳入协变量和逆概率加权时,估计更为实质性,置信区间更窄:2019-2020年为-0.9个百分点(95% CI: -1.4至-0.3),2019-2021年为- 0.6个百分点(95% CI: -1.2至-0.1)。意向治疗方法的估计值与每个方案的结果一致。结论:《工作时间法》改革降低了快速回报,改革后,减少与医疗保健员工缺勤率的小幅增加有关。政策制定者和护理管理者应该评估和调整快速回报的频率,以实现对员工福利、健康和运营效率的潜在影响,在本研究中,病假的减少表明了这一点。
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引用次数: 0
Effectiveness of exercise-based interventions in preventing cancer therapy-related cardiac dysfunction in patients with breast cancer: A systematic review and network meta-analysis
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-10 DOI: 10.1016/j.ijnurstu.2025.104997
Dandan Zhang , Xingyu Xiong , Hexiao Ding , Xiaole He , Huan Li , Yuzhi Yao , Ruisi Ma , Ting Liu
<div><h3>Background</h3><div>Despite advances in cancer treatment that have improved survival rates among patients with breast cancer, they are at high risk of developing cancer therapy-related cardiac dysfunction, which typically manifests as heart failure. Although exercise improves cardiorespiratory fitness in these patients, its effectiveness in preventing cancer therapy-related cardiac dysfunction remains unclear.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of exercise-based interventions using cardiac function parameters and to identify the optimal exercise modality for preventing cancer therapy-related cardiac dysfunction.</div></div><div><h3>Design</h3><div>A systematic review and network meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across PubMed, Embase, Scopus, Web of Science, and the Cochrane Library databases, covering all records from their inception through August 6, 2024. Studies that used exercise-based interventions, either exercise alone or with other interventions, were included. Those with insufficient data for the primary and secondary outcomes were excluded. Quality appraisal was evaluated using the risk of bias tool (RoB-2). All statistical analyses were conducted using the meta (version 7.0–0) and gemtc (version 1.0–2) packages in R software (version 4.3.3). For continuous outcomes, pairwise and network meta-analysis were employed to estimate mean differences (MDs) and 95 % confidence intervals (CI). The Surface Under the Cumulative Ranking Curve (SUCRA) was employed to rank treatments. The study protocol has been registered on PROSPERO (ID: CRD42024501160).</div></div><div><h3>Results</h3><div>In total, 13 randomized controlled trials involving 1122 participants were included in the review. There was low-to-high risk of bias across thirteen studies. Compared to usual care, exercise-based interventions significantly improved left ventricular ejection fraction (MD, 1.68; 95 % CI, 0.59–2.77) and global longitudinal strain (MD, 1.40; 95 % CI, 0.59–2.21). Based on the ranking probabilities, combined aerobic and resistance exercise was the most efficacious method for improving left ventricular ejection fraction (four studies; SUCRA, 0.96), followed by exercise-based cardio-oncology rehabilitation (two studies; SUCRA, 0.45) and aerobic exercise (four studies; SUCRA, 0.42). In terms of improving global longitudinal strain, combined aerobic and resistance exercise also ranked highest (three studies; SUCRA, 0.88). However, exercise-based cardio-oncology rehabilitation (two studies; SUCRA, 0.47) and aerobic exercise (one study; SUCRA, 0.45) were less effective.</div></div><div><h3>Conclusions</h3><div>This network meta-analysis showed very low certainty for the prospective efficacy of exercise-based interventions, especially the combined aerobic and resistance exercise, in preventing cancer therapy-related cardiac dysfunction. Further rigorous studies are required to
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引用次数: 0
‘Entanglement of nursing care’: A theoretical proposition to understand the complexity of nursing work and division of labour “护理的纠缠”:一个理解护理工作和劳动分工复杂性的理论命题。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-09 DOI: 10.1016/j.ijnurstu.2025.104995
Dewi Stalpers , Lisette Schoonhoven , Chiara Dall'Ora , Jane Ball , Peter Griffiths
Ongoing challenges in the provision of care, driven by growing care complexity and nursing shortages, prompt us to reconsider the basis for efficient division of nursing labour. In organising nursing work, traditionally the focus has been on identifying nursing tasks that can be delegated to other less expensive and less highly educated staff, in order to make best use of scarce resources. We argue that nursing care activities are connected and intertwined. As such ‘entanglement’ is a hallmark of nursing work, it needs to be understood to identify optimal and sustainable options for division of labour in nursing.
We elaborate the value of entanglement as a theoretical proposition to shift the focus away from old models of task-oriented nursing and put forward a model of labour division that acknowledges the importance of entangled nursing care activities. We build on the work of Jackson, Anderson, and Maben (2021) in which nursing work was conceptualised as a combination of cognitive, emotional, organisational, and physical labour. We assert that just allocating labour based on the type of work will not do the trick. The complexity of nursing work also needs to be considered. This is commonly framed as the combination of care activities required in the interest of patients and the complexity of each of these activities (‘task complexity’). Integrating the concept of entanglement brings to light that even ‘simple’ care activities contribute to the complexity of work, as activities are potentially bound up with other activities (‘entangled care activities’). That is to say, nursing work is not simply a function of the tasks undertaken. Based on our conceptualisation, we propose that the existence and nature of entangled care activities (‘task entanglement’) should be taken into account, to express what is needed in dividing the labour (‘labour complexity’). This should in turn underpin future staffing and skill mix decisions.
In the pursuit of guaranteeing high quality of care, further research on ‘ideal’ mixes of skills and optimal team compositions in various health care contexts is necessary. For nursing practice, our theoretical proposition can be used to explicate the complexity of daily work. Hereby, giving nurses something to demonstrate their added value in providing the best care to patients.
Tweetable abstract: Nursing work is more than the accumulation of care activities; to comprehend its complexity care entanglement (intertwining) should be acknowledged.
由于护理日益复杂和护理人员短缺,在提供护理方面面临着持续的挑战,促使我们重新考虑有效分工护理工作的基础。在组织护理工作方面,传统上的重点是确定可以委托给其他费用较低和受教育程度较低的工作人员的护理任务,以便最好地利用稀缺资源。我们认为护理活动是相互联系和交织的。由于这种“纠缠”是护理工作的标志,因此需要了解如何确定护理劳动分工的最佳和可持续选择。我们阐述了纠缠作为一个理论命题的价值,将焦点从任务导向型护理的旧模型转移开来,并提出了一个承认纠缠护理活动重要性的劳动分工模型。我们以Jackson、Anderson和Maben(2021)的工作为基础,其中护理工作被概念化为认知、情感、组织和体力劳动的结合。我们断言,仅仅根据工作类型分配劳动力是行不通的。护理工作的复杂性也需要考虑。这通常被定义为患者利益所需的护理活动和这些活动的复杂性(“任务复杂性”)的结合。整合纠缠的概念揭示了即使是“简单”的护理活动也会增加工作的复杂性,因为活动可能与其他活动联系在一起(“纠缠的护理活动”)。也就是说,护理工作不仅仅是承担任务的功能。根据我们的概念,我们建议应该考虑到纠缠护理活动(“任务纠缠”)的存在和性质,以表达分工(“劳动复杂性”)所需的内容。这应该反过来支持未来的人员配置和技能组合决策。为了保证高质量的护理,有必要进一步研究各种卫生保健环境中的“理想”技能组合和最佳团队组成。对于护理实践,我们的理论命题可以用来解释日常工作的复杂性。因此,给护士一些东西来展示他们在为患者提供最佳护理方面的附加价值。摘要:护理工作不仅仅是护理活动的积累;要理解其复杂性,必须认识到关怀的纠缠(缠结)。
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引用次数: 0
How do we co-produce care planning with people living with dementia: A scoping review 我们如何与痴呆症患者共同制定护理计划:范围审查
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-08 DOI: 10.1016/j.ijnurstu.2025.104994
Inga Stewart , Ellie Gray , Maria Livanou

Background

Legislation, policy and clinical guidance champions the values of co-production in good care planning; however, it is unclear what kind of information is available in the literature about how concepts of co-production have been applied in practice to care planning from the perspective of people living with dementia and their carers as experts-by-experience. A scoping review was conducted to map the current evidence addressing care planning co-production practice from the perspectives of people living with dementia and their carers across various settings of dementia care.

Methods

A two-phase process was employed. Phase 1 comprised of a systematic search of the literature exploring co-production of care planning with people living with dementia from the perspective of experts-by-experience, followed by a data charting process to extract the relevant information from the included studies and present in a table format. Phase 2 utilised a process of category construction to synthesise the outcome of the data charting and present the key care planning co-production categories from the included publications into a table format with an accompanying narrative.

Results

We identified eight international papers, published between 2001 and 2023, addressing care planning co-production practice from the perspectives of people living with dementia and their carers across various settings of dementia care. The synthesis of results revealed seven key care planning co-production categories: ‘preparedness’, ‘accessibility’, ‘active involvement of the person with dementia’, ‘active involvement of the carer’, ‘decision-making’, ‘outcomes and measurement’, and ‘care plan review’. Principles of co-production of care planning within dementia settings were established from the perspective of people living with dementia and their carers, as well as indicators of co-production of care planning having taken place.

Conclusions

Our scoping review has implications for change at all levels of healthcare provision. It highlights the lack of research in this area, but the learning that was uncovered pointed towards a largely absent voice of people with dementia and their carers in day-to-day care planning knowledge-exchanges and decision-making. This is despite this group's evident expertise on the subject of themselves and their loved ones from their own living experience.
The scoping review was registered with the Open Science Framework (OSF) on 3 February 2023 (doi:10.17605/OSF.IO/KMR7G).
立法、政策和临床指导倡导良好保健规划中合作生产的价值;然而,目前尚不清楚文献中关于如何从痴呆症患者及其护理人员作为经验专家的角度将合作生产的概念应用于实践中的护理计划的信息。进行了范围审查,从痴呆症患者及其护理人员在各种痴呆症护理环境中的角度,绘制了当前关于护理计划合作生产实践的证据。
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引用次数: 0
The prevalence of mental health issues among nursing students: An umbrella review synthesis of meta-analytic evidence 护生中心理健康问题的普遍性:综合meta分析证据的综述。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-07 DOI: 10.1016/j.ijnurstu.2025.104993
Maria Efstathiou , Varvara Kakaidi , George Tsitsas , Stefanos Mantzoukas , Mary Gouva , Elena Dragioti
<div><h3>Background</h3><div>The ongoing global student mental health crisis indicates the urgent need for updated research specifically targeting nursing students. Considering their anticipated transition into healthcare professions, their mental well-being is critical, not only for their academic performance but also for the quality of care they will deliver in their professional roles.</div></div><div><h3>Objective</h3><div>To estimate the prevalence of mental health issues among nursing students by synthesizing data from systematic reviews and meta-analyses.</div></div><div><h3>Design</h3><div>An umbrella review of published prevalence meta-analyses.</div></div><div><h3>Review methods</h3><div>Publication records were retrieved from four databases—PubMed, CINAHL, PsycINFO, and Scopus—up to September 2024. The methodological quality of each meta-analysis was assessed using the A Measurement Tool for the Assessment of Multiple Systematic Reviews (AMSTAR-2). Assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline checklist. A random-effects model was used for the meta-analysis, and the <em>I</em><sup>2</sup> index was employed to assess between-study heterogeneity. Additionally, the Risk of Bias in Systematic Reviews tool was used to assess review quality, including calculation of overlap between primary studies and adherence to GRADE criteria.</div></div><div><h3>Results</h3><div>Twenty-five meta-analyses, comprising 375 primary studies and a total of 171,828 nursing students, were included, revealing an overall prevalence of mental health issues at 27 % (95 % CI: 25 % - 30 %). Sleep disturbances were the most prevalent at 50 % (95 % CI: 28 % - 72 %), followed by fear at 41 % (95 % CI: 7 % - 75 %), burnout at 32 % (95 % CI: 25 % - 38 %), and depression at 29 % (95 % CI: 21 % - 38 %). Nomophobia/smartphone addiction had a prevalence of 30 % (95 % CI: 12 % - 49 %), anxiety 29 % (95 % CI: 17 % - 40 %), and stress 27 % (95 % CI: 17 % - 37 %). Lower prevalence rates were observed for smoking, eating disorders, post-traumatic stress disorder, and suicidal ideation/attempts. Significant heterogeneity was noted, particularly in the meta-analyses for anxiety, nomophobia/smartphone addiction, and stress.</div></div><div><h3>Conclusions</h3><div>Our review identified eleven prevalent mental health issues among nursing students, with sleep disturbances, anxiety, depression, and burnout being the most common. Behavioral issues, such as nomophobia, are also rising concerns. These findings indicate the need for targeted interventions and further research into causal factors (e.g., geographical and cultural contexts), gender disparities (as most studies focused on female students), and resilience-building strategies.</div></div><div><h3>Registration</h3><div>The study protocol was uploaded to the Open Science Framework (OSF) at <span><span>https://doi.org/10.17605/OSF.IO/EN7UX</span><svg><path></p
背景:持续的全球学生心理健康危机表明迫切需要更新专门针对护理学生的研究。考虑到他们进入医疗保健行业的预期转变,他们的心理健康是至关重要的,不仅对他们的学业成绩,而且对他们在专业角色中提供的护理质量也至关重要。目的:通过综合系统综述和荟萃分析的数据,估计护生心理健康问题的患病率。设计:对已发表的流行病学荟萃分析进行综述。评审方法:从pubmed、CINAHL、PsycINFO和scopus四个数据库中检索到截至2024年9月的发表记录。使用多系统评价评估测量工具(AMSTAR-2)评估每个荟萃分析的方法学质量。评估遵循系统评价和荟萃分析(PRISMA)报告指南清单的首选报告项目。meta分析采用随机效应模型,I2指数评价研究间异质性。此外,使用系统评价偏倚风险工具来评估评价质量,包括计算主要研究之间的重叠和对GRADE标准的遵守。结果:纳入了25项荟萃分析,包括375项主要研究和171,828名护理学生,显示精神健康问题的总体患病率为27% (95% CI: 25% - 30%)。睡眠障碍最普遍,占50% (95% CI: 28% - 72%),其次是恐惧,占41% (95% CI: 7% - 75%),倦怠,占32% (95% CI: 25% - 38%),抑郁,占29% (95% CI: 21% - 38%)。无手机恐惧症/智能手机成瘾的患病率为30% (95% CI: 12% - 49%),焦虑为29% (95% CI: 17% - 40%),压力为27% (95% CI: 17% - 37%)。吸烟、饮食失调、创伤后应激障碍和自杀意念/企图的患病率较低。显著的异质性被注意到,特别是在焦虑、无手机恐惧症/智能手机成瘾和压力的荟萃分析中。结论:我们的综述确定了护生中11种常见的心理健康问题,其中睡眠障碍、焦虑、抑郁和倦怠是最常见的。行为问题,如无手机恐惧症,也越来越受到关注。这些发现表明,需要有针对性的干预措施,并进一步研究因果因素(例如,地理和文化背景)、性别差异(因为大多数研究集中在女学生上)和恢复力建设策略。注册:研究方案已上传到开放科学框架(OSF) https://doi.org/10.17605/OSF.IO/EN7UX(注册日期为28/10/23)。摘要:在护生中,整体心理健康问题占27%。主要问题包括睡眠障碍、倦怠、焦虑和抑郁。无恐惧症的流行程度也值得进一步研究。
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引用次数: 0
Comment on Gao and Gan (2024) ‘A novel nomogram for the prediction of subsyndromal delirium in patients in intensive care units: A prospective, nested case-controlled study’ 评论 Gao 和 Gan (2024):"用于预测重症监护病房患者亚综合征谵妄的新提名图:前瞻性、巢式病例对照研究"。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.ijnurstu.2024.104932
Yongqi Dong , Xiandong Lu
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引用次数: 0
International panel of reviewers
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-01 DOI: 10.1016/S0020-7489(24)00288-8
{"title":"International panel of reviewers","authors":"","doi":"10.1016/S0020-7489(24)00288-8","DOIUrl":"10.1016/S0020-7489(24)00288-8","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104975"},"PeriodicalIF":7.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143154744","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}
引用次数: 0
Authors' response to “Comment on Gao and Gan (2024) ‘A novel nomogram for the prediction of subsyndromal delirium in patients in intensive care units: A prospective, nested case-controlled study’” 作者对 "Gao 和 Gan (2024) '用于预测重症监护病房患者亚症状谵妄的新提名图:一项前瞻性、巢式病例对照研究 "的评论。
IF 7.5 1区 医学 Q1 NURSING Pub Date : 2025-01-01 DOI: 10.1016/j.ijnurstu.2024.104931
Yan Gao, Xiuni Gan
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引用次数: 0
期刊
International Journal of Nursing Studies
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