Pub Date : 2025-01-14DOI: 10.1016/j.ijnurstu.2025.105002
Wanchen Zhao, Hui Zhang
{"title":"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'","authors":"Wanchen Zhao, Hui Zhang","doi":"10.1016/j.ijnurstu.2025.105002","DOIUrl":"10.1016/j.ijnurstu.2025.105002","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 105002"},"PeriodicalIF":7.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990520","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 : 2025-01-13DOI: 10.1016/j.ijnurstu.2025.105001
Xiao Weiwei , Zhang Ping
{"title":"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’","authors":"Xiao Weiwei , Zhang Ping","doi":"10.1016/j.ijnurstu.2025.105001","DOIUrl":"10.1016/j.ijnurstu.2025.105001","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 105001"},"PeriodicalIF":7.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025723","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 : 2025-01-10DOI: 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.
{"title":"Evaluating quick return restrictions on sickness absence in healthcare employees: A difference-in-differences study","authors":"Jarno Turunen , Kati Karhula , Annina Ropponen , Rahman Shiri , Kari Hämäläinen , Jenni Ervasti , Aki Koskinen , Olli Haavisto , Mikael Sallinen , Jaakko Pehkonen , Mikko Härmä","doi":"10.1016/j.ijnurstu.2025.104996","DOIUrl":"10.1016/j.ijnurstu.2025.104996","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Design and methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 104996"},"PeriodicalIF":7.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 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
{"title":"Effectiveness of exercise-based interventions in preventing cancer therapy-related cardiac dysfunction in patients with breast cancer: A systematic review and network meta-analysis","authors":"Dandan Zhang , Xingyu Xiong , Hexiao Ding , Xiaole He , Huan Li , Yuzhi Yao , Ruisi Ma , Ting Liu","doi":"10.1016/j.ijnurstu.2025.104997","DOIUrl":"10.1016/j.ijnurstu.2025.104997","url":null,"abstract":"<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","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 104997"},"PeriodicalIF":7.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143164949","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 : 2025-01-09DOI: 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.
{"title":"‘Entanglement of nursing care’: A theoretical proposition to understand the complexity of nursing work and division of labour","authors":"Dewi Stalpers , Lisette Schoonhoven , Chiara Dall'Ora , Jane Ball , Peter Griffiths","doi":"10.1016/j.ijnurstu.2025.104995","DOIUrl":"10.1016/j.ijnurstu.2025.104995","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div><div><strong>Tweetable abstract:</strong> Nursing work is more than the accumulation of care activities; to comprehend its complexity care entanglement (intertwining) should be acknowledged.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 104995"},"PeriodicalIF":7.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 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).
{"title":"How do we co-produce care planning with people living with dementia: A scoping review","authors":"Inga Stewart , Ellie Gray , Maria Livanou","doi":"10.1016/j.ijnurstu.2025.104994","DOIUrl":"10.1016/j.ijnurstu.2025.104994","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div><div>The scoping review was registered with the Open Science Framework (OSF) on 3 February 2023 (doi:<span><span>10.17605/OSF.IO/KMR7G</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 104994"},"PeriodicalIF":7.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990552","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 : 2025-01-07DOI: 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
{"title":"The prevalence of mental health issues among nursing students: An umbrella review synthesis of meta-analytic evidence","authors":"Maria Efstathiou , Varvara Kakaidi , George Tsitsas , Stefanos Mantzoukas , Mary Gouva , Elena Dragioti","doi":"10.1016/j.ijnurstu.2025.104993","DOIUrl":"10.1016/j.ijnurstu.2025.104993","url":null,"abstract":"<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","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"163 ","pages":"Article 104993"},"PeriodicalIF":7.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985324","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 : 2025-01-01DOI: 10.1016/j.ijnurstu.2024.104932
Yongqi Dong , Xiandong Lu
{"title":"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’","authors":"Yongqi Dong , Xiandong Lu","doi":"10.1016/j.ijnurstu.2024.104932","DOIUrl":"10.1016/j.ijnurstu.2024.104932","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104932"},"PeriodicalIF":7.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479630","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 : 2025-01-01DOI: 10.1016/j.ijnurstu.2024.104931
Yan Gao, Xiuni Gan
{"title":"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’”","authors":"Yan Gao, Xiuni Gan","doi":"10.1016/j.ijnurstu.2024.104931","DOIUrl":"10.1016/j.ijnurstu.2024.104931","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104931"},"PeriodicalIF":7.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512224","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}