International Journal of Nursing Studies最新文献

{"title":"Forecasting long-term care demands for dementia in China (2020–2040): A Markov model analysis of urban-rural disparities","authors":"Peijia Zhu ,&nbsp;Qifan Yang ,&nbsp;Jie Chen ,&nbsp;Liangwen Zhang ,&nbsp;Ya Fang","doi":"10.1016/j.ijnurstu.2025.105328","DOIUrl":"10.1016/j.ijnurstu.2025.105328","url":null,"abstract":"<div><h3>Background</h3><div>Since no cure for dementia has been found, providing accessible long-term care has become a major global public health challenge. The reliance on informal care has become a significant issue in global healthcare systems, especially in regions with limited formal care resources. The impact of dementia care demands at different stages on resource allocation in China remains unclear.</div></div><div><h3>Objective</h3><div>This study projects dementia care costs and workforce gaps from 2020 to 2040 using a nationwide Markov model to analyze long-term care demands under urban–rural disparities.</div></div><div><h3>Design</h3><div>A micro-simulation study.</div></div><div><h3>Methods</h3><div>We developed a Markov model with five health states (healthy, mild, moderate, severe dementia, and death) based on a Chinese aging cohort, using a 1-year cycle. The model integrated multi-source data (Chinese Longitudinal Healthy Longevity Survey, United Nations projections, official statistics, and surveys) to project age, gender, and urban–rural specific changes in dementia care demands among the population aged 65 and above. Scenario analyses (low and high standards) were conducted to predict care costs and workforce demands from both formal and informal care perspectives over 20 years.</div></div><div><h3>Results</h3><div>By 2040, China's dementia population is forecast to reach 29.83 million, with mild dementia accounting for 60.32 % of cases. Informal care will remain dominant, with workforce gaps ranging from 3.37 million (low standard) to 5.78 million (high standard). The burden is heaviest among rural females aged 65–69, but overall, urban areas face higher burdens than rural ones. Cumulative long-term care costs over 20 years are estimated to range from US$387.74 million (low standard, 0.0026 % of 2020 GDP) to US$937.52 million (high standard, 0.0064 % of 2020 GDP), driven primarily by increasing new dementia cases due to population aging.</div></div><div><h3>Conclusions</h3><div>Our study highlights the urgent need for enhanced informal care support, early screening for mild dementia, and an accessible long-term care system to address growing challenges. The findings provide a foundation for developing a visualization tool to support real-time policy decision-making in dementia care resource planning.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105328"},"PeriodicalIF":7.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145956983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speaking to machines, not patients: The unexamined uandate of AI-driven nursing Practice","authors":"Maxim Topaz","doi":"10.1016/j.ijnurstu.2025.105327","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105327","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"21 1","pages":"105327"},"PeriodicalIF":8.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145894052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How community nurses handle concerns voiced by older adults: A conversation analytic study","authors":"Leonie Slots ,&nbsp;Bogdana Humă ,&nbsp;Hedwig te Molder ,&nbsp;Marjolein den Ouden ,&nbsp;Ellen Oosterkamp-Szwajcer ,&nbsp;Geke Ludden","doi":"10.1016/j.ijnurstu.2025.105326","DOIUrl":"10.1016/j.ijnurstu.2025.105326","url":null,"abstract":"<div><h3>Background</h3><div>Community nurses play an important role in supporting older adults who live at home by encouraging self-determination, autonomy, and self-management, all of which are becoming increasingly important in home care. This study aims to identify and describe the ways in which community nurses deal with the concerns raised by older adults, who live independently at home with care support.</div></div><div><h3>Data and method</h3><div>We analysed a corpus of 21 recorded conversations that took place during home visits conducted in a large Dutch city between 2020 and 2022. To examine the data, we used conversation analysis, an inductive qualitative approach that is particularly suited to the analysis of real-life interactions, including healthcare interactions.</div></div><div><h3>Analysis</h3><div>We identified three different trajectories that characterise how community nurses handle clients' concerns and that yield distinct outcomes. The exploratory trajectory is characterised by nurses stimulating clients both to identify the cause or source of the concern as well as a solution to it. By contrast, the presumptive trajectory involves nurses proposing solutions themselves, while leaving the origins of the concern unexplored. Finally, the reassuring trajectory entails nurses normalising the concern which leads to clients volunteering possible remedies that they have already implemented.</div></div><div><h3>Conclusion</h3><div>Our findings highlight the crucial role of language in how concerns of clients are constructed during home visits and the importance of community nurses in shaping how those concerns unfold and get resolved.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105326"},"PeriodicalIF":7.1,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centered care revisited: From problematizing its conceptual and methodological assumptions to proposing alternative foundations","authors":"Ali Kazemi ,&nbsp;Tinna Elfstrand Corlin","doi":"10.1016/j.ijnurstu.2025.105325","DOIUrl":"10.1016/j.ijnurstu.2025.105325","url":null,"abstract":"<div><div>Person-centered care has achieved near-universal endorsement as a hallmark of quality in healthcare. Yet its status as an unquestioned “good” risks obscuring the assumptions that underpin it. Drawing on the problematization methodology, this paper critically examines the conceptual foundations of person-centered care to reveal how its dominant formulations may inadvertently constrain theory, research, practice, and evaluation. We identify twenty underlying assumptions grouped into six categories: normative-ethical, epistemic-psychological, practical-organizational, ontological-identity, justice, and measurement, and assess why they merit rethinking. These assumptions, such as personhood as individual autonomy, partnership as symmetrical collaboration, and care quality as measurable output, are shown to privilege individualism and standardization. To unsettle these taken-for-granted premises, this paper develops alternative assumption grounds that reconceptualize person-centered care as an emergent and context-dependent practice. Personhood is reframed as co-constructed within relationships; partnership as negotiated co-agency shaped by power and circumstance; and dignity as enacted through everyday attentiveness and mutual recognition. This reorientation shifts ethical and practical focus from implementing person-centered care as a fixed model toward cultivating conditions in which care can be continuously co-created. Rather than offering replacements or definitive solutions, the proposed alternatives serve as generative provocations aimed at stimulating critical dialog and new research directions. We argue that the future of person-centered care lies not in further technical refinement but in reimagining care as a moral and relational process, i.e., as something created with rather than delivered to persons. By cultivating reflexivity and moral imagination at personal, professional, and organizational levels, healthcare can better sustain the humane and contextually grounded spirit that person-centered care is meant to embody.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105325"},"PeriodicalIF":7.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145823699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The systemic roots of Chinese nurse burnout: A mixed-methods study using natural language processing of social media data","authors":"Qiuyue Cui ,&nbsp;Jialiang Jiang ,&nbsp;Ying Zhong ,&nbsp;Ruoyu Du ,&nbsp;Yamei Zhang ,&nbsp;Yuan Ge","doi":"10.1016/j.ijnurstu.2025.105324","DOIUrl":"10.1016/j.ijnurstu.2025.105324","url":null,"abstract":"<div><h3>Background</h3><div>Burnout, a global occupational health challenge, is particularly prevalent among Chinese nurses. Traditional research methods have limitations in capturing nurses' unfiltered burnout experiences.</div></div><div><h3>Objectives</h3><div>To identify the core themes of burnout expressed by Chinese nurses on social media, analyze its systemic causes, and provide evidence to inform intervention strategies.</div></div><div><h3>Design</h3><div>An explanatory sequential mixed-methods design.</div></div><div><h3>Methods</h3><div>We collected 10,164 public posts and comments regarding nurse burnout from four leading Chinese social media platforms (Weibo, REDnote, Zhihu, and DXY.cn). The dataset spans from January 1, 2015, to May 1, 2025, with varied data collection start times across platforms. Latent Dirichlet Allocation topic modeling was used to identify latent themes, followed by qualitative thematic analysis for in-depth interpretation and the development of an explanatory systemic model.</div></div><div><h3>Results</h3><div>Latent Dirichlet Allocation topic modeling identified 11 distinct burnout themes. Subsequent qualitative analysis integrated these findings to develop the systemic-pressure model of nurse burnout, a theoretical framework organizing these pressures into three functional domains: Early-career challenges, organizational &amp; daily pressures, and career &amp; well-being outcomes.</div></div><div><h3>Conclusion</h3><div>Burnout among Chinese nurses is a systemic problem rooted in the healthcare system, not an issue of individual adaptation. Findings indicate interventions must target systemic reforms in hospital management, work design, and incentive mechanisms, rather than focusing solely on individual support.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"175 ","pages":"Article 105324"},"PeriodicalIF":7.1,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of large language models in clinical documentation: A scoping review","authors":"Brigitte Fong Yeong Woo ,&nbsp;Kenrick Cato ,&nbsp;Hannah Cho ,&nbsp;Sang Bin You ,&nbsp;Jiyoun Song","doi":"10.1016/j.ijnurstu.2025.105322","DOIUrl":"10.1016/j.ijnurstu.2025.105322","url":null,"abstract":"<div><h3>Background</h3><div>Clinical documentation is essential for safe, high-quality care but has become increasingly complex, contributing to clinician burnout. Large language models offer potential to ease documentation by generating summaries, structuring data, and ensuring compliance. However, concerns remain regarding accuracy, bias, privacy, and regulatory risks.</div></div><div><h3>Objective</h3><div>To map current literature on large language models applications in clinical documentation, evaluating their benefits, limitations, and ethical considerations.</div></div><div><h3>Information sources</h3><div>Five electronic databases (i.e., PubMed, Scopus, CINAHL, Cochrane Library, and IEEE Xplore) covering peer-reviewed literature published in English between January 2009 and August 2025.</div></div><div><h3>Methods</h3><div>This scoping review followed Arksey and OMalleys framework and was reported in accordance with PRISMA-ScR guidelines. Screening, data extraction, and quality appraisal were conducted independently by multiple reviewers using Joanna Briggs Institute tools. Findings were synthesized using descriptive and narrative approaches.</div></div><div><h3>Results</h3><div>Forty-one studies met inclusion criteria, most originating from the United States. Large language models were primarily applied to clinical note generation, discharge summaries, and provider-patient encounter documentation. Key evaluation metrics included content accuracy, linguistic quality, and summarization performance. Large language models demonstrated potential to improve documentation efficiency and readability, with some studies reporting up to 40 % time savings. However, concerns about factual inaccuracies, hallucinations, and reduced performance in complex cases were common. Clinician perceptions were mixed. Some found notes generated by large language models helpful and well-structured, while others raised concerns about reliability, liability, and loss of clinical nuance. Ethical challenges included data privacy, security, and algorithmic bias, with varying levels of compliance across settings.</div></div><div><h3>Conclusions</h3><div>Large language models hold significant promise for enhancing clinical documentation by improving efficiency, standardization, and clarity. However, their safe and effective use requires rigorous attention to accuracy, ethical safeguards, and clinician trust. Integration must support, rather than supplant, clinical reasoning and patient-centered care. Co-design with clinicians, real-world evaluation, and artificial intelligence literacy are essential to ensure that these technologies augment, not erode, professional judgment and care quality.</div></div><div><h3>Registration</h3><div>Open Science Framework Registries (<span><span>https://osf.io/m4h3q</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"176 ","pages":"Article 105322"},"PeriodicalIF":7.1,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unit manager's integral nursing leadership linked to job satisfaction and intention to leave among nurses: A descriptive, correlational study","authors":"JiSun Choi ,&nbsp;Seon Mi Cho","doi":"10.1016/j.ijnurstu.2025.105321","DOIUrl":"10.1016/j.ijnurstu.2025.105321","url":null,"abstract":"<div><h3>Background</h3><div>Nurse leaders and managers face significant challenges in today's rapidly changing and complex healthcare environments. With the important role of leadership, integral nursing leadership has been proposed as a new and holistic approach, considering both the internal and external aspects of individual leaders, as well as nursing organizations. Little research has investigated the effects of this leadership on outcomes in nursing contexts.</div></div><div><h3>Objective</h3><div>To examine the relationships between unit manager's integral nursing leadership and nurse outcomes (job satisfaction and intention to leave the unit, the hospital, and nursing profession), while controlling for individual general characteristics.</div></div><div><h3>Design</h3><div>Descriptive, correlational study.</div></div><div><h3>Methods</h3><div>Data were collected from nurses (N = 507; 31 units) in two teaching hospitals in Seoul, South Korea, between June 2020 and August 2021. A structured questionnaire, including demographic and work-related characteristics, integral nursing leadership, job satisfaction, and intention to leave at three levels (unit, hospital, and nursing profession), was used. Multilevel modeling was conducted to examine the relationships between integral nursing leadership and nurse outcomes, accounting for nurses nested within their units.</div></div><div><h3>Results</h3><div>Significant variations across nursing units were found for all nurse outcomes. Integral nursing leadership was statistically significant in relation to nurse outcomes, including job satisfaction (B = 0.23, 95 % CI [0.16, 0.30]), intention to leave the unit (OR = 0.55, 95 % CI [0.40, 0.76]), and intention to leave the hospital (OR = 0.52, 95 % CI [0.37, 0.74]), while no statistically significant relationship was found for intention to leave nursing profession. Of the four aspects of integral nursing leadership, individual leadership qualities (B = 0.14, 95 % CI [0.01, 0.27]) and individual performance (B = 0.18, 95 % CI [0.05, 0.30]) were significantly related to job satisfaction. Only individual performance was also statistically significant in relation to intention to leave the unit (OR = 0.48, 95 % CI [0.28, 0.82]), whereas individual performance (OR = 0.40, 95 % CI [0.23, 0.71]) and organizational excellence (OR = 1.80, 95 % CI [1.05, 3.07]) were statistically significant in relation to intention to leave the hospital.</div></div><div><h3>Conclusion</h3><div>These findings provide evidence-based insights that can inform the development of leadership training programs. Such programs could help nursing leaders enhance their leadership practices, thereby fostering their internal and external growth while improving organizational outcomes.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"175 ","pages":"Article 105321"},"PeriodicalIF":7.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Decision Support Systems for cancer symptom management: A scoping review","authors":"Jing Chi ,&nbsp;Chuhan Zhong ,&nbsp;Jianyao Tang ,&nbsp;Bingqian Guo ,&nbsp;Yujie Zhang ,&nbsp;Shisi Deng ,&nbsp;Zihan Guo ,&nbsp;Yanni Wu","doi":"10.1016/j.ijnurstu.2025.105317","DOIUrl":"10.1016/j.ijnurstu.2025.105317","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Effective cancer symptom management significantly impacts patient outcomes and quality of life. While Clinical Decision Support Systems show promise for enhancing symptom management, comprehensive analysis of their implementation in nursing practice remains limited. Understanding Clinical Decision Support Systems characteristics is essential for advancing evidence-based nursing implementation and improving patient care quality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To comprehensively assess the landscape of Clinical Decision Support Systems in cancer symptom management by analyzing decision logic architectures, integration with existing clinical systems, application purposes, and implementation contexts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a systematic scoping review searching six databases (PubMed, Web of Science, EMBASE, CINAHL, Scopus, and Cochrane Library) from inception through October 2025, supplemented by citation tracking and gray literature websites. We included studies reporting on the development, implementation, or evaluation of Clinical Decision Support Systems for cancer symptom management. Two independent reviewers extracted data on system architecture, decision logic approaches, Electronic Health Records integration status, clinical applications, implementation settings, cancer types, treatment modalities, and Artificial Intelligence technology implementation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 28,891 articles identified, 220 met inclusion criteria after screening. Rule-based systems constituted the majority (78.6 %) of implementations, while machine learning approaches (15.0 %) and hybrid systems combining rule-based and machine learning methods (3.2 %) represented emerging alternatives. Electronic Health Records integration was achieved in only 25.5 % of systems, with Artificial Intelligence technologies incorporated in just 18.2 %. Temporal analysis from 2003 to 2025 revealed increasing adoption of artificial intelligence and hybrid architectures, particularly for managing complex treatment regimens such as chemotherapy (52.9 % of treatment-specific applications). The functions were mainly concentrated on the combination of intelligent monitoring and early warning with personalized management and clinical optimization (38.2 %), followed by systems focusing solely on intelligent monitoring and early warning (34.1 %). Multiple cancer types were the predominant focus (59.5 %), followed by breast cancer-specific systems (10.9 %), lung cancer (6.8 %), and head and neck cancer (6.8 %). Implementation settings were primarily clinical environments (41.8 %) and remote patient monitoring systems (27.5 %).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;These findings contribute to the understanding of current Clinical Decision Support Systems landscapes in cancer care and provide evidence to guide healthcare organizations in selecting appropriate technological approaches for symptom management in","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"175 ","pages":"Article 105317"},"PeriodicalIF":7.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of remote nurse consultations in chronic disease management: A systematic review","authors":"Carmine Ruggiero ,&nbsp;Marion Waite ,&nbsp;Louise Stayt","doi":"10.1016/j.ijnurstu.2025.105319","DOIUrl":"10.1016/j.ijnurstu.2025.105319","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Remote nurse consultations are transforming care by combining tailored support with practical convenience but require nurses to adapt in-person focused clinical skills. Many consultations are now driven by patient-initiated follow-up, enabling patients to take greater control over their care. This systematic review explores the experiences of remote consultations for patients across chronic diseases, alongside those of the registered nurses delivering this care. Analysing themes across participant experiences will identify areas where patient and nurse needs align, as well as their impact on nursing labour.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The purpose of this review was to systematically and critically appraise the current literature to examine the experiences of those living with chronic disease and registered nurses in remote consultations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design and data sources&lt;/h3&gt;&lt;div&gt;A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted. A comprehensive search was conducted across CINAHL, British Nursing Database, PubMed, and Web of Science from September to October 2023 and updated in October 2024. Inclusion criteria were any primary qualitative studies, in peer-reviewed journals published in English, which focused on real-time video or telephone nurse consultations for chronic disease management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 31 studies were included in the review, identifying three overarching concepts common to both patient and nurse experiences. Nurse-Associated Requirements outlines key prerequisites for effective remote care, where recognising the person beyond their disease enables long-term relationships and tailored care. Interaction Factors reflects the communication dynamics, where meaningful conversations and tangible nursing care can effectively bridge the lack of co-location. Anxiety Dynamics captures the emotional impact of remote consultations, with patients perceiving them as a lifeline offering greater control, while nurses fear missing critical clinical cues, with little control over patient demand. Remote consultations deliver greater frequency of patient contact, requiring nurses to become relationship managers navigating a distinct and previously unrecognised labour cycle.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Remote nurse consultations improve patient access and self-management while strengthening continuity of care and relational trust. However, they also place significant demands on nurses, requiring advanced communication skills, emotional resilience, and adaptability. Addressing these challenges requires a systemic approach, integrating comprehensive training, peer support, and hybrid care models to balance in-person and virtual interactions. These findings highlight the evolving role of nurses in remote care delivery and provide actionable insights for healthcare systems to support both clini","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"175 ","pages":"Article 105319"},"PeriodicalIF":7.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the effectiveness of mobilisation alarms to prevent hospital falls using disinvestment: A randomised clinical trial","authors":"Dai Pu ,&nbsp;Kelly Stephen ,&nbsp;Cassie McDonald ,&nbsp;Jessica Baker ,&nbsp;Georgina Sinforosa ,&nbsp;Anastasia Hutchinson ,&nbsp;Kerry Bradley ,&nbsp;Kirsten Woods-Lyon ,&nbsp;Michelle Tuck ,&nbsp;Natasha Brusco ,&nbsp;Lisa O'Brien ,&nbsp;Debra Mitchell ,&nbsp;Kate Steen ,&nbsp;Melinda Webb-St. Mart ,&nbsp;Peter Hunter ,&nbsp;Philip L. Russo ,&nbsp;Bernice Redley ,&nbsp;Kelly-Ann Bowles ,&nbsp;Mari Botti ,&nbsp;Alison M. Hutchinson ,&nbsp;Terry Haines","doi":"10.1016/j.ijnurstu.2025.105320","DOIUrl":"10.1016/j.ijnurstu.2025.105320","url":null,"abstract":"<div><h3>Background</h3><div>Mobilisation alarms are commonly used in hospitals to prevent falls in patients who are at high risk for falls, yet the evidence for their effectiveness is uncertain.</div></div><div><h3>Objective</h3><div>To investigate the effectiveness of mobilisation alarms to prevent falls in hospitals.</div></div><div><h3>Design</h3><div>This was a 3-group, concurrent, non-inferiority, stepped wedge, clinical trial with an embedded parallel, cluster randomised design that adopted a disinvestment approach. Disinvestment from the intervention was carried out from 1st April 2023 to 31st January 2024.</div></div><div><h3>Setting(s)</h3><div>This study was conducted in one private health service and four public health services in Metropolitan Melbourne, Australia.</div></div><div><h3>Participants</h3><div>Acute and sub-acute hospital wards with at least a 3 % rate of use of mobilisation alarms. Twenty-two wards were screened and found eligible for the trial, 18 wards were recruited and randomised. A random subsample of patients in the recruited wards completed questionnaires.</div></div><div><h3>Methods</h3><div>Two conditions were evaluated against the “current” condition of high alarm use (&gt;<!--> <!-->3 %), a “reduced” rate of use of mobilisation alarms (&lt;<!--> <!-->3 % but &gt;<!--> <!-->0 %) and “eliminated” use of alarms (0 %). Rate of falls was the primary clinical outcome; data for a range of other measures were collected for secondary clinical and intervention outcomes.</div></div><div><h3>Results</h3><div>There were 11 acute wards and 7 sub-acute wards with 157,037 occupied bed days observed; 1319 individual patients completed questionnaires. Non-inferiority of the “reduced” condition compared to the “current” condition was demonstrated [95 %, one-tailed, non-inferiority confidence limit of 2.00 falls/1000 occupied bed days (OBDs) increase] but not for the “eliminated” condition (3.68 falls/1000 OBDs increase). Superiority of any intervention condition was not demonstrated over another [“current” vs “reduced”: 0.22 falls/1000 OBDs (two-tailed, 95 % CI: −<!--> <!-->1.89 to 2.34), “current” vs “eliminated”: 0.90 (−<!--> <!-->2.41 to 4.21), “reduced” vs “eliminated”: 0.67 (−<!--> <!-->2.12 to 3.47)]. Patients' frequency of sleep disturbance due to alarms was reduced in the “eliminated” condition [ordered logistic coefficient 0.47 (0.08 to 0.87)].</div></div><div><h3>Conclusions</h3><div>Reduction in use of mobilisation alarms was not inferior to usual care, but complete elimination was uncertain.</div></div><div><h3>Registration</h3><div>The trial was registered with the Australian New Zealand Clinical Trials Registry, trial ID: ACTRN12621000823875p (<span><span>https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000823875p</span><svg><path></path></svg></span>). Registered on 28/06/2021, first enrolment on 26/10/2022.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"175 ","pages":"Article 105320"},"PeriodicalIF":7.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786002","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}