Pub Date : 2024-12-01DOI: 10.1016/j.ijnurstu.2024.104915
David R. Thompson , Hugh P. McKenna
{"title":"Is the PhD in nursing advancing or in retreat?","authors":"David R. Thompson , Hugh P. McKenna","doi":"10.1016/j.ijnurstu.2024.104915","DOIUrl":"10.1016/j.ijnurstu.2024.104915","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104915"},"PeriodicalIF":7.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299971","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 : 2024-12-01DOI: 10.1016/j.ijnurstu.2024.104913
Na Zhang , Qing Li , Shuoxin Chen , Yixin Wu , Bo Xin , Qiuyuan Wan , Panpan Shi , Yuxin He , Shan Yang , Wenhui Jiang
{"title":"Corrigendum to ‘Effectiveness of nurse-led electronic health interventions on illness management in patients with chronic heart failure: A systematic review and meta-analysis’ [Int. J. Nurs. Stud. 150 (2024) 104630]","authors":"Na Zhang , Qing Li , Shuoxin Chen , Yixin Wu , Bo Xin , Qiuyuan Wan , Panpan Shi , Yuxin He , Shan Yang , Wenhui Jiang","doi":"10.1016/j.ijnurstu.2024.104913","DOIUrl":"10.1016/j.ijnurstu.2024.104913","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104913"},"PeriodicalIF":7.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331577","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 : 2024-11-19DOI: 10.1016/j.ijnurstu.2024.104961
Lulu Shi , Bei Wu , Xiaoshen Liu , Yinxia Ren , Chen Zhang , Xiaoyan Wang , Lina Wang
<div><h3>Background</h3><div>Low awareness and misconceptions surrounding mild cognitive impairment highlight the urgent need for effective health education. Reluctance to seek intervention and poor adherence to management strategies make behavior-oriented health education essential.</div></div><div><h3>Objective</h3><div>To assess the effectiveness and clinical significance of a trans-theoretical model-based health education program on cognitive-behavioral outcomes in older adults with mild cognitive impairment.</div></div><div><h3>Design</h3><div>A two-arm and assessor-blinded randomized controlled trial.</div></div><div><h3>Settings and participants</h3><div>100 community-dwelling older adults with mild cognitive impairment in Huzhou, China.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to a trans-theoretical model-based health education program (weekly 45–60 min sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or a wait-list control group receiving standard health education. Disease knowledge, behavioral stage, and adherence to health management behaviors were assessed at baseline, 8-week, and 20-week. Effects were evaluated at the group level via generalized estimating equation and at the individual level using reliable and clinically significant change.</div></div><div><h3>Results</h3><div>The trans-theoretical model-based health education program demonstrated significant effects over the wait-listed control. Generalized estimating equation analyses showed statistically significant effects on behavioral stage (β<sub>8-week</sub> = 1.04, 95%CI = 0.34–1.75; β<sub>20-week</sub> = 1.72, 95%CI = 0.95–2.49), disease knowledge (β<sub>8-week</sub> = 1.14, 95%CI = 0.26–2.02; β<sub>20-week</sub> = 1.78, 95%CI = 0.87–2.69), and adherence to health management behaviors (β<sub>8-week</sub> = 6.20, 95%CI = 2.03–10.37; β<sub>20-week</sub> = 10.74, 95%CI = 6.47–15.01) at both measured intervals. Additionally, global cognitive function (β<sub>8-week</sub> = 0.60, 95%CI = − 0.18–1.38; β<sub>20-week</sub> = 2.42, 95%CI = 1.64–3.20), Purdue Pegboard Test Assembly and Bimanual Tasks (β<sub>8-week</sub> = 0.16/0.38, 95%CI = − 0.21–0.53/−<!--> <!-->0.18–0.94; β<sub>20-week</sub> = 0.96/1.80, 95%CI = 0.57–1.35/1.17–2.43) improved significantly over time. Reliable and clinically significant change analyses at 8 weeks indicated significant improvements in the intervention group: 57 % of participants improved in disease knowledge (22 % clinically significant), 90 % in adherence to health management behaviors (17 % clinically significant), and 61 % in global cognitive function (10 % clinically significant). By 20 weeks, these rates increased to 63 % (29 %), 100 % (25 %), and 78 % (27 %). However, non-significant improvements in depression symptoms and sleep quality were found at individual-level assessment.</div></div><div><h3>Conclusions</h3><div>This study shows that the trans-theoretical model-based health education pr
{"title":"Health changes from trans-theoretical model-based education in older adults with mild cognitive impairment: A randomized controlled trial","authors":"Lulu Shi , Bei Wu , Xiaoshen Liu , Yinxia Ren , Chen Zhang , Xiaoyan Wang , Lina Wang","doi":"10.1016/j.ijnurstu.2024.104961","DOIUrl":"10.1016/j.ijnurstu.2024.104961","url":null,"abstract":"<div><h3>Background</h3><div>Low awareness and misconceptions surrounding mild cognitive impairment highlight the urgent need for effective health education. Reluctance to seek intervention and poor adherence to management strategies make behavior-oriented health education essential.</div></div><div><h3>Objective</h3><div>To assess the effectiveness and clinical significance of a trans-theoretical model-based health education program on cognitive-behavioral outcomes in older adults with mild cognitive impairment.</div></div><div><h3>Design</h3><div>A two-arm and assessor-blinded randomized controlled trial.</div></div><div><h3>Settings and participants</h3><div>100 community-dwelling older adults with mild cognitive impairment in Huzhou, China.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to a trans-theoretical model-based health education program (weekly 45–60 min sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or a wait-list control group receiving standard health education. Disease knowledge, behavioral stage, and adherence to health management behaviors were assessed at baseline, 8-week, and 20-week. Effects were evaluated at the group level via generalized estimating equation and at the individual level using reliable and clinically significant change.</div></div><div><h3>Results</h3><div>The trans-theoretical model-based health education program demonstrated significant effects over the wait-listed control. Generalized estimating equation analyses showed statistically significant effects on behavioral stage (β<sub>8-week</sub> = 1.04, 95%CI = 0.34–1.75; β<sub>20-week</sub> = 1.72, 95%CI = 0.95–2.49), disease knowledge (β<sub>8-week</sub> = 1.14, 95%CI = 0.26–2.02; β<sub>20-week</sub> = 1.78, 95%CI = 0.87–2.69), and adherence to health management behaviors (β<sub>8-week</sub> = 6.20, 95%CI = 2.03–10.37; β<sub>20-week</sub> = 10.74, 95%CI = 6.47–15.01) at both measured intervals. Additionally, global cognitive function (β<sub>8-week</sub> = 0.60, 95%CI = − 0.18–1.38; β<sub>20-week</sub> = 2.42, 95%CI = 1.64–3.20), Purdue Pegboard Test Assembly and Bimanual Tasks (β<sub>8-week</sub> = 0.16/0.38, 95%CI = − 0.21–0.53/−<!--> <!-->0.18–0.94; β<sub>20-week</sub> = 0.96/1.80, 95%CI = 0.57–1.35/1.17–2.43) improved significantly over time. Reliable and clinically significant change analyses at 8 weeks indicated significant improvements in the intervention group: 57 % of participants improved in disease knowledge (22 % clinically significant), 90 % in adherence to health management behaviors (17 % clinically significant), and 61 % in global cognitive function (10 % clinically significant). By 20 weeks, these rates increased to 63 % (29 %), 100 % (25 %), and 78 % (27 %). However, non-significant improvements in depression symptoms and sleep quality were found at individual-level assessment.</div></div><div><h3>Conclusions</h3><div>This study shows that the trans-theoretical model-based health education pr","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104961"},"PeriodicalIF":7.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746117","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 : 2024-11-19DOI: 10.1016/j.ijnurstu.2024.104962
Xinyue Zhang , Na Wei , Mengli Li , Li Li , Xiaoyan Lv , Youjuan Zhang , Patricia M. Davidson , Yingjuan Cao
<div><h3>Background</h3><div>Sickness presenteeism has potential negative impacts on job burnout and health-related productivity loss among clinical nurses, whereas social support has been identified as a potential mitigating factor for such impacts. However, there is limited evidence regarding the relationships and mechanisms between sickness presenteeism, job burnout, social support, and health-related productivity loss.</div></div><div><h3>Objective</h3><div>To explore the role of job burnout and social support in the association between sickness presenteeism and health-related productivity loss among female nurses.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Setting(s)</h3><div>105 hospitals conveniently selected from 36 cities in 15 provinces in China.</div></div><div><h3>Participants</h3><div>50,653 registered female nurses.</div></div><div><h3>Methods</h3><div>This study utilizes the cross-sectional data from the baseline survey of the Chinese nurses' health cohort study (Towards A Revolution in GETting nurses' health ticked, TARGET), conducted from December 2020 to February 2024. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Maslach Burnout Inventory, and Perceived Social Support Scale. Data analyses were performed using independent sample t-tests, Pearson correlation analysis, one-way analysis of variance, multivariate linear regression analysis, and the Process 4.0 macro plug-in method.</div></div><div><h3>Results</h3><div>A total of 42,843 valid questionnaires were collected with an 85% response rate. The incidence of sickness presenteeism among female nurses was 62 %. Sickness presenteeism was positively correlated with job burnout and health-related productivity loss, and job burnout was also positively correlated with health-related productivity loss. Conversely, social support was negatively associated with sickness presenteeism, job burnout and health-related productivity loss. The findings showed that the association between sickness presenteeism and health-related productivity loss was partially mediated by job burnout. Moreover, the direct and indirect effects within the mediation model were moderated by social support. When levels of social support were high, the impact of sickness presenteeism on job burnout and health-related productivity loss was weaker, as was the impact of job burnout on health-related productivity loss.</div></div><div><h3>Conclusions</h3><div>Hospital administrators and nurses themselves can mitigate the adverse effects of sickness presenteeism on health-related productivity loss by alleviating job burnout and increasing levels of social support. By addressing these significant challenges, they can more effectively manage the consequences of sickness presenteeism and job burnout among nurses.</div></div><div><h3>Registration</h3><div>The protocol of TARGET was registered in the China Clinical Trial Registry (ChiCT
背景疾病出勤对临床护士的工作倦怠和与健康相关的生产力损失有潜在的负面影响，而社会支持已被确定为这种影响的潜在缓解因素。然而，关于出勤、工作倦怠、社会支持和健康相关生产力损失之间的关系和机制的证据有限。目的探讨职业倦怠和社会支持在女护士出勤与健康相关生产力损失的关系中的作用。设计横断面研究，选取中国15个省36个城市的105家医院。参与者：注册女护士50,653名。方法本研究利用了2020年12月至2024年2月进行的中国护士健康队列研究（Towards A Revolution in GETting nurses’health ticked， TARGET）基线调查的横断面数据。变量测量采用疾病出勤问卷、斯坦福出勤量表、马斯拉克倦怠量表和感知社会支持量表。数据分析采用独立样本t检验、Pearson相关分析、单向方差分析、多元线性回归分析和Process 4.0宏插件法。结果共回收有效问卷42843份，回复率85%。女护士出勤率为62%。病假出勤与工作倦怠和健康相关的生产力损失正相关，工作倦怠也与健康相关的生产力损失正相关。相反，社会支持与病假出勤、工作倦怠和与健康相关的生产力损失呈负相关。研究结果表明，病假出勤与健康相关的生产力损失之间的关系部分由工作倦怠介导。此外，社会支持对中介模型中的直接效应和间接效应都有调节作用。当社会支持水平较高时，病假出勤对工作倦怠和与健康相关的生产力损失的影响较弱，工作倦怠对与健康相关的生产力损失的影响也较弱。结论医院管理人员和护士自身可以通过减轻工作倦怠和提高社会支持水平来减轻出勤对健康相关生产力损失的不利影响。通过解决这些重大挑战，他们可以更有效地管理护士生病出勤和工作倦怠的后果。TARGET方案已在中国临床试验注册中心注册（ChiCTR2100043202）。摘要本研究分析了TARGET数据，以探索病假出勤与健康相关的生产力损失之间的机制。
{"title":"Sickness presenteeism, job burnout, social support and health-related productivity loss among nurses in the Chinese nurses' health cohort study (TARGET): A cross-sectional survey","authors":"Xinyue Zhang , Na Wei , Mengli Li , Li Li , Xiaoyan Lv , Youjuan Zhang , Patricia M. Davidson , Yingjuan Cao","doi":"10.1016/j.ijnurstu.2024.104962","DOIUrl":"10.1016/j.ijnurstu.2024.104962","url":null,"abstract":"<div><h3>Background</h3><div>Sickness presenteeism has potential negative impacts on job burnout and health-related productivity loss among clinical nurses, whereas social support has been identified as a potential mitigating factor for such impacts. However, there is limited evidence regarding the relationships and mechanisms between sickness presenteeism, job burnout, social support, and health-related productivity loss.</div></div><div><h3>Objective</h3><div>To explore the role of job burnout and social support in the association between sickness presenteeism and health-related productivity loss among female nurses.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Setting(s)</h3><div>105 hospitals conveniently selected from 36 cities in 15 provinces in China.</div></div><div><h3>Participants</h3><div>50,653 registered female nurses.</div></div><div><h3>Methods</h3><div>This study utilizes the cross-sectional data from the baseline survey of the Chinese nurses' health cohort study (Towards A Revolution in GETting nurses' health ticked, TARGET), conducted from December 2020 to February 2024. Variables were measured using the Sickness Presenteeism Questionnaire, Stanford Presenteeism Scale, Maslach Burnout Inventory, and Perceived Social Support Scale. Data analyses were performed using independent sample t-tests, Pearson correlation analysis, one-way analysis of variance, multivariate linear regression analysis, and the Process 4.0 macro plug-in method.</div></div><div><h3>Results</h3><div>A total of 42,843 valid questionnaires were collected with an 85% response rate. The incidence of sickness presenteeism among female nurses was 62 %. Sickness presenteeism was positively correlated with job burnout and health-related productivity loss, and job burnout was also positively correlated with health-related productivity loss. Conversely, social support was negatively associated with sickness presenteeism, job burnout and health-related productivity loss. The findings showed that the association between sickness presenteeism and health-related productivity loss was partially mediated by job burnout. Moreover, the direct and indirect effects within the mediation model were moderated by social support. When levels of social support were high, the impact of sickness presenteeism on job burnout and health-related productivity loss was weaker, as was the impact of job burnout on health-related productivity loss.</div></div><div><h3>Conclusions</h3><div>Hospital administrators and nurses themselves can mitigate the adverse effects of sickness presenteeism on health-related productivity loss by alleviating job burnout and increasing levels of social support. By addressing these significant challenges, they can more effectively manage the consequences of sickness presenteeism and job burnout among nurses.</div></div><div><h3>Registration</h3><div>The protocol of TARGET was registered in the China Clinical Trial Registry (ChiCT","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104962"},"PeriodicalIF":7.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746026","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 : 2024-11-19DOI: 10.1016/j.ijnurstu.2024.104958
Mandie Foster , L. Lisa Whitehead , Therese A. O'Sullivan , Julie Hill , Evalotte Mörelius
<div><h3>Background</h3><div>No internationally developed child-centred research checklist is currently available to enhance the quality and transparency of the development, reporting and evaluation of research undertaken with children.</div></div><div><h3>Objective</h3><div>To develop an internationally relevant, expert informed child-centred research checklist.</div></div><div><h3>Design</h3><div>A descriptive mixed methods study was undertaken in five sequential phases, including a Delphi component.</div></div><div><h3>Setting(s)</h3><div>Academic/international context.</div></div><div><h3>Methods</h3><div>This study involved five sequential stages:</div><div>1. Literature review using four databases (CINAHL, MEDLINE, Scopus, PsycINFO) and analysis to identify key themes in child-centred research (January 2020).</div><div>2. Generate a questionnaire based on the key themes for international experts in child research to provide their opinions on what should be included in a child-centred research checklist (March 2020).</div><div>3. Inductive thematic analysis of the experts' responses to generate the initial draft checklist (June 2020).</div><div>4. The checklist progressed through three rounds of Delphi study for a wider range of experts to provide their consensus on what a child-centred research checklist should contain (August 2020–February 2021).</div><div>5. Refinement of the child-centred research checklist based on the Delphi study (March 2021–November 2022).</div></div><div><h3>Results</h3><div>A total of 160 articles met the inclusion criteria for review and were considered in the development of a 10-item open-ended questionnaire, adapted for four age-brackets (0-1 yrs., 2-4 yrs., 5-10 yrs., ><!--> <!-->11 yrs). Responses from 14 experts across 10 countries generated 205 generic statements and 76 examples to inform a child-centred research checklist. Following this, 158 experts from eleven disciplines across 18 countries participated in the three round Delphi study (38 % retention rate over the three rounds). The final checklist includes 11 statements and 17 examples represented under three categories of “child-parent consent, assent and dissent”, “code of conduct” and “child focused methods”.</div></div><div><h3>Conclusion</h3><div>The child-centred research checklist was generated from a mixed methods study undertaken in five sequential phases, with input by 172 experts from 11 disciplines across 19 countries. The child-centred research checklist is the first international, expert informed tool to support good quality and transparent child-centred research. We call on researchers, clinicians, journal editors, organisations, and ethics committees to use this checklist for future research with children. The next phase of this project is engagement with children and their families to refine the checklist.</div></div><div><h3><strong>Tweetable abstract</strong></h3><div>New checklist to support good quality child research practices @
{"title":"A child-centred research checklist to improve the design and reporting of paediatric research studies: A descriptive mixed methods study","authors":"Mandie Foster , L. Lisa Whitehead , Therese A. O'Sullivan , Julie Hill , Evalotte Mörelius","doi":"10.1016/j.ijnurstu.2024.104958","DOIUrl":"10.1016/j.ijnurstu.2024.104958","url":null,"abstract":"<div><h3>Background</h3><div>No internationally developed child-centred research checklist is currently available to enhance the quality and transparency of the development, reporting and evaluation of research undertaken with children.</div></div><div><h3>Objective</h3><div>To develop an internationally relevant, expert informed child-centred research checklist.</div></div><div><h3>Design</h3><div>A descriptive mixed methods study was undertaken in five sequential phases, including a Delphi component.</div></div><div><h3>Setting(s)</h3><div>Academic/international context.</div></div><div><h3>Methods</h3><div>This study involved five sequential stages:</div><div>1. Literature review using four databases (CINAHL, MEDLINE, Scopus, PsycINFO) and analysis to identify key themes in child-centred research (January 2020).</div><div>2. Generate a questionnaire based on the key themes for international experts in child research to provide their opinions on what should be included in a child-centred research checklist (March 2020).</div><div>3. Inductive thematic analysis of the experts' responses to generate the initial draft checklist (June 2020).</div><div>4. The checklist progressed through three rounds of Delphi study for a wider range of experts to provide their consensus on what a child-centred research checklist should contain (August 2020–February 2021).</div><div>5. Refinement of the child-centred research checklist based on the Delphi study (March 2021–November 2022).</div></div><div><h3>Results</h3><div>A total of 160 articles met the inclusion criteria for review and were considered in the development of a 10-item open-ended questionnaire, adapted for four age-brackets (0-1 yrs., 2-4 yrs., 5-10 yrs., ><!--> <!-->11 yrs). Responses from 14 experts across 10 countries generated 205 generic statements and 76 examples to inform a child-centred research checklist. Following this, 158 experts from eleven disciplines across 18 countries participated in the three round Delphi study (38 % retention rate over the three rounds). The final checklist includes 11 statements and 17 examples represented under three categories of “child-parent consent, assent and dissent”, “code of conduct” and “child focused methods”.</div></div><div><h3>Conclusion</h3><div>The child-centred research checklist was generated from a mixed methods study undertaken in five sequential phases, with input by 172 experts from 11 disciplines across 19 countries. The child-centred research checklist is the first international, expert informed tool to support good quality and transparent child-centred research. We call on researchers, clinicians, journal editors, organisations, and ethics committees to use this checklist for future research with children. The next phase of this project is engagement with children and their families to refine the checklist.</div></div><div><h3><strong>Tweetable abstract</strong></h3><div>New checklist to support good quality child research practices @","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104958"},"PeriodicalIF":7.5,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746118","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}
Delirium is a common complication among older medical patients that can lead to undesirable outcomes.
Objectives
This study systematically investigated the incidence, prevalence, and risk factors of delirium to improve its recognition, prevention, and management in medically hospitalized older patients.
Methods
The study protocol was registered at PROSPERO on April 29, 2024 (registration number: CRD42024536624). We searched the PubMed, Embase, and ProQuest databases for relevant articles published between database inception and September 25, 2024. We included observational studies reporting the prevalence, incidence, and risk factors of delirium among medically hospitalized older patients. Two independent reviewers extracted the data. A random-effects model was used for data analysis.
Results
A total of 35 studies encompassing 12,097 participants met the inclusion criteria, yielding a 23.6 % pooled prevalence of delirium (95 % confidence interval = 19 % to 29 %) and a 13.5 % pooled incidence of delirium (n = 32, 95 % confidence interval = 11 % to 17 %) among medically hospitalized older patients. Study quality and country were significant moderators for explaining the heterogeneity observed in the prevalence and incidence of delirium, respectively (both P < 0.001). The risk factors of delirium included frailty (odds ratio = 2.05), physical restraints (5.01), prior falls (1.99), severe illness (1.32) (evaluated using the Acute Physiology and Chronic Health Evaluation II), and cognitive impairment (2.61). Older age increased delirium risk, whereas years of education mitigated it (B = 1.69 and 0.92, respectively).
Conclusion
Our findings considerably enhance the understanding of the prevalence of delirium and its influencing factors in medically hospitalized older patients. The insights this study provides can enable health-care providers to apply quick and effective assessment tools and can thereby support the implementation of interventions to prevent delirium.
Registration
The study protocol has been prospectively registered on PROSPERO (registration no. CRD42024536624).
{"title":"Global incidence and prevalence of delirium and its risk factors in medically hospitalized older patients: A systematic review and meta-analysis","authors":"Chia-Rung Wu , Kai-Mei Chang , Victoria Tranyor , Hsiao-Yean Chiu","doi":"10.1016/j.ijnurstu.2024.104959","DOIUrl":"10.1016/j.ijnurstu.2024.104959","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is a common complication among older medical patients that can lead to undesirable outcomes.</div></div><div><h3>Objectives</h3><div>This study systematically investigated the incidence, prevalence, and risk factors of delirium to improve its recognition, prevention, and management in medically hospitalized older patients.</div></div><div><h3>Methods</h3><div>The study protocol was registered at PROSPERO on April 29, 2024 (registration number: CRD42024536624). We searched the PubMed, Embase, and ProQuest databases for relevant articles published between database inception and September 25, 2024. We included observational studies reporting the prevalence, incidence, and risk factors of delirium among medically hospitalized older patients. Two independent reviewers extracted the data. A random-effects model was used for data analysis.</div></div><div><h3>Results</h3><div>A total of 35 studies encompassing 12,097 participants met the inclusion criteria, yielding a 23.6 % pooled prevalence of delirium (95 % confidence interval = 19 % to 29 %) and a 13.5 % pooled incidence of delirium (n = 32, 95 % confidence interval = 11 % to 17 %) among medically hospitalized older patients. Study quality and country were significant moderators for explaining the heterogeneity observed in the prevalence and incidence of delirium, respectively (both P < 0.001). The risk factors of delirium included frailty (odds ratio = 2.05), physical restraints (5.01), prior falls (1.99), severe illness (1.32) (evaluated using the Acute Physiology and Chronic Health Evaluation II), and cognitive impairment (2.61). Older age increased delirium risk, whereas years of education mitigated it (B = 1.69 and 0.92, respectively).</div></div><div><h3>Conclusion</h3><div>Our findings considerably enhance the understanding of the prevalence of delirium and its influencing factors in medically hospitalized older patients. The insights this study provides can enable health-care providers to apply quick and effective assessment tools and can thereby support the implementation of interventions to prevent delirium.</div></div><div><h3>Registration</h3><div>The study protocol has been prospectively registered on PROSPERO (registration no. CRD42024536624).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104959"},"PeriodicalIF":7.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700774","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 : 2024-11-14DOI: 10.1016/j.ijnurstu.2024.104953
Melati Fajarini , Agus Setiawan , Chien-Mei Sung , Ruey Chen , Doresses Liu , Chiu-Kuei Lee , Shu-Fen Niu , Kuei-Ru Chou
<div><h3>Background</h3><div>The growing recognition of advanced practice nurses' role has been challenged by the need for decreased health-care costs while ensuring quality of care and patient well-being. However, limited evidence exists from previous reviews evaluating the effectiveness of advanced practice nurses.</div></div><div><h3>Objectives</h3><div>To investigate the effects of advanced practice nurses on health-care costs, quality of care, and patient well-being.</div></div><div><h3>Design</h3><div>A meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>A literature search was conducted in CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, and Web of Science from their inception to June 2023. The primary outcome was health-care costs, including total cost with direct (hospitalization, medication, and diagnostic costs) and indirect costs. The secondary outcomes were quality of care (hospitalization, readmission, length of stay, mortality and patient satisfaction) and well-being [mental (anxiety, depression), physical (pain, fatigue), and quality of life]. Hedges' <em>g</em> and odds ratio with corresponding 95 % confidence intervals were calculated using a random-effects model to obtain pooled effect estimates for the primary and secondary outcomes. Heterogeneity was determined using <em>I</em><sup>2</sup> and <em>Q</em> statistics, and moderator analysis was performed to determine the sources of heterogeneity. Publication bias was evaluated using the Begg and Mazumdar rank correlation and Egger's test and through the visual inspection of a funnel plot.</div></div><div><h3>Results</h3><div>In this review, we included 22 studies involving 7764 participants, mostly women (56.4 %). Compared with other health professionals, advanced practice nurses significantly reduced patients' total costs (<em>g</em>, −<!--> <!-->0.21; 95 % confidence interval, −<!--> <!-->0.30 to −<!--> <!-->0.12), lowered direct costs (<em>g</em>, −<!--> <!-->0.15; 95 % confidence interval, −<!--> <!-->0.22 to −<!--> <!-->0.08), and decreased hospitalization costs (<em>g</em>, −<!--> <!-->0.19; 95 % confidence interval, −<!--> <!-->0.34 to −<!--> <!-->0.04). As well, advanced practice nurses significantly lowered hospital readmissions (odds ratio, 0.25; 95 % confidence interval, 0.11 to 0.57), increased patient satisfaction (<em>g</em>, 0.54; 95 % confidence interval, 0.31 to 0.77), reduced anxiety (<em>g</em>, −<!--> <!-->0.36; 95 % confidence interval, −<!--> <!-->0.71 to −<!--> <!-->0.00), depression (<em>g</em>, −<!--> <!-->0.28, 95 % confidence interval, −<!--> <!-->0.46 to −<!--> <!-->0.10), pain (<em>g</em>, −<!--> <!-->0.20; 95 % confidence interval, −<!--> <!-->0.35 to −<!--> <!-->0.04), and fatigue (<em>g</em>, −<!--> <!-->0.24; 95 % confidence interval, −<!--> <!-->0.41 to −<!--> <!-->0.07). Patient satisfaction improved in disease management, follow-up care, and blended intervention, although did not reach statistica
{"title":"Effects of advanced practice nurses on health-care costs, quality of care, and patient well-being: A meta-analysis of randomized controlled trials","authors":"Melati Fajarini , Agus Setiawan , Chien-Mei Sung , Ruey Chen , Doresses Liu , Chiu-Kuei Lee , Shu-Fen Niu , Kuei-Ru Chou","doi":"10.1016/j.ijnurstu.2024.104953","DOIUrl":"10.1016/j.ijnurstu.2024.104953","url":null,"abstract":"<div><h3>Background</h3><div>The growing recognition of advanced practice nurses' role has been challenged by the need for decreased health-care costs while ensuring quality of care and patient well-being. However, limited evidence exists from previous reviews evaluating the effectiveness of advanced practice nurses.</div></div><div><h3>Objectives</h3><div>To investigate the effects of advanced practice nurses on health-care costs, quality of care, and patient well-being.</div></div><div><h3>Design</h3><div>A meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>A literature search was conducted in CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, and Web of Science from their inception to June 2023. The primary outcome was health-care costs, including total cost with direct (hospitalization, medication, and diagnostic costs) and indirect costs. The secondary outcomes were quality of care (hospitalization, readmission, length of stay, mortality and patient satisfaction) and well-being [mental (anxiety, depression), physical (pain, fatigue), and quality of life]. Hedges' <em>g</em> and odds ratio with corresponding 95 % confidence intervals were calculated using a random-effects model to obtain pooled effect estimates for the primary and secondary outcomes. Heterogeneity was determined using <em>I</em><sup>2</sup> and <em>Q</em> statistics, and moderator analysis was performed to determine the sources of heterogeneity. Publication bias was evaluated using the Begg and Mazumdar rank correlation and Egger's test and through the visual inspection of a funnel plot.</div></div><div><h3>Results</h3><div>In this review, we included 22 studies involving 7764 participants, mostly women (56.4 %). Compared with other health professionals, advanced practice nurses significantly reduced patients' total costs (<em>g</em>, −<!--> <!-->0.21; 95 % confidence interval, −<!--> <!-->0.30 to −<!--> <!-->0.12), lowered direct costs (<em>g</em>, −<!--> <!-->0.15; 95 % confidence interval, −<!--> <!-->0.22 to −<!--> <!-->0.08), and decreased hospitalization costs (<em>g</em>, −<!--> <!-->0.19; 95 % confidence interval, −<!--> <!-->0.34 to −<!--> <!-->0.04). As well, advanced practice nurses significantly lowered hospital readmissions (odds ratio, 0.25; 95 % confidence interval, 0.11 to 0.57), increased patient satisfaction (<em>g</em>, 0.54; 95 % confidence interval, 0.31 to 0.77), reduced anxiety (<em>g</em>, −<!--> <!-->0.36; 95 % confidence interval, −<!--> <!-->0.71 to −<!--> <!-->0.00), depression (<em>g</em>, −<!--> <!-->0.28, 95 % confidence interval, −<!--> <!-->0.46 to −<!--> <!-->0.10), pain (<em>g</em>, −<!--> <!-->0.20; 95 % confidence interval, −<!--> <!-->0.35 to −<!--> <!-->0.04), and fatigue (<em>g</em>, −<!--> <!-->0.24; 95 % confidence interval, −<!--> <!-->0.41 to −<!--> <!-->0.07). Patient satisfaction improved in disease management, follow-up care, and blended intervention, although did not reach statistica","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104953"},"PeriodicalIF":7.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696556","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 : 2024-11-09DOI: 10.1016/j.ijnurstu.2024.104955
Andrea González-Mariscal , Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , Laura Ávila-Cabeza-de-Vaca , Manuel Costilla , Cristina Casals
<div><h3>Background</h3><div>There is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community.</div></div><div><h3>Design</h3><div>A 12-month, multicenter, randomized controlled trial.</div></div><div><h3>Settings</h3><div>The FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain.</div></div><div><h3>Participants</h3><div>A total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years).</div></div><div><h3>Methods</h3><div>Participants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton and Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons.</div></div><div><h3>Results</h3><div>At both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline.</div></div><div><h3>Conclusions</h3><div>The educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community.</div></div><div><h3>Registration</h3><div>This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (Id
{"title":"Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial","authors":"Andrea González-Mariscal , Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , Laura Ávila-Cabeza-de-Vaca , Manuel Costilla , Cristina Casals","doi":"10.1016/j.ijnurstu.2024.104955","DOIUrl":"10.1016/j.ijnurstu.2024.104955","url":null,"abstract":"<div><h3>Background</h3><div>There is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community.</div></div><div><h3>Design</h3><div>A 12-month, multicenter, randomized controlled trial.</div></div><div><h3>Settings</h3><div>The FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain.</div></div><div><h3>Participants</h3><div>A total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years).</div></div><div><h3>Methods</h3><div>Participants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton and Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons.</div></div><div><h3>Results</h3><div>At both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline.</div></div><div><h3>Conclusions</h3><div>The educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community.</div></div><div><h3>Registration</h3><div>This trial was registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (Id","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"162 ","pages":"Article 104955"},"PeriodicalIF":7.5,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695794","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 : 2024-11-08DOI: 10.1016/j.ijnurstu.2024.104956
Jingcan Xu , Shuyi Peng , Li Yao , Minhui Liu , Liqing Yue
Background
Inpatient falls are common adverse events in hospitals, particularly among older adults. However, current research on falls in the older population is limited by small sample sizes and reliance on single-center designs without distinguishing the different levels of fall injuries.
Objective
To examine the circumstances of falls in older inpatients and investigate the factors influencing serious fall injuries.
Design
A secondary analysis of multicenter cross-sectional administrative data from the China National Database of Nursing Quality (CNDNQ).
Setting(s)
67 hospitals in Hunan, China.
Participants
5143 fall incidents from 5048 older inpatients were included from January 2019 to December 2022.
Methods
Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to describe fall characteristics. Given the multilevel data structure, a Generalized Linear Mixed Model (GLMM) with a Logistic link function was employed, treating hospitals and wards as random effects. Univariate and multivariate analyses were conducted.
Results
The prevalences of fall-related injuries and serious fall injuries in this study were 63.3 % and 25.0 %, respectively. Nurse-to-patient ratio at the time of fall ≤ 0.05 (aOR = 1.522, 95% CI: 1.297–1.785), female gender (aOR = 1.304, 95% CI: 1.137–1.497), a lengthy hospital stay (aOR = 1.009, 95% CI: 1.001–1.018) were associated with an increased risk of serious fall injuries. Surgical (aOR = 0.655, 95% CI: 0.482–0.889) and orthopedic wards (aOR = 0.649, 95% CI: 0.449–0.939) exhibited lower risks of serious fall injuries than internal medicine wards. The period from 8:00 to 15:59 was associated with a higher risk of serious fall injuries compared to the period from 0:00 to 7:59 (aOR = 1.416, 95% CI: 1.171–1.713). Compared to lying, standing (aOR = 2.594, 95% CI: 1.733–3.883), getting in/out of bed (aOR = 1.403, 95% CI: 1.009–1.951), walking or rehabilitating (aOR = 3.039, 95% CI: 2.194–4.208), toileting (aOR = 1.411, 95% CI: 1.038–1.917), and showering (aOR = 2.170, 95% CI: 1.391–3.385) were associated with an increased risk of serious fall injuries.
Conclusions
Fall-related injuries and serious fall injuries are highly prevalent among older inpatients. The study provides insights for targeted fall prevention strategies, improving nursing management and patient safety.
{"title":"Clinical characteristics and influencing factors of serious fall injuries among older inpatients: A secondary analysis of multicenter cross-sectional administrative data","authors":"Jingcan Xu , Shuyi Peng , Li Yao , Minhui Liu , Liqing Yue","doi":"10.1016/j.ijnurstu.2024.104956","DOIUrl":"10.1016/j.ijnurstu.2024.104956","url":null,"abstract":"<div><h3>Background</h3><div>Inpatient falls are common adverse events in hospitals, particularly among older adults. However, current research on falls in the older population is limited by small sample sizes and reliance on single-center designs without distinguishing the different levels of fall injuries.</div></div><div><h3>Objective</h3><div>To examine the circumstances of falls in older inpatients and investigate the factors influencing serious fall injuries.</div></div><div><h3>Design</h3><div>A secondary analysis of multicenter cross-sectional administrative data from the China National Database of Nursing Quality (CNDNQ).</div></div><div><h3>Setting(s)</h3><div>67 hospitals in Hunan, China.</div></div><div><h3>Participants</h3><div>5143 fall incidents from 5048 older inpatients were included from January 2019 to December 2022.</div></div><div><h3>Methods</h3><div>Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to describe fall characteristics. Given the multilevel data structure, a Generalized Linear Mixed Model (GLMM) with a Logistic link function was employed, treating hospitals and wards as random effects. Univariate and multivariate analyses were conducted.</div></div><div><h3>Results</h3><div>The prevalences of fall-related injuries and serious fall injuries in this study were 63.3 % and 25.0 %, respectively. Nurse-to-patient ratio at the time of fall ≤<!--> <!-->0.05 (<em>aOR</em> = 1.522, <em>95</em> <em>% CI:</em> 1.297–1.785), female gender (<em>aOR</em> = 1.304, <em>95</em> <em>% CI:</em> 1.137–1.497), a lengthy hospital stay (<em>aOR</em> = 1.009, <em>95</em> <em>% CI:</em> 1.001–1.018) were associated with an increased risk of serious fall injuries. Surgical (<em>aOR</em> = 0.655, <em>95</em> <em>% CI:</em> 0.482–0.889) and orthopedic wards (<em>aOR</em> = 0.649, <em>95</em> <em>% CI:</em> 0.449–0.939) exhibited lower risks of serious fall injuries than internal medicine wards. The period from 8:00 to 15:59 was associated with a higher risk of serious fall injuries compared to the period from 0:00 to 7:59 (<em>aOR</em> = 1.416, <em>95</em> <em>% CI:</em> 1.171–1.713). Compared to lying, standing (<em>aOR</em> = 2.594, <em>95</em> <em>% CI:</em> 1.733–3.883), getting in/out of bed (<em>aOR</em> = 1.403, <em>95</em> <em>% CI:</em> 1.009–1.951), walking or rehabilitating (<em>aOR</em> = 3.039, <em>95</em> <em>% CI:</em> 2.194–4.208), toileting (<em>aOR</em> = 1.411, <em>95</em> <em>% CI:</em> 1.038–1.917), and showering (<em>aOR</em> = 2.170, <em>95</em> <em>% CI:</em> 1.391–3.385) were associated with an increased risk of serious fall injuries.</div></div><div><h3>Conclusions</h3><div>Fall-related injuries and serious fall injuries are highly prevalent among older inpatients. The study provides insights for targeted fall prevention strategies, improving nursing management and patient safety.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104956"},"PeriodicalIF":7.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689394","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 : 2024-11-07DOI: 10.1016/j.ijnurstu.2024.104957
Dongpo Song
{"title":"Comment on Tan et al. (2024) 'Interventions to promote readiness for advance care planning: A systematic review and meta-analysis'","authors":"Dongpo Song","doi":"10.1016/j.ijnurstu.2024.104957","DOIUrl":"10.1016/j.ijnurstu.2024.104957","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104957"},"PeriodicalIF":7.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631865","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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