Pub Date : 2024-10-22DOI: 10.1016/j.ijnurstu.2024.104934
Shixin Huang , Sui Yu Yau , Yin King Linda Lee , Jingxing Song , Yuhong Guo , Dong Dong
<div><h3>Background</h3><div>Within long-term care facilities, paraprofessional nursing assistants account for the largest proportion of the health care workforce and provide essential direct care to older people with complex care needs. There is a gap in developing a theory-driven, systematic synthesis of the job characteristics and well-being outcomes specific to this occupational group, as most existing studies evaluate either professional health care workers or both professional and nursing assistants.</div></div><div><h3>Aim</h3><div>Develop an occupation-specific conceptual model on the job characteristics and well-being of nursing assistants in long-term care facilities drawing upon the job demands-resources model.</div></div><div><h3>Design</h3><div>Mixed methods systematic review following the Joanna Briggs Institute approach. The review protocol was registered on PROSPERO (2023 CRD42023403654).</div></div><div><h3>Methods</h3><div>The review included qualitative, quantitative, and mixed-method studies meeting these inclusion criteria: (1) peer-reviewed empirical research; (2) involved paraprofessional nursing assistants in long-term care facilities; (3) addressed well-being outcomes; (4) addressed occupation-specific job characteristics. Studies that are (1) not written in English, or (2) published before 1 January 2000 were excluded. A convergent synthesis approach was conducted using the content analysis method.</div></div><div><h3>Data sources</h3><div>Database searches (i.e., MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Scopus, and Google Scholar) and manual searches were conducted. The last search was conducted on July 31st, 2024.</div></div><div><h3>Results</h3><div>A Nursing Assistants Job Demands-Resources Model was developed based on 21 studies included. Nursing assistants are particularly vulnerable to burnout and mental health conditions, as well as occupational hazards, because of their job characteristics. Working time demands, physical care task stressors, and emotional demands are occupation-relevant job demands, while financial rewards, professional development resources, work environment, and emotional resources are motivational job resources. Strain-related personal characteristics are also relevant to nursing assistants. Findings indicated a spiral of vulnerabilities characterized by the vicious cycle of individual vulnerabilities, poor quality job, and health inequalities among nursing assistants in long-term care facilities.</div></div><div><h3>Conclusion</h3><div>This study finds that empirical evidence on nursing assistants' job characteristics and well-being is underdeveloped compared to research focusing on professional and all health care workers. We adapt a conceptual model and identify job and personal characteristics specific to the occupation group. Occupational-specific macro, meso, and micro-level strategies that mitigate job demands and nurture job resources should be developed to tackle the occupa
{"title":"Job characteristics, personal characteristics and well-being of nursing assistants in long-term care facilities: A mixed methods systematic review and narrative synthesis","authors":"Shixin Huang , Sui Yu Yau , Yin King Linda Lee , Jingxing Song , Yuhong Guo , Dong Dong","doi":"10.1016/j.ijnurstu.2024.104934","DOIUrl":"10.1016/j.ijnurstu.2024.104934","url":null,"abstract":"<div><h3>Background</h3><div>Within long-term care facilities, paraprofessional nursing assistants account for the largest proportion of the health care workforce and provide essential direct care to older people with complex care needs. There is a gap in developing a theory-driven, systematic synthesis of the job characteristics and well-being outcomes specific to this occupational group, as most existing studies evaluate either professional health care workers or both professional and nursing assistants.</div></div><div><h3>Aim</h3><div>Develop an occupation-specific conceptual model on the job characteristics and well-being of nursing assistants in long-term care facilities drawing upon the job demands-resources model.</div></div><div><h3>Design</h3><div>Mixed methods systematic review following the Joanna Briggs Institute approach. The review protocol was registered on PROSPERO (2023 CRD42023403654).</div></div><div><h3>Methods</h3><div>The review included qualitative, quantitative, and mixed-method studies meeting these inclusion criteria: (1) peer-reviewed empirical research; (2) involved paraprofessional nursing assistants in long-term care facilities; (3) addressed well-being outcomes; (4) addressed occupation-specific job characteristics. Studies that are (1) not written in English, or (2) published before 1 January 2000 were excluded. A convergent synthesis approach was conducted using the content analysis method.</div></div><div><h3>Data sources</h3><div>Database searches (i.e., MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Scopus, and Google Scholar) and manual searches were conducted. The last search was conducted on July 31st, 2024.</div></div><div><h3>Results</h3><div>A Nursing Assistants Job Demands-Resources Model was developed based on 21 studies included. Nursing assistants are particularly vulnerable to burnout and mental health conditions, as well as occupational hazards, because of their job characteristics. Working time demands, physical care task stressors, and emotional demands are occupation-relevant job demands, while financial rewards, professional development resources, work environment, and emotional resources are motivational job resources. Strain-related personal characteristics are also relevant to nursing assistants. Findings indicated a spiral of vulnerabilities characterized by the vicious cycle of individual vulnerabilities, poor quality job, and health inequalities among nursing assistants in long-term care facilities.</div></div><div><h3>Conclusion</h3><div>This study finds that empirical evidence on nursing assistants' job characteristics and well-being is underdeveloped compared to research focusing on professional and all health care workers. We adapt a conceptual model and identify job and personal characteristics specific to the occupation group. Occupational-specific macro, meso, and micro-level strategies that mitigate job demands and nurture job resources should be developed to tackle the occupa","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104934"},"PeriodicalIF":7.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548701","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 : 2024-10-20DOI: 10.1016/j.ijnurstu.2024.104935
Anaïs Le Breton , Hugo Touzet , Lisa Fressard , Patrick Chamboredon , Patrick Peretti-Watel , Jeremy Ward , Pierre Verger
<div><h3>Background</h3><div>Before, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating.</div></div><div><h3>Objectives</h3><div>To study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy.</div></div><div><h3>Design</h3><div>A cross-sectional survey.</div></div><div><h3>Settings</h3><div>Salaried, community (self-employed) and mixed nurses in France.</div></div><div><h3>Participants</h3><div>18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323).</div></div><div><h3>Methods</h3><div>In February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors), a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults).</div></div><div><h3>Results</h3><div>Among the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10<sup>−3</sup>) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10<sup>−3</sup>) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses.</div></div><div><h3>Conclusions</h3><div>Satisfaction at work appears to enhance nurses' vaccination attitudes and be
{"title":"Dissatisfaction with working conditions associated with lower vaccine confidence, commitment and behaviors among nurses: A large scale cross-sectional survey in France","authors":"Anaïs Le Breton , Hugo Touzet , Lisa Fressard , Patrick Chamboredon , Patrick Peretti-Watel , Jeremy Ward , Pierre Verger","doi":"10.1016/j.ijnurstu.2024.104935","DOIUrl":"10.1016/j.ijnurstu.2024.104935","url":null,"abstract":"<div><h3>Background</h3><div>Before, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating.</div></div><div><h3>Objectives</h3><div>To study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy.</div></div><div><h3>Design</h3><div>A cross-sectional survey.</div></div><div><h3>Settings</h3><div>Salaried, community (self-employed) and mixed nurses in France.</div></div><div><h3>Participants</h3><div>18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323).</div></div><div><h3>Methods</h3><div>In February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors), a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults).</div></div><div><h3>Results</h3><div>Among the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10<sup>−3</sup>) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10<sup>−3</sup>) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses.</div></div><div><h3>Conclusions</h3><div>Satisfaction at work appears to enhance nurses' vaccination attitudes and be","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104935"},"PeriodicalIF":7.5,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570107","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 : 2024-10-17DOI: 10.1016/j.ijnurstu.2024.104927
Jingjing Jiang , Simin Zhuang , Xin Zhang , Xueping Liang , Cunmei Tan , Jin Liu , Rongjing Yuan , Ke Zhang , Yuxuan Feng , Wei Fan , Yanhong Wang
Background
Vaginal birth after cesarean is an effective way of reducing cesarean section rates and preventing a variety of short- and long-term complications associated with cesarean deliveries. Additionally, vaginal birth after cesarean can enhance breastfeeding rates, expedite postpartum recovery, and minimize hospitalization duration for women. Despite these benefits, the prevalence of vaginal birth after cesarean remains low in many countries, and only limited reviews have investigated the factors contributing to the low vaginal birth after cesarean rates.
Objectives
This review aims to explore the barriers and facilitators influencing decision-making during the process of vaginal birth after cesarean.
Design
A mixed-methods systematic review.
Methods
Ten electronic databases were systematically and comprehensively searched for qualitative, quantitative, and mixed-methods studies. Two reviewers critically appraised the eligible studies independently using the Joanna Briggs Institute Critical Appraisal Tool. We converted quantitative findings to narrative form and employed a convergent synthesis design to synthesize the data thematically.
Results
This review included 55 studies published between 2002 and 2024. These studies originated from 19 countries and comprised 21 quantitative studies, 31 qualitative studies, and three mixed-methods studies. The methodological quality of the included studies was assessed as moderate to high. We divided the barriers and facilitators influencing vaginal birth after cesarean decision-making into four categories and nine subcategories: individual factors of pregnant women (sociodemographic characteristics, physiological factors, cognition, and psychological factors); interpersonal relationships (emotional support and communication); healthcare system factors (healthcare professionals' acceptance and commitment to action as well as healthcare facilities); and social factors (culture and ethnicity, along with law and policy).
Conclusions
This study broadens the understanding of the various factors that influence vaginal birth after cesarean decisions and may provide valuable insights for future modifications in vaginal birth after cesarean practices to enhance its availability for women. We conclude that successful implementation of vaginal birth after cesarean requires the concerted efforts of all stakeholders. Hospitals should improve the quality of care, enhance the capacity of the healthcare system to support vaginal birth after cesarean, and respect the preferences of pregnant women by providing support and encouraging their active participation in decision-making.
Registration
This systematic review was registered in PROSPERO on June 24, 2022 (CRD42022339434).
{"title":"Barriers and facilitators of choosing a vaginal birth after cesarean: A mixed-methods systematic review","authors":"Jingjing Jiang , Simin Zhuang , Xin Zhang , Xueping Liang , Cunmei Tan , Jin Liu , Rongjing Yuan , Ke Zhang , Yuxuan Feng , Wei Fan , Yanhong Wang","doi":"10.1016/j.ijnurstu.2024.104927","DOIUrl":"10.1016/j.ijnurstu.2024.104927","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal birth after cesarean is an effective way of reducing cesarean section rates and preventing a variety of short- and long-term complications associated with cesarean deliveries. Additionally, vaginal birth after cesarean can enhance breastfeeding rates, expedite postpartum recovery, and minimize hospitalization duration for women. Despite these benefits, the prevalence of vaginal birth after cesarean remains low in many countries, and only limited reviews have investigated the factors contributing to the low vaginal birth after cesarean rates.</div></div><div><h3>Objectives</h3><div>This review aims to explore the barriers and facilitators influencing decision-making during the process of vaginal birth after cesarean.</div></div><div><h3>Design</h3><div>A mixed-methods systematic review.</div></div><div><h3>Methods</h3><div>Ten electronic databases were systematically and comprehensively searched for qualitative, quantitative, and mixed-methods studies. Two reviewers critically appraised the eligible studies independently using the Joanna Briggs Institute Critical Appraisal Tool. We converted quantitative findings to narrative form and employed a convergent synthesis design to synthesize the data thematically.</div></div><div><h3>Results</h3><div>This review included 55 studies published between 2002 and 2024. These studies originated from 19 countries and comprised 21 quantitative studies, 31 qualitative studies, and three mixed-methods studies. The methodological quality of the included studies was assessed as moderate to high. We divided the barriers and facilitators influencing vaginal birth after cesarean decision-making into four categories and nine subcategories: individual factors of pregnant women (sociodemographic characteristics, physiological factors, cognition, and psychological factors); interpersonal relationships (emotional support and communication); healthcare system factors (healthcare professionals' acceptance and commitment to action as well as healthcare facilities); and social factors (culture and ethnicity, along with law and policy).</div></div><div><h3>Conclusions</h3><div>This study broadens the understanding of the various factors that influence vaginal birth after cesarean decisions and may provide valuable insights for future modifications in vaginal birth after cesarean practices to enhance its availability for women. We conclude that successful implementation of vaginal birth after cesarean requires the concerted efforts of all stakeholders. Hospitals should improve the quality of care, enhance the capacity of the healthcare system to support vaginal birth after cesarean, and respect the preferences of pregnant women by providing support and encouraging their active participation in decision-making.</div></div><div><h3>Registration</h3><div>This systematic review was registered in PROSPERO on June 24, 2022 (CRD42022339434).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104927"},"PeriodicalIF":7.5,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607272","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 : 2024-10-16DOI: 10.1016/j.ijnurstu.2024.104926
Kun Wang , Xiang Zeng , Junwen Li , Yale Guo , Zhaolan Wang
{"title":"Corrigendum to “The prevalence and risk factors of work-related musculoskeletal disorders among nurses in China: A systematic review and meta-analysis” [Int. J. Nurs. Stud. 157 (2024) 104826]","authors":"Kun Wang , Xiang Zeng , Junwen Li , Yale Guo , Zhaolan Wang","doi":"10.1016/j.ijnurstu.2024.104926","DOIUrl":"10.1016/j.ijnurstu.2024.104926","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442941","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 : 2024-10-15DOI: 10.1016/j.ijnurstu.2024.104929
Martin Šimon , Barbora Latečková , Oto Potluka
Background
Homelessness as an extreme form of poverty perpetuates and exacerbates health inequalities. People experiencing homelessness face a mortality rate 10 times higher than that of the general population, with an average age of death at 45. There is a significant disconnect between the mainstream healthcare system and the specific health needs of people experiencing homelessness, leading to substantial human and economic costs.
Objective
The objective of this evaluation study is to assess the impact of an intervention in nurse-led healthcare outreach services to people experiencing homelessness on their utilization of healthcare services.
Design
This study is a part of research program aimed at assuring health equity of most vulnerable members of a society. Detailed understanding of barriers to care is a necessary precondition for improvements in healthcare use.
Data
The study analyzes data on hospitalization and emergency department visits by people experiencing homelessness across three cities in Czechia from 2014 to 2021.
Methods
A quantitative difference-in-differences approach is complemented by insights from field studies in these three cities.
Results
The intervention in people experiencing homelessness outreach led to a reduction in both hospital admissions and the emergency visits by people experiencing homelessness, alleviating pressure on health service capacity and reducing associated healthcare costs. Enhanced primary nurse-led healthcare outreach, along with cross-sectoral integration and activation, has lowered the barriers to accessing essential healthcare services.
Conclusion
A pivotal policy outcome of this study is the establishment of an insurance provision that allows medical doctors to claim additional costs incurred in treating people experiencing homelessness from a public insurance system.
{"title":"Health and healthcare use of homeless population: Evaluation study of joint social work and healthcare provision","authors":"Martin Šimon , Barbora Latečková , Oto Potluka","doi":"10.1016/j.ijnurstu.2024.104929","DOIUrl":"10.1016/j.ijnurstu.2024.104929","url":null,"abstract":"<div><h3>Background</h3><div>Homelessness as an extreme form of poverty perpetuates and exacerbates health inequalities. People experiencing homelessness face a mortality rate 10 times higher than that of the general population, with an average age of death at 45. There is a significant disconnect between the mainstream healthcare system and the specific health needs of people experiencing homelessness, leading to substantial human and economic costs.</div></div><div><h3>Objective</h3><div>The objective of this evaluation study is to assess the impact of an intervention in nurse-led healthcare outreach services to people experiencing homelessness on their utilization of healthcare services.</div></div><div><h3>Design</h3><div>This study is a part of research program aimed at assuring health equity of most vulnerable members of a society. Detailed understanding of barriers to care is a necessary precondition for improvements in healthcare use.</div></div><div><h3>Data</h3><div>The study analyzes data on hospitalization and emergency department visits by people experiencing homelessness across three cities in Czechia from 2014 to 2021.</div></div><div><h3>Methods</h3><div>A quantitative difference-in-differences approach is complemented by insights from field studies in these three cities.</div></div><div><h3>Results</h3><div>The intervention in people experiencing homelessness outreach led to a reduction in both hospital admissions and the emergency visits by people experiencing homelessness, alleviating pressure on health service capacity and reducing associated healthcare costs. Enhanced primary nurse-led healthcare outreach, along with cross-sectoral integration and activation, has lowered the barriers to accessing essential healthcare services.</div></div><div><h3>Conclusion</h3><div>A pivotal policy outcome of this study is the establishment of an insurance provision that allows medical doctors to claim additional costs incurred in treating people experiencing homelessness from a public insurance system.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104929"},"PeriodicalIF":7.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512225","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 : 2024-10-14DOI: 10.1016/j.ijnurstu.2024.104930
Jingying Huang , Jin Yang , Mengbo Han , Zihao Xue , Miaomiao Xu , Haiou Qi , Jiaojiao Chen , Caiya Xue , Yuting Wang
<div><h3>Background</h3><div>Patient Reported Experience Measures (PREM) have become a critical component in assessing healthcare quality from the patient's perspective. Accurate and reproducible assessment tools are essential for generating robust and reliable results for evaluating peri-anesthesia patient experiences, identifying associated factors, and assessing the impact of healthcare interventions. However, there is currently no systematic review that consolidates all existing peri-anesthesia PREMs and evaluates their psychometric properties.</div></div><div><h3>Objective</h3><div>To identify and assess the psychometric properties of PREMs for peri-anesthesia patients.</div></div><div><h3>Design</h3><div>Systematic review of measurement properties following the COSMIN guidelines.</div></div><div><h3>Methods</h3><div>Systematic searches were conducted in China National Knowledge Infrastructure, Wanfang, PubMed, Embase, Web of Science, CINAHL, and PsycINFO databases from January 1, 1993, to April 15, 2024. Studies reporting on the development and/or validation of any PREMs for use in the peri-anesthesia period were considered eligible. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, cross-cultural validity, reliability, hypothesis testing and responsiveness. For the same PREM across different studies, reliability coefficients were analyzed using a meta-analysis. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were carried out following the COSMIN methodology for systematic reviews.</div></div><div><h3>Results</h3><div>A total of 26 studies encompassing 16 PREMs were included. Among them, the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq), Perception of Quality in Anesthesia (PQA), Sindhvananda General Anesthesia Satisfaction questionnaire, and Daycare Anesthesia Satisfaction (DAS) demonstrated moderate to high-quality evidence of adequate content validity and internal consistency, resulting in strong recommendations. Five PREMs exhibited high-quality evidence of inadequate structural validity and internal consistency, receiving a “not recommended” status. The remaining PREMs were weakly recommended.</div></div><div><h3>Conclusions</h3><div>This systematic review identified PSPACq and PQA as effective tools for assessing peri-anesthesia experiences in surgical patients, suitable for both research and clinical use. Future studies should focus on thoroughly evaluating the measurement properties of these two PREMs, as many aspects remain underexplored. A high risk of bias was noted in other PREMs, particularly in content validity, structural validity, and reliability, which increases uncertainty in the evidence base.</div></div><div><h3>Registration</h3><div>This study's protocol has been registered at PROSPERO under the registration number CRD42024537900.</div><
{"title":"Psychometric evaluation of patient-reported experience measures for peri-anesthesia care: A systematic review based on COSMIN guidelines","authors":"Jingying Huang , Jin Yang , Mengbo Han , Zihao Xue , Miaomiao Xu , Haiou Qi , Jiaojiao Chen , Caiya Xue , Yuting Wang","doi":"10.1016/j.ijnurstu.2024.104930","DOIUrl":"10.1016/j.ijnurstu.2024.104930","url":null,"abstract":"<div><h3>Background</h3><div>Patient Reported Experience Measures (PREM) have become a critical component in assessing healthcare quality from the patient's perspective. Accurate and reproducible assessment tools are essential for generating robust and reliable results for evaluating peri-anesthesia patient experiences, identifying associated factors, and assessing the impact of healthcare interventions. However, there is currently no systematic review that consolidates all existing peri-anesthesia PREMs and evaluates their psychometric properties.</div></div><div><h3>Objective</h3><div>To identify and assess the psychometric properties of PREMs for peri-anesthesia patients.</div></div><div><h3>Design</h3><div>Systematic review of measurement properties following the COSMIN guidelines.</div></div><div><h3>Methods</h3><div>Systematic searches were conducted in China National Knowledge Infrastructure, Wanfang, PubMed, Embase, Web of Science, CINAHL, and PsycINFO databases from January 1, 1993, to April 15, 2024. Studies reporting on the development and/or validation of any PREMs for use in the peri-anesthesia period were considered eligible. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, cross-cultural validity, reliability, hypothesis testing and responsiveness. For the same PREM across different studies, reliability coefficients were analyzed using a meta-analysis. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were carried out following the COSMIN methodology for systematic reviews.</div></div><div><h3>Results</h3><div>A total of 26 studies encompassing 16 PREMs were included. Among them, the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq), Perception of Quality in Anesthesia (PQA), Sindhvananda General Anesthesia Satisfaction questionnaire, and Daycare Anesthesia Satisfaction (DAS) demonstrated moderate to high-quality evidence of adequate content validity and internal consistency, resulting in strong recommendations. Five PREMs exhibited high-quality evidence of inadequate structural validity and internal consistency, receiving a “not recommended” status. The remaining PREMs were weakly recommended.</div></div><div><h3>Conclusions</h3><div>This systematic review identified PSPACq and PQA as effective tools for assessing peri-anesthesia experiences in surgical patients, suitable for both research and clinical use. Future studies should focus on thoroughly evaluating the measurement properties of these two PREMs, as many aspects remain underexplored. A high risk of bias was noted in other PREMs, particularly in content validity, structural validity, and reliability, which increases uncertainty in the evidence base.</div></div><div><h3>Registration</h3><div>This study's protocol has been registered at PROSPERO under the registration number CRD42024537900.</div><","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104930"},"PeriodicalIF":7.5,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479632","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}
<div><h3>Background</h3><div>Older adults aged over 65 are increasingly admitted to hospital for acute care reasons, including surgical procedures. In multicultural societies, the diversity of an ageing population has significant implications for the planning and delivery of culturally responsive perioperative care for older adults from ethnically diverse backgrounds, who are admitted to hospital for surgical intervention.</div></div><div><h3>Objective</h3><div>To explore the perspectives and experiences of perioperative staff when caring for older adult patients from ethnically diverse backgrounds.</div></div><div><h3>Design</h3><div>Exploratory qualitative methodology.</div></div><div><h3>Setting(s)</h3><div>Staff working in Australian perioperative care settings were recruited for semi-structured interviews.</div></div><div><h3>Participants</h3><div>Purposive sampling was used to recruit 15 perioperative staff members, who had experience with caring for older adult patients from ethnically diverse backgrounds during their surgical procedure.</div></div><div><h3>Methods</h3><div>Individual, semi-structured interviews were conducted with perioperative staff. Reflexive thematic analysis was used to identify key themes.</div></div><div><h3>Results</h3><div>Two themes were identified. These were <em>‘Organisational barriers in delivering safe and culturally responsive care’, and ‘Staff experiences in navigating the challenges of providing culturally responsive care’.</em> Staff reported that safety protocols often overshadowed patient-specific needs, especially for patients requiring additional linguistic or cultural support. The lack of formal interpreter services and the pressure to meet efficiency targets were cited as major barriers to delivering culturally responsive care.</div></div><div><h3>Conclusions</h3><div>Delivering culturally responsive care in the fast-paced, high-risk environment of the operating theatre presents complex challenges, as perioperative staff must navigate competing priorities of patient safety, organisational efficiency, and cultural nuances. This article highlights how the emphasis on efficiency can compromise culturally responsive care for older adults, with staff often frustrated by the lack of formalised organisational support, especially those for facilitating effective communication. Current approaches tend to treat cultural care as an “add-on” rather than integrating it into perioperative safety measures. A shift towards pre-emptive planning, with an organisational culture change that embeds culturally responsive care into the broader safety framework, is essential. This proactive approach would enhance both patient outcomes and staff readiness, fostering a perioperative environment where safety and cultural care are synonymous.</div><div><strong>Tweetable abstract</strong>: Embedding culturally responsive care into safety protocols is essential for enhancing perioperative experiences among older migrant patient
{"title":"Enhancing culturally responsive care in perioperative settings for older adult patients: A qualitative interview study","authors":"Charmaine G. Bonus , Deborah Hatcher , Tiffany Northall , Jed Montayre","doi":"10.1016/j.ijnurstu.2024.104925","DOIUrl":"10.1016/j.ijnurstu.2024.104925","url":null,"abstract":"<div><h3>Background</h3><div>Older adults aged over 65 are increasingly admitted to hospital for acute care reasons, including surgical procedures. In multicultural societies, the diversity of an ageing population has significant implications for the planning and delivery of culturally responsive perioperative care for older adults from ethnically diverse backgrounds, who are admitted to hospital for surgical intervention.</div></div><div><h3>Objective</h3><div>To explore the perspectives and experiences of perioperative staff when caring for older adult patients from ethnically diverse backgrounds.</div></div><div><h3>Design</h3><div>Exploratory qualitative methodology.</div></div><div><h3>Setting(s)</h3><div>Staff working in Australian perioperative care settings were recruited for semi-structured interviews.</div></div><div><h3>Participants</h3><div>Purposive sampling was used to recruit 15 perioperative staff members, who had experience with caring for older adult patients from ethnically diverse backgrounds during their surgical procedure.</div></div><div><h3>Methods</h3><div>Individual, semi-structured interviews were conducted with perioperative staff. Reflexive thematic analysis was used to identify key themes.</div></div><div><h3>Results</h3><div>Two themes were identified. These were <em>‘Organisational barriers in delivering safe and culturally responsive care’, and ‘Staff experiences in navigating the challenges of providing culturally responsive care’.</em> Staff reported that safety protocols often overshadowed patient-specific needs, especially for patients requiring additional linguistic or cultural support. The lack of formal interpreter services and the pressure to meet efficiency targets were cited as major barriers to delivering culturally responsive care.</div></div><div><h3>Conclusions</h3><div>Delivering culturally responsive care in the fast-paced, high-risk environment of the operating theatre presents complex challenges, as perioperative staff must navigate competing priorities of patient safety, organisational efficiency, and cultural nuances. This article highlights how the emphasis on efficiency can compromise culturally responsive care for older adults, with staff often frustrated by the lack of formalised organisational support, especially those for facilitating effective communication. Current approaches tend to treat cultural care as an “add-on” rather than integrating it into perioperative safety measures. A shift towards pre-emptive planning, with an organisational culture change that embeds culturally responsive care into the broader safety framework, is essential. This proactive approach would enhance both patient outcomes and staff readiness, fostering a perioperative environment where safety and cultural care are synonymous.</div><div><strong>Tweetable abstract</strong>: Embedding culturally responsive care into safety protocols is essential for enhancing perioperative experiences among older migrant patient","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104925"},"PeriodicalIF":7.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683271","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 : 2024-10-11DOI: 10.1016/j.ijnurstu.2024.104928
Hongjuan Wang , Yaqian Liu , Jojo Yan Yan Kwok , Fan Xu , Rongzhi Li , Jingfei Tang , Siyuan Tang , Mei Sun
<div><h3>Background</h3><div>The highly prevalent menopausal symptoms among women, along with their deleterious health impacts, call for increased attention to the need for effective interventions targeting this growing public health problem. While increasing evidence demonstrates that yoga interventions benefit menopausal symptoms, no systematic review or meta-analysis has yet systematically examined the effectiveness of yoga on menopausal symptoms.</div></div><div><h3>Objective</h3><div>To systematically examine the effectiveness of Yoga in improving menopausal symptoms, hot flashes, depressive symptoms, anxiety, sleep quality, body mass index, systolic blood pressure, diastolic blood pressure, and quality of life among women with menopause.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Nine electronic databases, including PubMed, Web of Science, PsycINFO, Science Direct, EMBASE, Cochrane Central, CINAHL, WanFang, and the Chinese National Knowledge Infrastructure, were searched from their inception to March 3, 2024, and updated on August 1, 2024. Randomized controlled trials investigating Yoga interventions for women experiencing menopause were included in this study. The quality of the included studies was assessed using the Cochrane Collaboration's ‘risk of bias’ tool. Meta-analyses were conducted using RevMan 5.4.1 and Stata 18.0.</div></div><div><h3>Results</h3><div>A total of 1302 articles were initially identified. Eventually, 24 studies (n = 2028 individuals) were included in this systematic review. The pooled analysis demonstrated that Yoga had significant beneficial effects on total menopausal symptoms (95 % CI: −<!--> <!-->1.62 to −<!--> <!-->0.73), psychological menopausal symptoms (95 % CI: −<!--> <!-->1.87 to −<!--> <!-->0.68), somatic menopausal symptoms (95 % CI: −<!--> <!-->1.37 to −<!--> <!-->0.39), urogenital menopausal symptoms (95 % CI: −<!--> <!-->0.97 to −<!--> <!-->0.59), sleep quality (95 % CI: −<!--> <!-->1.97 to −<!--> <!-->0.62), anxiety (95 % CI: −<!--> <!-->1.82 to −<!--> <!-->0.09), depressive symptoms (95 % CI: −<!--> <!-->2.36 to −<!--> <!-->0.74), body mass index (95 % CI: −<!--> <!-->1.61 to −<!--> <!-->1.08), systolic blood pressure (95 % CI: −<!--> <!-->7.71 to −<!--> <!-->5.33), and diastolic blood pressure (95 % CI: −<!--> <!-->5.96 to −<!--> <!-->4.24). However, no significant differences were observed between Yoga and usual care in terms of hot flashes (95 % CI: −<!--> <!-->1.00 to 0.37) and quality of life (95 % CI: −<!--> <!-->0.50 to 1.82).</div></div><div><h3>Conclusions</h3><div>Yoga significantly improved menopausal symptoms, sleep quality, anxiety, depressive symptoms, body mass index, systolic blood pressure, and diastolic blood pressure among women with menopause. This suggests that integrating yoga interventions into clinical practice has the potential to address the significant burden of menopause-related outcomes. Future studies s
{"title":"The effectiveness of yoga on menopausal symptoms: A systematic review and meta-analysis of randomized controlled trials","authors":"Hongjuan Wang , Yaqian Liu , Jojo Yan Yan Kwok , Fan Xu , Rongzhi Li , Jingfei Tang , Siyuan Tang , Mei Sun","doi":"10.1016/j.ijnurstu.2024.104928","DOIUrl":"10.1016/j.ijnurstu.2024.104928","url":null,"abstract":"<div><h3>Background</h3><div>The highly prevalent menopausal symptoms among women, along with their deleterious health impacts, call for increased attention to the need for effective interventions targeting this growing public health problem. While increasing evidence demonstrates that yoga interventions benefit menopausal symptoms, no systematic review or meta-analysis has yet systematically examined the effectiveness of yoga on menopausal symptoms.</div></div><div><h3>Objective</h3><div>To systematically examine the effectiveness of Yoga in improving menopausal symptoms, hot flashes, depressive symptoms, anxiety, sleep quality, body mass index, systolic blood pressure, diastolic blood pressure, and quality of life among women with menopause.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Nine electronic databases, including PubMed, Web of Science, PsycINFO, Science Direct, EMBASE, Cochrane Central, CINAHL, WanFang, and the Chinese National Knowledge Infrastructure, were searched from their inception to March 3, 2024, and updated on August 1, 2024. Randomized controlled trials investigating Yoga interventions for women experiencing menopause were included in this study. The quality of the included studies was assessed using the Cochrane Collaboration's ‘risk of bias’ tool. Meta-analyses were conducted using RevMan 5.4.1 and Stata 18.0.</div></div><div><h3>Results</h3><div>A total of 1302 articles were initially identified. Eventually, 24 studies (n = 2028 individuals) were included in this systematic review. The pooled analysis demonstrated that Yoga had significant beneficial effects on total menopausal symptoms (95 % CI: −<!--> <!-->1.62 to −<!--> <!-->0.73), psychological menopausal symptoms (95 % CI: −<!--> <!-->1.87 to −<!--> <!-->0.68), somatic menopausal symptoms (95 % CI: −<!--> <!-->1.37 to −<!--> <!-->0.39), urogenital menopausal symptoms (95 % CI: −<!--> <!-->0.97 to −<!--> <!-->0.59), sleep quality (95 % CI: −<!--> <!-->1.97 to −<!--> <!-->0.62), anxiety (95 % CI: −<!--> <!-->1.82 to −<!--> <!-->0.09), depressive symptoms (95 % CI: −<!--> <!-->2.36 to −<!--> <!-->0.74), body mass index (95 % CI: −<!--> <!-->1.61 to −<!--> <!-->1.08), systolic blood pressure (95 % CI: −<!--> <!-->7.71 to −<!--> <!-->5.33), and diastolic blood pressure (95 % CI: −<!--> <!-->5.96 to −<!--> <!-->4.24). However, no significant differences were observed between Yoga and usual care in terms of hot flashes (95 % CI: −<!--> <!-->1.00 to 0.37) and quality of life (95 % CI: −<!--> <!-->0.50 to 1.82).</div></div><div><h3>Conclusions</h3><div>Yoga significantly improved menopausal symptoms, sleep quality, anxiety, depressive symptoms, body mass index, systolic blood pressure, and diastolic blood pressure among women with menopause. This suggests that integrating yoga interventions into clinical practice has the potential to address the significant burden of menopause-related outcomes. Future studies s","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104928"},"PeriodicalIF":7.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523499","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 : 2024-10-09DOI: 10.1016/j.ijnurstu.2024.104924
Mengqi Xu, Suzanne Hoi Shan Lo, Elaine Yi Ning Miu, Kai Chow Choi
<div><h3>Background</h3><div>Coronary artery disease is the leading cause of death worldwide. Adhering to coronary artery disease medications is the priority of its treatment. Medication adherence is suboptimal among older adults with coronary artery disease. Educational programmes are used and recommended in improving medication adherence among older adults with coronary artery disease. The evidence about the effects of educational programmes on medication adherence among older adults with coronary artery disease is, however, limited.</div></div><div><h3>Aim</h3><div>To evaluate the effects of educational programmes designed for improving medication adherence among older adults with coronary artery disease.</div></div><div><h3>Methods</h3><div>12 English databases and five Chinese databases were searched from database inception to January 2024. Randomised controlled trials examining the effects of educational programmes for improving medication adherence among older adults (aged 60 years old or above) with coronary artery disease (including myocardial infarction, stable or unstable angina, undergoing percutaneous coronary intervention, or undergoing coronary artery bypass grafting) were included. The quality of the included studies was assessed by the Cochrane Risk of Bias Tool v2. Meta-analysis was conducted using random-effect models with Review Manager 5.3. Narrative synthesis was conducted if the results of the included studies were not appropriate or possible for meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the certainty of evidence.</div></div><div><h3>Results</h3><div>5607 records were retrieved, and 5600 records were excluded. Six randomised controlled trials were included. The results showed that educational programmes could significantly improve medication adherence at two to six months post-intervention (standardised mean difference (SMD): 1.13, 95 % confidence interval (CI): 0.33 to 1.94, <em>P</em> = 0.006, Moderate certainty of evidence), but there was no significant evidence to support their effect on medication adherence within one-month post-intervention (SMD: 2.18, 95 % CI: −<!--> <!-->1.22, 5.58, <em>P</em> = 0.21, Low certainty of evidence). Narrative synthesis found that the educational programmes potentially improved medication adherence over six months post-intervention, understanding of coronary artery disease and related medications, and medication management capacity.</div></div><div><h3>Conclusions</h3><div>Educational programmes could significantly improve medication adherence among older adults with coronary artery disease at two to six months post-intervention, and potentially improve medication adherence over six months post-intervention. The effect on medication adherence within one-month post-intervention was inconclusive. Designing the educational programmes with theoretical frameworks and refined components helps address their complex health
{"title":"Educational programmes for improving medication adherence among older adults with coronary artery disease: A systematic review and meta-analysis","authors":"Mengqi Xu, Suzanne Hoi Shan Lo, Elaine Yi Ning Miu, Kai Chow Choi","doi":"10.1016/j.ijnurstu.2024.104924","DOIUrl":"10.1016/j.ijnurstu.2024.104924","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease is the leading cause of death worldwide. Adhering to coronary artery disease medications is the priority of its treatment. Medication adherence is suboptimal among older adults with coronary artery disease. Educational programmes are used and recommended in improving medication adherence among older adults with coronary artery disease. The evidence about the effects of educational programmes on medication adherence among older adults with coronary artery disease is, however, limited.</div></div><div><h3>Aim</h3><div>To evaluate the effects of educational programmes designed for improving medication adherence among older adults with coronary artery disease.</div></div><div><h3>Methods</h3><div>12 English databases and five Chinese databases were searched from database inception to January 2024. Randomised controlled trials examining the effects of educational programmes for improving medication adherence among older adults (aged 60 years old or above) with coronary artery disease (including myocardial infarction, stable or unstable angina, undergoing percutaneous coronary intervention, or undergoing coronary artery bypass grafting) were included. The quality of the included studies was assessed by the Cochrane Risk of Bias Tool v2. Meta-analysis was conducted using random-effect models with Review Manager 5.3. Narrative synthesis was conducted if the results of the included studies were not appropriate or possible for meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the certainty of evidence.</div></div><div><h3>Results</h3><div>5607 records were retrieved, and 5600 records were excluded. Six randomised controlled trials were included. The results showed that educational programmes could significantly improve medication adherence at two to six months post-intervention (standardised mean difference (SMD): 1.13, 95 % confidence interval (CI): 0.33 to 1.94, <em>P</em> = 0.006, Moderate certainty of evidence), but there was no significant evidence to support their effect on medication adherence within one-month post-intervention (SMD: 2.18, 95 % CI: −<!--> <!-->1.22, 5.58, <em>P</em> = 0.21, Low certainty of evidence). Narrative synthesis found that the educational programmes potentially improved medication adherence over six months post-intervention, understanding of coronary artery disease and related medications, and medication management capacity.</div></div><div><h3>Conclusions</h3><div>Educational programmes could significantly improve medication adherence among older adults with coronary artery disease at two to six months post-intervention, and potentially improve medication adherence over six months post-intervention. The effect on medication adherence within one-month post-intervention was inconclusive. Designing the educational programmes with theoretical frameworks and refined components helps address their complex health ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104924"},"PeriodicalIF":7.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434447","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}
Trauma has a well-established link with poor health outcomes. Adverse experiences in mental health inpatient settings contribute to such outcomes and should impact service design and delivery. However, there is often a failure to fully address these experiences.
Objective
To describe the spectrum of negative experiences that people identify while they are inpatients in adult mental health services.
Design
Qualitative systematic review of the international literature.
Setting(s)
Inpatient mental health settings globally.
Participants
Analysis includes findings from 111 studies across 25 countries.
Methods
CINAHL, MEDLINE and PsycINFO were searched from 2000 onwards, supplemented by Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme qualitative checklist. Data were synthesised using the ‘best-fit’ framework synthesis approach, enriched by patient and public involvement.
Results
Adverse mental health inpatient experiences can be conceptualised under three headings: the ecosystem (the physical environment and the resources available, and other people within or influential to that environment); systems (processes and transitions); and the individual (encroachments on autonomy and traumatisation).
Conclusions
This paper highlights the interplay between systemic, environmental and individual factors contributing to adverse experiences in mental health inpatient settings. By recognising and addressing these factors, we can significantly enhance patient outcomes. Application of adversity to Bronfenbrenner’s ecological systems theory provides a strategic approach to improving service design and delivery, advocating for environments that prioritise patient safety, dignity and respect. However, further research is needed to validate the framework and effectively integrate these insights into practice, ultimately transforming the inpatient care experience for all stakeholders.
Registration
The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022323237).
Tweetable abstract
Review suggests traumatic experiences in mental health inpatient settings can worsen outcomes. Urges redesign of environment, processes and autonomy to improve care @dr_nutmeg @EmxEn @RAVresearchUoB @IMH_UoB
{"title":"Adverse mental health inpatient experiences: Qualitative systematic review of international literature","authors":"Nutmeg Hallett , Rachel Dickinson , Emachi Eneje , Geoffrey L. Dickens","doi":"10.1016/j.ijnurstu.2024.104923","DOIUrl":"10.1016/j.ijnurstu.2024.104923","url":null,"abstract":"<div><h3>Background</h3><div>Trauma has a well-established link with poor health outcomes. Adverse experiences in mental health inpatient settings contribute to such outcomes and should impact service design and delivery. However, there is often a failure to fully address these experiences.</div></div><div><h3>Objective</h3><div>To describe the spectrum of negative experiences that people identify while they are inpatients in adult mental health services.</div></div><div><h3>Design</h3><div>Qualitative systematic review of the international literature.</div></div><div><h3>Setting(s)</h3><div>Inpatient mental health settings globally.</div></div><div><h3>Participants</h3><div>Analysis includes findings from 111 studies across 25 countries.</div></div><div><h3>Methods</h3><div>CINAHL, MEDLINE and PsycINFO were searched from 2000 onwards, supplemented by Google Scholar. Studies were appraised using the Critical Appraisal Skills Programme qualitative checklist. Data were synthesised using the ‘best-fit’ framework synthesis approach, enriched by patient and public involvement.</div></div><div><h3>Results</h3><div>Adverse mental health inpatient experiences can be conceptualised under three headings: the ecosystem (the physical environment and the resources available, and other people within or influential to that environment); systems (processes and transitions); and the individual (encroachments on autonomy and traumatisation).</div></div><div><h3>Conclusions</h3><div>This paper highlights the interplay between systemic, environmental and individual factors contributing to adverse experiences in mental health inpatient settings. By recognising and addressing these factors, we can significantly enhance patient outcomes. Application of adversity to Bronfenbrenner’s ecological systems theory provides a strategic approach to improving service design and delivery, advocating for environments that prioritise patient safety, dignity and respect. However, further research is needed to validate the framework and effectively integrate these insights into practice, ultimately transforming the inpatient care experience for all stakeholders.</div></div><div><h3>Registration</h3><div>The review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022323237).</div></div><div><h3><strong>Tweetable abstract</strong></h3><div>Review suggests traumatic experiences in mental health inpatient settings can worsen outcomes. Urges redesign of environment, processes and autonomy to improve care @dr_nutmeg @EmxEn @RAVresearchUoB @IMH_UoB</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"161 ","pages":"Article 104923"},"PeriodicalIF":7.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394888","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}
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