International Journal of Nursing Studies最新文献

{"title":"EffEctiveness of Prophylactic fOam dressings in the prevention of saCral pressure injuries in at-risk hospitalised patients (EEPOC): A randomised control trial","authors":"Rachel M. Walker ,&nbsp;Wendy Chaboyer ,&nbsp;Lukman Thalib ,&nbsp;Sharon Latimer ,&nbsp;Haitham Tuffaha ,&nbsp;Marie Cooke ,&nbsp;Brigid M. Gillespie","doi":"10.1016/j.ijnurstu.2025.105258","DOIUrl":"10.1016/j.ijnurstu.2025.105258","url":null,"abstract":"<div><h3>Background</h3><div>Hospital-acquired pressure injuries are a serious patient safety issue with the sacrum the most common location. Silicone foam border dressings are increasingly used in hospitalised patients, yet their clinical and cost-effectiveness in preventing pressure injuries is unclear in some patient cohorts.</div></div><div><h3>Objective</h3><div>To determine the clinical and cost-effectiveness of a silicone foam border dressing in preventing sacral hospital acquired pressure injuries in at-risk medical-surgical patients.</div></div><div><h3>Methods</h3><div>A prospective, multi-site, parallel group, pragmatic, superiority randomised controlled trial was conducted in Southeast Queensland, Australia. Medical-surgical adult patients (≥<!--> <!-->18 years) at-risk of pressure injury were recruited and randomly allocated to either an intervention (sacral dressing plus routine care) or control (routine care only) group. The Primary outcome was development of a new sacral pressure injury. Daily, blinded, and independent outcome assessments were conducted off-site for up to 14 days using edited photographs of deidentified participants' sacra. Intention-To-Treat analyses were performed using both best-case and worse-case scenarios. Additional complete case analyses were conducted as part of sensitivity analyses. Secondary outcomes comprised time to onset of hospital-acquired sacral pressure injury, severity, incidence rates per 1000 trial days (days patients were in the trial), incidence rates per 1000 hospital days (days patients were in hospital), and cost-effectiveness that compared the difference in pressure injury incidence between groups.</div></div><div><h3>Results</h3><div>Of the 1121 eligible patients approached, 958 agreed to participate. There were no significant differences in baseline characteristics between intervention and control groups. Cumulative incidence of sacral pressure injury was 1.67 % (8/478) and 1.25 % (6/480) in the intervention and control groups respectively (p = 0.592).</div><div>There was an increased risk of pressure injury for those in the intervention group (Relative Risk: 1.34 (95 % CI 0.47–3.83)), but the effect was not statistically significant and confidence intervals wide. Distribution of secondary outcomes was also similar in both the intervention and control groups. The intervention was more costly than the control showing an incremental cost of $99.90 (95 % CI $74.10–$125.60) associated with using the dressings.</div></div><div><h3>Conclusions</h3><div>The study did not provide evidence that silicone foam border dressings reduced the incidence of sacral hospital acquired pressure injuries in adult medical-surgical patients at risk of pressure injuries. Additionally, the silicone foam dressings incurred higher incremental costs than routine care.</div></div><div><h3>Trial registration number</h3><div>ACTRESN12619000763145, Registered 22/05/2019, first recruitment 10/07/2020.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105258"},"PeriodicalIF":7.1,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145382811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the care transition intervention on hospital readmission and quality of life in older adults with multiple chronic conditions: A mixed methods study","authors":"Azar Jafari-Koulaee ,&nbsp;Eesa Mohammadi ,&nbsp;Mary T. Fox ,&nbsp;Aliakbar Rasekhi ,&nbsp;Ozra Akha","doi":"10.1016/j.ijnurstu.2025.105257","DOIUrl":"10.1016/j.ijnurstu.2025.105257","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The care transition intervention has been designed to guide users in supporting older adults during care transitions; however, there is little knowledge about its effectiveness in older adults with multiple chronic conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study evaluated the effects of the care transition intervention in older adults with multiple chronic conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A randomized intervention study with a mixed-methods design was conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The quantitative phase of the study was conducted using a randomized clinical trial on older patients with multiple chronic conditions referred to the Imam Khomeini Hospital in Sari (Mazandaran, Iran) in 2022–2024. Patients in the experimental group received the care transition intervention which involved implementing a patient-centered record, and providing education on medication self-management, warning signs of worsening health condition(s) and how react to them, and follow-up. Patients in the control group received routine hospital care. Quality of life and the number of hospital readmissions were assessed before the intervention, and at one, three, and six months after hospital discharge. The qualitative phase focused on understanding the experiences of patients and caregivers who had participated in the care transition intervention. Qualitative data were analyzed using conventional content analysis. Finally, after analyzing the data from the quantitative and qualitative phases, the quantitative findings were compared to the qualitative findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There was a statistically significant between group difference in Quality of life at one (control group: 69.28(8.64), experimental group: 64.36(10.82)), three (control group: 71.41(8.70), experimental group: 64.20(10.90)) and six months (control group: 72.21(8.93), experimental group: 64.29 (11.26)) after hospital discharge (P &lt; 0.05). Also, hospital readmission in the control group was 73 % higher than the experimental group. The greatest effect of the intervention for quality of life (effect size = 0.77) and readmission (effect size = 0.63) was found six months after discharge. Qualitative findings support a beneficial effect of the care transition intervention on the quality of life and readmission in older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Using the care transition intervention for older adults with multiple chronic conditions improves health-related outcomes and is associated with reduced disease burden and more satisfaction towards life in different physical, psychological, and social dimensions for them. Therefore, implementing the care transition intervention can be useful for patients, their families and the healthcare system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Registration&lt;/h3&gt;&lt;div&gt;This trial was registered at &lt;span&gt;&lt;span&gt;irct.behdasht.gov.ir&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (Identifier: IRCT2","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"174 ","pages":"Article 105257"},"PeriodicalIF":7.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145475637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a theory-driven Brazilian jiu-jitsu-based medical self-defense training for nurses facing workplace violence: A multicenter quasi-experimental study","authors":"Ching-Yuan Ma ,&nbsp;Sheng-Ji Liao ,&nbsp;Yue-Cune Chang ,&nbsp;Hui-Hsun Chiang","doi":"10.1016/j.ijnurstu.2025.105260","DOIUrl":"10.1016/j.ijnurstu.2025.105260","url":null,"abstract":"<div><h3>Background</h3><div>Workplace violence negatively affects nurses' psychological well-being and job performance and the quality of patient care. Traditional workplace violence prevention training programs are not typically theory-driven and do not typically allow participants to apply practical skills. To address this gap, this study conducted a self-defense training intervention involving Brazilian jiu-jitsu training and elements of experiential learning theory. The primary outcome was self-efficacy in managing workplace violence. The secondary outcomes of interest were perceptions of and attitudes toward workplace violence management.</div></div><div><h3>Methods</h3><div>This multicenter, quasiexperimental study recruited 280 nurses from several health-care institutions. Participants were divided into an intervention group (<em>n</em> = 133), which completed a Brazilian jiu-jitsu-based self-defense training intervention, and a control group (<em>n</em> = 147), which received traditional classroom-based workplace violence prevention training. Outcomes were assessed using the General Self-Efficacy Scale, Perception of Aggression Scale, and Management of Aggression and Violence Attitude Scale. Assessments were conducted at baseline and after the intervention. Generalized estimating equations were used to examine the effects of the intervention.</div></div><div><h3>Results</h3><div>At immediate post-intervention, the intervention group exhibited significantly greater improvements in self-efficacy (β = 3.02; 95 % CI 1.47–4.57) and workplace violence perceptions (β = 6.94; 95 % CI 4.90–8.98) than did the control group. The intervention did not lead to a statistically significant improvement in attitudes toward workplace violence management (β = 0.83; 95 % CI −<!--> <!-->0.23–1.89). Covariate analysis revealed that sex (higher in men), work location (higher at medical centers), and work unit (lower in psychiatry units) significantly influenced outcomes.</div></div><div><h3>Conclusions</h3><div>Theory-driven Brazilian jiu-jitsu-based self-defense training significantly enhance nurses' perceptions and self-efficacy in handling workplace violence, highlighting the value of experiential learning in nursing workplace violence prevention programs.</div></div><div><h3>Registration number</h3><div>NCT 06129929.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105260"},"PeriodicalIF":7.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for depressive symptoms in older adults with preclinical Alzheimer's disease: A systematic review and meta-analysis","authors":"DanTing Chen ,&nbsp;ZiPing Zhu ,&nbsp;YanHong Shi ,&nbsp;Hong Li ,&nbsp;Rong Lin","doi":"10.1016/j.ijnurstu.2025.105259","DOIUrl":"10.1016/j.ijnurstu.2025.105259","url":null,"abstract":"<div><h3>Background</h3><div>Depression is more common in older adults with preclinical Alzheimer's disease, and the presence of depressive symptoms accelerates disease progression and affects patients' physical and mental health. Although the prevalence of and the risk factors associated with depressive symptoms in older adults with preclinical Alzheimer's disease have been widely reported, these results have not been synthesized.</div></div><div><h3>Objectives</h3><div>The aim of this review was to systematically assess the prevalence and risk factors affecting the occurrence of depressive symptoms in older adults with preclinical Alzheimer's disease.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Data sources</h3><div>The Cochrane Library, PubMed, Web of Science, CINAHL, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical Database were searched in the systematic review. The search included all literature published up to June 1st, 2025.</div></div><div><h3>Review methods</h3><div>Original journal articles that met the inclusion criteria were included. Two investigators independently assessed the methodological quality of the included studies. A meta-analysis was conducted using Stata 18.0, and the pooled prevalence of depressive symptoms was estimated using a random-effects model.</div></div><div><h3>Results</h3><div>In total, 46 eligible studies were included in this review, and there was a high degree of heterogeneity between the studies. The meta-analysis showed that the prevalence of depressive symptoms in older adults with preclinical Alzheimer's disease was 28 % (95 % CI: 0.24–0.32).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105259"},"PeriodicalIF":7.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrete choice experiments in nursing workforce research: A methodological review","authors":"Yin Li ,&nbsp;John Howell ,&nbsp;Jeannie P. Cimiotti","doi":"10.1016/j.ijnurstu.2025.105262","DOIUrl":"10.1016/j.ijnurstu.2025.105262","url":null,"abstract":"<div><h3>Background</h3><div>Discrete Choice Experiments are a widely used stated preference method that simulates real-world decision-making by presenting individuals with hypothetical choice sets that vary across attributes. In healthcare, and increasingly in nursing workforce research, discrete choice experiments offer valuable insights into job preferences and inform strategies for recruitment, retention, and policy development. This review examines the application of discrete choice experiments in nursing workforce research, evaluates methodological practices across studies, and identifies areas for improvement to guide future applications.</div></div><div><h3>Methods</h3><div>We conducted a literature search across Medline, CINAHL, Web of Science, and Google Scholar using keywords related to nursing and discrete choice experiments. Empirical studies published in English through December 2024 were included if they used discrete choice experiments to examine nurses' or midwives' job preferences. Non-empirical articles and studies that included other professionals were excluded. Twelve studies met the inclusion criteria and were analyzed.</div></div><div><h3>Results</h3><div>Most studies were conducted in low- and middle-income countries, with half focusing on rural–urban job preferences. Choice task designs varied widely; while most used binary choice formats, only a few included labeled designs or opt-out options. Attribute and level selection methods often relied on literature review or focus groups, but few studies used a comprehensive approach. Experimental designs were inconsistent, with half employing D-efficient designs and limited use of versioning to reduce respondent burden. Pilot testing was conducted in most studies, but it was typically small-scale and lacked representation of subgroups. Econometric analysis varied, including conditional logit, mixed logit, and multinomial logit models. About half of the reviewed studies estimated willingness to pay and conducted counterfactual simulations. Several studies lacked transparency in analytic reporting.</div></div><div><h3>Conclusions</h3><div>This review highlights both the promise and limitations of current discrete choice experiment practices in nursing workforce research. While discrete choice experiments are increasingly used to quantify nurses' job preferences, methodological rigor remains inconsistent, particularly in attribute development, experimental design, piloting, and analytic transparency. Future studies should adopt more systematic approaches, leverage advanced modeling techniques, and use simulations to enhance policy relevance. Standardizing best practices will improve the comparability and utility of discrete choice experiments for informing nursing workforce planning and health system policy.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105262"},"PeriodicalIF":7.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demands, resources, burnout, and work ability in long-term care: A multi-group structural equation model comparing residential and home care","authors":"Michael Herz ,&nbsp;Simon Blaschke ,&nbsp;Doris Gebhard","doi":"10.1016/j.ijnurstu.2025.105255","DOIUrl":"10.1016/j.ijnurstu.2025.105255","url":null,"abstract":"<div><h3>Background</h3><div>Demands and resources significantly influence burnout and work ability, which are critical outcomes in nursing workforce health research. Burnout is a multidimensional construct comprising emotional exhaustion, depersonalization, and reduced personal accomplishment due to prolonged work-related stress, while work ability describes a worker's capacity to meet job demands given their health, skills, and mental resources. Evidence suggests that the extent of burnout and work ability varies across different care settings. However, research on the relationships between demands, resources, burnout dimensions, and work ability in the context of long-term care remains limited.</div></div><div><h3>Objective</h3><div>To test a modified version of the Job Demands-Resources model by assessing measurement invariance and examining the relationships between demands, resources, burnout dimensions, and work ability, as well as comparing these relationships across residential long-term care and home care settings.</div></div><div><h3>Design</h3><div>A Multi-group Structural Equation Modelling approach.</div></div><div><h3>Participants</h3><div>301 employees working in German residential long-term care and home care facilities.</div></div><div><h3>Methods</h3><div>Data from two cross-sectional studies conducted in residential care (November–December 2019) and home care (September–October 2020) were analyzed using a multi-group structural equation model. Measurement invariance testing was applied to validate the model across both settings and to identify setting-specific differences.</div></div><div><h3>Results</h3><div>The modified Job Demands-Resources model demonstrated measurement invariance across residential and home care settings, confirming its applicability in both long-term care settings. High demands were linked to increased emotional exhaustion and depersonalisation, while resources were positively related to personal accomplishment in both settings. Statistically significant group differences were observed: emotional exhaustion was negatively associated with work ability only in home care (<em>β</em> = −<!--> <!-->0.58, p = .016), and paths from depersonalisation (p &lt; .001) and personal accomplishment (p &lt; .001) to work ability differed between settings.</div></div><div><h3>Conclusions</h3><div>Demands and resources shape burnout dimensions among long-term care employees. Similarities point to the potential of generic interventions, whereas differences in the relationships between burnout dimensions and work ability across settings underscore the need for setting-specific approaches. Further research should identify additional demands and resources and confirm these findings through longitudinal studies.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105255"},"PeriodicalIF":7.1,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and contributors to workarounds in the electronic health record system among inpatient nurses: Secondary analysis of a mixed-methods study","authors":"Oliver T. Nguyen ,&nbsp;Alexandria Carey ,&nbsp;Linsey M. Steege ,&nbsp;Hwayoung Cho","doi":"10.1016/j.ijnurstu.2025.105261","DOIUrl":"10.1016/j.ijnurstu.2025.105261","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The electronic health record system is known to have usability issues, in part, because of a mismatch between the design of electronic health record workflows and the realities of how workflows occur in clinical practice. In response to reducing this mismatch, healthcare workers, including nurses, have developed and implemented electronic health record workarounds. However, the nature and contributors of these workarounds are loosely understood, particularly among nurses, who make up the most common type of electronic health record user.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;1) To identify and characterize electronic health record workarounds used by inpatient nurses, 2) to determine work system factors contributing to the need for these workarounds, and 3) to understand how different levels of electronic health record usability influence the need for these workarounds.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This study was a secondary analysis of a larger mixed-methods study on how electronic health record usability influences nursing documentation burden across flowsheets, medication administration records, care plans, notes, and admission-discharge-transfer navigators. The present study used a convergent design to re-examine the interview data and usability survey responses originally collected from 20 inpatient nurses at a teaching hospital. Semi-structured interview transcripts were inductively analyzed to identify unique workarounds and deductively analyzed to examine work system contributors. Documentation features were grouped based on above vs. below average overall usability scores and compared for unique workarounds and contributing factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified eleven electronic health record workarounds, though some were used for specific documentation features rather than applied universally. All levels of the work system (e.g., electronic health record design, clinical environment) influenced nurses' needs for workarounds. Electronic health record usability levels influenced the specific workarounds used but not the work system contributors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Electronic health record workarounds are context-dependent and future research should contextualize what feature or task the workarounds were used for. Although some workarounds exist because of clinical necessity (e.g., prioritizing decompensating patients over documentation), other workarounds occurred from work system issues (e.g., lack of declarative knowledge on where to document certain information, integration issues between the electronic health record and connected devices) that can be targets for future interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Nurses' use of electronic health record workarounds is influenced by both electronic health record usability and the broader nursing work system. Future research is needed to quantify their frequency and assess their imp","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"173 ","pages":"Article 105261"},"PeriodicalIF":7.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453562","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}