Knowledge can guide and support behaviors. With accurate knowledge, patients are better equipped to engage in appropriate self-care behaviors and effectively manage hypoglycemia. However, there is currently a lack of reliable and valid assessment scales specifically designed to measure hypoglycemia knowledge, which could serve as valuable clinical evaluation tools for healthcare professionals.
Aim
To develop and validate a reliable and valid hypoglycemia management knowledge scale to assess the knowledge of hypoglycemia management in patients with diabetes.
Methods
A cross-sectional study was conducted, recruiting 300 patients with type 2 diabetes who had experienced hypoglycemic events from a medical center and a primary care clinic in southern Taiwan between December 2021 and September 2023.
Results
Initially, 25 questions were selected, achieving a content validity index of 0.92. Through exploratory factor analysis and confirmatory factor analysis, the scale was refined into an 8-factor and 3-factor model, with factor loadings ranging from 0.5 to 0.9. The questions were categorized into three factors: blood glucose determination, carbohydrate supplementation, and blood glucose testing. The internal consistency, measured using the Kuder-Richardson 20 (KR-20), was 0.758.
Conclusions
The hypoglycemia management knowledge scale developed in this study demonstrated sufficient validity and reliability, making it a useful tool for quickly assessing patients' knowledge of hypoglycemia management and serving as a reference for hypoglycemia education.
{"title":"Hypoglycemia knowledge assessment tool — Development and validation of the Hypoglycemia Management Knowledge Scale in Taiwan","authors":"Mei-Chuan Huang PhD , Hua-Tsen Hsiao PhD , Ya-Ping Yang PhD , Hsiu-Ling Liang Master, RN , Chung-Yuan Chen MD","doi":"10.1016/j.apnr.2025.151916","DOIUrl":"10.1016/j.apnr.2025.151916","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge can guide and support behaviors. With accurate knowledge, patients are better equipped to engage in appropriate self-care behaviors and effectively manage hypoglycemia. However, there is currently a lack of reliable and valid assessment scales specifically designed to measure hypoglycemia knowledge, which could serve as valuable clinical evaluation tools for healthcare professionals.</div></div><div><h3>Aim</h3><div>To develop and validate a reliable and valid hypoglycemia management knowledge scale to assess the knowledge of hypoglycemia management in patients with diabetes.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted, recruiting 300 patients with type 2 diabetes who had experienced hypoglycemic events from a medical center and a primary care clinic in southern Taiwan between December 2021 and September 2023.</div></div><div><h3>Results</h3><div>Initially, 25 questions were selected, achieving a content validity index of 0.92. Through exploratory factor analysis and confirmatory factor analysis, the scale was refined into an 8-factor and 3-factor model, with factor loadings ranging from 0.5 to 0.9. The questions were categorized into three factors: blood glucose determination, carbohydrate supplementation, and blood glucose testing. The internal consistency, measured using the <em>Kuder</em>-<em>Richardson 20</em> (KR-20), was 0.758.</div></div><div><h3>Conclusions</h3><div>The hypoglycemia management knowledge scale developed in this study demonstrated sufficient validity and reliability, making it a useful tool for quickly assessing patients' knowledge of hypoglycemia management and serving as a reference for hypoglycemia education.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151916"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143272504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-02DOI: 10.1016/j.apnr.2025.151920
Michela Luciani , Maddalena De Maria , Claudio Barbaranelli , Paola Claudia Fazio , Barbara Riegel , Davide Ausili
Introduction
Self-care is essential for health promotion, disease management and social justice. Robust, theory-based tools are needed for its measurement. The Self-care Inventory (SCI) was developed to measure self-care behaviours in adults regardless of their health status. The aims of this study are to measure validity of the SCI in an Italian sample and measurement equivalence in US and Italian samples.
Methods
We recruited 340 Italian and 294 US adults with convenience sampling. The Self-care Inventory, new General Self-Efficacy Scale, Positivity Scale, Perceived Stress Scale, and a clinical and sociodemographic questionnaire were administered online. Confirmatory factor analysis (CFA) was used to assess the factor structure of the SCI. Measurement equivalence testing was conducted using Multiple Group Confirmatory Factor Analysis, testing configural, metric, scalar, and strict invariance. For the Italian version of the SCI, reliability and construct validity were also tested.
Results
The SCI factorial structure was confirmed by CFA in the Italian sample. As for measurement equivalence, the Self-care maintenance scale demonstrated full metric and partial scalar invariance, indicating similar cognitive frameworks between US and Italian respondents. The Self-care Monitoring and Self-care Management scales achieved partial metric invariance. Reliability indices were satisfactory: Cronbach’s alpha and Global Reliability Index ranged from 0.69 to 0.84, and test-retest reliability values ranged from 0.70 to 0.84. Construct validity was supported by significant correlations between SCI scales and measures of self-efficacy, positivity, and perceived stress.
Conclusion
The SCI is valid and reliable for measuring self-care behaviours in the Italian population. Measurement equivalence show that SCI can be used cross-culturally and results from Italian and US samples are comparable. Our results support the use of the SCI in national and international self-care research and practice.Keywords: self-care, general adult population, measurement equivalence, validity, reliability.
{"title":"Measuring self-care in the general adult population: Cross-validation of the Self-care Inventory","authors":"Michela Luciani , Maddalena De Maria , Claudio Barbaranelli , Paola Claudia Fazio , Barbara Riegel , Davide Ausili","doi":"10.1016/j.apnr.2025.151920","DOIUrl":"10.1016/j.apnr.2025.151920","url":null,"abstract":"<div><h3>Introduction</h3><div>Self-care is essential for health promotion, disease management and social justice. Robust, theory-based tools are needed for its measurement. The Self-care Inventory (SCI) was developed to measure self-care behaviours in adults regardless of their health status. The aims of this study are to measure validity of the SCI in an Italian sample and measurement equivalence in US and Italian samples.</div></div><div><h3>Methods</h3><div>We recruited 340 Italian and 294 US adults with convenience sampling. The Self-care Inventory, new General Self-Efficacy Scale, Positivity Scale, Perceived Stress Scale, and a clinical and sociodemographic questionnaire were administered online. Confirmatory factor analysis (CFA) was used to assess the factor structure of the SCI. Measurement equivalence testing was conducted using Multiple Group Confirmatory Factor Analysis, testing configural, metric, scalar, and strict invariance. For the Italian version of the SCI, reliability and construct validity were also tested.</div></div><div><h3>Results</h3><div>The SCI factorial structure was confirmed by CFA in the Italian sample. As for measurement equivalence, the Self-care maintenance scale demonstrated full metric and partial scalar invariance, indicating similar cognitive frameworks between US and Italian respondents. The Self-care Monitoring and Self-care Management scales achieved partial metric invariance. Reliability indices were satisfactory: Cronbach’s alpha and Global Reliability Index ranged from 0.69 to 0.84, and test-retest reliability values ranged from 0.70 to 0.84. Construct validity was supported by significant correlations between SCI scales and measures of self-efficacy, positivity, and perceived stress.</div></div><div><h3>Conclusion</h3><div>The SCI is valid and reliable for measuring self-care behaviours in the Italian population. Measurement equivalence show that SCI can be used cross-culturally and results from Italian and US samples are comparable. Our results support the use of the SCI in national and international self-care research and practice.Keywords: self-care, general adult population, measurement equivalence, validity, reliability.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151920"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143272500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Improving healthcare professionals' digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals' digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.
Aim
This study aimed to identify the key characteristics influencing healthcare professionals' digital health competence.
Methods
Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.
Results
Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.
Conclusions
Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals' digital health competences.
{"title":"Factors influencing digital health competence among healthcare professionals: A cross-sectional study","authors":"Goran ERFANI , Jemma McCREADY , Beckie GIBSON , Bethany NICHOL , John UNSWORTH , Erika JARVA , Kristina MIKKONEN , Marco TOMIETTO","doi":"10.1016/j.apnr.2025.151922","DOIUrl":"10.1016/j.apnr.2025.151922","url":null,"abstract":"<div><h3>Background</h3><div>Improving healthcare professionals' digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals' digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.</div></div><div><h3>Aim</h3><div>This study aimed to identify the key characteristics influencing healthcare professionals' digital health competence.</div></div><div><h3>Methods</h3><div>Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.</div></div><div><h3>Results</h3><div>Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.</div></div><div><h3>Conclusions</h3><div>Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals' digital health competences.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151922"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-10DOI: 10.1016/j.apnr.2025.151924
Hui-Chen Chao , Yen-Lin Chen , Hsiu-Ching Lin , Jing-Jy Wang , Ya-Ping Yang
There is growing recognition of advance directives (AD) in dementia, however a gap remains between their perceived importance and actual implementation. This emphasizes the need to enhance healthcare professionals' support for people with dementia (PWD) with regards to making AD. This study aimed to investigate the competence, difficulties, and support needs of nurses in assisting institutionalized PWD to make AD. This mixed methods study included both quantitative and qualitative data analysis. Purposive sampling was used to recruit potential participants, and a self-developed questionnaire was used for data collection. Data were analyzed using descriptive statistics and t-test for quantitative information, and content analysis for qualitative information. A total of 188 questionnaires from 19 institutions were completed. The scores of knowledge, attitudes and skills in assisting PWD with making AD were 33.9, 39.4 and 39.5, respectively. The nurses stated that the difficulties in assisting PWD with making AD were a lack of relevant expertise, understanding the AD, and that they were unsure of how to handle conflicting viewpoints within the family. More in-service training and online courses on dementia and AD were required, as well as the creation of health education pamphlets and patient decision aids to help PWD and their families make decisions about AD. The results of this study can serve as a reference for understanding the competencies, improvements, needed support and in-service education of nurses in an institutional setting to assist PWD with making AD. We recommend the promotion of AD through related leading associations and their institutions.
{"title":"Nurses' competence and needs to assist advance directives for institutionalized people with dementia and their family","authors":"Hui-Chen Chao , Yen-Lin Chen , Hsiu-Ching Lin , Jing-Jy Wang , Ya-Ping Yang","doi":"10.1016/j.apnr.2025.151924","DOIUrl":"10.1016/j.apnr.2025.151924","url":null,"abstract":"<div><div>There is growing recognition of advance directives (AD) in dementia, however a gap remains between their perceived importance and actual implementation. This emphasizes the need to enhance healthcare professionals' support for people with dementia (PWD) with regards to making AD. This study aimed to investigate the competence, difficulties, and support needs of nurses in assisting institutionalized PWD to make AD. This mixed methods study included both quantitative and qualitative data analysis. Purposive sampling was used to recruit potential participants, and a self-developed questionnaire was used for data collection. Data were analyzed using descriptive statistics and <em>t</em>-test for quantitative information, and content analysis for qualitative information. A total of 188 questionnaires from 19 institutions were completed. The scores of knowledge, attitudes and skills in assisting PWD with making AD were 33.9, 39.4 and 39.5, respectively. The nurses stated that the difficulties in assisting PWD with making AD were a lack of relevant expertise, understanding the AD, and that they were unsure of how to handle conflicting viewpoints within the family. More in-service training and online courses on dementia and AD were required, as well as the creation of health education pamphlets and patient decision aids to help PWD and their families make decisions about AD. The results of this study can serve as a reference for understanding the competencies, improvements, needed support and in-service education of nurses in an institutional setting to assist PWD with making AD. We recommend the promotion of AD through related leading associations and their institutions.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151924"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-04DOI: 10.1016/j.apnr.2025.151919
Agnieszka Maj , Marta Makowska , Katarzyna Sacharczuk
Background
This article explores how AI supports nurses by employing content analysis for scientific nursing research.
Methods
A narrative literature review was conducted.
Results
The article summarizes the knowledge known about content analysis and outlines qualitative and quantitative content analysis concepts and simplifies the issues related to the coding process. It explains how to identify and assess quality during content analysis and gives examples of topics that can be investigated using it, especially in the field of nursing.
Conclusions
Knowledge of AI capabilities is needed to make positive use of it. These capabilities change very quickly and require constant knowledge updates. Legal and ethical regulations concerning the use of technology are still lacking, so AI outputs still require human verification of them.
{"title":"The content analysis used in nursing research and the possibility of including artificial intelligence support: A methodological review","authors":"Agnieszka Maj , Marta Makowska , Katarzyna Sacharczuk","doi":"10.1016/j.apnr.2025.151919","DOIUrl":"10.1016/j.apnr.2025.151919","url":null,"abstract":"<div><h3>Background</h3><div>This article explores how AI supports nurses by employing content analysis for scientific nursing research.</div></div><div><h3>Methods</h3><div>A narrative literature review was conducted.</div></div><div><h3>Results</h3><div>The article summarizes the knowledge known about content analysis and outlines qualitative and quantitative content analysis concepts and simplifies the issues related to the coding process. It explains how to identify and assess quality during content analysis and gives examples of topics that can be investigated using it, especially in the field of nursing.</div></div><div><h3>Conclusions</h3><div>Knowledge of AI capabilities is needed to make positive use of it. These capabilities change very quickly and require constant knowledge updates. Legal and ethical regulations concerning the use of technology are still lacking, so AI outputs still require human verification of them.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151919"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-19DOI: 10.1016/j.apnr.2025.151931
Lu-Yen Anny Chen PhD , Chu-Ying Huang RN, MSc , Yueh-Hsin Wang MD , Po-Chin Yang MD , Hsiao-Ting Chang MD, PhD , Ming-Hwai Lin MD, PhD , Tzu-Ting Huang PhD , Cheng-Pei Lin PhD
Background
Discussing advance care planning (ACP) preferences for nasogastric tube (NG) insertion remains challenging among older adults. Multimedia decision-making aids have demonstrated potential to enhance understanding and support informed decision-making.
Aim
To evaluate the effectiveness of the EATING program (multimedia decision-making aids + traditional educational module) compared to usual care (traditional educational module alone) in improving ACP readiness on NG insertion for community older adults with chronic illness.
Methods
A single blind, two-arm parallel cluster randomized controlled trial was conducted across four community villages in Northern Taiwan. Participants from two villages received the EATING program, while the other two villages received the usual care. Eligible criteria included community older adults aged ≥65 with at least one chronic disease who were able to provide informed consent. Exclusion criteria included hearing or visual impairments or a history of mental illness. Pre- and post-intervention outcomes, along with one-month follow-up data, were analyzed using descriptive statistics and generalized estimating equations.
Results
Both groups showed significant immediate improvements in knowledge (p < 0.001), belief/behavior (p < 0.001), decision confidence (p < 0.001), and readiness for ACP (p < 0.001). The experimental group showed greater improvement, particularly in emotional response and preferences (Z = -5.51, p < 0.001), observed only in this group. Sustained effect on knowledge (B = 35.029, p < 0.001), emotional response and preferences (B = 9.342, p < 0.001), refusal NG tube insertion (Z = -2.770, p = 0.006), and likelihood of signing official documents (p = 0.035) were observed after one month.
Conclusion
The study highlights the potential of multimedia program to enhance NG insertion discussions among community older adults. Further qualitative investigations and cultural adaptation are recommended.
背景：在老年人中讨论鼻胃管（NG）置入的预先护理计划（ACP）偏好仍然具有挑战性。多媒体决策辅助工具已显示出增强理解和支持知情决策的潜力。目的评价进食计划（多媒体决策辅助+传统教育模块）与常规护理（单独的传统教育模块）相比，在提高社区慢性病老年人植入术的ACP准备度方面的有效性。方法在台湾北部4个社区村进行单盲、双臂平行整群随机对照试验。来自两个村庄的参与者接受了饮食计划，而其他两个村庄的参与者接受了常规护理。入选标准包括年龄≥65岁且至少患有一种慢性疾病且能够提供知情同意的社区老年人。排除标准包括听力或视觉障碍或精神病史。使用描述性统计和广义估计方程对干预前后的结果以及一个月的随访数据进行分析。结果两组在知识方面均有显著的即时改善(p <；0.001)，信念/行为(p <；0.001)，决策置信度(p <；0.001)， ACP准备情况(p <；0.001)。实验组表现出更大的改善，特别是在情绪反应和偏好方面(Z = -5.51, p <；0.001)，仅在该组中观察到。对知识的持续影响(B = 35.029, p <；0.001)、情绪反应和偏好(B = 9.342, p <；0.001)、1个月后拒绝插入NG管（Z = -2.770, p = 0.006）、签署官方文件的可能性（p = 0.035）。结论本研究强调了多媒体节目在社区老年人中促进NG插入讨论的潜力。建议进一步进行定性调查和文化适应。
{"title":"Use of multimedia shared decision-making aids (EATING program) for improving advance care planning engagement among community-dwelling older adults with chronic diseases: A cluster randomized controlled trial","authors":"Lu-Yen Anny Chen PhD , Chu-Ying Huang RN, MSc , Yueh-Hsin Wang MD , Po-Chin Yang MD , Hsiao-Ting Chang MD, PhD , Ming-Hwai Lin MD, PhD , Tzu-Ting Huang PhD , Cheng-Pei Lin PhD","doi":"10.1016/j.apnr.2025.151931","DOIUrl":"10.1016/j.apnr.2025.151931","url":null,"abstract":"<div><h3>Background</h3><div>Discussing advance care planning (ACP) preferences for nasogastric tube (NG) insertion remains challenging among older adults. Multimedia decision-making aids have demonstrated potential to enhance understanding and support informed decision-making.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of the EATING program (multimedia decision-making aids + traditional educational module) compared to usual care (traditional educational module alone) in improving ACP readiness on NG insertion for community older adults with chronic illness.</div></div><div><h3>Methods</h3><div>A single blind, two-arm parallel cluster randomized controlled trial was conducted across four community villages in Northern Taiwan. Participants from two villages received the EATING program, while the other two villages received the usual care. Eligible criteria included community older adults aged ≥65 with at least one chronic disease who were able to provide informed consent. Exclusion criteria included hearing or visual impairments or a history of mental illness. Pre- and post-intervention outcomes, along with one-month follow-up data, were analyzed using descriptive statistics and generalized estimating equations.</div></div><div><h3>Results</h3><div>Both groups showed significant immediate improvements in knowledge (<em>p</em> < 0.001), belief/behavior (p < 0.001), decision confidence (<em>p</em> < 0.001), and readiness for ACP (p < 0.001). The experimental group showed greater improvement, particularly in emotional response and preferences (Z = -5.51, <em>p</em> < 0.001), observed only in this group. Sustained effect on knowledge (B = 35.029, p < 0.001), emotional response and preferences (B = 9.342, p < 0.001), refusal NG tube insertion (Z = -2.770, <em>p</em> = 0.006), and likelihood of signing official documents (<em>p</em> = 0.035) were observed after one month.</div></div><div><h3>Conclusion</h3><div>The study highlights the potential of multimedia program to enhance NG insertion discussions among community older adults. Further qualitative investigations and cultural adaptation are recommended.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151931"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-22DOI: 10.1016/j.apnr.2025.151932
Lating Zhang , Xianzhen Jin , Na Cheng , Ruhua Wang , Xinhui Liang , Haiyan Fan , Xue Jiang
Background
ICU nurses frequently confront lengthy working hours, elevated job intensity, heavy medical responsibilities, round-the-clock shifts, and a comparatively closed working environment. The high-risk, high-intensity, high-stress nature of the profession may prompt nurses to consider resignation, culminating in a significant shortage of nursing staff, adversely affecting the health and well-being of nurses. Necessitating a comprehensive investigation into the factors influencing their subjective well-being and the interrelations among these factors, thereby establishing a theoretical foundation for a more focused intervention program aimed at enhancing the subjective well-being of nurses.
Methods
This study employed a cross-sectional design in accordance with STROBE criteria. Two hundred forty-seven ICU nurses from four tertiary general hospitals were intentionally chosen to take an online survey. Metrics encompassed self-efficacy, work-family balance, and subjective well-being.
Results
The findings demonstrated that self-efficacy strongly influenced nurses' work-family balance and subjective well-being. The work-family balance served as a mediating factor in the association between self-efficacy and subjective well-being. Mediation analysis indicated a substantial overall influence of self-efficacy on subjective well-being (β = 0.758, p < 0.01). In addition, self-efficacy had a direct effect on subjective well-being (β = 0.575, p < 0. 01), on work-family balance (β = 0.458, p < 0. 01), and work-family balance had a direct effect on subjective well-being (β = 0.399, p < 0.01).
Conclusion
This study found that among nurses in ICU have moderate levels of self-efficacy and subjective well-being, which are positively correlated. This suggests that improving the self-efficacy and work-family balance of ICU nurses may help enhance their subjective well-being levels.
icu护士经常面临工作时间长、工作强度高、医疗责任重、24小时轮班和相对封闭的工作环境。这一职业的高风险、高强度、高压力的性质可能促使护士考虑辞职，最终导致护理人员严重短缺，对护士的健康和福祉产生不利影响。有必要对影响护士主观幸福感的因素及各因素之间的相互关系进行全面调查，从而为更有针对性地提高护士主观幸福感的干预方案奠定理论基础。方法采用STROBE标准的横断面设计。选择四所三级综合医院的247名ICU护士进行在线调查。衡量标准包括自我效能、工作与家庭平衡和主观幸福感。结果自我效能感对护士工作家庭平衡和主观幸福感有显著影响。工作家庭平衡在自我效能感与主观幸福感之间起中介作用。中介分析显示，自我效能感对主观幸福感有显著的整体影响(β = 0.758, p <；0.01)。此外，自我效能感对主观幸福感有直接影响(β = 0.575, p <；0. 01)，工作家庭平衡(β = 0.458, p <；0. 01)，工作家庭平衡对主观幸福感有直接影响(β = 0.399, p <；0.01)。结论ICU护士自我效能感与主观幸福感呈中等水平正相关。提示提高ICU护士的自我效能感和工作与家庭的平衡有助于提高其主观幸福感水平。
{"title":"Work-family balance mediates self-efficacy and subjective well-being among nurses in Chinese intensive care units: A cross-sectional study","authors":"Lating Zhang , Xianzhen Jin , Na Cheng , Ruhua Wang , Xinhui Liang , Haiyan Fan , Xue Jiang","doi":"10.1016/j.apnr.2025.151932","DOIUrl":"10.1016/j.apnr.2025.151932","url":null,"abstract":"<div><h3>Background</h3><div>ICU nurses frequently confront lengthy working hours, elevated job intensity, heavy medical responsibilities, round-the-clock shifts, and a comparatively closed working environment. The high-risk, high-intensity, high-stress nature of the profession may prompt nurses to consider resignation, culminating in a significant shortage of nursing staff, adversely affecting the health and well-being of nurses. Necessitating a comprehensive investigation into the factors influencing their subjective well-being and the interrelations among these factors, thereby establishing a theoretical foundation for a more focused intervention program aimed at enhancing the subjective well-being of nurses.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional design in accordance with STROBE criteria. Two hundred forty-seven ICU nurses from four tertiary general hospitals were intentionally chosen to take an online survey. Metrics encompassed self-efficacy, work-family balance, and subjective well-being.</div></div><div><h3>Results</h3><div>The findings demonstrated that self-efficacy strongly influenced nurses' work-family balance and subjective well-being. The work-family balance served as a mediating factor in the association between self-efficacy and subjective well-being. Mediation analysis indicated a substantial overall influence of self-efficacy on subjective well-being (β = 0.758, p < 0.01). In addition, self-efficacy had a direct effect on subjective well-being (β = 0.575, p < 0. 01), on work-family balance (β = 0.458, p < 0. 01), and work-family balance had a direct effect on subjective well-being (β = 0.399, p < 0.01).</div></div><div><h3>Conclusion</h3><div>This study found that among nurses in ICU have moderate levels of self-efficacy and subjective well-being, which are positively correlated. This suggests that improving the self-efficacy and work-family balance of ICU nurses may help enhance their subjective well-being levels.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151932"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-21DOI: 10.1016/j.apnr.2025.151930
Miyase Avcı PhD , Ahmet Avcı PhD
{"title":"Turnover intention, collaboration and competences of intensive care unit nurses: A descriptive correlational study","authors":"Miyase Avcı PhD , Ahmet Avcı PhD","doi":"10.1016/j.apnr.2025.151930","DOIUrl":"10.1016/j.apnr.2025.151930","url":null,"abstract":"","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151930"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this study, researchers investigated experiences and key elements of effective support programs that promote recovery in nurses who identify as second victims in Australia.
Design
Sequential explanatory mixed methods investigated experiences of nurses who identify as second victims, including support received and any educational and training included.
Methods
Data were collected using survey and in-depth interviews. Survey data were analysed using descriptive and non-parametric testing and thematic analysis was used to analyse qualitative data.
Results
Forty-three nurses indicated involvement in a patient safety incident in the previous five years with 27 nurses completing the survey. Thirty-seven percent reported experiencing psychological distress and 33% physical symptoms. Only 4% reported experiencing weak colleague support while 22% reported poor supervisor and 56% poor organisational support. Qualitative data from seven interviews revealed five themes identified included the Education and training; Environment surrounding the event; Burden of reporting; a ‘You’ve just got to get on with it’ culture; and Ways to action positive change.
Conclusion
Empathy and support from trained peer support colleagues were key elements to recovery of nurses who identified as second victims. The role of culture, and family values and beliefs in support of second victims need further investigation. Support programs need to address, not only psychological consequences of a patient safety event on the nurse, but also physical ramifications. Support of supervisors and organisations following a patient safety event may facilitate retention of nurses. The role of education and training in support programs requires further investigation.
{"title":"Experiences and support of Australian nurses who identify as a second victim: A mixed methods study","authors":"Monica Peddle , Madeline McPhillips , Rachel Cross , Lauren Zarb","doi":"10.1016/j.apnr.2025.151925","DOIUrl":"10.1016/j.apnr.2025.151925","url":null,"abstract":"<div><h3>Aims</h3><div>In this study, researchers investigated experiences and key elements of effective support programs that promote recovery in nurses who identify as second victims in Australia.</div></div><div><h3>Design</h3><div>Sequential explanatory mixed methods investigated experiences of nurses who identify as second victims, including support received and any educational and training included.</div></div><div><h3>Methods</h3><div>Data were collected using survey and in-depth interviews. Survey data were analysed using descriptive and non-parametric testing and thematic analysis was used to analyse qualitative data.</div></div><div><h3>Results</h3><div>Forty-three nurses indicated involvement in a patient safety incident in the previous five years with 27 nurses completing the survey. Thirty-seven percent reported experiencing psychological distress and 33% physical symptoms. Only 4% reported experiencing weak colleague support while 22% reported poor supervisor and 56% poor organisational support. Qualitative data from seven interviews revealed five themes identified included the Education and training; Environment surrounding the event; Burden of reporting; a ‘You’ve just got to get on with it’ culture; and Ways to action positive change.</div></div><div><h3>Conclusion</h3><div>Empathy and support from trained peer support colleagues were key elements to recovery of nurses who identified as second victims. The role of culture, and family values and beliefs in support of second victims need further investigation. Support programs need to address, not only psychological consequences of a patient safety event on the nurse, but also physical ramifications. Support of supervisors and organisations following a patient safety event may facilitate retention of nurses. The role of education and training in support programs requires further investigation.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151925"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-04DOI: 10.1016/j.apnr.2025.151921
Shan Zhang , Shu Ding , Wei Cui , Xiangyu Li , Jun Wei , Ying Wu
Background
Clinical decision support systems (CDSS) have been identified to aid clinical decision-making, but few studies focus on the application of CDSS in intensive care unit (ICU) delirium, and particularly usability testing is not employed. We aimed to develop and conduct usability testing of Artificial Intelligence Assisted Prevention and Management for Delirium (AI-AntiDelirium), a CDSS designed to identify delirium and modifiable risk factors and prevent and manage delirium in the ICU.
Methods
Between January and April 2021, a cross-sectional study including 117 ICU nurses recruited for usability testing from four ICUs in two university-affiliated hospitals was conducted. The development of AI-AntiDelirium included needs assessment, function design, iterative design, agile development, and usability testing using the Delirium System Usability Evaluation Scale (Delirium-SUES).
Results
Based on the needs assessment, AI-AntiDelirium was developed to contain four main modules—delirium assessment tools, risk-factor assessment, nursing care plan, and care activity list—and was designed to provide individualized interventions based on patient risk factors. The mean Delirium-SUES score was 184.64 (full score: 210), indicating that AI-AntiDelirium was acceptable in terms of usefulness, ease of use, attitude, use tendency, and long-term effects.
Conclusions
Our study developed AI-AntiDelirium, a CDSS perceived as useful and easy to use. Incorporating usability evaluation when designing AI-AntiDelirium may be effective in and enhancing clinical staff use.
{"title":"Development and usability evaluation of a nurse-led clinical decision support system (AI-AntiDelirium) for management of intensive care unit delirium: A mixed methods study","authors":"Shan Zhang , Shu Ding , Wei Cui , Xiangyu Li , Jun Wei , Ying Wu","doi":"10.1016/j.apnr.2025.151921","DOIUrl":"10.1016/j.apnr.2025.151921","url":null,"abstract":"<div><h3>Background</h3><div>Clinical decision support systems (CDSS) have been identified to aid clinical decision-making, but few studies focus on the application of CDSS in intensive care unit (ICU) delirium, and particularly usability testing is not employed. We aimed to develop and conduct usability testing of <u>A</u>rtificial <u>I</u>ntelligence <u>A</u>ssisted Preve<u>nti</u>on and Management for <u>Delirium</u> (<em>AI-AntiDelirium</em>), a CDSS designed to identify delirium and modifiable risk factors and prevent and manage delirium in the ICU.</div></div><div><h3>Methods</h3><div>Between January and April 2021, a cross-sectional study including 117 ICU nurses recruited for usability testing from four ICUs in two university-affiliated hospitals was conducted. The development of <em>AI-AntiDelirium</em> included needs assessment, function design, iterative design, agile development, and usability testing using the Delirium System Usability Evaluation Scale (Delirium-SUES).</div></div><div><h3>Results</h3><div>Based on the needs assessment, <em>AI-AntiDelirium</em> was developed to contain four main modules—delirium assessment tools, risk-factor assessment, nursing care plan, and care activity list—and was designed to provide individualized interventions based on patient risk factors. The mean Delirium-SUES score was 184.64 (full score: 210), indicating that <em>AI-AntiDelirium</em> was acceptable in terms of usefulness, ease of use, attitude, use tendency, and long-term effects.</div></div><div><h3>Conclusions</h3><div>Our study developed <em>AI-AntiDelirium</em>, a CDSS perceived as useful and easy to use. Incorporating usability evaluation when designing <em>AI-AntiDelirium</em> may be effective in and enhancing clinical staff use.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151921"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143272482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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