Applied Nursing Research最新文献_第2页

Nurses' psychological impact of caring for patients with LVADs: Patients, providers, & caregivers “triangle of relationships” 护士对lvad患者护理的心理影响：患者、提供者和护理者的“三角关系”

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2025-12-31 DOI: 10.1016/j.apnr.2025.152044

John C. Mikovits , Kayla Biege

Nurses risk developing psychological distress due to the nature of their work environments and patient populations. Nurses caring for Left Ventricular Assist Device (LVAD) patients are at risk of distress related to stressful care requirements, patient relationships, and ethical dilemmas.

Objectives

To explore the impact of caring for patients with LVADs on nurses' psychological health and examine strategies for stress management.

Methods

A descriptive, qualitative study was completed using a semi-structured interview process. Interviews with registered nurses working in various roles and settings included predetermined questions to provide structure while allowing for open-ended elaboration of the topic from the participant's perspective through natural conversation.

Findings

Five themes were developed from interviews with nurses and include Caring for the LVAD Instead of the Patient; Right Implant, Wrong Patient; Complex and Connected Care; Mental Exhaustion and Life Balance; Effective Coping and Semi-effective Resources.

Conclusions

The results of the study provide implications for nursing practice and education surrounding the use of LVADs while highlighting the importance of emotional and mental health support in the workplace to decrease the burden experienced by nurses caring for these patients.

Implications for clinical practice

The complexity of relationships with patients with LVADs and their multidisciplinary teams creates a workplace culture that fails to prioritize mental health support for nurses caring for these patients. Current support for nurses caring for patients with LVADs is not effective. Clinical practice settings would benefit in supporting nurses' mental health to allow them to remain mentally present, resilient, and effective clinically.

由于护士的工作环境和患者群体的性质，护士有发展心理困扰的风险。护理左心室辅助装置（LVAD）患者的护士面临着与压力护理要求、患者关系和道德困境相关的痛苦风险。目的探讨左心室辅助器患者护理对护士心理健康的影响，探讨压力管理策略。方法采用半结构化访谈法进行描述性定性研究。对在不同角色和环境中工作的注册护士的采访包括预先确定的问题，以提供结构，同时允许通过自然对话从参与者的角度对主题进行开放式阐述。从对护士的采访中得出了五个主题，包括照顾LVAD而不是病人；正确的种植体，错误的患者；复杂和互联护理；精神疲劳与生活平衡；有效的应对和半有效的资源。结论本研究的结果为lvad的护理实践和教育提供了启示，同时强调了工作场所情感和心理健康支持的重要性，以减轻护理这些患者的护士所经历的负担。与lvad患者及其多学科团队关系的复杂性造成了一种工作场所文化，无法优先考虑照顾这些患者的护士的心理健康支持。目前对护理lvad患者的护士的支持并不有效。临床实践环境将有利于支持护士的心理健康，使他们保持精神上的存在，弹性和有效的临床。

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引用次数: 0

Psychological capital and organizational culture as mediators between workplace bullying type and its consequences for male nurses 心理资本和组织文化在男护士职场欺凌类型及其后果之间的中介作用

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2026-01-10 DOI: 10.1016/j.apnr.2026.152048

Byung-Kul Lee , Young Sook Roh

Background

Workplace bullying among nurses has gained prominence as a crucial societal concern. Although previous studies have examined gender differences in workplace bullying and have often reported no significant differences by gender, research focusing specifically on the experiences of male nurses remains relatively limited.

Purpose

This study aimed to examine the impact of workplace bullying types on the consequences and to explore the mediating roles of psychological capital and nursing organizational culture among male nurses.

Methods

This study was a cross-sectional descriptive survey with a convenience sample of 175 male nurses. Participants completed a web-based self-administered questionnaire. A mediation analysis was conducted to examine the indirect effects of psychological capital and organizational culture on the relationships between workplace bullying types and their consequences.

Results

The type of workplace bullying had a significant direct effect on its consequences and a partial indirect effect via psychological capital. Nursing organizational culture did not significantly mediate this relationship. The model explained 49.7% of the variance in consequences.

Conclusions

These findings suggest that the type of workplace bullying directly affects the consequences, and psychological capital partially mediates this relationship. Enhancing psychological capital may help mitigate the negative outcomes of workplace bullying, whereas the nursing organizational culture showed no significant mediating effect.

护士的职场欺凌已经成为一个重要的社会问题。虽然以前的研究已经调查了职场欺凌中的性别差异，并且经常报告没有显著的性别差异，但专门针对男护士经历的研究仍然相对有限。目的探讨职场欺凌类型对男护士职场欺凌后果的影响，并探讨心理资本和护理组织文化的中介作用。方法采用横断面描述性调查方法，方便抽样175名男护士。参与者完成了一份基于网络的自我管理问卷。通过中介分析，考察了心理资本和组织文化对职场欺凌类型及其后果关系的间接影响。结果职场霸凌类型通过心理资本对霸凌后果有显著的直接影响，并有部分间接影响。护理组织文化对这一关系无显著调节作用。该模型解释了49.7%的结果差异。结论职场霸凌类型直接影响霸凌后果，心理资本在其中起部分中介作用。增强心理资本可能有助于缓解职场欺凌的负面后果，而护理组织文化没有显著的中介作用。

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引用次数: 0

Effectiveness of an online mindfulness-based stress reduction program for nurses in high-stress occupational settings during the COVID-19 pandemic 2019冠状病毒病大流行期间高压力职业环境中护士在线正念减压计划的有效性

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2025-11-27 DOI: 10.1016/j.apnr.2025.152032

Ching-Wen Hsieh , Wan-Na Sun , Hui-Ying Chiang , Shih-Feng Weng , Yi-Fen Hsu , Erica Yu , Hsin-Tien Hsu

Background

Frontline nurses face heavy infection control demands, rotating shifts, and psychological stress, leading to pandemic fatigue and reduced resilience. Evidence on mindfulness-based stress reduction (MBSR) for this group remains limited.

Aims

To evaluate the effectiveness of an online MBSR program on pandemic-related fatigue and resilience among nurses in COVID-19–designated wards.

Method

A convergent parallel mixed-methods design was used. Sixty nurses were assigned to the MBSR (n = 30) or control (n = 30) groups. The six-week online program included weekly 90-min sessions. Data were collected at baseline (T1), week 3 (T2), and week 6 (T3). Seven MBSR participants also completed qualitative interviews.

Results

At baseline, both groups demonstrated moderate levels of pandemic fatigue and resilience. The MBSR group showed a significant reduction in pandemic fatigue at T3 (p < 0.001) but not at T2 (p = 0.057), and significant improvements in resilience at both T2 (p < 0.001) and T3 (p < 0.001). Compared with the control group, the MBSR group exhibited significantly greater reductions in fatigue at T2 (p = 0.007) and T3 (p < 0.001), as well as greater improvements in resilience at T2 (p < 0.001) and T3 (p < 0.001). Qualitative analysis further identified four themes illustrating participants' experiences of the program.

Conclusions

This study provides preliminary evidence that an online MBSR program may help alleviate pandemic fatigue and strengthen resilience among frontline nurses. Integrating digital mindfulness programs into occupational health initiatives could support nurses' mental well-being and compassionate care in high-stress clinical settings.

Trial registration

ClinicalTrials.gov identifier no. NCT06433544 (https://clinicaltrials.gov/study/NCT06433544).

一线护士面临着沉重的感染控制需求、轮班和心理压力，导致大流行疲劳和应变能力下降。针对这一群体的正念减压（MBSR）的证据仍然有限。目的评估在线MBSR项目对covid -19指定病房护士与大流行相关的疲劳和恢复能力的有效性。方法采用收敛并行混合方法设计。60名护士被分为MBSR组（n = 30）和对照组（n = 30）。这个为期六周的在线课程包括每周90分钟的课程。在基线（T1）、第3周（T2）和第6周（T3）收集数据。7名正念减压参与者还完成了定性访谈。结果在基线水平上，两组均表现出中等水平的流行病疲劳和恢复能力。MBSR组在T3 （p < 0.001）时的大流行疲劳显著减少，但在T2 （p = 0.057）时则没有（p = 0.057），在T2 （p < 0.001）和T3 （p < 0.001）时恢复力均有显著改善。与对照组相比，MBSR组在T2 （p = 0.007）和T3 （p < 0.001）时表现出更大的疲劳减轻，在T2 （p < 0.001）和T3 （p < 0.001）时表现出更大的弹性改善。定性分析进一步确定了四个主题，说明了参与者对该计划的体验。本研究提供了初步证据，表明在线MBSR计划可能有助于缓解大流行的疲劳，增强一线护士的应变能力。将数字正念计划整合到职业健康计划中可以支持护士在高压力临床环境中的心理健康和同情心护理。临床试验注册号：clinicaltrials .govNCT06433544 (https://clinicaltrials.gov/study/NCT06433544)。

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引用次数: 0

Factors influencing nurses' safety voices about patient safety concerns: A cross-sectional study 影响护士对患者安全问题安全发声的因素：一项横断面研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2026-01-04 DOI: 10.1016/j.apnr.2025.152046

Shinae Ahn

Aim

This study aimed to examine the relationships among perceived concerns about patient safety, patient safety culture, systems thinking, and nurses' safety voices.

Background

Nurses' speaking up behavior is a crucial strategy for enhancing patient safety and preventing incidents in hospital settings. As patient advocates, nurses should be encouraged to speak up appropriately when they encounter situations that threaten patient safety.

Methods

A descriptive cross-sectional design was used. Questionnaires were used to collect data on socio-demographic information, perceived concerns about patient safety, patient safety culture, systems thinking, and safety voices. An online survey tool was used from May 25 to June 30, 2023. This study was conducted in South Korea, and 235 clinical nurses participated. Data were analyzed using multiple linear regression analysis and Hayes' PROCESS macro with the bootstrap method.

Results

Perceived concerns about patient safety, patient safety culture (‘communication openness’ and ‘handoffs and information exchange’) and job tenure were significant predictors of both types of safety voices. Patient safety culture partially mediated the relationship between perceived concerns about patient safety and speaking up (β = −0.087, 95 % confidence interval: −0.160 to −0.032), and also between perceived concerns about patient safety and withholding voice (β = 0.140, 95 % confidence interval: 0.069 to 0.222).

Conclusions

Creating a supportive and open communication environment that fosters information sharing is essential for encouraging nurses to voice their opinions regarding patient safety. Further research is needed to develop and implement assertive communication programs for clinical nurses.

目的本研究旨在探讨患者安全关注感知、患者安全文化、系统思维和护士安全声音之间的关系。护士直言不讳的行为是提高患者安全和预防医院事故的关键策略。作为病人的倡导者，当护士遇到威胁病人安全的情况时，应该鼓励他们适当地说出来。方法采用描述性横断面设计。使用问卷收集有关社会人口统计信息、对患者安全的感知关注点、患者安全文化、系统思维和安全声音的数据。从2023年5月25日到6月30日使用了在线调查工具。本研究在韩国进行，共有235名临床护士参与。数据分析采用多元线性回归分析，Hayes’PROCESS宏采用自举法。结果对患者安全、患者安全文化（“沟通开放”和“交接和信息交流”）和工作任期的感知担忧是两种安全声音的显著预测因子。患者安全文化部分介导了患者安全感知担忧与直言之间的关系（β = - 0.087, 95%置信区间：- 0.160至- 0.032），以及患者安全感知担忧与沉默之间的关系（β = 0.140, 95%置信区间：0.069至0.222）。结论营造一个支持性和开放性的沟通环境，促进信息共享，是鼓励护士就患者安全发表意见的必要条件。需要进一步的研究，以制定和实施自信的沟通方案，临床护士。

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引用次数: 0

Mediating effects of depressive and heart failure symptoms in their associations with quality of life in patients with heart failure 抑郁和心衰症状在心衰患者生活质量相关性中的中介作用

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2025-11-30 DOI: 10.1016/j.apnr.2025.152039

Seongkum Heo , Jisun Yang , KyungAh Cho , JinShil Kim

Aim

To test the bidirectional mediating relationships among heart failure (HF) symptoms, depressive symptoms, and health-related quality of life (HRQoL) in patients with HF, controlling for age, functional status, comorbidity, self-care, and self-care self-efficacy.

Background

Patients with HF often have poor HRQoL. HF and depressive symptoms affect HRQoL, suggesting their potential mediating roles. However, these associations have not been investigated in patients with HF.

Methods

In this cross-sectional, correlational study, data on all study variables and sociodemographic and clinical characteristics were collected from 54 patients with HF (mean age = 67.5). The PROCESS macro for SPSS was used to address the purpose.

Results

More severe HF symptoms (p < 0.001) were significantly associated with more severe depressive symptoms, and both symptoms (p = 0.007 and p = 0.005, respectively) were significantly associated with poorer HRQoL (F = 7.947, R² = 0.619, p < 0.001), after controlling for covariates (indirect effect: effect = 0.309, bootstrap 95 % CI = 0.045–0.648). By contrast, HF symptoms did not mediate the relationship between depressive symptoms and HRQoL.

Conclusions

Both depressive and HF symptoms play critical roles in the HRQoL; however, their mechanisms differ. Depressive symptoms were only directly associated, whereas HF symptoms were directly and indirectly associated with HRQoL. Healthcare providers and researchers should prioritize improving HF symptoms and addressing depressive symptoms to improve HRQoL in patients with HF.

目的在控制年龄、功能状态、合并症、自我保健和自我保健效能的情况下，检验心力衰竭（HF）症状、抑郁症状和健康相关生活质量（HRQoL）之间的双向中介关系。心衰患者的HRQoL通常较差。心衰和抑郁症状影响HRQoL，提示其潜在的中介作用。然而，这些关联尚未在心衰患者中进行研究。方法在这项横断面相关研究中，收集了54例HF患者（平均年龄67.5岁）的所有研究变量以及社会人口学和临床特征的数据。SPSS的PROCESS宏被用来解决这个问题。结果经协变量控制（间接效应：效应= 0.309,bootstrap 95% CI = 0.045-0.648）后，HF症状越严重与抑郁症状越严重相关（p < 0.001），两种症状（p = 0.007和p = 0.005）与HRQoL越差相关（F = 7.947, R2 = 0.619, p < 0.001）。相比之下，心衰症状不介导抑郁症状与HRQoL之间的关系。结论抑郁和心衰症状对患者HRQoL均有重要影响；然而，它们的机制不同。抑郁症状仅与HRQoL直接相关，而心衰症状与HRQoL直接或间接相关。医疗保健提供者和研究人员应优先改善心衰症状和解决抑郁症状，以改善心衰患者的HRQoL。

{"title":"Mediating effects of depressive and heart failure symptoms in their associations with quality of life in patients with heart failure","authors":"Seongkum Heo , Jisun Yang , KyungAh Cho , JinShil Kim","doi":"10.1016/j.apnr.2025.152039","DOIUrl":"10.1016/j.apnr.2025.152039","url":null,"abstract":"<div><h3>Aim</h3><div>To test the bidirectional mediating relationships among heart failure (HF) symptoms, depressive symptoms, and health-related quality of life (HRQoL) in patients with HF, controlling for age, functional status, comorbidity, self-care, and self-care self-efficacy.</div></div><div><h3>Background</h3><div>Patients with HF often have poor HRQoL. HF and depressive symptoms affect HRQoL, suggesting their potential mediating roles. However, these associations have not been investigated in patients with HF.</div></div><div><h3>Methods</h3><div>In this cross-sectional, correlational study, data on all study variables and sociodemographic and clinical characteristics were collected from 54 patients with HF (mean age = 67.5). The PROCESS macro for SPSS was used to address the purpose.</div></div><div><h3>Results</h3><div>More severe HF symptoms (<em>p</em> < 0.001) were significantly associated with more severe depressive symptoms, and both symptoms (<em>p</em> = 0.007 and <em>p</em> = 0.005, respectively) were significantly associated with poorer HRQoL (F = 7.947, R<sup>2</sup> = 0.619, p < 0.001), after controlling for covariates (indirect effect: effect = 0.309, bootstrap 95 % CI = 0.045–0.648). By contrast, HF symptoms did not mediate the relationship between depressive symptoms and HRQoL.</div></div><div><h3>Conclusions</h3><div>Both depressive and HF symptoms play critical roles in the HRQoL; however, their mechanisms differ. Depressive symptoms were only directly associated, whereas HF symptoms were directly and indirectly associated with HRQoL. Healthcare providers and researchers should prioritize improving HF symptoms and addressing depressive symptoms to improve HRQoL in patients with HF.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152039"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693553","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}

引用次数: 0

Nurses' decisions to recognize and respond to deterioration not meeting rapid response system activation criteria: A qualitative descriptive study 护士识别和应对不符合快速反应系统激活标准的恶化的决定：一项定性描述性研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.apnr.2025.152040

Gabrielle Burdeu , Bodil Rasmussen , Grainne Lowe , Julie Considine

To explore and describe nurses’ assessment and management decisions to recognize and respond to patient deterioration not meeting rapid response system (RRS) activation criteria.

Nurses’ decision-making in response to deterioration that meets RRS activation criteria is well documented. RRSs are activated when deterioration meets pre-defined criteria or from clinicians’ concern, escalating care to teams of suitably qualified clinicians. Most deterioration is expected from illness and treatment and is managed within nurses’ clinical role. Safe healthcare relies on nurses’ surveillance for patient changes to prevent deterioration progressing towards RRS activation criteria. Evidence does not examine nurses’ safety role in response to expected deterioration occurring from acute illness and treatment. Studies examining nurses’ decision making in response to patient changes have limitations in designs that rely on self-report and retrospective audits.

Informed by Tanner’s Clinical Judgment Model, a qualitative descriptive study was conducted using non-participant observations of nurse-patient interactions followed by semistructured interviews between January and May 2021. Twenty nurses participated. Verbatim transcripts were analyzed using reflexive thematic analysis. First, nurses make targeted assessment decisions based on their prediction of patients’ risk of deterioration. Second, subjective assessment was perceived by nurses as highly sensitive in identifying early signs of deterioration. Third, nurses’ concern for patients prompted further assessment to inform safety-related judgments.

This study reaffirms nurses’ essential safety role for patients who experience deterioration during their hospitalization. Further research should evaluate nurses’ concern and subjective assessment to recognize deterioration to contribute to the evidence-based approach to patient assessment.

探讨和描述护士在识别和应对不符合快速反应系统（RRS）激活标准的患者恶化时的评估和管理决策。护士应对病情恶化的决策符合RRS激活标准，这是有充分记录的。当病情恶化符合预先定义的标准或临床医生的担忧时，就会启动rrs，将护理升级到由合格的临床医生组成的团队。大多数恶化是预期的疾病和治疗，并在护士的临床角色管理。安全的医疗保健依赖于护士对患者变化的监测，以防止病情向RRS激活标准发展。没有证据检验护士在应对急性疾病和治疗导致的预期恶化时的安全作用。研究检查护士的决策，以应对病人的变化有局限性的设计，依赖于自我报告和回顾性审计。根据坦纳的临床判断模型，在2021年1月至5月期间进行了一项定性描述性研究，使用非参与性观察护士-患者互动，然后进行半结构化访谈。20名护士参与了研究。使用反身性主题分析对逐字文本进行分析。首先，护士根据对患者病情恶化风险的预测，做出有针对性的评估决策。其次，护士认为主观评估在识别早期恶化迹象方面非常敏感。第三，护士对患者的关心促使进一步评估，为安全相关判断提供信息。本研究重申了护士在住院期间经历病情恶化的患者中扮演的重要安全角色。进一步的研究应评估护士的关注和主观评价，以识别恶化，有助于循证方法的患者评估。

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引用次数: 0

Cross-cultural adaptation and psychometric validation of an Arabic version of the 12-item Zarit burden interview 阿拉伯语版12题Zarit负担访谈的跨文化适应与心理计量学验证

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-20 DOI: 10.1016/j.apnr.2025.152021

Eman Alhalal RN, MScN, PhD

Background

Globally, there is a demand for long-term care, driven by an aging population and the prevalence of chronic diseases. Informal caregivers play a role in contributing to healthcare services. The Zarit Burden Interview (ZBI-12) is one of the several scales that assess caregiver burden; however, its psychometric evaluation is lacking in the Arab context.

Aim

To test the internal consistency, structural validity (factor structure), and convergent validity of the 12-item ZBI translated version among informal caregivers.

Design

A cross-sectional, multiregional study.

Methods

A random sample of 476 informal caregivers was recruited from 11 cities across four regions in Saudi Arabia. After translating the ZBI-12, assessing content validity, and conducting pilot testing, a structured telephone interview was conducted. For exploratory and confirmatory factor analysis, the full sample was randomly split into two subsamples. To assess its convergent validity, a correlation analysis was conducted with the psychological distress scale. Internal consistency was assessed.

Results

Structural validity analysis supported the three-factor model: role strain, personal strain, and guilt. A positive correlation with psychological distress (r

=

0.461) supported convergent validity. Internal consistency was evidenced by the Cronbach's alpha coefficient (α

=

0.929) and McDonald's omega (ω

=

0.923).

Conclusion

The study demonstrates evidence that the Arabic ZBI-12 is a psychometrically robust scale. The availability of this version provides healthcare providers with a screening tool to identify caregiver burden in Arabic-speaking populations. It can be used in guiding evidence-based interventions. The scale has implications for cross-cultural research and the development of health policies related to Arab informal caregiving.

在全球范围内，由于人口老龄化和慢性病的流行，对长期护理有需求。非正式护理人员在促进保健服务方面发挥着作用。Zarit负担访谈（ZBI-12）是评估照顾者负担的几个量表之一；然而，其心理测量评估缺乏在阿拉伯的背景下。目的检验12项ZBI译文在非正式照顾者中的内部一致性、结构效度（因子结构）和收敛效度。设计一项横断面、多地区的研究。方法从沙特阿拉伯四个地区的11个城市随机抽取476名非正式护理人员。在翻译完ZBI-12，评估内容效度，并进行试点测试后，进行结构化电话访谈。为了进行探索性和验证性因子分析，整个样本被随机分成两个子样本。为了评估其收敛效度，我们与心理困扰量表进行了相关分析。评估内部一致性。结果结构效度分析支持角色应变、个人应变和内疚三因素模型。与心理困扰正相关（r=0.461）支持收敛效度。Cronbach's α系数（α=0.929）和McDonald's ω (ω =0.923)证明了内部一致性。结论阿拉伯语ZBI-12量表具有较强的心理测量稳健性。该版本的可用性为医疗保健提供者提供了一种筛选工具，以确定阿拉伯语人口的护理负担。它可用于指导循证干预措施。该量表对跨文化研究和制定与阿拉伯非正式照料有关的卫生政策具有影响。

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引用次数: 0

Analysis of factors influencing empathy fatigue among emergency nurses based on the Conservation of Resources theory 基于资源守恒理论的急诊护士共情疲劳影响因素分析

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1016/j.apnr.2025.152030

Min Dai , Ningxiang Li , Yizhu Gao , Zhenfei Yuan

Aim

The present study, grounded in the Conservation of Resources theory, aimed to investigate the levels of empathy fatigue among emergency department nurses.

Background

Empathy fatigue is prevalent among emergency department nurses and is largely attributed to external factors, such as stress. However, the underlying psychological mechanisms of these factors remain underexplored.

Methods

Using a cross-sectional survey design, data were collected from emergency department nurses across 22 general tertiary care hospitals. The survey included a general demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Ruminative Thinking Scale, Pittsburgh Sleep Quality Index, and the Mental Capital Scale. Empathy fatigue was assessed using a specialized quality-of-life scale, with high scores indicating high levels of empathy fatigue.

Results

The overall empathy fatigue score among emergency department nurses was 86.35 ± 20.34, with an average score of 2.87 ± 0.68. The mean scores for the dimensions, ranked in descending order, were as follows: burnout (3.01 ± 0.70), empathy satisfaction (2.92 ± 0.87), and secondary traumatic stress (2.70 ± 0.74). Univariate analysis indicated that marital status, residence, education, work area, job title, position, rotating shifts, and night shifts significantly influenced empathy fatigue scores. Multiple linear regression analysis identified ruminative thinking, sleep quality, educational level, work area, and position as significant predictors of empathy fatigue.

Conclusion

This study confirms a high incidence of empathy fatigue among emergency department nurses. Nursing administrators should focus on high-risk individuals and develop targeted prevention strategies.

目的本研究以资源守恒理论为基础，探讨急诊科护士的共情疲劳水平。病理性疲劳在急诊科护士中普遍存在，主要归因于外部因素，如压力。然而，这些因素的潜在心理机制仍未得到充分探讨。方法采用横断面调查设计，收集22家综合三级医院急诊科护士的数据。调查内容包括一般人口统计问卷、中文版职业生活质量量表、反思思维量表、匹兹堡睡眠质量指数和心理资本量表。共情疲劳采用专门的生活质量量表进行评估，得分高表明共情疲劳水平高。结果急诊护士共情疲劳总得分为86.35±20.34分，平均得分为2.87±0.68分。各维度平均得分由高到低依次为：倦怠（3.01±0.70）、共情满意度（2.92±0.87）、继发性创伤应激（2.70±0.74）。单因素分析显示，婚姻状况、居住地、教育程度、工作区域、职称、职位、轮班和夜班对共情疲劳得分有显著影响。多元线性回归分析发现，反刍思维、睡眠质量、受教育程度、工作区域和职位是共情疲劳的显著预测因子。结论急诊科护士共情疲劳发生率较高。护理管理者应关注高危人群，制定有针对性的预防策略。

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引用次数: 0

Sleep quality and predicting factors among patients undergoing hemodialysis: A descriptive cross sectional study 血液透析患者的睡眠质量及其预测因素：一项描述性横断面研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-09-11 DOI: 10.1016/j.apnr.2025.152016

Eman A. Badr , Fahad M. Alhowaymel , Abdulaziz F. Abaoud

Background

Many patients with end-stage renal disease (ESRD) undergoing hemodialysis encounter sleep disturbances. This study aimed to assess the quality of sleep and identify the factors predicting it among patients undergoing hemodialysis.

Methods

A descriptive, cross-sectional design was used. The study was carried out in the hemodialysis unit at Zagazig University Hospitals. A convenient sample of 81 patients who were receiving hemodialysis was selected. Data collected by using Patient Interview Questionnaire, Factors Affecting Sleep Pattern Questionnaire, and Pittsburgh Sleep Quality Index (PSQI). ANOVA test was utilized for data analysis.

Results

93.8 % of patients exhibited poor sleep quality (PSQI >5). The mostly reported factors that could affect patients' sleep pattern were daytime napping (67.9 %), sharing a room with others (79 %), pruritus (79 %), muscle cramps (79 %), chronic pain (79 %), and feel of weakness (86.4 %). There was a statistical significant relation between sleep quality and comorbidity (P = 0.004), skin problems (P = 0.001). A strong positive statistical significant correlation was found between sleep quality and age, dialysis duration, schedule/week, session/h, health problems, and factors affecting sleep pattern with (P = 0.001). Health problems, education, age, and occupation were statistically significant predictors affecting sleep quality detected by the step wise multiple linear regression.

Conclusion

Sleep quality is poor among the majority of patients. The reported factors that may affect their sleep pattern were daytime napping, sharing a room with others, skin itching, muscle cramps, persistent pain, and feel of weakness. The predicting factors affecting sleep quality were health problems, education, age, and occupation.

背景：许多接受血液透析的终末期肾病（ESRD）患者会遇到睡眠障碍。本研究旨在评估血液透析患者的睡眠质量，并确定预测睡眠质量的因素。方法采用描述性、横断面设计。这项研究是在扎加齐格大学医院的血液透析部门进行的。选择了81名接受血液透析的患者作为方便的样本。采用患者访谈问卷、睡眠模式影响因素问卷和匹兹堡睡眠质量指数（PSQI）收集数据。结果93.8%的患者表现为睡眠质量差（PSQI >5）。据报道，影响患者睡眠模式的主要因素是白天午睡（67.9%）、与他人合住（79%）、瘙痒（79%）、肌肉痉挛（79%）、慢性疼痛（79%）和无力感（86.4%）。睡眠质量与合并症（P = 0.004）、皮肤问题（P = 0.001）有统计学意义相关。睡眠质量与年龄、透析持续时间、透析时间/周、透析时间/小时、健康问题和影响睡眠模式的因素有显著正相关（P = 0.001）。健康问题、教育程度、年龄和职业是影响睡眠质量的统计学显著预测因素。结论多数患者睡眠质量较差。据报道，可能影响他们睡眠模式的因素包括白天打盹、与他人合住一个房间、皮肤瘙痒、肌肉痉挛、持续疼痛和感觉虚弱。影响睡眠质量的预测因素有健康问题、教育程度、年龄和职业。

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引用次数: 0

Exploration of nurses' knowledge and perceptions regarding palliative care in the oncology context in Morocco 护士的知识和观念的探索关于姑息治疗在肿瘤学背景下在摩洛哥

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-11-08 DOI: 10.1016/j.apnr.2025.152025

Mohamed Aboufaras , Fahd Elkhalloufi , Loubna Zarouali , Chaimae Sahir , Rachid Fares

Introduction

Despite the growing need for palliative care, limited evidence exists on Moroccan nurses' knowledge and perceptions in this field, representing a critical gap that may affect the quality of patient care. Addressing this gap is essential to ensure effective palliative care delivery. Therefore, this study aimed to assess Moroccan nurses' knowledge and perceptions of palliative care and to identify factors influencing their competencies in this area.

Methods

A cross-sectional analytical study was conducted among Moroccan nurses between April 2023 and April 2024. An anonymized online questionnaire (Palliative Care Quiz for Nursing) was distributed. Data were analyzed using descriptive and inferential statistics with R/RStudio and Excel software.

Results

A total of 480 nurses participated in the study. Overall, nurses demonstrated limited knowledge of palliative care, with a mean score of 5.6/20, corresponding to a 28.53 % correct response rate, particularly low in the psychological and spiritual dimensions. Independent predictors of a higher level of knowledge included male gender (OR = 5.46, p < 0.001), professional experience exceeding 16 years (OR = 2.12, p = 0.001), and training in oncology or palliative care (OR = 3.53, p = 0.006).

Conclusion

The study reveals a low level of palliative care knowledge among nurses in Morocco, despite institutional efforts. It recommends the early integration of palliative care into health systems, the development of multidisciplinary teams, access to essential medications, and the creation of educational programs tailored to low-resource settings.

尽管对姑息治疗的需求日益增长，但摩洛哥护士在这一领域的知识和观念的证据有限，这是一个可能影响患者护理质量的关键差距。解决这一差距对于确保有效提供姑息治疗至关重要。因此，本研究旨在评估摩洛哥护士对姑息治疗的知识和看法，并确定影响其在这一领域能力的因素。方法对2023年4月至2024年4月期间摩洛哥护士进行横断面分析研究。发放一份匿名在线问卷（姑息治疗护理测验）。使用R/RStudio和Excel软件对数据进行描述性统计和推断性统计。结果共480名护士参与研究。总体而言，护士对姑息治疗的知识有限，平均得分为5.6/20，对应的正确率为28.53%，特别是在心理和精神方面。较高知识水平的独立预测因子包括男性（OR = 5.46, p < 0.001）、超过16年的专业经验（OR = 2.12, p = 0.001）和肿瘤学或姑息治疗培训（OR = 3.53, p = 0.006）。结论该研究揭示了低水平的姑息治疗知识护士在摩洛哥，尽管机构的努力。它建议尽早将姑息治疗纳入卫生系统，发展多学科团队，提供基本药物，并针对资源匮乏环境制定教育规划。

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引用次数: 0