Applied Nursing Research最新文献_第3页

The role of artificial intelligence in enhancing triage decisions in healthcare settings: A systematic review 人工智能在加强医疗机构分诊决策中的作用：系统综述

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-11-04 DOI: 10.1016/j.apnr.2025.152024

Hasan Abualruz , Islam Yasin , Mohammad A. Abu Sabra , Hamzeh Yousef Abunab , Rania Azayzeh , Yara Zubidi , Saja Emad , Baraah alriyati

Background

Triage is an essential function of healthcare providers in various healthcare settings, such as physicians and nurses, allowing the prioritization of patients based on severity of presenting problem. Artificial intelligence (AI) provides a promising solution by enhancing the accuracy, efficiency, and consistency of triage decisions process. Although AI shows potential in supporting healthcare providers and improving patient outcomes, its role in triage is still developing and requires more research into its effectiveness, challenges, and ethical considerations.

Objectives

This systematic review aims to explore the role of AI in enhancing healthcare providers triage decisions process in the various healthcare settings.

Methods

We conducted JBI Systematic Reviews and reported results following PRISMA guidelines to screen 211 studies published between January 2020 and May 2025 from databases including Google Scholar, Wiley Online Library, PsycINFO, CINAHL Plus, and Medline.

Results

Twenty-two studies met inclusion criteria. Results indicated that AI-based triage systems outperformed traditional methods in diagnostic accuracy, efficiency, and decision support, especially for critical conditions. Additionally, the studies demonstrated statistically significant improvements over clinician-assigned Emergency Severity Index (ESI) scores. AI models used included machine learning, deep learning, natural language processing, and hybrid approaches.

Conclusion

AI-based triage systems present a transformative opportunity for enhancing emergency care delivery, with evidence supporting improvements in diagnostic accuracy, triage efficiency, and decision support. Successful implementation depends not only on technical performance but also on trust, usability, ethical governance, and contextual adaptation. A multidisciplinary approach will be required to fully utilize AI in numerous healthcare settings, including triage.

分诊是各种医疗保健机构（如医生和护士）的一项基本功能，允许根据出现问题的严重程度对患者进行优先排序。人工智能（AI）通过提高分诊决策过程的准确性、效率和一致性，提供了一个有前途的解决方案。尽管人工智能在支持医疗保健提供者和改善患者预后方面显示出潜力，但其在分诊中的作用仍在发展中，需要对其有效性、挑战和伦理考虑进行更多研究。目的：本系统综述旨在探讨人工智能在各种医疗环境中增强医疗服务提供者分诊决策过程中的作用。方法：根据PRISMA指南，对2020年1月至2025年5月从谷歌Scholar、Wiley Online Library、PsycINFO、CINAHL Plus和Medline等数据库中发表的211项研究进行JBI系统评价并报告结果。结果22项研究符合纳入标准。结果表明，基于人工智能的分诊系统在诊断准确性、效率和决策支持方面优于传统方法，特别是在危急情况下。此外，研究表明，在临床分配的紧急严重性指数（ESI）评分上，有统计学上的显著改善。使用的人工智能模型包括机器学习、深度学习、自然语言处理和混合方法。结论基于人工智能的分诊系统为加强急诊护理提供了一个变革性的机会，有证据支持在诊断准确性、分诊效率和决策支持方面的改进。成功的实现不仅取决于技术性能，还取决于信任、可用性、道德治理和上下文适应。将需要一种多学科的方法来充分利用人工智能在众多医疗保健环境中，包括分诊。

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引用次数: 0

The mediating role of self-efficacy in the relationship between spirituality and burnout among intensive care unit nurses: a pathway analysis 自我效能感在重症监护室护士灵性与倦怠关系中的中介作用：一个通路分析

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-09-03 DOI: 10.1016/j.apnr.2025.152005

Fatin Lailatul Badriyah , Mundakir Mundakir , Tita Rohita , Bih-O Lee , Santo Imanuel Tonapa

Background

Burnout is a critical issue among intensive care unit (ICU) nurses, impacting both their well-being and excellence in care. Spiritual wellbeing and self-efficacy have been identified as potential protective factors against burnout, yet their interrelationships remain unclear, particularly in the Indonesian nurse's context.

Objectives

This study examines the role of spirituality and self-efficacy in burnout and explores the mediating effect of self-efficacy.

Methods

A cross-sectional correlational design with convenience sampling was conducted among 410 ICU nurses in public hospitals in East Java, Indonesia. Participants completed validated measures of burnout, spirituality and self-efficacy. Partial least squares structural equation modelling was employed to test direct and indirect relationships between variables.

Results

Most participants were female, with a mean age of around 31 years and more than two years of ICU experience. Higher workload significantly predicted greater burnout (β = 0.21, p < 0.001), while spirituality (β = −0.17, p = 0.001) and self-efficacy (β = −0.24, p < 0.001) negatively predicted burnout. Mediation analysis confirmed that self-efficacy mediated the relationship between spirituality and burnout (β = −0.13, p < 0.001), indicating that ICU nurses with higher levels of spiritual wellbeing reported stronger self-efficacy, which in turn predicted lower burnout.

Conclusion

The findings reveal that self-efficacy is a key mechanism through which spirituality mitigates burnout among ICU nurses. These insights may inform the development of healthy work environment initiatives that incorporate spiritual support and self-efficacy training through structured mentorship and organisational systems, ultimately reducing burnout and enhancing nurses' resilience in high-stress settings.

背景：职业倦怠是重症监护病房（ICU）护士的一个重要问题，它影响着护士的幸福感和护理质量。精神健康和自我效能已被确定为防止倦怠的潜在保护因素，但它们之间的相互关系尚不清楚，特别是在印度尼西亚护士的背景下。目的探讨精神和自我效能感在职业倦怠中的作用，并探讨自我效能感的中介作用。方法采用方便抽样的横断面相关设计，对东爪哇省公立医院410名ICU护士进行调查。参与者完成了倦怠、精神和自我效能的有效测量。采用偏最小二乘结构方程模型检验变量之间的直接和间接关系。结果大多数参与者为女性，平均年龄31岁左右，有2年以上ICU工作经验。高工作负荷显著预测倦怠（β = 0.21, p < 0.001），而灵性（β = - 0.17, p = 0.001）和自我效能（β = - 0.24, p < 0.001）负向预测倦怠。中介分析证实，自我效能感在灵性与倦怠之间起中介作用（β = - 0.13, p < 0.001），表明精神健康水平越高的ICU护士自我效能感越强，进而预测倦怠程度越低。结论自我效能感是灵性缓解ICU护士职业倦怠的重要机制。这些见解可以为健康工作环境倡议的发展提供信息，通过结构化的指导和组织系统，将精神支持和自我效能培训结合起来，最终减少倦怠，增强护士在高压力环境中的适应能力。

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引用次数: 0

Effect of evidence-based nursing intervention under quantitative evaluation strategy on psychological resilience and illness perception in lung cancer patients undergoing chemotherapy 定量评价策略下循证护理干预对肺癌化疗患者心理弹性和疾病感知的影响

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-09-08 DOI: 10.1016/j.apnr.2025.152013

Liwei Zhang , Haixian Fang , Xin Su, Yongqian Zhang, Changwen Bo, Jing Liu, Li He, Juan Zhang, Yusha Yan, Zhaohui Xu, Feifei Wang

Objective

To investigate the effect of evidence-based nursing intervention guided by a quantitative evaluation strategy on psychological resilience and illness perception in lung cancer patients undergoing chemotherapy.

Methods

A total of 142 lung cancer patients receiving chemotherapy from March 2024 to March 2025 were enrolled and randomly divided into a study group (receiving evidence-based nursing intervention under a quantitative evaluation strategy, n = 71) and a control group (receiving routine nursing, n = 71). Psychological resilience, illness perception control, coping styles, and complication rates were compared before and 3 months after intervention.

Results

Before intervention, no significant differences were observed in the scores for psychological resilience domains (optimism, tenacity, strength, total score), illness perception domains (emotional, cognitive, comprehension, total score), or coping styles between the two groups (P > 0.05). After 3 months, the study group showed significantly higher scores in optimism, tenacity, strength, and total psychological resilience than the control group (P < 0.05). Similarly, post-intervention, the study group demonstrated superior scores in all illness perception domains (P < 0.05) and showed a significant shift toward more active and less passive coping styles (P < 0.05). The study group also exhibited lower incidences of gastrointestinal reactions and pulmonary infections (P < 0.05), while no significant differences were observed in hepatorenal toxicity, bone marrow suppression, or phlebitis (P > 0.05).

Conclusion

Evidence-based nursing intervention guided by quantitative evaluation effectively enhances psychological resilience and illness perception and promotes adaptive coping styles in lung cancer patients undergoing chemotherapy, warranting clinical application.

目的探讨定量评价策略指导下循证护理干预对肺癌化疗患者心理弹性和疾病感知的影响。方法选取2024年3月~ 2025年3月期间接受化疗的肺癌患者142例，随机分为研究组（71例，采用循证护理干预定量评价策略）和对照组（71例，采用常规护理）。比较干预前和干预后3个月的心理弹性、疾病知觉控制、应对方式和并发症发生率。结果干预前，两组在心理弹性领域（乐观、坚韧、力量、总分）、疾病感知领域（情绪、认知、理解、总分）和应对方式得分均无显著差异（P > 0.05）。3个月后，研究组在乐观、坚韧、力量、总心理弹性方面得分显著高于对照组（P < 0.05）。同样，干预后，研究组在所有疾病感知领域都表现出更高的得分（P < 0.05），并表现出更积极和更少被动应对方式的显著转变（P < 0.05）。研究组的胃肠道反应和肺部感染发生率也较低（P < 0.05），而肝肾毒性、骨髓抑制和静脉炎的发生率无显著差异（P < 0.05）。结论定量评价指导下的循证护理干预能有效提高肺癌化疗患者的心理弹性和疾病感知，促进适应性应对方式，值得临床推广应用。

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引用次数: 0

Sustained quality-of-life gains following nurse-led cardiac rehabilitation: A longitudinal study to support nursing practice 护士主导的心脏康复后持续的生活质量提高：一项支持护理实践的纵向研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-24 DOI: 10.1016/j.apnr.2025.152020

María José Ferreira Díaz

Background

Cardiac rehabilitation (CR) is a key component of secondary prevention in cardiovascular care. While its effects on clinical outcomes are well established, the long-term impact on health-related quality of life (HRQoL) and the specific contribution of nurse-led care remain underexplored in real-world settings.

Aims

To evaluate longitudinal changes in HRQoL among patients who completed a structured nurse-led CR program, and to identify subgroup differences and predictors of sustained improvement.

Methods

A prospective cohort study was conducted with 181 patients following myocardial infarction or cardiac surgery. HRQoL was assessed using the SF-36 questionnaire at four time points: baseline, discharge, 6 months, and 12 months. Sociodemographic, clinical, and psychosocial variables were analyzed. Nurse-led interventions were guided by standardized NIC classifications, including health education (NIC 5240), cardiac rehabilitation (NIC 5246), and emotional support (NIC 5270).

Results

HRQoL improved significantly across all SF-36 domains over 12 months (p < 0.001), especially in physical functioning, vitality, and general health. Women, patients with low education, and those with baseline anxiety showed lower initial scores but meaningful gains. Adherence to the full program was strongly associated with sustained improvements.

Conclusions

Nurse-led CR is effective in promoting sustained HRQoL gains across physical and emotional domains. Standardized interventions based on NIC contribute to structured, person-centered care delivery, especially in vulnerable populations.

Implications for nursing practice

Monitoring HRQoL through validated tools and NIC-guided nursing plans enhances long-term cardiovascular recovery. Integration of psychosocial assessment and extended follow-up may improve equity and personalization in post-cardiac care.

背景心脏康复（CR）是心血管护理二级预防的关键组成部分。虽然它对临床结果的影响已经确定，但对健康相关生活质量（HRQoL）的长期影响以及护士主导的护理的具体贡献在现实环境中仍未得到充分探讨。目的评估完成结构化护士主导的CR项目的患者HRQoL的纵向变化，并确定亚组差异和持续改善的预测因素。方法对181例心肌梗死或心脏手术患者进行前瞻性队列研究。采用SF-36问卷在基线、出院、6个月和12个月四个时间点评估HRQoL。分析了社会人口学、临床和社会心理变量。护士主导的干预以标准化NIC分类为指导，包括健康教育（NIC 5240）、心脏康复（NIC 5246）和情感支持（NIC 5270）。结果在12个月内，SF-36各领域的患者生活质量均有显著改善（p < 0.001），特别是在身体功能、活力和一般健康方面。女性、受教育程度低的患者和基线焦虑患者的初始得分较低，但有意义的提高。坚持整个计划与持续的改善密切相关。结论护士主导的CR能有效促进身体和情绪领域HRQoL的持续提高。基于NIC的标准化干预有助于结构化的、以人为本的护理提供，特别是在弱势群体中。通过有效的工具和nic指导的护理计划监测HRQoL可以提高心血管的长期康复。整合心理社会评估和延长随访可以提高心脏后护理的公平性和个性化。

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引用次数: 0

A multidimensional assessment of vibration and cold for venipuncture pain in children aged 7 and above: A randomized controlled trial 振动和寒冷对7岁及以上儿童静脉穿刺疼痛的多维评估：一项随机对照试验

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-09-12 DOI: 10.1016/j.apnr.2025.152012

Hu Long-yi , Zhou Zi-yun , Wang Ming-li , Zhou Le-shan

Aims

To investigate the effects of cold and vibration on venipuncture pain in children aged 7 and above, evaluating outcomes through subjective and objective child measures, parental feedback, and nurse assessments.

Method

This randomized controlled trial enrolled 120 children aged 7 and above undergoing venipuncture between July and November 2023. Participants were allocated into four groups using a random number table: cold, vibration, cold combined with vibration, and a control group. After procedure, pain and parental anxiety were assessed using a self-reported Numerical Rating Scale. Child anxiety was evaluated with the Children's Anxiety Meter Scale, while children's cooperation was evaluated by the operating nurse.

Results

External cold, vibration, and cold combined with vibration significantly reduced changes in children's pulse and pain (p < 0.05). Multiple comparisons indicated that the cold and vibration combination group exhibited the smallest pulse changes and the lowest pain scores(p < 0.05). However, it cannot yet be concluded that external cold and vibration effectively reduce children's anxiety, relatives' anxiety, or the cooperation of the children (p > 0.05).

Conclusion

Cold and vibration significantly reduced pain and physiological responses during venipuncture in children aged 7 and above, though no benefits were found for anxiety or cooperation. Future multicenter studies with larger sample sizes are recommended to further explore its role in pediatric pain management.

目的探讨低温和振动对7岁及以上儿童静脉穿刺疼痛的影响，通过主观和客观的儿童测量、家长反馈和护士评估来评估结果。方法本随机对照试验于2023年7月至11月对120名7岁及以上儿童进行静脉穿刺治疗。参与者使用随机数字表分为四组：冷、振动、冷与振动结合，以及对照组。手术后，疼痛和父母焦虑使用自我报告的数字评定量表进行评估。使用儿童焦虑量表评估儿童焦虑，由手术护士评估儿童合作能力。结果外寒、震动及寒颤联合震动均能显著降低患儿脉搏和疼痛的变化（p < 0.05）。多次比较显示，冷震动联合组脉搏变化最小，疼痛评分最低（p < 0.05）。但是，目前还不能得出外部寒冷和振动能有效降低儿童焦虑、亲属焦虑或儿童合作的结论（p > 0.05）。结论低温和振动可显著降低7岁及以上儿童静脉穿刺时的疼痛和生理反应，但对焦虑和合作无明显改善。未来的多中心研究，更大的样本量，建议进一步探讨其在儿童疼痛管理中的作用。

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引用次数: 0

The relationship between anxiety about artificial intelligence and nurses' perceptions of job security: The impact of technological transformation 人工智能焦虑与护士工作安全感之间的关系：技术转型的影响

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI: 10.1016/j.apnr.2025.152023

Ganime Esra SOYSAL, Mehmet Ali CALIŞKAN, Aykut TURGUT

Aim

The objective of this study is to evaluate the anxiety levels of nurses regarding artificial intelligence and its impact on their perception of job security.

Background

The nursing profession, which is affected by artificial intelligence, has concerns about this transformation.

Design

This study employed a cross-sectional and descriptive.

Methods

The was conducted with 104 nurses working in a hospital between December 2024 and March 2025. Data was collected using the Descriptive Information Form, Artificial Intelligence Anxiety Scale and Job Security Perception Scale.

Results

The nurses participating in this study exhibited moderate anxiety towards artificial intelligence according to the scores they received from the Artificial Intelligence Anxiety Scale. The relationship between nurses' artificial intelligence anxiety and the perception of job security was not statistically significant (p ≥ 0.165). Nurses with ≥10 years' experience had higher AIA scores than those with less experience, but this difference was not significant (p = 0.056). It was stated that 80.8 % (n:84) of the nurses did not use ChatGPT or any other application supported by artificial intelligence in their professional life. The Job Security Perception Scale scores were no different between those who saw artificial intelligence as a threat and those who did not (p = 0.870).

Conclusions

It was observed that nurses were inadequate in using artificial intelligence technologies and experienced moderate anxiety, but there was no significant relationship between this anxiety and their perceptions of job security.

目的本研究旨在评估护士对人工智能的焦虑程度及其对工作安全感的影响。受人工智能影响的护理行业对这种转变感到担忧。本研究采用横断面和描述性方法。方法对2024年12月~ 2025年3月在某医院工作的104名护士进行问卷调查。采用描述性信息表、人工智能焦虑量表和工作安全感知量表收集数据。结果根据人工智能焦虑量表得分，参与本研究的护士对人工智能表现出中度焦虑。护士人工智能焦虑与工作安全感感知的关系无统计学意义（p≥0.165）。经验≥10年的护士AIA得分高于经验不足的护士，但差异无统计学意义（p = 0.056）。80.8% （n:84）的护士在职业生活中未使用ChatGPT或其他人工智能支持的应用程序。将人工智能视为威胁的人与不将其视为威胁的人之间的工作安全感知量表得分没有差异（p = 0.870）。结论护理人员对人工智能技术的使用不足，存在中度焦虑，但焦虑与工作安全感无显著关系。

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引用次数: 0

Effectiveness of light intervention on daytime sleepiness, fatigue, and sleep quality among female shift-working nurses - A randomized control trail 光干预对倒班女护士日间嗜睡、疲劳和睡眠质量的影响——一项随机对照试验

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-09-19 DOI: 10.1016/j.apnr.2025.152017

Shu-Fen Niu , Yu-Ying Lu , Yu-Chieh Lin , Kuei-Fen Liu

Background

Sleep disturbances and fatigue are prevalent among female shift-working nurses, adversely affecting their health and job performance.

Objectives

This study aimed to evaluate the effectiveness of light intervention in reducing daytime sleepiness, fatigue, and improving sleep quality among female shift-working nurses.

Methods

A randomized controlled trial was conducted at a medical center in northern Taiwan with 80 female nurses assigned to either an experimental or control group. Baseline assessments included demographics, work characteristics, and measures using the Epworth Sleepiness Scale (ESS), Brief Fatigue Inventory (BFI), and Pittsburgh Sleep Quality Index (PSQI). The experimental group used a wearable light device (Re-Timer®) for 30–40 min daily over four weeks, while the control group continued their usual routines. Follow-up assessments occurred on day 14 (T1) and day 28 (T2).

Results

Results from Generalized Estimating Equations (GEEs) analysis showed significant reductions in sleepiness (ESS) at T2 and improvements in sleep quality (PSQI) at T1 and T2 in the experimental group compared to the control (p < .05). No significant changes were found in fatigue (BFI).

Conclusions

The study supports light intervention as a safe, low-cost, and non-pharmacological approach to reduce daytime sleepiness and enhance sleep in shift-working nurses, suggesting its integration into occupational health programs for healthcare providers.

睡眠障碍和疲劳在轮班工作的女性护士中普遍存在，对她们的健康和工作表现产生不利影响。目的探讨光干预对减少轮班女护士日间嗜睡、疲劳及改善睡眠质量的效果。方法在台湾北部某医疗中心进行随机对照试验，将80名女护士分为实验组和对照组。基线评估包括人口统计、工作特征和使用Epworth嗜睡量表（ESS）、简短疲劳量表（BFI）和匹兹堡睡眠质量指数（PSQI）的测量。实验组在四周内每天使用可穿戴照明设备（Re-Timer®）30-40分钟，而对照组则继续他们的日常生活。随访时间分别为第14天（T1）和第28天（T2）。结果广义估计方程（GEEs）分析结果显示，与对照组相比，实验组在T1和T2时嗜睡（ESS）显著减少，睡眠质量（PSQI）显著改善（p < 0.05）。疲劳（BFI）未见明显变化。结论：本研究支持轻干预作为一种安全、低成本和非药物的方法来减少轮班护士白天嗜睡和增强睡眠，建议将其纳入医疗保健提供者的职业健康计划。

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引用次数: 0

Nurses' knowledge and evidence-based practice in pain management for sedated ICU patients: Results of a national cross-sectional study 护士在镇静ICU患者疼痛管理方面的知识和循证实践：一项全国性横断面研究的结果

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-29 DOI: 10.1016/j.apnr.2025.152022

Nurdan Yalçın Atar PhD, RN, Asst. Prof. , Semra Açıksöz PhD, RN, Asst. Prof. , Öznur Tuğba Çelebi Dursun MSc, RN, Lect.

Aim

This study aimed to evaluate intensive care nurses' knowledge and evidence-based practices regarding pain management in sedated patients and to identify influencing factors.

Background

Pain management is a critical component of nursing care in intensive care units, yet managing pain in sedated patients remains complex and requires specialized competencies. To date, no study has specifically examined ICU nurses' knowledge and practices related to pain management in this population, nor the factors influencing them.

Methods

A descriptive, cross-sectional study was conducted among 218 ICU nurses using standardized self-report instruments. Data were collected using the “Descriptive Information Form,” the “Pain Management Knowledge Test in Sedated Patients,” and the “Evidence-based Practices Test for Pain Management in Sedated Patients.”

Results

The mean knowledge score was 26.48 ± 7.01 (range: 0–35), significantly differing by education and professional background (p < 0.05). The mean evidence-based practice score was 27.47 ± 6.74 (range: 13–39), with no significant demographic differences. Although nurses' knowledge varied according to education and experience, their practices were similar across groups.

Conclusion

Given that sedated ICU patients often receive end-of-life care, improving nurses' pain management competencies may directly enhance palliative outcomes. İnstitutional protocols and ongoing training programs are recommended.

目的本研究旨在评估重症监护护士对镇静患者疼痛管理的知识和循证实践，并确定影响因素。背景：疼痛管理是重症监护室护理的关键组成部分，然而镇静患者的疼痛管理仍然很复杂，需要专业能力。迄今为止，还没有研究专门调查ICU护士在这一人群中与疼痛管理相关的知识和实践，也没有研究调查影响这些知识和实践的因素。方法采用标准化自我报告工具对218名ICU护士进行描述性横断面调查。使用“描述性信息表”、“镇静患者疼痛管理知识测试”和“镇静患者疼痛管理循证实践测试”收集数据。结果平均知识得分为26.48±7.01分（范围：0 ~ 35分），学历、专业差异有统计学意义（p < 0.05）。平均循证实践评分为27.47±6.74（范围：13-39），人口统计学差异无统计学意义。尽管护士的知识因教育程度和经验而异，但他们的做法在不同群体中是相似的。结论镇静ICU患者常接受临终关怀，提高护士疼痛管理能力可直接提高姑息治疗效果。建议使用İnstitutional协议和正在进行的培训计划。

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引用次数: 0

Examination of the sleep quality status of patients who underwent cranial surgery in terms of perceived stress, socio-demographic, and clinical characteristics 从感知压力、社会人口统计学和临床特征方面对颅脑手术患者的睡眠质量状况进行检查

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.apnr.2025.152019

Altun Baksi , Esra Ertuğrul , Saadet Çömez , Furkan Ersen

Background

Sleep quality is important for both the recovery and quality of life of patients who underwent cranial surgery.

Objectives

This study aimed to examine the relationship between sleep quality and perceived stress, as well as the socio-demographic and clinical characteristics of patients who underwent cranial surgical intervention.

Methods

A descriptive and correlational research design was employed. The study enrolled 142 patients at the neurosurgery clinic of a university hospital in Türkiye between December 2019 and December 2020. Data were collected using the Descriptive Characteristic Form, Richards–Campbell Sleep Questionnaire, and Perceived Stress Scale.

Results

The mean age of patients who underwent cranial surgical intervention was 52.87 ± 14.16 years (range, 18–84). The mean sleep score was 46.68 ± 19.35 (range, 3–93) and the mean perceived stress score was 29.70 ± 4.29 (range, 20–44). Factors associated with lower sleep quality scores, in order of importance, were: presence of sleep problems after hospitalization (β = −0.363), presence of one attached medical equipment (β = −0.209), American Society of Anesthesiologists (ASA) physical status III prior to surgery (β = −0.205), and room occupancy of 2–3 patients (β = −0.134). Factors associated with higher sleep quality scores, in order of importance, were: absence of sleep problems after hospitalization (β = 0.384) and a higher total number of surgeries (β = 0.172).

Conclusions

The findings of this study indicate that patients undergoing cranial surgery experience moderate sleep quality and perceived stress levels. Evaluation of sleep quality should account for significant influencing factors, and additional studies in diverse patient samples are warranted.

背景：睡眠质量对颅脑手术患者的康复和生活质量都很重要。目的探讨颅脑外科手术患者的睡眠质量与感知压力的关系，以及患者的社会人口统计学和临床特征。方法采用描述性和相关性研究设计。该研究于2019年12月至2020年12月期间在泰国一家大学医院的神经外科诊所招募了142名患者。采用描述性特征表、Richards-Campbell睡眠问卷和感知压力量表收集数据。结果接受颅脑手术干预的患者平均年龄为52.87±14.16岁（范围18 ~ 84岁）。平均睡眠评分为46.68±19.35（范围3 ~ 93），平均应激感知评分为29.70±4.29（范围20 ~ 44）。与较低睡眠质量评分相关的因素，按重要性排序为：住院后是否存在睡眠问题（β = - 0.363），是否有一台附属医疗设备（β = - 0.209），手术前美国麻醉医师协会（ASA）的身体状况III (β = - 0.205)，以及2-3名患者的房间占用（β = - 0.134）。与较高睡眠质量评分相关的因素，按重要性排序为：住院后无睡眠问题（β = 0.384）和手术总次数较高（β = 0.172）。结论颅脑手术患者的睡眠质量和感知压力水平处于中等水平。对睡眠质量的评估应考虑到重要的影响因素，需要在不同的患者样本中进行额外的研究。

{"title":"Examination of the sleep quality status of patients who underwent cranial surgery in terms of perceived stress, socio-demographic, and clinical characteristics","authors":"Altun Baksi , Esra Ertuğrul , Saadet Çömez , Furkan Ersen","doi":"10.1016/j.apnr.2025.152019","DOIUrl":"10.1016/j.apnr.2025.152019","url":null,"abstract":"<div><h3>Background</h3><div>Sleep quality is important for both the recovery and quality of life of patients who underwent cranial surgery.</div></div><div><h3>Objectives</h3><div>This study aimed to examine the relationship between sleep quality and perceived stress, as well as the socio-demographic and clinical characteristics of patients who underwent cranial surgical intervention.</div></div><div><h3>Methods</h3><div>A descriptive and correlational research design was employed. The study enrolled 142 patients at the neurosurgery clinic of a university hospital in Türkiye between December 2019 and December 2020. Data were collected using the Descriptive Characteristic Form, Richards–Campbell Sleep Questionnaire, and Perceived Stress Scale.</div></div><div><h3>Results</h3><div>The mean age of patients who underwent cranial surgical intervention was 52.87 ± 14.16 years (range, 18–84). The mean sleep score was 46.68 ± 19.35 (range, 3–93) and the mean perceived stress score was 29.70 ± 4.29 (range, 20–44). Factors associated with lower sleep quality scores, in order of importance, were: presence of sleep problems after hospitalization (β = −0.363), presence of one attached medical equipment (β = −0.209), American Society of Anesthesiologists (ASA) physical status III prior to surgery (β = −0.205), and room occupancy of 2–3 patients (β = −0.134). Factors associated with higher sleep quality scores, in order of importance, were: absence of sleep problems after hospitalization (β = 0.384) and a higher total number of surgeries (β = 0.172).</div></div><div><h3>Conclusions</h3><div>The findings of this study indicate that patients undergoing cranial surgery experience moderate sleep quality and perceived stress levels. Evaluation of sleep quality should account for significant influencing factors, and additional studies in diverse patient samples are warranted.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"86 ","pages":"Article 152019"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362892","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

Organizational change fatigue among nurses and its impact on work engagement: A qualitative study 护士组织变革疲劳及其对工作投入的影响：一项质的研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-10-06 DOI: 10.1016/j.apnr.2025.152018

Hui Duan , Dongmei He , Yanli Zeng , Xiaolin Ma , Qian Li , Xinxu Zhou

Aim

To explore how organizational change fatigue influences nurses' work engagement based on their lived experiences in tertiary hospitals in China.

Background

Organizational change fatigue undermines nurse engagement, a factor consistently linked to patient safety and workforce retention. Nurses are frequently positioned at the center of hospital reforms and must adapt to structural, technological, and policy-driven changes. These transitions often create cumulative stress, yet little is known about how nurses subjectively experience change fatigue or how it shapes their professional engagement. Addressing this gap is essential, as understanding lived experiences can inform leadership and policy strategies to sustain nurse well-being and ensure safe, high-quality patient care.

Methods

A descriptive phenomenological design was employed. Semi-structured interviews were conducted with 12 registered nurses from three tertiary hospitals using purposive sampling. Data were analyzed using Colaizzi's seven-step method, and reporting followed the Consolidated Criteria for Reporting Qualitative Research.

Results

Four themes were identified: perceptions of organizational change, emotional and behavioral responses, coping strategies and perceived support, and impact on work engagement. Nurses described a cyclical trajectory from emotional fatigue to disengagement, with the potential for re-engagement when supported by psychologically safe and inclusive environments.

Conclusions

Organizational change fatigue erodes nurses' motivation, professional commitment, and care quality. However, recovery is possible through relational leadership, transparent communication, and recognition of emotional labor. These findings highlight the need for human-centered change strategies to maintain engagement and ensure workforce sustainability during continuous healthcare reform.

目的探讨组织变革疲劳对三级医院护士工作投入的影响。组织变革疲劳会破坏护士的敬业度，而这一因素一直与患者安全和员工留任有关。护士经常被定位在医院改革的中心，必须适应结构、技术和政策驱动的变化。这些转变通常会产生累积的压力，但很少有人知道护士是如何主观地经历变化疲劳的，或者它是如何塑造他们的专业参与的。解决这一差距至关重要，因为了解生活经验可以为领导和政策战略提供信息，以维持护士的福祉，并确保安全、高质量的患者护理。方法采用描述现象学设计。采用有目的抽样方法，对来自三所三级医院的12名注册护士进行半结构化访谈。数据分析采用Colaizzi的七步法，报告遵循定性研究报告的统一标准。结果确定了四个主题：对组织变革的看法，情绪和行为反应，应对策略和感知支持，以及对工作投入的影响。护士们描述了从情绪疲劳到脱离的周期性轨迹，在心理安全和包容的环境支持下，有可能重新投入。结论组织变革疲劳会影响护士的工作积极性、职业承诺和护理质量。然而，通过关系型领导、透明的沟通和对情绪劳动的认识，恢复是可能的。这些发现强调了在持续的医疗改革期间，需要以人为中心的变革战略来保持参与并确保劳动力的可持续性。

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引用次数: 0