Applied Nursing Research最新文献_第4页

Safety attitudes among general practice nurses: A cross-sectional mixed-methods study 全科护士的安全态度：一项横断面混合方法研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-12-01 Epub Date: 2025-11-13 DOI: 10.1016/j.apnr.2025.152026

Yeojin Kil , Roisin Doogue , Anna V. Chatzi

Background

Safety is a critical element within general practice as it is a unique environment with limited resources, diverse patients' needs, and varied healthcare environments. Within this landscape, general practice is a complex clinical environment with General Practice Nurses making up 45 % of the clinical workforce. Understanding the factors that influence general practice nurses' safety attitudes is important to improving patient care and organisational safety culture. This study aimed to explore factors associated with general practice nurses' safety attitudes, including demographics, safety perceptions, and experiences in practice.

Methods

A cross-sectional mixed methods study was conducted with survey comprising Likert scale and open-ended questions. A total of 302 fully completed responses were obtained from general practice nurses. Quantitative data were analysed to examine associations between safety attitudes and demographic characteristics. Qualitative data were thematically analysed to provide contextual insights into safety-related challenges.

Results

The length of work as a General Practice Nurse, regular operational briefings and smaller working teams are positively associated with the General Practice Nurses' safety attitudes. Participants expressed their preference towards regular and systematic communication. High workload, time pressures, inadequate communication, and unsupportive teamwork appeared as barriers of effective functioning within general practice.

Conclusion

Work experience and team size significantly impact safety attitudes, with experienced nurses and smaller teams showing better understanding and accountability. Regular operational briefings enhance collaboration and preparedness, while inconsistent communication leads to frustration. Positive perceptions of teamwork and communication are strongly linked to favourable safety attitudes, while excessive workload and limited autonomy pose challenges.

Practical applications

To improve safety within general practice, it is essential to address these issues through organisational support, systematic communication systems, and targeted training programmes.

在全科医疗中，安全是一个关键因素，因为它是一个独特的环境，资源有限，患者需求多样，医疗环境也各不相同。在这种情况下，全科执业是一个复杂的临床环境，全科执业护士占临床劳动力的45%。了解影响全科护士安全态度的因素对改善病人护理和组织安全文化很重要。本研究旨在探讨与全科护士安全态度相关的因素，包括人口统计学、安全观念和实践经验。方法采用李克特量表和开放式问卷调查相结合的横截面混合方法进行研究。从全科护士中获得了302份完整的回复。定量数据进行了分析，以检查安全态度和人口特征之间的关系。定性数据进行了主题分析，以提供有关安全相关挑战的背景见解。结果全科护士的工作时长、定期的业务简报和较小的工作团队与全科护士的安全态度呈正相关。与会者表示，他们倾向于定期和系统的沟通。高工作量、时间压力、沟通不足和不支持的团队合作在全科实践中成为有效运作的障碍。结论工作经验和团队规模对安全态度有显著影响，经验丰富的护士和规模较小的团队表现出更好的理解和责任。定期的业务简报会加强协作和准备，而不一致的沟通会导致挫折。对团队合作和沟通的积极看法与良好的安全态度密切相关，而过度的工作量和有限的自主权则构成挑战。实际应用为了在一般医疗实践中提高安全性，必须通过组织支持、系统沟通系统和有针对性的培训计划来解决这些问题。

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引用次数: 0

The Italian validation of the Watson Caritas Co-Worker Score for nurses and health care professionals Italian validation of the WCCS 意大利对沃森明爱护士和卫生保健专业人员同事评分的验证

IF 2.7 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-07-24 DOI: 10.1016/j.apnr.2025.151990

Marika Lo Monaco , Laura Maniscalco , Mariachiara Figura , Alessandro Stievano , Domenica Matranga , Jean Watson , Cirus Rinaldi , Daniela Nigrelli , Ella Domanskaya , Vincenzo Cascino , Giuliano Anastasi , Silvia Oggioni , Irene Zerilli , Roberto Latina

引用次数: 0

Contributing factors to missed nursing care: A systematic review with clinical implications for practice and patient safety 导致护理遗漏的因素：对实践和患者安全的临床意义的系统回顾

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-19 DOI: 10.1016/j.apnr.2025.152002

Federica Breno , Daniele Marchetti , Daniela Cattani , Simone Cosmai , Stefano Mancin , Diego Lopane , Beatrice Mazzoleni

Objectives

Missed Nursing Care (MNC) is increasingly recognized as an indicator of care quality and a potential contributor to adverse events. This systematic review aimed to explore the correlation between MNC and adverse events in hospitalized patients across public and private settings.

Methods

A systematic review was conducted according to PRISMA 2020 guidelines. Searches were performed in PubMed, Embase, CINAHL, Scopus, and TripDatabase between January and February 2025. Included studies were quantitative, published in English or Italian, and focused on acute hospital settings. Methodological quality was assessed using the Joanna Briggs Institute (JBI) checklist; risk of bias was evaluated with ROBINS-I.

Results

Seven studies met the inclusion criteria, involving 13,619 nurses and 902 patients. Study designs included four cross-sectional, two observational (one correlational), and one secondary data analysis. Five studies reported a positive association between MNC and adverse events, while two found inverse or non-significant relationships. Common adverse outcomes included falls, infections, pressure ulcers, and medication errors.

Conclusions

Despite methodological heterogeneity and limitations—such as the use of non-validated tools or contextual differences—the evidence suggests a consistent association between MNC and adverse events. These findings underscore the importance of addressing missed care as a patient safety concern. Further longitudinal studies are needed to confirm causality and inform predictive models.

Implications for nursing practice

Recognition of the link between MNC and adverse events should prompt healthcare organizations to address care omissions through staffing optimization, safety culture, and clinical governance. Targeted interventions may reduce preventable harm and improve care quality.

目的护理缺失（MNC）越来越被认为是护理质量的一个指标，也是不良事件的潜在诱因。本系统综述旨在探讨MNC与公立和私立医院住院患者不良事件之间的相关性。方法根据PRISMA 2020指南进行系统评价。检索于2025年1月至2月在PubMed、Embase、CINAHL、Scopus和TripDatabase中进行。纳入的研究是定量的，以英语或意大利语发表，并专注于急性医院环境。采用乔安娜布里格斯研究所（JBI）检查表评估方法学质量；采用ROBINS-I评估偏倚风险。结果7项研究符合纳入标准，共纳入13619名护士和902名患者。研究设计包括四项横断面分析、两项观察分析（一项相关分析）和一项辅助数据分析。五项研究报告了MNC与不良事件之间的正相关，而两项研究发现了负相关或不显著的关系。常见的不良后果包括跌倒、感染、压疮和用药错误。尽管方法上存在异质性和局限性，如使用未经验证的工具或背景差异，但证据表明跨国公司与不良事件之间存在一致的关联。这些发现强调了作为患者安全问题解决错过护理的重要性。需要进一步的纵向研究来确认因果关系并为预测模型提供信息。对护理实践的启示认识到跨国公司与不良事件之间的联系应促使医疗保健组织通过人员配置优化、安全文化和临床治理来解决护理疏忽问题。有针对性的干预措施可以减少可预防的伤害并提高护理质量。

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引用次数: 0

Nurses' intention to leave: A cross-sectional study in the northern Italy 护士离职意向：意大利北部的一项横断面研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-11 DOI: 10.1016/j.apnr.2025.152000

Paola Pinotti , Simone Cosmai , Diego Lopane , Beatrice Mazzoleni , Gianluca Solitro

Introduction

A growing number of nurses are expressing the intention to leave their current jobs or the nursing profession entirely. This trend poses a significant threat to healthcare systems, contributing to increased adverse events, reduced quality of care, poorer patient outcomes, and elevated healthcare costs due to staff turnover and organizational instability.

Objective

This study aimed to examine job satisfaction and the intention to leave both current employment and the nursing profession among registered nurses affiliated with the Provincial Order of Nurses (Ordine delle Professioni Infermieristiche, OPI) in Bergamo, Northern Italy.

Methods

A cross-sectional survey was conducted among all nurses registered with OPI Bergamo. A total of 1,167 nurses completed the questionnaire. The Italian validated version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) was used to assess the quality of the nursing work environment. Descriptive statistics were employed to describe the sample and main variables. Logistic regression models were used to explore associations between job satisfaction and intention to leave.

Results

Overall, 56.4% of respondents (n = 659) reported an intention to leave their current job, while 46.6% considered leaving the nursing profession entirely. In both groups, the mean PES-NWI score was 2.18 (SD ± 0.46).

Conclusions

These findings indicate a high level of dissatisfaction among nurses in the Bergamo area, with substantial implications for workforce retention and healthcare system performance. Targeted strategies are urgently needed to improve work environments and reduce the risk of attrition among qualified nursing staff in Italy. Key words: Intention to leave, Job satisfaction, Work environment, PES-NWI (Practice Environment Scale of the Nursing Work Index), Hospital nurses.

越来越多的护士表示打算完全离开目前的工作或护理行业。这一趋势对医疗保健系统构成了重大威胁，导致不良事件增加、护理质量下降、患者预后较差，以及由于人员流动和组织不稳定而导致的医疗保健成本上升。目的本研究旨在调查意大利北部贝加莫省护士协会（Ordine delle Professioni intermieristiche， OPI）注册护士的工作满意度和离职意向。方法对本院注册护士进行横断面调查。共有1167名护士完成了问卷调查。采用意大利验证版护理工作指数实践环境量表（PES-NWI）评估护理工作环境的质量。采用描述性统计对样本和主要变量进行描述。运用Logistic回归模型探讨工作满意度与离职意向之间的关系。结果总体而言，56.4%（659人）的受访者表示有意离职，46.6%的受访者考虑完全离开护理行业。两组患者PES-NWI平均评分为2.18 （SD±0.46）。这些发现表明贝加莫地区护士的高度不满，这对劳动力保留和医疗保健系统绩效具有重大影响。迫切需要有针对性的战略来改善意大利合格护理人员的工作环境和减少人员流失的风险。关键词：离职意向，工作满意度，工作环境，PES-NWI（护理工作指标实践环境量表），医院护士。

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引用次数: 0

The role of sense of coherence, self-efficacy, social support and perceived stress on postpartum depression during the transition to motherhood: A path analysis. 融贯感、自我效能感、社会支持和感知压力对产后抑郁的影响：路径分析。

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-08 DOI: 10.1016/j.apnr.2025.151998

Lebeza Alemu Tenaw, Fei Wan Ngai, Ka Wai Katherine Lam

Background: The transition to motherhood is a women's life event that, while often joyful, can present challenges leading to postpartum depression. Understanding the roles of sense of coherence, self-efficacy, and social support in mitigating postpartum depression is crucial, particularly among Ethiopian mothers, where cultural practices may influence these dynamics.

Objectives: The objective of this study to evaluate the effect of sense of coherence, self-efficacy, social support, and stress on postpartum depression during the transition to motherhood.

Methods: This cross-sectional study involved 200 mothers recruited from Woldia Comprehensive Specialized Hospital, Ethiopia. The data collection conducted by two BSc midwives from 10 to 30 November 2024. Path analysis using Maximum Likelihood Estimation was performed to evaluate the effects of sense of coherence, self-efficacy, social support, and perceived stress on postpartum depression. Model fit evaluated using indices such as the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root-Mean-Square Error of Approximation (RMSEA).

Results: The modified path model demonstrated a good fit with the data, indicated by χ² = 1.64 (p > 0.44), CFI = 1.00, TLI = 1.02, RMSEA <0.001, and SRMR = 0.02. The model explained 29.8 % of the variance in postpartum depression. A higher sense of coherence significantly predicted lower levels of postpartum depression, with a path coefficient of β = -0.15 (p = 0.02). Similarly, sense of coherence was associated with lower perceived stress (β = -0.21, p = 0.02), while perceived stress was a significant positive predictor of postpartum depression (β = 0.49, p < 0.001). The model also demonstrated that both social support and self-efficacy were inversely related to postpartum depression.

Conclusions: Sense of coherence plays a direct role in preventing postpartum depression, while the effects of social support and self-efficacy on depressive symptoms are mediated through sense of coherence and perceived stress levels.

背景：转变为母亲是女性生活中的一件大事，虽然经常是快乐的，但也可能带来导致产后抑郁的挑战。理解连贯感、自我效能感和社会支持在减轻产后抑郁症中的作用至关重要，特别是在埃塞俄比亚母亲中，那里的文化习俗可能会影响这些动态。目的：本研究旨在探讨融贯感、自我效能感、社会支持和压力对产后抑郁的影响。方法：本横断面研究涉及从埃塞俄比亚Woldia综合专科医院招募的200名母亲。两名BSc助产士于2024年11月10日至30日进行了数据收集。采用最大似然估计法进行通径分析，评估连贯性感、自我效能感、社会支持和感知压力对产后抑郁的影响。使用比较拟合指数（CFI）、塔克-刘易斯指数（TLI）和近似均方根误差（RMSEA）等指标评估模型拟合。结果：修正路径模型与数据拟合良好，χ2 = 1.64 (p > 0.44), CFI = 1.00, TLI = 1.02， RMSEA。结论：连贯性感在预防产后抑郁中起直接作用，而社会支持和自我效能感通过连贯性感和应激感知水平介导对抑郁症状的影响。

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引用次数: 0

Development and validation of the Male Nurse Identity Scale 男护士认同量表的编制与验证

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-15 DOI: 10.1016/j.apnr.2025.152001

Luhao Liu , Xueting Wang , Renjie Zhang , Yuanyuan Li , Minmin Leng , Lijuan Yang , Guangzhao Li , Changan Li , Heng Sun , Tengfei Jiang

Aim

To develop the Male Nurse Identity Scale (MNIS) and further evaluate its validity and reliability.

Background

In a context where occupational gender stereotypes continue to influence the nursing profession, the male nurse population often experiences identity dilemmas. The Male Nurse Identity Scale (MNIS) focuses on measuring multidimensional identity; to our knowledge, no similar instrument exists.

Methods

The MNIS was constructed through a systematic scale development process in which the total sample(n=837) was randomly split in half: Sample 1(n=418) was subjected to exploratory factor analysis (EFA) and Sample 2(n=419) was subjected to validation factor analysis (CFA); the full sample was analyzed for reliability.

Results

An exploratory factor analysis (EFA) of Sample 1 yielded a 19-item MNIS scale consisting of four dimensions: self-identity, role-identity, occupational group-identity, and occupational cultural-identity. Structural equation modeling (SEM) showed good model fit. Reliability analyses showed excellent internal consistency, with Cronbach's alpha coefficients ranging from 0.901 to 0.961 for the four dimensions.

Conclusion

The MNIS has strong validity and reliability, and it provides a valuable tool for enhancing the career development of male nurses and their retention in the healthcare workforce.

目的编制男性护士认同量表（MNIS），并进一步评价其信度和效度。在职业性别刻板印象持续影响护理职业的背景下，男性护士群体经常经历身份困境。男护士认同量表（MNIS）侧重于测量多维认同；据我们所知，没有类似的工具存在。方法通过系统量表开发过程构建MNIS，将总样本（n=837）随机分成两半：样本1（n=418）进行探索性因子分析（EFA），样本2（n=419）进行验证因子分析（CFA）；对整个样品进行了可靠性分析。结果对样本1进行探索性因子分析（EFA），得到一个包含自我认同、角色认同、职业群体认同和职业文化认同四个维度的19项MNIS量表。结构方程模型（SEM）表明模型拟合良好。信度分析显示了良好的内部一致性，四个维度的Cronbach's alpha系数在0.901 ~ 0.961之间。结论MNIS具有较强的效度和信度，为促进男护士职业发展和挽留男护士提供了有价值的工具。

{"title":"Development and validation of the Male Nurse Identity Scale","authors":"Luhao Liu , Xueting Wang , Renjie Zhang , Yuanyuan Li , Minmin Leng , Lijuan Yang , Guangzhao Li , Changan Li , Heng Sun , Tengfei Jiang","doi":"10.1016/j.apnr.2025.152001","DOIUrl":"10.1016/j.apnr.2025.152001","url":null,"abstract":"<div><h3>Aim</h3><div>To develop the Male Nurse Identity Scale (MNIS) and further evaluate its validity and reliability.</div></div><div><h3>Background</h3><div>In a context where occupational gender stereotypes continue to influence the nursing profession, the male nurse population often experiences identity dilemmas. The Male Nurse Identity Scale (MNIS) focuses on measuring multidimensional identity; to our knowledge, no similar instrument exists.</div></div><div><h3>Methods</h3><div>The MNIS was constructed through a systematic scale development process in which the total sample(n=837) was randomly split in half: Sample 1(n=418) was subjected to exploratory factor analysis (EFA) and Sample 2(n=419) was subjected to validation factor analysis (CFA); the full sample was analyzed for reliability.</div></div><div><h3>Results</h3><div>An exploratory factor analysis (EFA) of Sample 1 yielded a 19-item MNIS scale consisting of four dimensions: self-identity, role-identity, occupational group-identity, and occupational cultural-identity. Structural equation modeling (SEM) showed good model fit. Reliability analyses showed excellent internal consistency, with Cronbach's alpha coefficients ranging from 0.901 to 0.961 for the four dimensions.</div></div><div><h3>Conclusion</h3><div>The MNIS has strong validity and reliability, and it provides a valuable tool for enhancing the career development of male nurses and their retention in the healthcare workforce.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"85 ","pages":"Article 152001"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865542","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

The chain mediating effects of psychological resilience and organizational commitment on the association between workplace incivility and job withdrawal among Chinese oncology nurses: A cross-sectional study. 心理弹性和组织承诺在中国肿瘤科护士工作场所不文明行为与工作退缩关系中的连锁中介作用：一项横断面研究。

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-07 DOI: 10.1016/j.apnr.2025.151999

Jiaxun Kang, Rui Zhao, Qiushi Zhang, Wenbo Jing, Hui Xu, Shanshan Wang

Background: Workplace incivility experienced by nurses has a substantial impact on job withdrawal, psychological resilience and organizational commitment also show certain associations with both incivility and work withdrawal. However, the specific mechanisms underlying these factors remain unclear.

Aim: This study aimed to identify the relationship between workplace incivility and job withdrawal and the chain mediating effects of psychological resilience and organizational commitment.

Methods: A cross-sectional study was conducted with oncology nurses working in 7 hospitals using a convenience sampling method, which were all situated in central China, comprising four hospitals in Henan Province, two in Hunan Province, and one in Shandong Province. Demographic questionnaire and four validated and reliable scales were utilized for assessing demographic and occupational characteristics, workplace incivility, job withdrawal, psychological resilience, and organizational commitment. Participants (N = 1442) completed the survey.

Results: The effects of workplace incivility, job withdrawal, psychological resilience, and organizational commitment were interrelated (all p < 0.01). Workplace incivility influenced job withdrawal through three statistically significant indirect pathways: (a) the mediating effect of psychological resilience (β = 0.017; SE = 0.003; 95 % CI: 0.012, 0.022); (b) the mediating effect of organizational commitment (β = 0.011; SE = 0.002; 95 % CI: 0.006, 0.015) and (c) the chain mediating effect between psychological resilience and organizational commitment (β = 0.001; SE = 0.004; 95 % CI: 0.001, 0.002).

Conclusion: This study further elucidated the intrinsic connection between nurses' experiences of workplace incivility and their job withdrawal. This suggested that improving the working environment, reducing instances of uncivilized behavior in the workplace, enhancing psychological resilience and organizational commitment may contribute to reducing nurses' job withdrawal, thereby improving the quality of nursing care and ensuring patient safety.

背景：护士经历的职场不文明行为对工作退缩有实质性影响，心理弹性和组织承诺也与不文明行为和工作退缩有一定的关联。然而，这些因素背后的具体机制尚不清楚。目的：本研究旨在探讨职场不文明行为与工作退缩的关系，以及心理弹性和组织承诺的连锁中介效应。方法：采用方便抽样的方法，对河南省4家医院、湖南省2家医院和山东省1家医院7家医院的肿瘤护士进行横断面研究。采用人口统计问卷和四个有效可靠的量表来评估人口统计和职业特征、工作场所不礼貌、工作退缩、心理弹性和组织承诺。参与者（N = 1442）完成了调查。结果：工作场所不文明行为、工作退缩、心理弹性和组织承诺的影响相互关联（均为p）。结论：本研究进一步阐明了护士工作场所不文明经历与工作退缩之间的内在联系。因此，改善工作环境，减少工作场所不文明行为，增强心理弹性和组织承诺，有助于减少护士的离职现象，从而提高护理质量，保障患者安全。

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引用次数: 0

Voices from the intensive care unit: A qualitative study on communication between family members and nurses 重症监护病房的声音：家庭成员与护士沟通的质性研究

IF 2.7 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-07-22 DOI: 10.1016/j.apnr.2025.151991

Essa Majed Tadros MSN, RN , Hekmat Yousef Al-Akash PhD, RN , Anas Ababneh PhD, RN , Mariam Kawafha PhD, RN , Osama A. Al-Kouri PhD, RN , Suhair Hussni Al-Ghabeesh PhD, RN , Zyad T. Saleh PhD, RN , Ahmed Yahya Ayoub RN, PhDc, Case Manager , Ahmad Rajeh Saifan PhD, RN

Background

Effective communication between ICU nurses and patients' families is essential in ensuring optimal care, reducing anxiety, and enhancing decision-making. However, communication difficulties persist globally, particularly in intensive care units (ICUs) where patients are in critical condition and their families are distressed.

Aim

To explore the lived experiences of ICU nurses and family members in Jordan to understand how nurse workload, emotional stress, and cultural expectations influence the quality, clarity, and emotional tone of communication in intensive care settings.

Study design

A qualitative exploratory design was used. Individual face-to-face semi-structured interviews were done with 15 ICU nurses and 15 family members in two tertiary hospitals in Jordan. Braun and Clark's thematic analysis was utilized to generate the main themes and subthemes.

Results

The study identified three major themes: (1) communication disconnect and information gaps, including inadequate or inconsistent updates across shifts; (2) emotional load and its impact on communication, driven by family emotional overload and nurse burnout; and (3) balancing families' needs with nurses' workload, involving tensions between frequent updates, transparency, emotional support, and professional boundaries.

Conclusions

The study shows that ICU nurses in Jordanian hospitals face barriers to communicating with family members owing to irregular information distribution, emotional turmoil within families, and nurse exhaustion. These problems overlap with time pressure and workload stress, creating gaps in information flow, trust erosion, and emotional overload. Families' experiences could be improved through an improved ICU structure, easier communication pathways, enhanced nurse education and support, and improved family satisfaction.

ICU护士与患者家属之间的有效沟通对于确保最佳护理、减少焦虑和提高决策能力至关重要。然而，在全球范围内，沟通困难仍然存在，特别是在重症监护病房（icu），那里的病人情况危急，他们的家人感到痛苦。目的探讨约旦ICU护士及其家属的生活经历，了解护士工作量、情绪压力和文化期望如何影响重症监护环境中沟通的质量、清晰度和情绪基调。研究设计采用定性探索性设计。对约旦两所三级医院的15名重症监护室护士和15名家属进行了面对面的半结构化访谈。Braun和Clark的主位分析被用来生成主位和副位。结果研究确定了三个主要主题：(1)沟通脱节和信息缺口，包括不同班次的信息更新不足或不一致；(2)情绪负荷及其对沟通的影响，由家庭情绪负荷和护士倦怠驱动；(3)平衡家庭需求和护士工作量，包括频繁更新、透明度、情感支持和专业界限之间的紧张关系。结论约旦医院ICU护士与家属沟通存在障碍，主要原因是信息分布不规律、家庭内部情绪动荡、护士身心疲惫。这些问题与时间压力和工作量压力重叠，造成信息流的空白，信任的侵蚀和情绪的过载。通过改善ICU结构，简化沟通途径，加强护士教育和支持，提高家庭满意度，可以改善家庭体验。

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引用次数: 0

Resilience as a mediator between empathy and professional grief among nurses in high-mortality services 复原力在高死亡率服务中护士共情与职业悲伤之间的中介作用

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-21 DOI: 10.1016/j.apnr.2025.152003

Ozkan Uguz , Ozan Ozkol , Dilay Gungor , Zeynep Ozcan

Background

Nurses working in high-mortality clinical services, such as intensive care, oncology, and palliative care units, frequently witness patient deaths. This repeated exposure places them at a high risk of bereavement reactions; however, limited research has explored how individual emotional traits, particularly empathy and resilience, shape this experience.

Aims

This study aimed to investigate the mediating role of resilience in the relationship between empathy and bereavement reactions—both short-term emotional reactions and long-term cumulative effects—among nurses working in high-mortality services.

Methods

A cross-sectional design was used. Data were collected online from 238 purposively sampled nurses working in a tertiary public hospital in northwestern Turkey. Standardized tools were used to measure empathy, resilience, and professional bereavement.

Results

Nurses reported moderate levels of bereavement reactions following patient deaths. Empathy was positively associated with both short-term bereavement reactions (β = 0.253, p = 0.001) and long-term cumulative effects (β = 0.359, p < 0.001). Resilience partially mediated these associations, reducing the impact of empathy on both short-term bereavement reactions (β = 0.071, 95 % CI [0.017, 0.133]) and long-term cumulative effects (β = 0.137, 95 % CI [0.084, 0.193]).

Conclusion

Nurses in high-mortality services are particularly vulnerable to experiencing bereavement. While higher empathy intensifies bereavement reactions, resilience plays a protective role. Interventions aimed at strengthening resilience may help mitigate the negative effects of bereavement and promote emotional well-being, job sustainability, and improved patient care outcomes in these emotionally demanding settings.

在高死亡率的临床服务部门工作的护士，如重症监护室、肿瘤科和姑息治疗病房，经常目睹病人死亡。这种反复接触使他们面临丧失亲人反应的高风险；然而，有限的研究探索了个人的情感特征，特别是同理心和适应力，是如何塑造这种经历的。目的本研究旨在探讨心理韧性在护士共情与丧亲反应（短期情绪反应和长期累积效应）之间的中介作用。方法采用横断面设计。数据在线收集了238名在土耳其西北部一家三级公立医院工作的护士。标准化的工具被用来测量同理心、恢复力和职业丧亲之痛。结果护士报告患者死亡后出现中等程度的丧亲反应。共情与短期丧亲反应（β = 0.253, p = 0.001）和长期累积效应（β = 0.359, p < 0.001）呈正相关。复原力部分介导了这些关联，降低了共情对短期丧亲反应（β = 0.071, 95% CI[0.017, 0.133]）和长期累积效应（β = 0.137, 95% CI[0.084, 0.193]）的影响。结论高死亡率服务机构的护士特别容易经历丧亲之痛。虽然更高的同理心会加剧丧亲反应，但恢复力起着保护作用。旨在增强复原力的干预措施可能有助于减轻丧亲之痛的负面影响，促进情绪健康、工作可持续性，并改善这些情绪要求高的环境中的患者护理结果。

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引用次数: 0

Nurse-led implementation of evidence-based bundles to reduce CAUTIs in an academic acute care hospital: A four-year longitudinal quasi-experimental study 护士主导的以证据为基础的捆绑实施，以减少学术急症医院的CAUTIs：一项为期四年的纵向准实验研究

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research

Pub Date : 2025-10-01 Epub Date: 2025-08-26 DOI: 10.1016/j.apnr.2025.152004

May Mei-Sheng Riley DNP, MSN, MPH, RN, ACNP, CCRN, CIC, FAPIC , Wei-Chen Tung Ph.D., RN, FAAN , Chris Tofanelli MSN, RN, CNS, PCCN

Aim

This study aimed to evaluate the effectiveness of evidence-based catheter bundles, guided by the Plan-Do-Check-Act model, in reducing catheter-associated urinary tract infections (CAUTIs) and catheter usage at a 643-bed academic hospital.

Background

Despite previous efforts, our facility's CAUTI rates remained high, leading to increased morbidity, extended hospital stays, and higher costs. A four-year project was initiated to implement targeted interventions.

Method

This quasi-experimental study used a four-year strategy, including catheter insertion and maintenance bundles, a nurse-driven removal protocol, and extensive education. We compared pre- and post-intervention data on Standardized Infection Ratios (SIRs) and Standardized Utilization Ratios (SURs) with a goal of greater than 10 % reduction in both metrics; catheter reinsertion rates monitored as a secondary endpoint.

Results

Among 2448 catheterized patients, CAUTI cases declined from 66 to 60. The SIR decreased from 0.93 to 0.58 post-intervention, a 38 % reduction in CAUTI risk (p = .007). Catheter SURs fell from 0.75 to 0.67, an 11 % reduction in utilization risk (p < .001). Reinsertion rates decreased by approximately 6 %.

Conclusions

Nurse-led, evidence-based prevention bundles successfully reduced both CAUTIs and catheter use beyond the 10 % target. These findings underscore the critical role of nursing in driving practice change and improving patient safety.

目的本研究旨在评估以计划-执行-检查-行动模式为指导的循证导尿管束在减少有643个床位的学术医院导尿管相关尿路感染（CAUTIs）和导尿管使用方面的有效性。背景：尽管以前做过努力，我们医院的CAUTI率仍然很高，导致发病率增加、住院时间延长和费用增加。为执行有针对性的干预措施，启动了一个为期四年的项目。方法这项准实验研究采用为期四年的策略，包括导管插入和维护包、护士驱动的拔除方案和广泛的教育。我们比较了干预前和干预后的标准化感染率（SIRs）和标准化利用率（SURs）数据，目标是两项指标均降低10%以上；导管重新插入率监测作为次要终点。结果2448例留置导管患者中，CAUTI病例由66例下降至60例。干预后，SIR从0.93降至0.58，CAUTI风险降低38% （p = .007）。导管SURs从0.75降至0.67，使用风险降低11% （p < .001）。再插入率下降了大约6%。结论以护士为主导的循证预防包成功地将CAUTIs和导管使用率降低了10%以上。这些发现强调了护理在推动实践变革和提高患者安全方面的关键作用。

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