Journal of Nursing Scholarship最新文献

Introduction: Nurses and healthcare support staff have a higher suicide risk than the public. This elevated risk calls for increased efforts to support mental health. Additionally, nursing leaders' education on employee-specific suicide prevention is lacking.

Design: An evidence-based project was implemented using the PICO question: Among nurse leaders at an academic healthcare system in California, does the provision of an educational program using role-playing practice and the creation of a suicide prevention toolkit versus no standard education or training improve self-efficacy and knowledge on how to take action with a team member who is suspected of being suicidal or voicing suicidal ideation?

Methods: Education sessions were planned based on the literature, with surveys collected preintervention, immediately posteducation, and 1-month postintervention to assess suicide prevention self-efficacy and knowledge. Knowledge was measured using a researcher-constructed questionnaire validated by six suicide prevention experts. The General Self-Efficacy Scale (range: 10-40) was used.

Results: Sixty participants attended one of 11 scheduled remote-learning sessions. Mean self-efficacy significantly improved (pre: 31.3 [n = 46, min: 18, max: 40]; immediate post: 33.49 [n = 37, min: 24, max: 40]; 1-month post: 33.77 [n = 31, min: 28, max: 40]) (X² = 8.0184, df = 2, p = 0.01815). The proportion of incorrect knowledge questions was significantly lower postintervention (mean pre: 24.5%, immediate post: 11.5%, 1-month post: 10.7%, X² = 23.195, df = 2, p = 0.000001). All participants (100%, n = 55) recommended the program. Leaders reported feeling better prepared to support suicidal employees.

Conclusion: Project results demonstrate the need to provide suicide prevention training for leaders. The authors recommend requiring training/return demonstration competency as a component of new leaders' onboarding. This program can easily be modified for nurses from prelicensure through senior leadership.

Clinical relevance: Suicide rates in healthcare members are higher than those of the general population. Suicide prevention programs can help nursing leaders feel better prepared to support and connect at-risk healthcare workers with resources.

Introduction: To deliver palliative care, it is important to understand what a "good death" means to the relevant people. Such studies have mostly occurred in high-income settings that usually live by Western ideals. What matters to people is likely to vary across different regions of the world, influenced by multiple factors. Although there is a great need for palliative care in South Asia, there is a lack of comprehensive understanding of what a good death means in this setting. This study aimed to increase understanding of what is considered a good death in South Asia.

Design: Systematic review and narrative synthesis.

Method: A systematic search was conducted across eight databases, an Advanced Google search, and a bibliography search of selected articles. A data-based convergent synthesis was performed, along with quality appraisal.

Results: Twenty-five empirical studies were selected for analysis from India, Pakistan, Bangladesh, Sri Lanka, and Bhutan. Four themes emerged. Mutual care and connection support a continued sense of self: contributing to others, while receiving connection through relationships and spiritual practices, was important for patients and supported by families and healthcare workers. Freedom to choose-privilege or burden?: the choice to participate in care was necessary for some patients but a burden for others, who preferred the family to lead their care. Severe uncontrolled pain and financial distress precluded choice for some patients, who felt death was the only option. Decisions regarding artificial prolongation of life were complex for patients and healthcare workers. Opportunities in the last days: when actively dying, there was general agreement on the importance of being pain-free, feeling safe, and having family present. Home was not always the preferred place of death. For family, it was critical to perform last rites. After death matters: What happens after death-influenced by leaving a legacy and religious beliefs-affected all parties before, during, and post-death.

Conclusions: To our knowledge, this is the first review of what a good death means in South Asia. There is a dearth of research from most South Asian countries. Although the South Asian perspective has similarities with the Western perspective, we note important nuances around decision-making, prolongation of life, prognostic awareness, and wanting to end one's life, moderated by culture, religion, and poverty. We support policies that account for these variations. Ongoing work is required to provide good symptom management, thus increasing opportunities for patient participation in care. Further research is needed in areas of ethics and religion at the end of life in South Asia.

Introduction: Delay in detecting acute deterioration in older adults in care homes is associated with avoidable hospitalizations and adverse outcomes, including premature death.

Objective: Underpinned by the Knowledge to Action Framework, this study aimed to understand the barriers and enablers to direct care staff detecting and responding to the early signs of acute deterioration in care home residents.

Study design: Online focus groups or interviews with regulated (registered and enrolled nurses) and unregulated (assistants in nursing and personal care workers) direct care staff from participating care homes were conducted. Homes were recruited using disproportionate stratified random sampling to include metropolitan, inner regional, and outer regional care homes. Interview and focus group recordings were transcribed verbatim and analyzed using inductive thematic analysis.

Results: Eighty direct care staff (n = 48 regulated; n = 32 unregulated) from eight care homes participated. Fifteen focus groups (n = 7 unregulated staff, n = 8 regulated staff) and two interviews (n = 1 regulated staff, n = 1 unregulated staff) were conducted between July 2021 and October 2022. Four themes related to the barriers and enablers of detecting and responding to acute deterioration were generated: decision-making within the scope of practice; resource availability; streamlined communication; and teamwork.

Conclusion: Findings highlight the challenges direct care staff encounter in being able to detect early signs of acute deterioration and implement appropriate care pathways. Perceived barriers and enablers highlighted in this study need to be considered when developing and implementing programs to optimize the timely detection of, and response to, acute deterioration in care homes.

Clinical relevance: Workforce knowledge, experience, and confidence deficits are significant barriers to detecting acute deterioration, while the unique workforce mix in care homes poses additional challenges for the accurate detection of early signs of acute deterioration. Knowing the resident, working as a team, and valuing the contribution of aged care staff and families in managing acute deterioration are enablers to achieving better outcomes for residents experiencing acute deterioration.

Introduction: The diverse cultural landscape of Europe underscores the importance of culturally safe healthcare. There is a necessity to assess cultural competence among European nursing faculty to provide an international perspective on cultural competence.

Design: A descriptive, cross-sectional study.

Methods: An assessment of cultural competencies was conducted using the Cultural Competence Assessment scale, either in its original language (English) or in its translated and validated versions in Spanish, Italian, Portuguese, and Turkish. An online questionnaire was used to collect data. The study was conducted in 71 higher institutions, distributed across 17 countries through a consecutive sample of 1364 nursing faculty. The ethical principles of biomedical research were respected during the study, and the confidentiality of the data was guaranteed.

Results: The mean level of cultural competence of the European nursing faculty was at the level of 'good'. They showed greater cultural awareness and sensitivity than cultural competence behaviors. Significant associations were found between cultural competence level and the language of the questionnaire, level of education, having a nursing degree, leisure stays abroad, having friends from other countries or cultures, and international experiences abroad and at home. The better levels of cultural competence were found in profiles with the categories of: women with a Nursing Degree, a higher level of education, and with an ERASMUS+ stay experience.

Conclusions: This study offers an international overview of the cultural competence of nursing faculty. While the overall level of cultural competence was good, there is a need to reinforce the behaviors and factors that influence it.

Purpose: The aim of the study was to explore the impact of patient safety culture on nurses' negative work outcomes resulting from patient safety incidents, as well as the mediating roles of second victim support and distress.

Design: A cross-sectional survey was conducted. The participants included 208 nurses, each with over a year of clinical experience, working in hospitals across South Korea.

Methods: Data were collected through self-reported questionnaires on general characteristics, patient safety culture, second victim support and distress, and negative work outcomes. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Scheffé test, and Pearson correlation coefficients. Additionally, model 6 of Hayes' PROCESS macro and the Sobel test were employed to determine the mediating effect.

Results: Mediation analysis revealed significant indirect effects of patient safety culture on the work outcomes experienced by nurses following patient safety incidents, mediated by second victim distress, after controlling for participants' marital status, position, and the severity of patient safety incidents.

Conclusions: This study demonstrates that in healthcare settings, patient safety culture that supports the second victim and alleviates second victim distress mitigates the negative work outcomes resulting from patient safety incidents. The findings highlight the significance of culturally sensitive support systems, particularly considering the diverse impacts on Korean nurses. Based on this study, healthcare leaders are recommended to develop strategies to support nurses and reduce their second victim distress, which can ultimately improve patient safety and the quality of nursing care.

Clinical relevance: The findings of this study can be used to develop strategies to support second victims in addressing their distress. Taking steps to alleviate the distress of second victims will help prevent negative work outcomes in nurses.

Background: Menopause is associated with significant physical, psychosocial, and emotional changes that can negatively affect women's quality of life (QoL). In response to this, psychological interventions like mindfulness-based interventions have shown promise in alleviating menopausal symptoms and improving psychological well-being.

Methods: A comprehensive randomized controlled trial was conducted from May to August 2024 at Damanhour University, Egypt. One hundred and twenty menopausal women were randomly assigned to either the intervention group (n = 60), which participated in seven mindfulness sessions, or the control group (n = 60), which received general health education. Pre and postintervention data were collected using the Menopause-Specific QoL questionnaire, the Depression Anxiety Stress Scale-21, and the Mindful Attention Awareness Scale. Independent samples t-tests were performed to compare groups, while paired t-tests assessed within-group changes post-intervention. Effect sizes were calculated using Cohen's d, ensuring a robust and reliable data analysis.

Results: The intervention group showed significant improvements across all domains of menopause-specific QoL, including vasomotor (d = 0.788, p < 0.01), psychosocial (d = 1.042, p < 0.01), physical (d = 0.809, p < 0.01), and sexual (d = 0.794, p < 0.01). Additionally, significant reductions were observed in anxiety (d = 1.221, p < 0.01), stress (d = 1.030, p < 0.01), and depression (d = 0.880, p < 0.01), along with a significant increase in mindfulness (d = 1.335, p < 0.01) postintervention.

Conclusion: The MBIS significantly improved menopause-specific QoL and reduced anxiety, stress, and depression while enhancing mindfulness in menopausal women. These findings suggest that mindfulness-based interventions could be game changers in managing menopausal symptoms and improving overall psychological well-being, offering hope for a better QoL for menopausal women.

Clinical relevance: The research will primarily impact healthcare providers working with menopausal women, particularly those offering psychological support or nonpharmacological treatments. It also impacts menopausal women themselves by providing evidence-based intervention options that could alleviate menopausal symptoms. Furthermore, researchers and policymakers focusing on women's health and mental well-being may use these findings to inform future studies and healthcare strategies.

Patient or public contribution: Women from Damanhur University.

Trial registration: This trial was registered with the ClinicalTrials.gov database under the registration number NCT06421909.

Aim(s): To determine the correlation between preoperative health education and the emotions of lung cancer patients, artificial intelligence software was used.

Design: This was a cross-sectional study.

Methods: This study included 210 lung cancer patients from Sun Yat-sen University Cancer Center and examined the impact of health education on patient emotions using an AI-based emotion analysis tool.

Results: This study indicated a significant relationship between the tone and emotional content of health education materials and patient emotions. Specifically, educational materials with an explanatory tone and negative sentiment appeared to impact patients' emotional states.

Conclusion: Quality improvements in health education can potentially benefit lung cancer patients' emotional well-being by minimizing the use of both explanatory tone and negative sentiment in educational content.

Implications for the profession and/or patient care: This research suggests that the careful crafting of health education materials, taking into consideration tone and emotional expressions, can have a tangible positive effect on the emotional state of lung cancer patients.

Reporting method: The study was reported in accordance with the STROBE guidelines.

Patient or public contribution: No patients, service users, caregivers, or members of the public were involved in the design, conduct, collection, analysis, or interpretation of the data for this study, nor were they involved in writing the manuscript.