To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implications for professional identity and autonomy.
Design
Qualitative multimethod design.
Methods
Forty-five interviews were conducted with nurses and physicians. The collected qualitative data underwent automatic textual data analysis using a multidimensional exploratory approach and a gender framework analysis.
Results
In Italy, nurses' roles are still associated with gender stereotypes stemming from the predominant male culture, which affects sexual and gender identity, the division of labor, and access to career paths. This leads to disadvantages in the nursing profession, which is heavily dominated by women.
Conclusion
Biological differences between sexes generate an unconscious yet shared symbolic gender order composed of negative stereotypes that influence nurses' professional roles and activities. They follow behaviors that enter the work routine and institutionalize organizational processes. These effects are also seen in the asymmetric, limited, and reciprocal interprofessional relationships between male physicians and female nurses, where the former hinders the latter's professional autonomy and access to top positions.
Implications for the Profession
This survey raises awareness of gender issues and stimulates reflection. It also enables health and nursing organizations to take action to raise gender awareness and education by countering the image of a non-autonomous profession. The analysis of gender processes allows us to identify interventions that can counteract forms of oppression in the work environment that lead to the emergence of nursing as a non-autonomous profession.
{"title":"The impact of gender on the nursing figure and nurses' interprofessional relationships: A multimethod study","authors":"Loredana Piervisani PhD, RN, Maddalena De Maria PhD, Sabrina Spagnuolo BSc, Patrizia Nazzaro BSc, Gennaro Rocco PhD, RN, FAAN, Ercole Vellone PhD, RN, FAAN, Rosaria Alvaro MSN, RN, FAAN","doi":"10.1111/jnu.13020","DOIUrl":"10.1111/jnu.13020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implications for professional identity and autonomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative multimethod design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-five interviews were conducted with nurses and physicians. The collected qualitative data underwent automatic textual data analysis using a multidimensional exploratory approach and a gender framework analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Italy, nurses' roles are still associated with gender stereotypes stemming from the predominant male culture, which affects sexual and gender identity, the division of labor, and access to career paths. This leads to disadvantages in the nursing profession, which is heavily dominated by women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Biological differences between sexes generate an unconscious yet shared symbolic gender order composed of negative stereotypes that influence nurses' professional roles and activities. They follow behaviors that enter the work routine and institutionalize organizational processes. These effects are also seen in the asymmetric, limited, and reciprocal interprofessional relationships between male physicians and female nurses, where the former hinders the latter's professional autonomy and access to top positions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications for the Profession</h3>\u0000 \u0000 <p>This survey raises awareness of gender issues and stimulates reflection. It also enables health and nursing organizations to take action to raise gender awareness and education by countering the image of a non-autonomous profession. The analysis of gender processes allows us to identify interventions that can counteract forms of oppression in the work environment that lead to the emergence of nursing as a non-autonomous profession.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"298-313"},"PeriodicalIF":2.9,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liat Hamama PhD, Inbal Amit RN, MA, Michal Itzhaki RN, PhD
Introduction
Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]).
Design
This study utilizes a cross-sectional design.
Method
Two hundred nurses at a major public hospital in southern Israel completed self-report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software.
Findings
Two distinct profiles were identified: “reactive” and “resilient.” The “reactive” group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the “resilient” group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the “reactive” group were younger, with greater seniority, worse self-rated health, and a higher frequency of kidnapped family members compared to nurses from the “resilient” group.
Conclusion
Nurses in wartime are at risk if identified as “reactive.” Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well-being.
Clinical Relevance
Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime.
{"title":"Nurses during war: Profiles-based risk and protective factors","authors":"Liat Hamama PhD, Inbal Amit RN, MA, Michal Itzhaki RN, PhD","doi":"10.1111/jnu.13019","DOIUrl":"10.1111/jnu.13019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study utilizes a cross-sectional design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Two hundred nurses at a major public hospital in southern Israel completed self-report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Two distinct profiles were identified: “reactive” and “resilient.” The “reactive” group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the “resilient” group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the “reactive” group were younger, with greater seniority, worse self-rated health, and a higher frequency of kidnapped family members compared to nurses from the “resilient” group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nurses in wartime are at risk if identified as “reactive.” Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"228-238"},"PeriodicalIF":2.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.13019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed.
Design
A quasi-experimental pre–post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program.
Methods
A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates.
Results
Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), p < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39).
Conclusion
Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.
{"title":"Implementation of a structured oral hygiene program through nursing assistant education to address non-ventilator hospital-acquired pneumonia: A quasi-experimental study","authors":"Elizabeth Kozub MS, APRN, CCNS, ACNP, CNRN, CCRN, Emily Gorzycki DNP, APRN, AGCNS-BC, Abbey Sidebottom PhD, MPH, Sandra Castro-Pearson PhD, Ruth Bryant PhD, MS, RN, CWOCN-Retired/Emeritus, FAAWC","doi":"10.1111/jnu.13018","DOIUrl":"10.1111/jnu.13018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A quasi-experimental pre–post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, <i>p</i> = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, <i>p</i> = 0.005) and toothbrushes (89.3% vs. 95.3%, <i>p</i> = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), <i>p</i> < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"204-215"},"PeriodicalIF":2.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.13018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wen-Yu Kuo PhD, RN, Chen-Yin Chen MS, PT, Jeng Wang PhD, RN, Chin-Man Wang MD, Min-Chi Chen PhD, Ting-Yu Chang MD
Introduction
The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms.
Design
Quasi-experimental design.
Methods
This study included 105 caregiver–survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022.
Results
The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms.
Conclusion
Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life.
Clinical Relevance
This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.
{"title":"Evaluating the combination of in-person and electronic social networking services for family caregivers of stroke survivors: A quasi-experimental analysis","authors":"Wen-Yu Kuo PhD, RN, Chen-Yin Chen MS, PT, Jeng Wang PhD, RN, Chin-Man Wang MD, Min-Chi Chen PhD, Ting-Yu Chang MD","doi":"10.1111/jnu.13022","DOIUrl":"10.1111/jnu.13022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Quasi-experimental design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 105 caregiver–survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"216-227"},"PeriodicalIF":2.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Introduction</h3> <p>The War on Terrorism, which included Operation Enduring Freedom (OEF) in Afghanistan from 2001 to 2014 and the concurrent Operation Iraqi Freedom (OIF) from 2003 to 2011, exposed military nurses to situations and challenges for which many reported feeling unprepared. Clinically, nurses faced multi-trauma injuries and devastating wounds suffered by military troops and civilians alike. Cultural issues and harsh living conditions added further complications to the care environment. The purpose of this study was to address the research question: How do military nurses identify, assess, manage, and personally resolve ethical issues occurring in nursing practice during wartime deployments?</p> </section> <section> <h3> Design</h3> <p>Qualitative grounded theory provided the design for this study.</p> </section> <section> <h3> Methods</h3> <p>Using the constant comparative method, data collection, and data analysis occurred simultaneously to build a theory of ethical issues management during wartime. Using a focused interview guide responsive to emerging themes and developing theory, interviews were conducted until theoretical saturation was achieved. Participants represented primarily Army (55%) active duty (83%) female nurses (71%) who had deployed to Iraq (52%), Afghanistan (32%), or both (16%). A sampling grid was used to recruit nurses representative of the demographics deployed in support of OIF and OEF. Data analysis used grounded theory methods to identify a core construct to detail proposed relationships and concepts. Rigor was maintained in study methods and analysis using established tenets to support trustworthiness.</p> </section> <section> <h3> Results</h3> <p>The nurses shared stories regarding their experiences during deployment. Many struggled to find internal resolutions regarding the care of detainees, cultural differences, end-of-life decision-making, pain management, and care of civilian casualties.</p> </section> <section> <h3> Conclusion</h3> <p>The study described the ethical issues military nurses encountered during wartime and the strategies used to mitigate moral conflict. By better understanding how nurses define, assess, and manage ethical situations, we can better prepare our deploying nurses for future conflicts.</p> </section> <section> <h3> Clinical Relevance</h3> <p>Military nurses returning from wars with unresolved moral conflicts are at risk for moral distress. Moral distress has been associated with
{"title":"“Doing the right thing”: Moral conflicts and ethical issues experienced by military nurses during wartime","authors":"Janice Agazio PhD, CRNP, RN, FAANP, FAAN, Diane L. Padden PhD, CRNP, FAANP","doi":"10.1111/jnu.13011","DOIUrl":"10.1111/jnu.13011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The War on Terrorism, which included Operation Enduring Freedom (OEF) in Afghanistan from 2001 to 2014 and the concurrent Operation Iraqi Freedom (OIF) from 2003 to 2011, exposed military nurses to situations and challenges for which many reported feeling unprepared. Clinically, nurses faced multi-trauma injuries and devastating wounds suffered by military troops and civilians alike. Cultural issues and harsh living conditions added further complications to the care environment. The purpose of this study was to address the research question: How do military nurses identify, assess, manage, and personally resolve ethical issues occurring in nursing practice during wartime deployments?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative grounded theory provided the design for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the constant comparative method, data collection, and data analysis occurred simultaneously to build a theory of ethical issues management during wartime. Using a focused interview guide responsive to emerging themes and developing theory, interviews were conducted until theoretical saturation was achieved. Participants represented primarily Army (55%) active duty (83%) female nurses (71%) who had deployed to Iraq (52%), Afghanistan (32%), or both (16%). A sampling grid was used to recruit nurses representative of the demographics deployed in support of OIF and OEF. Data analysis used grounded theory methods to identify a core construct to detail proposed relationships and concepts. Rigor was maintained in study methods and analysis using established tenets to support trustworthiness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The nurses shared stories regarding their experiences during deployment. Many struggled to find internal resolutions regarding the care of detainees, cultural differences, end-of-life decision-making, pain management, and care of civilian casualties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study described the ethical issues military nurses encountered during wartime and the strategies used to mitigate moral conflict. By better understanding how nurses define, assess, and manage ethical situations, we can better prepare our deploying nurses for future conflicts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Military nurses returning from wars with unresolved moral conflicts are at risk for moral distress. Moral distress has been associated with ","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"56 6","pages":"854-866"},"PeriodicalIF":2.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Historically, the most significant feature of a profession is its unique body of knowledge, or the foundation of common information that guides its practitioners in their activities. Terminologies in nursing are essential for describing nursing-related phenomena and are part of a scientific and constantly updated body of knowledge. More generally, a standardized terminology, as defined by the World Health Organization (WHO), is “<i>a compilation of terms used in the clinical assessment</i>, <i>management and care of patients</i>, <i>which includes agreed definitions that adequately represent the knowledge behind these terms and link with a standardized coding and classification system</i>” (Fennelly et al., <span>2021</span>). Therefore, standardized nursing terminologies (SNTs) offer a unique opportunity to make nursing practice more visible, generate valuable knowledge, and provide essential data for decision-making and research.</p><p>The idea behind creating SNTs was to organize the knowledge of nursing discipline by developing a vocabulary that could explain nurses' clinical judgments (e.g., nursing diagnoses) and the consequences of their detection (e.g., nursing actions). The movement began in the 1970s, and today several widely recognized nursing classification systems are in use because no single universal SNT has been adopted. Among these, 12 nursing-specific SNTs have been officially recognized by the American Nurses Association (ANA): Clinical Care Classification (CCC), Alternative Billing Concepts (ABC) Codes, International Classification for Nursing Practice (ICNP), Logical Observation Identifiers Names and Codes (LOINC), NANDA International (NANDA-I), Nursing Interventions Classification System (NIC), Nursing Outcomes Classification (NOC), Nursing Minimum Data Set, Nursing Management Minimum Data Set (NMMDS), Omaha System, Perioperative Nursing Data Set (PNDS), SNOMED Clinical Terms (SNOMED CT) (Chae et al., <span>2020</span>). Due to their ability to represent vital information about patients' health and the overall value of nursing care, all of these languages are potentially necessary. The use of SNTs to document nursing care in electronic health records (EHRs) can encourage nursing participation in big data research, thereby advancing knowledge of the multifaceted effects of nursing on public health, regardless of the specific SNT used in clinical practice.</p><p>SNTs can thus enhance patient knowledge by improving the quality of professional evaluation, raising the visibility of nursing, and producing data that reflects the impact of nursing care on patient outcomes. However, several challenges complicate this process. SNTs are not widely used in clinical practice, and a global issue persists due to the insufficient collection and encoding of nursing data with SNTs in EHRs. Additionally, managing and analyzing unstructured textual data—often found in paper-based nursing documentation—presents significant difficulties. As a
{"title":"Clinical nursing information systems based on standardized nursing terminologies: How are we doing?","authors":"Manuele Cesare PhD, RN, Maurizio Zega PhD, RN","doi":"10.1111/jnu.13023","DOIUrl":"10.1111/jnu.13023","url":null,"abstract":"<p>Historically, the most significant feature of a profession is its unique body of knowledge, or the foundation of common information that guides its practitioners in their activities. Terminologies in nursing are essential for describing nursing-related phenomena and are part of a scientific and constantly updated body of knowledge. More generally, a standardized terminology, as defined by the World Health Organization (WHO), is “<i>a compilation of terms used in the clinical assessment</i>, <i>management and care of patients</i>, <i>which includes agreed definitions that adequately represent the knowledge behind these terms and link with a standardized coding and classification system</i>” (Fennelly et al., <span>2021</span>). Therefore, standardized nursing terminologies (SNTs) offer a unique opportunity to make nursing practice more visible, generate valuable knowledge, and provide essential data for decision-making and research.</p><p>The idea behind creating SNTs was to organize the knowledge of nursing discipline by developing a vocabulary that could explain nurses' clinical judgments (e.g., nursing diagnoses) and the consequences of their detection (e.g., nursing actions). The movement began in the 1970s, and today several widely recognized nursing classification systems are in use because no single universal SNT has been adopted. Among these, 12 nursing-specific SNTs have been officially recognized by the American Nurses Association (ANA): Clinical Care Classification (CCC), Alternative Billing Concepts (ABC) Codes, International Classification for Nursing Practice (ICNP), Logical Observation Identifiers Names and Codes (LOINC), NANDA International (NANDA-I), Nursing Interventions Classification System (NIC), Nursing Outcomes Classification (NOC), Nursing Minimum Data Set, Nursing Management Minimum Data Set (NMMDS), Omaha System, Perioperative Nursing Data Set (PNDS), SNOMED Clinical Terms (SNOMED CT) (Chae et al., <span>2020</span>). Due to their ability to represent vital information about patients' health and the overall value of nursing care, all of these languages are potentially necessary. The use of SNTs to document nursing care in electronic health records (EHRs) can encourage nursing participation in big data research, thereby advancing knowledge of the multifaceted effects of nursing on public health, regardless of the specific SNT used in clinical practice.</p><p>SNTs can thus enhance patient knowledge by improving the quality of professional evaluation, raising the visibility of nursing, and producing data that reflects the impact of nursing care on patient outcomes. However, several challenges complicate this process. SNTs are not widely used in clinical practice, and a global issue persists due to the insufficient collection and encoding of nursing data with SNTs in EHRs. Additionally, managing and analyzing unstructured textual data—often found in paper-based nursing documentation—presents significant difficulties. As a ","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"56 5","pages":"625-627"},"PeriodicalIF":2.9,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.13023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leodoro J. Labrague RN, DM, PhD, CNE, Sulaiman Al Sabei RN, PhD, Raeda AbuAlRub RN, PhD, Ikram Burney MD, PhD, Omar Al Rawajfah RN, PhD, FAAN
Introduction
While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.
Methods
This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.
Results
A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, p < 0.001) and a lower frequency of missed nursing care (β = −0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = −0.055, p < 0.001).
Conclusion
Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.
Clinical Relevance
Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.
{"title":"The role of nurses' adherence to clinical safety guidelines in linking nurse practice environment to missed nursing care","authors":"Leodoro J. Labrague RN, DM, PhD, CNE, Sulaiman Al Sabei RN, PhD, Raeda AbuAlRub RN, PhD, Ikram Burney MD, PhD, Omar Al Rawajfah RN, PhD, FAAN","doi":"10.1111/jnu.13017","DOIUrl":"10.1111/jnu.13017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, <i>p</i> < 0.001) and a lower frequency of missed nursing care (β = −0.2919, <i>p</i> = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = −0.055, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"354-362"},"PeriodicalIF":2.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jemma McCready MSc, BSc (Hons), Goran Erfani PhD, Dania Comparcini PhD, RN, Giancarlo Cicolini PhD, RN, Kristina Mikkonen PhD, RN, Jeremia Keisala M.H.Sc Student (Educ.), RN, Marco Tomietto PhD, RN, the Sigma IMPACT Research team
Introduction
Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community.
Design
This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023.
Methods
Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters.
Results
Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A).
{"title":"Profiling vaccine hesitancy in nursing to tailor public healthcare policies: A cross-sectional international study","authors":"Jemma McCready MSc, BSc (Hons), Goran Erfani PhD, Dania Comparcini PhD, RN, Giancarlo Cicolini PhD, RN, Kristina Mikkonen PhD, RN, Jeremia Keisala M.H.Sc Student (Educ.), RN, Marco Tomietto PhD, RN, the Sigma IMPACT Research team","doi":"10.1111/jnu.13016","DOIUrl":"10.1111/jnu.13016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study has identified specif","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"253-265"},"PeriodicalIF":2.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.13016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. D. Udeshika Priyadarshani Sugathapala MPhil, BScN(Hons), RN, Sharon Latimer PhD, RN, Brigid M. Gillespie PhD, RN, Aindralal Balasuriya MD, MSc, MBBS, Wendy Chaboyer PhD, RN
<div> <section> <h3> Aim</h3> <p>To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes.</p> </section> <section> <h3> Background</h3> <p>Pressure injury prevalence and incidence are indicators of safety and quality of care. A significant portion of the global population has a skin color dominated by the presence of melanin. Yet, the number of nursing home residents with darker skin tones who develop pressure injuries in nursing homes is relatively unknown.</p> </section> <section> <h3> Design</h3> <p>Prospective multisite cohort study conducted in nine nursing homes in Sri Lanka. The sample comprised 210 residents aged ≥60 years old.</p> </section> <section> <h3> Methods</h3> <p>Semi structured observations and chart audits were used to gather data from July to October 2023. Head-to-toe visual skin assessment to check for nursing home- acquired pressure injuries, Braden pressure injury risk scale and Fitzpatrick skin tone assessments were conducted on all recruited residents at baseline. All recruited residents were followed-up weekly for 12 weeks until detection of a new pressure injury, death, discharge, or transfer.</p> </section> <section> <h3> Results</h3> <p>Pressure injury point prevalence at baseline was 8.1% (17/210). Cumulative incidence was 17.1% (36/210). Incidence density was 15.8 per 1000 resident weeks. Most nursing home-acquired pressure injuries were located on the ankle at baseline (29.4%; 5/17) and in the follow-up period (27.8%; 10/36). Stage I pressure injuries were most common: 58.8% (10/17) and 44.4% (16/36) at baseline and during follow-up respectively.</p> </section> <section> <h3> Conclusions</h3> <p>About one in six nursing home residents developed a new pressure injury over the 12-week follow-up period. Despite staff and resource constraints, there remains a need to focus on the prevention of pressure injuries in Sri Lankan nursing homes.</p> </section> <section> <h3> Clinical Relevance</h3> <p>Studies on the burden of pressure injuries among darker skin tone nursing home residents are lacking and the current evidence available are predominantly from Western countries. The findings of this study highlight the need of targeted preventive mea
{"title":"Prevalence and incidence of pressure injuries among nursing home residents with darker skin tones: A prospective cohort study","authors":"R. D. Udeshika Priyadarshani Sugathapala MPhil, BScN(Hons), RN, Sharon Latimer PhD, RN, Brigid M. Gillespie PhD, RN, Aindralal Balasuriya MD, MSc, MBBS, Wendy Chaboyer PhD, RN","doi":"10.1111/jnu.13012","DOIUrl":"10.1111/jnu.13012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pressure injury prevalence and incidence are indicators of safety and quality of care. A significant portion of the global population has a skin color dominated by the presence of melanin. Yet, the number of nursing home residents with darker skin tones who develop pressure injuries in nursing homes is relatively unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective multisite cohort study conducted in nine nursing homes in Sri Lanka. The sample comprised 210 residents aged ≥60 years old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi structured observations and chart audits were used to gather data from July to October 2023. Head-to-toe visual skin assessment to check for nursing home- acquired pressure injuries, Braden pressure injury risk scale and Fitzpatrick skin tone assessments were conducted on all recruited residents at baseline. All recruited residents were followed-up weekly for 12 weeks until detection of a new pressure injury, death, discharge, or transfer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pressure injury point prevalence at baseline was 8.1% (17/210). Cumulative incidence was 17.1% (36/210). Incidence density was 15.8 per 1000 resident weeks. Most nursing home-acquired pressure injuries were located on the ankle at baseline (29.4%; 5/17) and in the follow-up period (27.8%; 10/36). Stage I pressure injuries were most common: 58.8% (10/17) and 44.4% (16/36) at baseline and during follow-up respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>About one in six nursing home residents developed a new pressure injury over the 12-week follow-up period. Despite staff and resource constraints, there remains a need to focus on the prevention of pressure injuries in Sri Lankan nursing homes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Studies on the burden of pressure injuries among darker skin tone nursing home residents are lacking and the current evidence available are predominantly from Western countries. The findings of this study highlight the need of targeted preventive mea","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"56 6","pages":"826-835"},"PeriodicalIF":2.9,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jnu.13012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chiu-Yueh Hsiao PhD, RN, Huei-Lan Lu MSN, RN, Kuan-Yi Wu MD, Chia-Chun Li PhD, RN, Chi-Rong Li PhD, Yun-Fang Tsai PhD, RN, FAAN
<div> <section> <h3> Introduction</h3> <p>Family engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partner with families in mental healthcare. However, little is known about how mental health nurses engage with families and quality of family-centered care (FCC) perceived by patients and caregivers. The study aimed to examine the mediating effect of family nursing practice on the association between mental health nurses' attitudes toward integrating families into care and quality of FCC perceived by patients with schizophrenia and caregivers.</p> </section> <section> <h3> Design</h3> <p>A cross-sectional study was conducted.</p> </section> <section> <h3> Methods</h3> <p>A convenience sample of 143 dyads of patients with schizophrenia and their caregivers and 109 mental health nurses were recruited from inpatient wards at two psychiatric hospitals in Taiwan. Demographic and clinical questionnaires, Families' Importance in Nursing Care-Nurses' Attitudes scale, Family Nursing Practice Scale, and Measure of Process of Care for Adults were used to collect data. Data were analyzed using descriptive statistics, independent-sample <i>t</i>-tests, one-way analysis of variance, Pearson correlation coefficients, paired-sample <i>t</i>-tests, and intraclass correlation coefficient (ICC). Mediation analyses were performed using Hayes' PROCESS macro in SPSS (Model 4) with bootstrapping.</p> </section> <section> <h3> Results</h3> <p>Mental health nurses exhibited supportive attitudes toward integrating families into care (Mean = 98.96) and greater perceptions of family nursing practice (Mean = 2.44). The concordances between patients and caregivers on perceived quality of family-centered care were significant (ICC = 0.63–0.77). Attitudes of mental health nurses toward integrating families into care had both the total and direct effects on all domains of quality of FCC perceived by patients and caregivers, respectively. The indirect effects of mental health nurses' attitudes toward integrating families into care on aspects of quality of FCC through family nursing practice were significant for patients (95% bias-corrected bootstrap CI of 0.015–0.053) and caregivers (95% bias-corrected bootstrap CI of 0.004–0.041). The magnitude of the indirect effects was medium to large for patients (ES = 0.209–0.257) and caregivers (ES = 0.148–0.221).</p> </section> <section> <h3> Conclusion</h3> <p>Family nursing practice partially mediated t
前言家庭参与护理一直被提倡用于促进精神疾病患者的康复。心理健康护士对家庭重要性的态度影响着他们在心理保健中与家庭合作的方式。然而，人们对心理健康护士如何与家庭合作以及患者和护理人员认为的以家庭为中心的护理（FCC）质量知之甚少。本研究旨在探讨家庭护理实践对精神卫生护士将家庭融入护理的态度与精神分裂症患者和护理人员感知的以家庭为中心的护理质量之间的关联的中介效应：设计：进行了一项横断面研究：方法：从台湾两家精神科医院的住院病房招募了143名精神分裂症患者及其照顾者和109名精神科护士。采用人口统计学和临床问卷、家庭在护理中的重要性-护士态度量表、家庭护理实践量表和成人护理过程量表收集数据。数据分析采用描述性统计、独立样本 t 检验、单因素方差分析、皮尔逊相关系数、配对样本 t 检验和类内相关系数 (ICC)。使用 SPSS 中的 Hayes PROCESS 宏（模型 4）和引导分析进行了中介分析：结果：心理健康护士对家庭融入护理表现出支持态度（平均值 = 98.96），并对家庭护理实践有更高的认识（平均值 = 2.44）。患者和护理人员对以家庭为中心的护理质量的认知具有显著的一致性（ICC = 0.63-0.77）。心理健康护士对家庭融入护理的态度分别对患者和护理人员感知的 FCC 质量的所有领域产生了总体和直接影响。心理健康护士对将家庭融入护理的态度通过家庭护理实践对 FCC 质量的各个方面产生的间接影响对患者（95% 经偏差校正的引导系数 CI 为 0.015-0.053）和护理者（95% 经偏差校正的引导系数 CI 为 0.004-0.041）具有显著影响。患者（ES = 0.209-0.257）和护理人员（ES = 0.148-0.221）的间接影响程度为中等至较大：从患者和护理人员的角度来看，家庭护理实践在心理健康护士将家庭融入护理的态度与 FCC 质量的各个方面之间起到了部分中介作用：对心理健康护士的实践技能和与家庭的互惠性进行量身定制的干预，有可能增强心理健康护士对与家庭合作的支持态度，并进一步改善心理健康护理实践中患者-护理者二人组的FCC感知质量。
{"title":"Family involvement in mental healthcare practice: Perspectives of mental health nurses, patients, and caregivers","authors":"Chiu-Yueh Hsiao PhD, RN, Huei-Lan Lu MSN, RN, Kuan-Yi Wu MD, Chia-Chun Li PhD, RN, Chi-Rong Li PhD, Yun-Fang Tsai PhD, RN, FAAN","doi":"10.1111/jnu.13013","DOIUrl":"10.1111/jnu.13013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Family engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partner with families in mental healthcare. However, little is known about how mental health nurses engage with families and quality of family-centered care (FCC) perceived by patients and caregivers. The study aimed to examine the mediating effect of family nursing practice on the association between mental health nurses' attitudes toward integrating families into care and quality of FCC perceived by patients with schizophrenia and caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional study was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A convenience sample of 143 dyads of patients with schizophrenia and their caregivers and 109 mental health nurses were recruited from inpatient wards at two psychiatric hospitals in Taiwan. Demographic and clinical questionnaires, Families' Importance in Nursing Care-Nurses' Attitudes scale, Family Nursing Practice Scale, and Measure of Process of Care for Adults were used to collect data. Data were analyzed using descriptive statistics, independent-sample <i>t</i>-tests, one-way analysis of variance, Pearson correlation coefficients, paired-sample <i>t</i>-tests, and intraclass correlation coefficient (ICC). Mediation analyses were performed using Hayes' PROCESS macro in SPSS (Model 4) with bootstrapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mental health nurses exhibited supportive attitudes toward integrating families into care (Mean = 98.96) and greater perceptions of family nursing practice (Mean = 2.44). The concordances between patients and caregivers on perceived quality of family-centered care were significant (ICC = 0.63–0.77). Attitudes of mental health nurses toward integrating families into care had both the total and direct effects on all domains of quality of FCC perceived by patients and caregivers, respectively. The indirect effects of mental health nurses' attitudes toward integrating families into care on aspects of quality of FCC through family nursing practice were significant for patients (95% bias-corrected bootstrap CI of 0.015–0.053) and caregivers (95% bias-corrected bootstrap CI of 0.004–0.041). The magnitude of the indirect effects was medium to large for patients (ES = 0.209–0.257) and caregivers (ES = 0.148–0.221).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Family nursing practice partially mediated t","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 2","pages":"190-203"},"PeriodicalIF":2.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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