Journal of Nursing Scholarship最新文献_第5页

Documentation of social determinants of health across individuals from different racial and ethnic groups in home healthcare. 记录家庭医疗保健中不同种族和民族群体个人健康的社会决定因素。

IF 3.4 3区医学 Q1 Nursing

Journal of Nursing Scholarship

Pub Date : 2024-05-13 DOI: 10.1111/jnu.12980

Mollie Hobensack, Danielle Scharp, Jiyoun Song, Maxim Topaz

Introduction: Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on race or ethnicity. Social determinants of health (SDOH) describe the external factors influencing a patient's health, such as access to care and social support. Individuals from racially or ethnically minoritized communities are known to be disproportionately affected by SDOH. Existing evidence suggests that SDOH are documented in clinical notes. However, no prior study has investigated the documentation of SDOH across individuals from different racial or ethnic backgrounds in the HHC setting. This study aimed to (1) describe frequencies of SDOH documented in clinical notes by race or ethnicity and (2) determine associations between race or ethnicity and SDOH documentation.

Design: Retrospective data analysis.

Methods: We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models.

Results: Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC.

Conclusion: As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided.

Clinical relevance: The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.

导言：家庭医疗保健（HHC）使患者能够在家中接受医疗保健服务，以控制慢性疾病并从疾病中康复。最近的研究发现，基于种族或民族的家庭医疗保健存在差异。健康的社会决定因素（SDOH）描述了影响患者健康的外部因素，如获得医疗服务和社会支持。众所周知，来自少数种族或族裔社区的个人受到 SDOH 的影响尤为严重。现有证据表明，SDOH 记录在临床笔记中。但是，之前还没有研究调查过在 HHC 环境中不同种族或民族背景的个人的 SDOH 记录情况。本研究旨在：（1）按种族或民族描述临床笔记中记录的 SDOH 频率；（2）确定种族或民族与 SDOH 记录之间的关联：设计：回顾性数据分析：我们对纽约一家大型 HHC 机构在 2015 年 1 月 1 日至 2017 年 12 月 31 日期间收集的 86 866 个 HHC 病历（代表 65 693 名患者）进行了横断面二次数据分析。我们报告了临床记录中记录的六种 SDOH（物理环境、社会环境、住房和经济状况、食品不安全、获得护理的机会以及教育和识字率）的频率，这些记录涉及报告为亚洲/太平洋岛民、黑人、西班牙裔、多种族、美国原住民或白人的个人。我们使用逻辑回归模型分析了不同种族或族裔在 SDOH 记录方面的差异：结果：与报告为白人的患者相比，其他种族或民族的患者在临床笔记中记录 SDOH 的频率更高。我们的结果表明，种族或民族与 HHC 中的 SDOH 记录有关：随着对高危健康护理中 SDOH 研究的不断发展，我们的研究结果为评估高危健康护理环境中的社会信息以及了解其如何影响护理质量奠定了基础：这项探索性研究的结果可以帮助临床医生了解不同种族和民族群体的个体在 SDOH 方面的差异，并为今后旨在促进更具包容性的 HHC 文件记录实践的研究奠定基础。

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引用次数: 0

Investigation of core symptoms and symptom clusters in maintenance hemodialysis patients: A network analysis 对维持性血液透析患者核心症状和症状群的调查：网络分析

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-13 DOI: 10.1111/jnu.12982

Yingjun Zhang MM, Li Liu BNS, Lin Chen BNS, Li He MM, Mei Shi BNS, Hui Chen MM

Purpose

To construct a symptom network of maintenance hemodialysis patients and identify the core symptoms and core symptom clusters. Finally, this study provides a reference for accurate symptom management.

Design and Method

A correlational cross-sectional design. A total of 368 patients who underwent maintenance hemodialysis were enrolled from two hemodialysis centers in Chengdu, Sichuan Province, China. A symptom network was constructed with the R coding language to analyze the centrality index. Symptom clusters were extracted by exploratory factor analysis, and core symptom clusters were preliminarily determined according to the centrality index of the symptom network.

Findings

The most common symptoms in maintenance hemodialysis patients were fatigue, dry skin, and pruritus. In the symptom network, headache had the highest mediation centrality (rB = 2.789) and closeness centrality (rC = 2.218) and the greatest intensity of numbness or tingling in the feet (rS = 1.952). A total of six symptom clusters were extracted, including pain and discomfort symptom clusters, emotional symptom clusters, gastrointestinal symptom clusters, sleep disorder symptom clusters, dry symptom clusters, and sexual dysfunction symptom clusters. The cumulative variance contribution rate was 69.269%.

Conclusions

Fatigue, dry skin, and pruritus are the sentinel symptoms of maintenance hemodialysis patients, headache is the core symptom and bridge symptom, and pain symptom clusters are the core symptom clusters of MHD patients. Nurses can develop interventions based on core symptoms and symptom clusters to improve the effectiveness of symptom management in maintenance hemodialysis patients.

Clinical Relevance

Understanding the core symptoms and symptom groups that plague maintenance hemodialysis patients is critical to providing accurate symptom management. To ensure that maintenance hemodialysis patients receive effective support during treatment, reduce the adverse effects of symptoms, and improve the quality of life of patients.

目的：构建维持性血液透析患者的症状网络，识别核心症状和核心症状群。最后，本研究为准确的症状管理提供参考：相关横断面设计。在中国四川省成都市的两家血液透析中心共招募了 368 名接受维持性血液透析的患者。使用 R 编码语言构建了症状网络，以分析中心性指数。通过探索性因子分析提取症状群，并根据症状网络的中心性指数初步确定核心症状群：维持性血液透析患者最常见的症状是疲劳、皮肤干燥和瘙痒。在症状网络中，头痛的中介中心度（rB = 2.789）和亲近中心度（rC = 2.218）最高，脚麻或刺痛的强度最大（rS = 1.952）。共提取了六个症状群，包括疼痛和不适症状群、情绪症状群、胃肠道症状群、睡眠障碍症状群、干燥症状群和性功能障碍症状群。累计方差贡献率为 69.269%：疲劳、皮肤干燥和瘙痒是维持性血液透析患者的前哨症状，头痛是核心症状和桥梁症状，疼痛症状群是MHD患者的核心症状群。护士可根据核心症状和症状群制定干预措施，以提高维持性血液透析患者症状管理的有效性：了解困扰维持性血液透析患者的核心症状和症状群对于提供准确的症状管理至关重要。为了确保维持性血液透析患者在治疗期间得到有效的支持，减少症状的不良影响，提高患者的生活质量。

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引用次数: 0

Beyond order-based nursing workload: A retrospective cohort study in intensive care units 超越基于医嘱的护理工作量：重症监护病房的回顾性队列研究。

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-12 DOI: 10.1111/jnu.12979

Yi Chen PhD, Carri W. Chan PhD, Jing Dong PhD, Emily M. Jackson BSN, MBOE, RN, NEA-BC, Natalie H. Yip MD, Sarah C. Rossetti RN, PhD

Introduction

In order to be positioned to address the increasing strain of burnout and worsening nurse shortage, a better understanding of factors that contribute to nursing workload is required. This study aims to examine the difference between order-based and clinically perceived nursing workloads and to quantify factors that contribute to a higher clinically perceived workload.

Design

A retrospective cohort study was used on an observational dataset.

Methods

We combined patient flow, nurse staffing and assignment, and workload intensity data and used multivariate linear regression to analyze how various shift, patient, and nurse-level factors, beyond order-based workload, affect nurses' clinically perceived workload.

Results

Among 53% of our samples, the clinically perceived workload is higher than the order-based workload. Factors associated with a higher clinically perceived workload include weekend or night shifts, shifts with a higher census, patients within the first 24 h of admission, and male patients.

Conclusions

The order-based workload measures tended to underestimate nurses' clinically perceived workload. We identified and quantified factors that contribute to a higher clinically perceived workload, discussed the potential mechanisms as to how these factors affect the clinically perceived workload, and proposed targeted interventions to better manage nursing workload.

Clinical Relevance

By identifying factors associated with a high clinically perceived workload, the nurse manager can provide appropriate interventions to lighten nursing workload, which may further reduce the risk of nurse burnout and shortage.

导言：为了应对日益严重的职业倦怠和护士短缺问题，需要更好地了解造成护理工作量的因素。本研究旨在探讨基于医嘱的护理工作量与临床感知的护理工作量之间的差异，并量化导致临床感知工作量增加的因素：方法：我们结合了患者流量、护士人员配备和临床感知工作量：我们结合了患者流量、护士人员配备和分配以及工作量强度数据，并使用多元线性回归分析了除医嘱工作量以外的各种轮班、患者和护士层面的因素如何影响护士的临床感知工作量：结果：在 53% 的样本中，临床感知工作量高于医嘱工作量。与临床感知工作量较高相关的因素包括周末或夜班、病人较多的班次、入院后 24 小时内的病人以及男性病人：结论：基于医嘱的工作量测量往往低估了护士的临床感知工作量。我们确定并量化了导致临床感知工作量增加的因素，讨论了这些因素影响临床感知工作量的潜在机制，并提出了有针对性的干预措施，以更好地管理护理工作量：临床相关性：通过识别与临床认知工作量高相关的因素，护士长可提供适当的干预措施以减轻护理工作量，从而进一步降低护士倦怠和短缺的风险。

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引用次数: 0

Personal and work-related factors associated with post-traumatic growth in nurses: A mixed studies systematic review 与护士创伤后成长相关的个人和工作因素：混合研究系统综述

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-04 DOI: 10.1111/jnu.12973

Lian Kwang Tang BSc (Nursing) (Honours), RN, Piyanee Yobas PhD, RN, Dionne Ning Xuan Wong EdD, RN, Minna Pikkarainen PhD, Renwen Zhang PhD, Dean Ho PhD, Hong-Gu He PhD, MD, RN

Introduction

Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses.

Design

Mixed studies systematic review.

Methods

Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design.

Results

A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation.

Conclusion

The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors.

Clinical Relevance

Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.

导言：护士在医疗团队中承担着广泛的临床和患者护理职责，极易直接或间接地受到创伤经历的影响。然而，有文献表明，具有某些特质的护士在面对逆境时会产生一种新的个人力量感，即所谓的创伤后成长（PTG）。本综述旨在综合现有的最佳证据，评估与护士创伤后成长相关的个人因素和工作相关因素。设计混合研究系统性综述。方法纳入研究影响所有医疗机构认证护士创伤后成长的因素的研究。通过检索 12 个数据库中从开始到 2023 年 2 月 4 日已发表和未发表的研究。两名审稿人独立筛选、评估、试用数据收集表并提取相关数据。进行了元总结、元综合、元分析以及亚组和敏感性分析。结果共纳入了来自 18 个国家的 98 项研究，涉及 29 706 名护士。其中包括 49 项定量研究、42 项定性研究和 7 项混合方法研究。对 46 个影响因素进行了元分析，对 9 个促进因素进行了元总结。绘制了 PTG 概念图。整合归纳出四个概念：（a）个人系统；（b）与工作相关的系统；（c）与事件相关的因素；以及（d）认知转变。实际意义包括根据 PTG 促进因素制定干预计划。进一步的研究应探讨 PTG 的发展趋势及其对不同护理因素的动态响应。临床相关性目前还缺乏针对护士心理健康的创伤焦点疗法的研究。因此，本综述的研究结果可为医疗机构提供有关 PTG 现象的信息，并通过医疗政策和临床实践为护士制定支持措施。

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引用次数: 0

Impact of authentic leadership on nurses' well-being and quality of care in the acute care settings 真实领导力对急症护理环境中护士福祉和护理质量的影响

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-01 DOI: 10.1111/jnu.12978

Eman Alhalal, Johara Fahad Alharbi, Sabah Turyhib Alharbi, Sarah Saad Alotaibi, Norah Saleh Albagami, Salman Mutarid Alruwaili, Saad Aqeel Alshammari

Introduction

Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital.

Design

A cross-sectional design was used.

Methods

This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model.

Results

The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care.

Conclusion

The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital.

Clinical Relevance

Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.

导言：护士的福祉和护理质量都是医疗保健系统的重中之重。然而，人们对真正的领导力在多大程度上以及如何对其产生影响的认识仍然存在差距。我们需要这些信息来为制定有效的干预措施、组织实践和政策提供依据。因此，本研究旨在测试在护理实践环境和护士心理资本的作用下，护士对其管理者真实领导力的感知如何影响护士的幸福感和对护理质量的感知。最终有 415 个样本完成了调查，回复率为 61%。研究结果表明，护士对管理者真实领导力的感知会直接对其护理质量感知产生积极影响，但不会直接影响护士的幸福感。护理实践环境和心理资本完全调节了真实领导力与护士幸福感之间的关系。临床相关性设计专门针对护理管理者真实领导风格的干预措施和政策对于提高护士的幸福感和患者护理质量具有重要意义。需要采取制度措施，帮助领导者实践真实的领导风格，以创造积极的护理实践环境和培养护士的心理资本，这两者都有助于护士的幸福感和获得更好的护理质量。还需要进一步开展工作，强调实施真实领导风格的结果与其他领导风格的相关性。

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引用次数: 0

Comparative efficacy of telehealth interventions on promoting cancer screening: A network meta-analysis of randomized controlled trials 远程保健干预对促进癌症筛查的比较效果：随机对照试验网络荟萃分析

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-01 DOI: 10.1111/jnu.12974

Shu Zhang MSN, Lin Zhou MSN, Li Yi MSc, Xiaoli Chen MSN, Yun Zhang MSN, Juejin Li PhD, Yalin Zhang MSN, Xiaolin Hu RN, PhD

Background

Cancer screening is a pivotal method for reducing mortality from disease, but the screening coverage is still lower than expected. Telehealth interventions demonstrated significant benefits in cancer care, yet there is currently no consensus on their impact on facilitating cancer screening or on the most effective remote technology.

Design

A network meta-analysis was conducted to detect the impact of telehealth interventions on cancer screening and to identify the most effective teletechnologies.

Methods

Six English databases were searched from inception until July 2023 to yield relevant randomized controlled trials (RCTs). Two individual authors completed the literature selection, data extraction, and methodological evaluations using the Cochrane Risk of Bias tool. Traditional pairwise analysis and network meta-analysis were performed to identify the overall effects and compare different teletechnologies.

Results

Thirty-four eligible RCTs involving 131,644 participants were enrolled. Overall, telehealth interventions showed statistically significant effects on the improvement of cancer screening. Subgroup analyses revealed that telehealth interventions were most effective for breast and cervical cancer screening, and rural populations also experienced benefits, but there was no improvement in screening for older adults. The network meta-analysis indicated that mobile applications, video plus telephone, and text message plus telephone were associated with more obvious improvements in screening than other teletechnologies.

Conclusion

Our study identified that telehealth interventions were effective for the completion of cancer screening and clarified the exact impact of telehealth on different cancer types, ages, and rural populations. Mobile applications, video plus telephone, and text message plus telephone are the three forms of teletechnologies most likely to improve cancer screening. More well-designed RCTs involving direct comparisons of different teletechnologies are needed in the future.

Clinical Relevance

Telehealth interventions should be encouraged to facilitate cancer screening, and the selection of the optimal teletechnology based on the characteristics of the population is also necessary.

背景癌症筛查是降低疾病死亡率的关键方法，但筛查覆盖率仍低于预期。方法检索了六个英文数据库，以获得相关的随机对照试验 (RCT)，检索时间从开始到 2023 年 7 月。两位作者使用 Cochrane 偏倚风险工具完成了文献筛选、数据提取和方法学评估。为确定总体效果并比较不同的远程技术，进行了传统的配对分析和网络荟萃分析。总体而言，远程医疗干预对癌症筛查的改善有显著的统计学效果。分组分析表明，远程医疗干预对乳腺癌和宫颈癌筛查最有效，农村人口也能从中受益，但老年人的筛查没有改善。网络荟萃分析表明，与其他电信技术相比，移动应用程序、视频加电话和短信加电话与筛查的明显改善相关。移动应用、视频加电话和短信加电话是最有可能改善癌症筛查的三种形式的远程技术。临床相关性应鼓励采取远程医疗干预措施来促进癌症筛查，同时有必要根据人群的特点选择最佳的远程医疗技术。

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引用次数: 0

Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation tool for rigor in mixed methods implementation research 特殊性、参与性、可操作的推论、反身性和合法性工具，确保混合方法实施研究的严谨性

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-05-01 DOI: 10.1111/jnu.12977

Ahtisham Younas PhD, Sergi Fàbregues PhD

Background

Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct qualitative and quantitative methods and data sets to unravel the implementation process and context and design contextual tools for optimizing the implementation. To date, there has been limited discussion on how to ensure rigor in mixed methods implementation research.

Purpose

To present Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation (PEARL) as a practical tool for understanding various components of rigor in mixed methods implementation research.

Data Sources

This methodological discussion is based on a nurse-led mixed methods implementation study. The PEARL tool was developed based on an interpretive, critical reflection, and purposive reading of selected literature sources drawn from the researchers' knowledge, experiences of designing and conducting mixed methods implementation research, and published methodological papers about mixed methods, implementation science, and research rigor.

Conclusion

An exemplar exploratory sequential mixed methods study in nursing is provided to illustrate the application of the PEARL tool. The proposed tool can be a useful and innovative tool for researchers and students intending to use mixed methods in implementation research. The tool offers a straightforward approach to learning the key rigor components of mixed methods implementation research for application in designing and conducting implementation research using mixed methods.

Clinical Relevance

Rigorous implementation research is critical for effective uptake of innovations and evidence-based knowledge into practice and policymaking. The proposed tool can be used as the means to establish rigor in mixed methods implementation research in nursing and health sciences.

背景实施科学有助于产生加快在实践中采纳证据的方法。混合方法常用于实施研究，因为它们允许研究人员整合不同的定性和定量方法及数据集，以揭示实施过程和背景，并设计优化实施的背景工具。迄今为止，关于如何确保混合方法实施研究的严谨性的讨论还很有限。目的介绍特殊性、参与、可操作的推论、反身性和合法性（PEARL），作为了解混合方法实施研究严谨性各组成部分的实用工具。PEARL 工具是在解释性、批判性反思和有目的性阅读所选文献资料的基础上开发的，这些文献资料来自研究人员的知识、设计和开展混合方法实施研究的经验，以及已发表的有关混合方法、实施科学和研究严谨性的方法学论文。对于打算在实施研究中使用混合方法的研究人员和学生来说，所建议的工具是一个有用的创新工具。临床相关性严格的实施研究对于将创新和循证知识有效纳入实践和决策至关重要。建议的工具可作为在护理和健康科学领域的混合方法实施研究中建立严谨性的手段。

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引用次数: 0

The effect of work readiness on work well-being for newly graduated nurses: The mediating role of emotional labor and psychological capital 工作准备对新毕业护士工作幸福感的影响：情感劳动和心理资本的中介作用

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-04-23 DOI: 10.1111/jnu.12976

Yueming Ding PhD student, Haishan Tang MD, Yiming Zhang MD, Qianwen Peng MD, Wanglin Dong MD, Guangli Lu PhD, Chaoran Chen PhD

Objective

To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship.

Methods

A cross-sectional survey was conducted in mainland China. A total of 478 newly graduated nurses completed the Work Readiness Scale, Emotional Labour Scale, Psychological Capital Questionnaire, and Work Well-being Scale. Descriptive statistical methods, Pearson correlation analysis, and a structural equation model were used to analyze the available data.

Results

Newly graduated nurses' work readiness was significantly positively correlated with work well-being (r = 0.21, p < 0.01), deep acting (r = 0.11, p < 0.05), and psychological capital (r = 0.18, p < 0.01). Emotional labor and psychological capital partially mediated the relationship between work readiness and work well-being. Additionally, emotional labor and psychological capital had a chain-mediating effect on the association.

Conclusions and Clinical Relevance

Work readiness not only affects newly graduated nurses' work well-being directly but also indirectly through emotional labor and psychological capital. These results provide theoretical support and guidance for the study and improvement of newly graduated nurses' work well-being and emphasize the importance of intervention measures to improve work readiness and psychological capital and the adoption of deep-acting emotional-labor strategies.

方法在中国大陆进行了一项横断面调查。共有 478 名新毕业护士填写了工作准备量表、情绪劳动量表、心理资本问卷和工作幸福感量表。结果新毕业护士的工作准备度与工作幸福感（r = 0.21，p < 0.01）、深度行为（r = 0.11，p < 0.05）和心理资本（r = 0.18，p < 0.01）显著正相关。情感劳动和心理资本在一定程度上调节了工作准备度与工作幸福感之间的关系。结论与临床意义工作准备不仅直接影响新毕业护士的工作幸福感，还通过情感劳动和心理资本间接影响新毕业护士的工作幸福感。这些结果为研究和改善新毕业护士的工作幸福感提供了理论支持和指导，并强调了采取干预措施改善工作准备和心理资本以及采取深层情感劳动策略的重要性。

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引用次数: 0

Ethical, innovative, and globally significant 道德、创新和全球意义

IF 3.4 3区医学 Q1 Nursing

Journal of Nursing Scholarship

Pub Date : 2024-04-21 DOI: 10.1111/jnu.12972

Susan Gennaro PhD, RN, FAAN

引用次数: 0

Evaluation of nurse-reported missed care in a post-anesthesia care unit: A mixed-methods study 对麻醉后护理病房护士报告的遗漏护理进行评估：混合方法研究

IF 2.4 3区医学 Q1 NURSING

Journal of Nursing Scholarship

Pub Date : 2024-04-16 DOI: 10.1111/jnu.12975

Laura Mun Tze Heng BSc, RN, Darshini Devi Rajasegeran BSc, RN, Siew Hoon Lim PhD, RN

Background

Nurse-reported missed care (NRMC) is considered as any significant delay or omission in provision of nursing care.

Aim

(i) Evaluate the frequency, types, and reasons for NRMC in the Post-anesthesia Care Unit (PACU). (ii) Evaluate associations between nurse demographic and workload factors with NRMC. (iii) Explore nurses' perception of NRMC in the PACU.

Methods

A cross-sectional study was conducted in the PACU in a tertiary acute care hospital over 3 months. Full-time PACU nurses were conveniently sampled to complete an anonymous survey after their daily shift over different shifts. It contained three sections: (i) nurse demographics; (ii) elements of NRMC; and (iii) reasons for NRMC. Qualitative interviews employed a semi-structured guide to explore perceptions and experiences of NRMC. Descriptive, inferential statistics, and thematic analyses were applied.

Results

Sixty-six survey responses were collected. 48.5% of respondents indicated at least one NRMC activity. Activities more clinically sensitive were less missed. Eight nurses were interviewed. Four main themes were identified: (i) communication with patients; (ii) communication and teamwork with colleagues; (iii) dual role of documentation; and (iv) staffing inadequacy. Language barriers made communication challenging. Staff shortage exacerbates workload but effective teamwork and documentation facilitates nursing care.

Conclusion

Communication and staffing concerns aggravate NRMC. Teamwork and personal contentment were satisfactory. Nurses' turnover intention may worsen staffing.

Clinical Relevance

Timeliness and quality of nursing care is impacted by elements such as manpower, allocation of resources, work processes, and workplace environmental or interpersonal factors such as culture and language fit. Re-evaluation of nursing resources and work processes may assist post-anesthesia care unit nurses in fulfilling their role, decreasing the prevalence of nurse-reported missed care.

背景护士报告的护理遗漏（NRMC）是指在提供护理服务时出现的任何重大延误或遗漏。目的(i) 评估麻醉后护理病房（PACU）中出现 NRMC 的频率、类型和原因。(ii) 评估护士人口统计和工作量因素与 NRMC 之间的关联。(iii) 探讨护士对 PACU 中 NRMC 的看法。方法：在一家三级急症护理医院的 PACU 中进行了为期 3 个月的横断面研究。研究人员方便地抽取了 PACU 的全职护士，让她们在每天轮班后填写一份匿名调查问卷。调查包括三个部分：(i) 护士人口统计；(ii) NRMC 要素；(iii) NRMC 原因。定性访谈采用了半结构化指南，以探讨对 NRMC 的看法和体验。结果共收集到 66 份调查回复。48.5% 的受访者表示至少参加过一次 NRMC 活动。临床敏感性较高的活动较少被错过。八名护士接受了访谈。确定了四大主题：(i) 与病人的沟通；(ii) 与同事的沟通和团队合作；(iii) 文件记录的双重作用；以及 (iv) 人手不足。语言障碍使沟通具有挑战性。人员短缺加剧了工作量，但有效的团队合作和文件记录有利于护理工作。团队合作和个人满意度令人满意。临床相关性护理服务的及时性和质量受到人力、资源分配、工作流程、工作环境或人际因素（如文化和语言适应性）等因素的影响。重新评估护理资源和工作流程可帮助麻醉后护理病房的护士履行其职责，减少护士报告的护理遗漏率。

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引用次数: 0