Research and Theory for Nursing Practice最新文献

Background and Purpose: Debriefing is a strategy that can help improve communication and teamwork. This study explored obstetrical (OB) nurses' perceptions and practices of real-time (clinical) debriefing following OB emergencies and how debriefing impacts their practices and unit policies. Methods: A cross-sectional quantitative study was based on a descriptive nonexperimental design with qualitative components about the debriefing practices in the OB units. A convenience sample of OB nurses participated in this study. Among the 150 nurses who received the survey, 69 completed the questionnaire (response rate = 46). The OB-Registered Nurse Debriefing Survey was developed to gather data from OB nurses about debriefing following OB emergencies. Donabedian's model "structure, process, and outcome" was used to guide data collection and analysis. Results: OB nurses defined debriefing as a formal discussion of what happened, what went well, what improvement is needed, and identifying resources. Nurses reported multiple perceived benefits of debriefings, including the opportunity to learn, celebrate success and appraisal, improve teamwork, promote patient safety, and identify opportunities for improvement. Several barriers to OB debriefing were reported, including increased nursing workload, emotional distress, lack of confidence, and limited nursing staffing. Conclusions and Implications: Real-time (clinical) debriefing may improve OB outcomes, promote patient safety, and address organizational/structural failures. Despite being beneficial, implementing debriefings is challenging due to various barriers. It also addresses and resolves psychological distress resulting from clinical events. Increased nursing and provider staff engagement and ongoing training would enhance debriefing facilitation. Empowering nurses to lead clinical debriefing that promotes safety and communication and improves OB outcomes is required.

Background and Purpose: Evaluating self-efficacy for symptom management and self-care is crucial for ensuring follow-up care after cardiac surgery. As there is not yet a validated measurement tool for this evaluation, the aim of this study was to develop the Self-Efficacy Scale for Symptom Management and Self-Care (SESMSC: Cardiac Surgery) in patients with cardiac surgery and to examine its psychometric properties. Methods: The Symptom Management Theory and Bandura's Self-Efficacy Theory were used as the theoretical background for scale development. A multiphase design was utilized. The initial development phase consisted of item generation and expert panel review. The second phase comprised a three-step validation process: (a) face and content validity analysis, (b) exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) for construct validity, and (c) Cronbach's α, test-retest, and item-total correlation analysis to assess internal consistency reliability. The sample (n = 401) was randomly divided into two subsamples for EFA and CFA (EFA group: n = 201; CFA group: n = 200). Results: EFA suggested a 20-item, two-factor structure with factor loadings of .342-0.782. The two subscales of the scale were labeled symptom management self-efficacy and self-efficacy for self-care activities. Goodness-of-fit indices indicated a good model fit. Cronbach's α, test-retest, and item-total correlation results demonstrated acceptable internal consistency reliability. Implications for Practice: The SESMSC: Cardiac Surgery may be a useful tool to evaluate self-efficacy for symptom management and self-care after cardiac surgery. Further evaluation in independent samples is needed to investigate its psychometric properties and usefulness in clinical practice.

Background and Purpose: The study aimed to examine key features of publications on hope in nursing. Method: A bibliometric analysis of 3,814 nursing-related publications from Web of Science (August 2023) was conducted using the R Bibliometrix Package. Including numerical data, word clouds, trend topics, and thematic maps was applied for the analysis. Results: The average age of articles published in 1980-2023 was 9.71 years, with an annual increase of 10.82%. Hope in nursing was primarily explored in oncology, focusing on the quality of life and palliative care through qualitative studies. The longest-studied topic was "stress." "Quality of life" is the motor theme in the field, while "palliative care" and "spirituality" are the themes that continue to evolve in this field. On the centrality line, a significant part of the "recovery" theme was niche, and a significant part of the "COVID-19" theme was emerging or declining. Implications for Practice: This bibliometric analysis reviews 43 years of research on hope in nursing. It has been observed that hope is examined in the context of illness, particularly in populations with a high risk of mortality. Investigating hope from the perspective of positive psychology in terms of protecting health and enhancing well-being would offer contributions. It has been understood that specific assessment tools are needed. Nurses must be prepared to maintain hope and work with patients who feel hopeless. As this bibliometric analysis highlights gaps in research, practice, and education, it can serve as a guide for future strategies.

Background: Nursing theory plays an integral part of the nursing discipline. The use of nursing theory provides value and confidence to nurses in practice within the discipline. The American Association of Colleges of Nursing recognizes the importance of nursing theory by noting in their new Essentials that theory must be integrated into curricula at entry and advanced levels in nursing education. However, the use and value of nursing theory in nursing administration practice are unclear. The American Organization of Nursing Leadership Core Competencies do not explicitly mention nursing theory use in nursing administration practice. Therefore, this discussion article seeks to identify the status of nursing theory use in nursing administration practice. Design: A discussion paper format is used. Literature Review: Sixteen articles published from 1986 to 2025 were retrieved from searches using CINAHL, Embase, PubMed, Scopus, and ScienceDirect and were sorted and analyzed using thematic networks to identify global themes reflecting the use of nursing theory in nursing administration practice. Implications for Nursing: There is a weak history of nursing theory use in nursing administration practice. Nursing administrators must develop business acumen and leadership skills to help guide their decision-making in health care while also incorporating theory use and development, including economic and leadership theories outside of nursing, anchored by nursing theory. Conclusion: Six global themes reflecting the use of nursing theory in nursing administration practice emerged: (a) undervaluing of nursing theory, (b) the case of borrowed theory, (c) theory imbalances of business acumen and nursing leadership, (d) importance of the practice environment, (e) intentionality of theory-integrated practice, and (f) underdevelopment of nursing theory-guided practice.

Background: Cardioprotective medications have been shown to be effective in reducing morbidity and mortality in patients with a history of myocardial infarction; however, the adherence rate is lower than expected. An adherence-based intervention was designed. Purpose: The purpose of the study is to describe the theory of "Action and Coping Plans for Medication Adherence Intervention (ADHERE)," a nursing intervention to promote adherence to cardioprotective medications. Methods: Theoretical and empirical approaches were combined with the clinical and research experience of a committee of experts to carry out the following stages: (a) in-depth understanding of the problem under study, (b) defining the objectives and identifying the theoretical framework of the intervention, and (c) operationalization of the intervention and identification of immediate, intermediate, and final outcomes. Results: The application of the stages resulted in the generation of the theory underpinning the ADHERE nursing intervention, which aims to promote adherence to cardioprotective medications in patients with a history of myocardial infarction and should be implemented by a nurse in a primary health care unit. The content of ADHERE is delivered through action and coping plans, developed by patients with the support of the nurse, verbally and in writing, in a meeting lasting 30 minutes and a reinforcement at a 30-day interval. Implications for Practice: The description of the theory of this intervention provides detailed information to researchers and health professionals about how the intervention contributes to changing behavior related to medication adherence and in what context; the theory can enhance the fidelity of its implementation in clinical practice.

Background and Purpose: Supported Conversation for Adults with Aphasia (SCA^™ ), an evidence-based framework to improve communicative access, is a unique concept to nursing with theoretical and technical components. Effective communication is essential in all patient interactions, and SCA™ could aid health care professionals in meeting the needs of people with aphasia. Methods: A principle-based concept analysis was conducted using a systematic and conceptually driven literature search. A review of literature from 1998 to 2024 contained in CINAHL, PubMed, and PsycINFO databases was performed on the concept of SCA^™ The concept was explored for (a) definitional clarity (epistemological principle), (b) relevance to nursing (pragmatic principle), (c) consistency in meaning (linguistic principle), and (d) differentiation from related concepts (logical principle). Results: The final dataset consisted of 49 articles. Findings revealed that (a) SCA^™ is composed of theoretical and technical components used to acknowledge and reveal the competence of a person with aphasia, but there is a vague use and a lack of definitional clarity; (b) the philosophical framework and techniques outlined by the concept are relevant and useful for nursing; (c) there is variability in the use, nomenclature, and conceptualization of SCA^™; and (d) the concept is poorly differentiated from other similar concepts. Implications for Practice: Nurses working with people diagnosed with aphasia and other communication disorders should consider SCA^™ and its application in nursing practice. Findings from this concept analysis stress the importance of an interdisciplinary approach to future SCA^™ studies, as nursing can lend its distinct viewpoint to integrate SCA^™ techniques into practice.

Background and Purpose: Compassion is a well-known nursing principle with a rich literature on concept development and clarification. Despite being central to care and at risk of being compromised due to increasingly challenging working conditions, compassion continues to be described as a predominantly individual attribute, with the responsibility to demonstrate compassion (and address lack of compassion) placed squarely on the shoulders of individual nurses. There is scant literature holding health care institutions accountable for implementing policies and practices that demonstrate, support, and sustain compassion. Acknowledging the encouraging recent literature on the potential for compassionate leadership, we look to other models based on compassion as embedded in practices and communities to better examine how it can shape nursing work environments. Methods: This paper examines the Compassionate Communities movement, first developed at the intersection of public health and palliative care. We trace its development, highlight ongoing methodological and conceptual tensions, and showcase its applicability as a conceptual framework for research and policy in health care beyond the palliative care context, specifically in nursing. Results: Literature on Compassionate Communities aligns with the priorities and concerns of nursing care, policy, and research. It also has the potential to transform health care institutions, creating compassionate spaces for patients, families, and nurses themselves. Implications for Practice: Proposed definitions and principles for using Compassionate Communities as a conceptual framework are offered; considerations on how health care organizations can become more compassionate, using reflections from our program of research examining nurses' psychological safety.

Background and Purpose: The body has undergone significant aesthetic transformations throughout the centuries. A normalization has gradually taken place in contemporary Western society regarding the criteria attributed to a healthy and attractive body. The image of a thin body is omnipresent in how we conceptualize aesthetic norms in Western societies. This dominance of bodily beauty, this idealization of thinness, generates and reinforces a "cult of the body" that is already prevalent in our current societies. Methods: We believe our understanding of the "cult of the body" could be enlightened by the writings of Michel Foucault and Nikolas Rose. Results: The forthcoming article will initially delve into how immanent power operates within normative disciplinary practices, technologies of the self, and neoliberal practices. It will then seek to comprehend the extent and influence of the normative regime on the social construction of societal ideals of beauty and thinness to which adolescents in contemporary societies may be exposed. Implications for Practice: Foucault's and Rose's works allow us to expose power relations and interrogate the patient's body as constructed through technical and medical discourse. Their work allows for questioning, reevaluation, and deconstruction of certain paradigms in mental health nursing and raises awareness of not unquestionably accepting a single psychiatric and mental health nursing epistemology. Finally, they provide important insights for nursing practice, especially when it comes to comprehending how societal standards around beauty and health influence the behaviors and body image of adolescents.

Background: Family members provide emotional and psychosocial support and are an integral component of patient care for older patients with chronic critical illness (CCI). Purpose: This study aimed to describe how family members work with health care providers (HCPs) to support their loved ones by identifying their adaptive challenges, adaptive work, and technical work. Methods: This was an exploratory mixed-method study. Study participants were family members and HCPs of patients admitted to a long-term acute care hospital (LTACH). Surveys and semistructured interviews were completed between February and March 2023. Interviews were coded using a priori codes developed from the Adaptive Leadership Framework for Chronic Illness (ALFCI). Results: Nine participants (five family members and four with HCPs) were enrolled. Family members rated their HCPs' communication skills as very good. Similarly, HCPs' assessment of their communication skills was very good. Four themes were identified: family members' adaptive challenges, adaptive work, HCP-described family adaptive challenges, and HCPs' technical work. Family members' adaptive challenges included communication, care expectations, and individual challenges. Adaptive work included voicing concerns, advocating for their loved one, setting expectations, and coordinating with other family members. HCPs' technical work focused on communication strategies and collaboration with family members and other team members. Implications for practice: Family members play a crucial role in patient care. They experience adaptive challenges supporting their loved ones and managing their everyday activities. Collaborative work between family and HCPs addresses these challenges.

Background and Purpose: Adolescent involvement in decision-making processes is influenced by their developmental phase in life, the type of decision, the severity of the adolescent's condition or prognosis, and vulnerability. While developmental science does not support the exclusion of adolescents from decision-making, work to promote adolescent shared decision-making has been hampered by the uncertainty of what the concept means. This paper analyzes the concept of adolescent shared decision-making and brings light to a special population within pediatrics. Methods: Rodgers's evolutionary method was used for this concept analysis. Adolescent shared decision-making was defined along with surrogate and related terms, antecedents, attributes, and consequences. An exemplar was included to further describe the application and context of adolescent shared decision-making. Results: Adolescent shared decision-making is defined as an ongoing process with active participation of multiple parties through shared decision-making to reach an agreed medical decision with a goal to optimize the adolescent's future medical wishes; it may change with time and/or growth and development of the adolescent. Implications for Practice: Adolescent shared decision-making bridges the gap in the continuum of patient-centered, medical care participation. Since nurses often have more contact with patients than providers, the integration of adolescent shared decision-making into practice may help nurses better advocate for adolescents' wishes, especially if they are not able to speak for themselves. Adolescents will feel better prepared for future decision-making in adulthood by empowering them to use their voices to become active contributors within our global society.