British journal of nursing (Mark Allen Publishing)最新文献

Nurses often experience high-stress situations, dealing with long hours and emotionally challenging situations. These pressures can lead to a decrease in team morale and a decline in performance. This article discusses how socialising outside work can significantly enhance the morale and cohesion of nursing teams. By examining recent studies and theoretical frameworks, the author explores the potential of social interactions outside the workplace to improve communication, reduce stress, foster a sense of community and ultimately enhance patient care. Furthermore, it will provide practical recommendations for integrating social activities within nursing teams.

Background: Prompt diagnosis of aerodigestive cancers and other time-sensitive conditions improves survival and reduces morbidity and anxiety. However, early symptoms do not reliably differentiate between different pathologies and, in isolation, seldom localise the disease anatomically.

Objectives: To disseminate a multidisciplinary foregut (head and neck, oesophagogastric, and respiratory) diagnostic dataset, using patients' integrated clinical histories to initiate diagnostic pathways, reassure patients, and communicate information between stakeholders.

Methods: 260 patients had their clinical histories taken either by two nurse specialists following training and then supported by a digital proforma (n=81), or by one laryngologist (n=179). The discriminative performance of the clinical history to ascertain specific symptoms was tested against validated Patient-Reported Outcome Measures (PROMs) using Receiver Operating Characteristic Area Under the Curve (ROC AUC) statistics.

Results: There were 103 men and 157 women. Mean age was 58±16 years. All ROC AUCs were significantly greater than 0.5. For dysphagia, against the Eating Assessment Tool, AUC was 0.86±0.02 [0.81-0.90]. For hoarseness, against the 10-item Voice Handicap Index, AUC was 0.82±0.03 [0.77-0.0.86]. There were no significant differences in symptom ROCs between the laryngologist and trained nurse specialists using a digital proforma.

Conclusions: The Integrated Foregut Clinical History implements the clinical history as diagnostic technology to guide clinical pathways. It performs well against validated PROMs and can form the basis of nurse-led pre-visit planning to support head and neck and upper gastrointestinal timed diagnostic pathways.

Neuroaesthetics is the interdisciplinary study of how the brain processes aesthetic experiences including beauty, art and design, and how these perceptions influence emotions, cognition, and physiology. It integrates principles from neuroscience, psychology and design theory to inform evidence based product and environment development. In different settings it is evident how our senses - sight, sound, hearing, smell and touch - can be stimulated by various forms of art to positively impact both physical and mental wellbeing. Neuroaesthetics therefore can reduce stress and anxiety, enhance wellbeing and improve patient outcomes, including in stoma care. Adopting aesthetic design in stoma devices may help reduce stigma, foster emotional acceptance and improve patients' quality of life.

Sam Foster reflects on why organisations should embrace neurodiversity and considers ways to create healthcare environments that are more supportive for neurodivergent patients and colleagues.

Background: Older cancer survivors with a stoma often experience a decline in quality of life (QoL) due to multiple factors.

Aims: This scoping review aimed to identify factors affecting QoL among older people with a cancer-related stoma.

Methods: After conducting a systematic search, nine studies were included. Data were analysed and classified into four domains: physical, psychological, social and spiritual.

Findings: Physical factors included difficulties in stoma management, bowel irregularities (diarrhoea and constipation), fatigue, and peristomal skin complications. Psychological factors, such as depression, anxiety, and altered self-concept were prominent, especially in women. Social isolation, reduced support, and loss of spirituality were also significant. Gender and regional disparities influenced QoL outcomes.

Conclusion: Complex and interrelated factors influence QoL among older people with a cancer-related stoma. Hence, comprehensive support strategies that simultaneously addresses physical, psychological, social and spiritual needs are essential for improving QoL.

Post-intensive care syndrome (PICS) refers to physical, cognitive and psychological problems that can develop after treatment in an intensive care unit. As survival after critical illness increases, more patients and families experience longer term impairments that affect recovery, quality of life and return to usual functioning. Nurses have a key role in recognising risk factors and early features of PICS, reducing avoidable harms during admission, and supporting recovery after discharge. Evidence-informed approaches include early mobilisation, minimising deep sedation where clinically appropriate, delirium prevention, family involvement and structured follow-up. Improving outcomes also depends on better awareness across ward and community teams, clear patient and family education, and co-ordinated pathways that link intensive care, wards and community services.

Sam Foster reflects on the reasons why nurses choose to stay in the profession - the other side of the coin to the ongoing discussions around why nurses are leaving.

This article explores the perceived challenges experienced by first-year adult nursing students with no prior clinical exposure during their initial placements in UK healthcare settings. Drawing on current literature and educational policy, three core themes are examined: the persistent theory-practice gap, the emotional preparedness and resilience required for effective transition, and the value of peer learning in enhancing support and confidence. Students new to clinical practice frequently report feeling unprepared, anxious, and overwhelmed. Contributing factors include limited supervision, emotionally demanding environments, and a lack of belonging. The findings highlight the importance of emotionally safe placements, effective preceptorship, and structured opportunities for reflection and peer support. Peer learning has emerged as a powerful strategy for enhancing engagement, reducing stress, and fostering a professional identity. These insights are vital for nurse educators and practice partners to improve support mechanisms, reduce attrition, and prepare students for compassionate, competent practice.