Research in Nursing & Health最新文献

This study aims to synthesize the perceptions and expectations of long-term caregivers regarding the use of nursing robots to inform strategies for enhancing the quality and operational efficiency of care services. Global poulation aging has exacerbated long-term caregiver burnout and critical staff shortages. Nursing robots present a potential solution to mitigate these challenges and improve care standards. We conducted a meta-synthesis of qualitative studies, searching eleven databases (PubMed, Web of Science, Embase, CINAHL, Scopus, Cochrane Library, PsycINFO, SinoMed, China National Knowledge Infrastructure, Wanfang, and Vip) from their inception through January 1, 2025, for publications in Chinese and English. The search strategy utilized a comprehensive set of terms related to four core concepts: long-term caregivers, nursing robots, long-term care settings, and perceptions/experiences. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal tools. Following a rigorous screening and data extraction process, a thematic synthesis of 26 included studies was conducted using NVivo software. The analysis yielded three analytical themes and nine sub-themes: (1) Affirmation and Acceptance, (2) Concerns and Challenges, and (3) Expectations and Requirements. Findings reveal that while most long-term caregivers are enthusiastic about nursing robots, they also express significant concerns about technical reliability, safety, and privacy. Future efforts should prioritize user-centered design, supportive policy development, and comprehensive training programs to facilitate robot adoption and enhance care quality. The protocol was registered with PROSPERO (CRD42024583919). No patient or public contribution was included in this study.

Symptoms with the highest strength centrality in mental disorders are regarded as potential intervention targets, and their suitability as intervention targets remains uncertain. This study employs the NodeIdentifyR algorithm (NIRA), a novel network intervention method, to examine how alleviating or aggravating specific symptoms affects the network's sum scores. A total of 701 pregnant women from the U.S. National Health and Nutrition Examination Survey (2003-2023) were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9, and pregnancy status was confirmed via urine tests or self-report. The Ising model was used to construct the symptom network, and NIRA was applied to simulate both alleviating and aggravating interventions. The results revealed that the centrality analysis identified "guilt or low self-worth" as the central symptom with the highest strength value. Alleviating interventions targeting "fatigue" had the greatest reduction in symptom network activation, resulting in the largest decrease in the projected symptom sum score by 52.53%, indicating it as a potential target for alleviating depressive symptoms. Aggravating interventions targeting "guilt or low self-worth" had the greatest increase in the severity of depressive symptoms, causing the largest increase in the symptom sum score by 70.97%, suggesting its potential as a prevention target. Aggravating interventions caused greater overall changes in symptom activation than alleviating interventions, with both affecting the same symptoms in different ways. Notably, "fatigue" is primarily associated with physiological and other somatic factors rather than emotional symptoms, highlighting the need for cautious interpretation of fatigue-targeted interventions.

Understanding how older adults make decisions about their self-care is essential for designing tailored interventions that promote autonomy and well-being. However, no instrument currently exists to specifically measure self-care decision-making styles in this population. The study aimed to develop and test the psychometric properties of the Self-Care Decision-Making Styles of Older Adult (DECIDE) Inventory, a new instrument designed to assess styles of self-care decision-making among older adults. A three-phase process was undertaken: (i) instrument development based on theory and previous studies; (ii) content validity evaluation with 10 experts and cognitive interviews with 10 older adults; and (iii) psychometric testing, including assessment of structural and construct validity, internal consistency, and test-retest reliability. A convenience sample of 350 older adults from various Italian regions participated in the validation phase. The study followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) reporting guidelines. Following content validation, an instrument was finalized, assessing four decision-making styles-independent, responsible, self-neglected, and guided-, with five items per scale. Confirmatory factor analyses supported the structural validity of the four-scale model. Construct validity was confirmed through hypothesis testing. Reliability indicators, including Omega coefficients, factor score determinacy, item-total correlations, and intraclass correlation coefficients, ranged from adequate to optimal across all scales. The Self-Care Decision-Making Styles of Older Adult Inventory demonstrated good validity and adequate reliability for assessing self-care decision-making styles in older adults. Further refinement and cross-cultural validation are recommended before its use in clinical practice.

This study aimed to develop and validate the Traditional Chinese version of the Interprofessional Collaborative Competency Attainment Survey (TC-ICCAS), a culturally sensitive tool for assessing interprofessional education (IPE) competencies in Taiwan's hierarchical healthcare system. Conducted from 2022 to 2023 at a tertiary medical center and guided by the COSMIN framework, this psychometric validation study involved 324 early-career healthcare professionals. A three-phase process was employed: (1) translation and cultural adaptation with expert review; (2) pilot testing with 30 professionals to ensure cultural relevance; and (3) field testing using post-IPE program surveys. Confirmatory factor analysis (CFA) of the field test data confirmed the instrument's six-domain structure (communication, collaboration, roles and responsibilities, patient-centered care, conflict management, and team functioning) and established its construct validity. All subscales demonstrated high internal consistency (Cronbach's α = 0.86-0.93). Notably, the limited discriminant validity of the "roles and responsibilities" domain was interpreted not as a flaw, but as evidence of the tool's cultural sensitivity, reflecting the authentic role overlap common in Confucian-influenced contexts. The TC-ICCAS provides a reliable and valid tool for evaluating IPE outcomes, filling a critical gap in culturally appropriate instruments for hierarchical settings. Its use can enhance interprofessional training and holds the potential to improve teamwork and patient safety in Taiwan and similar Asian healthcare contexts. No patient or public contribution was included as the study focused on professional competencies.

To estimate the pooled prevalence of feeding difficulties among persons with dementia and to explore heterogeneity, including regional differences and study characteristics. Feeding difficulties, including impaired ability to feed oneself, swallowing problems, reduced appetite, and behavioral resistance to eating, are common among individuals with dementia, leading to malnutrition, and caregiver burden. Evidence on the prevalence of feeding difficulties is fragmented, with no prior meta-analysis available. Six databases were searched until April 2025 for observational studies. This systematic review and meta-analysis followed MOOSE and PRISMA guidelines with PROSPERO registration (CRD420251024333). Studies were included if they reported feeding difficulty prevalence in dementia using validated instruments or clinical observation. Two reviewers independently screened studies, extracted data, and assessed quality using the Newcastle-Ottawa Scale. Pooled prevalence and 95% prediction intervals were calculated using a random-effects model with Freeman-Tukey double arcsine transformation. Subgroup analyses and meta-regression explored heterogeneity. Fifteen studies involving 3175 participants were included. The pooled prevalence of feeding difficulties among persons with dementia was 48% (95% PI: 38%-59%), with significant heterogeneity (I² = 97%). Prevalence was notably higher in studies conducted in Asia (59%) compared to non-Asian regions (32%). Neither publication year nor mean participant age significantly moderated prevalence estimates. Nearly half of individuals with dementia experience feeding difficulties, with particularly high prevalence in Asia. This regional disparity stresses the importance of routine assessment. High heterogeneity and inconsistent disease staging reporting call for standardized assessments and further research across dementia stages to improve care globally.

Timely and adequate prenatal care (PNC) is essential for optimizing maternal and infant health outcomes. However, persistent disparities in PNC utilization exist in the United States, particularly among ethnic/racial minority populations. While discrimination has been recognized as a barrier, its multifaceted influence across social and structural contexts remains underexplored. This systematic review, guided by the Social-Ecological Model, synthesizes evidence on how various forms of discrimination affect PNC utilization. We conducted comprehensive searches in PubMed, Web of Science, and CINAHL for peer-reviewed studies published in the United States between 2010 and 2024. After screening 342 records, 11 studies met the inclusion criteria. Five studies employed qualitative methods, five used quantitative methods, and one utilized a mixed-methods approach. Findings revealed that structural discrimination, such as language barriers and institutional policies, was associated with delayed or insufficient PNC utilization. Interpersonal dynamics, including negative patient-provider interactions and implicit bias, discouraged engagement with care. Additionally, intrapersonal factors, like internalized discrimination, shaped perceptions of care quality and trust in healthcare systems. The review highlights how discrimination operates across multiple levels to influence PNC behaviors and outcomes. Addressing discrimination requires culturally responsive care models, provider training in cultural humility, and institutional reforms aimed at equity. Future research should explore protective factors, such as social support and resilience, that may buffer the negative effects of discrimination. Understanding these dynamics is crucial for developing interventions that promote equitable and effective PNC utilization.

Increasing reliance on Internationally Educated Nurses (IENs) in the U.S. healthcare system, particularly in Long-Term Care (LTC) settings, necessitates an in-depth exploration of their transition experiences. The primary purpose of this qualitative study was to understand how IENs describe their experiences transitioning to work with older adults in LTC settings in the United States and the policies and practices that contribute to the successful integration of IENs. A qualitative descriptive design was used, including one-time individual interviews with 22 IENs working in various LTC settings across the United States via Zoom using a semi-structured interview guide. Demographic data were analyzed using descriptive statistics, while NVivo 14 software was utilized to organize the data; verified verbatim transcripts were subjected to thematic analysis. Three key themes were identified: Systemic and Practice-Based Barriers to IEN Integration, Structural and Social Enablers of IEN Integration, and Role of Structured Support Systems in the IENs' Transition. This study highlighted the critical challenges and facilitators that influence IENs during their integration into LTC settings in the United States. Participants reported concerns, specifically noting experiences of racial discrimination and xenophobia perpetrated by co-workers, patients, and patients' families. These experiences highlight the complex interpersonal dynamics faced by IENs, underscoring the need for proactive strategies to mitigate discriminatory practices and provide culturally sensitive orientation and mentorship programs to support the smooth integration of IENs into LTC settings. Addressing these challenges can have profound implications for strengthening inclusivity and enhancing the overall resilience of the U.S. nursing workforce, particularly within LTC environments.

Pain and pain-related functional limitations are common in fibromyalgia patients. In this regard, attempts to cope with pain and related symptoms are important. This study was conducted to investigate the effect of progressive muscle relaxation exercises on pain, kinesiophobia and functional status in fibromyalgia patients. This randomized controlled study has been conducted with 85 individuals diagnosed with fibromyalgia between November 2022 and June 2023. The study consisted of experimental and control groups. Progressive relaxation exercise was applied to the experimental group 2 days a week for 8 weeks. Data have been collected with Descriptive Information Form, Visual Analogue Scale, Tampa Scale of Kinesiophobia, and Revised Fibromyalgia Impact Questionnaire. In this study, it has been determined that Visual Analogue Scale, Tampa Scale of Kinesiophobia and Fibromyalgia Impact Questionnaire total mean scores of the progressive muscle relaxation exercise group have decreased significantly compared to the control group (p < 0.01). This study has shown that progressive muscle relaxation exercises improve pain, kinesiophobia and functional status in fibromyalgia patients. It is recommended to be applied by individuals with chronic pain and in clinics. Trial Registration: This study is registered in the Clinical Trial Registry (registration number NCT05695274).