Nursing Outlook最新文献_第4页

Rethinking nursing: The re-classifying of a professional lifeline 反思护理：职业生命线的重新分类。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-22 DOI: 10.1016/j.outlook.2025.102660

S. Raquel Ramos PhD, MSN, FNYAM, FAHA, FAAN, Adrienne Martinez-Hollingsworth PhD, RN, PHN, Schenita D. Randolph PhD, MPH, RN, FAAN

引用次数: 0

Nurse-endorsed strategies to repair nurse-employer relationships, alleviate burnout, boost retention, and rebuild trust in the post-pandemic era 护士认可的战略旨在修复护士与雇主的关系，缓解倦怠，提高留任率，并在大流行后时代重建信任

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-20 DOI: 10.1016/j.outlook.2025.102627

Carlie M. Felion PhD, FNP-BC, PMHNP-BC , Danielle Morgan PhD, CNS, Family PMHNP , Karen Johnson PhD, RN, FAAN , Jessica Rainbow PhD, RN, CNE

Background

Burnout, turnover, and eroded trust between nurses and healthcare organizations worsened during the COVID-19 pandemic and continue to threaten workforce stability. Addressing these issues requires understanding both individual and system-level contributors to nurse distress.

Purpose

This study sought to identify nurse-endorsed strategies for reducing burnout and improving organizational resilience through analysis of pandemic-era survey data.

Methods

A qualitative content analysis was conducted using responses from two organizational surveys completed during the pandemic. Trauma-informed analytic methods were applied. The SEIPS 2.0 framework guided deductive coding of work-system domains, while Foli’s Middle Range Theory of Nurses’ Psychological Trauma informed inductive analysis of trauma-related themes.

Discussion

Nurses described persistent challenges across all SEIPS 2.0 domains, including insufficient resources, system-induced and secondary trauma, workplace violence, and perceptions of institutional betrayal. They emphasized transparent communication, equitable treatment, fair pay, safe environments, adequate staffing, and meaningful recognition. Most recommendations reflected low-cost cultural and structural reforms that could be readily implemented.

Conclusion

Findings underscore the importance of trauma-informed, system-level strategies—such as reliable staffing, visible leadership, and genuine recognition—to reduce burnout, rebuild trust, strengthen workforce resilience, and enhance nurse retention.

在2019冠状病毒病大流行期间，护士和医疗机构之间的职业倦怠、人员流失和信任受损等问题进一步恶化，并继续威胁着员工队伍的稳定。要解决这些问题，需要了解造成护士痛苦的个人和系统层面的因素。目的本研究旨在通过分析大流行时期的调查数据，确定护士支持的减少职业倦怠和提高组织弹性的策略。方法利用大流行期间完成的两次组织调查的答复进行定性内容分析。采用创伤知情分析方法。SEIPS 2.0框架指导工作系统领域的演绎编码，Foli的护士心理创伤中程理论指导创伤相关主题的归纳分析。讨论护士描述了所有SEIPS 2.0领域持续存在的挑战，包括资源不足、系统诱导和继发性创伤、工作场所暴力以及对制度背叛的看法。他们强调透明的沟通、公平的待遇、公平的报酬、安全的环境、充足的工作人员和有意义的认可。大多数建议反映了可以轻易实施的低成本文化和结构改革。结论研究结果强调了创伤知情的系统级战略的重要性，例如可靠的人员配备，可见的领导和真正的认可，以减少倦怠，重建信任，增强劳动力弹性，并提高护士保留率。

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引用次数: 0

Recommendations from transgender youth for health care providers: “Treat Us With Dignity, Be Person-Centered, and Be Compassionate” 跨性别青年对医疗保健提供者的建议：“有尊严地对待我们，以人为本，富有同情心”

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-19 DOI: 10.1016/j.outlook.2025.102659

Linda M. Wesp PhD, RN, FNP-C, FAAN , Laura Jadwin-Cakmak MPH , Elliot E. Popoff MPH , Iris A. Mustich MPH, BS , Peninnah Kako PhD, RN, FNP-BC, FAAN , Sari Reisner ScD, MA , Gary W. Harper PhD, MPH

Transgender, nonbinary, and gender diverse (TGD) youth face well-documented health inequities and continue to experience discrimination and targeted political attacks when seeking care. As the largest segment of the health care workforce, nurses have both ethical and professional responsibilities to address injustice. This study analyzed qualitative interviews with 186 TGD youth (ages 16–24) from across the United States who were asked about their recommendations for health care professionals. Using phenomenological analysis, we identified three themes that describe what TGD youth recommended: Treat Us With Dignity, Be Person-Centered, and Be Compassionate. Subthemes describe what the recommendations entail, why the recommendations matter, and how health care professionals can enact them. Findings are discussed using a critical reflection model to explore implications for nursing practice, education, and policy. This study offers concrete guidance for delivering ethical nursing care to TGD youth and resisting structural harms in clinical settings.

有充分证据表明，跨性别、非二元性和性别多样化（TGD）青年面临卫生不公平现象，并在寻求治疗时继续遭受歧视和有针对性的政治攻击。作为卫生保健工作人员中最大的一部分，护士在解决不公正问题方面负有道德和专业责任。本研究分析了来自美国各地的186名TGD青年（16-24岁）的定性访谈，这些青年被问及他们对卫生保健专业人员的建议。通过现象学分析，我们确定了三个主题来描述TGD青年的建议：以尊严对待我们，以人为本，富有同情心。分主题描述建议的内容、建议的重要性以及卫生保健专业人员如何实施这些建议。研究结果讨论使用一个关键的反思模型，以探讨护理实践，教育和政策的影响。本研究为在临床环境中为TGD青年提供伦理护理和抵抗结构性伤害提供了具体的指导。

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引用次数: 0

End-of-life education: An explorative study using artificial intelligence simulations in undergraduate nursing 临终教育：在本科护理中应用人工智能模拟的探索性研究。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-17 DOI: 10.1016/j.outlook.2025.102652

Karen Hall PhD , Stephen McKeever PhD , Myles Ojabo PhD , Irene Simonda MD , Josie Tighe MD , Julie Shaw PhD

Background

Generative Artificial Intelligence (Gen AI) enables nursing students to practice complex, sensitive end-of-life care discussions in a simulated environment. This approach provides opportunities to develop person-centred communication and feedback with students without involving real patients, supporting preparation for clinical practice.

Purpose

To explore Australian undergraduate nursing students’ satisfaction and competence in conducting end-of-life (EOL) conversations after interacting with AI-generated characters representing diverse backgrounds.

Methods

An exploratory pre- and post-test survey design incorporating both quantitative and qualitative data. Third-year undergraduate nursing students from one Australian university participated. Pre-test surveys assessed self-reported competence in sensitive EOL conversations. Post-test surveys measured self-reports of competence in EOL conversations, confidence, and satisfaction with the learning experience. A total of 109 students completed the pre-test, and 82 completed the post-test. Data were analysed using descriptive statistics and thematic analysis.

Discussion

The intervention positively impacted students’ confidence and competence in EOL conversations (respondents who stated, 'Strongly Agree' or 'Agree’ increased by 15% to 34%). The identified qualitative themes included content-specific learning, as well as the development of knowledge, skills, and attributes. It was perceived as a safe learning environment that offered interactivity and engagement, realism, but also had challenges and emotional limitations.

Conclusion

Gen AI simulations enhanced students’ competence and engagement in EOL discussions. While some participants noted a lack of emotional depth in AI responses, the overall experience was found to be safe, informative, and promising for nursing education.

背景：生成式人工智能（Gen AI）使护理学生能够在模拟环境中练习复杂、敏感的临终关怀讨论。这种方法提供了与学生发展以人为本的交流和反馈的机会，而不涉及真正的病人，支持临床实践的准备。目的：探讨澳大利亚本科护生在与代表不同背景的人工智能生成角色互动后进行临终（EOL）对话的满意度和能力。方法：采用探索性测试前和测试后的调查设计，包括定量和定性数据。来自澳大利亚一所大学的大三护理本科生参与了研究。测试前调查评估了自我报告的敏感EOL对话能力。测试后调查测量了EOL会话能力的自我报告、信心和对学习经验的满意度。109名学生完成了前测，82名学生完成了后测。数据分析采用描述性统计和专题分析。讨论：干预对学生在EOL对话中的信心和能力产生了积极影响（表示“非常同意”或“同意”的受访者增加了15%至34%）。确定的定性主题包括特定内容的学习，以及知识、技能和属性的发展。它被认为是一个安全的学习环境，提供互动性和参与性，现实性，但也有挑战和情感限制。结论：Gen AI模拟提高了学生在EOL讨论中的能力和参与度。虽然一些参与者注意到人工智能的反应缺乏情感深度，但总体而言，人工智能的体验是安全的、信息丰富的，对护理教育来说是有希望的。

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引用次数: 0

Access to healthcare in rural settings: An evolutionary concept analysis 在农村环境中获得医疗保健：一个进化概念分析。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-17 DOI: 10.1016/j.outlook.2025.102657

Ayisha Alhassan BSN, RN , Elizabeth G. Epstein PhD, RN, HEC-C, FAAN , Pam B. DeGuzman PhD, MBA, RN , Virginia LeBaron PhD, APRN, FAAN

Background

The concept of “access to healthcare in rural settings” has evolved beyond physical proximity, necessitating a contemporary conceptual analysis.

Purpose

Explore the evolution of the concept “access to healthcare” and provide an updated definition with an emphasis on rural settings.

Methods

Rodgers’s evolutionary concept analysis method.

Discussion

“Access to healthcare in rural settings” can be redefined as the ability of individuals to identify, seek, reach, and effectively utilize physical or digital health services in a timely and appropriate manner. It includes not only the availability of services but also the capacity to afford, understand, and engage with healthcare technologies and systems, despite geographic, economic, or infrastructural barriers.

Conclusion

Access to healthcare has transformed from a purely physical concept to one that encompasses both traditional face-to-face and digital modalities. This conceptualization provides a framework to design and evaluate more equitable, inclusive, and technologically responsive healthcare systems.

背景：“在农村环境中获得医疗保健”的概念已经超越了物理距离，有必要进行当代概念分析。目的：探讨“获得医疗保健”概念的演变，并提供一个以农村环境为重点的最新定义。方法：Rodgers进化概念分析法。讨论：“在农村环境中获得医疗保健”可以重新定义为个人及时和适当地识别、寻求、获得和有效利用物理或数字医疗服务的能力。它不仅包括服务的可用性，还包括支付、理解和参与医疗技术和系统的能力，尽管存在地理、经济或基础设施障碍。结论：获得医疗保健已经从纯粹的物理概念转变为包含传统面对面和数字模式的概念。这一概念为设计和评估更加公平、包容和技术响应的卫生保健系统提供了一个框架。

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引用次数: 0

The effect of surgical nurses' phubbing levels on their care behaviors: A descriptive and correlational study 外科护士低头水平对护理行为的影响：一项描述性和相关性研究。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-17 DOI: 10.1016/j.outlook.2025.102653

Esra Özkan PhD, RN , Belgin Şen Atasayar PhD, RN , Elif Güzide Emirza PhD, RN

Background

Excessive smartphone use can lead to phubbing, a phenomenon of great importance in nursing practice where sustained attention is essential for high-quality, patient-centered care.

Purpose

This study investigates the impact of phubbing on the care behaviors of surgical nurses, offering a novel contribution to nursing literature.

Methods

Using a descriptive-correlational design, face-to-face data were obtained from 115 surgical nurses in two hospitals in northern Türkiye using the Personal Information Form, Generic Scale of Phubbing, and Care Behavior Scale-24. Analyses employed Pearson correlation, t-test, Analysis of Variance (ANOVA), and regression analyses with p < .05 as the significance threshold.

Discussion

Phubbing significantly predicted care behaviors (F = 3.126; p < .05). Correlations revealed positive links with nomophobia and interpersonal conflict, and a negative association with problem awareness.

Conclusion

Phubbing adversely influences surgical nurses’ care behaviors, highlighting the need for institutional strategies to address this issue.

背景：过度使用智能手机会导致低头症，这是一种在护理实践中非常重要的现象，在护理实践中，持续的关注对于高质量、以患者为中心的护理至关重要。目的：本研究探讨低头症对外科护士护理行为的影响，为护理文献提供新的贡献。方法：采用描述性相关设计，采用个人信息表、低头症通用量表和护理行为量表-24对北部地区两家医院的115名外科护士进行面对面调查。分析采用Pearson相关、t检验、方差分析（ANOVA）和回归分析，p < 0.05为显著性阈值。讨论：低头症显著预测护理行为（F = 3.126; p）结论：低头症对外科护士的护理行为有不利影响，强调需要制度性策略来解决这一问题。

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引用次数: 0

Why “Professional Student” must mean advanced clinical practice only 为什么“专业学生”必须是指高级临床实践。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-17 DOI: 10.1016/j.outlook.2025.102651

Raymond Zakhari DNP, EdM, NP-BC

引用次数: 0

Recommendations for addressing threats to the nursing profession: An agenda from research leaders 解决护理专业威胁的建议：来自研究领导者的议程

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-11 DOI: 10.1016/j.outlook.2025.102623

Bridgette M. Rice PhD, MDiv, APRN, FAAN , Teri Aronowitz PhD, APRN, FAAN , Teri L. Hernandez PhD, RN, FAAN , Susan DeSanto-Madeya PhD, MSN, RN, FPCN, FAAN , Nicholas Havey PhD , Amanda J. Kirkpatrick PhD, RN, FAAN, FNAP , Melissa O’Connor PhD, MBA, RN, FGSA, FAAN , Sarah Mollman PhD, RN, CHPN, CNE , Darpan I. Patel PhD, FACSM , Nancy A. Pike PhD, CPNP-AC/PC, FAHA, FAAN

The nursing profession is at a critical juncture, facing numerous synergistic challenges that impact research, education, and practice; specifically, a critical nursing shortage, disinvestment in nursing education and practice, decreased federal funding for nursing research, and the continued invisibility of nursing’s impact. Addressing these concerns is essential for ensuring the health and well-being of our society. Associate Deans for Research from around the United States convened to discuss key threats to nursing, and ultimately population health. Herein, these challenges are addressed, and recommendations are provided. We also propose an agenda to: (a) rigorously evaluate the workforce shortage and address causative factors; (b) increase nurses’ engagement in political advocacy and government affairs to enact legislation in support of nursing research, education, and practice; (c) expand the valuation of extramural research funding and dissemination to broaden the metrics of scholarly success; and (d) promote public visibility of nursing’s value and impact.

护理专业正处于关键时刻，面临着影响研究、教育和实践的众多协同挑战；具体来说，是严重的护理短缺，护理教育和实践的投资减少，护理研究的联邦资金减少，护理的影响持续被忽视。解决这些问题对于确保我们社会的健康和福祉至关重要。来自美国各地的研究副院长聚集在一起讨论护理的主要威胁，最终是人口健康。本文讨论了这些挑战，并提出了建议。我们还提出了一项议程：(a)严格评估劳动力短缺并解决造成短缺的因素；(b)增加护士对政治宣传和政府事务的参与，以制定支持护理研究、教育和实践的立法；(c)扩大对校外研究经费和传播的评价，以扩大学术成功的衡量标准；(d)促进公众对护理的价值和影响的认识。

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引用次数: 0

A concept analysis of high-quality primary care for transgender and gender-diverse adults 跨性别和性别多样化成人高质量初级保健的概念分析

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-11 DOI: 10.1016/j.outlook.2025.102625

Hillary J. Dutton MS, MPH, RN, Marissa Bergh BSN, RN, Allison Squires PhD, RN, FAAN, Caroline Dorsen PhD, FNP-BC, FAAN, Chenjuan Ma PhD

Background

Transgender and gender-diverse (TGD) adults experience health disparities related to stigma and discrimination. Mistreatment and substandard primary care contribute to these inequities.

Purpose

This concept analysis aimed to identify aspects of high-quality primary care for TGD adults.

Methods

A comprehensive literature review was conducted to identify articles that described primary care delivery for TGD adults. Articles were coded and analyzed using directed content and dimensional analysis processes to identify characteristics of high-quality primary care.

Discussion

Thirty-seven articles were included in the analysis. Through comparison of patient, clinician, and organizational perspectives, we identified five dimensions, comprising 12 subdimensions, of high-quality primary care for TGD adults: accessibility, affirmation, collaborative partnership, integrated care, and safety.

Conclusion

These dimensions illustrate the complex interplay among patients, clinicians, and organizations in the primary care setting. Our conceptualization can be used to guide clinicians, organizations, and researchers in improving primary care quality for TGD patients.

跨性别和性别多样化（TGD）成年人经历与污名和歧视相关的健康差异。虐待和不合格的初级保健助长了这些不平等。目的本概念分析旨在确定TGD成人高质量初级保健的各个方面。方法进行全面的文献综述，以确定描述TGD成人初级保健服务的文章。采用定向内容和量纲分析过程对文章进行编码和分析，以确定高质量初级保健的特征。37篇文章被纳入分析。通过比较患者、临床医生和组织的观点，我们确定了TGD成人高质量初级保健的五个维度，包括12个子维度：可及性、肯定性、合作伙伴关系、综合护理和安全性。结论：这些维度说明了初级保健环境中患者、临床医生和组织之间复杂的相互作用。我们的概念可以用来指导临床医生、组织和研究人员提高TGD患者的初级保健质量。

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引用次数: 0

Early implementation study of a co-caring and virtual nursing model 共同护理与虚拟护理模式的早期实施研究。

IF 3.7 2区医学 Q1 NURSING

Nursing Outlook

Pub Date : 2025-12-09 DOI: 10.1016/j.outlook.2025.102613

Trisha Saul PhD, RN , Cara Gallegos PhD, RN , Robyn Husa PhD, Troy Larkin PhD, RN, Cynthia Salisbury MSN, RN, Andria Moore MN, RN, Julie Levine BS, Ann Vita BS, Amy Parrish BS, Jim Scanlan PhD, Syl Trepanier DNP, RN, Kara Bensley PhD MSc , Canada Parrish PhD, MSPH

Background

The Co-Caring Nursing Model, incorporating virtual registered nurses (vRNs) into team-based nursing, aims to address challenges due to nursing shortages, increasing patient acuity, and professional burnout.

Purpose

To evaluate the early impact of the Co-Caring Nursing Model on patient experience, safety (as measured by rates of catheter-associated urinary tract infections and central line-associated bloodstream infections), cost of care, and employee experience.

Methods

This study used a difference in difference approach, analyzing electronic medical records from August 2023 to August 2024. Employee experience with the model and burnout in the workplace were assessed via a survey administered 6 months post implementation.

Discussion

Length of stay increased modestly for intervention units; no significant changes in readmissions, patient experience, or safety metrics were observed. Employee feedback revealed varied experiences: vRNs favored the model, while bedside registered nurses (bRNs) reported more challenges.

Conclusion

The model does not adversely affect patient safety or costs but presents challenges in bRN workload and adaptation. Effective change management is crucial for successful implementation.

背景：将虚拟注册护士（vrn）纳入团队护理的共同护理模式，旨在解决护理短缺、患者敏锐度提高和职业倦怠带来的挑战。目的：评估共同护理模式对患者体验、安全性（以导尿管相关尿路感染和中心静脉相关血流感染的发生率衡量）、护理成本和员工体验的早期影响。方法：本研究采用异差法对2023年8月至2024年8月的电子病历进行分析。在实施后6个月，通过一项调查评估了员工对该模型的体验和工作场所的倦怠程度。讨论：干预单位的住院时间略有增加；在再入院、患者经历或安全指标方面未观察到显著变化。员工的反馈显示了不同的体验：vrn喜欢这种模式，而床边注册护士（brn）则报告了更多的挑战。结论：该模型不会对患者的安全或成本产生不利影响，但在bRN工作量和适应性方面提出了挑战。有效的变更管理是成功实施的关键。

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引用次数: 0