Journal of Advanced Nursing最新文献_第3页

Pluralising Scholarship: Repositioning Doctor of Nursing Practice Faculty Through Boyer's Framework: A Discursive Paper. 多元化学术：通过Boyer的框架重新定位护理实践博士：一篇论文。

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-20 DOI: 10.1111/jan.70577

Rachel Wangari Kimani

AIMTo critically examine the structural exclusion of Doctor of Nursing Practice (DNP)-prepared faculty from academic advancement and promotion pathways and to propose reforms grounded in Boyer's model of scholarship.BACKGROUNDThe DNP is a practice-focused doctorate established in the United States, distinct from the research-oriented PhD. Similar professional doctorates in the United Kingdom and Australia share the goal of integrating clinical expertise with scholarly inquiry. Despite the rapid growth of DNP programs and the increasing recognition of applied scholarship, many universities continue to privilege traditional research metrics in academic tenure and promotion. This narrow focus on discovery-based outputs marginalises the contributions of DNP faculty in implementation science, systems leadership, and education.DESIGNDiscursive position paper.DATA SOURCESAnalysis of policy reports, faculty promotion guidelines, AACN Essentials, and peer-reviewed literature on doctoral education, professional doctorates, and academic equity, 2000-2025.IMPLICATIONS FOR DOCTORAL EDUCATIONCurrent academic evaluation systems sustain hierarchical norms that undervalue practice-based scholarship. This misalignment restricts the career trajectories of DNP-prepared faculty and constrains nursing's leadership in applied innovation. Reframing scholarly legitimacy through Boyer's model of discovery, integration, application, and teaching enables recognition of diverse expertise without compromising academic rigour.CONCLUSIONFully integrating professional doctorates into academic structures requires deliberate reforms in evaluation frameworks, mentorship programs, and institutional policies. Such changes would advance equity, reflect the realities of modern nursing, and align doctoral education with the evolving needs of healthcare systems.IMPACTThis paper contributes to the international discourse on the future of doctoral education by offering a practical model for inclusive faculty advancement. It also advocates adopting pluralistic definitions of scholarship to support diverse academic career paths in nursing.NO PATIENT OR PUBLIC CONTRIBUTIONNo patients, service users, caregivers, or members of the public were involved in the development of this discursive paper. The analysis synthesises existing scholarship, policy documents, and theoretical frameworks and does not draw on primary data requiring patient or public involvement.

目的：批判性地审视护理实践博士（DNP）准备的教师在学术进步和晋升途径中的结构性排斥，并提出基于Boyer的奖学金模式的改革。DNP是在美国建立的以实践为重点的博士学位，与研究型博士学位不同。在英国和澳大利亚，类似的专业博士学位的目标是将临床专业知识与学术研究相结合。尽管DNP项目快速增长，应用奖学金也越来越受到认可，但许多大学在学术任期和晋升方面仍然优先考虑传统的研究指标。这种对基于发现的产出的狭隘关注边缘化了DNP教师在实施科学、系统领导和教育方面的贡献。design论述立场文件。数据来源对2000-2025年政策报告、教员晋升指南、AACN要点和同行评议的博士教育、专业博士学位和学术公平文献的分析。对博士教育的启示当前的学术评估体系维持了等级规范，低估了以实践为基础的学术。这种错位限制了dnp准备教师的职业轨迹，并限制了护理在应用创新方面的领导地位。通过Boyer的发现、整合、应用和教学模式重新构建学术合法性，可以在不损害学术严谨性的情况下认可各种专业知识。结论：将专业博士学位纳入学术结构需要在评估框架、指导计划和制度政策方面进行深思熟虑的改革。这样的改变将促进公平，反映现代护理的现实，并使博士教育与医疗保健系统不断变化的需求保持一致。本文通过提供包容性教师发展的实践模型，为博士教育未来的国际讨论做出了贡献。它还提倡采用多元化的奖学金定义，以支持护理领域多样化的学术职业道路。没有患者或公众的贡献没有患者、服务使用者、护理人员或公众成员参与这篇论文的撰写。该分析综合了现有的学术研究、政策文件和理论框架，没有利用需要患者或公众参与的原始数据。

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引用次数: 0

From Wage Dissatisfaction to Union Expectations: The Mediating Role of Union Perception Among Nurses 从工资不满到工会期望：护士工会感知的中介作用

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-19 DOI: 10.1111/jan.70580

Salih Tosun, Gökçe Cerev, Doğa Başar Sariipek

Aim This study examines the relationships between wage satisfaction, union perceptions, expectations, and union membership among Turkish nurses, identifying factors associated with union participation. Design Sequential explanatory mixed‐methods design. Methods This two‐phase study (January–July 2023) included: (1) a quantitative survey of 210 nurses assessing wage satisfaction, union perceptions, and expectations, analysed using regression and PROCESS Macro (Model 4); and (2) qualitative interviews with 22 nurses, including 15 with union leadership experience, analysed through thematic analysis using MAXQDA. Results Quantitative findings indicated that wage satisfaction was associated with nurses' perceptions of unions but did not independently predict union expectations. The study hypothesises that union perception functions as a key mediating mechanism, translating wage dissatisfaction into expectations for union action. Qualitative findings supported this pattern, showing that although wage dissatisfaction was widespread, nurses' expectations were primarily shaped by perceptions of unions' transparency, political independence, democratic participation, and representational capacity rather than by wages alone. Conclusions Union participation among nurses is influenced by both economic conditions and normative evaluations of unions. While wage dissatisfaction provides an important contextual background, expectations and engagement are mainly driven by perceptions of union credibility, fairness, and representational effectiveness. Implications for Profession and/or Patient Care Nursing unions should prioritise transparent governance, democratic participation, and political independence to enhance trust, member engagement, workforce stability, and quality of care. Impact This study addresses persistent wage dissatisfaction alongside declining union membership and trust. The findings demonstrate that union engagement depends not only on economic dissatisfaction but also on perceived representational fairness. The results are particularly relevant for nursing unions, professional organisations, and policymakers aiming to strengthen union legitimacy and workforce engagement in healthcare systems. Reporting Method Compliant with COREQ guidelines and mixed‐methods reporting standards. Patient or Public Contribution No patient or public contribution.

目的本研究考察土耳其护士工资满意度、工会观念、期望和工会成员之间的关系，确定与工会参与相关的因素。顺序解释混合方法设计。该研究分为两个阶段（2023年1月至7月），包括：(1)对210名护士进行定量调查，评估工资满意度、工会观念和期望，并使用回归和过程宏观（模型4）进行分析；(2)对22名护士进行定性访谈，其中15名具有工会领导经验，采用MAXQDA进行主题分析。结果量化结果表明，工资满意度与护士对工会的看法有关，但不能独立预测工会的期望。该研究假设工会感知作为一个关键的中介机制，将工资不满转化为对工会行动的期望。定性调查结果支持这一模式，表明尽管对工资的不满普遍存在，但护士的期望主要受到对工会透明度、政治独立性、民主参与和代表能力的看法的影响，而不仅仅是工资。结论护士工会参与受到经济条件和工会规范性评价的双重影响。虽然对工资的不满提供了一个重要的背景，但期望和参与主要是由对工会可信度、公平性和代表性有效性的看法所驱动的。护理工会应优先考虑透明治理、民主参与和政治独立，以增强信任、成员参与、劳动力稳定和护理质量。这项研究解决了持续的工资不满以及工会会员和信任的下降。研究结果表明，工会参与不仅取决于对经济的不满，还取决于对代表性公平的感知。研究结果对护理工会、专业组织和旨在加强工会合法性和劳动力参与医疗保健系统的政策制定者尤为重要。报告方法符合COREQ指南和混合方法报告标准。病人或公众捐款：没有病人或公众捐款。

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引用次数: 0

Culturally and Linguistically Diverse Fathers' Experiences of Early Parenting: A Qualitative Study 文化和语言差异的父亲早期养育经验：一项定性研究

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-17 DOI: 10.1111/jan.70565

Rakime Elmir, Simone Ormsby, Particia Leahy-Warren, Lloyd Frank Philpott, Alka Kothari, Virginia Schmied

This study aimed to explore culturally and linguistically diverse (CALD) fathers' early parenting support needs in the perinatal period in Australia.

本研究旨在探讨澳大利亚文化和语言多样性（CALD）父亲在围产期的早期育儿支持需求。

引用次数: 0

Psychological Safety of Culturally and Linguistically Diverse Nurses in Healthcare Work Environments-Systematic Review of Mixed-Methodology. 不同文化和语言的护士在医疗保健工作环境中的心理安全——混合方法的系统评价。

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-17 DOI: 10.1111/jan.70575

Judith Yabal,Suleiman Kamau,Marco Tomietto,Kristina Mikkonen

BACKGROUNDThe international mobility of nurses is a significant component of healthcare systems worldwide, resulting in the global recruitment and adaptation of culturally and linguistically diverse nurses into diverse work environments. CALD nurses face integration challenges, which can potentially compromise their well-being and adjustment to the new setting. Psychological safety is a key component to promoting individual well-being and effective organisational integration.OBJECTIVEThis systematic review aimed to identify the current evidence on the psychological safety of culturally and linguistically diverse nurses in healthcare work environments and the factors associated with it.METHODSThis systematic review was conducted using JBI guidelines. PiCo/PEO format was utilised for inclusion and exclusion criteria, including English/Finnish, without time limitations. The screening process was conducted by two independent researchers, with a third researcher resolving the conflicts. The PRISMA checklist was utilised in reporting. Data were analysed using content analysis for qualitative and data synthesis for quantitative.DATA SOURCESCINAHL, PubMed, ProQuest, Scopus and Medic.SEARCH PERIOD24.10.2024-23.1.2025.RESULTSThe systematic review yielded 15 qualitative, one mixed-methods and one quantitative article. The content analysis produced 270 codes, 67 subcategories, seven categories and two main categories. Professional growth and acceptance captured inclusion, professional competence and support from colleagues and managers in creating job satisfaction. Marginalised disempowerment reflected factors linked to low psychological safety, contributing to reduced job satisfaction in the workplace.CONCLUSIONHealthcare organisations should confront existing inequities on psychological safety in culturally diverse healthcare environments that are structured around professional inequalities to create equitable spaces for CALD nurses. More research is needed to understand psychological safety experiences from the CALD nurse perspective, exploring the equitability of facilitating factors amid systemic disadvantages in the healthcare workplace.PATIENT OR PUBLIC CONTRIBUTIONNo patient or public involvement.TRIAL REGISTRATIONProspero registration: CRD42024581860.

护士的国际流动是全球医疗保健系统的重要组成部分，导致全球招聘和适应不同文化和语言的护士到不同的工作环境。CALD护士面临着整合挑战，这可能会损害他们的福祉和适应新的环境。心理安全是促进个人福祉和有效组织整合的关键组成部分。目的：本系统综述旨在确定目前关于不同文化和语言的护士在医疗保健工作环境中的心理安全及其相关因素的证据。方法采用JBI指南进行系统评价。纳入和排除标准采用PiCo/PEO格式，包括英语/芬兰语，没有时间限制。筛选过程由两名独立研究人员进行，第三名研究人员负责解决冲突。报告采用了PRISMA核对表。定性分析采用内容分析，定量分析采用数据综合。数据来源：cinahl， PubMed, ProQuest， Scopus和Medic。搜索PERIOD24.10.2024-23.1.2025。结果本系统综述共收录定性文献15篇，混合方法1篇，定量方法1篇。内容分析产生270个代码、67个子类别、7个类别和2个主要类别。职业成长和接受是指同事和经理在创造工作满意度方面的包容、专业能力和支持。被边缘化的被剥夺权力反映了与低心理安全感相关的因素，导致工作场所工作满意度降低。结论：医疗机构应面对在多元文化的医疗环境中存在的心理安全不平等，这些环境是围绕专业不平等构建的，为CALD护士创造公平的空间。需要更多的研究从CALD护士的角度来理解心理安全体验，探索在医疗保健工作场所的系统性劣势中促进因素的公平性。患者或公众贡献：无患者或公众参与。试用注册普洛斯彼罗注册：CRD42024581860。

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引用次数: 0

Artificial Intelligence Technologies in Nursing Clinical Decision-Making: An Umbrella Review. 人工智能技术在护理临床决策中的应用综述

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-17 DOI: 10.1111/jan.70579

Robyn Cant,Colleen Ryan,Ritesh Chugh

AIMTo describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making.METHODSAn umbrella review of literature reviews.DATA SOURCESFour major databases were searched for reviews published between 2019 and 2024.RESULTSSixteen literature reviews reported on 965 nursing artificial intelligence primary studies. The studies focused on technology development and emerging performance evaluations, whilst real-world testing or implementation in nursing clinical settings was rare. Rigorous comparative analyses were lacking. While artificial intelligence demonstrates promise in decision-making, challenges such as a lack of controlled studies, algorithmic bias, limited reproducibility and insufficient clinical trials hinder its practical impact. Ethical concerns, transparency and patient data privacy issues pose barriers to AI integration in nursing practice. Ethical and legal guidelines for patient privacy are needed and should be taught along with AI literacy training for nurses.CONCLUSIONSArtificial intelligence has the potential to enhance clinical nursing decision-making, although evidence is limited by too few examples of nurse participation during development. Underutilisation in administrative nursing functions hinders implementation. Nurses should assume a central role in the design and development of AI applications to ensure that these technologies address the realities of nursing practice. With such improvements, artificial intelligence can transform nursing practice, improve nurses' clinical decision-making and ultimately enhance consumer healthcare outcomes.PATIENT OR PUBLIC INVOLVEMENTNo Patient or Public Involvement.REPORTING METHODWhile there is no reporting checklist for umbrella reviews, the PRISMA guide for systematic reviews was followed.

目的描述人工智能在护士临床决策中的当代同行评议文献。方法综述文献。数据来源检索了2019年至2024年间发表的四个主要数据库。结果对965项护理人工智能初步研究进行了16篇文献综述。这些研究集中在技术开发和新兴绩效评估上，而在护理临床环境中进行实际测试或实施的情况很少。缺乏严格的比较分析。虽然人工智能在决策方面表现出了希望，但缺乏对照研究、算法偏差、可重复性有限和临床试验不足等挑战阻碍了它的实际影响。伦理问题、透明度和患者数据隐私问题对人工智能在护理实践中的整合构成了障碍。患者隐私的道德和法律准则是必要的，应该在对护士进行人工智能素养培训的同时教授这些准则。结论人工智能具有增强临床护理决策的潜力，但在开发过程中护士参与的实例太少，证据有限。行政护理职能的利用不足阻碍了实施。护士应该在人工智能应用的设计和开发中发挥核心作用，以确保这些技术能够解决护理实践的现实问题。有了这些改进，人工智能可以改变护理实践，改善护士的临床决策，最终提高消费者的医疗保健结果。患者或公众参与：无患者或公众参与。报告方法虽然没有总结性审查的报告清单，但遵循了PRISMA系统审查指南。

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引用次数: 0

Scope of Nursing Work and Models of Service Delivery in Australian Primary and Secondary Schools: A Scoping Review 澳大利亚中小学护理工作的范围和服务提供模式：范围审查

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-14 DOI: 10.1111/jan.70562

Anita Moyes, Chelsey Williams, Elizabeth Rankin, Imelda Hoodcamp, Eliza‐Jane Potter, Brent A. Hayward

Aim To map the scope of nursing work and models of service delivery in Australian primary and secondary schools for children aged 3–18 years. Design Scoping Review. Data Sources A search of CINAHL, Medline, PsycINFO, ERIC, Informit and Google was conducted in August 2024 for peer reviewed, non‐peer reviewed and grey literature giving insight into nursing work in primary and secondary Australian schools in urban, regional and remote areas of all Australian states and territories. Methods The review employed Johanna Briggs Institute methodology for scoping reviews and reported the findings in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) Checklist. Results One hundred and forty‐two sources were included. Findings indicate that nurses working in Australian schools conduct a wide range of activities which vary by jurisdiction, education sector, employer and school type. Models of nursing service delivery are similarly varied and range from full‐time school‐based nurses to nurses who visit schools on an occasional basis. Conclusion The varied scope of nursing work and models of service delivery provide evidence that the nursing workforce in schools is adaptable and flexible, but unequal access to nursing services raises important questions about equity. There is an urgent need for a national approach to nursing work in Australian schools. Impact This is the first review to map the scope of nursing work and models of service delivery in Australian primary and secondary schools.

目的绘制澳大利亚3-18岁儿童小学和中学护理工作的范围和服务提供模式。设计范围审查。我们于2024年8月检索了CINAHL、Medline、PsycINFO、ERIC、Informit和谷歌，检索了同行评议、非同行评议和灰色文献，这些文献深入了解了澳大利亚所有州和领地的城市、区域和偏远地区的澳大利亚中小学的护理工作。方法本综述采用约翰娜·布里格斯研究所的方法进行范围评价，并按照系统评价和范围评价扩展元分析首选报告项目（PRISMA‐ScR）清单报告研究结果。结果纳入142个来源。调查结果表明，在澳大利亚学校工作的护士开展了广泛的活动，这些活动因司法管辖区、教育部门、雇主和学校类型而异。提供护理服务的模式同样多种多样，范围从全日制学校护士到偶尔访问学校的护士。护理工作范围和服务提供模式的多样化证明了学校护理人员的适应性和灵活性，但护理服务的不平等提出了关于公平的重要问题。澳大利亚学校迫切需要一个全国性的护理工作方法。这是澳大利亚中小学护理工作范围和服务提供模式的首次回顾。

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引用次数: 0

Advance Care Planning Intention and Associated Factors Among People With Dementia: A Mixed-Methods Study. 痴呆患者的提前护理计划意向和相关因素：一项混合方法研究。

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-13 DOI: 10.1111/jan.70521

Xi Zhang,Jing Wang,Fangyao Chen,Xiaohong Hu,Yan Qu

AIMTo explore the current status and associated factors of advance care planning intentions among people living with dementia in China.DESIGNAn explanatory sequential mixed-methods design was adopted.METHODSThe research is guided by the knowledge-attitude-practice model and the theory of planned behaviour. Quantitative surveys were used to assess advance care planning intentions and associated factors in people living with dementia, followed by qualitative semi-structured interviews to delve into participants' perceptions and feelings about advance care planning. Quantitative data were analysed using multiple linear regression, while qualitative data were analysed using thematic analysis.RESULTSThe overall advance care planning behavioural intention was at a moderately high level. The quantitative results revealed that higher education level, certain religious beliefs, greater advance care planning knowledge, positive behavioural attitudes and stronger subjective norms were significantly positively associated with advance care planning intentions. Qualitative analysis identified three themes: positive attitude but limited ACP awareness, supportive relationships enable early ACP consideration and cultural norms shape willingness to engage in ACP.CONCLUSIONAdvance care planning intentions among people living with dementia are shaped by a combination of social, familial and individual factors. Increasing public awareness, addressing cultural challenges and establishing professional teams are crucial to promoting advance care planning practices. Future research should focus on larger, multicenter studies to enhance intervention strategies.IMPLICATIONSAlthough the attitude toward advance care planning is more positive, various factors need to be carefully considered in the process of constructing relative intervention strategies.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct or reporting.

目的探讨中国老年痴呆患者提前护理计划意愿的现状及相关因素。设计采用解释性顺序混合方法设计。方法以知识-态度-实践模型和计划行为理论为指导。定量调查用于评估痴呆症患者的提前护理计划意图和相关因素，随后进行定性半结构化访谈，以深入研究参与者对提前护理计划的看法和感受。定量数据采用多元线性回归分析，定性数据采用专题分析。结果患者提前护理计划行为意愿总体处于中高水平。定量结果显示，较高的教育程度、一定的宗教信仰、较高的事前护理计划知识、积极的行为态度和较强的主观规范与事前护理计划意图显著正相关。定性分析确定了三个主题：积极的态度但有限的ACP意识，支持性关系使早期ACP考虑和文化规范塑造参与ACP的意愿。结论老年痴呆患者的提前护理计划意向受社会、家庭和个人因素的综合影响。提高公众意识、应对文化挑战和建立专业团队对于促进提前护理规划实践至关重要。未来的研究应侧重于更大的、多中心的研究，以加强干预策略。结论虽然患者对提前护理计划的态度较为积极，但在制定相关干预策略时仍需综合考虑各种因素。患者或公众的贡献本研究的设计、实施或报告中没有患者或公众的参与。

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引用次数: 0

Delayed Admission to the Intensive Care Unit Is Associated With Increased Mortality Risk in Critically Ill Patients: A Prospective Cohort Study. 延迟入住重症监护病房与危重患者死亡风险增加相关：一项前瞻性队列研究

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-13 DOI: 10.1111/jan.70493

Shivaprasad Anagi,Diane Chamberlain,Nigel Barr,Ahmed Mehdi,William Pinzon Perez,Raju Pusapati,Daryl Taypin Shaw,Christine Jennings,Frances Lin

AIMTo examine the impact of delays in intensive care unit (ICU) admission on patient outcomes, specifically clinical deterioration and mortality among patients transferred from the emergency department (ED) or general wards following acute deterioration in an Australian public hospital.DESIGN & METHODSThis prospective cohort study was conducted over a 12-month period (15 April 2022-14 April 2023) in a 209-bed regional hospital. It included adult patients (aged ≥ 18 years) admitted to the ICU from ED or general wards following acute deterioration. Primary outcomes measured were duration of delay in ICU admission, ICU and hospital mortality and changes in Sequential Organ Failure Assessment (SOFA) scores over time to assess organ dysfunction and progression.RESULTSA total of 403 patients were included. Of these, 276 (68.5%) experienced delays in ICU admission, ranging from 25 min to 347.25 h (median: 7.13 h). Delayed ICU admission was associated with increased mortality. Each one-point increase in the highest recorded SOFA score was linked to a 7.5% rise in mortality odds, while each one-point increase in the initial or 24-h SOFA score corresponded to a 6.8% increase.CONCLUSIONSDelayed ICU admission was significantly associated with increased mortality, particularly in patients with elevated SOFA scores, indicating worsening organ dysfunction and clinical instability.IMPLICATIONS FOR PRACTICEThese findings highlight the urgent need for improved triage systems, early warning protocols and streamlined escalation pathways to expedite ICU transfers for deteriorating patients. Timely intervention is essential to reduce harm and improve outcomes.IMPACTThis study reinforces the clinical risks of delayed ICU admission and supports timely escalation of care in emergency and ward settings across Australian public hospitals.REPORTINGConducted in accordance with STROBE guidelines.PATIENT/PUBLIC CONTRIBUTIONNo direct patient or public involvement. The study used routinely collected clinical data to evaluate systemic and clinical outcomes.

目的：研究澳大利亚一家公立医院重症监护病房（ICU）入院延迟对患者预后的影响，特别是从急诊科（ED）或普通病房转过来的急性病情恶化患者的临床恶化和死亡率。设计与方法本前瞻性队列研究在一家拥有209个床位的地区医院进行，为期12个月（2022年4月15日至2023年4月14日）。它包括急性恶化后从急诊科或普通病房入住ICU的成年患者（年龄≥18岁）。测量的主要结局是ICU入院延迟时间、ICU和住院死亡率以及顺序器官衰竭评估（SOFA）评分随时间的变化，以评估器官功能障碍和进展。结果共纳入403例患者。其中，276例（68.5%）在ICU住院时出现延迟，时间从25分钟到347.25小时不等（中位数：7.13小时）。延迟入住ICU与死亡率增加有关。最高记录的SOFA评分每增加1分，死亡率就会增加7.5%，而初始或24小时SOFA评分每增加1分，死亡率就会增加6.8%。结论：延迟入住ICU与死亡率增加显著相关，特别是SOFA评分升高的患者，表明器官功能障碍加重和临床不稳定。实践意义这些研究结果强调迫切需要改进分诊系统、早期预警方案和简化升级途径，以加快病情恶化患者的ICU转移。及时干预对于减少伤害和改善结果至关重要。影响本研究加强了延迟ICU入院的临床风险，并支持澳大利亚公立医院急诊和病房设置的及时升级护理。报告按照STROBE指南进行。患者/公众贡献：无患者或公众直接参与。该研究使用常规收集的临床数据来评估系统和临床结果。

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引用次数: 0

Experiences and Responses to Cancer-Related Anorexia Across Patients, Caregivers and Healthcare Professionals: A Qualitative Meta-Synthesis. 癌症相关厌食症患者、护理人员和医疗保健专业人员的经历和反应：一项定性综合研究。

IF 3.4 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-12 DOI: 10.1111/jan.70409

Xiaoying Sun, Zhaohui Zhang, Chunyuan Tang, Xiaoqin Hu, Lina Wu, Qiangqiang Zhao, Shouzhen Cheng

Aim: To synthesise qualitative evidence on how patients, caregivers and healthcare professionals perceive and respond to cancer-related anorexia (CRA), and to develop a multi-level framework for improving CRA care.

Design: A qualitative meta-synthesis using the Joanna Briggs Institute (JBI) methodology, informed by the Social Ecological Model (SEM).

Methods: Seven databases were searched for qualitative studies from inception to April 2025. Studies were assessed using the JBI Critical Appraisal Checklist. Meta-aggregation was used to synthesise findings, and the ConQual method assessed confidence levels.

Data sources: PubMed, Embase, CINAHL, PsycINFO, Cochrane Library, CNKI and WanFang.

Results: Seventeen studies from 10 countries were included, reflecting the perspectives of patients, caregivers and healthcare professionals. Four synthesised findings were identified. At the individual level, CRA was linked to physical decline, emotional distress and changes in identity. The interpersonal level involved feeding-related tensions and caregiver burden. Organisational barriers included delayed care and poor cultural responsiveness. Policy-level factors such as limited insurance coverage and rural access further impeded care. Overall confidence in these synthesised findings was low to moderate.

Conclusion: CRA is not solely a biological condition but a multidimensional experience. Addressing CRA requires integrated and context-sensitive strategies across personal, relational, organisational and policy domains.

Implications: Nurses and clinicians should address not only physical symptoms but also the emotional and social dimensions of eating. Structured support for caregivers and improved service access, particularly in underserved settings, are needed.

Impact: This study provides a multi-level understanding of CRA. The findings support better patient care, caregiver support and more equitable healthcare policy design.

Reporting method: JBI methodology and ENTREQ guideline.

Patient or public contribution: No Patient or Public Contribution.

Trial registration: PROSPERO Database: CRD420251041265.

目的：综合关于患者、护理人员和医疗保健专业人员如何感知和应对癌症相关厌食症（CRA）的定性证据，并建立一个改善CRA护理的多层次框架。设计：采用乔安娜布里格斯研究所（JBI）的方法，根据社会生态模型（SEM）进行定性综合。方法：检索自成立至2025年4月的7个数据库进行定性研究。使用JBI关键评估清单对研究进行评估。Meta-aggregation用于综合研究结果，并使用conquest方法评估置信水平。数据来源：PubMed， Embase， CINAHL, PsycINFO, Cochrane Library， CNKI，万方。结果：纳入了来自10个国家的17项研究，反映了患者、护理人员和医疗保健专业人员的观点。确定了四项综合发现。在个人层面上，CRA与身体衰退、情绪困扰和身份变化有关。人际关系层面包括与喂养有关的紧张和照顾者负担。组织障碍包括延迟护理和文化响应能力差。政策层面的因素，如有限的保险覆盖面和农村可及性，进一步阻碍了护理。对这些综合发现的总体信心为低至中等。结论：CRA不仅仅是一种生理状态，而是一种多维度的体验。解决CRA问题需要在个人、关系、组织和政策领域采取综合的、对环境敏感的战略。启示：护士和临床医生不仅要解决身体症状，还要解决饮食的情感和社会层面。需要为护理人员提供结构化支持，并改善服务获取，特别是在服务不足的环境中。影响：本研究提供了对CRA的多层次理解。研究结果支持更好的患者护理、护理人员支持和更公平的医疗保健政策设计。报告方法：JBI方法和ENTREQ指南。患者或公众捐赠：无患者或公众捐赠。试验注册：PROSPERO数据库：CRD420251041265。

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引用次数: 0

Disabled Nurses in an Ableist Profession: Lessons From the Past and Directions for the Future. 残疾护士的职业：从过去的教训和未来的方向。

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing

Pub Date : 2026-03-12 DOI: 10.1111/jan.70581

Anna M Valdez

引用次数: 0