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AnteayerInternacionales

Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID‐19 pandemic: Testing an integrated model using structural equation modelling

Abstract

Purpose

A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic.

Background

Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety.

Methods

A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist.

Results

The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life.

Conclusion

The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.

Relevance to clinical practice

These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.

Prevalence of adverse events in pronated intubated adult COVID‐19 patients: A systematic review with meta‐analysis

Abstract

Aim

To present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients.

Design

A systematic review and meta-analysis.

Data sources

This study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources.

Methods

The studies were meta-analysed using JAMOVI 1.6.15 software. A random-effects model was used to identify the global prevalence of adverse events, confidence intervals and the heterogeneity data. Risk of bias was assessed using the Joanna Briggs Institute tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Of the 7904 studies identified, 169 were included for full reading, and 10 were included in the review. The most prevalent adverse events were pressure injuries (59%), haemodynamic instability (23%), death (17%) and device loss or traction (9%).

Conclusion

The most prevalent adverse events in mechanically ventilated pronated patients with COVID-19 are pressure injuries, presence of haemodynamic instability, death and device loss or traction.

Implications for the patient care

The evidence identified in this review can help improve the quality and safety of patient care by helping to design care protocols to avoid the development of adverse events that can cause permanent sequelae in these patients.

Impact

This systematic review addressed the adverse events related to prone position in intubated adult COVID-19 patients. We identified that the most prevalent adverse events in these patients were pressure injuries, haemodynamic instability, device loss or traction and death. The results of this review may influence the clinical practice of nurses who work in intensive care units and, consequently, the nursing care provided not only to COVID-19 patients but for all intubated patients due to other reasons in intensive care units.

Reporting method

This systematic review adhered to the PRISMA reporting guideline.

Patient or public contribution

As this is a systematic review, we analysed data from primary studies conducted by many researchers. Thus, there was no patient or public contribution in this review.

Perceived quality of life and associated factors in long COVID syndrome among older Brazilians: A cross‐sectional study

Abstract

Aims and objectives

This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL.

Background

Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome.

Design

A cross-sectional survey design using the STROBE checklist.

Methods

Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL.

Results

The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors.

Conclusions

Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society.

Relevance to clinical practice

Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns.

Patient or Public Contribution

No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.

Family members' experiences of COVID‐19 visiting restrictions in the intensive care unit—A qualitative study

Abstract

Objective

To describe how family members of critically ill patients experienced the COVID-19 visiting restrictions in Sweden.

Background

In Sweden, the response to COVID-19 was less invasive than in many other countries. However, some visiting restrictions were introduced for intensive care units, with local variations. Although there is a growing body of literature regarding healthcare professionals' and family caregivers' perspectives on visiting restriction policies, there may be inter-country differences, which remain to be elucidated.

Design

This study has a qualitative descriptive design. Focus group interviews with 14 family members of patients treated for severe COVID-19 infection were conducted. The interviews took place via digital meetings during the months after the patients' hospital discharge. Qualitative content analysis was used to interpret the interview transcripts. Reporting of the study followed the COREQ checklist.

Results

Two categories—dealing with uncertainty and being involved at a distance—described family members' experiences of coping with visiting restrictions during the COVID-19 pandemic. These restrictions were found to reduce family members' ability to cope with the situation. Communication via telephone or video calls to maintain contact was appreciated but could not replace the importance of personal contact.

Conclusions

Family members perceived that the visiting restriction routines in place during the COVID-19 pandemic negatively influenced their ability to cope with the situation and to achieve realistic expectations of the patients' needs when they returned home.

Relevance to Clinical Practice

This study suggests that, during the COVID-19 pandemic, the visiting restrictions were experienced negatively by family members and specific family-centred care guidelines need to be developed for use during crises, including the possibility of regular family visits to the ICU.

Patient and Public Contribution

None in the conceptualisation or design of the study.

The long‐term impact of COVID‐19 on nursing: An e‐panel discussion from the International Network for Child and Family Centred Care

Abstract

Aim

To explore the International Network for Child and Family Centred Care (INCFCC) members' experiences and views on the long-term impact of COVID-19 on the nursing workforce.

Background

On the 11 March 2020, the World Health Organization declared COVID-19 a global pandemic. While some countries adopted a herd immunity approach, others imposed stricter measures to reduce the transmission of the virus. Hospitals in some countries faced an avalanche of extremely sick admissions, whereas others experienced an early surge in cases or were able to control the spread.

Design

Discursive paper.

Methods

A web-based survey was e-mailed to 63 INCFCC members from 28 March to 30 April 2022, as an invitation to share their experience concerning the long-term impact of COVID-19 on their role as a nurse educator, clinician or researcher.

Results

Sixteen members responded, and the responses were grouped under the themes stress and anxiety, safe staffing and pay, doing things differently, impact on research, impact on teaching and learning, impact on clinical practice, nursing made visible and lessons for the future.

Conclusion

The INCFCC members provided their views and highlighted the impact on their role in nursing education, administration, research and/or practice. This discussion of international perspectives on the similarities and differences imposed by COVID-19 found that the impact was wide-ranging and prolonged. The overarching theme revealed the resilience of the participating members in the face of COVID-19.

Relevance to Clinical Practice

This study highlights the importance of all areas of nursing, be it in academia or in clinical practice, to work together to learn from the present and to plan for the future. Future work should focus on supporting organizational and personal resiliency and effective interventions to support the nursing workforce both during a disaster and in the recovery phase. Nursing workforce resilience in the face of COVID-19.

‘All we've ever known is Covid’: A follow‐up study with newly qualified nurses who worked as student nurses during the pandemic

Abstract

Aims and Objectives

To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic.

Background

Experiences of health professionals and student nurses during the pandemic are now well documented, but the transition of students to qualification is less well understood. In Summer 2020, we interviewed 16 student nurses who had worked as health care assistants on paid extended placements as part of the COVID-19 response in the East of England, finding surprisingly positive experiences, including perceived heightened preparedness for qualification. A year later, we re-interviewed 12 participants from the original study to hear about transitioning to qualification during the ongoing pandemic. This study provides novel insights into their experiences.

Design

A qualitative study design was used.

Methods

Twelve newly qualified nurses who had participated in the original study took part in qualitative, online interviews where they shared their experiences of working and transitioning to qualification during the ongoing pandemic since we spoke to them a year earlier. The data was analysed using thematic analysis. COREQ guidelines were used in developing and reporting this study.

Results

Three themes were identified. Constant change: in the clinical environment and arising out of the transition to newly qualified nurse, mental health and well-being and reflecting on the past to learn for the future.

Conclusions

Participants experienced a unique transition to qualification. The perceived heightened preparedness for qualification that participants who had worked as students during the first wave of the pandemic had become a reality, ameliorating some of the known effects of transition. However, increased expectations and added responsibilities in extremely busy, fluctuating clinical environments with minimal support add weight to calls for mandatory preceptorship programmes. While heightened resilience was evident, provision of ongoing mental health and well-being support is strongly recommended.

Relevance to Clinical Practice

We need a partnership approach with nurse educators and practice colleagues which ensures preparation for qualified practice is appropriate. If we do not effectively prepare students for qualified nurse posts, patient care will almost certainly be compromised.

Living in a multicultural context: Health and integration from the perspective of undocumented Mediterranean migrants, residents, and stakeholders in Italy. A qualitative‐multimethod study

Abstract

Aim

To catch a representative view of a multicultural population's needs.

Design

Qualitative study.

Methods

Semi-structured interviews were conducted from July 2022 to January 2023 with the project's stakeholders, migrants, and residents. Data analysis was performed using a multimethod textual analysis technique.

Findings

Territorial barriers, lack of social network, and specific professionals' training emerged as healthcare delivery obstacles. For migrants, language improvement emerged as a health priority. A deep relationship with migrants emerged as a deficiency for residents.

Conclusion

A welcoming project equipped with solid leadership and the right resources can be fundamental in mediating health promotion and integration. In this process, the involvement of the resident population is essential.

Implications for the Profession and/or Patient Care

Analysing the migrants' needs and the strengths and limitations of a reception system could help identify the challenges for professionals in delivering culturally competent care. In this context, the nurse's role becomes relevant, being responsible for taking charge and caring for the population and the link between professionals and the population.

What Problem Did the Study Address?

The study addressed the problem of improving the overall health of migrants, refugees, and asylum seekers, mainly focusing on reception and integration into a new society process.

What Were the Main Findings?

Worse health was identified with adaptation, integration, and family problems. Territorial barriers emerged, hindering good health.

Where and on Whom Will the Research Have An Impact?

These research findings can be valuable for health professionals who want to improve the reception process and enhance a care model integrated with residents.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

To describe the research report, we referred to the COREQ checklist (Tong et al., 2007).

The parent perspective on paediatric delirium and an associated care bundle: A qualitative study

Abstract

Aims

To explore how parents experienced their child with delirium and how parents viewed our delirium management bundle.

Design

We conducted a qualitative exploratory descriptive study using semi-structured individual or dyad interviews.

Methods

Twelve semi-structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis.

Findings

We generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long-term consequences, (4) adding insight to the bundle, and (5) family engagement.

Conclusion

The parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium.

Impact

This paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit.

Reporting Method

The consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting.

Patient or Public Contribution

No patient or public contribution to the research design.

What does this Paper Contribute to the Wider Global Community?

- It increases awareness of the parent's perspective on PD in critically ill children. - It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage. - It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child.

Exploring NICU nurses' views of a novel genetic point‐of‐care test identifying neonates at risk of antibiotic‐induced ototoxicity: A qualitative study

Abstract

Aim

To explore the views of neonatal intensive care nursing staff on the deliverability of a novel genetic point-of-care test detecting a genetic variant associated with antibiotic-induced ototoxicity.

Design

An interpretive, descriptive, qualitative interview study.

Methods

Data were collected using semi-structured interviews undertaken between January and November 2020. Participants were neonatal intensive care nursing staff taking part in the Pharmacogenetics to Avoid Loss of Hearing trial.

Results

Thematic analysis resulted in four themes: perceived clinical utility; the golden hour; point-of-care device; training and support. Recommendations were made to streamline the protocol and ongoing training and support were considered key to incorporating the test into routine care.

Conclusion

Exploring the views of nurses involved in the delivery of the point-of-care test was essential in its implementation. By the study endpoint, all participants could see the value of routine clinical introduction of the point-of care test.

Implications for the Profession and/or Patient Care

Nurses are in a key position to support the delivery of point-of-care genetic testing into mainstream settings. This study has implications for the successful integration of other genetic point-of-care tests in acute healthcare settings.

Impact

The study will help to tailor the training and support required for routine deployment of the genetic point-of-care test. The study has relevance for nurses involved in the development and delivery of genetic point-of-care tests in other acute hospital settings.

Reporting Method

This qualitative study adheres to the Standards for Reporting Qualitative Research EQUATOR guidelines and utilizes COREQ and SRQR checklists.

Patient or Public Contribution

All staff working on the participating neonatal intensive care units were trained to use the genetic point-of-care test. All inpatients on the participating units were eligible to have testing via the point-of-care test. The Pharmacogenetics to Avoid Loss of Hearing Patient and Public Involvement and Engagement group provided valuable feedback.

Trial and Protocol Registration

Registered within the University of Manchester. Ethics approval reference numbers: IRAS: 253102 REC reference: 19/NW/0400. Also registered with the ISRCTN ref: ISRCTN13704894.

Understanding what shapes the priorities of women who are mothering in the context of intimate partner violence: A qualitative study

Abstract

Aim

To explore the priorities of women mothering children in the context of intimate partner violence and to understand what shapes those priorities.

Design

A qualitative study using interpretive description, informed by Feminist Intersectionality adhering to the COREQ guidelines.

Methods

Thematic analysis was used to analyse the data.

Data Sources

Dialogic, semi-structured interviews were conducted with a community sample of 20 adult Canadian women who were mothering dependent children (under 18 years) in the context of recent intimate partner violence from a current or former partner.

Results

Women's main priorities focused on their own and their children's well-being and creating stability related to housing and finances. Three themes identified: it's all about the kids; my safety…totally disregarded; and I have to take care of him. Multiple external factors (coercive control, structural inequities, assumptions about mothering) shape priorities and the tensions arising from competing priorities women felt compelled to address simultaneously.

Conclusion

Priorities of women mothering in the context of intimate partner violence are complex, shaped not only by what they want but by the limited options available to them given constraints such as income, employment, housing and service responses. Coercive control, structural inequities and assumptions about mothering are important factors influencing mothers' priorities and experiences. Better understanding mothers' priorities can support better tailored policies, services and nursing practice.

Implications for Nursing

Structural inequities that negatively impact health and well-being by limiting access to resources and the supports needed to enhance health can be better recognized and addressed through a trauma and violence informed care approach.

Impact

This study addressed understanding the priorities of women mothering in the context of intimate partner violence. This research will impact women mothering in the context of intimate partner violence who receive care from nurses and other providers as well as those who provide care.

Reporting Method

This study adhered to relevant EQUATOR guidelines (the COREQ checklist).

No Patient or Public Contribution

The women who took part in the interviews for this study did not participate in the study design, analysis or manuscript preparation.

Satisfaction with maternity triage following implementation of the Birmingham Symptom‐Specific Obstetric Triage System (BSOTS): Perspectives of women and staff

Abstract

Aim

To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital.

Design

Cross-sectional descriptive survey.

Methods

Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage-related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis.

Results

There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital.

Conclusion

The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system.

Implications for the Profession and/or Patient Care

Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women.

Impact

Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies.

Reporting Method

The reporting of this paper has followed SQUIRE guidelines.

Patient or Public Contribution

Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study.

Factors associated with dietary behaviour change support in patients: A qualitative study among community nurses

Abstract

Aim

To explore which factors, influencing dietary behaviour change support among patients by Dutch community nurses (CNs; nurses), are key focal points in training programmes.

Background

Nurses have an important role in counselling patients towards healthier dietary behaviour to prevent or delay long-term complications from chronic lifestyle-related diseases. Most nurses do not incorporate dietary behaviour change support in their routines to the fullest potential.

Design

A qualitative descriptive study.

Methods

Data were collected in the Netherlands in 2018–2019 via semi-structured face-to-face interviews with 18 nurses. Interview guide themes were informed by the COM-B model, using validated descriptions in Dutch. Data were recorded, transcribed and analysed using inductive thematic analysis.

Results

Factors that affected dietary behaviour change support were linked to (1) the nurse (role identity, dietary knowledge and competences such as methodical approach, behaviour change techniques and communication techniques), (2) nurse–patient encounter (building a relationship with a patient, supporting patient autonomy and tailoring the approach) and (3) cooperation and organizational context.

Conclusion

It is of utmost importance to pay attention to nurses' role identity regarding dietary behaviour change support, as this underlies professional behaviour. This should be accompanied by improving competences on dietary behaviour change support. Focus on competences regarding the application of behaviour change technique is crucial. Furthermore, having a relationship of trust with a patient was important for discussing sensitive topics such as diet.

Impact

The promotion of a healthy diet provides opportunities to contribute to patient autonomy and self-management. Well-fitted training offers for (senior) nurses will lead to improved professional practice of nurses, leading to healthier dietary behaviour of patients.

Patient or Public Contribution

A nurse provided feedback on the interview guide.

Life after paediatric brain tumour; the perspectives of the survivors and their parents

Abstract

Aims

To explore how long-term and late effects of paediatric brain tumours influence the everyday lives of survivors at various ages and their parents.

Design

A qualitative interview study using reflexive thematic analysis.

Methods

We conducted individual interviews and focus groups with 14 paediatric brain tumour survivors aged 9–52 years and 16 parents, which were audiorecorded and transcribed. We inductively analyzed the data using Braun and Clarke's reflexive thematic analysis. Inductively derived themes were then mapped onto the components of the International Classification of Functioning, Disability and Health framework to examine the survivors' everyday functioning.

Results

All survivors experienced ongoing long-term and late effects but with considerable variations in how these restricted the survivors' functioning and thus their ability to participate in everyday life activities (e.g. social, educational and work activities). All survivors expressed an explicit focus on and use of different strategies to manage their perceived functional limitations and participation restrictions. Many survivors expressed discrepancies between their own goals, expectations and actual abilities post-cancer; making them very aware of their limitations. In addition, many survivors and parents experienced ongoing concerns about the survivors’ future, including the risk of late effects, relapse or other complications.

Conclusion

A wide range of long-term and late effects continue to affect the survivors and their parents' functioning and everyday lives. Their ongoing needs emphasize the importance of comprehensive, life-long follow-up care, as recommended.

Implications for the Profession and/or Patient Care

The complex challenges across the biopsychosocial realms faced by the survivors supports the call for multidisciplinary survivorship care. Nurses are well positioned to lead such care, as they are trained to provide holistic care and thereby support survivors' functioning and activity participation in everyday life.

Reporting Method

We used the COREQ guidelines when reporting the study.

Patient or Public Contribution

Two user representatives (one young adult PBT survivor and one mother of a PBT survivor) ensured the relevance and quality of the semi-structured interview guides prior to the interviews with the survivors and parents. The guides were sent to the user representatives by mail, and they provided their written feedback by mail to the first author.

A cross‐sectional study of discipline‐based self‐perceived digital literacy competencies of nursing students

Abstract

Aims

This study offers an empirical exploration of self-assessed digital competencies of students, most of whom studied in nursing courses, using a discipline-based self-assessment survey tool. A range of digital competencies were explored: information and communication technology proficiency and productivity, information literacy, digital creation, digital research, digital communication, digital learning and development, digital innovation, digital identity management and digital well-being.

Design

A cross-sectional empirical study.

Methods

Quantitative data were collected from November to December 2021 via a questionnaire survey administered to students. Quantitative results were reported through descriptive statistical analysis. Mann–Whitney (U-test) and Kruskal–Wallis non-parametric statistical tests were used to identify statistically significant differences based on age demographics and pre- or post-registration course. Thematic analysis was utilized for survey open-ended questions data.

Results

Students reported low competencies in the following digital literacy dimensions, all of which were imperative for their studies and for their future professional careers: information literacy, digital research, digital innovation. Significant statistical subgroup differences were found between age demographics and pre/post-registration within most of the digital competence dimensions. The survey open-ended comments revealed that students encountered challenges around digital skills they had mostly developed via everyday life experiences and trial-and-error approaches.

Conclusion

Increasing awareness of existing digital gaps and offering tailored digital skills enhancement can empower students as future-proof evidence-based practitioners in an evolving digital healthcare landscape.

Implications for the Profession and/or Patient Care

Highlights the importance of embedding digital literacy within nursing study programmes, as preparation for comprehensive patient healthcare.

Impact

Offers insights into digital competencies gaps of nursing students. Proposes targeted educational digital skills training interventions. Stresses the value of academic staff supporting nursing students to develop digital skills in important areas of professional practice.

Reporting Method

JBI critical appraisal checklist.

No patient or public contribution.

The role of nursing care continuity report in predicting length of hospital stay in older people: A retrospective cohort study

Abstract

Background

The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission.

Aim

To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days).

Research Design and Setting

A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR.

Results

A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital-acquired pressure ulcers.

Conclusions

Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital-acquired ulcers at hospital discharge.

Relevance to Clinical Practice

Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation.

No Patient or Public Contribution

No direct patient contact was made during the data collection.

Impact of virtual reality‐based therapy on post‐stroke depression: A systematic review and meta‐analysis of randomized controlled trials

Abstract

Background

Post-stroke depression is the most common neuropsychiatric consequence and reduces rehabilitation effectiveness. However, the efficacy of virtual reality (VR) on mental health treatment for patients after a stroke is uncertain.

Aims

The aim of this study was to evaluate the efficacy of VR as a co-adjuvant form of treatment to reduce depression in stroke patients admitted to neurorehabilitation units.

Methods

We systematically searched medical databases including PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov from inception to November 16, 2023. Clinical trials comparing the use of VR as an adjuvant form of treatment in stroke patients' rehabilitation with the usual treatment were included. Pooled standardized mean differences were calculated using a random-effects model. Subgroup analyses were performed according to type of stroke, VR characteristics, and the scale used to measure depression. Meta-regression analysis was performed for intervention duration and to determine the mean age of the participants.

Results

Eight studies and 388 stroke patients were included. The VR interventions were associated with a lower risk of depression in patients (ES = −0.69; 95% CI [−1.05, −0.33]; I 2 = 57.6%; p ≤ .02). The estimates were not affected by the type of stroke, the type of VR used, the blinding process, the type of scale used to detect depression, the duration of the intervention (weeks and minutes), and the total number of sessions. Meta-regression shows that younger samples (p = .00; 95% CI [0.01, 0.08) and longer interventions (p = < .05; 95% CI [−0.00, −0.00) lead to a greater reduction in depression.

Linking Evidence to Action

This review provides an important basis for treating depression in patients after a stroke. Professionals working in stroke neurorehabilitation units should consider VR as a form of co-adjuvant treatment for depression in patients.

Systematic Review Registration

CRD42022303968.

Recreational‐vehicle‐dwelling American nomads' experiences seeking healthcare: A qualitative field study

Abstract

Aim

To explore the experiences of recreational-vehicle-dwelling American nomads when seeking healthcare in the United States.

Design

This exploratory, qualitative study employed interpretive description design to maintain a disciplinary focus in nursing.

Methods

Twenty-five participants were recruited from campgrounds in eight states. Semi-structured interviews were conducted face-to-face. Thematic analysis was conducted using a phronetic iterative approach.

Results

Three overarching themes described participants' experiences seeking healthcare: overwhelming logistics, don't need healthcare, and orchestrating a web of care.

Conclusion

Recreational-vehicle-dwelling nomads in the United States face additional complexity when accessing healthcare related to seeking care in unfamiliar locations and policies that prevent the portability of healthcare across state lines.

Implications

More research is needed to evaluate solutions to improve healthcare access for recreational-vehicle-dwelling nomads. Nurses and policymakers should consider healthcare practices through the lens of nomads' lifestyle mobility. The impact of policy decisions on people who are geographically mobile should be considered, and barriers to healthcare portability should be addressed.

Impact

This was the first study focused on the healthcare experiences of recreational-vehicle-dwelling nomads in the United States. Nomads face additional complexity and barriers to healthcare access. Some nomads developed strategies to overcome barriers, while others disengaged from healthcare. The findings will impact researchers and nurses who study and care for nomads.

Reporting Method

The SRQR reporting guidelines were followed.

Patient or Public Contribution

Recreational-vehicle-dwelling nomads reviewed the recruitment flyer and interview guide and provided input on recruitment methods and sites.

An examination of retracted articles in nursing literature

Abstract

Introduction

The output of scholarly publications in scientific literature has increased exponentially in recent years. This increase in literature has been accompanied by an increase in retractions. Although some of these may be attributed to publishing errors, many are the result of unsavory research practices. The purposes of this study were to identify the number of retracted articles in nursing and reasons for the retractions, analyze the retraction notices, and determine the length of time for an article in nursing to be retracted.

Design

This was an exploratory study.

Methods

A search of PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, and Retraction Watch databases was conducted to identify retracted articles in nursing and their retraction notices.

Results

Between 1997 and 2022, 123 articles published in the nursing literature were retracted. Ten different reasons for retraction were used to categorize these articles with one-third of the retractions (n = 37, 30.1%) not specifying a reason. Sixty-eight percent (n = 77) were retracted because of an actual or a potential ethical concern: duplicate publication, data issues, plagiarism, authorship issues, and copyright.

Conclusion

Nurses rely on nursing-specific scholarly literature as evidence for clinical decisions. The findings demonstrated that retractions are increasing within published nursing literature. In addition, it was evident that retraction notices do not prevent previously published work from being cited. This study addressed a gap in knowledge about article retractions specific to nursing.

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