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AnteayerJournal of Clinical Nursing

Psychometric properties of parental stress scales used in paediatric health care settings: A systematic review

Abstract

Aim

To identify scales that assess parental stress in the paediatric clinical population and to analyse their psychometric properties.

Methods

Four electronic databases (PubMed, Web of Science, PsycINFO, and Scopus) and metasearch engines (Google Scholar and Open Grey) were searched with no time period limitations. Methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach modified by COSMIN. Finally, recommendations were made for the instruments with the highest quality of evidence.

Results

A total of 38 studies reporting on 11 different instruments for assessing parental stress in the paediatric clinical setting were included. Six instruments were ‘A’ rated (recommended) in the final phase in line with COSMIN guidelines. The Paediatric Inventory for Parents was the instrument that evaluated the highest number of psychometric properties and obtained the highest methodological quality, global assessment, and quality of evidence for the different psychometric properties.

Conclusions

This systematic review provides an overview of the measurement properties of the parental stress instruments used in the paediatric clinical setting. The Paediatric Inventory for Parents stands out as being one of the most robust instruments for measuring stress in parents with a hospitalised or sick child. Evidence needs to be generated for all the parental stress scales used in the clinical setting.

Impact

Given that the psychometric properties of the existing parental stress scales used in paediatric health care settings have not been systematically assessed, the present review utilised comprehensive methods according to COSMIN.

No Patient or Public Contribution

Reporting method

PRISMA statement and COSMIN reporting guidelines for studies on measurement properties of patient-reported outcome measures.

Parents' and nurses' perceptions and behaviours of family‐centred care during periods of busyness

Abstract

Purpose

Busyness as a construct within modern healthcare is complex and multidimensional. To date, few studies have sought to explore how busyness influences family-centred care. This study explored the influence of busyness on the delivery of family-centred care for nurses and parents.

Design and Method

Ethnography was selected as the research design. The study site was a metropolitan tertiary hospital inpatient paediatric unit in Sydney, Australia. Semi-structured interview and non-participant observation techniques were used for data collection. Ten paediatric nurses and 10 parents were interviewed and 40 h of non-participant observations were undertaken. The COREQ was used to report the study.

Results

The findings are presented as three key themes: (i) ‘Supporting family-centred care’ in which participants detail beliefs about the nurse-parent relationships and how despite busyness nurses sought out moments to engage with parents; (ii) ‘Being present at the bedside’ identified the challenges in optimising safety and how parents adapted their way of being and interacting on the unit; and (iii) ‘The emotional cost of busyness’ and how this influenced nurse-parent interactions, care delivery and family-centred care.

Conclusions

The ethnography has given shape to social understandings of busyness, the complexities of paediatric nursing and family-centred care. The culture of care changed in moments of busyness and transformed parent and nursing roles, expectations and collaborative care that at time generated internal emotional conflict and tension.

Practice implications

Given the increasing work demands across health systems, new agile ways of working need to ensure maintenance of a family-centred approach. Strategies need to be developed during periods of busyness to better support collaborative connections and the well-being of paediatric nurses and parents. At an organisational level, fostering a positive workplace culture that shares a vision for family-centred care and collaboration is essential.

Patient or Public Contribution

Parents of sick children admitted to an acute paediatric inpatient ward were invited to be a participant in a single interview. Parents were aware of the study through ward advertisement and informal discussions with the researchers or senior clinical staff. Engagement with parents was important as healthcare delivery in paediatrics is focused on the delivery of family-centred care. To minimise the risk of child distress and separation anxiety, children were present during the parent interview. Whist children and young people voices were not silenced during the interview process, for this study the parent's voice remained the focus. While important, due to limited resources, parents were not involved in the design analysis or interpretation of the data or in the preparation of this manuscript.

Data sharing

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Sleep deprivation and medication administration errors in registered nurses—A scoping review

Abstract

Aim

To explore whether sleep deprivation contributes to medication errors in registered nurses (RNs).

Background

Sleep deprivation is a potential issue for RNs, particularly those who work shifts. Sleep deprivation has been found to have a negative impact on numerous cognitive processes. Nurses administer several medications to patients a day, potentially while sleep deprived—anecdotal reports suggest that this could result in an increased risk of error occurring.

Design

A scoping review was conducted using the Prisma-ScR extension framework to explore what is known about the effect of RNs' sleep deprivation on medication administration errors.

Methods

A search of databases generated 171 results. When inclusion and exclusion criteria were applied, 18 empirical studies were analysed. Studies included retrospective analysis of errors, surveys of perceptions of causes and observational studies.

Results

Data indicated that RNs consider fatigue, which may be caused by sleep deprivation, to be a contributing factor to medication errors. The search only identified three observer studies, which provided conflicting results as to whether lack of sleep contributes to the error rate. Of the numerous tools used to measure sleep, the Pittsburgh Sleep Quality Index was the most frequently used.

Conclusion

Although RNs anecdotally consider a lack of sleep potentially contributes to medication errors, there is insufficient research to provide robust evidence to confirm this assumption.

No Patient or Public Contributions

Patient or public contributions were not required for this scoping review.

Relevance to Clinical Practice

Sleep deprivation is a potential issue for nurses, especially those who work shifts. Poor sleep impacts cognitive processes that potentially could increase errors. Nurses should be aware of the impact sleep may have on patient safety.

Factors related to motivation, organisational climate and work engagement within the practice environment of nurse practitioners in the Netherlands

Abstract

Aim

To explore motivation, organisational climate, work engagement and related factors within the practice environment of nurse practitioners.

Background

Motivation in the workplace, organisational climate and work engagement are important to motivate nurse practitioners and prevent early exit. However, little is known about related factors.

Design

A cross-sectional design using a digital survey with multiple-choice and open-ended questions. Data were collected from 1 November 2019 to 30 March 2020.

Methods

The survey contained demographic and job-related data, instruments on motivation in the workplace, organisational climate and work engagement. Three open-ended questions were added to invite respondents to tell about their next career step, (dis)satisfaction with salary and additional comments. Quantitative data were not normally distributed (Kolmogorov–Smirnov test). Kruskal Wallis tests and Mann–Whitney U tests were used to test the relationship between independent and dependent variables. Answers on the open-ended questions were coded and categorised in themes. The STROBE checklist was followed.

Results

In total 586 questionnaires were completed. The majority of the respondents were female (85%), and their mean age was 47 years (range 26–66 years). Aged 45 or over, more work experience, working in nursing homes, experiencing more autonomy, collaboration with other nurse practitioners, a firmly anchored position, satisfaction with salary and developmental opportunities contributed positively to the practice environment. Answers on the open-ended questions supported the quantitative results.

Conclusions

Work motivation, organisational climate and work engagement are positively related to a large variety of personal and work-related factors. Therefore, policymakers and professional organisations should be aware of the impact of these influencing factors to enhance an inspiring work environment.

Relevance to Clinical Practice

Awareness of factors that influence nurse practitioners' practice environment can be used as a tool to screen and improve the present work environment.

Needs, barriers and facilitators for a healthier lifestyle in haemodialysis patients: The GoodRENal project

Abstract

Background

Malnutrition, sedentary lifestyle, cognitive dysfunction and poor psychological well-being are often reported in patients on haemodialysis (HD).

Aims

We aimed to explore needs, barriers and facilitators—as perceived by patients, their carers, and healthcare professionals (HCPs) for increasing the adherence to the diet, to physical activity and cognition and psychological well-being.

Methods

This is an observational cross-sectional study following the STROBE statement. This study is part of an ERASMUS+ project, GoodRENal—aiming to develop digital tools as an educational approach to patients on HD. For that, the GoodRENal comprises HD centers located in four Belgium, Greece, Spain and Sweden. Exploratory questionnaires were developed regarding the perceived needs, barriers and facilitators regarding the diet, physical activity, cognition and psychological well-being from the perspective of patients, their carers and HCPs.

Results

In total, 38 patients, 34 carers and 38 HCPs were included. Nutrition: For patients and carers, the main needs to adhere to the diet included learning more about nutrients and minerals. For patients, the main barrier was not being able to eat what they like. Physical activity: As needs it was reported information about type of appropriate physical activity, while fatigue was listed as the main barrier. For Cognitive and emotional state, it was perceived as positive for patients and carers perception but not for HCPs. The HCPs identified as needs working as a team, having access to specialised HCP and being able to talk to patients in private.

Conclusions

Patients and their carers listed as needs guidance regarding nutrition and physical activity but were positive with their cognitive and emotional state. The HCPs corroborated these needs and emphasised the importance of teamwork and expert support.

Association between health literacy and nursing care in hospital: A retrospective study

Abstract

Aims

To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks.

Design

Retrospective study.

Methods

The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single-Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs.

Results

Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care.

Conclusions

The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes.

Implications for the profession and/or patient care

HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge.

Patient or Public Contribution

No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection.

Flow of information contributing to medication incidents in home care—An analysis considering incident reporters' perspectives

Abstract

Aim

To describe the contributing factors and types of reported medication incidents in home care related to the flow of information in different phases of the medication process, as reported by multi-professional healthcare groups.

Design

This descriptive, qualitative study used retrospective data.

Methods

An incident-reporting database was used to collect 14,289 incident reports from 2017 to 2019 in a city in Finland. We used this data to select medication incidents (n = 1027) related to the flow of information in home care and between home care and hospitals. Data were divided into five groups based on the medication phase: (1) prescribing, (2) dispensing, (3) administration, (4) documentation and (5) self-administration. In addition, the types of medication-related incidents were described. The data were examined using abductive content analysis. The EQUATOR SRQR checklist was used in this report.

Results

Four main categories were identified from the data: (1) issues related to information management, (2) cooperation issues between different actors, (3) work environment and lack of resources and (4) factors related to healthcare workers. Cooperation issues contributed to medication-related incidents during each phase. Incomplete communication was a contributing factor to medication incidents. This occurred between home care, remote care, hospital, the client and the client's relatives. Specifically, a lack of information-sharing occurred in repatriation situations, where care transitioned between different healthcare professionals.

Conclusion

Healthcare professionals, organisations, clients and their relatives should focus on the efficient and safe acquisition of medications. Specifically, the use of electronic communication systems, together with oral reports and checklists for discharge situations, and timely cooperation with pharmacists should be developed to manage information flows.

Relevance to Clinical Practice

These findings demonstrate that healthcare professionals require uniform models and strategies to accurately and safely prescribe, dispense and administer medications in home care settings.

No patient or public contributions.

Needs assessment in patients with inflammatory bowel disease in the encounter and communication with healthcare professionals: A fieldwork study

Abstract

Aim

To explore how patients with Inflammatory bowel disease experienced encounters with healthcare professionals in two gastrointestinal outpatient clinics to demonstrate what matters in the communication between patients and healthcare professionals.

Design

This fieldwork study is part of a larger study developing an application for patients with inflammatory bowel disease in a framework inspired by Participatory Design. Participatory design consists of three phases and this study focused on the first phase, needs assessment. A phenomenological hermeneutic approach and qualitative methods were applied to obtain an understanding of patients' needs.

Methods

Three weeks of participant observations and three focus groups with 14 subjects were conducted at two university hospitals in Denmark. Field notes and interview transcripts were analysed using condensation of meaning and interpreted based on interactional nursing practice theory. The reporting method adhered to the EQUATOR guideline: COREQ.

Results

Four themes emerged: Easy and dependable access to healthcare professionals. Predictability of follow-up appointments. Importance of privacy during patient exams and Quality of time spent with healthcare professionals.

Conclusion

Easy, dependable access, privacy, presence and predictability of follow-up appointments were important to patients with Inflammatory Bowel Disease.

Implications for the profession and patient care

In communication with patients with inflammatory bowel disease, healthcare professionals must be aware of privacy and the importance of predictable follow-up agreements. They must be aware that presence and easy, reliable access positively affect patients' self-care skills.

Patient contribution

This study is part of a larger project based on Participatory design involving patients and healthcare professionals in the development of technology to support communication.

The global prevalence of overweight and obesity among nurses: A systematic review and meta‐analyses

Abstract

Background

Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.

Objective

To investigate the global prevalence of overweight and obesity among nurses.

Design

Systematic review with meta-analysis.

Setting

29 different countries across the WHO-classified geographical region.

Participants

Nurses.

Methods

Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I 2 statistic.

Results

Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%–33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%–19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.

Conclusions

This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.

Patient or Public Contribution

Not applicable as this is a systematic review.

Registration

PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.

Tweetable Abstract

High prevalence of overweight and obesity among nurses worldwide.

Should oral care be about more than a gut feeling? A qualitative study investigating patients' and healthcare professionals' experiences

Abstract

Aim

To explore patients' and healthcare professionals' (HCPs) experiences of oral care during hospitalisation to identify needs and challenges.

Background

Daily oral care is important to patients' health and well-being, to prevent diseases in the oral cavity, systemic infections and increased morbidity, which subsequently can lead to prolonged hospitalisation and, at worst, increased mortality. Despite this knowledge, oral care is a neglected part of nursing practice. Studies do not clearly identify barriers regarding oral care, as the existing knowledge is inadequate.

Design

A qualitative study exploring participants' experiences to gain new in-depth knowledge of oral care among hospitalised patients.

Methods

A phenomenological-hermeneutic approach was applied. Participant observations were conducted on five hospital wards, combined with individual semi-structured interviews with 16 patients and 15 HCP. Data analysis was based on Ricoeur's theory of narrative and interpretation.

Results

Four themes describing the challenges regarding oral care emerged: Oral care as a gut feeling; oral care fades into the background; even self-reliant patients need help with oral care; and the mouth reflects the life lived.

Conclusions

The identified challenges show there is a need for improvement in the health professional approach to oral care in nursing practice. Focus on increasing HCPs' knowledge, skills and competences can increase their nursing agency and support patients' self-care capacity.

Impact

Investigation of oral care during hospitalisation revealed four main challenges concerning both patients' and HCPs' lack of knowledge and awareness of oral care. Thus, patients and HCPs should be included in developing solutions to improve oral care in nursing practice.

Reporting methods

The COREQ criteria for reporting qualitative research were adhered to.

Patient contribution

A patient representative was involved in the discussion of the proposal, conduct and results of the study.

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders

Abstract

Aims and objectives

To explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting.

Background

Understanding collaborative practice in diabetes care in developing countries helps to design and provide patient-centred and cost-effective care.

Design

An exploratory qualitative study.

Methods

Interviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration.

Results

Most participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking.

Conclusions

Perceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies.

Relevance to Clinical Practice

The findings in this study inform development of tailored and patient-centred diabetes care in tertiary care settings in sub-Saharan Africa.

Reporting Method

The study was reported in accordance with the COREQ checklist.

Patient or Public Contribution

Patients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback.

Critical care nursing workforce in crisis: A discussion paper examining contributing factors, the impact of the COVID‐19 pandemic and potential solutions

Abstract

Aims and Objectives

The critical care nursing workforce is in crisis, with one-third of critical care nurses worldwide intending to leave their roles. This paper aimed to examine the problem from a wellbeing perspective, offering implications for research, and potential solutions for organisations.

Design

Discursive/Position paper.

Method

The discussion is based on the nursing and wellbeing literature. It is guided by the authors' collaborative expertise as both clinicians and researchers. Data were drawn from nursing and wellbeing peer-reviewed literature, such as reviews and empirical studies, national surveys and government and thinktank publications/reports.

Results

Critical care nurses have been disproportionately affected by the COVID-19 pandemic with studies consistently showing critical care nurses to have the worst psychological outcomes on wellbeing measures, including depression, burnout and post-traumatic stress disorder (PTSD). These findings are not only concerning for the mental wellbeing of critical care nurses, they also raise significant issues for healthcare systems/organisations: poor wellbeing, increased burnout and PTSD are directly linked with critical care nurses intending to leave the profession. Thus, the wellbeing of critical care nurses must urgently be supported. Resilience has been identified as a protective mechanism against the development of PTSD and burnout, thus offering evidence-based interventions that address resilience and turnover have much to offer in tackling the workforce crisis. However, turnover data must be collected by studies evaluating resilience interventions, to further support their evidence base. Organisations cannot solely rely on the efficacy of these interventions to address their workforce crisis but must concomitantly engage in organisational change.

Conclusions

We conclude that critical care nurses are in urgent need of preventative, evidence-based wellbeing interventions, and make suggestions for research and practice.

The paradoxical position of nurses regarding euthanasia and its legalisation: A descriptive quantitative study

Abstract

Aims and Objectives

To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation.

Background

Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process.

Design

Observational descriptive study.

Methods

A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used.

Results

The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories ‘Ethical considerations’, ‘Practical considerations’ and ‘Treasuring life’. On the other hand, there was a significant positive correlation between age and work experience and ‘Spiritual beliefs’ category.

Conclusions

The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application.

Relevance to Clinical Practice

It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession.

Patient or Public Contribution

No patient or public contribution.

Emotional, mental health and physical symptom experience of patients hospitalized with COVID‐19 up to 3 months post‐hospitalization: A longitudinal study

Abstract

Aims and objectives

To explore emotional, mental health and physical symptoms up to 3 months after discharge for adults hospitalized with COVID-19.

Background

10%–30% of adults with COVID-19 experience physical and psychological symptoms 3 months or more following infection. Knowing symptoms can help direct early intervention.

Design

A longitudinal descriptive design to study COVID-related symptoms 2 weeks, 6 weeks and 3 months after hospitalization.

Methods

Sixty-six patients were recruited from a hospital system in Midwestern US (October 2020–May 2021). Participants self-reported demographics, hospital and post discharge symptoms, PROMIS measures (depression, anxiety, fatigue, cognitive function, satisfaction social roles, sleep disturbance) and Impact of Event Scale-Revised (IES-R). Hospital length of stay, comorbidities, lowest oxygen saturation, respiratory support and resources used were collected. Descriptive and nonparametric statistics described the sample and identified correlations between variables. The STROBE checklist was used.

Results

Data from 1 (T1) and 3 months (T2) post discharge were analysed (N = 52). A majority were female, white and married; 96% experienced ≥1 COVID-related symptoms at T1; 85% at T2. Fatigue was most prevalent, followed by shortness of breath, muscle weakness and foggy thinking. More physical symptoms during hospitalization correlated positively with number of symptoms at T1 and T2; a majority stated these impacted their normal routine ‘somewhat’ or ‘a lot’. T1 depression highly correlated with all T2 PROMIS and IES-R scores and number of physical symptoms. More symptoms at T1 were associated with worse fatigue, lower cognitive function and lower satisfaction with social roles at T2.

Conclusion

This study adds to the growing knowledge of mental, physical and emotional symptoms and relationships between these early after hospitalization with COVID-19.

Relevance to clinical practice

Findings can help identify holistic nursing interventions to improve health and mitigate symptoms for people with long COVID.

Patient or public contribution

Patients contributed via study participation.

Patient safety culture predictors and outcomes for sustainable oncology nursing practice: A cross‐sectional correlational study

Abstract

Aims and Objectives

To examine the predictors and outcomes of patient safety culture (PSC) among oncology nurses working in public Saudi hospitals according to participant characteristics and evaluate the relationship between PSC domains.

Background

PSC is crucial in healthcare systems, particularly in oncology and chemotherapy units, and its assessment can enhance the standard service provided and cancer care quality. There is currently limited research on the status, predictors and outcomes of PSC in cancer care settings in developing countries, including Saudi Arabia.

Design

A cross-sectional correlational study.

Methods

A convenience sample of 101 oncology nurses working in two large Saudi tertiary care hospitals participated in this study. The Hospital Survey on Patient Safety Culture validated instrument and demographic and work surveys were completed by the participants. The study methods were compliant with the STROBE checklist. Descriptive statistics and multiple linear regressions were used to analyse the data.

Results

The areas of PSC strength were related to organizational learning–constant improvement, feedback and communication about errors, and transitions and handoffs. Manager/supervisor actions and expectations, hospital management support, communication openness, experience in the current unit and oncology unit/area were the predictors of PSC. In terms of PSC outcomes, the oncology nurses reported either no or one to two adverse events and a substantially good patient safety rating.

Conclusion

The level of PSC was lower than expected. Communication openness, experience in the current unit and oncology unit/area were the strongest predictors of PSC. Investing in oncology nursing practice that addresses these concerns and prioritizes patient safety is critical in Saudi cancer care settings to increase patient safety.

Relevance to clinical practice

The findings contribute to a better understanding of the predictors and outcomes of PSC, which should be considered when establishing effective nursing interventions or strategies for PSC in cancer care settings.

Patient or Public Contribution

No patient or public contribution.

Nurse‐led models of care for metabolic syndrome in primary care: A scoping review

Abstract

Aim

To identify and map out existing nurse-led models of care for treatment and prevention of metabolic syndrome in primary care settings.

Design

A scoping review.

Methods

Conducted in accordance with the JBI methodology.

Data Sources

A search of the databases PubMed, CINAHL Complete, Cochrane Library, Scopus, handsearch and a grey literature search was conducted in June 2022 and updated in March 2023.

Results

Title and abstract screening was performed on 926 articles resulting in 40 articles for full text screening. Full text screening yielded seven articles that met inclusion criteria.

Conclusion

Additional research is needed on nursing models of care to prevent and treat metabolic syndrome. Future studies should concentrate on rigour with clearly defined objective inclusion criteria.

Implications to Clinical Practice

This review contributes a synthesis of the evidence on nurse-led models for metabolic syndrome in primary care.

Impact

This scoping review addresses metabolic syndrome, the precursor to non-communicable disease. The review mapped the evidence for nurse-led models of care for metabolic syndrome in the primary care setting. These findings promote the development and evaluation of novel nurse-led models of care which can mitigate the effect of the current epidemic.

Reporting Method

PRISMA checklist for scoping reviews.

No patient or public contribution was part of this study.

Protocol Registration: Open Science Framework accessible at: https://osf.io/jfpw7/.

Cut‐off scores of the Depression Anxiety Stress Scale‐8: Implications for improving the management of chronic pain

Abstract

Aim

Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.

Design

This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years).

Methods

Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.

Results

Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.

Conclusion

CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.

Implications for patient care

At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.

Factors associated with risk of falling among younger inpatients in a mental health setting—A systematic review

Abstract

Aim

To synthesise evidence related to risk factors of falls among younger mental health inpatients age ≤65 years old.

Background

Hospitalised patients with mental illness are at increased risk of falling. Specific risk factors for falls for younger inpatients are poorly understood.

Design

Systematic review.

Methods

Medline, CINAHL, APA PsycINFO, Scopus and Web of Science were searched for studies published in English till December 2022. The review followed the 2020 PRISMA checklist. Odds ratios and P values of significant risk fall factors and the frequency of factors related to circumstances of falls were extracted.

Results

Nine studies were included and 95 risk factors, across seven categories were extracted. These categories included socio-demographic, fall-related factors, functional status, health and mental status, psychiatric diagnosis and assessment, medication, and staff related factors. Factors related to medication, health and mental status are most reported. Majority of the patients sustained minor or no injury from the fall and circumstances of fall vary across studies.

Conclusion

Factors strongly associated with risk of falls were dizziness, use of psychotropics and antihypertensive drugs. A meta-analysis of risk factors was not possible due to different dependent variables studied, controlled confounding variables and control groups used.

Relevance to clinical practice

Fall prevention is relevant to all patients in mental health settings. Approaches to fall risk assessment and management need to be better tailored to younger mental health patients in the psychiatric setting.

Patient and public contribution

Patient or public contribution was not possible because of the study design.

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