To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient-provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections.
Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient-provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear.
A cross-sectional, correlational study.
The STROBE guidelines for cross-sectional studies were followed. Participants included Hebrew-speaking participants who were members of two Facebook groups: ‘Shades of Purple’ and ‘Fibromyalgia- Get to Know!’ Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire-9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient-provider communication, and used the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations between the variables were explored using Pearson's correlations and path analyses.
The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)—low, 33.3% (N = 47)—medium and 13.5% (N = 19)—high. Depression positively correlated with stigma. Stigma negatively correlated with patient-provider communication. Patient-provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient-provider communication was found.
Perceived stigma and patient-provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia.
Addressing stigma related to fibromyalgia and effective patient-provider communication can positively influence treatment adherence.
No patient or public contribution.
To explore patients' experiences of shared decision-making, in nursing care during their stay in a healthcare institution.
This study employed a qualitative descriptive design.
Twenty participants were interviewed from two rehabilitation centres, a nephrology ward of a hospital, and a rehabilitation ward of a long-term care facility. A constant comparative method was used for the inductive analysis.
The main theme was ‘feeling seen and understood’, in the context of person-centred care, which served as the unifying thread across five themes. The five themes included the importance of a positive nurse–patient relationship as a foundation for shared decision-making. Next, patients experienced collaboration, and this was influenced by verbal and non-verbal communication. Another theme was that patients often felt overwhelmed during their stay, affecting shared decision-making. The fourth theme was that many decisions were not made through the shared decision-making process but were still perceived as satisfactory. The final theme highlighted patients' perspectives on their role in decision-making and influencing factors.
Patients describe how feeling seen and understood is a prerequisite for shared decision-making as a part of person-centred care. For nurses, this implies that they should focus on aspects such as building a good relationship and acknowledgement of patients' feelings and circumstances, next to empowering patients to feel knowledgeable and valued. This way patient's motivation to participate in shared decision-making will be enhanced.
Following the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ).
Patients were involved in the study through interviews during the research process and member checks during analysis.
Before initiating shared decision-making processes, prioritise making the patient feel seen and understood. Be mindful that patients often feel overwhelmed during their stay. Use a person-centred approach to make patients feel knowledgeable—this empowers them for shared decision-making.
Research on patients' experiences of shared decision-making in nursing care is limited, yet crucial for understanding patients' needs in shared decision-making. This study highlights patients' perceptions that shared decision-making is best facilitated within the nurse–patient relationship by nurses who primarily focus on ensuring that patients feel acknowledged and understood.
To gather and understand the experience of hospital mealtimes from the perspectives of those receiving and delivering mealtime care (older inpatients, caregivers and staff) using photovoice methods to identify touchpoints and themes to inform the co-design of new mealtime interventions.
This study was undertaken on acute care wards within a single metropolitan hospital in Brisbane, Australia in 2019. Photovoice methods involved a researcher accompanying 21 participants (10 older patients, 5 caregivers, 4 nurses and 2 food service officers) during a mealtime and documenting meaningful elements using photographs and field notes. Photo-elicitation interviews were then undertaken with participants to gain insight into their experience. Data were analysed using inductive thematic analysis, involving a multidisciplinary research team including a consumer.
Themes were identified across the three touchpoints: (1) preparing for the meal (the juggle, the anticipation), (2) delivering/receiving the meal (the rush, the clutter and the wait) and (3) experiencing the meal (the ideal, pulled away and acceptance). Despite a shared understanding of the importance of meals and shared vision of ‘the ideal’ mealtime, generally this was a time of tension, missed cares and dissatisfaction for staff, patients and caregivers. There was stark contrast in some aspects of mealtime experience, with simultaneous experiences of ‘the rush’ (staff) and ‘the wait’ (patients and caregivers). There was an overwhelming sense of acceptance and lack of control over change from all.
This study identified themes during hospital mealtimes which have largely gone unaddressed in the design of mealtime interventions to date. This research may provide a framework to inform the future co-design of mealtime interventions involving patients, caregivers and multidisciplinary staff, centred around these key touchpoints.
Mealtimes are experienced differently by patients, caregivers, nurses and food service officers across three key touchpoints: preparing for, delivering/receiving and experiencing the meal. Improving mealtime experiences therefore necessitates a collaborative approach, with co-designed mealtime improvement programs that include specific interventions focusing each touchpoint. Our data suggest that improvements could focus on reducing clutter, clarifying mealtime roles and workflows and supporting caregiver involvement.
Mealtimes are the central mechanism to meet patients' nutritional needs in hospital; however, research consistently shows that many patients do not eat enough to meet their nutritional requirements and that they often do not receive the mealtime assistance they require. Interventions to improve hospital mealtimes have, at best, shown only modest improvements in nutritional intake and mealtime care practices. Gaining deeper insight into the mealtime experience from multiple perspectives may identify new opportunities for improvement.
Patients, caregivers and staff have shared ideals of comfort, autonomy and conviviality at mealtimes, but challenges of complex teamwork and re-prioritisation of mealtimes in the face of prevailing power hierarchies make it difficult to achieve this ideal. There are three discrete touchpoints (preparing for, delivering/receiving and experiencing the meal) that require different approaches to improvement. Our data suggests a need to focus improvement on reducing clutter, clarifying mealtime roles and workflows and supporting caregivers.
The research provides a framework for multidisciplinary teams to begin co-designing improvements to mealtime care to benefit patients, caregivers and staff, while also providing a method for researchers to understand other complex care situations in hospital.
This manuscript is written in adherence with the Standards for Reporting Qualitative Research.
Patients and caregivers were involved in the conception and design of the study through their membership of the hospital mealtime reference group. A consumer researcher (GP) was involved in the team to advise on study conduct (i.e. recruitment methods and information), data analysis (i.e. coding transcripts), data interpretation (i.e. review and refinement of themes) and manuscript writing (i.e. review and approval of final manuscript).
To explore the rate of NUPs and associated factors in the PED of the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain) using Andersen's Behavioural Model.
We conducted a descriptive cross-sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the ‘Hospital Universitario y Politécnico La Fe’ in Valencia (Spain).
The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first-time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031).
The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs.
Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well-being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high-quality PC services. Providing support to parents during the transition to parenthood would also be beneficial.
This paper adheres to the STROBE initiative guidelines.
Participants, who voluntarily agreed to take part, contributed to the study by completing a paper-based questionnaire containing all the study variables as prepared by the research team.
To explore the meaning ascribed to the concept of compassion by healthcare professionals.
Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear.
A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines.
Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed.
Seventeen papers met the inclusion criteria. An overarching theme, ‘It's very values driven’ underpins the four main themes identified: (1) ‘It's about people and working with them’: Compassion as being human, (2) ‘There is this feeling’: Compassion as being present, (3) ‘If I don't understand them, I won't be able to help’: Compassion as understanding, (4) ‘Wanting to help in some way’: Compassion as action.
Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice.
To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers.
Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice.
This systematic review had no patient or public contribution.
This study aimed to examine (a) changes in coping strategies and vicarious post-traumatic growth (VPTG) across three timepoints of the COVID-19 pandemic among nurses; (b) discrete groups of nurses with unique coping profiles and (c) the association of these coping profiles with VPTG across the timepoints.
Although literature abounds with the negative mental health consequences of the pandemic among healthcare professionals, much less is known about the positive consequences on nurses, the coping strategies that they use, and how these change over time.
This was a cross-sectional web-based survey at three timepoints during the pandemic.
A sample of 429 nurses completed online the Post-Traumatic Growth Inventory (PTGI) and the Brief Coping Orientation to Problems Experienced Inventory (COPE) to measure vicarious post-traumatic growth (VPTG) and coping strategies, respectively. The STROBE checklist was used to report the present study.
Significantly higher VPTG scores were observed during the third timepoint. Different coping strategies were employed across the three timepoints. Nurses responded to the pandemic either with an active, an avoidant or a passive coping profile. Significantly higher VPTG levels were reported by the nurses of the active profile compared to those of the passive profile, whereas the difference between active and avoidant profiles was not significant.
Notwithstanding the preponderance of the nurses with the active coping profile in achieving high VPTG, the avoidant copers had more gains (VPTG) than the passive copers, suggesting that doing something to cope with the stressor—let it be trying to avoid it—was better than doing nothing.
The identification of distinct coping profiles among nurses and their association with VPTG is of particular use to policymakers and practitioners in developing tailored prevention and intervention efforts to help the nurses effectively manage the demands of the pandemic.
No patient or public contribution since the study was exclusively conducted by the authors.
In this study, we aimed to characterize the impact of long COVID on quality of life and approaches to symptom management among Black American adults.
As a novel condition, qualitative evidence concerning long COVID symptoms and their impact on quality of life can inform the refinement of diagnostic criteria and care plans. However, the underrepresentation of Black Americans in long COVID research is a barrier to achieving equitable care for all long COVID patients.
We employed an interpretive description study design.
We recruited a convenience sample of 15 Black American adults with long COVID. We analysed the anonymized transcripts from race-concordant, semi-structured interviews using an inductive, thematic analysis approach. We followed the SRQR reporting guidelines.
We identified four themes: (1) The impact of long COVID symptoms on personal identity and pre-existing conditions; (2) Self-management strategies for long COVID symptoms; (3) Social determinants of health and symptom management; and (4) Effects on interpersonal relationships.
Findings demonstrate the comprehensive ramifications of long COVID on the lives of Black American adults. Results also articulate how pre-existing conditions, social risk factors, distrust due to systemic racism, and the nature of interpersonal relationships can complicate symptom management.
Care approaches that support access to and implementation of integrative therapies may be best suited to meet the needs of long COVID patients. Clinicians should also prioritize eliminating patient exposure to discrimination, implicit bias, and microaggressions. This is of particular concern for long COVID patients who have symptoms that are difficult to objectively quantify, such as pain and fatigue.
While patient perspectives and experiences were the focus of this study, patients were not involved with the design or conduct of the study, data analysis or interpretation, or writing the manuscript.
To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign.
The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential.
A repeated cross-sectional design was carried out with a time-lapse of 12 months.
A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies.
The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = − .16, p = .001; r = − .22, p ≤ .001).
Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care.
The nurses collaborated by participating in the present study anonymously and disinterestedly.
To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.
Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.
A longitudinal cohort study.
In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.
HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)).
A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.
Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients’ HRQoL from being impaired at 6–7 months after their reported recovery.
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.
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.
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.
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.
The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout.
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.
To present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients.
A systematic review and meta-analysis.
This study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources.
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.
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%).
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.
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.
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.
This systematic review adhered to the PRISMA reporting guideline.
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.
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.
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.
A cross-sectional survey design using the STROBE checklist.
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.
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.
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.
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.
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.
To describe how family members of critically ill patients experienced the COVID-19 visiting restrictions in Sweden.
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.
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.
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.
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.
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.
None in the conceptualisation or design of the study.
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.
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.
Discursive paper.
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.
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.
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.
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.
To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic.
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.
A qualitative study design was used.
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.
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.
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.
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.
To explore the priorities of women mothering children in the context of intimate partner violence and to understand what shapes those priorities.
A qualitative study using interpretive description, informed by Feminist Intersectionality adhering to the COREQ guidelines.
Thematic analysis was used to analyse the data.
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.
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.
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.
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.
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.
This study adhered to relevant EQUATOR guidelines (the COREQ checklist).
The women who took part in the interviews for this study did not participate in the study design, analysis or manuscript preparation.
The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission.
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).
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.
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.
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.
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 direct patient contact was made during the data collection.
To investigate fundamental care delivery regarding oral care in a surgical context, and to compare patients' self-reported oral health with registered nurse assessments.
A descriptive and comparative study, with a consecutive selection.
A patient oral health rating tool, including questions about performed oral care, was distributed to patients (n = 50), at four surgical wards in Sweden. The response rate was 72%. Oral health status was assessed by a registered nurse using the Revised Oral Assessment Guide (ROAG), and a comparison between patient and registered nurse assessment was performed by calculating Cohen's kappa coefficient and percentage agreement.
Patients (38%) reported severe oral symptoms, mostly dry lips and not an adequate amount of saliva, and 80% were not offered help with oral care. ROAG assessments revealed that 74% had problems with oral health. Almost half of the patients (48%) needed assistance with oral care but only 10% received help. Registered nurses assessed the patient's oral health as worse than the patient's self-assessment did.
There are deficiencies in fundamental care delivery regarding oral care in a surgical care context. Oral health assessments need to be performed by registered nurses. Routines for systematic oral assessments and for oral care need to be implemented by nurse managers to ensure that patients' fundamental care needs are fulfilled.
Oral health assessments need to be performed regularly by registered nurses since it is insufficient that patients self-assess their oral health. Nurse managers need to provide and implement routines for nurse assessments and oral care in surgical care contexts.
There are deficiencies in patients' oral health and oral care, and registered nurses need to perform oral health assessments. Nurse managers need to implement routines for registered nurse assessments and oral care.
Patients admitted to a surgical ward were included in the study after being screened for inclusion criteria. After participants signed informed consent, they filled in a questionnaire about oral health and oral care, and a registered nurse performed an oral health assessment.
This study was carried out according to the STROBE checklist.