FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerInternacionales

Nurses' and Physicians' Experiences With Digital Remote Patient Monitoring—Transforming the Boundaries of Breast Cancer Care

ABSTRACT

Aim

To explore expectations and experiences of nurses and physicians with remote care monitoring for breast cancer patients within the Norwegian specialist health service.

Design

Qualitative exploratory study.

Methods

Individual semi-structured interviews were conducted with nine nurses and physicians before and after the implementation of remote patient monitoring. The data were analysed using reflexive thematic analysis.

Results

Three key themes were developed: (1) ‘Navigating patient empowerment: Reassurance, misinterpretation and guidance in remote patient monitoring communication’; (2) ‘Digital care impacts the workflow: Efficiency gains and hidden burdens’; and (3) ‘Clinical judgement in a digital context: Balancing standardisation and clinical discretion’.

Conclusion

While remote patient monitoring increased flexibility and targeted follow-up, it also reshaped roles and workloads and introduced new interpretive demands that often lack formal delegation, highlighting the need for clearer task allocation and organisational support.

Implications for the Profession

Remote patient monitoring expands nurses' roles in symptom assessment and digital follow-up. As such, clear role boundaries and support for clinical judgement are essential for its successful implementation.

Impact

The results are relevant for management in healthcare services, nurses and other healthcare professionals implementing remote patient monitoring.

Reporting Method

The study followed CORQ guidelines.

Patient or Public Contribution

Four user representatives with lived experience of breast cancer contributed to the design of the study and gave input regarding the interview guide.

Social Avoidance Trajectories, Core Characteristics and Maintenance Factors in Postoperative Breast Cancer Patients: A Longitudinal Mixed‐Methods Study

ABSTRACT

Aim

To examine the trajectories, core characteristics, and maintenance factors of social avoidance in patients with breast cancer during the first postoperative year.

Design

Longitudinal, explanatory sequential mixed-method design.

Methods

This longitudinal study enrolled 176 postoperative breast cancer patients, conducting six follow-up assessments over 1 year. Latent class growth analysis was employed to identify heterogeneous trajectories of social avoidance behaviour, with multivariate logistic regression subsequently analyzing predictive factors. Building on these quantitative findings, semi-structured in-depth interviews were administered to target individuals identified through the analysis. Phenomenological methods were then utilized to elucidate core manifestations and maintenance factors of social avoidance.

Results

Among the 176 enrolled breast cancer patients, 138 completed all six follow-up assessments. Latent class growth analysis identified two distinct subgroups with significant differences in social avoidance trajectories: ‘persistent high social avoidance’ and ‘persistent low social avoidance group’. Logistic regression revealed melancholic temperament as an independent risk factor for ‘persistent high social avoidance group’, while choleric temperament demonstrated protective effects. Phenomenological analysis of qualitative data systematically identified four core themes: (1) affective manifestations, (2) behavioural patterns, (3) psychological drivers, and (4) environmental determinants of social avoidance.

Conclusion

This study revealed heterogeneous dynamic trajectories of social avoidance behaviour in breast cancer patients, with core manifestations encompassing both affective and behavioural dimensions, sustained by multiple factors of personality, psychology, and environment.

Impact

This mixed-methods study systematically examined the developmental trajectories, core manifestations, and sustaining factors of social avoidance behaviour in breast cancer patients. The results provide robust evidence to inform precision screening for social avoidance risk, early prevention initiatives, and tailored intervention strategies in clinical nursing practice.

Reporting Method

Journal article reporting standards for mixed-methods research.

Patient or Public Contribution

No patient or public contribution.

Retractions in Nursing as a Systems Problem: A Journal Systems Framework Perspective

ABSTRACT

Problem

Retractions in nursing are often framed as isolated instances of author misconduct or editorial failure. Drawing on recent longitudinal analysis of retracted nursing articles and the Journal Systems Framework (JSF), this Commentary argues that retractions are better understood as system-level signals reflecting differences in editorial capacity, governance, and infrastructure across journal systems.

Results

Between 1997 and 2022, 123 nursing articles were retracted, with persistent concerns related to ethical violations, variability in retraction notice quality, delayed corrective action, and continued post-retraction citation.

Discussion

Applying the JSF highlights how corrective capacity varies across journal systems, shaping the timeliness, transparency, visibility, and downstream amplification of retraction practices. High-profile retractions in flagship journals may reflect greater corrective capacity rather than uniquely severe ethical failure. Interpreting retractions as indicators of system stress, rather than moral anomalies, shifts attention from individual blame toward strengthening editorial infrastructure.

Conclusion

A systems-aware approach positions nursing scholarship to improve transparency, resilience, and trust as publication volume and complexity continue to grow.

Clinical Relevance

Because nursing scholarship informs clinical care, education, and policy, failures in the scholarly record have implications beyond publishing itself. Greater understanding of retractions and corrective editorial processes can help strengthen trust in evidence used to guide nursing and health care practice.

Simulation and the Translation Into Clinical Practice of Nursing Students' Clinical Judgement, Knowledge of the Nursing Process and Self‐Confidence: A Mixed Methods Randomized Controlled Study

ABSTRACT

Aims

To evaluate the effectiveness of simulation on nursing students' translation into practice of clinical judgement, knowledge about the nursing process self-confidence and to comprehend the learning process and translation into clinical practice of competencies developed through clinical simulation in nursing students.

Design

Two-arm, experimental, randomized controlled study designed using the explanatory sequential mixed method with qualitative step anchored in grounded theory.

Methods

Eighty undergraduate nursing students were allocated in practice groups and the groups were randomly assigned to an experimental (simulation; n = 39) or control group (study case; n = 41) and, after the intervention, participated in 3-day clinical practice activities and were assessed regarding clinical judgement, knowledge of the nursing process and self-confidence. Students in the experimental group were invited to focus groups.

Results

Seventy-six students were analysed. The findings showed the effectiveness of simulation combined with clinical practice in the development and translation of clinical judgement (β = 5.03; p = 0.001) and knowledge of nursing process (β = 2.20; p < 0.001). There was no difference regarding self-confidence. A grounded theory emerged with three categories related to consolidation of prior knowledge, translating competencies into clinical practice and application of these competencies in nursing care that explain the theoretical category ‘learning and translating into clinical practice’.

Conclusion

Findings suggest that simulation combined with clinical practice can effectively enhance nursing students' clinical judgement and knowledge of the nursing process, facilitating the translation of these competencies into real-world practice. The qualitative findings suggest that simulation promotes meaningful learning and supports the practical application of nursing competencies.

Implications for Nursing Education

This study supports the integration of simulation into nursing curricula to enhance clinical judgement and nursing process competencies. By promoting meaningful learning and facilitating knowledge transfer to clinical settings, simulation prepares students for real-world decision-making and strengthens the quality and safety of nursing care delivery.

Patient or Public Contribution

No patient or public contribution.

Registration

RBR-7v374c6 (Brazilian Clinical Trials Registry) https://ensaiosclinicos.gov.br/rg/RBR-7v374c6

Prevalence and Types of Workplace Violence Against Clinical Nursing Students: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To assess the prevalence of workplace violence (WPV) against clinical nursing students during internships and quantify the prevalence of different types of violence, such as physical, verbal and sexual.

Design

Systematic review and meta-analysis.

Methods

Eligible cross-sectional studies that reported WPV prevalence among clinical nursing students were included. Two researchers independently screened literature and extracted data. The Joanna Briggs Institute tool was used to evaluate bias risk. Pooled prevalence rates, heterogeneity and publication bias were examined.

Data Sources

A comprehensive search was conducted across eight databases, from the inception of each database to 31 March 2025.

Results

A total of 16 cross-sectional studies from eight countries involving 8037 nursing students were included in the analysis, with 11 studies (n = 5550) contributing to the overall pooled estimate. Using a random-effects model, the pooled prevalence of WPV of any type was found to be 40%, with substantial heterogeneity. Verbal violence emerged as the most prevalent subtype (47%), followed by sexual violence (12%) and physical violence (10%). Significant publication bias was detected for both physical and sexual violence, indicating a potential underestimation of the true prevalence.

Conclusions

This systematic review indicated that WPV is a significant occupational hazard encountered by clinical nursing students across diverse international contexts represented during internships.

Impact

These findings highlight the urgent need for educational and healthcare institutions and policymakers to implement coordinated measures, such as enhanced preventive training, comprehensive reporting and support systems and a zero tolerance safety culture to protect the future nursing workforce.

Reporting Method

This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

Study Registration

The research protocol was registered with PROSPERO (CRD420251027354).

Enhancing Learning in Graduate Nursing Education Through a Co‐Designed AI Virtual Tutor: A Mixed‐Methods Evaluation

ABSTRACT

Background

Large language model tools are increasingly used in higher education, offering opportunities to support self-directed learning. In nursing education, course-specific AI virtual tutors may provide contextualised support while addressing concerns about content accuracy and alignment; yet empirical evidence remains limited.

Objective

This study evaluated the use and perceived impact of a co-designed AI-powered virtual tutor embedded in a graduate-level Master of Nursing (MN) course. We explored how students used the tutor, their perceptions of benefits and limitations, and its influence on learning and engagement.

Methods

A pilot study using a mixed-methods explanatory sequential design was employed. The tutor was trained on course-specific materials and integrated into the institutional learning management system. Data included anonymised usage logs and user interactions coded using Bloom's Taxonomy of Educational Objectives, post-course surveys assessing AI self-efficacy, usability, and learning impact, and semi-structured interviews with students and teaching assistants (TAs). Quantitative and qualitative strands were integrated through a joint display.

Results

A total of 651 interactions by individuals within a group of ~120 MN students were logged. Interactions peaked in evenings and around assignment deadlines. Most interactions reflected lower-order education processes, with more application and analysis later in the course. Eleven participants completed surveys; students reported high AI self-efficacy and moderate tutor use. Perceived usefulness was mixed, but most reported the tutor enhanced both lower- and higher-level learning and recommended its future use. Interviews revealed that students valued the tutor's immediacy and course-specific accuracy, while TAs noted efficiency gains. Reported challenges included usability issues, scope limitations, privacy concerns, and risk of over-reliance on the tool.

Conclusions

A co-designed AI virtual tutor was feasible and valued for contextual relevance, though perceived usefulness was variable. Findings support responsible, pedagogically integrated use of AI tutors in graduate nursing education.

Predictive Models for Hypoglycemia Risk in Haemodialysis Patients With Diabetic Kidney Disease: Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To provide evidence for selecting and developing reliable clinical assessment tools for hypoglycemia in diabetic kidney disease patients during haemodialysis.

Design

Review.

Methods

Systematic searches were performed in 9 Chinese and English databases to collect literature regarding the development of hypoglycemia risk prediction models in haemodialysis patients with diabetic kidney disease. Two reviewers independently performed literature screening, data extraction, risk-of-bias assessment, and applicability evaluation. The Prediction Model Risk of Bias Assessment Tool was used to assess the risk of bias and applicability of the included studies. Meta-analysis was conducted using R software.

Data Sources

CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, EMbase, Web of Science, and CINAHL. The search period covered from the establishment date of each database to December 2025.

Results

Six studies, comprising six prediction models, were included. Two studies performed internal validation, and three conducted external validation. All models reported the area under the curve, ranging from 0.813 to 0.866, and calibration measures. Four studies were rated as having a high risk of bias, while all six demonstrated good overall applicability. The meta-analysis showed that the pooled AUC value of the six studies was 0.846 (95% CI: 0.823–0.867).

Conclusion

Research on hypoglycemia risk prediction models in haemodialysis patients with diabetic kidney disease remains in the developmental stage. Although the included prediction models exhibited satisfactory apparent discriminatory ability and clinical applicability, most of the original studies suffered from a high risk of bias and lacked adequate validation. The true predictive performance and clinical application value of these models remain to be further verified. Accordingly, routine and unconditional clinical application is not recommended at this stage. Future studies should include more high-quality, multicenter external validation and develop models with high generalizability, favourable clinical applicability, and robust predictive performance to facilitate early identification of hypoglycemia risk in this population.

Impact

This study systematically evaluated the hypoglycemia risk prediction models for diabetic kidney disease patients during haemodialysis, and the research on hypoglycemia risk prediction models for maintenance haemodialysis patients during dialysis is still in the development stage. This study provides a reference for clinical medical staff to select or develop hypoglycemia risk prediction and assessment tools for diabetic kidney disease patients during haemodialysis.

Reporting Method

This study was conducted in accordance with the relevant guidelines of the EQUATOR Network and followed the TRIPOD-SRMA Checklist.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

PROSPERO: CRD420251243352

Predicting the Intention to Sign an Advance Directive: A Machine Learning Model Accounting for Cultural and System‐Level Factors

ABSTRACT

Purpose

To develop a machine learning model for predicting Taiwanese adults' intention to sign an advance directive (AD) and to identify the psychosocial, demographic, and system-level predictors relevant to culturally sensitive nursing. This study distinguishes between the reflective process of advance care planning (ACP) and the formal legal act of AD completion, addressing the need to understand cultural and system-level influences.

Design

This was a cross-sectional quantitative study.

Methods

A survey was conducted with 1412 Taiwanese adults by using validated instruments, such as the Knowledge of Advance Care Planning Questionnaire and Advance Care Planning Attitude Scale. Data were analyzed using linear regression, random forest, and extreme gradient boosting models to predict the intention to sign an AD. A SHapley Additive exPlanations analysis was performed to interpret the model and investigate the effects of personal values and system-level barriers.

Results

The extreme gradient boosting model outperformed the other models, with mean absolute error and root mean squared error values of 1.68 and 2.13, respectively. The SHapley Additive exPlanations analysis highlighted attitude toward ACP as the strongest predictor of signing intention. In addition to psychosocial factors, system-level factors such as procedural unfamiliarity and high consultation costs emerged as key barriers. Furthermore, older age and a higher number of children were associated with a weaker intention to sign an AD, reflecting a preference for informal family consensus over formal legal documentation.

Conclusion

Machine learning models effectively identify the interplay between personal attitudes, family dynamics, and institutional conditions that shape AD-related decision-making. The transition from ACP dialogue to formal AD signing is determined by both cultural values and structural factors.

Clinical Relevance

Nurses should adopt a dual-track strategy—supporting advance care planning through family-inclusive dialogues and serving as “system navigators” to help patients overcome legal and financial barriers to advance directive signing. Data-driven insights from the present study may inform precise, culturally responsive interventions that honor patient autonomy.

Patient Outcomes Associated With Continuous Remote Patient Monitoring: A Scoping Review

ABSTRACT

Background

The COVID-19 pandemic highlighted the need for alternative healthcare delivery models, leading to the development of Continuous Remote Patient Monitoring (CRPM). CRPM allows for real-time monitoring of high-risk patients, reducing the burden on hospital resources. The integration of virtual nursing into CRPM has enhanced remote care capabilities, though it has also introduced new challenges related to patient safety and staffing, that is, nurse-to-patient ratios.

Objective

This scoping review aims to explore the current evidence on virtual nursing using CRPM and identify challenges or barriers that help further future research and healthcare practices.

Methods

This scoping review followed the PRISMA-ScR guidelines. Eligible studies focused on virtual nursing with physiological monitoring in either remote hospital or home-based care settings, with explicit examination of nursing care and its impact on patient and nursing outcomes. Peer-reviewed articles published in the past 10 years in English were included. Four databases (Ovid, PubMed, CINAHL, and Medline) were searched with support from a medical librarian. After screening 207 records using Covidence, 17 studies met the inclusion criteria. Two reviewers independently screened all records, with a third resolving discrepancies. Data was charted using a standardized extraction template.

Results

Seventeen studies were included in this review. CRPM was associated with reported benefits in managing chronic conditions, extending acute care into home settings, and enhancing healthcare system adaptability, particularly during the COVID-19 pandemic. Clinical benefits included early detection of health deterioration, reduced hospital readmissions, and improved patient satisfaction. Nurses played a pivotal role in physiologic data interpretation and intervention, highlighting the importance of continuous oversight in achieving favorable outcomes. However, implementation challenges, such as alert fatigue, data overload, user interface complexity, and financial sustainability were consistently reported. These findings underscore the need for improved data management systems, targeted nurse training, and sustainable funding models to support broader CRPM adoption.

Linking Evidence to Action

Virtual nursing within CRPM demonstrates strong potential to improve patient outcomes and reduce hospitalizations by extending inpatient-level physiologic surveillance into home-based and hospital-at-home settings through continuous, nurse-led monitoring. Successful integration of this model into routine practice will require addressing challenges related to data management, clinician workload associated with 24/7 surveillance, and sustainable funding mechanisms to support continuous virtual nursing coverage.

Thriving or Leaving? The Role of PERMA Being Associated With Thriving and Retention Among Early Career Nurses

ABSTRACT

Aim

To examine which elements of thriving and PERMA may be associated with thriving and intentions to leave both the job and profession among early career nurses.

Background

Retention of early career nurses is a global concern, with up to 60% leaving the profession within 2 years. While organisational factors have been widely examined, psychological constructs such as thriving and well-being are underexplored.

Design

A cross-sectional design.

Methods

The study surveyed early career nurses (n = 90, response rate 34.1%) across Australia. Validated instruments assessed thriving, PERMA dimensions, organisational support and intention to leave. Multiple linear and logistic regressions identified key factors associated with thriving and intention to leave the job or profession. Reporting adhered to STROBE guidelines for observational studies.

Results

Thriving was a significant factor associated with engagement (β 0.039, p = 0.031), relationships with colleagues (β 0.167, p = 032), and occupational hardiness (β 0.502, p = 0.001), while accomplishment was a negative factor associated with thriving (β −0.163, p = 0.001). Intention to leave the job was linked to lower levels of thriving (β −1.303, p = 0.048), reduced perceived organisational support (β −0.180, p = 0.048), and higher negative emotions (β 0.747, p = 0.009). Intention to leave the profession was associated with accomplishment (β 0.222, p = 0.048), perceived organisational support (β 0.193, p = 0.001), and years since graduation (β 0.299, p = 0.016).

Conclusions

Thriving was associated with engagement, peer support, and resilience, whereas attrition was associated with poor organisational support and negative affect. Accomplishment is negatively aligned with thriving and may reflect unmet expectations, increasing role strain, or other personal factors not directly related to organisational contexts. Results suggest psychologically supportive environments and PERMA-informed strategies may be important for enhancing early career nurse retention. Supporting nurses to thrive should be a key focus for managers seeking to sustain the nursing workforce.

Relevance to Clinical Practice

This study provides actionable insights for creating psychologically supportive environments that may be associated with improved early career nurse retention. By applying the PERMA framework, healthcare leaders may consider implementing targeted strategies, such as fostering engagement, informing the importance of collegial relationships, and promoting resilience, in order to positively inform well-being and achieve lower levels of attrition in clinical settings.

Patient or Public Contribution

No patient or public contribution.

Factors Influencing Nurses' Participation in Voluntary‐Assisted Dying: A National Cross‐Sectional Study

ABSTRACT

Aim

To identify nurse practitioners' and registered nurses' willingness to participate in voluntary assisted dying, and the factors that influence these decisions.

Design

A cross-sectional design.

Methods

An online survey was disseminated to members of 16 professional nursing organisations and associations between April and August 2024.

Results

Responses from 396 participants were analysed. Most were registered nurses (n = 335, 84.6%), aged between 45 and 64 years (n = 217, 54.8%). Over half of the participants (n = 219, 55.3%) had some knowledge of voluntary assisted dying, and more than two-thirds (n = 274, 69.2%) strongly supported it. Respect for a person's rights (n = 345, 89.8%) and relieving suffering (n = 342, 89.1%) were the main reasons nurses participated. Most nurse practitioner participants would be prepared to assess a person's eligibility for voluntary assisted dying (n = 32, 82.1%) or prescribe a substance (n = 31, 79.5%), if permitted by law. Religion, age and years of experience were characteristics associated with reasons for participation.

Conclusion

In Australia, some RNs and NPs are willing to participate in a range of VAD-related activities. However, in some jurisdictions, nurses' engagement is limited by legislative and policy settings. Reconsideration of nurses' roles may enhance access.

Implications for the Profession

With appropriate support, nurses can make a valuable contribution to the sustainability of the voluntary assisted dying workforce.

Analysis of Resilience in Nurses Exposed to Workplace Violence: A Cross‐Sectional Study

ABSTRACT

Aim

To assess the resilience of nurses exposed to workplace violence and analyse its influencing factors.

Design

A cross-sectional study.

Methods

From October 2023 to April 2025, 396 nurses were recruited from hospitals in Shanghai and Nanjing, China. Personal Information Form, Hospital Workplace Violence Questionnaire, Resilience Assessment Scale for Medical Staff, General Self-efficacy Scale and Social Support Rating Scale were used to collect data. Descriptive statistics, t-tests, analysis of variance, Pearson's correlation analysis, multiple regression analysis and mediating effect analysis were used to analyse the data.

Results

The mean resilience score was 67.38 ± 15.52. Professional title, self-efficacy and social support were the main influencing factors on resilience among nurses exposed to workplace violence. Resilience showed a significant positive correlation with both self-efficacy and social support. Self-efficacy was directly and positively associated with resilience, and was positively associated with social support, and social support partially mediated the relationship between self-efficacy and resilience.

Conclusion

Self-efficacy is directly and positively associated with resilience. Social support partially mediates the relationship between self-efficacy and resilience. These findings highlight the interaction between personal and environmental factors in shaping the resilience of nurses exposed to workplace violence.

Implications for the Profession and/or Patient Care

Enhancing resilience among nurses exposed to workplace violence has important implications for increasing patient satisfaction and improving the quality of nursing.

Impact

Provided valuable insights into workplace violence within the nursing profession. Social support partially mediated the relationship between self-efficacy and resilience. Improving nurses' resilience requires enhancing personal self-efficacy and strengthening social support systems.

Reporting Method

STROBE checklist was used.

No Patient or Public Contributions

Shift‐Specific Patterns of Nursing Workloads in the Emergency Department: AI Powered Analysis

ABSTRACT

Aim

To identify and differentiate workload patterns across shifts and to provide evidence for optimizing nursing workforce allocation in emergency departments:

Design

A cross-sectional study.

Methods

Real time data were collected from an emergency department in a general hospital in Seoul, South Korea, between October 30, 2023 to October 24, 2024. Smartphones, beacons, and smartwatches were used to capture nursing time, physical activity, work-related characteristics, and location transitions across 238 shifts. A multiclass eXtreme Gradient Boosting model was developed and evaluated to classify working shifts (day, evening, night). Shapely Additive exPlanations were applied to identify key contributing features, and shift-specific differences were examined using analysis of variance with post hoc tests.

Results

The model demonstrated strong performance in distinguishing shifts. Key features included the number of admissions, discharges, assigned patients, and both direct and indirect nursing time, all of which varied across shifts. In contrast, location transition patterns were relatively consistent.

Conclusion

Shift-specific nursing workloads in emergency departments can be effectively identified using multidimensional, real-world nursing activity data.

Implications for the Profession and/or Patient Care

Findings support the development of staffing strategies that account for variation in workload across shifts, with potential to improve efficiency and maintain quality of care.

Impact

This study addresses the lack of objective evidence for shift-specific workload differences in emergency nursing. It demonstrates that multidimensional activity data can distinguish workload patterns across shifts. The findings may inform staffing decisions for emergency department nurses and support improvements in workforce management and patient care.

Reporting Method

This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Patient or Public Contribution

No patients or members of the public were involved in the design, conduct, analysis, or reporting of this study.

Patient Safety Competencies, Clinical Learning Environment and Unfinished Care From the Perspective of Nursing Students: A Multinational Study

ABSTRACT

Aim

To assess perceived patient safety competencies among nursing students and to examine their associations with their perceptions regarding clinical learning environment and unfinished nursing care.

Design

An international comparative cross-sectional study.

Methods

A total of 1442 nursing students from the Czech Republic, Italy, Slovakia, and Türkiye participated between February and December 2025. Data were collected using the Health Professional Education in Patient Safety Survey, the Clinical Learning Environment, Supervision and Nurse Teacher scale, and the Unfinished Nursing Care Survey for Students. Descriptive statistics, non-parametric tests, Spearman correlations, and multivariate general linear modelling were applied.

Results

Students reported significantly higher patient safety competencies in clinical compared with academic settings (p ≤ 0.001). Significant cross-country differences were observed across all competency domains (p ≤ 0.001). Perceived patient safety competencies were positively correlated with the overall quality of the clinical learning environment (r = 0.356–0.420; p < 0.001) and negatively correlated with unfinished nursing care (r = −0.107 to −0.171; p < 0.001). Multivariate analysis demonstrated that pedagogical atmosphere, premises of nursing care, supervisory relationship, and particularly the role of the nurse teacher were significant predictors of patient safety competencies.

Conclusion

The development of nursing students' patient safety competencies is closely linked to the quality of clinical learning environments. Strengthening educational and organisational conditions within clinical placements may play an important role in preparing future nurses for safe clinical practice.

Implications for the Profession and/or Patient Care

Improving the quality of clinical learning environments, strengthening supervision, and addressing unfinished nursing care may support the development of nursing students' patient safety competencies and contribute to safer patient care.

Reporting Method

The study was carried out according to the STROBE checklist.

Patient or Public Contribution

No Patient or Public Contribution.

Dyadic Coping and Its Influencing Factors in Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy and Their Spouses: A Latent Class Analysis

ABSTRACT

Aim(s)

To identify distinct dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses using a person-centred approach, and to explore factors associated with these patterns to inform the development of personalised interventions.

Design

A cross-sectional, observational study design.

Methods

A total of 223 patient-spouse dyads were recruited from two tertiary urology departments in Guangdong Province, China, between October 2024 and August 2025. All participants completed a general information questionnaire and the Dyadic Coping Inventory. Latent profile analysis was used to identify distinct coping profiles. Univariate analysis and multivariate logistic regression were performed to examine factors associated with profile membership.

Results

Among 223 patient-spouse dyads, four distinct dyadic coping profiles were identified: Efficient Coping (12.0%), Ambivalent Coping (30.0%), Stable Coping (53.8%), and Coping Distress (4.0%). The small Coping Distress subgroup (n = 9) was excluded from further analysis. Higher dyadic coping levels were associated with patient education of high school or above, absence of tumour recurrence, sufficient patient-perceived family support, low-to-moderate spouse-perceived medical burden, frequent dyadic communication, and sufficient spouse-perceived friend/colleague support. Spouse-perceived insufficient family support was unexpectedly associated with better dyadic coping.

Conclusion

Dyadic coping patterns among prostate cancer patients undergoing androgen deprivation therapy and their spouses are heterogeneous. Healthcare professionals should identify distinct dyadic coping characteristics and provide personalised nursing interventions based on the key influencing factors identified in this study.

Implications for the Profession and/or Patient Care

This study provides a person-centred classification framework for dyadic coping in couples undergoing androgen deprivation therapy, enabling nurses and other healthcare professionals to deliver targeted, stratified psychosocial care. Early identification of vulnerable couples, particularly those in the ambivalent coping subgroup, helps prevent maladaptive coping and alleviate psychological distress. By addressing modifiable factors including communication, family support, and caregiver burden, clinical practice can more effectively improve the psychosocial well-being and quality of life of both patients and their spouses throughout androgen deprivation therapy.

Reporting Method

This study adheres to the relevant EQUATOR guidelines (STROBE) for cross-sectional studies.

Patient or Public Contribution

Patients and their spouses were involved in the design of the study by providing feedback on the clarity and relevance of the questionnaire items during a pilot phase. They also participated in data collection by completing the self-report measures, and their input informed the interpretation of the findings related to dyadic coping experiences.

Evaluation of Evidence‐Based Intervention Implementation in Adult Intensive Care Settings: A Scoping Review

ABSTRACT

Background

Although implementing evidence-based interventions has been shown to improve the quality of care, there is limited evidence evaluating how these interventions are implemented. In intensive care settings, the use of evidence-based protocols, guidelines and care bundles has been associated with enhanced care quality and reduced burden on patients.

Aim

To identify and map existing evidence on the evaluation of evidence-based intervention implementation in adults' intensive care.

Design

A scoping review was conducted by including original published and unpublished studies in English and Finnish.

Methods

The studies were retrieved from five databases (CINAHL, Scopus, Ovid Medline, Medic ja Mednar) from January 2000 to December 2024. The data search was performed on 29 November 2022 and updated on 10 December 2024. The results were synthesized and presented in a tabular and descriptive form.

Results

A total of 19 studies were included in the review. These studies evaluated the implementation of evidence-based interventions, focusing on nurse and patient outcomes. Nurse outcomes included measures such as compliance, knowledge and self-confidence. Patient outcomes included indicators such as body temperature, blood glucose, incidence of pressure ulcers and length of stay.

Conclusion

The evaluation of evidence-based intervention implementation does not consistently extend to the evaluation of the entire implementation process. More consistent research reporting would improve disseminating the evidence. The evaluation implementation makes it possible to show the impact of nurse and patient outcomes. The evaluation results can reveal the success of the implementation. Further research on evaluation implementation, development of systematic and comprehensive evaluation implementation methods, or evaluation matrix is needed.

Implications

The review will be useful for nursing professionals in planning evidence of implementation, developing or researching evaluation implementation. Promoting evaluation of evidence-based intervention implementation in Nursing can improve the quality of patient care, improve disseminating evidence and uniformities of care practice.

Impact

What Problem Did the Study Address? There is limited evidence of evaluation of evidence-based interventions of implementation. Evaluating evidence-based implementation is important to ensure the quality of patient care and patient safety.

What Were the Main Findings? Evaluation of implementation of evidence-based interventions focused on nurse and patient outcomes. Evaluation of the entire implementation process was not identified, and implementation strategies were not evaluated.

Where and on Whom Will the Research Have an Impact? Evidence-based practice implementation in nursing for researchers, developers, nursing leaders and clinical nursing practitioners who implement and evaluate evidence-based practice implementation.

Reporting Method

PRISMA 2020 statement.

Patient or Public Contribution

No Patient of Public Contribution: This study did not include patient or public involvement in its design, conduct or reporting.

Caregiver Burden Among Families of Paediatric Patients With Tuberculosis: A Mixed‐Methods Study

ABSTRACT

Aim

To assess caregiver burden and its relationship with health literacy, self-efficacy, stigma, and social support among caregivers of children with tuberculosis in Shanghai, China.

Design

Explanatory sequential mixed-methods design.

Methods

In the quantitative phase, 132 caregivers were recruited from a Shanghai Hospital, and 21 participated in the qualitative interviews. Data were collected (April 2023–April 2025) using the Zarit Burden Interview scale, Chinese Health Literacy Scale for Tuberculosis, General Self-Efficacy Scale, Tuberculosis-related Stigma Scale, Multidimensional Scale of Perceived Social Support, and semi-structured interviews. Quantitative data were analysed using descriptive statistics and multiple regression analyses, and qualitative data were analysed using content analysis.

Results

Most caregivers were mothers (72.7%). Burden levels were classified as mild (58.3%), moderate (27.3%), or severe (2.3%). The quantitative analysis identified lower health literacy, limited social support, reduced self-efficacy, and being a female caregiver as significant predictors. Social support partially mediated and self-efficacy mediated the effect of perceived stigma and health literacy on caregiver burden, respectively. Qualitative themes revealed psychological and physical effects, impact on social life, and coping strategies.

Conclusion

Caregiver burden in paediatric tuberculosis is multidimensional and influenced by complex mechanisms. Interventions should address health literacy gaps, enhance self-efficacy, strengthen social support systems, and implement targeted stigma-reduction strategies while considering developmental-stage-specific needs.

Implications for Patient Care

Healthcare systems should routinely assess caregiver burden, and multidisciplinary teams should be trained to provide integrated targeted support.

Impact

This study demonstrates distinct stigma pathways and comprehensively shows that caregiver burden is significantly associated with modifiable psychosocial factors. Consequently, healthcare providers should develop targeted support interventions that address both psychological and practical caregiving challenges, ultimately contributing to improved patient care outcomes and caregiver well-being in tuberculosis management.

Reporting Method

This study adheres to the Good Reporting of A Mixed Methods Study checklist.

Patient or Public Contribution

None.

Attitudes Towards Remote Monitoring for Falls Prevention Among Staff, Patients, Residents and Families in Hospital and Aged Care: Scoping Review

ABSTRACT

Aim

To examine the reasons for and methods of using remote video monitoring to prevent falls across hospital and residential aged care, and explore how staff, patients, residents and families perceive its use and benefits.

Design

Scoping Review.

Methods

Following JBI methodology, eight databases were searched in July 2025 with no date restrictions. Two reviewers independently screened studies using predefined criteria, and one reviewer extracted data. Narrative and thematic syntheses described how video monitoring is implemented for falls prevention and explored stakeholders' attitudes.

Results

Thirty-five studies were included, with 77% conducted in hospitals and 86% focusing on staff perspectives, highlighting a critical underrepresentation of patients/residents and families. Perceived effectiveness was shaped by underlying motivations—falls prevention, workforce optimisation, or cost reduction. Attitudes were influenced by workload impacts, video monitoring knowledge, ethical and liability concerns. Three remote video monitoring models were identified: technician-based, automated alerts, and nurse-observed without alerts. Technician-based systems were only in hospitals, with no equivalent in aged care.

Conclusion

Research on remote video monitoring for falls prevention is heavily weighted towards hospitals and staff perspectives. Nurses generally viewed video monitoring as effective but still preferred in-person observers. Although there is interest in innovative monitoring systems in aged care that balance safety with a homelike environment, empirical research is lacking. Patient, resident, and family experiences remain underrepresented and require further research.

Impact

Remote video monitoring has emerged as an alternative to mobilisation alarms, given their uncertain effectiveness and negative consequences for patients and nurses. Much U.S. hospital research reflects a cost-reduction paradigm aimed at replacing in-person observers, a trend not seen internationally or in aged care. This research is relevant to decision-makers considering technological options for falls prevention and to nurse leaders seeking insight into the appeal and apprehension surrounding video monitoring.

Reporting Method

PRISMA-ScR.

Patient/Public Contribution

None.

Prevalence of Loneliness and Social Isolation Among People Living With HIV: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To estimate the prevalence of loneliness, social isolation, and their co-occurrence among people living with HIV and to explore factors explaining heterogeneity between estimates.

Design

A systematic review and meta-analysis.

Data Sources

PubMed, Cochrane Library, SciELO Citation Index (via Web of Science), Scopus, Embase, PsycArticles, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from inception until November 1, 2024 for relevant studies.

Methods

Study eligibility, data extraction, and methodological quality assessment were conducted independently by two reviewers. Random-effects meta-analysis was used to estimate pooled prevalence. Subgroup analyses were performed.

Results

A total of 66 studies were included. The pooled prevalence of loneliness was 46.9% and that of social isolation was 25.9%. However, heterogeneity was very high across studies, and these pooled estimates should therefore be interpreted cautiously. Subgroup analyses suggested regional variation in both loneliness and social isolation. Other subgroup findings should be interpreted cautiously because some subgroup estimates were based on small numbers of studies.

Conclusion

Loneliness and social isolation are highly prevalent among people living with HIV. Population-specific intervention strategies are needed to reduce this burden, and future studies should further examine contextual and demographic differences to guide intervention design.

Implications for the Profession and/or Patient Care

Routine HIV services should include screening and referral pathways for loneliness and social isolation.

Impact

This systematic review identified the pooled prevalence of loneliness and social isolation among people living with HIV, highlighting a substantial and clinically relevant burden. The findings may influence HIV nurses' practice and inform care approaches for other clinical populations experiencing loneliness and social isolation.

Reporting Method

This systematic review followed the PRISMA and MOOSE reporting guidelines.

Patient or Public Contribution

No patient or public contribution.

Workplace Incivility and Nurses' Job Satisfaction and Leaving Intentions in Taiwan: A Cross‐Sectional Study

ABSTRACT

Background

Workplace incivility is a pervasive challenge in healthcare. Few studies drew on theoretical concepts to simultaneously examine organisational correlates of incivility and its associations with nurses' work outcomes.

Aim

This study examined workplace incivility among nurses, focusing on job control, psychological job demands and workplace justice as workplace characteristics, and assessing its association with job satisfaction and intentions to leave.

Methods

A cross-sectional survey was conducted among 528 full-time nurses at a medical centre in Taiwan. Validated questionnaires assessed workplace incivility (the Workplace Incivility Scale), workplace characteristics, job satisfaction and intentions to leave. Multivariable linear regression examined associations of workplace characteristics with incivility, and associations of incivility with job satisfaction and intentions to leave, adjusting for demographic and workplace factors.

Results

High workplace incivility was reported by 41.1% of nurses. In adjusted analyses, lower job control and lower workplace justice were associated with higher incivility scores. After adjustment for demographic and workplace factors, workplace incivility was negatively associated with job satisfaction and positively associated with leaving intentions. Among workplace characteristics, psychological job demands showed strong associations with both job satisfaction and leaving intentions.

Conclusions

Workplace incivility reflects underlying organisational conditions and is associated with lower job satisfaction and greater leaving intentions. Addressing job demands, autonomy and fairness may reduce incivility and sustain the nursing workforce.

Implications for the Profession and/or Patient Care

Workplace incivility is associated with lower job satisfaction and greater leaving intentions, and may co-occur with lower job control and perceived organisational justice, highlighting the need for organisational strategies that foster fairness and supportive work environments to enhance nurse retention.

Reporting Method

The authors adhered to the STROBE guidelines.

Patient or Public Contribution

No patient or public involvement.

❌