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AnteayerInternacionales

Beyond association: strengthening causal evidence between childhood trauma and chronic widespread pain

Por: Hu · J. · Kang · J.

Commentary on: Timmins KA, Hales TG, Macfarlane GJ, et al. Childhood maltreatment and chronic ‘all over’ body pain in adulthood: a counterfactual analysis using UK Biobank. Pain. Published Online First: 15 November 2024. doi: 10.1097/j.pain.0000000000003457

Implications for practice and research

  • Healthcare providers should routinely screen for childhood maltreatment in patients with chronic pain and integrate targeted mental health interventions.

  • Future research should prioritise longitudinal studies to establish clearer interactions between childhood maltreatment, mental health, adult stressors and chronic pain development.

  • Context

    Adverse childhood experiences (ACEs), including maltreatment (abuse, neglect) and household challenges, have been identified as risk factors for various health conditions in adulthood.1 Chronic pain, particularly chronic widespread pain, is increasingly linked to ACEs.2 Theoretical frameworks propose that ACEs contribute to chronic pain through interconnected biological, psychological and social pathways, each triggering a cascade of effects that lead...

    Educational interventions for healthcare professionals can reduce stigma towards mental illness

    Por: Chue · P. · Tate · M.

    Commentary on: Effectiveness of educational interventions in reducing stigma of healthcare professionals and healthcare students towards mental illness: A systematic review and meta- analysis—Wong et al.

    Implications for practice and research

  • Training programmes for all healthcare professionals should incorporate appropriate and early education on mental illness and its common societal implications to ensure that care is inclusive and non-judgmental.

  • Education must be tailored, multimodal (in-person/online; contact-no-contact) and repeated.

  • Further research looking at why, when and how stigma develops is necessary.

  • Context

    Stigma exists in society towards mental health and is also demonstrated by healthcare professionals. It develops early on in careers and impacts the delivery of care which further stigmatises this already disadvantaged population. Up to 75% of individuals with mental illness refuse treatment because of stigma leading to negative outcomes.1 Problems of knowledge (ignorance), attitudes (prejudice) and behaviour (discrimination)...

    Clinical Nurses' Workplace Spirituality and Moral Resilience: A Correlational Study

    ABSTRACT

    Aim

    To investigate the current status of workplace spirituality and moral resilience among clinical nurses and to explore the relationship between these two factors, thereby providing a reference for developing strategies to enhance nurses' moral resilience.

    Design

    A cross-sectional survey design.

    Methods

    From February to April 2025, a convenience sampling method was used to select 1680 nurses from ten hospitals in the Pingliang area of China. Data were collected using the general data questionnaire, Workplace Spirituality Scale(WSS). Furthermore, the relationship between workplace spirituality and moral resilience was analyzed.

    Results

    A total of 1657 valid questionnaires were ultimately recovered, yielding an effective response rate of 98.63%. The mean score for workplace spirituality was 102.36 ± 21.65, and the mean score for moral resilience was 41.76 ± 6.31, both indicating a moderate level. A significant positive correlation was found between the two variables (r = 0.231, p < 0.05). Multivariate linear stepwise regression analysis revealed that monthly income, department, monthly night shifts, and workplace spirituality scores were significant predictors of moral resilience (p < 0.05).

    Conclusion

    The moral resilience of clinical nurses is at a moderate level. Enhancing workplace spirituality can contribute to improving their moral resilience.

    Exploring the Service Features of Telephone Cancer Information and Support Services From Callers' Experiences: A Qualitative Evidence Synthesis

    ABSTRACT

    Aim

    This study aims to synthesise evidence on users' experiences of telephone cancer information and support services (CISS) to identify important service features and inform service development.

    Design

    A qualitative evidence synthesis.

    Methods and Data Sources

    OVID MEDLINE, EMBASE, CINAHL, PsycINFO and SocINDEX databases were searched for peer-reviewed qualitative literature fitting the inclusion criteria from database inception to 30 March 2023. The included articles were double-screened, and quality appraised using the CASP checklist. GRADE-CERQual was used as a tool to assess the confidence of review findings. Content synthesis combined the qualitative data with the Loiselle cancer experience measurement framework guiding analysis. This paper is reported as per the equator network recommended SRQR checklist.

    Results

    Of the 607 articles screened, seven studies were included. Four main themes and 14 sub-themes about CISS aspects were identified: psychological well-being (managing emotions/coping, hope/reassurance, supporting close others and a reluctance to call the CISS); knowledge is power (information seeking, the burden of knowledge and empowerment); truth and clarity (adjunct support, credible source and improved understanding and confidence); and service adequacy (operators' ability to connect with users, convenience, service provision and awareness, and the cancer journey).

    Conclusion

    Findings suggest people with cancer and their carers accessing a CISS value emotional support combined with trusted information, topic expertise and a connection with the service operator. future service provision should address the lack of awareness regarding the range of services and the convenience extended operating hours may offer.

    Implications for Patient Care

    The results add to our understanding of CISS service provision. However, knowledge gaps remain regarding preferences among service features and the hierarchy of CISS characteristics to be prioritised to enhance services.

    Impact

    Focused CISS awareness campaigns will inform communities and healthcare professionals of the available resources to improve the lives of those affected by cancer. Ongoing service review will enable resources to be tailored to callers' needs, potentially easing the burden on existing services that are overwhelmed and under-resourced.

    Patient or Public Contribution

    This qualitative evidence synthesis did not directly involve patient or public contribution to the manuscript.

    Trial Registration

    Systematic Review Registration Number (PROSPERO): CRD42023413897

    Orchestrating Human Connection in Digital NICUs: Leadership Strategies for Technology‐Enhanced Family‐Centred Care

    ABSTRACT

    Aim(s)

    To explore how neonatal nurse leaders sustain human-centred care while implementing digital technologies in neonatal intensive care units (NICUs).

    Design

    Qualitative descriptive multi-site study across four NICUs in the Eastern Region of Saudi Arabia (November 2024–May 2025), reported in accordance with COREQ.

    Methods

    Purposive maximum-variation sampling recruited 24 neonatal nurse leaders across leadership levels, hospital types and digital maturity stages. Semi-structured interviews were conducted in Arabic or English, transcribed, translated as needed and thematically analysed in NVivo 14 using a hybrid inductive–deductive approach. Directed content analysis of key organisational documents enabled triangulation. Trustworthiness was supported through member checking, peer debriefing, audit trail, external review and double coding of a subset of transcripts.

    Results

    Four interrelated strategies were identified: (1) embedding a values-based human-centred vision; (2) selecting and customising digital tools to strengthen, not replace, nurse–family connection; (3) redesigning workflows (e.g., device-free openings, protected presence time, family-inclusive portals) to preserve presence and partnership; and (4) fostering team capability and psychological safety for digital–human integration.

    Conclusion

    Human-centred care in digital NICUs is intentionally led and structurally engineered. The study offers a practice-ready framework that translates values into reproducible routines within complex sociotechnical systems.

    Implications for the Profession and/or Patient Care

    The framework supports nurse leaders in aligning digital transformation with family-centred care, protecting nurse–family presence, and enhancing safety, trust and partnership for high-risk neonates.

    Impact

    Addresses risks of relational erosion in digital and AI-enabled NICUs and provides transferable nurse-led strategies to sustain ethical, family-centred practice.

    Reporting Method

    COREQ-compliant qualitative study.

    Patient or Public Contribution

    No Patient or Public Contribution.

    Barriers and Facilitators of Advance Care Planning in Patients With Cancer: A Qualitative Study

    ABSTRACT

    Background

    Advance Care Planning (ACP) has the potential to enhance end-of-life care and improve the allocation of healthcare resources for patients with cancer. However, its successful implementation requires considerable effort to overcome challenges and deliver health benefits. Healthcare providers and patients are key players in ACP, and their perceptions of the process must be understood to address implementation challenges effectively.

    Aims and Objectives

    To identify barriers and facilitators to ACP implementation in Chinese oncology settings, providing a foundation for culturally appropriate healthcare strategies.

    Methods

    A qualitative study guided by the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews (n = 30) were conducted between April and August 2022 to synthesise the perspectives of nurses, physicians, patients with cancer and their families who had participated in ACP. Data were analysed using a directed qualitative content analysis approach, and reporting followed the SRQR guidelines.

    Results

    Twenty implementation determinants were identified across four CFIR domains, including 13 barriers and 7 facilitators. Key barriers included limited adaptability of ACP to local cultural and family norms, high complexity of ACP processes, insufficient knowledge and skills among clinicians, unclear team responsibilities, low organisational readiness, limited resources and poor public awareness. Facilitators included strong team culture, clinician motivation, supportive leadership and alignment with national policies. Two determinants showed mixed influences: the relative advantage of ACP compared to existing practices, and the extent of collaboration with external organisations.

    Conclusions

    Our study highlights the challenges of implementing ACP in China, as well as the unique and specific barriers to implementation. These findings contribute to a deeper understanding of context-specific determinants and offer actionable insights to inform the development of culturally tailored ACP implementation strategies in resource-limited healthcare settings.

    Relevance to Clinical Practice

    To inform the development of implementation strategies to promote ACP in healthcare systems dominated by traditional medicine.

    Development and Preliminary Application of a KAP Scale for Nursing Assistants in Pain Care for Older Adults With Dementia

    ABSTRACT

    Aim

    This study aimed to develop and preliminarily validate the KAP scale for pain management in older adults with dementia among nursing assistants.

    Design

    A cross-sectional study.

    Methods

    An initial item pool was constructed through literature reviews, semi-structured interviews and team discussions. Items were screened and optimised through two rounds of Delphi expert consultations, a pilot survey and item analysis, yielding a draft version of the scale. Psychometric evaluation was conducted to refine the scale into its final form.

    Results

    The final KAP scale developed in this study comprised 31 items. The scale exhibited good content validity, with item-level content validity index (I-CVI) values ranging from 0.83 to 1.00. Exploratory factor analysis revealed that the scale extracted five factors, which accounted for 65.732% of the cumulative variance, and all items demonstrated rotated factor loadings > 0.5, indicating good construct validity. The Cronbach's α coefficients for the knowledge, attitudes and practices dimensions were 0.877, 0.915 and 0.935, respectively, and the split-half reliability coefficients were 0.909, 0.886 and 0.864.

    Conclusion

    The KAP scale for pain care in older adults with dementia developed in this study possesses good reliability and validity and can be used to assess the knowledge, attitudes and behavioural levels of nursing assistants in pain care.

    Implications for the Profession and/or Patient Care

    This study developed and psychometrically validated a KAP scale specifically designed to assess pain care for older adults with dementia among nursing assistants. Clinical managers can utilise this tool to systematically identify deficiencies in staff members' knowledge, attitudes or practices, thereby providing scientific evidence for the development of targeted pain care training programs and pain management strategies. This contributes to enhancing nursing assistants' pain care competence, ultimately alleviating the pain burden of older adults with dementia and improving their quality of life.

    Reporting Method

    The STROBE checklist was used as a guideline.

    Patient or Public Contribution

    No patient or public involvement.

    Consultations Within School Health Services: A Cross‐Sectional Observational Study

    ABSTRACT

    Aim

    This study aims to (1) describe the content of consultations within school health services, (2) outline school nurses' assessments, and (3) identify factors that influence the duration of consultations.

    Design

    A cross-sectional observational study was conducted.

    Methods

    The data were collected in Norway during November 2023 using a self-report form by school nurses (n = 96). Consultations (n = 382) were registered and analysed using descriptive statistical methods and multiple linear regression analyses to identify factors influencing the duration of consultations.

    Results

    Nearly 30% of the pupils had to wait for a consultation and 29% of the registered consultations were drop-in. School nurses had to prioritise due to limited time in 41% of the consultations. Mental health was the predominant theme. Several adverse factors, such as interruptions during consultations, affected the time spent.

    Conclusion

    This study provides knowledge about the content of consultations within school health services in Norway, contributing to the enhancement of this activity within these services.

    Implications for Profession and/or Patient Care

    The insights from this study may serve as a foundation for developing guidelines for consultations, helping to ensure equitable support for all children and adolescents.

    Impact

    To our knowledge, this is the first study that gives a broad insight into consultations within the Norwegian school health services. Having enough resources is essential for providing good services. Politicians and central authorities need to consider this when deciding on budgets.

    Reporting Method

    This study adhered to STROBE guidelines for reporting cross-sectional studies.

    Patient or Public Contribution

    No patient or public involvement.

    Timely Implementation of Patient‐Reported Outcomes in Clinical Care: Insights From Clinicians and Health Informatics Experts

    ABSTRACT

    Aim

    To explore the optimal timing of patient-reported outcome assessment, defined as the collection and use of patient-reported outcomes at clinically meaningful points such as before or during encounters, treatment initiation and follow-up, and to identify the facilitators and barriers to timely use.

    Design

    A qualitative analysis of semi-structured interviews with healthcare professionals across diverse US health systems.

    Methods

    Thematic analysis was used to identify key themes related to the timing and implementation of patient-reported outcomes assessments. Interviews were analysed iteratively to develop a coding framework and synthesise overarching themes.

    Results

    Fourteen healthcare professionals, including nurse practitioners, cardiologists and health informatics experts across seven U.S. health systems from academic and community hospitals, were interviewed in February 2024. Three major themes emerged: (1) value proposition of timely patient-reported outcome data collection (2) key facilitators for timely implementation and (3) multilevel barriers. The value proposition focused on the use of patient-reported outcomes for prevention and active disease management. Critical facilitators for the timely implementation of patient-reported outcomes included the involvement of research and clinical coordinators, strategies for pre-visit and on-site patient-reported outcome collection, the use of standardised templates within EHRs and the alignment of patient-reported outcome collection with patients' long-term treatment goals. Finally, multilevel barriers included time constraints, patient-level challenges (e.g., fatigue, literacy, language) and systemic issues (e.g., technical limitations, lack of reimbursement and unclear guidelines).

    Conclusion

    Timely collection and use of patient-reported outcomes is critical for improving symptom monitoring and supporting patient-centered clinical decision-making. However, multilevel barriers hinder consistent implementation across health care settings.

    Implications for the Profession and/or Patient Care

    Integrating patient-reported outcomes into clinical workflows can improve the patient-centeredness of patient-healthcare professional interactions, and provide a more holistic picture of a patient's health status. Addressing barriers to patient-reported outcome implementation, including lack of time, poor health literacy and workflow integration barriers, is crucial for improving clinical outcomes.

    Reporting Method

    This study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist, in accordance with EQUATOR Network guidelines.

    Patient or Public Contribution

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

    Psychosocial Support Interventions After Perinatal Loss: A Network Meta‐Analysis of RCTs Indicates What Works Best for Women's Mental Health?

    ABSTRACT

    Background

    Psychosocial interventions are recognized as effective nonpharmacological treatments that can enhance the mental well-being of women dealing with perinatal loss. However, as these interventions vary widely, there is currently no review that systematically evaluates and ranks their effects on the mental health of women affected by perinatal loss.

    Objective

    The aim of this study is to integrate the existing evidence, assess and compare the effects of psychosocial interventions on negative emotions among women experiencing perinatal loss, rank the effect sizes of various interventions, and identify the most effective intervention on the basis of different outcome measures.

    Methods

    Seven English-language databases were systematically searched for randomized controlled trials (RCTs) focusing on women experiencing perinatal loss, with publications up to August 20, 2024. Traditional pairwise meta-analyses were performed using Review Manager 5.4.1, while Stata 18.0 was employed for network meta-analysis and evidence synthesis. The surface under the cumulative ranking curve (SUCRA) was used to assess the efficacy of the interventions. The protocol was registered with PROSPERO under number CRD42024530312.

    Results

    A total of 30 RCTs encompassing 6181 participants were included in the analysis. On the basis of the SUCRA rankings, problem-solving therapy was identified as an effective treatment for alleviating depression and anxiety among women experiencing perinatal loss (depression: SUCRA = 82.55%, SMD = −1.34, 95% CI [−2.41, −0.27]; anxiety: SUCRA = 97.7%, SMD = −2.83, 95% CI [−4.26, −1.40]). Additionally, bereavement intervention emerged as the most effective approach for improving grief symptoms (SUCRA = 81.60%, SMD = −1.11, 95% CI [−2.14, −0.09]).

    Linking Evidence to Action

    Compared with traditional treatment, psychosocial intervention can improve the psychological state of women with perinatal loss, and the differences in the effects of face-to-face and technology-assisted interventions should be further explored. Moreover, problem-solving therapy has proven to be effective and appears to be the most effective method for alleviating depressive and anxiety symptoms among women experiencing perinatal loss, while bereavement support is the most effective method for grief due to perinatal loss. Nursing and health policymakers can develop various intervention strategies according to the varied psychological states of women experiencing perinatal loss.

    Suicide Risk and Protective Factors in Nursing Students in the United States

    ABSTRACT

    Aim

    This study examined cultural, contextual and psychological risk and protective factors for suicide risk (i.e., suicide ideation, planning and attempting in the past year) in a cross-sectional sample of nursing students in the United States.

    Design

    A cross-sectional study design was employed.

    Methods

    Nursing students (n = 9871) were selected from the national 2020–2021 Healthy Minds Study (HMS). Students reported their demographics, suicidality and non-suicidal self-injurious behaviour (NSSIB). They also completed validated self-report measures of depression, belonging and flourishing.

    Results

    Logistic regressions revealed that racial minority nursing students were at risk for suicidal ideation and attempts, and sexual minority students were at risk for suicidal ideation. Nursing students with a history of mental illness severe enough to seek treatment and those who reported more NSSIB also evidenced greater odds of reporting all forms of suicide risk. Specifically, the odds of suicidal ideation and attempts were more than three times greater for nursing students who reported NSSIB. Additionally, positive elements of flourishing only marginally protected against suicidal ideation, and belonging was not associated with any form of suicide risk.

    Conclusion

    Findings highlight the high number of nursing students at risk for suicidality and highlight potential demographic and psychological targets for suicide interventions. Impact: Early intervention during nursing school could impact suicide risk throughout a nurse's educational and professional journey. Thus, nurse educators should consider implementing suicide and mental health interventions in their programmes.

    Patient or Public Contribution

    No direct patient or public contribution.

    Nursing Students' Perceptions and Attitudes on the Application of Artificial Intelligence in Nursing Education: A Mixed‐Methods Systematic Review

    ABSTRACT

    Background

    The utilisation of artificial intelligence in the context of nursing education has become increasingly extensive. However, various studies show differing perspectives and attitudes among nursing students, and the findings have not been systematically synthesised.

    Aim

    To systematically review the perceptions and attitudes of nursing students on the application of artificial intelligence in nursing education.

    Design

    Mixed-methods systematic review.

    Method

    A comprehensive literature search was conducted across 10 databases, including PubMed, Cochrane, Embase, Web of Science, CINAHL, Scopus, China Science and Technology Journal Database, SinoMed, China National Knowledge Internet, and WanFang database, the inclusive years of articles searched were from 1969 to 2025. Two researchers independently screened the literature and extracted the data. The mixed methods assessment tool was used to evaluate the risk of bias in the included literature. The relevant data were extracted and synthesised according to the Joanna Briggs Institute's convergence synthesis method, ensuring the comprehensive integration of qualitative and quantitative results. These results were then integrated into the Technology Acceptance Model.

    Results

    A total of 28 articles were included, including 13 qualitative studies, 13 quantitative studies, and 2 mixed-method studies. According to the Technology Acceptance Model, the perceptions and attitudes of nursing students on the nursing education's adoption of artificial intelligence were integrated into 10 categories of three comprehensive themes: (i) Nursing students' perceptions and attitudes of the ease of use of artificial intelligence in nursing education, including 3 categories; (ii) nursing students' perceptions and attitudes on the usefulness of artificial intelligence in nursing education, including 4 categories; (iii) nursing students' behavioural intention, including 3 categories.

    Conclusions

    Overall, our study demonstrated that nursing students had an active willingness to utilise artificial intelligence. However, they acknowledged that certain issues persist regarding the ease and practicality of artificial intelligence in nursing education.

    Patient or Public Contribution

    No patients or members of the public were directly involved in this systematic review, as the study synthesised existing literature.

    Horizontal Violence or Workplace Bullying Among Intensive Care Unit Nurses: A Mixed Systematic Review

    ABSTRACT

    Aims

    To synthesise literature about horizontal violence or workplace bullying among Intensive Care Unit nurses, exploring its awareness, factors, impacts, and strategies.

    Design

    Following PRISMA standards, a mixed systematic review using a narrative synthesis approach and thematic analysis design of the Joanna Briggs Institute.

    Data Sources

    Four electronic databases from 2013 to 2023 studies published were searched.

    Results

    Eight studies were included: three qualitative and five quantitative. Four key themes emerged: (i) awareness and understanding of horizontal violence or workplace bullying, (ii) factors affecting horizontal violence or workplace bullying, (iii) impacts of horizontal violence or workplace bullying, and (iv) strategies to address horizontal violence or workplace bullying.

    Conclusion

    Addressing horizontal violence or workplace bullying requires hospitals should adopt conflict resolution policies, stress management programs, and supportive supervision to improve nurse retention. Nurse management should establish confidential reporting mechanisms, provide training on interpersonal respect, and implement supportive structures to promote psychological safety. Intensive care unit nurses are encouraged to take proactive steps to address workplace bullying, ensuring improved staff well-being and care quality.

    Impact

    This paper addresses a significant gap in the literature regarding horizontal violence or workplace bullying among Intensive Care Unit nurses.

    The findings will impact on healthcare administrators, policymakers, and educators. By understanding horizontal violence or workplace bullying, strategies can be implemented to improve workplace environment, support nurses' well-being, increase nurse retention, and improve the quality of patient care.

    Reporting Method

    This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review methodology, including data selection, extraction, and synthesis, follows PRISMA standards to ensure clarity, transparency, and reproducibility.

    Patient or Public Contribution

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

    Trial Registration

    There is a protocol that does not require registration, it made accessible at: https://doi.org/10.17605/OSF.IO/CFNEJ.

    The Climate‐Asthma Connection: Examining the Influence of Climate Change Anxiety on Asthma Control and Quality of Life: A Multi‐National Study

    ABSTRACT

    Aims

    This study aims to identify the impact of climate change anxiety and asthma control on asthmatics' quality of life and examine the moderating role of climate change anxiety in this linkage.

    Method

    A multi-national cross-sectional study was conducted in four Arabian countries on 1266 asthmatics selected by convenience sampling. Data were collected from November 2023 to February 2024 using a climate anxiety scale, mini-asthma quality of life questionnaire, and an asthma control questionnaire.

    Results

    Climate anxiety was higher among middle-aged participants, as well as those with longer disease durations and previous hospitalisations. Climate anxiety showed strong negative correlations with asthma control (r = −0.704, p ≤ 0.05) and asthma quality of life (r = − 0.638, p ≤ 0.05). Climate anxiety and asthma control are powerful predictors of quality of life among asthmatics. Climate anxiety moderates the relationship between asthma control and quality of life, making it less positive (B = −0.094, p > 0.001). Covariates such as gender, age, comorbidities, employment status, disease duration, and previous hospitalisation showed significant associations with asthma quality of life.

    Implications for Nursing Practice

    Assessment and mitigation of climate anxiety among asthmatics is a key strategy for controlling asthma and improving the quality of life. So, nurses must incorporate climate anxiety assessment into the care plan for asthmatics.

    Impact

    Climate change is a global concern, and insights into how climate-related psychological stressors exacerbate asthma symptoms and overall health outcomes are necessary. The findings provide actionable data for healthcare professionals to underscore the need for integrated healthcare approaches considering environmental and psychological factors.

    Reporting Method

    This study adheres to strengthening the reporting of observational studies in epidemiology (STROBE) statement.

    Patient or Public Contribution

    Clients with asthma across multiple nationalities actively contributed to our paper.

    The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal–Fetal Attachment in Primigravida Women

    ABSTRACT

    Aim

    To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal–fetal attachment in primigravida women.

    Design

    A multi-site cross-sectional research design study.

    Methods

    This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal–Fetal Attachment Scale (MFAS-HU-20).

    Results

    The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal–fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal–fetal attachment tends to decrease. The correlations range from −0.263 to −0.426, all significant at p < 0.001.

    Conclusions

    The emotional impact of climate change can adversely affect the bonding process between mother and fetus.

    Implications for the Profession

    Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers.

    Impact

    The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women.

    Reporting Method

    The research adhered to that is STROBE.

    Patient or Public Contribution

    Public contributions by women in community health centers.

    Positive Psychological Experiences in Chronic Heart Failure: A Qualitative Meta‐Synthesis

    ABSTRACT

    Aims

    Determine the positive psychological experience of patients with chronic heart failure through a systematic literature review and to provide a reliable basis for their psychological care.

    Design

    Qualitative meta-synthesis.

    Data Source

    A qualitative meta-synthesis was conducted to extract and analyse qualitative research from PubMed, Web of Science, Embase, Cochrane, CINAHL, PsycINFO and Chinese Database, including China National Knowledge Internet, Wanfang Database, China Biology Medicine Disc and VIP database from the inception of the database to 24 March 2024.

    Review Methods

    Two researchers screened, extracted and cross-checked data. Disputes resolved via discussion or 3rd researcher. Irrelevant titles/abstracts were excluded; full-texts were reviewed for final inclusion.

    Results

    A total of 17 qualitative studies yielded 58 results, categorised into 10 groups and synthesised into three themes: positive attitudes and emotional responses, positive changes after the disease diagnosis and supportive factors for positive psychology.

    Conclusions

    Heart failure patients can experience positive psychology post-illness. Care providers should prioritise psychological assessment and support factors to meet needs, foster rehabilitation and improved quality of life.

    Patient or Public Contribution

    CHF patients crucially contributed to this qualitative meta-synthesis by sharing insights into their positive psychological experiences, resilience and coping strategies.

    Exploring the Unique Challenges of ICU‐To‐Ward Transitions for Patients and Families: A Meta‐Synthesis of Qualitative Research

    ABSTRACT

    Background

    The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care.

    Aim

    Explore the experiences of patients and families during the transition from the intensive care unit to the general ward.

    Design

    A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis.

    Data Sources

    PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024.

    Review Methods

    Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method.

    Results

    Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories.

    Conclusions

    Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being.

    Impact

    Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications. The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care. Identify patient and family needs when designing transition interventions. Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings.

    No Patient or Public Contribution

    This is a meta- synthesis without direct patient involvement.

    Video‐Based Climate Change Program Boosts Eco‐Cognizance, Emotional Response and Self‐Efficacy in Rural Nursing Students: Randomised Controlled Trial

    ABSTRACT

    Background

    The Munich Security Conference 2024 highlighted the complex connections between climate change and global security risks. Engaging students in fighting climate change is a stepping stone to achieving the Sustainable Development Goals.

    Aim

    To investigate the effect of a video-based climate change program on revitalising eco-cognizance, emotional response, and self-efficacy among nursing students in rural communities.

    Design

    A randomised controlled trial research design was adopted.

    Method

    A total of 140 nursing students completed a survey related to the Climate Change Perceptions, the Climate Change Anxiety Scale, and the Environmental Self-Efficacy Scale. The study group engaged in the video-based climate change program, while the comparison group received flyers related to climate change across the globe.

    Results

    The intervention group significantly improved climate change perception and environmental self-efficacy compared to the control group, with large effect sizes. On the other hand, significantly lower levels of cognitive impairment due to climate change anxiety were recorded among the intervention group compared to the control group.

    Conclusion

    Our intervention improved nursing students' climate change literacy, pro-environmental attitudes, environmental self-efficacy, and anxiety. Future research may target a variety of university majors and use RCTs nested in a mixed-method design to capture the student experience with climate change before and after the RCT.

    Impact

    This study demonstrated that a comprehensive educational program significantly improved climate literacy, pro-environmental attitudes, and environmental self-efficacy among undergraduate nursing students while reducing climate anxiety. The findings of this study offer valuable insights for enhancing student nurses' ability to translate their scientific understanding into informed decision-making regarding issues like climate change.

    Implications for Practice and/or Policy

    Drastic natural disasters, including extreme temperatures, flooding, wildfires and snow and sandstorms, significantly affect populations, including nursing students. Early screening and management of climate change anxiety among university students is recommended as a buffer against upcoming mental health issues. Student counselling services are urged to consider the effect of climate change as a mental health parameter that significantly affects students' psychological and, consequently, academic life and progress. A video-based climate change program (VBCCP) is beneficial for equipping students with climate change literacy. The revitalization of the participant's overall eco-emotional response, pro-environmental behaviour and cognizance signalled the potential of VBCCP as a simulation teaching tool that might be integrated into nursing curriculums. Additionally, VBCCP is a cost-effective strategy that complies with International Nursing Association for Clinical Simulation and Learning (INACSL) requirements. The VBCCP can be delivered in the conventional classroom environment or through the digital platform without incurring additional costs and in alignment with the definition of simulation provided by the Agency for Healthcare Research and Quality.

    Patient or Public Contribution

    No public or patient contributions.

    Trial Registration

    RCT registration: NCT06223412, on 23rd January 2024

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