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AnteayerInternacionales

Clinical Nurses' Attitudes and Self‐Reported Practices of Family Nursing in Japan Following COVID‐19 Visitation Restrictions: A Cross‐Sectional Study

ABSTRACT

Aim

To examine clinical nurses' attitudes towards and self-reported experiences of family nursing in Japan following the relaxation of COVID-19 visitation restrictions. Particular attention is paid to early career nurses whose formative training occurred during visitation bans. The study focused on nurses' negative perceptions and emotional burdens associated with family involvement.

Design

A quantitative-dominant mixed-methods cross-sectional study reported in accordance with the STROBE guideline.

Methods

Using a convenience sampling approach, a self-administered, paper-based questionnaire was distributed to clinical nurses in four general hospitals in Japan between January and May 2024. The questionnaire consisted of four parts: demographic and professional background, learning methods related to family nursing, 17 items including negatively valenced statements adapted from the Families' Importance in Nursing Care–Nurses' Attitudes (FINC-NA) scale, and one open-ended question. Quantitative data were analysed using descriptive statistics and t-tests, and qualitative responses were thematically analysed.

Results

Of 1921 nurses invited, 957 responded (response rate: 49.8%), and data from 892 valid responses were analysed. Overall, the nurses demonstrated positive recognition of family nursing as a professional value but also reported lingering emotional burdens and practical challenges when interacting with families. Early-career nurses who began practice during the pandemic showed greater uncertainty and lower affective engagement. Thematic analysis revealed five key themes: relational disruption, emotional stress, moral conflict, reappraisal of family engagement and ongoing barriers.

Conclusion

The findings underscore the need to structurally and educationally reintegrate families into nursing care. Simulation-based training, clear institutional policies and hybrid communication models are essential to rebuild relational continuity and support nurses' emotional and ethical capacity for family nursing.

Implications for the Profession and/or Patient Care

The findings highlight the need to structurally and educationally reintegrate families into clinical care to address the emotional burden and ambivalence reported by nurses. Organisational support—such as clear visitation policies, simulation-based education and reflective opportunities—can help rebuild nurses' relational competence and confidence in engaging with families. Creating supportive learning environments, including on-the-job mentoring and team-based reflection, may further facilitate the restoration of family nursing.

Impact

This study addressed how prolonged COVID-19 visitation restrictions disrupted family nursing practice in Japan, created generational differences in nurses' competencies, and shaped nurses' perceptions of family involvement. Nurses reported emotional strain, feelings of being monitored and lack of time when families were present. Early career nurses showed lower relational engagement, while experienced nurses expressed moral distress. ‘Latent indifference’ was also noted. The findings provide valuable insights for healthcare organisations, nurse educators and policymakers by informing strategies to reintegrate families into patient care, improve discharge planning and strengthen training models.

Reporting Method

The STROBE checklist.

Patient or Public Contribution

No patient or public contribution.

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.

Development and Psychometric Evaluation of the Forensic Nursing Competency Scale‐Short Form for Hospital Nurses

ABSTRACT

Aim

To develop and evaluate the psychometric properties of the Forensic Nursing Competency Scale-Short Form (FNCS-SF) for hospital nurses.

Background

Nurses who care for victims of sexual abuse, domestic violence and elder or child abuse require forensic nursing competencies. However, few valid and reliable tools exist to assess these competencies in hospital settings.

Design

A cross-sectional study.

Methods

The study was conducted in two phases. Phase 1 involved the development and refinement of the FNCS-SF with input from 10 nurses. Phase 2 tested the tool's psychometric properties. A total of 420 nurses from two tertiary hospitals in South Korea participated. Participants were divided into two groups: Study 1 (n = 200) for exploratory factor analysis and Study 2 (n = 220) for confirmatory factor analysis.

Results

The FNCS-SF consists of 27 items across six factors: awareness of the medicolegal problem, evidence-based practice in forensic nursing, collaborative forensic nursing with community partners, safety and security, professional career development and multidisciplinary integrated knowledge. An item analysis revealed significant correlations between each item and the total scale score. Criterion validity was supported by significant correlations between the FNCS-SF and attitudes and beliefs towards forensic nursing and the performance of the forensic nursing role. Confirmatory factor analysis supported a six-factor model with good fit indices. Cronbach's alpha indicated strong internal consistency.

Conclusion

The FNCS-SF is a valid and reliable tool for assessing hospital nurses' forensic nursing competencies, which can improve patient safety and treatment outcomes. Further validation in diverse clinical settings is recommended.

Impact

The FNCS-SF can be used to improve forensic nursing competency through professional development.

Patient or Public Contribution

None.

Implications for Clinical Practice

The FNCS-SF provides a standardised framework to evaluate nurses' forensic competency, guiding education and practice to enhance clinical preparedness and deliver victim-centred care.

Reporting Methods

STROBE guidelines.

Factors Associated With the Survival of Older Patients With Pneumonia in the Emergency Department: A Retrospective Observational Study

ABSTRACT

Aims

To determine the clinical characteristics and identify not only the Korean Triage and Acuity Scale levels of older patients with pneumonia in the emergency department but also the factors associated with their survival.

Design

This study employed a retrospective observational design.

Methods

This study was conducted at the emergency department of a university hospital in Seoul, South Korea. It utilised medical data from January 1 to December 31, 2023. The study sample comprised 327 patients aged 65 years or older who received a pneumonia diagnosis (International Classification of Diseases: J10–J18). Binary logistic regression analysis was performed to identify independent factors associated with their survival.

Results

Survival was significantly associated with and influenced by sex (specifically, male sex), initial Korean Triage and Acuity Scale level, oxygen supplementation in the emergency department, consciousness level (specifically, painful response), body temperature (> 37.5°C) and a diagnosis of solid or hematologic malignancies.

Conclusions

The findings highlight the need for improved triage protocols, emphasising consciousness level, body temperature and malignancies. Incorporating geriatric-specific age thresholds and oncologic status into Korean Triage and Acuity Scale classifications may enhance risk stratification, timely intervention and resource allocation in emergency department settings.

Implications for the Profession and/or Patient Care

This study provides insight into triage accuracy for older pneumonia patients, emphasising early recognition of high-risk individuals and strengthening nursing assessment protocols. Improved Korean Triage and Acuity Scale classifications can optimise resource allocation and emergency care strategies, ultimately reducing mortality rates.

Impact

The study provides actionable insights for emergency nurses, triage clinicians and policymakers. The findings support the refinement of KTAS protocols to enhance risk stratification and guide resource allocation for older pneumonia patients, ultimately aiming to reduce mortality rates.

Reporting Method

Adhered to STROBE guidelines for observational studies.

Patient or Public Contributions

Although patients did not directly participate, the findings advocate for patient-centred triage improvements, enhancing early identification of high-risk older patients with pneumonia.

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.

Artificial Intelligence Technologies Supporting Nurses' Clinical Decision‐Making: A Systematic Review

ABSTRACT

Background

The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.

Objectives

To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.

Design

A systematic literature review.

Data Sources

CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.

Review Methods

JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.

Results

Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%–95% versus 55%–80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).

Conclusions

AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.

Impact

The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.

Competencies Required for Hospital‐Based Wound, Ostomy, and Continence Nurses to Provide PI Care in Home Care in Japan: A Mixed‐Methods Study

ABSTRACT

Aim

To identify the competencies required for hospital-based WOC nurses to provide direct pressure injury (PI) care in home care settings in Japan.

Design

Mixed methods convergent design.

Methods

The qualitative strand used a descriptive design to explore competencies for overcoming barriers faced by hospital-based WOC nurses when providing PI care at home. The quantitative strand used a cross-sectional design to assess competencies in organising the hospital PI management system.

Results

Six competencies were identified: (1) Establish relationships with home healthcare professionals; (2) Promote hospital-based WOC nurse's expertise to home healthcare professionals; (3) Collaborate with the regional medical liaison office in WOC nurse's hospital; (4) Involve hospital administrators in home PI management; (5) Utilise social media/Information and Communication Technology for patient or home-visiting nurse communication; and (6) Utilise public or academic support projects to facilitate home-based activities. The median scoring rate for each medical staff domain on the revised Collaboration Competency Scale for WOC Nurses ranged from 80% to 91%.

Conclusion

The results of this study can serve as a practical resource to help WOC nurses expand their activities into home-care settings.

Implications for the Profession

Their ability to coordinate with staff and manage PI care within hospitals supports active engagement in home care, improving continuity and quality.

Impact

This study addressed the issue that many hospital-based WOC nurses cannot visit patients at home. The competencies identified may enable these nurses to expand their role into home care.

Reporting Method

This study followed EQUATOR guidelines, with the STROBE Statement applied to the quantitative part and the COREQ checklist to the qualitative part.

Patient or Public Contribution

Patients or the public were not involved in the study's design, conduct, or reporting.

The Mediating Effect of Organisational Support Between Change Fatigue and Adaptive Performance Among ICU Nurses: A Cross‐Sectional Study

ABSTRACT

Aims

The main purpose of this hypothesis-driven study was to assess levels of change fatigue, adaptive performance and organisational support among ICU nurses; to explore the effects of change fatigue and organisational support on adaptive performance; and to examine the mediating role of organisational support in the relationship between change fatigue and adaptive performance.

Design

A multi-site, cross-sectional survey.

Methods

From February to April 2025, 621 ICU nurses from 12 public secondary and tertiary hospitals in Guizhou, Zhejiang, Anhui and Hebei Provinces were recruited via convenience sampling. A questionnaire assessed their change fatigue, perceived organisational support and adaptive performance.

Results

The surveyed ICU nurses in this study exhibited moderate change fatigue, adaptive performance and perceived organisational support. Change fatigue was negatively correlated with both adaptive performance and perceived organisational support (both p < 0.05), while adaptive performance was positively correlated with perceived organisational support (p < 0.05). Perceived organisational support mediated between change fatigue and adaptive performance, accounting for 29.17% of the total effect.

Conclusion

The level of change fatigue can directly affect adaptive performance and influence it indirectly through the mediating role of organisational support. Managers should establish a multidimensional organisational support system to enhance the adaptive performance of ICU nurses.

Impact

The findings of this cross-sectional study suggest administrators provide both instrumental and emotional support to ICU nurses to mitigate change fatigue, and recommend implementing resource depletion alert systems and adopting targeted interventions.

Patient or Public Contribution

No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.

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.

Summary of the Best Evidence for Weaning From Mechanical Ventilation in Neurocritical Care Patients

ABSTRACT

Aim

The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.

Methods

According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.

Results

A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.

Conclusions

This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.

Implications for Clinical Practice

Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.

Reporting Method

This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.

Trial Registration

This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823

Secondary Traumatic Stress and Post‐Traumatic Stress Symptoms in Nurses: Mediating Role of Psychological Distress and Moderating Role of Emotional Support

ABSTRACT

Aim

This study aimed to investigate whether psychological distress mediates the relationship between secondary traumatic stress (STS) and post-traumatic stress symptoms (PTSS) among clinical nurses, and whether perceived emotional support moderates this mediating effect.

Design

A cross-sectional study.

Methods

A total of 205 clinical nurses who had direct patient contact and trauma-related experience were included. Data were collected using validated instruments: the Secondary Traumatic Stress Scale (STSS), Depression Anxiety Stress Scale-12 (DASS-12), Impact of Event Scale-Revised (IES-R), and the Multidimensional Scale of Perceived Social Support (MSPSS). All scales demonstrated high internal consistency (Cronbach's α = 0.88–0.97).

Results

Psychological distress significantly mediated the relationship between STS and PTSS. Perceived emotional support moderated the path from STS to psychological distress, such that higher emotional support amplified the association. However, emotional support did not significantly moderate the relationship between psychological distress and PTSS.

Conclusion

Psychological distress plays a central role in translating STS into PTSS among clinical nurses. Although emotional support may buffer early psychological distress, it does not attenuate PTSS development once distress is established.

Implications for the Profession and/or Patient Care

Early detection and management of psychological distress can prevent STS from progressing to PTSS. Nurses frequently exposed to trauma require timely psychological support. We recommend implementing routine screening and early interventions focused on distress, along with peer-support programmes and supervisory encouragement to enhance resilience. Trauma-informed care training and organisational awareness should also be strengthened to foster a supportive environment.

Impact

This study shows that managing early emotional symptoms is critical in preventing PTSS among nurses exposed to secondary trauma. Findings can inform global policies, peer-support initiatives, and early screening systems to enhance resilience and safeguard patient care.

Reporting Method

The study adhered to the STROBE checklist for cross-sectional studies.

Patient or Public Contribution

No patient or public contribution.

The Mediating Effect of Team Job Crafting on the Association Between Transformational Leadership and Occupational Well‐Being in Newly Graduated Nurses

ABSTRACT

Objective

To explore the mediating effect of team job crafting on the transformational leadership–occupational well-being association in newly graduated nurses.

Methods

A multicentre cross-sectional study was conducted in three tertiary hospitals in China. Using convenience sampling, 677 newly graduated nurses were recruited between August 2024 and September 2024, and completed the transformational leadership questionnaire, team job crafting scale for nurses, and healthcare providers' occupational well-being scale. Data analysis was performed using IBM SPSS 27.0 software and the PROCESS 4.2 plugin. Hayes' mediation model (Model 4) was employed to test the indirect effect. The significance of the mediating effect was assessed using the bias-corrected bootstrap method (5000 resamples).

Results

Ultimately, 546 valid questionnaires were collected. The participants' transformational leadership, nurse team job crafting and healthcare providers' occupational well-being scores were all above average. Linear regression analysis revealed that transformational leadership and team job crafting positively predicted occupational well-being (β = 0.549, p < 0.001; β = 0.695, p < 0.001). Mediating analysis revealed that the indirect effect of transformational leadership on occupational well-being was 0.276 (95% confidence interval: 0.174, 0.377), indicating the presence of an indirect effect. Additionally, team job crafting accounted for 33.5% of the effect of transformational leadership on occupational well-being.

Conclusion

Perceived transformational leadership among newly graduated nurses could positively influence their occupational well-being, with team job crafting playing a partial mediating role between the two. Therefore, it is recommended that nursing managers strengthen their transformational leadership practices to promote the accumulation and internalisation of job resources among newly graduated nurses, thereby enhancing their ability and level of team job crafting and further promoting their occupational well-being.

A Qualitative Study of Follow‐Up Needs in Patients With Diabetic Foot Ulcers Based on the Biopsychosocial Model

ABSTRACT

Aim

The aim of this study was to explore the follow-up needs of patients with diabetic foot ulcers.

Design

A qualitative descriptive study was conducted, guided by Engel's biopsychosocial model.

Methods

Purposive sampling was used to recruit 17 patients with diabetic foot ulcers of Wagner grade ≥ 1. These patients had received care in the Endocrinology and Metabolism Department or the Wound Clinic of a tertiary hospital in Xi'an, China. Guided by the biopsychosocial model, individual face-to-face semi-structured interviews were conducted between April and July 2024. Data were analysed using thematic analysis.

Results

Nine themes were identified. In the biological domain, patients reported needs for disease care and lifestyle modification. In the psychological domain, they highlighted the importance of emotional coping support and building trust with healthcare providers. In the social domain, patients expressed needs for personalised follow-up, equitable access to healthcare, financial support, community assistance, and management of family caregiving role conflicts.

Conclusions

This study identified biological, psychological, and social follow-up needs among patients with diabetic foot ulcers, highlighting the importance of holistic follow-up to promote recovery and improve quality of life after discharge.

Implications for the Profession

Nurses should assess and address the biological, psychological, and social follow-up needs of patients with diabetic foot ulcers after discharge, providing tailored care to promote ulcer healing and prevent recurrence.

Reporting Methods

This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.

Patient or Public Contribution

None.

Relationships Between Job Engagement and Self‐Efficacy, Perceived Organisational Support and Perceived Job Security for Newly Recruited Nurses: A Cross‐Sectional Study

ABSTRACT

Aims

To examine the relationships among perceived organisational support, perceived job security, self-efficacy and job engagement among newly recruited nurses and the mediating role of perceived job security and self-efficacy in the relationship between perceived organisational support and job engagement.

Design

Cross-sectional study.

Methods

This study employed a multicentre cross-sectional survey design and used the Perceived Job Security Scale, General Self-Efficacy Scale, Perceived Organisational Support Scale and Job Engagement Scale to survey 536 newly recruited nurses (from September 2023 to April 2024). Structural equation modelling was used to test the effects of perceived organisational support, perceived job security and self-efficacy on job engagement.

Results

In the study model, perceived organisational support, perceived job security and self-efficacy all directly affect job engagement among newly recruited nurses. Additionally, perceived organisational support can be used to predict job engagement through self-efficacy and perceived job security.

Conclusion

Perceived organisational support, job security and self-efficacy are positive predictors of job engagement among newly recruited nurses. Furthermore, perceived job security and self-efficacy mediate the relationship between perceived organisational support and job engagement.

Impact

Newly recruited nurses, as key agents in clinical nursing practice, play a crucial role in reducing nursing errors and improving work efficiency. The results of this study show that perceived organisational support, perceived job security and self-efficacy positively predict job engagement among newly recruited nurses. Clinical nursing managers and educators should assist newly recruited nurses in enhancing their perceived organisational support to foster job engagement by bolstering their perceived job security and self-efficacy.

Reporting Method

This study adhered to the STROBE guidelines.

Patient or Public Contributions

No patient or public contribution.

Effects of Non‐Pharmacological Interventions on Psychological Distress in Patients With Malignant Tumors: A Systematic Review and Network Meta‐Analysis

ABSTRACT

Background

The incidence of psychological distress in patients with malignant tumors is high, which seriously affects the treatment compliance and quality of life of patients and even reduces the survival time. Non-pharmacological interventions are acceptable to patients because of their minor side effects. However, among the numerous interventions, which non-pharmacological intervention has demonstrated the most significant effect is still unclear.

Aims

This study aimed to compare the efficacy of different non-pharmacological interventions on psychological distress in patients with malignant tumors.

Methods

The databases, including Wanfang databases, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, were searched systematically for randomized controlled trials on non-pharmacological interventions for psychological distress in patients with malignant tumors that were published up to July 5, 2025. Revman 5.3 and Stata 18.0 were used for paired and network meta-analysis, respectively.

Results

A total of 43 randomized controlled trials were included. The area under the cumulative sorting curve was ranked as Naikan Morita therapy (99.6%) > acceptance and commitment therapy (79.0%) > music therapy (78.3%) > logotherapy (77.8%) > behavioral activation (67.5%) > solution-focused nursing (66.1%) > dignity therapy (51.2%) > mindfulness-based stress reduction (50.6%) > mindfulness-based cognitive therapy (46.7%) > Mika app (39.8%) > psychological education (38.5%) > multi-dimensional collaborative nursing (29.0%) > life review therapy (26.0%) > exercise therapy (14.7%) > usual care (5.0%).

Linking Evidence Action

Non-pharmacological interventions had overall benefits in reducing the psychological distress of patients with malignant tumors, especially Naikan Morita therapy, acceptance and commitment therapy, music therapy and logotherapy. However, more high-quality randomized controlled trials are still needed to obtain more reliable conclusions.

THE Effect of Mentoring Programmes on Newly Graduated Nurses' Retention and Turnover: An Umbrella Review

ABSTRACT

Aim

To summarise the effect of mentoring within mentoring programmes on the retention and turnover of newly graduated nurses in healthcare settings.

Design

An umbrella review.

Methods

Two independent reviewers screened the titles, abstracts and full texts for eligibility and critically appraised the included reviews using the JBI critical appraisal. The findings were tabulated and synthesised.

Data Sources

The search was conducted in five electronic databases (CINAHL, OvidMedline, ProQuest, Scopus, Cochrane and Medic) in November 2023.

Results

Out of 450 Papers, 13 systematic and integrative reviews were included. Thirteen mentoring programmes were identified and categorised into three groups based on their content: didactic mentoring programmes, interaction-based mentoring programmes and combined mentoring programmes. Across these programme types, retention among newly graduated nurses ranged from 72% to 100% at the 1-year mark and 70% to 98% at 2 years. Turnover rates showed consistent reductions, with post-intervention rates ranging from 3.5% to 20% compared to pre-intervention rates of up to 50%. Several studies reported statistically significant improvements in retention and turnover, particularly in programmes integrating structured education and preceptorship models.

Conclusions

Several different mentoring programmes have been developed to support the transition of newly graduated nurses. Mentoring programmes that provide ongoing support and structured guidance increase retention and reduce turnover among newly graduated nurses.

Implications for the Profession and/or Patient Care

Effective mentoring programmes are key to ensuring high-quality patient care and a sufficient supply of qualified nurses in the future.

Impact

The findings can provide information for developing transition support and mentoring programmes for newly graduated nurses.

Reporting Method

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

Patient or Public Contribution

No patient or public contribution.

Trial and Protocol Registration

The umbrella review protocol was registered in PROSPERO: CRD42023478044.

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