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Hoy — Octubre 14th 2025Internacionales

Communication Between Patients and Healthcare Professionals in Neurological Hospitalisation: A Qualitative Photo‐Voice Study

ABSTRACT

Aim

To explore and compare patients' and healthcare professionals' experiences of communication during hospitalisation for neurological diseases.

Background

Effective communication is essential for establishing strong relationships between patients and healthcare professionals, thereby ensuring patient-centred care that respects individual values and preferences. Neurological patients face additional communication challenges due to cognitive and motor deficits, such as speech difficulties and delayed cognitive processing. Limited research has investigated how both patients and healthcare professionals experience communication in this context.

Design

An explorative, qualitative design was applied within a hermeneutic framework inspired by photo-voice methods.

Methods

Data were obtained through interviews with patients (n = 12), one focus group discussion with healthcare professionals (n = 10) and six additional interviews with healthcare professionals (n = 6). Interviews were combined with photographs taken during the interviews. Data were analysed using reflexive thematic analysis, and the COREQ guideline was applied.

Results

The analysis revealed a main theme: The core of connected care, encompassing three subthemes: Guided alignment, A changing environment and Human before patient. These themes created the foundation for effective, compassionate and humanised care. Participants metaphorically compared this to an aquarium, emphasising that, like an ecosystem, effective communication requires balance between alignment, environment and humanity. This main theme represents the quality of communication between patients with cognitive challenges and their healthcare providers.

Conclusions

This study provides insight into the experiences of communication from both patients and healthcare professionals. Effective communication is important to manage treatment and engage patients in care.

Implications for Practice

Improving communication, promoting shared decision-making and enhancing the implementation of person-centred care are key strategies for increasing patient outcomes and satisfaction.

Patient and Public Contribution

None.

AnteayerInternacionales

Exploring Oral Health Promotion Among Palliative Care Providers: An Integrative Review

ABSTRACT

Aim

Poor oral health is a common but often overlooked concern in palliative care, negatively impacting patients' quality of life. There is limited understanding of how palliative care providers (PCPs) approach oral health promotion in this context. This review synthesises evidence on the knowledge, attitudes and practices of PCPs regarding oral health care and strategies to support them in this area.

Design

Integrative review.

Data Sources

A systematic literature search was undertaken until January 2025 across multiple databases (MEDLINE, CINAHL, Cochrane, ProQuest, EMBASE and Scopus) and grey literature. Inclusion criteria focused on nurses, medical specialists and allied health professionals involved in palliative or end-of-life care, with no publication year restriction.

Methods

This review followed Whittemore and Knafl's (2005) framework for integrative reviews. Study quality was assessed using appropriate tools for qualitative and quantitative studies, clinical guidelines and screening tools. A hybrid thematic synthesis approach was used for analysis.

Results

Twenty-five studies were included, mostly of moderate to high quality. Sample sizes ranged from 8 to 1339, with most participants being nurses and nursing assistants, followed by medical professionals. Findings revealed inconsistent knowledge, varied practices and limited prioritisation of oral health care. Barriers included system constraints, limited training and patient-related challenges. Supportive strategies such as guidelines, screening tools and educational interventions were identified.

Conclusion

A significant gap exists in PCP knowledge and practices regarding oral healthcare due to various barriers, with few supportive strategies documented in this field.

Implications for the Profession and/or Patient Care

There is an urgent need for enhanced education, robust evidence-based guidelines and tailored training for providers to advance and integrate oral health care in palliative care settings.

Reporting Method

PRISMA Checklist.

Patient or Public Contribution

No patient or public contribution.

Harnessing Machine Learning to Predict Nurse Turnover Intention and Uncover Key Predictors: A Multinational Investigation

ABSTRACT

Aims

To predict nurses' turnover intention using machine learning techniques and identify the most influential psychosocial, organisational and demographic predictors across three countries.

Design

A cross-sectional, multinational survey design.

Methods

Data were collected from 1625 nurses in the United States, Türkiye and Malta between June and September 2023 via an online survey. Twenty variables were assessed, including job satisfaction, psychological safety, depression, presenteeism, person-group fit and work engagement. Turnover intention was transformed into a binary variable using unsupervised machine learning (k-means clustering). Six supervised algorithms—logistic regression, random forest, XGBoost, decision tree, support vector machine and artificial neural networks—were employed. Model performance was evaluated using accuracy, precision, recall, F1 score and Area Under the Curve (AUC). Feature importance was examined using logistic regression (coefficients), XGBoost (gain) and random forest (mean decrease accuracy).

Results

Logistic regression achieved the best predictive performance (accuracy = 0.829, f1 = 0.851, AUC = 0.890) followed closely by support vector machine (polynomial kernel) (accuracy = 0.805, f1 0.830, AUC = 0.864) and random forest (accuracy = 0.791, f1 = 0.820, AUC = 0.859). In the feature importance analysis, job satisfaction consistently emerged as the most influential predictor across all models. Other key predictors identified in the logistic regression model included country (USA), work experience (6–10 years), depression and psychological safety. XGBoost and random forest additionally emphasised the roles of work engagement, group-level authenticity and person–group fit. Job-stress-related presenteeism was uniquely significant in XGBoost, while depression ranked among the top predictors in both logistic regression and random forest models.

Conclusion

Machine learning can effectively predict turnover intention using multidimensional predictors. This methodology can support data-driven decision-making in clinical retention strategies.

Impact

This study provides a data-driven framework to identify nurses at risk of turnover. By integrating machine learning into workforce planning, healthcare leaders can develop targeted, evidence-based strategies to enhance retention and improve organisational stability.

Reporting Method

This study adhered to STROBE reporting guideline.

Patient and Public Contribution

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

Exploring Subjective Cognitive Decline and Its Related Factors Among Young‐Old Adults: A Perspective on Social Network Types

ABSTRACT

Aims

To identify distinct social network types among young-old adults based on the characteristics of social network structure and to explore the relationship between different types, socio-demographic characteristics and subjective cognitive decline.

Design

A cross-sectional study was conducted from July 2022 to October 2023.

Methods

A total of 652 young-old adults aged 60–74 years completed the sociodemographic questionnaire, the subjective cognitive decline questionnaire-9 and the self-designed egocentric social network questionnaire. The types of social networks were identified by latent profile analysis. Univariate analysis and binary logistic regression were used to analyse the influencing factors of subjective cognitive decline.

Results

The incidence of subjective cognitive decline was 38%. Social networks of young-old adults tended to be large, predominantly family-centred and characterised by strong contact strength, high density and significant demographic heterogeneity among network members. Four social network types were identified: diverse-moderate, family-dense, family-strong and friend-loose. Young-old adults embedded in the family-dense and family-strong types were more likely to develop subjective cognitive decline than those in the diverse-moderate type. Additionally, age, education level, previous occupation, daily sleep duration and exercise were related to the incidence of subjective cognitive decline.

Conclusions

The findings highlight the relatively high incidence of subjective cognitive decline in young-old adults that is notably influenced by the type of social network they are embedded in. More attention needs to be paid to identifying and supporting young-old adults at high risk of subjective cognitive decline, especially to promote their social integration and friend network building, to improve their subjective cognitive function.

Implications for the Profession and/or Patient Care

The findings emphasise the importance of considering the structure and composition of social networks when addressing subjective cognitive decline among young-old adults. A diversified social network incorporating both familial and friendship ties may provide enhanced cognitive protection. Therefore, interventions targeting subjective cognitive decline should promote the expansion of friendship-based relationships and foster the development of more heterogeneous and multi-source networks.

Reporting Method

STROBE checklist.

Patient or Public Contribution

Not applicable.

Perceptions of Recurrence Risk Among Patients With Atrial Fibrillation: A Qualitative Study

ABSTRACT

Aims

The study aims to investigate patients' perceptions of recurrence risk associated with atrial fibrillation, with the goal of establishing a theoretical foundation for developing future measurement scale and intervention strategies.

Design

A qualitative interview study.

Methods

Seventeen patients diagnosed with atrial fibrillation at a Grade-A tertiary hospital participated in semi-structured, in-depth interviews conducted between October and December 2024. Participants were selected via purposive sampling. The data were analysed employing thematic analysis in accordance with Colaizzi's method. The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.

Results

The perceptions of recurrence risk among patients with atrial fibrillation can be summarised into five themes: (1) perceived likelihood of recurrence, (2) perceived severity of recurrence, (3) perceived triggers of recurrence, (4) emotional reaction to recurrence, and (5) efficacy perception of managing recurrence risk.

Conclusion

Perceptions of recurrence risk among patients with atrial fibrillation are diverse and often underestimated due to limited knowledge and subjective symptom interpretation, affecting health behaviours. Understanding patients' subjective appraisals, emotions, and perceived efficacy is essential. Validated assessment tools and tailored risk communication may enhance self-management and support targeted interventions.

Impact

This study provides critical insights into how atrial fibrillation patients perceive their risk of recurrence. It also provides a theoretical foundation for creating validated assessment tools and tailoring individualised health education and intervention programmes.

Patient Contribution

Patients were involved in the study design, data collection, and interpretation of findings. Their contributions included providing feedback on the initial interview guide to ensure relevance and clarity, participating in in-depth interviews to share their lived experiences with atrial fibrillation recurrence, and offering reflections on key themes emerging from the data.

The Relationship Between Chinese Nurses' Subjective Age and Career Satisfaction: The Mediating Role of Role Breadth Self‐Efficacy

ABSTRACT

Aim(s)

To assess career satisfaction among Chinese nurses, explore influencing factors, and examine the mediating role of role breadth self-efficacy (RBSE) in the relationship between subjective age and career satisfaction.

Design

A multi-centre, cross-sectional study.

Methods

Between June and October 2024, 2033 questionnaires were distributed to nurses across seven geographic regions in China, collecting data on demographics, subjective age, RBSE, and career satisfaction. Descriptive statistics, Pearson correlation analysis, multiple linear stepwise regression, and path analysis were used to identify determinants of career satisfaction and test the mediating effect of RBSE.

Results

The effective response rate was 97%. Chinese nurses reported moderate-to-high career satisfaction, younger subjective age relative to chronological age, and moderate RBSE levels. Multivariate linear regression analysis identified education level, work institution, salary, weekly working hours, subjective age, and RBSE as significant predictors of career satisfaction. Path analysis revealed a significant negative association between subjective age and career satisfaction (β = −0.23, p < 0.001), which was partially mediated by RBSE (indirect effect = −0.11, 95% CI: −0.18 to −0.05).

Conclusions

The career satisfaction of Chinese nurses is at a moderately high level; the influencing factors include the intensity of nursing work and salary levels. There is a certain difference between the subjective age and the chronological age of Chinese nurses. RBSE partly mediates the relationship between subjective age and career satisfaction.

Implications for the Profession and/or Patent Care

Valuing the breadth of nurses' roles, self-efficacy, and subjective age may help improve job satisfaction.

Impact

What problem did the study address?: This study elucidates the present level of career satisfaction among nurses in China and the variables affecting it. What were the main findings?: The subjective age of Chinese nurses influences career satisfaction, with RBSE partly mediating the connection between subjective age and career satisfaction. Where and on whom will the research have an impact?: This study presents novel variables of subjective age and RBSE in the investigation of factors influencing career satisfaction among Chinese nurses, offering new avenues for enhancing career satisfaction in this demographic in the future.

Reporting Method

We adhered to STROBE guidelines for cross-sectional research.

Patient or Public Contribution

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

Research Capability and Influencing Factors Among Clinical Nurses: A Multicentre Cross‐Sectional Study

ABSTRACT

Aim

To evaluate the research capability of clinical nurses in China and identify the determinants associated with their capability.

Background

As nursing evolves into an increasingly independent discipline, the research capability of clinical nurses has become critical for the development of the profession, advancing evidence-based practice and improving patient care quality.

Methods

A multicentre cross-sectional survey was conducted using convenience sampling from September 2023 to February 2024, among clinical nurses in tertiary hospitals across three provinces in China. The Nursing Research Capability Self-Assessment Scale was used to assess the research capability of the nurses. Chi-square tests, one-way analysis of variance and multiple linear regression were used to examine factors associated with research capability. The Strengthening the Reporting of Observational Studies in Epidemiology was followed.

Results

A total of 1074 clinical nurses participated. The mean research capability score was 89.11 ± 27.69, reflecting a moderate level of research capability. However, two dimensions of research questions and literature review received lower scores. Multiple linear regression analysis identified that education level, professional title, administrative position and nursing job title (all p < 0.05) were independent predictors of research capability.

Conclusions

Clinical nurses exhibit moderate research capability, with notable deficiencies in formulating research questions and conducting literature reviews. Key factors influencing research capability include education, professional title, administrative position, and job title. Targeted training and development programmes should address these factors to enhance nurses' research competence and advance nursing science.

Individual's Experience of Living With Roux‐en‐Y Gastric Bypass Surgery: An Interpretative Phenomenological Analysis

ABSTRACT

Aim

To explore the lived experience following Roux-en-Y gastric bypass surgery of eight men and women in the South of England who had undergone surgery a minimum of 12 months prior.

Design

This phenomenologically based qualitative study utilised Interpretative Phenomenological Analysis (IPA) as a framework for the analysis and exploration of participants' lived experiences.

Method

Semi-structured individual interviews were conducted with eight men and women in the South of England in 2017.

Results

Interpretative Phenomenological Analysis revealed four superordinate themes: Managing change and uncertainty; The affective experience of change; The post-operative body within its relational context; and The presence and absence of appropriate support.

Conclusion

Participants described the complex nature of the post-operative experience and highlighted the deeply personal nature of the adjustment required following surgery. The process of change and adjustment does not represent a smooth transition from pre- to post-operative life, and the experience of weight loss is intertwined with relationships that require patients to renegotiate the ways in which they understand themselves within social encounters.

Implications and Contribution

The clinical significance of this study lies in its support for the contribution that an existential phenomenological approach can offer in supporting individuals who choose to have bariatric surgery through its acknowledgment of the body as a site of experience which is situated within a person's wider social, cultural and historical world. These findings contribute an in-depth appreciation of the biopsychosocial experiences of individuals following Roux-en-Y gastric bypass surgery that can be applied in nursing practice to better inform the development of appropriate ways in which to support the overall wellbeing of individuals who made the decision to undergo bariatric surgery.

Patient and Public Contribution

Limited patient involvement was incorporated, focusing on feedback on the interview process.

The Perceptions of Male Accessibility to the Fields of Nursing Practice by Those Studying or Teaching Nursing in England: Cross‐Sectional Survey

ABSTRACT

Aims

Investigate the perception of male accessibility to the fields of nursing practice by those studying or teaching nursing in England.

Design

Cross-sectional survey.

Methods

Online questionnaire with three closed-scale questions and two open-text questions designed to elicit perceptions on the accessibility of men to the fields of nursing practice. The questionnaire was distributed to the staff and students at 61 nursing schools in England. Inferential and descriptive statistics were used to analyse the closed questions data and inductive content analysis was used to analyse open-text questions data.

Results

Students (n = 52) and staff (n = 51) responded to the survey. Adult (Mdn = 6, IQR = 2) and mental health (Mdn = 6, IQR = 2) were perceived as the most accessible fields of nursing practice to men, and child (Mdn = 4, IQR = 2) the least. Specialised practice areas in acute and emergency (Mdn = 6, IQR = 2), education (Mdn = 6, IQR = 2), leadership (Mdn = 7, IQR = 1), prison services (Mdn = 7, IQR = 1), and research (Mdn = 7, IQR = 2) were rated the most accessible to men and neonatal care (Mdn = 3, IQR = 3) the least. Societal stereotyping and stigma were seen as barriers to men entering the nursing profession. The perception that nursing is a feminised profession persists and a distrust of men is associated with child nursing. Men were viewed as progressing to leadership roles with greater ease than women.

Conclusion

Societal level stereotyping and stigma are perceived as prevalent in nursing practice areas considered less accessible to men entering the nursing profession.

Impact

This study adds insight into the gendered nature of nursing and highlights the barriers to men entering a profession with a workforce crisis.

Reporting Methods

STROBE cross-sectional studies guidelines. COREQ guidelines for content analysis.

Patient or Public Contribution

No patient or public contribution.

Association Between Colleague Violence and the Professional Image of Nursing and Career Decisions Among Nursing Students: A Cross‐Sectional Study

ABSTRACT

Aim

To examine how colleague violence affects professional image and career decisions among nursing students.

Design and Setting

This cross-sectional study was conducted from February 1 to March 1, 2023, at two public universities in Turkey.

Sample and Methods

All nursing students who met the inclusion criteria and voluntarily agreed to participate were included without any special sample calculation, and a final sample of 357 students was obtained. Data were collected between February 1 and March 1, 2023. Data were collected using a survey form that included questions on sociodemographic characteristics, as well as three scales: the Exposure to Colleague Violence Scale (ECVS) scale, the Image of Nursing Profession Scale (INPS) scale, and the Career Decision Scale (CDS). Data analysis included descriptive statistics, t-tests, ANOVA, Pearson correlation, and regression analyses.

Results

The mean ECVS score was 45.43 (20.80), the mean INPS score was 147.15 (13.51), and the mean CDS score was 79.67 (17.34). A weak negative correlation was found between colleague violence and nursing image, a weak positive correlation between colleague violence and career decision, and a moderate negative correlation between nursing image and career decision.

Conclusion

This study highlights the negative impact of exposure to colleague violence on nursing students, affecting both their professional image and career decision-making. Greater exposure to colleague violence correlates with more negative perceptions of the nursing profession and increased uncertainty in career choices. Implementing targeted interventions to reduce and prevent colleague violence, especially in clinical practice settings, is essential for promoting a positive professional image and supporting informed career decisions among nursing students.

Implications for the Profession and Patient Care

Addressing and reducing colleague violence among nursing students can enhance their professional image and decision-making regarding their careers, which, in turn, may lead to improved patient care and more significant long-term commitment to the nursing profession.

Reporting Method

This study adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for cross-sectional studies.

Patient or Public Contribution

There was no patient or public involvement in this study.

Knowledge and Opinions of Operating Room Nurses About Artificial Intelligence: A Descriptive Cross‐Sectional Study

ABSTRACT

Aims and Objectives

To assess the knowledge and opinions of operating room nurses about artificial intelligence.

Background

Artificial intelligence technologies play a significant role in improving the quality of care and ensuring patient safety. Operating room nurses play a crucial role in adopting technological innovations and improving patient safety.

Design

A descriptive cross-sectional study.

Methods

This study was conducted among 95 nurses working in the operating room departments of a private hospital between December 2023 and March 2024. Data were collected via Google Forms, which included questions about personal information, knowledge about artificial intelligence and opinions about artificial intelligence. Data analysis was performed using descriptive statistics.

Results

The level of knowledge about artificial intelligence among nurses was high. Social media emerged as the most commonly reported and predominant source of AI-related information, despite being considered unreliable. Nurses widely expressed ethical concerns, particularly regarding issues such as the lack of empathy and potential malfunctions. Nevertheless, many believed that AI could reduce workload and enhance the quality of patient care.

Conclusions

Although nurses have good knowledge about artificial intelligence, they require training to access reliable information. Nurses should be trained on artificial intelligence, and the technology should be integrated in a way that supports their professional roles.

Relevance to Clinical Practice

This study, which presents operating room nurses' knowledge and opinions on artificial intelligence, emphasises the need for nurses to receive training in artificial intelligence, highlighting that this will support the integration of artificial intelligence into nursing practices. Consequently, it suggests that the quality of nursing care can be enhanced.

Trends in Spirituality and Spiritual Care in Nursing—A Discursive Paper

ABSTRACT

Aim

This paper outlines key developments, innovations, and milestones in the field of spirituality and spiritual care in nursing.

Design

A discursive paper.

Results

Nursing scholars have significantly influenced the profession and contributed to the development of nursing knowledge, particularly in the field of spirituality and spiritual care. Key research has focused on nurses' perceptions and attitudes toward spirituality, clarifying foundational spiritual concepts, and establishing a framework of core spiritual care competencies for the profession.

Conclusion

Despite these advancements, significant gaps remain in nurses' knowledge, understanding, and experience in providing spiritual care. The development of agreed-upon spiritual care competencies at the European level offers important guidance for the profession, and educational initiatives are underway to support their integration. However, the field remains in an early stage of development, and further research is needed to embed spiritual care competencies into national and international nursing policy and practice. Moreover, continued research is also essential to inform and evaluate current educational programmes and nursing interventions, and to support the translation of evidence-based knowledge into effective spiritual care delivery.

Implications for the Profession and/or Patient Care

Spiritual support is proven to be an important consideration for many patients and families globally. Imbedding spiritual care education into both undergraduate and postgraduate nursing curricula is essential to prepare nurses to address the spiritual needs of patients in healthcare settings. Structured curricula that provide clear instructions on how to recognise, assess, and respond to spiritual concerns in clinical practice can enhance nurses' competence and confidence. Embedding spiritual care into education and training helps normalise spiritual care as a component of holistic nursing, supporting its inclusion in everyday care rather than treating it as an optional or marginal practice. Such educational integration has the potential to improve the consistency and quality of spiritual care across healthcare settings.

Impact

Internationally there are evident gaps in the consistent provision of spiritual care to patients and their families. These are being addressed through conceptual clarity, the agreed-upon competencies, and enhanced educational initiatives. It is essential to continue to increase awareness among the nursing profession on the necessity of addressing spiritual care needs, within the context of cultural perspectives to ensure that value is placed on the significance of these issues on a global scale.

Patient or Public Contribution

There was no patient or publication contribution in this specific commentary.

Changed Personal Attitudes Predict Sexual Behaviours Among Men Living With HIV in the Era of U=U: A Half‐Longitudinal Study

ABSTRACT

Introduction

In the era of ‘Undetectable = Untransmittable’ (U=U), reductions in condom use and increases in casual partnerships may contribute to elevated risks of coinfection with other sexually transmitted infections (STIs) and HIV super-infections among men living with HIV. These trends may reflect a shift in personal attitudes towards sexual behaviour and HIV risk, yet their influence on actual behaviours remains unclear.

Aim

To investigate how changes in personal attitudes and safe sex self-efficacy influence sexual decision-making.

Design

Two-wave longitudinal study design.

Methods

We conducted a 3-month longitudinal study from March to December 2023 among HIV-positive men (≥ 18 years) initiating ART in Changsha, China. Cross-lagged panel analysis and half-longitudinal mediation analysis were used to examine how changes in personal attitudes influenced sexual behaviours.

Results

427 men living with HIV were included at baseline, and 301 completed the follow-up survey. Sexual behaviours were associated with personal attitudes, namely safe sex fatigue, viral load/transmission beliefs, and sexual sensation seeking. More positive personal attitudes in these domains at baseline predicted lower safe sex self-efficacy over 3 months, while reduced baseline self-efficacy increased the likelihood of engaging in condomless sex and/or multiple sexual partners. All three personal attitude domains had significant indirect effects on sexual behaviours via safe sex self-efficacy.

Conclusion

In the era of U=U, the changed personal attitudes among men living with HIV may lead to the increased likelihood of engaging in condomless sex and/or having multiple sexual partners, and safe sex self-efficacy serves as a mediator in this relationship.

Impact

This study highlights the potential influence of attitudinal changes on sexual behaviours among men living with HIV in the ‘U=U’ era. Findings provide valuable evidence for developing more targeted interventions that address not only behavioural outcomes but also underlying personal attitudes.

Patient or Public Contribution

No patient or public contribution.

The Experience of Self‐Care in People With Osteoporosis: A Qualitative Descriptive Study

ABSTRACT

Introduction

Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailored nursing interventions. The objective of the study was to explore and describe the experience of self-care maintenance, monitoring, and management in people with osteoporosis.

Design

A qualitative descriptive study.

Methods

We conducted semi-structured interviews. Data were analyzed using Mayring's qualitative content analysis with a deductive approach based on Riegel's theory of self-care. We reported data in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.

Results

Participants (1 Male, 19 Females; Aged 55–80) Identified Four Themes of self-care: maintenance (e.g., Medication Adherence, Physical Activity), monitoring (e.g., Symptom Recognition, Test Interpretation), management (e.g., Lifestyle Reflections, Prevention), and general self-care. Key factors included motivation, trust in healthcare professionals, and integration of health behaviors into daily life. Barriers were low self-efficacy, poor symptom recognition, and inconsistent adherence.

Conclusion

Self-care in osteoporosis is a multidimensional and dynamic process influenced by individual beliefs, contextual factors, and support from healthcare professionals. Recognizing the variability in patients' self-care behaviors is essential to develop personalized education and support. Strengthening general health behaviors may enhance disease-specific self-care. This understanding can guide healthcare professionals in designing more effective, tailored care strategies.

Identity and Body in Emerging Adults With Congenital Heart Disease: A Qualitative Exploration

ABSTRACT

Aim

To explore the identity and body experiences of emerging adults with congenital heart disease.

Design

Qualitative descriptive study.

Methods

Narratives from 152 emerging adults about living with congenital heart disease and its impact on their identity and body experiences were analysed using template analysis. An inductive and deductive approach was combined, and the frameworks of illness identity and experience of embodiment were used as a starting point.

Results

The template analysis generated two primary themes: (1) identity and (2) body, each containing several subthemes. For identity, the subthemes were (1.1) illness identity and (1.2) acknowledgement. For body, the subthemes were (2.1) the dimensions of embodiment and (2.2) the process of embodiment. In addition, the related themes (3) self in light of the other and (4) lack of impact were included.

Conclusion

This study highlights the unique challenges emerging adults with congenital heart disease can encounter regarding their identity and body experiences.

Implications for Patient Care

Patient care would benefit from adopting a more holistic and person-centred approach that fosters positive identity and body experiences in emerging adults with congenital heart disease.

Impact

This study deepens our understanding of how congenital heart disease affects identity and body experiences in emerging adults. Recognising these aspects as crucial to psychological care can facilitate patients in sharing identity and body-related challenges and receiving tailored support.

Reporting Method

This study adheres to the EQUATOR guidelines and used SRQR as the reporting method.

Research Priorities for Nursing and Allied Health: A Priority‐Setting Project Using a Partnership Approach

ABSTRACT

Background

Research priorities guide research activities, funding and resources within health services. To ensure that research efforts are meaningful and impactful, it is vital that organisational research agendas reflect the priorities of both healthcare consumers and staff, alongside broader national and international research frameworks. This paper outlines a research priority-setting project conducted across two hospitals in Western Australia, aimed at identifying shared research priorities through a collaborative and inclusive approach.

Aim

To identify the top ten nursing and allied health research priorities for two hospitals in Western Australia.

Methods

A modified James Lind Alliance Priority Setting Partnership approach was used, involving health services users, nurses, allied health professionals, and community members in a co-design approach across three phases. In phase 1, four community conversations were conducted to elicit an initial set of research topics. This data-informed phase 2, a survey to collect diverse views from a wider participant pool. In phase 3, a pre-selected sample of potential research priorities was discussed in a consensus workshop to reach a group consensus of the top ten research priorities. Qualitative data was analysed using multi-step thematic analysis, and quantitative data was analysed using descriptive statistics.

Results

A total of 67, 151 and 18 people participated across study phases 1, 2 and 3, respectively, comprising nurses, allied health professionals, healthcare users, carers, and interested community members. The top ten research priorities reflected three areas: healthcare systems re/design (streamlining care; access to healthcare; patient journey and quality of care), workforce needs (workforce well-being, retention and adequate staffing; workforce training), and specific health issues and needs (dementia and delirium; mental health; caring for carers; Aboriginal and Torres Strait Islander health; palliative care and elderly people).

Conclusion

The research priorities identified in this study for two hospitals in Western Australia reflect the strong desire of nurses, allied health professionals, healthcare users and community members to improve structural issues in healthcare systems. This includes how healthcare systems are designed and integrated with each other, how workforce needs affect service delivery, and a greater focus on holistic service provision for specific health issues and needs.

Patient or Public Contribution

Healthcare consumers were an integral part of this study. Healthcare consumers were involved in the design of the study, the conduct of the study, and the review of the data analysis.

Nurses' Role in Transitional Care During Intensive Care Unit Family Meetings for Patients With Prolonged Mechanical Ventilation

ABSTRACT

Aim

To describe nurses' roles in transitional care planning during intensive care unit (ICU) family meetings for patients with prolonged mechanical ventilation (PMV).

Design

A qualitative descriptive study.

Methods

Using secondary data from a trial of a decision aid about PMV, transcripts from 19 unstructured ICU family meetings were purposively sampled and analysed using directed content analysis.

Findings

Among 76 recorded ICU family meetings where nurses engaged and spoke at length beyond introduction, nurses spoke at length in 19 (25%) of them. These 19 family meetings were analysed in depth. Three themes were identified describing the roles nurses served: (1) Transitional care liaisons (e.g., introducing next levels of care, identifying/engaging family members, providing patient/family education, managing medications, planning for discharge, assessing patient/family needs, coordinating care, setting goals, providing care continuity, offering provider guidance and referring to resources); (2) information and communication facilitators (e.g., moderating family meetings, facilitating family understanding and serving as communication intermediaries) and (3) family support providers (e.g., providing emotional support, describing expectations and advocating for patients/families).

Conclusion

Although nurses play a central role in patient care, they engage in only a minority of ICU family meetings addressing transitional care planning. Increased nursing involvement in these discussions may enhance care coordination and better support families navigating complex care transitions.

Implications for Clinical Practice

Findings suggest that more consistent engagement of nurses in ICU family meetings has the potential to support transitional care planning and family-centred care for patients with PMV and their families.

Impact

This work adds to a growing body of knowledge about nurses' role in ICU transitional care planning. These findings provide valuable guidance for future research and development of transitional care standards to guide nurses in ICU transitional care planning.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ).

Patient or Public Contribution

No patient or public contribution.

Preventing Child Maltreatment in Early Childhood: The Clinical Role of Public Health Nurses in Primary Care

ABSTRACT

Aim and Objective

To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.

Background

Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.

Design and Method

A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.

Result

Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.

Conclusion

Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.

Implications for Practice

This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.

Reporting Method

EQUATOR guidelines were followed, using the COREQ checklist.

Patient or Public Contribution

No patient or public contribution.

Refining Fall Risk Assessment Scale for Nursing Homes Among Older Adults With Cognitive Impairment: A Mokken Analysis

ABSTRACT

Aim

To refine fall risk assessment scale among older adults with cognitive impairment in nursing homes.

Design

A cross-sectional survey.

Methods

Mokken analysis was conducted to refine the assessment scale based on unidimensionality, local independence, monotonicity, dimensionality, and reliability. Data were gathered from cognitively impaired older adults in a nursing home from January to February 2023. Trained nursing assistants conducted face-to-face assessments and reviewed medical records to administer the scale.

Results

Emotion and State Dimension did not meet unidimensionality criteria (H = 0.14), particularly item Q9, which also violated local independence. Monotonicity analysis showed all items exhibited monotonic increases. After refinement at c = 0.3, the scale consists of nine items. With increasing c-values, the first seven items were ultimately retained to form the final version of the scale. Both optimised scales (9-item and 7-item) satisfied reliability requirements, with all coefficients (Cronbach's α, Guttman's lambda-2, Molenaar-Sijtsma, Latent Class Reliability Coefficient) ≥ 0.74.

Conclusions

The scale is suitable for assessing fall risk among older adults with cognitive impairment, with a unidimensional scale of the first seven items recommended for practical use. Future efforts should refine the scale by exploring additional risk factors, especially emotion-related ones.

Implications for the Profession and Patient Care

The refined 7-item scale provides nursing home staff with a practical, reliable tool for assessing fall risk in cognitively impaired older adults, enabling targeted prevention strategies to enhance safety and reduce injuries.

Impact

The refined 7-item scale provides nursing home staff with a reliable, practical, and scientifically validated tool specifically designed for assessing fall risk in older adults with cognitive impairment. Its simplicity enables efficient integration into routine clinical workflows, empowering caregivers to proactively identify risk factors and implement timely, targeted interventions. This approach directly enhances resident safety by translating assessment results into actionable prevention strategies within daily care practices.

Reporting Method

This study was reported in accordance with the STROBE guidelines.

Patient or Public Contribution

No Patient or Public Contribution.

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