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AnteayerInternacionales

Virtual reality‐based reminiscence therapy for older adults to improve psychological well‐being and cognition: A systematic review

Abstract

Background

Virtual reality-reminiscence therapy (VR-RT) has increasingly been applied to older adults to improve psychological well-being and cognition.

Objective

This review aims to identify (1) the design characteristics of conducting a VR-RT and (2) the effects of VR-RT on the user experience, cognitive outcomes and psychological well-being.

Design

Systematic review.

Methods

Eligible studies were sourced across nine electronic databases, trial registries, grey literature and hand-searching of the reference list. A narrative synthesis was conducted. Twenty-two studies were included, and most were appraised as high quality. Most of the VR-RTs were highly immersive and personalised, with participants having the autonomy of control. VR-RT has the potential to improve anxiety and depression, and cognitive outcomes for older adults. Overall, VR-RT was reported to be an enjoyable experience for older adults.

Conclusions

VR-RT is a promising innovation that can improve older adults' psychological well-being and cognition without significant side effects, including cybersickness and with the potential for scalability across various settings. More randomised controlled studies are needed to evaluate the effectiveness of VR-RT and its features and treatment dosage. These studies could also examine the effectiveness of VR-RT as an intervention to promote independence in activities of daily living and physical rehabilitation.

Relevance to Clinical Practice

VR-RT is a promising intervention for older adults in community settings to enhance psychological well-being and cognition. VR's versatility enables personalised experiences within dynamic virtual environments, possibly enhancing engagement and therapeutic outcomes.

No Patient or Public Contribution

This systematic review did not directly involve patient or public contribution to the manuscript.

Nurse Practitioner Students' Perceptions of an Artificial Intelligence Differential Diagnosis Tool: A Pilot Study

ABSTRACT

Aim

The aim of this study is to assess nurse practitioner students' perceptions and engagement with Isabel's artificial intelligence (AI) based differential diagnosis tool to support their decision-making skills during their theoretical and clinical placement training.

Design

This pilot study used a cross-sectional design.

Methods

Twenty-six nurse practitioner students provided feedback on their use of an AI differential diagnosis tool in both academic and clinical contexts. This survey used the Post-Study System Usability Questionnaire to assess the engagement levels and usability of the AI tool. Additional questions were included to evaluate the usage patterns, adequacy in training and confidence in diagnosis.

Results

There were mixed engagement levels: 44.4% (n = 8/18) used Isabel in two subjects—typically one or both clinical placement units—and 27.8% (n = 5/18) in one subject; students most often used the tool to confirm differential diagnoses. Usability was rated positively with the disease ranking, red flag diagnosis and link to national guideline features demonstrating the highest student usage. While most students found the tool beneficial to use during clinical placement and completing university assignments, some reported challenges due to insufficient training, impacting confidence in clinical application.

Conclusion

Isabel has potential as a valuable educational tool in Nurse Practitioner programs, but successful implementation depends on adequate training and support. The findings highlight the importance of comprehensive training and support to maximise AI tool utilisation, with direct implications for programme curricula, clinical education strategies and potential improvements in diagnostic reasoning skills for future nurse practitioners.

Implications for the Profession and/or Patient Care

This study provides an example of integrating artificial intelligence (AI) guided clinical decision-making training in nurse practitioner (NP) education. The findings can be used by educational institutions to trial similar AI-integrated learning approaches, enhancing diagnostic competence and potentially improving patient care outcomes.

Reporting Method

The Study adhered to the STROBE checklist for reporting.

Patient or Public Contribution

No patient or public contribution was made to this study.

Dyadic and Triadic Interviewing Techniques in Qualitative Research: Theoretical Underpinnings and Methodical Considerations

ABSTRACT

Aim

To discuss the dyadic and triadic interviewing techniques as distinct approaches to data collection in qualitative research.

Design

Methodological/methodical discussion.

Findings

Underpinned by a layered theoretical basis involving interpretivism, social constructivism and symbolic interactionism, dyadic and triadic interviewing approaches represent a tapestry that seeks to illuminate not only what participants think at the individual level, but also how they think together to generate shared, nuanced meanings. Key methodical considerations include participant recruitment and selection to form the dyads or triads, ethical issues, navigating power dynamics, determining saturation at the dyad or triad level and shifting the unit of analysis from the individual level to the dyad or triad level. Notable challenges to using these approaches include logistical complexity, ethical risks and the great need for skilled moderation.

Conclusion

Dyadic and triadic interviewing techniques occupy a vital methodological niche in qualitative studies, particularly within the contexts of health and social care research where relational dynamics and collaborative decision-making are central. By foregrounding co-constructed narratives and real-time interactions, dyadic and triadic interviewing techniques illuminate the interplay of individual agency, power asymmetries and cultural norms, offering insights that transcend the limitations of individual interviews or focus groups.

Implication for the Profession and Patient Care

The increasing complexity of care, treatment pathways, recovery and family-centered decision making warrants engagement beyond individual interviews. Dyadic and triadic interview techniques facilitate this by combining the in-depth benefit of individual interviews and shared interpretations of focus group discussions to capture meanings and experiences.

Impact

This methodological/methodical discussion offers clarity to employing dyadic or triadic interviewing approaches to improve their uptake in health and social care research.

Reporting Method

Not applicable.

Patient and Public Contribution

No patient or public contribution.

Perspectives of Patients, Family Caregivers and Healthcare Providers on End‐of‐Life Communication in Chinese Acute Care Settings: A Qualitative Study

ABSTRACT

Aims

To explore key stakeholders' experiences and perceptions of end-of-life communication in acute care settings.

Design

A qualitative descriptive study.

Methods

Data were collected from 4 May to 31 October 2023. Patients with terminal illness, family caregivers and healthcare providers were recruited from two Chinese hospitals via purposive sampling. Individual interviews were conducted with patients and family caregivers, whereas healthcare providers participated in focus group discussions. Thematic analysis was conducted.

Results

Nineteen patients, 22 family caregivers and 25 healthcare providers participated. Five themes emerged: (1) protective end-of-life communication, characterised by dominant family involvement, truth concealment and restricted end-of-life topics; (2) open end-of-life communication, characterised by dominant patient involvement, truth disclosure and diverse end-of-life topics; (3) patient-related factors, including comfort level in talking about end-of-life, burden and treatment engagement; (4) family-related factors, including comfort, burden, expectations, values and trust in healthcare providers and (5) healthcare provider-related factors, including comfort, time availability and clinical priorities, end-of-life communication awareness and skills and end-of-life care knowledge.

Conclusion

End-of-life communication in Chinese acute care settings oscillates between protective and open approaches, influenced by several individual factors.

Implications for the Profession and Patient Care

Healthcare providers must overcome stereotypes rooted in cultural values and adopt a proactive approach to end-of-life communication. Enhanced training and institutional procedures are needed to improve end-of-life communication in acute care settings.

Impact

The study provides nuanced insights into end-of-life communication dynamics in Chinese acute care settings, complementing global evidence. Coexisting protective and open communication approaches highlight the need for context-sensitive approaches to end-of-life communication. Multifocal interventions addressing patient-, family- and healthcare provider-related factors are warranted.

Reporting Method

Standards for Reporting Qualitative Research.

Patient or Public Contribution

No patient or public contribution was involved in the design or conduct of the study.

Development and Evaluation of a Generative AI Chatbot for Database Searching in Systematic Review

ABSTRACT

Introduction

Systematic reviews (SRs) require comprehensive, reproducible searches, yet developing search strategies is resource-intensive and demands specialized expertise. Generative AI offers potential to streamline this process, but empirical evaluations for GAI-assisted SR searching remain scarce. The objectives of this study are to: demonstrate a step-by-step process for developing a custom ChatGPT-based chatbot to support SR search strategy development, and evaluate its performance.

Design

A cross-sectional evaluation study.

Methods

We used ChatGPT-4.0 to create a chatbot designed to mimic a medical librarian, generating PICO-informed searches. Its knowledge base was augmented with two methodological references. After piloting testing, we refined its instructions. For evaluation, we randomly sampled 50 Cochrane SRs published in 2024. Standardized P–I–O prompts produced database-ready queries for PUBMED and EMBASE. The primary outcome was per-review success rate, summarized by median and inter-quartile range. A sensitivity analysis was conducted.

Results

Pilot testing achieved a retrieval rate of 41/49 (83.7%). In the main sample (1169 studies; median 13.5 studies per SR), the chatbot identified a median of 67.4% of included studies (IQR: 43.1%–88.4%). When limited to indexed studies (n = 1114), retrieval rose to 72.0% (IQR: 46.0%–92.5%). Lower performance was observed when outcomes were absent from the abstracts or interventions had many lexical variants.

Conclusions

A GAI-based chatbot can rapidly generate SR searches (~67%–72% identification), serving as a useful starting point but not a replacement for expert-led approaches. Integration of librarian expertise, structured prompts, and controlled vocabularies may improve performance. Further benchmarking and transparent reporting are needed to guide adoption.

The Effectiveness of Non‐Pharmacological Interventions on Preoperative and Postoperative Anxiety Among Patients Undergoing Abdominal Surgery: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

Patients undergoing abdominal surgeries have a chance to experience surgical-related anxiety. But the most effective non-pharmacological interventions in managing this anxiety have not yet been identified.

Aim(s)

To examine the effectiveness of different types of non-pharmacological interventions, and identify the effective components on pre- and postoperative anxiety management among patients undergoing abdominal surgeries.

Methods

A systematic search of randomized control trials (RCTs) examined the effects of non-pharmacological interventions on preoperative and/or postoperative anxiety (Primary outcomes) among patients undergoing abdominal surgery was conducted across MEDLINE, Ovid Nursing, AMED, PsycINFO, CINAHL, EMBASE, Cochrane Library, HyRead, and WANFANG DATA from 1987 to March 1, 2024. Secondary outcomes including postoperative pain, postoperative analgesics consumption, resumption of postoperative bowel movements, and length of hospital stay were also examined. Cochrane Risk of Bias Tool (version 2.0) was used for quality assessment. Meta-analysis was performed to synthesize the findings. Narrative summaries were provided for the studies that could not be included in the meta-analysis.

Results

This review included 35 RCTs. The interventions of included studies were categorized as prehabilitation, sensory stimulation, preoperative counseling, information provision, and psychological interventions. Meta-analysis revealed that preoperative counseling was beneficial in managing preoperative anxiety (SMD = −1.36; 95% CI = −1.96, −0.76), postoperative anxiety (SMD = −1.30; 95% CI = −1.62, −0.98), and postoperative pain (SMD = −0.84; 95% CI = −1.21, −0.47). Meanwhile, psychological interventions adopting relaxation exercises had potential effects in reducing postoperative opioid consumption and shortening time to postoperative bowel movement.

Linking Evidence to Action

Adopting preoperative counseling is suggested for the management of pre- and postoperative anxiety and postoperative pain among patients undergoing elective abdominal surgeries. A one-off lasting for 20–45 min preoperative counseling including individualized information about the coming surgery and perioperative process, and a discussion addressing patients' concerns is recommended. Future research is needed to explore the effects of relaxation exercise on important patients' outcomes such as postoperative analgesics consumption and time to resume bowel movement among patients undergoing abdominal surgery.

Trial Registration

PROSPERO registration number: CRD42023359484

Standards for Hospital Falls Prevention and Management: An International Comparative Analysis

ABSTRACT

Background

Hospital falls and associated injuries are a global issue associated with harm and significant costs to individuals and society, especially for older adults. Hospital standards specify the minimum level of care required to optimise patient safety, quality and outcomes. Standards are often used during hospital accreditation. This investigation analysed the content and quality of hospital falls standards across the globe.

Methods

Hospital standards were located by searching online databases (PubMed, CINAHL, Google Scholar, MEDLINE), ChatGPT, the grey literature via internet search engines, and websites of accreditation agencies, government agencies, and other relevant organisations. We searched for standards from the 60 largest countries by population plus the 60 countries with the highest gross domestic product (n = 82 after accounting for duplicates). For inclusion, hospital standards had to mention ‘fall/s’. Data were analysed using a deductive framework synthesis and content analysis to identify emergent themes.

Results

Forty-one standards used by at least 72 countries were identified from our search. Sixteen were excluded from detailed analysis because they did not mention falls and 3 could not be retrieved. A total of 22 standards were included in the final detailed analysis. Included standards showed wide variations in content and quality. Seven were assessed as high quality, 12 medium quality, and 3 were deemed to be of low quality. Some lacked details on hospital falls screening, assessment, prevention, and management. Consumer engagement in development, implementation, or evaluation was not mentioned in all standards. Procedures for falls data collection and reporting were seldom documented. Hospital standards infrequently referred readers to contemporary research or clinical practice guidelines.

Conclusion

There are variations in the quality and content of standards on hospital falls. International collaboration is recommended to increase the consistency and validity of hospital falls standards across nations, in order to optimise healthcare outcomes.

Impact

The findings of this global analysis of hospital falls standards have the potential to impact falls rates and fall-related injuries in hospital patients by providing data to inform the content, evidence base and use of hospital standards to optimise the safety and quality of care delivery. The findings inform the review, design and implementation of hospital accreditation procedures to improve patient outcomes, patient experiences, and service quality.

Factors Affecting Patient Safety Near Miss Reporting: A Systematic Review

ABSTRACT

Aim

To explore individual and organisational factors affecting near-miss reporting in healthcare settings.

Design

Systematic review following the PRISMA 2020 guidelines.

Data Sources

Five electronic databases from 2013 to 2024 studies published were searched.

Methods

A comprehensive search was conducted across PubMed, Web of Science, MEDLINE, Scopus and OpenAlex, covering English, full-text literature from 2013 to 2024. Inclusion criteria focused on studies investigating factors influencing near-miss reporting in healthcare. The risk of bias was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Data were synthesised using the Health Belief Model and the Hospital Patient Safety Culture framework.

Results

A total of 20 studies were included. Key individual barriers to near-miss reporting included a lack of knowledge and negative perceptions. Organisational factors, including hospital safety culture, leadership support, error communication, and non-punitive responses to reporting, significantly impacted reporting behaviours.

Conclusion

Promoting a structured and supportive reporting culture, educational initiatives, and simplified reporting mechanisms can improve near-miss reporting practices.

Implications for the Profession and/or Patient Care

Improving near-miss reporting practices by addressing identified barriers can lead to safer healthcare environments and better patient outcomes.

Impact

This paper addresses a gap in the literature regarding near-miss underreporting. The findings will have an impact on healthcare administrators, healthcare professionals, and ultimately, patients. Implementing strategies such as peer mentoring and constructive feedback, targeted training and simplified reporting systems can encourage consistent near-miss reporting. These efforts will ultimately lead to safer healthcare environments and improved patient outcomes.

Reporting Method

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

This systematic review has been registered with the OSF and is publicly available at https://doi.org/10.17605/OSF.IO/EJGY2

Patient Agitation in the Intensive Care Unit: A Concept Analysis

ABSTRACT

Aim

Exploring the concept of patient agitation in the intensive care unit.

Background

Patient agitation in the intensive care unit is of widespread concern and linked to negative outcomes for patients, staff, and family members. There is currently no consensus on what constitutes agitation in the intensive care context, hindering effective and tailored prevention and management.

Design

Concept Analysis.

Method

Walker and Avant's eight-step concept analysis approach.

Data Sources

A comprehensive search was carried out in the databases MEDLINE, PsychINFO and CINAHL. A total of 32 papers published between 1992 and 2023 were included, reviewed, and analysed to explore definitions, attributes, antecedents and consequences of patient agitation.

Results

Patient agitation in the intensive care unit is characterised by excessive motor activity, emotional tension, cognitive impairment, and disruption of care, often accompanied by aggression and changes in vital signs. Antecedents encompass critical illness, pharmacological agents and other drugs, physical and emotional discomfort, patient-specific characteristics and uncaring staff behaviours. Consequences of agitation range from treatment interruptions and poor patient outcomes to the psychological impact on patients, families, and staff.

Conclusion

Agitation in the intensive care unit is a complex issue which significantly impacts patient treatment and clinical outcomes. For healthcare professionals, patient agitation can contribute to high workloads and job dissatisfaction. Due to the complex nature of agitation, clinicians must consider multifaceted strategies and not rely on medication alone. Further research is needed to fully understand patient agitation in the ICU. Such understanding will support the development of improved strategies for preventing and managing the behaviours.

Implications

A clearer understanding of patient agitation supports the development of tailored interventions that improve patient care, guide ICU training, and inform future research.

Patient or Public Contribution

This concept analysis was developed with input from a patient representative.

Social Frailty in Heart Failure: Concept, Impact and Preventive Strategies

ABSTRACT

Aims

To explore the conceptualisation of social frailty and discuss its role in shaping the disease trajectory of heart failure. Based on the discussion, recommendations on how to prevent and manage social frailty in this clinical cohort are delineated.

Design

A discursive paper.

Methods

This paper searched two databases, PubMed and Google Scholar, for a narrative review of the literature related to social frailty and heart failure from 2008 to 2024.

Findings

By integrating the conceptualisation of social frailty from different theoretical paradigms, social frailty is a multi-domain construct that relies on a balance between the availability of environmental resources, social interactions and an individual's ability to maintain and acquire these resources to enhance their well-being. Substantial evidence showed the prognostic impact of social frailty on patient-reported, functional and clinical outcomes of patients with heart failure. The underlying mechanism is still under-investigated, but heart failure-related self-care may mediate its impact. Based on this evidence, improving social frailty may rely on a diagnostic protocol to enhance the person-centred care planning on ways to optimise the social resources to support complex self-care.

Conclusion

Social frailty poses a greater risk to health outcomes in patients with heart failure. Further research is needed to explore determinants and interventions for social frailty in this population.

Implications

This paper increases the awareness of social frailty in heart failure patients and provides important insights on how to combat this social determinant of poor health outcomes among this clinical cohort. A dual-purpose approach of improving social resources and self-care behaviours may have great promise in reducing their social frailty, and this postulation will need to be investigated in future research.

Patient or Public Contribution

There is no involvement of patients or the public in the design or writing of this discursive paper.

Community Dwelling Adults’ Lived Experiences of Participating in Death Cafés: A Phenomenological Study With Photovoice

ABSTRACT

Aim

To explore community dwelling adults' lived experiences of participating in death café in Singapore.

Design

A descriptive phenomenological study with Photovoice.

Methods

A purposive sample of community dwelling adults who participated in a community-based death café was recruited for this study. Data was collected through online individual semi-structured interviews. The Colaizzi's six-step descriptive phenomenological analysis was conducted for data analysis.

Results

Twenty community dwelling adults who participated in a death café were recruited. Participants' experiences of the death café were expounded in four themes: appeals of attending death cafés, enabling features of death café, engaging in die-logues, and perceived impacts of death café on everyday lives. The participants were attracted to death cafés for various reasons including curiosity and grief. A comfortable environment, accompanied by open dialogues and refreshments, was credited as enablers for death conversations. Through these ‘die-logues’, the participants had a deeper understanding of death and began engaging in advance planning.

Conclusions

Death cafés provide a supportive environment for individuals to engage in death-related conversations that may not easily occur in daily life. By engaging in conversations about mortality within death cafés, participants are encouraged to take proactive steps towards advance planning.

Implications for the Profession and/or Patient Care

Findings from this study can guide the development of community-based interventions by highlighting the essential components required for a death café tailored to the Asian context.

Impact

This study describes the community dwelling adults' lived experiences of participating in a death café. The findings from this study underscore the role of informal conversations about death as a tool to promote population health based palliative care initiatives such as overcoming death taboos and stimulating advance care planning among community dwelling adults.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Studies was used.

Patient and Public Contribution

Community-dwelling adults participated in the interviews.

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 to Implementing a Nurse‐Led Information System for Older Adult Patients' Post‐Discharge Self‐Care: An Exploratory Sequential Mixed‐Methods Study

ABSTRACT

Aim

To explore determinants impacting an Electronic Health Record-based information system implementation and their association with implementation fidelity based on the Theoretical Domains Framework (TDF) from nurses' perspectives.

Design

Exploratory sequential mixed-method design.

Methods

In stage one, semi-structured interviews with 53 purposively selected nurses informed the exploration of TDF domains influencing the implementation of the information system with directed content analysis. In stage two, a cross-sectional survey, informed by the qualitative findings, was conducted among 482 nurses to identify the most relevant and relatively important TDF domains by running generalised linear regression models.

Results

The qualitative interviews generated 13 TDF domains that were identified as major influencing factors, including technology characteristics, knowledge, attitudes, role agreement, self-efficacy, goal-setting, information circulation, and communication among nurses. Quantitative findings showed that 70% of nurses used and printed the written form through the information system, and only 34% offered verbal education consistently. Regression analysis identified nine domains that were relevant and important factors for implementation fidelity, including knowledge, skills, role identity, beliefs in consequences, beliefs in capabilities, intentions, goals, memory and decision processes, and environmental context.

Conclusion

Our findings confirmed previous evidence on determinants of implementing digital health technologies, including knowledge, competencies, perceived effectiveness, role agreement, intentions, decision processes, and environmental context. Additionally, we highlighted the importance of goal-setting for successful implementation.

Impact

This study investigated the relatively important associated factors that can impact the successful implementation of the nurse-led information system for post-acute care based on nurses' perspectives. These results can guide nurse practitioners in implementing similar initiatives and support evidence-based decision-making. Researchers can also further investigate the relationships between the identified determinants.

Reporting Method

Journal Article Reporting Standards for Mixed Methods Research.

Patient or Public Contribution

No patient or public contribution.

Validating the Doctoral and Academic Writing in Nursing, Midwifery and Allied Health Profession Survey Questionnaire for Writing Group Interventions

ABSTRACT

Aims

Despite extensive research on doctoral education, reliable tools to measure how writers' development relates to participation in social interventions such as writing groups are lacking. To address this, we conducted a study to create and evaluate a measurement tool for assessing the impact of writing group interventions on writers' development.

Design

This methodology paper reports on the design, content validity, and evaluation of a new survey tool: the Doctoral and Academic Writing in Nursing, Midwifery, and Allied Health Professional writing questionnaire (DAWNMAHP).

Methods

We created a pool of 39 items based on empirical articles from SCOPUS, ERIC, BEI, ZETOC, CINAHL, EBHOST, and PsycINFO, our experience, and stakeholder consultations. After a content validity assessment by writing experts, we revised the pool to 44 items in five domains. Finally, we tested it on doctoral writing workshop attendees using factor analysis, Pearson correlations, and Cronbach's Alpha evaluation.

Results

Thirty-six participants completed the DAWNMAHP survey tool: 22 doctoral students, seven early-career researchers, and seven participants on a designated pre-doctoral pathway. Cronbach's Alpha evaluation demonstrated good reliability (α > 0.70) for all five factors. This sample was deemed moderately sufficient (KMO = 0.579), and the items were loaded onto the five factors with all items' factor loadings > 0.5 through principal component analysis.

Conclusion

DAWNMAHP is a novel, reliable tool that measures the impact of writing group interventions on an individual writer's development concerning time management, the writing process, identity, social domains, and relational agency.

Implications for the Profession

Conducting pre- and post-writing group intervention tests and recruiting larger sample sizes is essential to further developing DAWNMAHP. It is a rigorous tool for researching the benefits of writing group interventions. Furthermore, DAWNMAHP is an effective assessment and measurement tool, making a novel contribution to research into doctoral education.

Patient or Public Contribution

No patient or public involvement was necessary at the validation stage of the DAWNMAHP tool.

Consensus‐Building Processes for Implementing Perioperative Care Pathways in Common Elective Surgeries: A Systematic Review

ABSTRACT

Aims

To identify and understand the different approaches to local consensus discussions that have been used to implement perioperative pathways for common elective surgeries.

Design

Systematic review.

Data Sources

Five databases (MEDLINE, CINAHL, EMBASE, Web of Science and the Cochrane Library) were searched electronically for literature published between 1 January 2000 and 6 April 2023.

Methods

Two reviewers independently screened studies for inclusion and assessed quality. Data were extracted using a structured extraction tool. A narrative synthesis was undertaken to identify and categorise the core elements of local consensus discussions reported. Data were synthesised into process models for undertaking local consensus discussions.

Results

The initial search returned 1159 articles after duplicates were removed. Following title and abstract screening, 135 articles underwent full-text review. A total of 63 articles met the inclusion criteria. Reporting of local consensus discussions varied substantially across the included studies. Four elements were consistently reported, which together define a structured process for undertaking local consensus discussions.

Conclusions

Local consensus discussions are a common implementation strategy used to reduce unwarranted clinical variation in surgical care. Several models for undertaking local consensus discussions and their implementation are presented.

Implications for the Profession and/or Patient Care

Advancing our understanding of consensus building processes in perioperative pathway development could be significantly improved by refining reporting standards to include criteria for achieving consensus and assessing implementation fidelity, alongside advocating for a systematic approach to employing consensus discussions in hospitals.

Impact

These findings contribute to recognised gaps in the literature, including how decisions are commonly made in the design and implementation of perioperative pathways, furthering our understanding of the meaning of consensus processes that can be used by clinicians undertaking improvement initiatives.

Reporting Method

This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

No patient or public contribution.

Trial Registration: CRD42023413817

Professional Self‐Realisation of Diabetes Nurse Practitioners: A Descriptive Study Using Quantitative and Qualitative Data

ABSTRACT

Introduction

To examine the personal characteristics, promoting factors and organisational barriers to the professional realisation of diabetes nurse practitioners in Israel.

Design

A descriptive study using quantitative and qualitative data.

Methods

The participants self-completed an electronic questionnaire, which included questions on demographic and professional characteristics and a self-realisation questionnaire constructed by the authors. Researcher-led focus groups were conducted, guided by a semi-structured guide. The discussions were recorded, transcribed and analysed by qualitative methods.

Results

Forty-one diabetes nurse practitioners (median age 50 years, 98% females) participated in the study. On average, the participants reported a relatively high self-realisation of their professional role, especially those who have been working in this role for many years. While some of them work independently and are supported by their organisation, their managers and other healthcare team members, specifically physicians, many feel that there are barriers to the full implementation of the role and achieving professional realisation. These include multitasking challenges and insufficient remuneration. Self-realisation was viewed by the participants as an opportunity to provide excellent care to patients as well as being professional beyond caring for patients. They wanted to expand their knowledge as well as guide and teach. Furthermore, they also associated self-realisation with the autonomy to carry out procedures and make decisions independently of physicians. Internal motivation was perceived as an important factor for personal self-realisation, which stems from personal creativity, aspiration for excellence, a subjective sense of freedom, self-guidance, desire for self-development and aspiration for personal growth at the highest levels.

Conclusion

Recognition and fostering of diabetes nurse practitioners' role contribute to nurses' self-realisation and professional growth.

Implications for the Profession

Personal and organisational factors should be aligned to support diabetes nurse practitioners in delivering high-quality care to patients with diabetes.

Reporting Method

COREQ (COnsolidated criteria for REporting Qualitative research).

Patient or Public Contribution

No patient or public contribution.

Adolescents, parents and providers experiences of triadic encounters in paediatric diabetes clinics: a qualitative study - Coyne et al 2023

Por: Yardley · D. · Waite · M.

Commentary on: Feeling like I’m failing a test, parents’ and adolescents’ opinions of diabetes clinic appointments.

Implications for practice and research

  • Developing communication skills is essential for healthcare professionals to enhance practice and avoid alienating adolescent patients.

  • Further research should be completed with patients who disengage from the clinic to understand how to best improve services and health outcomes.

  • Context

    Diabetes is a long-term health condition that requires continuous high-intensity self-management to prevent complications. This can be challenging for teenagers striving for independence and developing a sense of self. Maintaining engagement with adolescents with diabetes has favourable outcomes. Coyne et al1 undertook a qualitative study in two clinics in Ireland. The study aimed to understand the perceptions of attending diabetes clinics and experiences of consultations from multiple viewpoints. Researchers completed individual interviews, or focus group, with adolescent patients, their parents and...

    Nurse Practitioner Regulatory Assessment: Transitioning From an Onsite to a Virtual Format

    imageThe Nurse Practitioner Onsite Peer Review is an integral part of the British Columbia College of Nurses and Midwives Quality Assurance program. Traditionally an in-person assessment, Nurse Practitioner Onsite Peer Review involves a critical review of documentation by an experienced nurse practitioner assessor against regulatory standards and entry-level competencies. The onset of the COVID-19 pandemic and resulting environmental limitations required the college to rethink its approach to onsite reviews, resulting in the quality assurance program embarking on a pilot project to explore the feasibility of conducting reviews virtually. As there are many factors that can affect the transition of an onsite assessment to one that is virtual, it was important to consider the technical, workflow, and usability aspects in developing this new method of performance assessment. Therefore, including usability testing and a human factors approach to exploring this emerging method was vital to ensuring its success. In this article, we discuss our experience, including benefits, technical and administrative considerations, barriers, challenges, and lessons learned.

    Recently graduated midwives in Uganda: Self-perceived achievement, wellbeing and work prospects

    to investigate how recent graduates from a combined work/study midwifery degree programme in Uganda viewed its effects on their wellbeing and work prospects.
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