Conectar
To examine which elements of thriving and PERMA may be associated with thriving and intentions to leave both the job and profession among early career nurses.
Retention of early career nurses is a global concern, with up to 60% leaving the profession within 2 years. While organisational factors have been widely examined, psychological constructs such as thriving and well-being are underexplored.
A cross-sectional design.
The study surveyed early career nurses (n = 90, response rate 34.1%) across Australia. Validated instruments assessed thriving, PERMA dimensions, organisational support and intention to leave. Multiple linear and logistic regressions identified key factors associated with thriving and intention to leave the job or profession. Reporting adhered to STROBE guidelines for observational studies.
Thriving was a significant factor associated with engagement (β 0.039, p = 0.031), relationships with colleagues (β 0.167, p = 032), and occupational hardiness (β 0.502, p = 0.001), while accomplishment was a negative factor associated with thriving (β −0.163, p = 0.001). Intention to leave the job was linked to lower levels of thriving (β −1.303, p = 0.048), reduced perceived organisational support (β −0.180, p = 0.048), and higher negative emotions (β 0.747, p = 0.009). Intention to leave the profession was associated with accomplishment (β 0.222, p = 0.048), perceived organisational support (β 0.193, p = 0.001), and years since graduation (β 0.299, p = 0.016).
Thriving was associated with engagement, peer support, and resilience, whereas attrition was associated with poor organisational support and negative affect. Accomplishment is negatively aligned with thriving and may reflect unmet expectations, increasing role strain, or other personal factors not directly related to organisational contexts. Results suggest psychologically supportive environments and PERMA-informed strategies may be important for enhancing early career nurse retention. Supporting nurses to thrive should be a key focus for managers seeking to sustain the nursing workforce.
This study provides actionable insights for creating psychologically supportive environments that may be associated with improved early career nurse retention. By applying the PERMA framework, healthcare leaders may consider implementing targeted strategies, such as fostering engagement, informing the importance of collegial relationships, and promoting resilience, in order to positively inform well-being and achieve lower levels of attrition in clinical settings.
No patient or public contribution.
To identify nurse practitioners' and registered nurses' willingness to participate in voluntary assisted dying, and the factors that influence these decisions.
A cross-sectional design.
An online survey was disseminated to members of 16 professional nursing organisations and associations between April and August 2024.
Responses from 396 participants were analysed. Most were registered nurses (n = 335, 84.6%), aged between 45 and 64 years (n = 217, 54.8%). Over half of the participants (n = 219, 55.3%) had some knowledge of voluntary assisted dying, and more than two-thirds (n = 274, 69.2%) strongly supported it. Respect for a person's rights (n = 345, 89.8%) and relieving suffering (n = 342, 89.1%) were the main reasons nurses participated. Most nurse practitioner participants would be prepared to assess a person's eligibility for voluntary assisted dying (n = 32, 82.1%) or prescribe a substance (n = 31, 79.5%), if permitted by law. Religion, age and years of experience were characteristics associated with reasons for participation.
In Australia, some RNs and NPs are willing to participate in a range of VAD-related activities. However, in some jurisdictions, nurses' engagement is limited by legislative and policy settings. Reconsideration of nurses' roles may enhance access.
With appropriate support, nurses can make a valuable contribution to the sustainability of the voluntary assisted dying workforce.
To examine the role of self-efficacy in the relationship between medication adherence and self-care behaviours in patients with Inflammatory Bowel Disease by describing their levels and exploring the interconnections among these variables.
Multicenter, cross-sectional.
A total of 452 patients were recruited through consecutive non-probabilistic sampling across nine Italian outpatient Inflammatory Bowel Disease Units. Data were collected using validated tools: the Morisky Medication Adherence Scale-8, the Self-Care Self-Efficacy Scale, and the Self-Care of Chronic Illness Inventory. Descriptive statistics, Pearson correlations, and mediation analyses were performed to explore associations and the mediating role of self-efficacy between medication adherence and self-care behaviours.
Participants had a mean age of 43.49 years; 50.9% were male, 49.2% had Crohn's disease, and 50.8% had ulcerative colitis. Only 10.2% reported high medication adherence, while most showed medium or low adherence. The mean self-efficacy score was 74.82. Medication adherence was positively associated with self-care maintenance, and self-efficacy statistically accounted for part of this association. Lower levels were observed in self-care monitoring and management behaviours.
Medication adherence was positively associated with self-care maintenance, and self-efficacy partially explained this relationship.
Routine assessment of medication adherence and self-efficacy may help identify patients at risk of poor self-care. Interventions aimed at strengthening self-efficacy, such as motivational interviewing, nurse-led counselling, and digital monitoring tools, may improve adherence and self-care maintenance.
The study addressed low medication adherence and suboptimal self-care in patients with IBD. Findings support integrating self-efficacy-enhancing strategies into multidisciplinary care to improve adherence and self-care behaviours.
Patients completed validated self-report questionnaires; however, they were not involved in the study design, conduct, analysis, or manuscript preparation.
To evaluate the health-related quality of life (HRQOL) of adults with Long COVID 2 years and beyond after COVID-19 illness.
Cross-sectional study.
Health status was assessed using the EQ-5D-5L instrument among 226 adults diagnosed in primary care with mild-to-moderate COVID-19 during the 2021 pandemic. Data were collected through a cross-sectional survey using a standardized questionnaire with a set of validated clinical outcomes for Long COVID. The sample consisted of adults aged ≥ 18 years who attended the specified ambulatory settings, tested positive for SARS-CoV-2, and agreed to be interviewed; the response rate was 70%. Health utility scores were compared between adults with and without Long COVID. Multivariate logistic regressions were applied to investigate the relationship between Long COVID and health-related quality of life outcomes.
Primary data were collected from six public Family Health Care Units in João Pessoa, Brazil, between May 2023 and July 2024.
Adults with Long COVID had statistically significantly lower median utility scores (0.784, IQR: 0.633–0.902) than those without persistent symptoms (1.0, IQR: 0.877–1.0). Poorer HRQOL was more evident among women, older adults, non-White individuals, participants with pre-existing chronic diseases, and those with lower educational attainment. Long COVID was associated with impairments in anxiety/depression, pain/discomfort and usual activities.
Adults with Long COVID experienced poorer HRQOL 2 years or longer after mild-to-moderate infection compared with those without persistent symptoms, regardless of sex, age, ethnicity, education level or comorbidities. These findings support the implementation of targeted interventions and rehabilitation services in primary care for individuals experiencing long-term health problems following COVID-19 illness.
Identifying adults at greater risk of persistent health impairments following COVID-19 may help health professionals, caregivers and policymakers better address the aspects of patients' lives that lack quality and develop a multidisciplinary approach in primary care to managing this condition.
What problem did the study address? ○
This study examined the association between persistent symptoms 2 years or longer after non-severe COVID-19 illness and health-related quality of life.
What were the main findings? ○
Long COVID was associated with poorer health-related quality of life, particularly in the domains of anxiety/depression, pain/discomfort and usual activities.
Where and on whom will the research have an impact? ○
The findings highlight the need for multidisciplinary management of long-term health problems among adult COVID-19 survivors in primary care.
The STROBE checklist was followed.
No patient or public contribution.
This study aimed to (1) implement a Safety Protocol of Thirst Management (SPTM) as an evidence-based practice for quenching postoperative thirst and (2) evaluate its effectiveness using a comparative pre-and-post induction design.
A quasi-experimental study using propensity scored matching.
Guided by the Iowa Model, the SPTM was implemented at a tertiary medical centre in Taiwan in 2023. Outcomes were compared between adult surgical patients admitted in 2023 (post-induction) and those admitted prior (pre-induction). Data on thirst and pain intensity, body temperature, and PACU length of stay (LOS) were analyzed for 15,168 patients.
A standardized SPTM flow diagram was established. Following SPTM induction, mean thirst scores significantly decreased from 5.76 to 1.30 (p < 0.001). Although pain intensity and PACU LOS (63.63 vs. 62.23 min) showed statistically significant increases, these changes were clinically marginal. Body temperature remained stable with no incidence of perioperative hypothermia.
The Iowa Model effectively guides nursing organizations in translating evidence into practice. The SPTM provides a safe, consistent framework for nurses to alleviate postoperative thirst, significantly enhancing the quality of surgical care.
This study addresses the lack of standardized thirst management. Results demonstrate that an evidence-based SPTM protocol effectively quenches thirst without increasing adverse clinical risks.
The SPTM was triggered by patient reports of thirst-related distress. During the design phase, patient feedback on the acceptability of cold oral stimuli was used to refine the protocol. While patients did not participate in the data analysis, the primary outcome (thirst intensity) was selected based on its significance to patient-cantered care.
This study was reported according to TIDieR guideline.
To examine the association between compassion fatigue and spiritual care competence amongst palliative care nurses, investigate the mediating role of palliative care quality and determine the moderating effect of job satisfaction.
Palliative care nurses face intense emotional demands and end-of-life stressors, increasing their risk of compassion fatigue and potentially affecting care delivery. Spiritual care competence is central to holistic palliative nursing; however, its association with compassion fatigue and the organisational factors shaping this relationship remain unclear.
A cross-sectional, correlational study.
Using a convenience sampling approach, 141 nurses working in palliative care units across hospitals in different regions of Türkiye were recruited. Data were collected between April and August 2024 via an online questionnaire including demographic variables and validated instruments measuring compassion fatigue, palliative care quality, spiritual care competence and job satisfaction. Data were analysed using SPSS and PROCESS macro.
The mean spiritual care competence score was 107.9 ± 14.7. Compassion fatigue was negatively associated with palliative care quality and spiritual care competence, whereas palliative care quality was positively associated with spiritual care competence. Mediation analysis indicated a significant indirect association between compassion fatigue and spiritual care competence through palliative care quality. Moderated mediation analysis indicated that this indirect effect was significant only amongst nurses reporting higher job satisfaction.
Compassion fatigue was negatively associated with palliative care nurses' spiritual care competence. Mediation analysis suggested that this association was statistically explained by palliative care quality, whilst job satisfaction moderated the relationship between compassion fatigue and care quality.
Addressing compassion fatigue as a critical occupational risk in palliative care nursing is essential. Organisational strategies that enhance job satisfaction and support high-quality care delivery may help sustain nurses' spiritual care competence and promote high-quality palliative nursing practise.
No patients or members of the public were involved in this study. Palliative care nurses participated by completing online questionnaires.
This cross-sectional study was reported in accordance with the STROBE Statement.
This study provides up-to-date knowledge on the correlates of workplace loneliness among Finnish nurses in the post-COVID-19 era. We examined the factors (background, work-related and dispositional) that were associated with loneliness among nurses. We also investigated the relationship between loneliness and job burnout, which was used as a mental health outcome in this study.
Workplace loneliness can be a notable stressor in contemporary working life. However, it has received little attention in nursing since COVID-19. Consequently, the present study focused on the antecedents and outcomes of workplace loneliness in nursing.
Cross-sectional survey design was used.
The dataset (n = 5893) was collected in the spring of 2024 from members of the Finnish Union of Practical Nurses. Analyses were conducted via regression analysis.
Regarding prevalence, over 20% of the nurses reported workplace loneliness at least occasionally. Psychosocial factors were most strongly related to greater loneliness: lack of co-worker and supervisory support, experiences of being bullied, and workaholism. Moreover, loneliness was also associated with the core symptoms of job burnout.
Loneliness can be experienced in nursing in contemporary working life, and it is likely to be one potential risk factor for nurses' job burnout. Social interventions should be developed and implemented in nursing organisations to tackle workplace loneliness. These interventions should concentrate on providing social support, preventing bullying, and increasing awareness of the ‘dark side’ of workaholism.
To identify and differentiate workload patterns across shifts and to provide evidence for optimizing nursing workforce allocation in emergency departments:
A cross-sectional study.
Real time data were collected from an emergency department in a general hospital in Seoul, South Korea, between October 30, 2023 to October 24, 2024. Smartphones, beacons, and smartwatches were used to capture nursing time, physical activity, work-related characteristics, and location transitions across 238 shifts. A multiclass eXtreme Gradient Boosting model was developed and evaluated to classify working shifts (day, evening, night). Shapely Additive exPlanations were applied to identify key contributing features, and shift-specific differences were examined using analysis of variance with post hoc tests.
The model demonstrated strong performance in distinguishing shifts. Key features included the number of admissions, discharges, assigned patients, and both direct and indirect nursing time, all of which varied across shifts. In contrast, location transition patterns were relatively consistent.
Shift-specific nursing workloads in emergency departments can be effectively identified using multidimensional, real-world nursing activity data.
Findings support the development of staffing strategies that account for variation in workload across shifts, with potential to improve efficiency and maintain quality of care.
This study addresses the lack of objective evidence for shift-specific workload differences in emergency nursing. It demonstrates that multidimensional activity data can distinguish workload patterns across shifts. The findings may inform staffing decisions for emergency department nurses and support improvements in workforce management and patient care.
This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.
No patients or members of the public were involved in the design, conduct, analysis, or reporting of this study.
To assess perceived patient safety competencies among nursing students and to examine their associations with their perceptions regarding clinical learning environment and unfinished nursing care.
An international comparative cross-sectional study.
A total of 1442 nursing students from the Czech Republic, Italy, Slovakia, and Türkiye participated between February and December 2025. Data were collected using the Health Professional Education in Patient Safety Survey, the Clinical Learning Environment, Supervision and Nurse Teacher scale, and the Unfinished Nursing Care Survey for Students. Descriptive statistics, non-parametric tests, Spearman correlations, and multivariate general linear modelling were applied.
Students reported significantly higher patient safety competencies in clinical compared with academic settings (p ≤ 0.001). Significant cross-country differences were observed across all competency domains (p ≤ 0.001). Perceived patient safety competencies were positively correlated with the overall quality of the clinical learning environment (r = 0.356–0.420; p < 0.001) and negatively correlated with unfinished nursing care (r = −0.107 to −0.171; p < 0.001). Multivariate analysis demonstrated that pedagogical atmosphere, premises of nursing care, supervisory relationship, and particularly the role of the nurse teacher were significant predictors of patient safety competencies.
The development of nursing students' patient safety competencies is closely linked to the quality of clinical learning environments. Strengthening educational and organisational conditions within clinical placements may play an important role in preparing future nurses for safe clinical practice.
Improving the quality of clinical learning environments, strengthening supervision, and addressing unfinished nursing care may support the development of nursing students' patient safety competencies and contribute to safer patient care.
The study was carried out according to the STROBE checklist.
No Patient or Public Contribution.
Workplace incivility is a pervasive challenge in healthcare. Few studies drew on theoretical concepts to simultaneously examine organisational correlates of incivility and its associations with nurses' work outcomes.
This study examined workplace incivility among nurses, focusing on job control, psychological job demands and workplace justice as workplace characteristics, and assessing its association with job satisfaction and intentions to leave.
A cross-sectional survey was conducted among 528 full-time nurses at a medical centre in Taiwan. Validated questionnaires assessed workplace incivility (the Workplace Incivility Scale), workplace characteristics, job satisfaction and intentions to leave. Multivariable linear regression examined associations of workplace characteristics with incivility, and associations of incivility with job satisfaction and intentions to leave, adjusting for demographic and workplace factors.
High workplace incivility was reported by 41.1% of nurses. In adjusted analyses, lower job control and lower workplace justice were associated with higher incivility scores. After adjustment for demographic and workplace factors, workplace incivility was negatively associated with job satisfaction and positively associated with leaving intentions. Among workplace characteristics, psychological job demands showed strong associations with both job satisfaction and leaving intentions.
Workplace incivility reflects underlying organisational conditions and is associated with lower job satisfaction and greater leaving intentions. Addressing job demands, autonomy and fairness may reduce incivility and sustain the nursing workforce.
Workplace incivility is associated with lower job satisfaction and greater leaving intentions, and may co-occur with lower job control and perceived organisational justice, highlighting the need for organisational strategies that foster fairness and supportive work environments to enhance nurse retention.
The authors adhered to the STROBE guidelines.
No patient or public involvement.
To identify and prioritize educational needs for early ambulation after abdominal surgery from the perspectives of surgical-ward nurses and postoperative patients.
Early ambulation is a core component of enhanced recovery after abdominal surgery, yet educational gaps in nurses' practice and patients' participation remain underexplored.
A descriptive cross-sectional study.
The study was conducted in a 2700-bed tertiary hospital in Seoul, Republic of Korea from May to August 2022. Nurses (n = 100) and postoperative patients (n = 111) after abdominal surgery completed validated self-report questionnaires assessing demographic and clinical characteristics and the perceived importance and performance of 15 early ambulation-related activities using 5-point Likert scales. Educational priorities were evaluated using the Borich Needs Assessment Model and the Locus for Focus Model.
Both nurses and patients rated early ambulation as important, but notable gaps between perceived importance and actual performance were identified. Pre-ambulation preparation activities, including muscle-strength assessment and simple in-bed exercises, consistently showed the greatest discrepancies and were ranked as the highest-priority unmet educational needs across both Borich and Locus for Focus analyses.
Early ambulation after abdominal surgery is highly valued but inconsistently implemented by nurses and patients, revealing substantial unmet educational needs. Focusing education on pre-ambulation preparation, particularly muscle-strength assessment and in-bed exercises, may enhance engagement in early ambulation.
The findings provide an evidence-based rationale for developing targeted educational programmes for surgical-ward nurses and postoperative patients that emphasize structured pre-ambulation preparation. Integrating these priorities into postoperative care may strengthen early ambulation practices and support improved recovery outcomes.
STROBE guidelines.
Postoperative patients and surgical-ward nurses participated in the study by completing the questionnaires used for data collection. No further patient or public involvement occurred in the design or analysis of this study.
Disparities in cancer care among lesbian, gay, bisexual and transgender (LGBT) individuals persist across healthcare systems worldwide. Nurses play an important role in delivering culturally competent cancer care; however, limited research has examined nurses' practices in caring for LGBT individuals with cancer and identified factors influencing such care, particularly in non-Western cultural contexts.
To examine nurses' experiences in providing cancer care for LGBT individuals, their cancer care behaviours, influencing factors and perceived needs regarding knowledge, skills and care settings for delivering culturally competent cancer care.
Cross-sectional survey.
Between September and December 2024, a cross-sectional survey was conducted in Taiwan across two hospitals, ten nursing associations, five cancer-related foundations and three online nursing communities. A total of 608 nurses with experience caring for patients with cancer were recruited through purposive and snowball sampling. Nurses completed either an online or paper-based survey.
Nearly half of the nurses had no prior experience providing cancer care for LGBT individuals. Experience providing such care was associated with older age, non-heterosexual identity, longer length of service, higher LGBT-related care competencies and higher levels of job-related compassion satisfaction and stress. Affirmative cancer care behaviours were associated with a broader and more integrated set of competencies, including knowledge, attitudes, skills, affirmative beliefs and job-related compassion satisfaction. Nurses also reported unmet needs regarding knowledge, skills and care settings for delivering culturally competent cancer care to LGBT individuals.
These findings highlight the importance of education, resources and resilience support to strengthen nurses' delivery of culturally competent cancer care for LGBT individuals.
Related training courses, curricula and supporting resources are essential to enhance nurses' culturally competent cancer care practices for LGBT individuals.
STROBE checklist.
No patient or public contribution.
To identify nursing-sensitive process indicators documented during hospitalization and at discharge that predict 30-day hospital readmission among adults with chronic heart failure (CHF).
A retrospective case–control study.
This study included 640 adults hospitalized with CHF at two cardiac referral centres in Sabzevar, Iran, between February 2020 and April 2024. Cases were patients readmitted within 30 days of discharge (n = 320), and controls were patients without readmission during this period (n = 320). Data were extracted from medical records on nursing-sensitive process indicators, including in-hospital falls, fall-risk identification at admission, structured nursing education at discharge, nursing-led post-discharge follow-up, patient knowledge of prescribed medications, polypharmacy (≥ 4 medications at discharge), and medication dosing frequency. Sociodemographic and clinical characteristics were also collected.
In-hospital falls, identification of fall risk at admission, poor knowledge of prescribed medications, polypharmacy, and complex medication dosing schedules were associated with higher odds of 30-day readmission. In contrast, receipt of structured nursing education at discharge was associated with a significantly lower likelihood of 30-day readmission.
Nursing-sensitive process indicators are significant and independent predictors of 30-day hospital readmission among adults with CHF. Strengthening fall prevention strategies, improving medication-related education, and enhancing discharge preparation represent actionable nursing interventions to reduce avoidable 30-day readmission.
Targeted nursing interventions focused on fall prevention, medication management, and structured discharge education may improve discharge readiness, enhance continuity of care, and reduce preventable 30-day readmission in patients with CHF.
Unplanned 30-day readmission following hospitalization for chronic heart failure remains a persistent challenge for healthcare quality and patient safety.
Several nursing-sensitive process indicators, particularly fall-related indicators and discharge education, independently predicted readmission risk.
The findings support the integration of targeted nursing-led interventions in cardiac and medical units to reduce readmission risk.
This study was reported in accordance with the STROBE guidelines for observational studies.
No patient or public involvement was included in the design, conduct, or reporting of this study.
To explore pressure injury prevention and management in acute care settings from the perspective of patients, caregivers and families.
Cross-sectional survey.
A convenience sample of patients at risk of pressure injuries and their family or caregivers was recruited from medical, surgical and intensive care units across the province of Alberta, Canada. The custom survey included questions about perspectives on the care they received, involvement in care and preferences regarding involvement. Data were summarised with descriptive statistics and analysed using generalised estimating equations, logistic regressions and Mann–Whitney U-tests.
The response rate was 44%. The survey was completed by 161 participants (80.1% patients and 19.9% caregivers). The participants were 58.4% female, 63.4% from rural locations and 21.1% self-reported a pressure injury. Participants were most involved in repositioning activities and least involved in activities related to exercise. While 80.7% of respondents reported knowing what a pressure injury was, 69.6% reported that they had not heard about or received prevention resources from the healthcare team. Hearing about pressure injury prevention while admitted to hospital was associated with a significantly lower self-reported presence of pressure injuries. Brochures/pamphlets and verbal information were the most preferred educational resources.
Patient and family perspectives should inform pressure injury education and prevention activities in acute care settings. We recommend utilising brochures/pamphlets and verbal information, enhancing activity levels and exercise, encouraging patients and families to actively participate in prevention and maintaining a culture of supporting patient and family advocacy.
Findings provide insight into patient and family perspectives on pressure injury prevention and management in the hospital setting that can be addressed to enhance patient and family-centred pressure injury prevention.
Patient and family advisors informed the design of the survey and provided feedback on content, formatting and readability.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.
New graduate nurses experience transition shock during the first year of their professional lives. Limited prior studies have shown how transition shock affects freshly graduated nurses' ability to provide care, but further evidence related to missed care is required. This study is a report that evaluates the relationship between transition shock experienced and missed nursing care among new graduate nurses.
This descriptive and correlational study involved 277 new graduate nurses working in four hospitals.
Data were collected using two standardised scales: the MISSCARE Survey and the Nursing Transition Shock Scale. The data were collected from December 2023 to February 2024. The data were analysed using Pearson correlation and multiple regression.
Transition shock was significantly associated with missed nursing care practices and the causes of missed nursing. Transition shock was significantly associated with human resources, material resources and communication.
These results showed that transition shock significantly predicted missed nursing care practices and their causes.
The study highlighted that the transition shock of new graduate nurses is associated with missed nursing care. To prevent missed care by new graduate nurses, the determinants should be considered when providing nursing care. According to the study's conclusions, helping recently graduated nurses with continuing education and mentoring may have beneficial effects on preventing missed care.
Adhered to the STROBE guidelines.
No patient or public contribution.
To describe the characteristics of paediatric postoperative patients with cognitive dysfunction and assess the prevalence of pain and associated factors.
A descriptive observational study.
Cross-sectional study in children and adolescents who had undergone surgery in the previous 72 h with cognitive dysfunction impeding verbal communication of pain. The Spanish-language version of the revised Face, Legs, Activity, Cry and Consolability scale was used to assess pain intensity.
The 51 included patients underwent 1072 pain assessments. Moderate to severe pain was detected in 12.1% of the evaluations (n = 130). Girls showed more intense pain after analgesia than boys. Higher pain intensity before analgesia was associated with neurodegenerative disease and autism spectrum disorder.
In children with cognitive dysfunction, female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain.
Hospital pain management protocols should differentiate between patients with cognitive dysfunction and patients with neurotypical development.
–
This study addresses the prevalence of postsurgical pain in paediatric patients with cognitive dysfunction and associated factors
–12.1% of postsurgical evaluations showed moderate to severe pain. Female sex and baseline cognitive conditions seem to be associated with more intense postsurgical pain.
–This research will have an impact on the care of paediatric patients with cognitive dysfunction in postsurgical hospitalization units.
This study was performed according to EQUATOR GUIDELINES and the STROBE statement.
No Patient or Public Contribution.
To examine whether shared decision-making at baseline is associated with trajectories of self-management confidence over 12 months among individuals living with chronic conditions attending nurse-led clinics.
A longitudinal design.
Individuals with at least one clinician confirmed chronic condition were recruited from six nurse-led primary care clinics between March and September 2022. Data collection took place between March 2022 and September 2023, with baseline, 6 and 12-month assessments completed within routine follow-up contacts. Self-management confidence was measured using the Self-Efficacy for Managing Chronic Disease Scale, and perceived shared decision-making was assessed using the nine-item Shared Decision-Making Questionnaire (SDM-Q-9). Linear mixed-effects modelling examined changes in confidence over time and associations with baseline shared decision-making, adjusting for age, gender, education and number of chronic conditions.
Of 157 eligible individuals approached, 151 consented to participate (96.2%), and 146 were retained at 12 months (96.7%). Mean self-management confidence increased from 40.2 at baseline to 44.5 at 12 months. In adjusted models, confidence was significantly higher at 6 months (β = 2.63, 95% CI: 1.54–3.72, p < 0.001) and 12 months (β = 4.21, 95% CI: 2.93–5.49, p < 0.001) compared with baseline. Higher baseline shared decision-making was positively associated with repeated confidence scores across follow-up (β = 0.10, 95% CI: 0.04–0.16, p = 0.002). The association was stronger among participants aged under 60 years.
Within established nurse-led chronic condition care, perceived shared decision-making was statistically associated with subsequent trajectories of self-management confidence over 12 months. Confidence demonstrated gradual change rather than stability within routine practice.
Strengthening the visibility and consistency of collaborative dialogue within nurse-led consultations may support self-management confidence. Structured conversational approaches that help nurses enact shared decision-making more explicitly warrant further evaluation in primary care.
No patients were involved in study design.
To map factors influencing nurses' engagement in clinical mentorship in nursing education and explore their interactions using network analysis.
Observational cross-sectional study employing an online survey from July 2024 to May 2025.
A total of 261 clinical mentors from healthcare institutions in Catalonia, Spain, completed the survey. Key variables included engagement in clinical mentorship (implication, motivation, satisfaction, compromise), perceived obstacles, ward manager support, emotional intelligence, emotional wellbeing, working and employment conditions. Data were analysed using regularized partial correlation network analyses. Centrality indices were calculated to determine the most influential variables within the network structure.
Motivation, ward manager support, and emotional intelligence emerged as the most central, interconnected drivers of engagement. Motivation showed positive associations with commitment and implication in the mentoring role and a negative association with perceived obstacles. Ward manager support was linked to emotional wellbeing and peer support, reflecting the importance of psychosocial resources. Emotional intelligence appeared to support motivation, work control, and satisfaction with the mentoring role. In contrast, professional experience and employment conditions showed limited influence within the network.
This study provides a comprehensive understanding of how multiple factors interact to shape nurses' engagement in clinical mentorship. Motivation, ward manager support, and emotional intelligence represent key leverage points for strengthening mentorship practices.
Sustainable, high-quality clinical practicums require supportive work environments that recognize and foster mentors' intrinsic motivation, leadership support, and emotional skills.
Clinical mentors are essential to student learning, and so is their engagement in the mentoring role. This study is the first to apply network analysis to this process, revealing that motivation, emotional intelligence, and ward manager support are central to engagement, while professional experience and employment conditions are less relevant. These findings can guide institutional strategies to promote supportive and nurturing clinical learning environments.
The manuscript is based on the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).
This study did not include patient or public involvement in its design, conduct, or reporting.
To improve the rates of central line–associated bloodstream infections in an intensive care and non-intensive care setting in a large Australian health service.
Evidence-based care bundles targeting central line practices were developed and implemented using a pragmatic action research–approach.
Wards recruited change facilitators to implement the bundles. Compliance and ward engagement were measured, and pre-intervention and intervention central line–related infection rates were compared.
Wards showed a reduction in central line–related infections by 90% during the intervention for up to 2 years. Adherence to bundles was high in both settings. Improvements in insertion practices were observed after baseline and were sustained, with the largest improvement seen in documentation. Maintenance and removal practices showed less variation than insertion practices.
Care bundles are an effective intervention to reduce central-line-related infections over a sustained period when clinician adherence is high.
Care bundles can be effective in high-risk settings beyond intensive care units, including haemodialysis.
Central lines were identified from local hospital data as a major contributor to health care–associated infection rates. Care bundles were implemented in high-risk settings and demonstrated sustained reductions in central-line-related infections. Care bundles are an effective intervention for health care organisations to reduce and sustain preventable infections in high-risk patient cohorts.
We adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) framework.
No patient or public contribution.
Cardiac rehabilitation (CR) is an effective intervention for improving outcomes in patients with coronary heart disease (CHD). However, the actual participation rate is unsatisfactory and exhibits significant gender disparities. This study aimed to investigate gender-specific determinants of the decision to participate in CR among patients with CHD, together with underlying causes.
Cross-sectional study.
A cross-sectional survey of 264 patients with CHD from 3 Chinese tertiary hospitals between February 2024 and February 2025. Data were collected using questionnaires based on the Information Need in Cardiac Rehabilitation scale, the Chinese version of Cardiac Rehabilitation Barriers Scale, the Family APGAR index questionnaire, and the International Physical Activity Questionnaire-Short Form.
There were 158 men aged 66 (SD = 13.3) and 106 women aged 66 (SD = 11.0). 55.1% of men CHD patients decided to participate in CR, significantly higher than in women patients (34.0%; χ 2 = 11.351, p = 0.001). Logistic regression analysis for men indicated that the facilitators of the decision to participate in CR were the level of family functioning and ≥ 2 comorbidities. The barriers included emergency/safety information needs and functional status. For women, the facilitators were retirement, family functioning level, being overweight/obesity, ≥ 2 comorbidities, and work/vocational/social factors. The barriers included medication information needs, logistical factors, and functional status. Fairlie decomposition revealed gender differences primarily driven by work/vocational/social factors (contribution: 71.19%), functional status (50.50%), and retirement (−39.16%) (all p < 0.05).
This study highlights the necessity of gender-specific interventions during the decision-making phase for CR. Healthcare professionals should tailor CR strategies to address women's social role barriers and men's emergency risk concerns, while enhancing family functioning and targeting support for functional status and work-related factors.
STROBE checklist, cross-sectional.
Three tertiary hospitals assisted in participant recruitment.
FreshRSS 