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Parenting concerns, stemming from cancer's projected impact on children, are a common and significant source of emotional distress for parents. A quantitative synthesis of existing data is critically absent, and the role of modulating factors (e.g., male sex, single parenthood, and the number of children) remains unclear.
This meta-analysis aims to quantify the association between parenting concerns and emotional distress in cancer patients, examining male sex, single parenthood, and number of children as key moderators.
This systematic review and meta-analysis followed PRISMA guidelines. Searches (PubMed, Embase, PsycINFO, Airiti Library; inception-November 2025) identified observational studies of adult cancer patients with minor children. Data on parenting concerns, anxiety, and depression were extracted and appraised using a modified JBI Checklist. Correlations were synthesized. Meta-regression addressed the quantitative void, examining male sex, single parenthood, and number of children as key moderators. Publication bias and sensitivity were assessed.
We included 12 studies (N = 3895). Our meta-analysis found significant positive associations (r = 0.50, p < 0.001) between parenting concerns and both anxiety and depression. Meta-regression, controlling for time since diagnosis, identified male sex, single parenthood, and fewer children as significant moderators for anxiety (p < 0.001), with similar trends for depression.
This meta-analysis highlights parenting concerns linked to distress in cancer patients, with fathers, single parents, and those with fewer children particularly vulnerable. Routine assessment and tailored, family-centered psychosocial interventions are urgently needed.
This systematic review was registered with the International Prospective Register of Systematic Reviews and Meta-analysis (PROSPERO; Registration No. CRD42024592899).
Accelerated population aging has driven substantial growth in demand for palliative care services. Such services can effectively enhance the living quality for end-of-life patients through multidimensional interventions. Currently, China lacks a localised experience-oriented quality assessment scale for palliative care, resulting in gaps in service quality supervision. To develop a self-reported measurement for palliative care services, with the foundation in the Senses Framework.
This study developed a scale by extracting core contributors of palliative care experiences through 14 patients and 16 families' narratives. To refine and improve the scale, a total of 19 experts were invited to participate in a two-round Delphi expert consultation. Additionally, an empirical research was conducted, with 380 valid samples from two independent cohorts collected to complete the full psychometric testing of the scale.
The final Palliative Care Experience Scale (PCES) comprises two dimensions: sense of security and belonging, and sense of purpose and significance, with a total of 13 items. The total variance includes 79.26% that is explained by these two factors. Confirmatory factor analysis confirmed a stable factor structure for the PCES. The scale exhibited good reliability, with a total Cronbach' α of 0.937, McDonald' ω of 0.952, and Spearman-Brown corrected split-half reliability of 0.897. Cronbach's α for both dimensions exceeded 0.88. The scale's SEM was 1.50 and MDC95 was 4.16, offering a validated threshold to identify real changes in patients' palliative care experience.
This study developed an assessment scale of palliative care quality based on the Senses Framework, uniquely centred on patient experiences. Validated through robust methodologies, this scale fills a gap in the evaluation of experiential dimensions of palliative care in China, providing a scientific and feasible measurement tool for the continuous improvement of services.
This study addresses the critical gap of a culturally adapted, patient experience-centred tool for evaluating palliative care service quality in China. Its core finding is the successful development and full psychometric validation of the 13-item Palliative Care Experience Scale (PCES). This research provides a reliable tool for palliative care clinical practice and academic research to capture patients' care experience, offers clinicians and administrators a practical instrument to identify service gaps and guide quality improvement, and delivers foundational reference data for policymakers to advance patient-centred palliative care development in China.
We adhered to the relevant EQUATOR reporting guidelines. The development and validation process followed the COSMIN framework for patient-reported outcome measures.
Patients receiving palliative care and familes played an integral role in designing and conducting this study. In Phase I, qualitative data from semi-structured interviews with 14 patients and 16 families helped define core thematic constructs and develop the initial item pool, which ensured the scale's content validity were based on their real-life experiences. In Phase III, we recruited a new, independent cohort of participants to complete the psychometric testing of the scale, providing key data for its validation.
To identify different longitudinal trajectories of hypoglycaemia problem-solving ability in patients with diabetes mellitus (DM) and explore their predictive factors. To examine the impact of these heterogeneous trajectories on quality of life.
This study adopted a prospective longitudinal design.
A total of 272 patients who completed follow-up were longitudinally assessed for their hypoglycaemia problem-solving abilities over 6 months. Latent class growth modelling (LCGM) was used to identify heterogeneous trajectories of hypoglycaemia problem-solving ability. Multiple logistic regression was conducted to determine predictors, while univariate ANOVA and multiple linear regression analysis were applied to explore the effects of heterogeneous trajectories on quality of life.
The overall level of hypoglycaemia problem-solving ability in DM patients increased from hospitalisation to 1 month after discharge and gradually decreased from 3 to 6 months after discharge. LCGM identified three heterogeneous trajectories of hypoglycaemia problem-solving ability. Results of multinomial logistic regression analysis showed that employment status, monthly income, frequency of blood glucose monitoring, fear of hypoglycaemia, and social support were predictors of heterogeneous trajectories of hypoglycaemia problem-solving ability in DM patients. In addition, hypoglycaemia problem-solving ability positively predicts quality of life.
Our findings establish a critical theoretical foundation for designing and implementing effective interventions tailored to patients' distinct trajectories in diabetes management.
This study explores the trajectories and predictors of hypoglycaemia problem-solving abilities in DM patients, providing a theoretical basis for nurses to guide patients in diabetes management.
Research findings indicate that nurses should regularly assess the hypoglycaemia problem-solving abilities in DM patients, and use trajectory subgroups to identify distinct patient characteristics in hypoglycaemia problem-solving abilities in order to implement personalised interventions.
This study was based on the STROBE guideline.
No patient or public engagement.
Procedural pain and distress in children can result in severe short- and long-term consequences, including post-traumatic stress syndrome and needle phobia. While distraction techniques (e.g., toys, music) have been widely used, virtual reality (VR) offers a novel, immersive form of distraction. Despite the rapid development of VR technologies, there is a lack of comprehensive evidence regarding which paediatric patients and procedures benefit most from VR interventions.
We conducted a scoping review following the PRISMA-ScR guidelines. A systematic search across PubMed, Embase, Web of Science, Cochrane Library and Chinese databases (CNKI, Wanfang, VIP, SinoMed) identified studies from January 1, 2000 to November 15, 2025. Inclusion criteria were randomized controlled trials (RCTs) or quasi-experimental designs assessing VR for pain/anxiety management during medical procedures in paediatric patients, with outcomes including pain intensity, distress, feasibility, satisfaction or safety.
Of the 5458 original database citations, 201 were eligible for full-text evaluation. Of these articles, a total of 22 were included in the scoping review. RCTs comprised 81.8% (n = 18). The majority (86.4%) employed immersive VR and 27.3% utilized cost-effective smartphone-based systems. Procedures targeted included venipuncture, needle-related interventions, intravenous access, surgery and burn wound care. Approximately 86.4% of studies reported VR's superiority over standard care in reducing procedural pain and distress.
VR is an effective, non-pharmacological tool for managing procedural pain and distress in paediatric clinical settings, showing promise for integration into routine care. However, existing studies exhibit methodological heterogeneity and focus primarily on short-term outcomes. Future research should prioritize large-scale, rigorously designed RCTs with long-term follow-up, and focus on developing standardized, evidence-based VR protocols for diverse paediatric populations.
No patient or public contribution was required for this scoping review, as it only synthesized existing published literature without primary data collection.
To identify facilitators and barriers to quality, equitable discharge teaching by paediatric emergency department nurses during the COVID-19 pandemic, describe impacts of inequitable discharge teaching, and identify potential solutions to the barriers.
Twenty-two nurses in a single urban paediatric hospital participated in individual interviews from January to April 2022 via phone or videoconference. Interviews were transcribed and analysed using an inductive codebook.
Six barriers to equitable discharge teaching were identified: ED overcrowding, travel nurse training/knowledge, burnout and stress, increased role complexity, COVID precautions, and resource bottlenecks. Two facilitators were also identified: engagement and effective communication. Nurses described the impacts of these barriers along with proposed solutions to improve discharge teaching.
The COVID-19 pandemic created additional barriers to discharge teaching in the paediatric emergency department. Nurses identified barriers and facilitators, the impacts on patients and families, and potential solutions to improve equitable discharge teaching.
This study identifies how periods of high patient volumes or frequent process changes during a pandemic exacerbate inequities in discharge teaching.
This study identifies barriers and facilitators that shaped nurses' ability to provide quality, equitable discharge teaching during the COVID-19 pandemic and offers actionable guidance for hospital leaders and health systems to improve discharge teaching and enhance emergency preparedness for future public health crises.
This study conforms to the Standards for Reporting Qualitative Research.
This study did not include patient or public involvement in its design, conduct, or reporting.
ClinicalTrials.gov identifier: NCT04676490
To explore the perceptions of older female caregivers living in poverty in a high-income country regarding their health and self-care needs.
Descriptive qualitative study.
Seventeen semi-structured interviews were conducted with older female caregivers between October 2023 and March 2024. The reflexive thematic analysis method described by Braun & Clarke was followed, and ATLAS.ti 25 software was used for data analysis.
The analysis identified one main overarching theme, ‘Caring as an expected role that shapes identity and daily life’ and two interrelated themes: (1) ‘The need for a holistic approach to self-care’ and (2) ‘Caring on empty in the context of economic hardship and limited support’.
Self-care among older female caregivers living in poverty is constrained by caregiving expectations and socioeconomic disadvantage. Addressing their health needs requires nursing interventions that recognise caregiving as a central element of their lives and adopt holistic, context-sensitive approaches.
Nursing interventions should comprehensively assess older female caregivers' multidimensional health needs and enhance access to integrated support and services, addressing structural gender and socioeconomic inequities to strengthen health, dignity, and resilience.
Living in poverty exacerbates the challenges older female caregivers face in attending to their own health and self-care, increasing the risk of exhaustion, distress, and chronic illness. Recognising and addressing these needs through equitable, targeted interventions is essential to reduce health inequalities.
The study has been reported following the COREQ guidelines.
Limited patient and public involvement was incorporated, focusing on verification of their transcripts, ensuring accuracy and credibility in the interpretation of their accounts.
To explore the perceived effectiveness, impact and benefits of a work-based cancer survivorship peer support programme for healthcare employees who have experienced or are experiencing cancer.
A qualitative descriptive study.
Purposive sampling was used to recruit 33 participants (10 peers, 12 peer supporters, 4 line managers and 7 members of the governance group). Data were collected between October 2024 and February 2025 through individual interviews and focus groups. Data were analysed using reflexive thematic analysis.
Four themes were generated: Programme Reach and Adoption, Implementing the Programme, Programme Effectiveness and Impact and Programme Maintenance and Growth. Challenges included the pilot status of the programme impacting awareness and uptake, potential reluctance to share diagnoses and the impact of cancer on colleagues. The approach of peer supporters was considered central to the programmes' success. Peer supporters valued training and continuous practice development opportunities.
Demonstrated benefits, including satisfaction and the value of peer support, were evident. To ensure programme maintenance, increased recruitment and training of peer supporters and clear communication regarding the programme and referral pathways are essential. Financial support is required to maintain training and address dissemination challenges.
Work-based peer support programmes can help cancer survivors reintegrate into the workforce more effectively, rebuilding confidence, fostering resilience and navigating workplace expectations. Enhanced staff well-being may also positively influence retention, performance and health-related disruptions.
Findings from this underexplored area of work-based peer support within a healthcare setting have the potential to influence healthcare leaders, policy makers and future research. Improving staff's' quality of life on return to work benefits the individual, the organisation and care delivery by ensuring a healthy, supported workforce.
The Standards for Reporting Qualitative Research (SRQR) checklist and the Template for Intervention Description and Replication (TiDieR) checklist were utilised.
No patient or public contribution.
To conduct a scoping review of nurse-led Knowledge Translation strategies aimed at promoting and enhancing patient safety in hospital settings.
Scoping review.
This review followed the Joanna Briggs Institute methodology and was reported according to PRISMA-ScR.
Twelve electronic databases and additional grey literature sources were searched for studies published between 2002 and 2023, with no language restrictions.
From 23,691 records identified, 59 studies were included. The majority (n = 56) employed multifaceted Knowledge Translation strategies, incorporating simulation, audits, digital tools and interprofessional education. The interventions focused on patient safety-related events, including falls, pressure injuries and catheter-associated complications. Nursing leadership emerged as a key component, particularly in team training, developing care protocols and delivering feedback. Outcomes included reductions in adverse events, improved adherence to clinical guidelines and cost savings. Yet, sustaining behaviour changes over time and limited interprofessional and family engagement remained recurrent challenges.
Nurse-led Knowledge Translation strategies were heterogeneous, with increasing use of simulations, technologies and multifaceted approaches. Evidence suggests potential associations with fewer adverse events, improved care quality, individualized planning and cost efficiency. Challenges related to the sustainability of interventions persist. Findings underscore the importance of investing in nursing leadership and capacity-building to strengthen patient safety.
Strengthening nurse-led KT capacities may enhance evidence-based care and improve safety outcomes. Investment in leadership and tailored implementation is critical.
What problem did the study address? The limited synthesis of how nurses lead KT strategies to improve patient safety in hospitals. What were the main findings? Most strategies were multifaceted, context-sensitive and associated with improved care processes and safety indicators. Where and on whom will the research have an impact? Findings are relevant to hospital nurses, nurse educators, managers and health systems seeking to implement evidence-informed safety interventions.
This scoping review followed the PRISMA-ScR reporting guideline.
This study did not include patient or public involvement in its design, conduct or reporting.
Open Science Framework (OSF); registration identifier: 10.17605/OSF.IO/K3VJC
To explore how chronically ill patients, family members and nurses perceive and experience patient participation in nursing care within a Chinese hospital context.
Focused ethnography.
The study was conducted in a Chinese public hospital over 8 months between February and September 2021. Data were generated through 90 h of participant observation and 30 semi-structured interviews, including individual and dyadic interviews with 10 nurses, 17 patients and 7 family members. Data were analysed using reflexive thematic analysis through an inductive and iterative process.
An overarching theme ‘participation as relational, holistic and dynamic’ was developed, comprising three themes: (1) participation as fulfilling individual responsibility, (2) family members as co-participants and (3) participation as an evolving multidimensional practice. These themes suggest that participation was understood as a relational responsibility enacted through everyday interactions. Family members were actively involved in care processes, and participation extended across physical, intellectual and emotional dimensions. Digital information and technologies further reshaped participation, creating new opportunities and tensions in everyday care.
Patient participation in nursing care extends beyond autonomy-based models and is shaped by relational responsibilities, family involvement and evolving digital healthcare contexts.
To promote patient participation, policies and practices should recognise relational and family-based dimensions of care. Healthcare organisations should foster environments that support collaborative participation among patients, families and nurses. Training and education should be developed to promote nurses' digital literacy, cultural competence, ethical sensitivity and relational communication to support participation in contemporary care contexts.
This study broadens prevailing autonomy-centred understandings of patient participation by demonstrating how participation is co-constructed through relational responsibilities and family involvement. The findings offer insights for nursing practice and policy in culturally diverse and increasingly digital healthcare environments.
COREQ.
No Patient or Public Contribution.
Deficient palliative care coverage and nursing training in Ecuador warrant examining self-efficacy to inform education strategies and strengthen equitable services.
To examine Ecuadorian nurses' self-efficacy in Palliative Care.
A sequential explanatory mixed-methods study was conducted. Convenience samples of nurses completed the Self-Efficacy in Palliative Care Questionnaire and participated in online semi-structured interviews. Descriptive statistics were used for quantitative data. A side-by-side joint display supported integration.
497 nurses completed the questionnaire (90.4% female; 11.47 years of experience). Teamwork scored highest, while communication scored lowest. Eighteen nurses were interviewed (88.8% female; 11.5 years of experience). Participants reported communication difficulties related to emotions, prognosis, denial, collusion of silence and paediatric cases. They expressed strong confidence in pain management but more difficulty with agitation and dyspnoea. Spiritual care was mainly understood as facilitating access to religious figures. Although teamwork was perceived positively, tensions with physicians and an excessive focus on physical aspects were noted.
Quantitative and qualitative findings aligned overall, with dissonances regarding psychological and social communication.
Strengthening communication and comprehensive patient management competencies, as well as addressing interdisciplinary tensions, is necessary to improve and consolidate Palliative Care in Ecuador.
This study adhered to EQUATOR guidelines and used COREQ for qualitative reporting.
No patient or public contribution.
To explore the perceptions of nursing professionals in high-demand healthcare services regarding the adoption of AI-based support systems for the prevention of medication errors.
A qualitative descriptive study was conducted between November 2024 and March 2025.
Sixteen semi-structured interviews were held with nurses from emergency and intensive care units, guided by conceptual dimensions of the Technology Acceptance Model framework. Participants were recruited using purposive and snowball sampling. ATLAS.ti v.9 software was used for an inductive thematic analysis.
Two major themes emerged: (i) professional reflections on medication safety and related risks; and (ii) integrating artificial intelligence into nursing practice to reduce such risks and prevent medication errors. While artificial intelligence was recognised as a promising resource to support clinical decision-making and reduce cognitive load, nurses identified barriers, including limited training, inadequate technological infrastructure, unreliable data sources, and ethical concerns that could compromise its safe implementation and thereby hinder its potential to prevent medication errors.
AI-based support systems are perceived as useful, but complex resources for addressing medication errors, which remain a critical challenge in healthcare. Its successful implementation depends not only on the availability of resources, but also on the organisational context and the ability to respond to the needs and concerns of healthcare professionals.
Integrating artificial intelligence into routine workflows to support clinical decision-making and reduce medication errors in high-demand settings requires more than infrastructure and technical training. Effective adoption demands participatory design, clear role delineation, and context-sensitive training aligned with medication-management processes. Lack of alignment may result in artificial intelligence increasing complexity instead of contributing to safer and more efficient medication administration.
Methods and findings are reported following SRQR recommendations.
No patient or public contribution.
Children on the move in the ECOWAS subregion are part of historical mobility networks shaped by structural poverty, inadequate services, and inequalities. Using the Structural Violence Theory framework, the review examines how economic, social service, and governance policies interact to both create the demand for migration and increase the risks faced by children on the move. The review has three research objectives.
Systematic literature review guided by PRISMA.
There was an overwhelming response of relevant literature sources. Literature from 1966 to 2025 on child migration, trafficking, displacement, and protection by ECOWAS was collected. Among the 987 sources identified through a literature search of central academic databases and institutional repositories, 56 met the selection criteria. Qualitative analysis was employed to evaluate the robustness of the sources based on their methods.
Findings indicate rising levels of children on the move, driven by independent migration from rural areas to cities and cross-border migration along traditional migration routes. Factors such as economic hardship, limited access to quality education, conflict, gender-related labor market conditions, and family dynamics are interconnected and play crucial roles. Children on the move are increasingly vulnerable to exploitation, labor dangers, trafficking, and social exclusion. While international, regional, and national frameworks set standards legally, their implementation remains inefficient.
Children on the move within ECOWAS are seen as an inevitable result of structural factors rather than isolated incidents. One policy implication of this analysis is to include children on the move within the ECOWAS mobility framework. Additionally, social protection programs for children need to be expanded in countries with high emigration rates.
Nurses and allied frontline providers are well-positioned to identify mobility-related risks, deliver trauma-informed, non-discriminatory care, document safeguarding concerns, and activate referral pathways for child protection, psychosocial support, and legal assistance.
To identify and describe the current literature on neurodivergence in nursing and to identify existing gaps in knowledge.
Scoping review guided by Joanna Briggs Institute scoping review guidelines and PRISMA-Scoping Review framework.
Comprehensive search with inclusion following Participants, Concept, and Context framework: nurses or nursing workforce; neurodiversity or neurodivergence defined as autism, attention deficit hyperactivity disorder, dyslexia; workplace environment. Articles were screened and data extracted by independent reviewers. Dates of inclusion were 1999–2025. Data analysed through descriptive categorisation.
MEDLINE (PubMed), CINAHL (EBSCOhost), and PsycINFO (Ovid) were searched in April 2025, followed by reference mining and citation cross-referencing. Inclusion criteria were set for empirical studies, reviews, or textual evidence (expert opinions or narratives).
Twenty-two sources met inclusion criteria. Most addressed dyslexia and neurodiversity. Sources described strengths of neurodivergent nurses (e.g., deep focus, relationality, novel perspectives), workable challenges (e.g., documentation and multitasking). Studies reported adaptations at multiple levels: individual, interpersonal, and intraprofessional, noting system influences of medical model framing and gender bias in diagnosis.
Literature on neurodivergent nurses in the workplace is scarce. Neurodivergence offers strengths and challenges, yet ableism and limited research restrict well-being and professional advancement.
Greater recognition of neurodivergence in nursing could enhance workforce retention, innovation, and inclusivity. Neurodivergent nurses' perspectives should inform research, workplace design, and professional development.
What problem did the study address?: Limited research on neurodivergence in nursing despite growing awareness of neurodivergence generally and overall challenges in nursing retention and well-being. What were the main findings?: Literature encompasses empirical studies and textual evidence presenting strengths and challenges for nurses. Adaptation centered on the individual. Where and on whom will the research have an impact?: Researchers to increase empirical studies on neurodivergent nurses, including participatory methods; Leaders interested in workplace inclusion, sustainable workplaces, and professional innovation; Neurodivergent nurses and policy-makers concerned with workforce rights and healthcare resilience.
No Patient or Public Contribution.
To explore how children, caregivers and healthcare providers experience shared decision-making in real time within an interdisciplinary paediatric feeding clinic in multicultural Singapore.
A qualitative ethnographic approach was used.
Data collection involved one-time participant observations of interdisciplinary feeding clinic consultations, observations of healthcare providers-only debrief and follow-up interviews with caregivers. Data were collected from July 2024 to November 2024. Participants included caregivers, healthcare providers and otherwise well children presenting with feeding difficulties. Fieldnotes, including observational matrices, reflexive journals and interview transcripts, were analysed thematically using Braun and Clarke's six-step process for thematic analysis.
Twenty observations and 11 interviews were conducted. Four themes were identified: (1) Centring the child: building trust and respect; (2) Tensions and teamwork: negotiating expertise and expectations; (3) Feeding across cultures; and (4) Parenting under pressure: the social context of feeding choices.
In an interdisciplinary feeding clinic, shared decision-making extends beyond the clinical encounter, reflecting relational, cultural and structural realities. The feeding clinic modelled effective shared decision-making through child-centred care practices, balancing biomedical expertise with lived experiences, actively engaging caregivers and codesigning culturally responsive and sustainable feeding strategies with the family. However, divergent perceptions of what problematic feeding entails, caregivers' hesitancy in taking on an active role in consultations, and the external pressures caregivers contended with constrained this process. These findings highlight the need for inclusive, culturally responsive care models and more caregiver support interventions that acknowledge the full complexity of feeding care.
Nurses, with their central role in relational and communicative care, are uniquely positioned to bridge tensions between medical paternalism and collaborative, family-centred approaches. By facilitating trust, clarifying goals and supporting caregiver participation in feeding decisions, they play a critical role in advancing child health outcomes while strengthening caregiver agency within multicultural healthcare systems.
This study revealed how cultural, familial and systemic pressures shape caregiving practices, often constraining caregiver participation and shared decision-making in clinical encounters. Shared decision making in an interdisciplinary feeding clinic comprised of child-centred care practices, balancing biomedical expertise with lived experiences, actively engaging caregivers and codesigning culturally responsive and sustainable feeding strategies with the family. This study expounds on the potentially critical role nurses could play within the multidisciplinary team to negotiate expectations, foster caregiver agency and contribute to culturally responsive, family-centred feeding care.
The reporting of this study is guided by the Standards for Reporting Qualitative Research (SRQR).
This study did not include patient or public involvement in its design, conduct or reporting.
To identify body temperature dynamic patterns and develop a machine learning model for the early detection of nosocomial infections.
A retrospective and observational study of patients hospitalised in the haematology department of the Chinese People's Liberation Army General Hospital between January 2014 and December 2023.
A latent class trajectory model was used to discover patterns in patients' body temperatures over time. Machine learning models were then built to predict nosocomial infections and evaluated using standard metrics (AUROC, sensitivity, specificity). SHAP (SHapley Additive exPlanations) values were used to interpret the final model.
Among 6989 patients, we identified four distinct body temperature trajectories. Bloodstream infections were most common in patients exhibiting either a slow rise followed by a gradual decrease or a rapid rise followed by a quick decrease in body temperature. The XGBoost model showed excellent predictive performance (AUROC = 0.801), with balanced sensitivity (0.718) and specificity (0.701). The top five predictors of nosocomial infections were elevated procalcitonin, neutropenia, prolonged central venous catheter use and two specific temperature trajectories: ‘stable and relatively high’ and ‘a rapid rise followed by a quick decrease’.
The XGBoost model effectively predicted nosocomial infections. Dynamic body temperature trajectories provided early, objective warning signs of infection. This predictive tool empowered nursing staff to proactively monitor nosocomial infection, allowing for timely, data-driven interventions in vulnerable hematologic patients.
The developed machine learning predictive tool can help clinical medical staff identify nosocomial infections as early as possible, facilitate personalised rehabilitation and health management plans, aligning with the philosophy of patient-centred precision nursing. Further, the four body temperature trajectory patterns identified provide nurses with objective, dynamic indicators for recognising potential infection subphenotypes, supporting a shift from experience-driven reactive care towards data-driven proactive nursing.
Previous studies suggested that body temperature could indicate the severity and prognosis of infections, but the pattern was unknown. In this study, we found that body temperature trajectories could signal infection subphenotypes, such as bloodstream infections being most common in patients with a slow rise followed by a gradual decrease in body temperature or with a rapid rise followed by a quick decrease. By integrating body temperature trajectories with key clinical biomarkers, the developed prediction model enables early and accurate identification of nosocomial infections in hematologic patients. The application of this tool may significantly shorten the time window between infection onset and intervention, potentially reducing infection-related complications, mortality and healthcare costs, thereby improving overall care quality and patient outcomes.
The study adhered to the relevant EQUATOR reporting guidelines, the TRIPOD Checklist for Prediction Model Development and Validation.
The research team included nursing staff and clinicians responsible for infection surveillance and control in the hospital, who contributed real-world insights into the definition of predictors, interpretation of temperature trajectories, clinical implications of the prediction model and preparation of the manuscript. Their expertise helped ensure that the study addressed relevant clinical questions and that the findings are interpretable and actionable in practice.
To achieve expert consensus on key organizational variables and categories of organizational interventions considered most relevant for promoting nurses' organizational well-being.
An e-Delphi study.
Three panels of experts were enrolled: nursing managers, clinical nurses and occupational psychologists. Eight variables from the Nursing Organizational Well-being model and six categories of intervention drawn from the literature were rated for perceived usefulness, applicability and organizational feasibility. Consensus was defined with thresholds for percentage agreement (≥ 75%; ≥ 85%), Content Validity Ratio (CVR ≥ 0.49) and Coefficient of Variation (CV < 0.5).
Eighty-four experts took part in Round 1, and forty-four in Round 2. The organizational variables with the most stable consensus were professional autonomy, workload, support from colleagues and superiors, with agreement > 90% and CV < 0.2. Among the areas of intervention, there was high consensus on organizational support. Mindfulness, meditation, yoga and digital interventions, although supported by literature, did not achieve a stable consensus.
This study identified organizational variables and areas of intervention that achieved stable expert consensus and can guide future organizational planning and empirical evaluation, rather than prescriptive recommendations, to improve nursing organizational well-being.
What problem did the study address? There is a lack of agreement on which organizational variables and areas of intervention should be a priority to support the organizational well-being of nurses, despite the extensive and heterogeneous literature on this topic. What were the main findings? Nurses, nursing managers and occupational psychologists agreed that: Organizational and work support, as well as educational/training were the most rated areas for intervention. Experts rated professional autonomy, workload and peer and supervisory support as priority areas in influencing nurses' well-being. Already noted interventions, such as mindfulness or yoga, did not reach consensus. Where and on whom will the research have an impact? The study results, highlighting shared priorities among experts, can inform nursing managers, organizational leadership and policymakers and guide organizational decision-making processes in designing future interventions. Professional autonomy, organizational support and working conditions emerged as shared expert priorities that may inform organizational reflection on nurses' well-being and workplace sustainability.
The study was conducted according to the Accurate Consensus Reporting Document (ACCORD) guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
FreshRSS 