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Nurses' burnout, work instability (WI), and job satisfaction (JS) in their practice environment (PE) are well established in the literature. However, perinatal missed care (PMC), a subset of missed nursing care, remains underreported among maternity nurses.
To examine the mediating role of PE and burnout in the associations of WI, JS, and PMC among maternity nurses.
A cross-sectional and correlational study employed consecutive sampling to recruit maternity nurses (n = 312) from five hospitals in Saudi Arabia (three government and two private hospitals in Hail and Makkah regions, respectively). Maternity staff nurses, regardless of their sex, years of professional nursing experience, or nationality, who met inclusion criteria were included in this study. Data was collected from July to September 2024 using four standardized self-report scales. Structural equation modeling was utilized for statistical analyses.
Maternity nurses' WI negatively influenced PE (β = −0.23, p = 0.014), while positively affected PMC (β = 0.15, p = 0.031). The PE positively affected JS (β = 0.24, p = 0.034) but had a negative effect on burnout (β = −0.24, p = 0.007) and PMC (β = −0.21, p = 0.038). Burnout negatively affected JS (β = −0.25, p = 0.028), while positively associated with PMC (β = 0.20, p = 0.022). PE mediated the associations between WI and burnout (β = 0.05, p = 0.019), JS (β = −0.07, p = 0.020), and PMC (β = −0.06, p = 0.008). Meanwhile, burnout mediated between PE and JS (β = 0.05, p = 0.030) and PMC (β = −0.04, p = 0.023).
Understanding the relationships among maternity nurses' burnout, JS, PE, and PMC is key to improving the quality of perinatal care and ensuring the patients' well-being. By focusing on strategies to enhance the PE (e.g., adequate staffing and resources, improved nurse–patient ratio), reduce burnout (e.g., meditation and mindfulness programs, coping intervention programs), and improve JS (e.g., work schedule flexibility, facilitate work-life balance, staff professional development), healthcare organizations can mitigate the occurrence of PMC.
To develop and pilot test the AdvantAGE transitional care model at a Swiss geriatric hospital.
Multi-method design.
The study progressed in three stages from January 2021 to December 2023: (1) contextual analysis using the Consolidated Framework for Implementation Research, incorporating qualitative interviews, (2) development and pilot testing of transitional care interventions on three acute geriatric wards using a descriptive explorative study design and (3) development and validation of a logic model using an iterative approach involving project interest groups and researchers.
We identified central challenges and needs related to transitions from hospital to home, including insufficient information flow, patient and caregiver insecurities and lacking adherence to recommended treatment. The newly developed transitional care model comprised five core elements: continuous support for patients and caregivers, care coordination with primary care providers, comprehensive health management at home, medication- and self-management with patients and caregivers and advance care planning. Of 137 eligible patients, 62 participated in the 10-month pilot test of the preliminary transitional care intervention, with an average participation duration of 69 days. Findings from the pilot informed the refinement of the intervention elements and the development of a preliminary logic model.
Employing an implementation science approach facilitated the development and refinement of the AdvantAGE model, ensuring alignment with the needs of project interest groups and the specific implementation context.
This study demonstrates the development of a transitional care model tailored to the specific needs and circumstances of the local healthcare context. Findings provide valuable insights for healthcare practitioners, researchers and policymakers, offering implications for developing transitional care practices and policies.
Limited patient and public involvement was incorporated, focusing on the interpretation of the findings of the first step of this study. Further contributions included providing feedback on the development of the elements of the AdvantAGE transitional care model, ensuring the research addressed priorities relevant to patients and primary health care providers in Basel-Stadt.
To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory.
A self-administered online cross-sectional survey.
A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).
GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients.
This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices.
Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services.
The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.
To understand the experiences and decision-making practices of registered nurses when assessing acuity at triage in emergency departments.
The study utilised a qualitative exploratory-descriptive design.
Purposive sampling recruited 11 registered nurses with triage experience from across the United Kingdom. Semi-structured online interviews, incorporating practice-based vignettes, were conducted between April and November 2024. Thematic analysis was selected to analyse the data.
Three themes were identified: (1) Pressurised decisions, highlighting the effects of overcrowding, staffing shortages and operational burdens; (2) Holistic assessments, revealing the shift from structured to intuitive decision-making as nurses gain experience; and (3) Confidence, competence and emotional wellbeing, illustrating the psychological impacts of triage and the importance of experience and support.
This study provides novel insight into how triage nurses navigate acuity assessment in high-pressure environments. It shows how experience, training and institutional culture influence decision-making and wellbeing. It identifies key areas for targeted intervention.
Triage nurses face substantial cognitive and emotional strain, which may compromise assessment quality and safety. Findings highlight the urgent need for structured triage training, protected time for assessment and access to wellbeing and peer support systems.
What problem did the study address?: A need for current literature exploring the practices and experiences of triage nurses. What were the main findings?: Triage nurses experience significant environmental and emotional pressures, develop decision-making strategies through experience and require enhanced training and support to ensure safe, effective care. Where and on whom will the research have an impact?: Findings are relevant to emergency departments internationally, triage nurses, nurse educators and healthcare leaders.
This study adheared to COREQ reporting guidelines, and a copy of the checklist is attached as Data S1.
This study did not include patient or public involvement in its design, conduct, or reporting.
Commentary on: Sushko K, Strachan P, Butt M, Nerenberg K, Sherifali D. Supporting self-management in women with pre-existing diabetes in pregnancy: a mixed-methods sequential comparative case study. BMC nursing. 2024 Jan 2;23(1):1.
Implications for practice and research Policies are required to support self-management of diabetes during labour and delivery in practice. Future research should focus on developing and implementing interventions to support self-management of diabetes during labour and delivery.
Sushko et al
Commentary on: Yao MM, Vy VPT, Chen TH, Hsu HH, Hsu GC, Lee CS, Lin LJ, Chia SL, Wu CC, Chan WP, Yen AM. Performance measures of 8,169,869 examinations in the National Breast Cancer Screening Program in Taiwan, 2004-2020. BMC Med. 2023 Dec 15;21(1):497. doi: 10.1186/s12916-023-03217-7.
Implications for practice and research The effectiveness of Taiwan’s Breast Cancer Screening Programme provides valuable insights for health policy-makers to enhance and expand the screening initiatives for breast cancer worldwide. To ensure the effectiveness of screening programmes, it is highly encouraged to use mobile units, broaden the age ranges and healthcare providers must uphold high standards of quality assurance and diagnostic accuracy.
Breast cancer continues to be a major public health concern, affecting millions of women globally each year.
Commentary on: Ji Q, Zhang L, Xu J, Ji P, Song M, Chen Y. et al. Associations of mental well-being with higher education- related stress and orientation of the academic goals among nursing students: a cross-sectional study. Int J Ment Health Nurs 2024; 00: 1–11. Available from: https: //doi.org /10.1111/in m.13313
Implications for practice and research Academic orientation is important for knowledge capacity, with implications for nursing students’ mental health. It is important to be clear about what questionnaires measure and interpret their findings accordingly.
Recruitment and retention of nursing staff has become a significant global challenge after the COVID-19 pandemic, with increased stress levels for both nurses and nursing students reported. Improving nursing education is one potential pathway to boost the nursing workforce, as nursing students often suffer from poor mental health and lack of sufficient preparation for the challenges of...
To describe nurses' roles in transitional care planning during intensive care unit (ICU) family meetings for patients with prolonged mechanical ventilation (PMV).
A qualitative descriptive study.
Using secondary data from a trial of a decision aid about PMV, transcripts from 19 unstructured ICU family meetings were purposively sampled and analysed using directed content analysis.
Among 76 recorded ICU family meetings where nurses engaged and spoke at length beyond introduction, nurses spoke at length in 19 (25%) of them. These 19 family meetings were analysed in depth. Three themes were identified describing the roles nurses served: (1) Transitional care liaisons (e.g., introducing next levels of care, identifying/engaging family members, providing patient/family education, managing medications, planning for discharge, assessing patient/family needs, coordinating care, setting goals, providing care continuity, offering provider guidance and referring to resources); (2) information and communication facilitators (e.g., moderating family meetings, facilitating family understanding and serving as communication intermediaries) and (3) family support providers (e.g., providing emotional support, describing expectations and advocating for patients/families).
Although nurses play a central role in patient care, they engage in only a minority of ICU family meetings addressing transitional care planning. Increased nursing involvement in these discussions may enhance care coordination and better support families navigating complex care transitions.
Findings suggest that more consistent engagement of nurses in ICU family meetings has the potential to support transitional care planning and family-centred care for patients with PMV and their families.
This work adds to a growing body of knowledge about nurses' role in ICU transitional care planning. These findings provide valuable guidance for future research and development of transitional care standards to guide nurses in ICU transitional care planning.
The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ).
No patient or public contribution.
Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission between couples. We aim to examine the mediation of dyadic coping between antepartum anxiety and stress in expectant mothers and fathers.
We implemented a cross-sectional study in Guangzhou, China, from October 2023 to January 2024.
Three-hundred and twenty-nine Chinese pregnant couples completed the Perceived Stress Scale, the Dyadic Coping Inventory, and the State–Trait Anxiety Inventory. The actor-partner interdependence mediation model was used for data analysis.
Expectant mothers experienced antepartum anxiety symptoms at a rate of 42.6%, while the rate for expectant fathers was 32.5%. Regarding the actor effects, stress was positively associated with antepartum anxiety in expectant mothers (β = 0.66, 95% confidence interval CI [0.56, 0.74]) and fathers (β = 0.58, 95% CI [0.42, 0.70]), with dyadic coping acting as a mediator (expectant mothers: β = 0.08, 95% CI [0.03, 0.14]; fathers: β = 0.11, 95% CI [0.04, 0.19]). Regarding the partner effects, maternal dyadic coping was positively associated with paternal stress (β = 0.10, 95% CI [0.01, 0.19]).
The study highlights the interplay of stress, dyadic coping, and antepartum anxiety in expectant mothers and fathers, emphasizing the need to assess their antepartum anxiety and implement couple-centered interventions to enhance their psychological well-being during the first trimester of pregnancy.
This study highlights the importance of assessing antepartum anxiety in both expectant mothers and fathers, emphasizing the mediation of dyadic coping in reducing stress and anxiety. The findings support the integration of couple-centered mental health interventions into routine antepartum care to enhance psychological well-being during pregnancy.
Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.
This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases—APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science—were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = −0.94; 95% CI = −1.33 to −0.55; I 2 = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.
This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.
CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.
The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.
Background
In hospitals that serve disproportionately patients of Black race, here termed Black-serving hospitals (BSH), nurse staffing is worse, mortality rates are higher, and nursing-sensitive indicators may be worse than in other hospitals, but this evidence has not been compiled.
Objective
The study objective was to examine whether nursing-sensitive indicators, which measure changes in patient health status directly affected by nursing care, differ in hospitals where Black patients predominantly access their care, as compared to other hospitals.
Methods
To fulfill the objective, a cross-sectional design using publicly available 2019 to 2022 Hospital Compare, 2019 Medicare Provider Analysis and Review (MEDPAR), and case mix index (CMI) file databases were used. Four nursing-sensitive indicators were evaluated: pressure ulcer, postoperative sepsis, perioperative pulmonary embolus/deep vein thrombosis, and death rate among surgical inpatients with serious treatable complications (“failure to rescue”) in hospitals classified into high, medium, and low BSHs according to the percentage of patients of Black race in the MEDPAR data. Mean outcome differences across BSH categories were assessed through analyses of variance and regression models, which controlled for hospital CMI.
Results
The 3,101 hospitals were predominantly urban nonteaching hospitals in metropolitan areas. Although 12% of hospitals had Magnet designation, BSHs were disproportionately Magnet (14%). The outcome rates were 0.59 for pressure ulcers, 3.38 for perioperative pulmonary embolus/deep vein thrombosis, 143.58 for failure to rescue, and 4.12 for sepsis. Rates were significantly higher for pressure ulcers, perioperative pulmonary embolus/deep vein thrombosis, and sepsis in high BSHs. The mean failure to rescue rate was similar across low-to-high BSHs and did not show significant differences. These results were unchanged in models adjusting for CMI.
Discussion
The evidence suggests that several nursing-sensitive indicators are worse in high BSHs. Research linking nursing-sensitive indicators to nursing resources such as staffing is needed to explicate the mechanism underlying these findings. Poorer nursing-sensitive indicators in combination with poorer nurse staffing in high BSHs presents a priority for policy and management intervention. Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized.
Systematic review and meta-analysis.
A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.
Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = −0.40; 95% CI: −0.72 to −0.08; I 2 = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07–0.83; I 2 = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13–0.86; I2 = 46.89%; p = 0.01).
This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults.
VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.
Background
Patients in hospitals that serve disproportionately patients of Black race have worse outcomes than patients in other hospitals, but the modifiable nursing factors that may contribute to such disparities have not been explored.
Objective
The study objective was to examine whether nurse staffing differs in hospitals that serve predominantly patients of Black race (Black-serving hospitals) as compared to other hospitals.
Methods
A cross-sectional correlational design using a nurse survey in a national hospital sample was used to fulfill the study objective. Nurse staffing was measured as the maximum number of patients cared for on the last shift from the 2015 annual registered nurse survey conducted in National Database of Nursing Quality Indicators hospitals. Hospitals were classified into subgroups of low, medium, and high percentages of patients of Black race using the 2019 Medicare Provider Analysis and Review database.
Results
In survey data from 179,336 registered nurses in 574 hospitals, nurse staffing was significantly worse in high-Black-serving hospitals as compared to medium- and low-Black-serving hospitals. In Poisson regression models that adjusted for nursing unit type and hospital characteristics, nurses in high-Black-serving hospitals and medium-Black-serving hospitals had more patients-per-nurse than did nurses in low-Black-serving hospitals.
Discussion
Small, statistically significant differences in nurse staffing that are worse in hospitals where Black patients disproportionately access their care were found using nurse survey data accounting for nursing unit type. The poorer nurse staffing in Black-serving hospitals may compromise the care and outcomes of the seven in 10 hospitalized Black older adults who receive care in Black-serving hospitals. The consequences for patient outcome disparities of poorer nurse staffing in Black-serving hospitals deserve investigation. Policies to increase nurse staffing in hospitals serving a higher proportion of patients of Black race are needed to contribute to efforts to reduce health disparities. 
FreshRSS 