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To systematically review advanced nursing roles in caring for people with cognitive impairment and their relatives in acute care hospitals, focusing on describing roles and intervention components.
Systematic review.
We included qualitative and quantitative studies on nurses in advanced roles caring for people with diagnosed or suspected cognitive impairment and their relatives, assessing outcomes at patient, staff and organisational levels. Nurses' advanced role profiles ranged from nurse-led interventions up to Advanced Practice Nurses. We employed the Mixed Methods Appraisal Tool for critical appraisal and conducted a synthesis without meta-analysis using a content analysis approach.
MEDLINE, CINAHL, Cochrane Library, ALOIS, Web of Science and LIVIVO up to May 2024, along with forward and backward citation tracking.
We included 48 studies that described 39 distinct interventions. The majority of these studies employed a quasi-experimental design. Most interventions involved Advanced Practice Nurses (n = 23) and focused on people at risk of or experiencing delirium (n = 22). Nurses in advanced roles predominantly engaged in tasks related to direct clinical practice, as well as coaching and guidance for patients, relatives and colleagues. Their responsibilities also included leadership, collaboration and consultation on a regular basis. Activities related to research and ethical decision-making were infrequently reported.
Many areas of responsibility of nurses in advanced roles align with the needs of hospitalised people with cognitive impairment. Nurses in advanced roles increasingly take on diverse activities across all competence domains of Advanced Practice Nursing, with a focus on coaching and guidance, as well as clinical practice, while leadership, collaboration, research and ethical decision-making become more prominent as their formal training advances.
Our comprehensive description of advanced nursing roles in the care of people with cognitive impairment provides a foundation for developing and refining such roles in hospitals.
We followed the PRISMA guideline and SWiM guideline for reporting.
This study did not include patient or public involvement in its design, conduct or reporting.
Prospero number: CRD42021265157
This study aims to (1) understand the impact of having a child with complex care needs in the family and (2) explore how siblings and parents experience the Sibling Talks intervention.
A qualitative exploratory design.
Semi-structured interviews were conducted with six siblings and 10 parents from seven families after completing the Sibling Talks intervention between January 2023 and April 2023. Data were analysed using Braun and Clarke's reflexive thematic analysis.
The analysis identified four themes, with separate findings for siblings and parents. Siblings described the impact of having a sibling with complex care needs as ‘Struggling to find their role and to understand themselves’ and their experiences with dialogues in Sibling Talks as ‘The importance of support from the school nurse’. Parents described their experience of their family situation as ‘A balancing act of care and other responsibilities’ and noted a shift ‘From scepticism to relief’ regarding the dialogues in Sibling Talks.
Sibling Talks facilitated open communication between siblings and parents, helping parents gain a deeper understanding of their children's perspectives. Sessions with nurses were experienced as respectful and caring, allowing siblings' perspectives to be heard and enhancing family interaction.
This study provides new insights into siblings' needs and how nurses can approach and communicate with siblings and parents, highlighting positive experiences with the Sibling Talks intervention.
The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).
There was no patient or public contribution.
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