Conectar
To explore the lived experiences and daily interactions of older couples living with multimorbidity.
A descriptive-interpretive qualitative study based on a generic interpretive description framework.
A total of 20 dyads were recruited using a purposive sampling strategy, and 24 semi-structured in-depth interviews were conducted between May 2023 and January 2025. Reflexive thematic analysis was used to analyse data.
Four overarching themes were generated: (1) dynamic relationship structures; (2) diverse interaction patterns; (3) double burdens; and (4) double resilience. Dynamic relationship structures occurred in dyadic and triadic forms. Diverse interaction patterns involved independence, interdependence and dependence. Double burdens manifested as physical toll, financial hardship, emotional contagion and perceptual misalignment, whereas double resilience was reflected in the nudge effect, emotional resonance and promotion of family ownership of health.
This study adopted a dyadic perspective to explore the experiences and interactions of older couples living with multimorbidity. The caring dynamics and blurred roles of patient and care partner deviate from the traditional unidirectional, linear model of ‘one person caring for the other’. Formal or informal caregiving support from third parties, as well as the nudge effect and emotional resonance between spouses, may help orient older couples as they navigate the challenges associated with multimorbidity.
Our findings indicate that community nurses can play a proactive role in identifying older couples living with multimorbidity through routine care attendance and assessments, enabling early recognition of health management needs. Geriatric nurses can leverage insights into couples' interaction patterns to tailor more effective care plans at different stages of illness, monitor emerging risks and identify optimal timing for third-party support. By facilitating a responsive triadic network, nurses can help ensure continuous and sustainable health care.
Adhered to SRQR guidelines for qualitative research.
This study did not include patient or public involvement in its design, conduct, or reporting.
We aimed to identify the barriers and facilitators to participation in interventions aimed at improving cognitive function among older adults with type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) in rural areas.
This study is the qualitative phase of a larger randomised controlled trial and employs a descriptive approach.
We conducted in-depth, semi-structured face-to-face interviews with older adults diagnosed with T2DM and MCI in rural areas of China in November 2023. The interviews were guided by the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). The interview recordings were transcribed and analysed using NVivo V.11 software. Two research assistants independently coded the transcriptions, and the identified barriers and facilitators were mapped to the corresponding domains within the COM-B model and TDF.
A total of 26 older adults, aged 60–87, participated in the interviews. Nine themes were identified, including disease awareness, disease attitude, social interaction, responsibility and health, emotion guidance, organisational management, expertise and benefits, self-perception and role identity crisis. These themes mapped onto the three core components of the COM-B model as well as the nine domains of the TDF, which include: knowledge, environmental context and resources, social influences, intentions, emotions, reinforcement, beliefs about consequences, beliefs about capabilities and social identity.
Addressing barriers and leveraging facilitators can effectively enhance the willingness of elderly patients in rural areas to participate in interventions aimed at improving cognitive function. A multi-layered approach should be adopted, focusing on disease knowledge and attitudes, social interactions, the impact of the disease burden on both family and individuals, emotional state, organisational management, team expertise and timely assessment, individual self-efficacy and role perception.
The study adheres to the COREQ reporting guidelines.
The participants in this study were older adults with T2DM and MCI from rural areas. Participants were involved in the development of the interview guide and were subsequently interviewed regarding the facilitators and barriers to their participation in cognitive function interventions.
Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.
A cross-sectional study was conducted from December 2023 to March 2024 in China.
A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.
Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.
A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.
This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.
This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.
This study was reported in accordance with the STROBE guidelines.
No patient or public contribution was involved in this study.
Skin temperature, including absolute temperature (at bony prominence areas under long-term compression) and relative temperature (the difference between bony prominence and adjacent control area), may serve as early warning indicators for PI. However, the optimal indicator remains unclear. This meta-analysis therefore synthesises evidence on their association with PI risk to identify the best indicator and evaluate its early-warning accuracy.
Systematic review and meta-analysis.
We included prospective cohort studies of adult patients investigating longitudinal associations between skin temperature and subsequent PI development. We pooled standardised mean difference (SMD) and odds ratios, complemented by summary receiver operating characteristic (SROC) curve analysis. The overall quality of evidence was evaluated using the GRADE method.
We researched PubMed, Embase, CINAHL, Cochrane Library (CENTRAL), Wanfang and CNKI databases from inception to September 25, 2024.
After screening 1354 titles and abstracts, ten studies comprising 1742 participants were included in the final synthesis. No significant difference in absolute temperature (combined SMD) was found between the PI and non-PI groups (seven studies included). In addition, decreased relative temperature (< −0.1°C) was associated with a 16-fold increased likelihood of PI (95% CI 6.38–40.19, I 2 = 79.4%) (three studies included), with the SROC curve analysis showing an AUC of 0.776. According to GRADE, the evidentiary certainty was very low for AT and low for RT.
Relative temperature is significantly related to the risk of PI, supporting its role as a promising early warning indicator. Future studies should establish a standardised measurement protocol to facilitate its clinical application.
Monitoring skin temperature changes holds promise as a non-invasive tool for early warning of PI risk. However, the amount and quality of available evidence limit our confidence in these findings, underscoring the need for further research before a definitive conclusion can be drawn.
This study followed PRISMA guidelines.
No patient or public contribution.
PROSPERO CRD42024550099
At-risk mothers experience disproportionately higher rates of antenatal depression and anxiety, which can hinder mother–infant bonding and adversely affect infant socioemotional development. Despite growing evidence on postpartum mental health, antenatal risk factors among psychosocially vulnerable mothers remain underexplored, particularly in multi-ethnic Asian settings.
To identify factors associated with antenatal depression, anxiety, and maternal–fetal bonding among at-risk mothers.
This cross-sectional observational study was nested within an ongoing randomised controlled trial. Two hundred at-risk mothers, defined as single, of low socioeconomic status, referred for psychosocial support, at risk of depression, with adverse childhood experiences, or with a fetus with a congenital malformation, were recruited from outpatient obstetric clinics between February and September 2024. Participants completed online self-administered questionnaires assessing antenatal depression, anxiety, perceived stress, social support, parenting self-efficacy, and maternal–fetal bonding. General Linear Models were used to analyse data and identify factors associated with depression, anxiety, and bonding.
Higher perceived stress was associated with increased depression (β = 0.28, p < 0.001) and anxiety (β = 1.28, p < 0.001) and poorer bonding (β = 0.08, p = 0.02), while greater social support predicted lower anxiety (β = −0.31, p < 0.001). Higher parenting self-efficacy was linked to stronger bonding (β = −0.09, p = 0.06). Younger mothers (β = −2.68, p = 0.025) and Indian mothers (β = 7.46, p = 0.017) were particularly vulnerable to anxiety, whereas post-secondary education was protective against depression (β = −1.44, p = 0.02). Model fit ranged from 0.14 to 0.65.
Perceived stress, social support, and parenting self-efficacy significantly influenced antenatal mental health and bonding in at-risk mothers. These findings underscore the need for culturally sensitive, nurse/midwife-led interventions that integrate early screening, stress reduction, and empowerment strategies within routine antenatal care to strengthen maternal mental health and early bonding outcomes.
(1) Nurses and midwives play a critical role in screening for antenatal depression and anxiety in mothers with risk profiles highlighted in this study. (2) Culturally responsive nursing practice that demonstrates sensitivity towards sociocultural pressures is needed to provide individualised care. (3) Integration of digital and community-based antenatal education programs could provide more equitable access to care for at-risk mothers who may face barriers to in-person care.
(1) Despite having a higher susceptibility for antenatal mental health conditions, risk factors for antenatal depression, anxiety, and maternal–infant bonding have been underexplored in at-risk mothers. (2) Antenatal stress and anxiety are universally associated with depression across risk groups, while maternal self-efficacy and perceived social support serve as key protective factors. (3) The findings from this study suggest the need for early screening and nurse-led interventions that support maternal parenting self-efficacy and stress management to improve maternal mental health outcomes among at-risk mothers.
STROBE reporting checklist.
No patient or public contribution.
To explore the concurrent trajectories of depressive symptoms and insomnia among adolescents and to analyse the individual, familial and social predictors of the concurrent trajectories.
This study tracked depressive symptoms and insomnia in eight secondary schools annually from 2021 to 2023. We also collected data on individual, familial and social factors that may influence these conditions. Group-based multi-trajectory (GBMT) modelling was used to categorise adolescents into depressive–insomnia severity subgroups.
This study included 2822 adolescents, who were categorised into four groups, including the no symptom group, mild symptom group, symptom relief group and symptom increase group. Compared with the no symptom group, predictors of the mild symptom group were gender (OR = 1.30), academic performance (OR = 1.57), subjective well-being (OR = 0.78), anxiety (OR = 1.14), economic status (OR = 1.23) and relationship with teachers (OR = 1.46). Predictors of the symptom relief group were personality (OR = 1.75), academic performance (OR = 2.28), subjective well-being (OR = 0.69) and anxiety (OR = 1.25). Predictors of the symptom-increasing group were personality (OR = 2.45), academic performance (OR = 1.96), subjective well-being (OR = 0.69), anxiety (OR = 1.20), maternal education level (OR = 1.58), family function (OR = 0.93), parental relationship (OR = 2.07) and relationship with teachers (OR = 1.54).
This study provided a comprehensive understanding of the concurrent trajectories of depressive symptoms and insomnia among adolescents, revealing distinct subgroups and identifying predictors across individual, familial and social levels.
This study emphasises the importance of a multi-faceted approach involving family, school and society to promote adolescent mental health and also highlights the need for conducting precise interventions according to adolescents' features.
The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.
STROBE checklist.
None.
To develop a comprehensive and psychometrically validated scale for evaluating the core competencies of community nurses for public health emergencies.
A study of instrument development and validation was conducted.
A total of 1057 community nurses provided valid responses for this study conducted in Shanghai, China. Building upon previous study findings of the adapted core competency model and integrating the World Health Organisation's Framework for Action, this study was conducted in two phases. First, scale items were developed through systematic review, qualitative research, stakeholder meeting, and Delphi survey, refined with cognitive interviews to establish version 1.0 of the scale. Second, item analysis was performed with item-total correlations, Cronbach's alpha, and exploratory factor analysis, resulting in version 2.0. The final scale was produced after assessing the validity (content validity, confirmatory factor analysis, known-groups validity) and reliability (internal consistency, test–retest reliability).
The final scale consisted of 47 items categorised into four competency factors: prevention, preparation, response, and recovery competency. Factor analysis results indicated adequate factor loadings, excellent model fit, and well-established construct validity. The overall scale and its sub-factors exhibited high internal consistency and good test–retest reliability.
The study presents a theoretically grounded and scientifically validated scale measuring the competencies that community nurses need for public health emergency response.
This study enhances the theoretical framework of community nurses' core competencies in public health emergencies, provides a validated assessment tool, and clarifies their role in enhancing preparedness and effectiveness.
The study addressed the need for a standardised tool for assessing community nurse core competency for public health emergencies and will impact policy initiatives to enhance early prevention, emergency response, and integrated recovery practices in crisis management.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No Patient or Public Contribution.
The study examines the associations between nursing competence, work environment, and health system resilience. It also analyzes how nursing competence and work environment relate to different patterns of health system resilience.
A multiple center cross-sectional study was conducted between December 2023 and January 2024 across 33 hospitals in eastern China, involving 2435 nurses.
Questionnaires measuring nursing competence, work environment resources, nurse disaster resilience, and organizational commitment to resilience were utilised, along with the collection of additional personal demographic data. Structural equation modelling and cluster analysis were performed to explore the underlying mechanisms within the overall model and across multiple groups. Multivariable regression was conducted to identify variables associated with resilience in different subgroups.
Structural equation modelling demonstrated significant influences of nursing competence and work environment support on system resilience. Cluster analysis identified four resilience patterns: strong, marginal, low, and critical vulnerability. Strong resilience correlated with balanced individual-organizational resources, while vulnerable systems relied heavily on environmental support.
Our findings support policymakers and managers in developing systematic strategies with distinct focal points—targeting nurse workforce investment and optimised work environment—to enhance health system resilience across varying levels of public health emergencies.
This study validated the framework connecting individual and organizational resilience, offering evidence-based insights for nurse training and resource allocation to enhance healthcare systems' adaptability during disasters.
The study addressed how nursing competence and work environment significantly influenced resilience during public health emergencies, identified four resilience patterns, and provided insights to guide policymakers and healthcare managers in developing targeted, effective strategies.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No patient or public contribution.
The aim of this study was to integrate Social Exchange Theory and the Ability—Motivation—Opportunity (AMO) Theory to examine the influence of organisational innovation climate on nurses' innovative behaviour, considering the mediating role of knowledge sharing and the moderating effect of person-organisation fit, thereby providing a multidimensional theoretical foundation for enhancing nurses' innovative behaviour.
A cross-sectional research design was adopted.
Participants included 380 nurses from two Grade-A tertiary hospitals in Henan Province, China. Data were collected using the Organisational Innovation Climate Scale, Knowledge Sharing Scale, Nurses' Innovative Behaviour Scale and Person-Organisation Fit Scale and analysed via descriptive statistics, correlation analysis, regression analysis and bootstrap testing for mediation and moderation effects.
Organisational innovation climate was positively correlated with nurses' innovative behaviour and knowledge sharing partially mediated this relationship. Person-organisation fit positively moderated both the direct relationship between organisational innovation climate and knowledge sharing and the indirect effect on innovative behaviour.
Under a supportive organisational innovation climate, nurses with high person-organisation fit are more likely to engage in innovative behaviour through knowledge sharing.
Establishing an organisational innovation climate and improving person-organisation fit can enhance nurses' work engagement and loyalty, advancing innovation and development in nursing.
Nursing managers should cultivate an innovation-friendly climate and facilitate knowledge sharing to inspire proactive problem-solving and innovation among nurses, ultimately improving nursing practice and patient care.
STROBE guidelines were followed.
This study clarifies how organisational and individual factors jointly affect nurses' innovative behaviour, providing a theoretical foundation for improving nursing management, service quality and disciplinary innovation.
To assess the acoustic environment of operating rooms (ORs) and its impact on nurses' perceptions in three surgical departments in a general hospital.
A mixed-methods study.
This study integrated sound level measurements, structured behavioural observations and a cross-sectional questionnaire survey. Acoustic data were collected during 41 surgeries in orthopaedics, general surgery and obstetrics–gynaecology. Observations identified typical noise events, and a validated questionnaire was used to assess perceived noisiness, communication and work efficiency interference, annoyance and the importance of a quiet environment.
Average noise levels in ORs exceed safety recommendations. The highest noise intensities occurred in the preoperative stage, primarily due to anthropogenic sources such as conversation, door movement and instrument collisions. Mid-frequency noise is dominant and overlaps with speech frequencies. Nurses identified conversation as the most frequent and disturbing noise source. Greater years of experience correlated with higher perceived noisiness, communication interference and annoyance.
Operating room noise affects nurses' communication, work efficiency and psychological comfort. As clinical experience increases, perceived cognitive load also rises. Anthropogenic noise sources are a major disruptive factor in a healthy OR environment and should be addressed through targeted interventions.
Noise mitigation should combine behavioural management, acoustic design and spatial optimisation to enhance nursing well-being and performance.
The study examined the impact of excessive OR noise on nurses' work performance and subjective well-being. OR noise exceeded safe thresholds, with conversation identified as the dominant and most disturbing source, particularly during preoperative phases. The findings inform OR design, management and training practices in surgical environments globally, with benefits for nursing staff.
This study followed STROBE guidelines.
No patient or public contribution.
Chinese Clinical Trial Registry (ChiCTR): ChiCTR2000038787
To explore latent profiles of social isolation in maintenance haemodialysis (MHD) patients and to analyse the factors influencing different latent profiles.
Multicentre cross-sectional study.
Between November 2024 to March 2025, 305 MHD patients from the haemodialysis centres of three hospitals in Henan Province, China, were recruited using a convenience sampling method. All participants completed the general information questionnaire, Lubben Social Network Scale 6 (LSNS-6), UCLA Loneliness Scale-6 (ULS-6) and Personal Mastery Scale. Latent Profile Analysis (LPA) was used to classify the participants into potential subgroups with different types of social isolation. The influencing factors of profiles were explored by univariate analysis and multiple logistic regression analysis.
Social isolation of 305 patients can be divided into three profiles: the family-friend dual isolation group (14.10%), friend isolation-only group (47.54%), and social network well-being group (38.36%). Multivariable logistic regression analysis revealed that monthly personal income, living arrangement, social participation, dialysis time, post-dialysis fatigue, number of comorbidities, loneliness and personal mastery were identified as factors influencing the profiles.
There is heterogeneity in social isolation among MHD patients. It is therefore necessary to implement targeted intervention measures based on the distinct characteristics of each subgroup to facilitate their social reintegration.
Nurses should identify differences in social isolation among MHD patients. It is necessary to establish tripartite connections between families, hospitals and communities, and develop personalised psychosocial interventions to alleviate social isolation.
The study identified distinct subgroups of social isolation among MHD patients, while emphasising the impact of psychological resources such as loneliness and personal mastery on social isolation. This may offer critical insights for nurses to develop targeted interventions for patients' social health.
The study followed the STROBE guidelines for cross-sectional studies.
No patient or public involvement.
Urinary incontinence, often perceived as embarrassing, perpetuates the stigma that delays treatment and encourages concealment. This stigma significantly diminishes quality of life and imposes both financial and medical burdens. Although prior research has examined stigma reduction in urinary incontinence, it persists as a widespread issue. Most studies have focused on interviews, primarily addressing urine leakage, with a limited understanding of the factors influencing urinary incontinence stigma and their interrelations. More in-depth quantitative studies are crucial to inform targeted interventions.
(1) To develop targeted interventions aimed at alleviating urinary incontinence-related stigma in older adults. (2) To identify factors that mitigate stigma in older adults with urinary incontinence. (3) To examine the associations between these factors and stigma.
Cross-sectional survey.
A cross-sectional survey was conducted with 510 older adults across three hospitals in Guangdong from July 2022 to January 2024, utilising the SSCI-24 and Incontinence Severity Index. Three multivariate linear regression models, adjusted for covariates based on directed acyclic graphs, were employed to explore the relationships between variables and stigma. Additionally, subgroup analyses were performed.
Participants reported higher levels of self-stigma compared to perceived stigma. Multivariate analysis revealed significant associations between urinary incontinence type, severity, frequency of micturitions and stigma. Key factors contributing to stigma reduction include managing incontinence severity, reducing frequency of micturitions and preventing the progression to mixed incontinence.
The study identified associations between urinary incontinence characteristics—type, severity and frequency of micturitions—and stigma. Strategies for stigma reduction are proposed, underscoring the vital role of nurses in this process.
The findings of this study contribute to a deeper understanding of stigma surrounding urinary incontinence in older adults and provide insights for developing more effective interventions by healthcare professionals and community caregivers.
This study adhered to the STROBE checklist for observational studies.
No patient or public contribution.
To examine the relationship between frailty status, family functioning, and quality of life in adolescents with congenital heart disease (CHD).
Frailty is a rarely assessed health outcome in adolescents. Despite advances in paediatric CHD treatment, potential complications may cause frailty, affecting family dynamics and quality of life. Family support and early screening are vital to managing the symptoms of frailty associated with CHD.
Cross-sectional study.
During the period from July 2022 to August 2023, 302 adolescents aged between 12 and 18 who had received a diagnosis of CHD were assessed for frailty using criteria that included slowness, weakness, exhaustion, shrinkage/body composition, and diminished physical activity. Data were collected from assessments of grip strength, the 6-min walk test, body mass index, triceps skinfold thickness, the PedsQL Multidimensional Fatigue Scale Adolescent, Physical Activity Questionnaire for Adolescents, the Family Adaptability, Partnership, Growth, Affection, and Resolve scale, and the PedsQL 3.0 Cardiac Module. All data were subjected to multiple linear regression analysis.
Frailty, as measured by exhaustion and diminished physical activity, was significantly more prevalent in adolescents with severe symptoms of CHD than in those without symptoms. Of the participants, 56.6% were prefrail, and 8.3% were frail. Adolescents who were frail and lived in dysfunctional families experienced a worse quality of life than participants with robust health and those with positive family functioning.
Frailty and family dysfunction negatively affect the quality of life in adolescents with CHD.
Developing programmes that detect frailty early and improve family functioning for adolescents with CHD is critical. Establishing guidelines for identifying frailty in this population can minimise adverse health effects and enhance familial relationships.
No patient or public involvement.
This study aims to identify distinct profiles of work engagement among oncology nurses through Latent Profile Analysis and explore how these profiles influence nurse safety behaviour.
A cross-sectional design with latent profile analysis.
A total of 957 oncology nurses from tertiary hospitals across five provinces and municipalities in China participated in this questionnaire-based study. Data were collected on demographic information, the Work Engagement Scale, the General Self-Efficacy Scale and the Nurse Safety Behaviour Scale. The analysis was conducted using SPSS 24.0 and Mplus 8.3, with Latent Profile Analysis, R3STEP and BCH methods employed to uncover underlying patterns and relationships.
The results revealed three distinct profiles of work engagement: ‘Highly Efficient and Focused Type’ (43.7%), ‘Moderately Balanced Type’ (37.4%) and ‘Low Effort and Coping Type’ (18.9%). The distribution of these profiles was closely related to factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy. Moreover, these work engagement profiles positively impacted nurse safety behaviour.
The study demonstrates that different work engagement profiles significantly influence the safety behaviour of oncology nurses. Key factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy play a crucial role in shaping these work engagement profiles.
The findings provide a new perspective and intervention approach for enhancing work engagement and nurse safety behaviour. It is recommended that hospital management develop personalised training and incentive measures tailored to nurses with different characteristics to improve overall nursing quality and patient safety.
No patient or public involvement.
Frailty affects over 35% of maintenance haemodialysis (MHD) patients globally—2–3 times higher than the general elderly—and is strongly linked to higher mortality, hospitalisation, and functional decline. Despite its clinical impact, frailty is often underdiagnosed in dialysis settings due to inconsistent assessments and limited resources. Existing prediction models vary widely in predictors and methods, requiring systematic review to guide clinical use and improve risk-stratified care.
To systematically identify, describe, and evaluate the existing risk prediction models for frailty in patients undergoing MHD.
Systematic review and Methodological appraisal.
A comprehensive search was conducted across multiple databases—PubMed, Web of Science Core Collection, Embase, Cochrane Library, CINAHL, China Biomedical Literature Database (CBM), Wanfang Database, VIP Database—covering studies up to November 1, 2024.
Two researchers independently conducted literature searches, screening, and data extraction. They used the Prediction Model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk of bias and the applicability of the included models.
Fifteen studies (21 models) were analysed, with sample sizes 141–786 and frailty incidence 11.00%–59.57%. Model AUCs ranged 0.720–0.998 (potential overfitting at extreme values). Key predictors included age, serum albumin, gender, Charlson comorbidity index, and activities of daily living scores. Methodological appraisal using PROBAST revealed moderate applicability but high bias risks: 53% of studies used retrospective designs, 95% lacked external validation, and limitations included small samples, non-standard variable selection, and inadequate handling of missing data.
While models demonstrate initial predictive utility, widespread bias and developmental-stage limitations hinder clinical application. Future research must prioritise TRIPOD-guided model development, emphasising large prospective cohorts, rigorous validation, and transparent reporting to enhance reliability and clinical utility in frailty risk stratification for MHD patients.
Nurses' health status significantly impacts their well-being and patient safety. Workflow interruptions, perceived workload, and missed nursing may potentially affect their physical and mental health. However, there is currently a lack of systematic studies on the relationships between these factors.
This study aims to explore how workflow interruptions influence nurses' health status through perceived workload and missed nursing, and provide strategies to promote nurses' health.
In October 2024, an online survey was conducted among 646 clinical nurses from three healthcare facilities in Henan Province. The survey covered nurses' demographic information, workflow interruptions, health status, perceived workload and missed nursing. Statistical analysis and model construction and validation were performed using SPSS 25.0 and AMOS 26.0 software.
Workflow interruptions were significantly negatively correlated with both physical component summary and mental component summary. Perceived workload and missed nursing served as mediators between workflow interruptions and physical and mental component summaries.
Workflow interruptions directly affect nurses' health status and indirectly influence it through perceived workload and missed nursing. Therefore, strategies should be implemented to optimise workflows, reduce workflow interruptions, lower perceived workload and take measures to minimise missed nursing. Future research could explore how to implement workflow optimization to improve nurses' health status effectively.
This study provides important guidance for improving nurses' health. The results reveal that optimising workflow and reducing work interruptions can effectively reduce nurses' perceived workload, thereby decreasing the occurrence of nursing omissions, and ultimately contributing to the overall improvement of nurses' health.
This study adhered to the cross-sectional Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
No patient or public contribution.
To identify and synthesise the available evidence of nurses' perceptions and experiences of providing bereavement care.
Systematic literature review of qualitative studies with meta-synthesis of findings.
We searched six databases, PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, and PsyINFO. Initial search in October 2023, and updated in December 2024.
The systematic review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. Two reviewers independently conducted study selection and data extraction, and quality appraisal was assessed using the Critical Appraisal Skills Program tool for qualitative research. Data synthesis was conducted using thematic analysis.
A total of thirteen studies were included, revealing nine sub-themes and three descriptive themes: challenges in bereavement care, coping strategies, and multifaceted job requirements. Six sub-themes were graded as high confidence and the other three were moderate confidence.
Bereavement care is a personalised, long-term and complex process, presenting nurses with unique challenges and requirements that must be measured through the authentic experiences of this group. Educational and practice policies should focus on nurse-centred strategies. Through this meta-synthesis, we can demonstrate to healthcare administrators how to enhance nurses' bereavement care practice experiences and meet their needs, thereby advancing future palliative care development and fostering professional fulfilment.
This systematic review synthesises evidence concerning nurses' experiences of providing bereavement care, revealing the multidimensional challenges, coping strategies, and professional demands encountered in practice. The findings offer significant implications for nursing education, clinical practice, and health policy development. Currently, research on nurses delivering bereavement support remains insufficient; further investigation into this group could help bridge gaps between grief counselling theory and practice while highlighting the identified societal issues they face.
Not applicable.
PROSPERO: CRD42024590469
To investigate the level of humanistic care ability of oncology nurses, its association with empathy and emotional intelligence, and the mediative role of emotional intelligence on empathy and humanistic caring ability.
This was a cross-sectional study conducted in a cancer hospital in China.
We enrolled a total of 1189 oncology nurses from several cancer hospitals from December 2023 to January 2024. All participants completed three general questionnaires: the Caring Ability Inventory, the Jefferson Scale of Empathy-Health Professionals and the Emotional Intelligence Scale.
The overall scores for the three scales were 202.35 ± 23.89, 112.38 ± 18.85 and 137.49 ± 17.81, respectively. A positive correlation was detected between caring ability, empathy and emotional intelligence (r = 0.741, p < 0.001; r = 0.577, p < 0.001). And emotional intelligence mediates the association between empathy and caring ability in oncology nurses (0.233, p < 0.001). The total and direct effect were also significant (0.825, p < 0.001; 0.592, p < 0.001).
The study findings indicated that oncology nurses exhibit a moderate level of caring ability. Emotional intelligence mediates the relationship between empathy and caring ability, at least in part. Therefore, an increase in the level of emotional intelligence in oncology nurses could improve their caring ability.
When designing training to improve humanistic care, we recommend the integration of specific training relating to empathy and emotional intelligence into the training system.
Oncology patients experience multiple forms of distress and require high-quality humanistic care. This study identified a moderate association between empathy and emotional intelligence. Our findings provide further recommendations for nurse leaders in medical institutions relating to how the humanistic care ability of oncology nurses can be improved by specific training in empathy and emotional intelligence.
This study was reported using the STROBE Checklist for cross-sectional studies.
Nurse leaders organised this survey in their own hospital.
This study aimed to develop and preliminarily validate the KAP scale for pain management in older adults with dementia among nursing assistants.
A cross-sectional study.
An initial item pool was constructed through literature reviews, semi-structured interviews and team discussions. Items were screened and optimised through two rounds of Delphi expert consultations, a pilot survey and item analysis, yielding a draft version of the scale. Psychometric evaluation was conducted to refine the scale into its final form.
The final KAP scale developed in this study comprised 31 items. The scale exhibited good content validity, with item-level content validity index (I-CVI) values ranging from 0.83 to 1.00. Exploratory factor analysis revealed that the scale extracted five factors, which accounted for 65.732% of the cumulative variance, and all items demonstrated rotated factor loadings > 0.5, indicating good construct validity. The Cronbach's α coefficients for the knowledge, attitudes and practices dimensions were 0.877, 0.915 and 0.935, respectively, and the split-half reliability coefficients were 0.909, 0.886 and 0.864.
The KAP scale for pain care in older adults with dementia developed in this study possesses good reliability and validity and can be used to assess the knowledge, attitudes and behavioural levels of nursing assistants in pain care.
This study developed and psychometrically validated a KAP scale specifically designed to assess pain care for older adults with dementia among nursing assistants. Clinical managers can utilise this tool to systematically identify deficiencies in staff members' knowledge, attitudes or practices, thereby providing scientific evidence for the development of targeted pain care training programs and pain management strategies. This contributes to enhancing nursing assistants' pain care competence, ultimately alleviating the pain burden of older adults with dementia and improving their quality of life.
The STROBE checklist was used as a guideline.
No patient or public involvement.
FreshRSS 