FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
Anteayer Journal of Advanced Nursing

Network Analysis of Self‐Efficacy and Professional Resilience in Emergency Nurses: A Multi‐Center Cross‐Sectional Study

ABSTRACT

Objective

This study aimed to investigate the network structural characteristics of self-efficacy and professional resilience among emergency nurses, identify core nodes within the network, and elucidate the key interactive mechanisms between these constructs.

Design

Descriptive cross-sectional study.

Methods

A multi-center cross-sectional study was conducted from January to February 2025, involving 612 emergency nurses from 20 hospitals in Sichuan, China. Data were collected using a self-administered demographic questionnaire, the General Self-Efficacy Scale, and the Chinese Emergency Nurse Professional Resilience Tool. An adjacent network integrating professional resilience and self-efficacy was developed. Key covariates—including title, position, tenure in the hospital or emergency department, education, and exposure to workplace violence—were included as control variables. Network precision and stability were evaluated using the correlation stability coefficient and confidence intervals for edge weights. To further test the robustness of the network model, sensitivity analyses were performed by adding each significant covariate to the original model. The Network Comparison Test was then used to compare the covariate-adjusted and unadjusted networks, assessing differences in network structure, overall strength, and edge weights.

Results

The analysis identified S9 as the central node in the network. The overall network showed satisfactory stability and precision. The Network Comparison Test showed no significant differences in network structure or global strength between the adjusted and unadjusted models, indicating that the network was stable and robust to covariate adjustment.

Conclusion

This network analysis revealed the interaction mechanisms between self-efficacy and professional resilience among emergency nurses through contemporaneous network modelling and identified S9 as the core node, suggesting that this coping strategy plays a key role in regulating psychological resources. The overall network demonstrated good stability and precision, with no statistically significant differences between the adjusted and unadjusted models according to the Network Comparison Test. These findings indicate that the network structure was robust to covariate adjustment and provide a reference for developing and optimising intervention strategies to enhance professional resilience among emergency nurses.

Implications

For Emergency Nurses and the Management of Emergency Nursing Practice: What problem does this study address?

This study addresses the gap in understanding how self-efficacy and occupational resilience interact in emergency nurses under high-stress conditions.

Key Findings

A contemporaneous network analysis revealed a central node linking self-efficacy and resilience, highlighting key pathways in their mutual influence.

Impact

The findings offer practical guidance for emergency nursing management, supporting the development of targeted strategies to strengthen nurses' resilience, enhance professional competence, and improve the quality of emergency care.

Reporting Method

This study is reported using the STROBE guidelines.

Patient or Public Contribution

No Patient or Public Involvement: This study did not include patient or public involvement in its design, conduct, or reporting.

Ethical Sensitivity as Mediator Between Conflict and Decision‐Making: A Cross‐Sectional Study of ICU Nurses

ABSTRACT

Aims

To examine the relationship between ethical conflicts and ethical decision-making ability, ethical sensitivity and demographic factors as mediator/moderator roles.

Design

A cross-sectional survey was conducted from June to December 2024.

Methods

This study involved 503 intensive care unit nurses from eight tertiary hospitals across Zhejiang, Guangdong and Guangxi provinces. Participants completed validated instruments including the Ethical Conflict Nursing Questionnaire-Critical Care Version, the Chinese Moral Sensitivity Questionnaire-Revised version and the Chinese Version of Judgement About Nursing Decision. SPSS 27.0 was used for descriptive statistics and Pearson correlation analysis, while PROCESS macro handled mediation and moderation analysis.

Results

The relationship between ethical conflict and decision-making ability was significantly mediated by both moral responsibility/strength and burden, with the latter demonstrating a stronger indirect effect. Furthermore, exploratory moderated mediation analysis showed that this mediation model varied significantly across different levels of work experience and types of intensive care unit. Given the exploratory nature of these findings, they require verification in future confirmatory studies.

Conclusions

The association between ethical conflict and decision-making ability was mediated by ethical sensitivity. This pathway was moderated by work environment and qualifications, indicating the need for tailored interventions.

Implications for the Profession and/or Patient Care

Developing nurses' ethical sensitivity is a key strategy for managers aiming to improve ethical decision-making when nurses face ethical conflicts.

Impact

This study addressed ambiguous findings regarding the relationship between ethical conflict and nurses' decision-making ability. For nurse managers, fostering ethical sensitivity among staff represents a key strategy for mitigating the ethical conflicts that are negatively associated with decision-making ability.

Reporting Method

The strengthening the reporting of observational studies in epidemiology statement (STROBE) was followed.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR): MR-33-24-032956

Relationship Between Sleep and Cognitive Frailty in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To explore the relationship between sleep and cognitive frailty in older adults.

Design

A systematic review and meta-analysis.

Data Sources

The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.

Methods

Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.

Results

This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.

Conclusions

This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.

Impact

The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.

Patient or Public Contribution

No patient or public contribution.

Midwives' Perception Towards Male Partners' Involvement in Labour Companionship: A Qualitative Study

ABSTRACT

Background

Labour companionship is a recommendation by WHO that health authorities enable women to choose a companion during labour to ensure a safe and dignified labour experience for the birthing woman. However, most healthcare facilities in low- and middle-income countries do not necessarily consider this maternal need, which hampers a positive maternal experience during labour.

Objective

This study aims to examine midwives' perception towards the involvement of male partners in labour companionship.

Methods

An exploratory phenomenological approach was chosen and semi-structured interviews were used for this study.

Results

The four main themes identified in this study include ‘Understanding of male partners' involvement in labour companionship’, ‘Involvement of midwives in decision-making’, ‘Barriers to male partners' involvement in labour companionship’ and ‘Facilitators of male partners' involvement in labour companionship’.

Conclusion and Implications

This study found a lack of understanding among midwives of the significance of male partners' involvement in labour companionship; and the identification of hierarchical and authoritarian leadership as a barrier to midwives' participation in decision-making highlights the need for transformational leadership styles to empower midwives. Overall, the findings of this study can inform maternity care policy as well as resource development, education and professional training in the field of midwifery.

The Relationships Among Family Involvement, Diabetes Self‐Management and Glycaemic Control in Patients With Type 2 Diabetes: A Cross‐Sectional Study

ABSTRACT

Aims

To investigate diabetes family involvement, including supportive and nonsupportive family behaviours in China, and explore the relationships among opposite forms of family involvement, diabetes self-management and glycaemic control.

Design

A cross-sectional study.

Methods

Type 2 diabetes patients were recruited from hospitals in Nanjing, Shanghai and Jinan, and communities across China, between April 2023 and August 2023. A total of 1648 patients completed questionnaires regarding diabetes family involvement, diabetes self-management, perceived glycaemic control and patient characteristics. Data analysis was conducted using SPSS 26.0 and PROCESS macro.

Results

The mean scores for supportive and nonsupportive family behaviours were 19.14 out of 40 and 12.47 out of 30, respectively, resulting in an overall family involvement score of 6.67. Overall family involvement, especially supportive family behaviours, was positively related to diabetes self-management and perceived glycaemic control, whereas nonsupportive family behaviours were not. Diabetes self-management partially mediated the relationships between both overall family involvement and supportive family behaviours with perceived glycaemic control.

Conclusion

Diabetes family involvement was suboptimal. Overall family involvement, especially supportive family behaviours, could not only directly improve glycaemic control but also indirectly enhance it through promoting diabetes self-management.

Implications for the Profession and/or Patient Care

The findings highlight the importance of promoting supportive family involvement and patient self-management in diabetes management.

Impact

This study endorses the necessity for healthcare professionals to integrate the family unit into diabetes management and implement interventions at the family unit level, to address the neglect of families in current interventions. It also advocates for promoting supportive family involvement rather than all family involvement in future interventions. Promoting supportive family involvement and patient self-management can better improve patients' glycaemic control and alleviate the burden on medical and social systems.

Reporting Method

This study adheres to the STROBE guideline of reporting.

Patient or Public Contribution

No Patient or Public Contribution.

Dysphagia in Head and Neck Cancer Patients: A Qualitative Meta‐Synthesis of Patient and Caregiver Experiences and Perspectives

ABSTRACT

Background

Dysphagia not only affects the nutritional intake of head and neck cancer (HNC) patients but may also lead to social avoidance, emotional fluctuations, and a decline in life confidence. Furthermore, dysphagia places an additional psychological and physical burden on caregivers, significantly altering their lifestyles.

Method

This study employed a qualitative systematic review approach to comprehensively analyse the experiences and coping strategies of HNC patients and their caregivers in relation to dysphagia. Relevant qualitative studies published from the inception of the database through September 2024 were selected. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research (2016), and a meta-aggregation method was applied to synthesise and categorise the research themes. This study standardised the presentation of results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.

Results

A total of 14 studies were included, resulting in 63 research outcomes, which were consolidated into 12 new categories and integrated into 4 main themes: (1) the impact of dysphagia on daily life; (2) coping with the changes caused by dysphagia; (3) understanding of dysphagia and related needs; and (4) the physiological and psychological challenges faced, and the efforts to seek support.

Conclusions

The dual physiological and psychological challenges posed by dysphagia profoundly affect patients' daily lives, prompting ongoing adjustments to cope with these changes. Both patients and caregivers have a limited understanding of dysphagia but exhibit a strong need for support. These findings underscore the importance of providing comprehensive, individualised support for patients and caregivers to improve their quality of life and coping experiences.

Patient or Public Contribution

No Patient or Public Contribution. This study aims to analyse and synthesise the experiences and perspectives of patients and their caregivers reported in existing research. As no original data were collected and no direct interaction with patients or the public occurred, specific patient or public contributions are not included.

Identification of the Central Symptoms of Multidimensional Frailty Among Older Adults Using the Tilburg Frailty Indicator: A Network Analysis

ABSTRACT

Background

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.

Design

A cross-sectional study was conducted from December 2023 to March 2024 in China.

Settings and Participants

A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.

Methods

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.

Results

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.

Conclusion

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.

Implications

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.

Reporting Methods

This study was reported in accordance with the STROBE guidelines.

Patient or Public Contribution

No patient or public contribution was involved in this study.

Absolute Versus Relative Skin Temperature as Early Warning Indicator for Pressure Injury: A Systematic Review and Meta‐Analysis

ABSTRACT

Aims

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.

Design

Systematic review and meta-analysis.

Methods

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.

Data Sources

We researched PubMed, Embase, CINAHL, Cochrane Library (CENTRAL), Wanfang and CNKI databases from inception to September 25, 2024.

Results

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.

Conclusions

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.

Implications for the Profession

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.

Reporting Method

This study followed PRISMA guidelines.

Patient or Public Contribution

No patient or public contribution.

Trial Registration

PROSPERO CRD42024550099

A Scoping Review of Available Scales and Tools Used to Measure Obstetric Violence

ABSTRACT

Aim

To identify and describe instruments used to assess obstetric violence and evaluate their methodological quality and psychometric properties.

Design

A scoping review.

Data Sources

Ten databases [Medline (via PubMed), Web of Science, the Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SinoMed, Wanfang Database, China National Knowledge Infrastructure (CNKI), VIP Database and China Medical Journal Full-text Database] were searched from inception to June 2025.

Methods

Studies focusing on the development or validation of obstetric violence measurement tools were eligible for this review. Methodological quality and psychometric properties were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and criteria.

Results

A total of 19 studies encompassing 25 obstetric violence measurement tools were included. These studies were conducted in 15 countries between 2018 and 2025. The tools targeted postnatal and pregnant women, healthcare providers, students and other populations. Most studies reported data on content validity, structural validity and internal consistency. Limited information was available on cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, hypotheses testing for construct validity and responsiveness.

Conclusion

This review identified multiple obstetric violence instruments used across diverse populations and settings. Whilst the methodological quality and measurement properties of the included tools were sub-optimal, they nevertheless provide a foundation for the timely assessment of obstetric violence and subsequent research.

Implications for the Profession

Future research should prioritise the establishment of a unified definition of obstetric violence, alongside the development, adaptation and rigorous validation of measurement instruments to enhance their reliability and validity.

Impact

This review underscores the need for maternity care professionals and educators to critically evaluate existing tools for measuring obstetric violence, given their current methodological limitations.

Reporting Method

The PRISMA Extension for Scoping Reviews (PRISMA-ScR) checklist.

Patient or Public Contribution

No patient or public contribution.

‘Can't Escape’—Survivors' Perspectives and Experiences of Psychological Detachment While Living With a Stoma: A Descriptive Qualitative Study

ABSTRACT

Aim

To explore survivors' perspectives and experiences of psychological detachment while living with a stoma.

Design

A qualitative descriptive study was conducted. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Methods

A total of 15 semi-structured interviews were conducted between February 2024 and May 2024. The phenomenological method proposed by Colaizzi was used to analyze the data.

Results

Four major themes emerged from the analysis: (1) Trapped in the Persistent Impact of Dual Traumas: Struggles with Adaptation; (2) Trapped by the Unrelenting Burden of Stoma Care: A Cycle of Powerlessness; (3) Trapped by the Shackles of a Stigmatised Identity: The Dilemma of Social Reintegration; and (4) Divergent Pathways of Detachment: Navigating Between Immersion and Transcendence. Within the main themes, eight subthemes were formulated.

Conclusion

This study thoroughly explored and elucidated the psychological detachment experiences of colorectal cancer survivors with a stoma, revealing its key role in mental health recovery and psychosocial rehabilitation and informing clinical interventions.

Implications for Practice

The study suggests that healthcare staff should guide survivors in drawing a clear boundary between stoma care and their personal life, encourage any correction of erroneous social cognition, and promote the positive development of psychological detachment among survivors.

Impact

This study explored the challenges of psychological detachment in stoma survivors, identifying key barriers like trauma, care burden, role misconceptions, and varying detachment levels. The findings can guide healthcare providers in supporting survivors' mental well-being and inform better survivorship care strategies.

Patient or Public Contribution

There was no patient or public contribution.

Concurrent Trajectories of Depressive Symptoms and Insomnia and Influencing Factors in Adolescents

ABSTRACT

Objective

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.

Study Design

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.

Result

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).

Conclusion

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.

Implications for Patient Care

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.

Impact

The identification of four distinct symptom trajectories and their predictors advances the understanding of adolescent mental health development, informing precision prevention strategies.

Reporting Method

STROBE checklist.

Patient or Public Contribution

None.

The Relationship Between Nurse Leadership and Structural Empowerment With Clinical Teaching Competencies: A Cross‐Sectional Study

ABSTRACT

Aims

To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.

Design

A cross-sectional study.

Methods

A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.

Results

The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).

Conclusion

Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.

Impact

Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.

Patient or Public Contribution

No patient or public contribution.

Measuring the Core Competency of Community Nurses for Public Health Emergencies: Instrument Development and Validation

ABSTRACT

Aim

To develop a comprehensive and psychometrically validated scale for evaluating the core competencies of community nurses for public health emergencies.

Design

A study of instrument development and validation was conducted.

Methods

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).

Results

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.

Conclusions

The study presents a theoretically grounded and scientifically validated scale measuring the competencies that community nurses need for public health emergency response.

Implications for the Profession

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.

Impact

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.

Reporting Method

Strengthening the Reporting of Observational studies in Epidemiology checklist.

Patient or Public Contribution

No Patient or Public Contribution.

Recruitment by Chance, Retention by Choice: A Qualitative Study of Managers Perspectives on Personal Care Workers' Intention to Stay in Residential Aged Care

ABSTRACT

Aim

To explore the perceptions and experiences of managers in residential aged care settings regarding personal care workers' intention to stay and build a career. Specifically, this study sought to identify enablers and challenges influencing personal care workers' retention and to explore strategies that could improve workforce sustainability.

Design

A qualitative study utilising semi-structured interviews underpinned by the Theory of Planned Behaviour.

Methods

The study was conducted in Australia from July 2023 to March 2024. Eleven managers participated in this study. Data were analysed using inductive thematic analysis.

Results

Four themes emerged from the analysis and were conceptualised to illustrate the intricate relationship between recruitment practices, work environment, organisational culture and leadership in influencing personal care workers' intentions to stay in residential aged care. A botanical metaphor was used for each theme. The ‘Diverse Seeds of Varied Potential’ theme highlighted how ad-hoc recruitment processes were a primary driver of workforce instability. Challenging work conditions and differing expectations from personal care workers and management led to ‘Wilting in Adverse Environments’, which also contributed to a broader misalignment between facility culture and values, encapsulated within ‘Mismatched Habitats’. Participants emphasised the need for ‘Building a Greenhouse’, a metaphor for cultivating sustainable leadership and workforce development to address these issues.

Conclusion

This study's findings underscore the critical need for a cohesive approach to workforce development strategies in residential aged care. Transitioning from reactive, ad-hoc recruitment to strategic workforce planning, fostering a supportive organisational culture that aligns with personal care workers' expectations, and prioritising sustainable leadership practices are essential steps. Addressing these interconnected challenges can help build a more stable, committed and skilled workforce, ultimately enhancing the quality and continuity of care for residents.

Implications for the Profession and Patient Care

Strategic workforce planning and sustainable leadership development are essential for building a stable workforce, which directly impacts the quality and continuity of resident care.

Impact

This study addressed the critical issue of high turnover among personal care workers in residential aged care facilities, specifically examining managers' perspectives on retention challenges: an underexplored area that is crucial for developing sustainable workforce strategies. The findings revealed that current ad hoc recruitment practices, misalignment between diverse personal care worker profiles and established organisational cultures, have great impact on long-term engagement and retention. These insights are particularly valuable for residential aged care facilities struggling with staffing stability, industry bodies focused on workforce development and educational institutions preparing future aged care workers. Furthermore, the findings can inform policy development aimed at strengthening the aged care workforce, ultimately benefiting the quality of care received by residents.

Reporting Guideline

The Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or Public Contribution

There was no patient or public contribution.

A Retrospective Study on the Analysis of Risk Factors for Bed Fall Events in Hospitalised Patients Based on the BERTopic Model

ABSTRACT

Aims

The aim of this study was to innovatively utilise the BERTopic model for topic modelling in order to comprehensively identify and understand the factors contributing to bed falls.

Design

Retrospective study.

Data Sources

The study collected 241 reports of bed fall accidents recorded by nurses from Peking University Third Hospital Nursing Department from 2014 to 2024. Among them, 102 reports met the inclusion and exclusion criteria.

Methods

This study follows the Minimum Information for Medical AI Reporting (MINIMAR). It collected patient bed fall reports from Peking University Third Hospital between 2014 and June 2024, preprocessed the texts, utilised the BERTopic library in Python for topic modelling, and manually aggregated secondary topics by combining visualisation results and professional knowledge.

Results

We utilised cluster bar charts to visually display the distribution of the 22 secondary topics and further consolidated them into five core topics through the use of a topic distribution diagram and a topic similarity matrix diagram. These topics were related to patient factors, ward equipment and surroundings factors, medication risk factors, caregiver factors, and nursing practice factors. The study highlights the environment's specificity in bed falls, especially bedside safety and patient-bed rail interaction.

Conclusions

The innovation of this study lies in the successful utilisation of BERTopic technology to identify topics of risk factors for bed falls through alternative data sources, providing a scientific basis for formulating preventive measures. The findings aim to optimise nursing processes, improve ward environments and enhance educational training, ultimately reducing patient bed falls and enhancing medical safety, nursing quality and patient experience.

Impact

This study not only helps nurses identify risk factors for patient bed falls, but also provides important guidance for developing effective prevention strategies.

Patient or Public Contribution

No patient or public contribution applied.

Network Analysis of Psychosocial Adaptation in Intestinal Stoma Patients: A National Cross‐Sectional Study in China

ABSTRACT

Aims

The aim of this study was to investigate factors affecting psychosocial adaptation in intestinal stoma patients and to identify central symptoms that might guide future interventions through network analysis.

Design

A multicenter cross-sectional study.

Methods

All intestinal stoma patients were evaluated for psychosocial adaptation using the Ostomy Adjustment Inventory-20 (OAI-20). Univariate and multivariate linear regression were used to analyse the potential relationship between the level of psychological adjustment of intestinal stoma patients and individual factors. By network analysis, we calculated the centrality indicators for each node in the ostomy psychosocial adaptation network at different levels of low, medium and high, respectively.

Results

This study ultimately enrolled a total of 19,909 intestinal stoma patients from 202 Chinese hospitals, out of which 6408 reported low psychosocial adaptation. It was found that there is a negative association between being female, partially self-care, completely dependent on others for care and having no medical insurance with psychosocial adaptation scores. In the low-level psychosocial adaptation network, no. OAI-14:limited activity, no. OAI-9: worried about ostomy, and no. OAI-11:always like a patient were identified as central indicators.

Conclusions

Being female, partially self-care, completely dependent on others for care, and having no health insurance can be considered characteristics of patients with lower psychosocial adaptation. Network analysis results provide intervention targets to improve adaptation.

Impact

Individualised and precise interventions can be carried out in terms of both the influencing factors and the most influential nodes of psychosocial adaptation in order to improve the level of psychosocial adaptation in intestinal stoma patients.

Patient or Public Contribution

No patient or public contribution.

Factor Structure and Longitudinal Invariance of the Cancer Behaviour Inventory: Assessing Cancer‐Coping Self‐Efficacy in Patients With Moderate‐to‐High Symptoms

ABSTRACT

Background

The Cancer Behaviour Inventory–Brief Version was designed to assess cancer-coping self-efficacy in clinical and research settings where minimising patient burden is essential. However, there is no evidence of its longitudinal validity. Although widely used in cancer research, the lack of evidence for longitudinal invariance significantly undermines its validity in studies spanning multiple time points. Establishing longitudinal invariance enables valid comparisons over time, enhancing our confidence in applying it in longitudinal research.

Aim

To examine the factor structure of the measurement and test its longitudinal invariance across four time points in cancer patients experiencing moderate-to-high symptoms during curative cancer treatment.

Design

A longitudinal psychometric evaluation.

Methods

This is a secondary data analysis of a randomised controlled trial in patients with moderate-to-high symptoms undergoing cancer treatment (N = 534). We conducted longitudinal invariance tests for the measurement using four time points. Other psychometric tests included confirmatory factor analysis, reliability analyses and correlations.

Results

Our confirmatory factor analysis supported the four-factor, 12-item structure for the Cancer Behaviour Inventory–Brief Version. Items 1 and 6 were found to be moderately correlated. The resulting 12-item measure demonstrated good internal consistency, with convergent and divergent validity supported by correlations with selected instruments. Finally, longitudinal invariance was tested, which revealed strict measurement invariance across four time points (CFI = 0.930, RMSEA = 0.045, SRMA = 0.056).

Conclusion

We found that the factor structure of the Cancer Behaviour Inventory–Brief Version remained stable over four time points in a sample of patients having moderate to high symptoms under cancer treatment. This supports its accountability for examining the changes in cancer-coping self-efficacy among cancer patients over time in longitudinal studies.

Implications

This study confirms that Cancer Behaviour Inventory–Brief Version has adequate internal consistency and demonstrated evidence of construct validity. Our conclusion of strict longitudinal invariance supports its credibility for continuous assessment of cancer-coping self-efficacy to evaluate patient outcomes and intervention processes over time in clinical and research settings.

Patient or Public Contribution

No patient or public contribution.

❌