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The foundation of nursing care is the nurse–client relationship. The Fundamentals of Care (FoC) Framework provides guidance on the core elements of this relationship: trust, focus, anticipate, know, and evaluate. A gap remains in understanding how older adults and nurses themselves engage with these relational elements in the context of long-term community care. This may hinder nurses and their clients from collaborating in care practices.
To explore how older adults and nurses, through and within their ongoing relationship in community care, concretely enact and co-construct the five elements of the nurse–client relationship and explore factors influencing this relationship.
A qualitative descriptive research design was employed in 2022–2023, utilizing both individual and group interviews. Thirteen unique clients and relatives as informal care givers and 22 nurses participated.
‘Trust’ related to clients trusting the nurses' expertise and nurses enabling clients to feel confident and safe. ‘Focus’ was understood as a shared aim and actions towards maintaining independency and autonomy of clients. ‘Anticipate’ was characterized by nurses responding to clients' preferences and needs and clients and nurses making shared decisions regarding care. ‘Know’ was aimed at gaining a good understanding of clients' needs, which required clients to be open and committed to telling their needs, and nurses actively listening to their clients. Finally, ‘evaluate’, both formal and informal, revealed to be necessary to align and adjust care when necessary. Poor care coordination and continuity of care were contextual factors influencing the caring relationship.
We showed that nurses and clients in community care settings were engaged in a constructive relationship to collaborate for optimal nursing care. An empirical understanding was obtained about how the core elements of this relationship were put into practice. These elements develop over time, influenced by the nurse–client interaction and the specific context.
This study highlights that both the client and the nurse have an active role in establishing the nurse–client relationship.
What problem did the study address? This study addressed how older adults and nurses themselves engage with the relational elements of trust, focus, anticipate, know, and evaluate in the context of long-term community care. What were the main findings? An empirical understanding was obtained of how nurses and clients put these relational elements into practice. These elements evolve over time, influenced by nurse–client interactions and specific contexts. Where and on whom will the research have an impact? This research will impact community-care nurses by offering them practical insights into establishing effective relationships with clients and engaging in dialogue about clients' responsibilities in shaping these relationships.
We adhered to the Consolidated criteria for reporting qualitative research (Coreq) guidelines (International Journal for Quality in Health Care, 2007, 19, 349).
In the research team, two co-researchers (J.A. and J.Z.) participated in the design of the study, data collection and analyses. These co-researchers are older women with experiences in participating in qualitative research (collecting and analysing data) and community-based nursing care (as informal care giver).
This narrative review synthesizes published evidence on the applications, benefits, limitations and governance considerations of ChatGPT and large language models (LLMs) in nursing, across three domains: education, clinical practice and workflow management.
The article was conducted as a narrative review.
A structured literature search was conducted in Medline (via PubMed), Scopus and arXiv, covering publications from January 2019 to March 2026. Peer-reviewed original studies, systematic reviews, scoping reviews, narrative reviews and expert commentaries addressing LLM applications in nursing education, clinical practice or workflow were eligible for inclusion. Studies limited exclusively to non-nursing medical specialties without transferable nursing implications were excluded. Findings were narratively synthesized across five thematic domains by authors with subject-matter expertise in each area.
In nursing education, ChatGPT demonstrates utility as an adaptive cognitive scaffold, supporting theoretical learning, simulation-based training and virtual patient encounters, though unregulated use poses risks to academic integrity and independent clinical reasoning. In clinical practice, LLMs can assist with preliminary symptom assessment and patient education material generation; however, performance deteriorates markedly in complex or data-sparse clinical scenarios and hallucination rates remain clinically significant. In workflow management, ChatGPT shows promise in reducing documentation burden and supporting administrative tasks, though data privacy obligations under frameworks such as GDPR constrain real-world deployment. Across all domains, concerns persist regarding algorithmic bias, professional accountability and the absence of clear medico-legal frameworks governing AI-related clinical errors.
ChatGPT and related LLMs are best positioned as auxiliary tools that augment rather than replace professional nursing judgement. Safe and ethical integration requires the development of AI literacy curricula, institutionally governed deployment frameworks, mandatory human-in-the-loop verification protocols and longitudinal evaluation of patient safety outcomes. Nurses must play an active role in shaping the responsible adoption of generative AI in healthcare.
1. Nurses must treat AI-generated content as a preliminary draft requiring mandatory human verification before clinical or documentation use. 2. Institutions should prioritize closed-loop, enterprise-grade AI deployments over public platforms to ensure GDPR compliance. 3. AI literacy must be embedded in undergraduate and continuing nursing education curricula. 4. Longitudinal research on patient safety outcomes following real-world LLM deployment in nursing is urgently needed.
As a narrative review, this article followed established guidance for the conduct and reporting of narrative reviews.
There was no patient or public involvement in this narrative review.
To gain insight into the experiences of nurses in outpatient paediatric asthma care regarding how their profession changed, with an emphasis on workload, nurse–patient relationship, and task shifting, after the implementation of a remote patient care platform (called Airbridge (Luchtbrug)).
A descriptive qualitative study.
Semi-structured face-to-face interviews were conducted from February 2023 to May 2023, with nurses who were working with Airbridge. Nurses were recruited using a purposive sampling method. An interview guide was developed partly based on the Technology Acceptance Model. Interviews were audio recorded, transcribed, and analysed according to Braun and Clarke's six phases of Thematic Analysis.
Eleven nurses participated in the interviews. Patient centred care and changes of professional practice due to working with remote patient care were identified as the main themes in relation to experiences of nurses after the introduction of a remote patient care platform.
Nurses are pivotal in the successful implementation and sustainability of remote patient care (RPC) platforms, yet they require adequate time and organisational support. As primary users alongside patients, nurses should actively be involved in remote patient care (RPC) practices and take leadership in defining their responsibilities. This study enhances understanding of nurses' experiences with remote patient care (RPC), emphasizing the importance of their role in maintaining the nurse–patient relationship in an advanced professional nursing practice.
These findings contribute to the understanding of the experience of nurses when working with a remote patient care (RPC) platform regarding effective implementation.
This study adhered to the COREQ guideline.
No paper or public contribution.
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