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The study aimed to translate the PUKAT 2.0 tool from English to Italian. This was an adaptation and validation study; the validity of the Italian version was determined through content validity, item validity and construct validity. The reliability of the instrument was assessed by conducting a test–retest analysis on a sample of 62 nurses. The I-CVI indices were above the threshold of 0.78 for 91% of the questions, and according to the S-CVI index, 96% of the evaluators agreed that the questionnaire was highly relevant. The overall values for item difficulty were good, with two items being too difficult and none being too easy. The item discriminant index was overall good and reasonable, low for four items. The overall ICC was poor to moderate with a value of 0.48 (95% CI 0.26–0.65). The instrument has proven to be a good starting point although not yet completely reliable, as it clearly requires more basic preparation on the part of the staff, further modifications regarding the reliability and clarity of the questions and more training of the nursing staff if it is to be used in the Italian context.
A comprehensive skincare regimen involves cleansing, moisturising, and using skin barrier protectants. Cyanoacrylate-based protectants safeguard vulnerable skin from damage caused by moisture, friction, and shear. This research involved two ex vivo and two clinical studies comparing the wear duration and wash-off resistance of a 100% cyanoacrylate and a solvent-cyanoacrylate mixture. Effectiveness was assessed using an ex vivo porcine skin model simulating urinary incontinence, evaluated with Lucifer yellow dye penetration and Corneometry, and a clinical model using Corneometry. Two single-blind clinical studies measured skin surface electrical capacitance in healthy volunteers. Study 1 (n = 42) evaluated the wear duration over 8 days, while Study 2 (n = 52) examined wash-off resistance after nine washes with various cleansers. Ex vivo results showed that both products were effective under repeated moisture and abrasion conditions, with the 100% cyanoacrylate outperforming the solvent-cyanoacrylate mixture. In clinical studies, both products maintained barrier protection throughout Study 1 (p < 0.007) and none of the cleansers significantly degraded either product in Study 2. In conclusion, the 100% cyanoacrylate provided superior protection compared to the solvent-cyanoacrylate mixture. Both products demonstrated comparable wear duration and wash-off resistance in clinical studies, but the 100% cyanoacrylate was more effective in ex vivo testing under harsh conditions.
Complex chronic wounds are an increasing health concern, affecting individuals both physically and psychologically. To measure the quality of life of this population properly translated and validated questionnaires in their native language are needed. The aim of this work is to provide a validated instrument for measuring the quality of life in the Catalan speaking population with complex wounds. A cultural adaptation of the Wound-QoL-17 questionnaire into Catalan was carried out by independent official translators and the back translation was approved by the original author. Validity, reliability, responsiveness, and feasibility were assessed. Face and content validity were determined by a group of experts: the 17 items of the Wound-QoL-17 Catalan version were appropriate for their purpose. Reliability was demonstrated by an interclass correlation coefficient of 0.884 for the scores obtained by two different observers and of 0.928 for the same observer on two time points. Chronbach's alpha coefficient was 0.926. Responsiveness was proved by a Pearson's correlation coefficient of 0.661. Feasibility was shown by the time, 3.46 min, taken to complete the questionnaire.
Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH.
A cross-sectional study design.
We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data.
Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group.
The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults.
Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.
The treatment of chronic wounds in the Aged is often difficult. Masquelet technique is used for the treatment of infected large segmental bone defects as it provides an adequate blood supply for bone and soft tissue reconstruction. In this study, a two-stage wound management strategy was used, consisting of covering the initial wound with bone cement and skin grafting under induced membranes. From September 2020 to September 2022, 20 Aged patients with chronic refractory wounds of the lower extremities with exposed bone or tendons were recruited in the Department of Wound Repair Surgery of the Second Affiliated Hospital of Wenzhou Medical University. Each patient was reconstructed according to a two-stage process. In the first stage, while treating the patient's underlying disease, several debridements were first performed on the wound; subsequently, the Masquelet technique was applied to seal the wound with antibiotic bone cement. Four to 6 weeks later, the second stage was initiated—after confirming the sufficient formation of wound induced membranes, the bone cement was removed, and free skin grafts were finally used to cover the chronic refractory wounds on the extremities. The area of the defects ranged from 4.5 × 3.0 cm to 15.0 × 6.0 cm, and all soft tissue defects were associated with tendon or bone exposure. After the surgery, patients attended regular outpatient visits and were followed up by telephone and video to observe the healing of the wounds and whether there were any complications in the donor site. The Lower Extremity Function Scale (LEFS) score was used to evaluate the functional recovery of the lower extremities. We found that all implants survived without necrosis or infection. All 20 cases were followed up regularly after surgery for 3 to 12 months, with a mean of 7.6 months. In the first stage, Induced Membranes induction was performed 1–4 times, with an average of (1.3 ± 0.7) times, and in the second stage, free skin grafting was performed on the induction membrane, and all 20 cases of skin grafting survived without necrosis or infection; the appearance and texture of the skin in the grafted area were satisfactory, and the postoperative LEFS score was (69.83 ± 10.82). Finally, our strategy for the management of chronic refractory wounds in the Aged can achieve satisfactory clinical results, reduce surgical risk, be simple and reliable, and be an effective addition to the repair modality.
Authentic leadership holds great potential to impact positive nursing and organizational outcomes. However, authentic leadership's connection to organizational culture, self-efficacy, and work engagement remains underreported.
To investigate the associations of authentic leadership, organizational culture, self-efficacy, and work engagement among nurses.
Cross-sectional and correlational design employing consecutive sampling in recruiting nurses (n = 534) between May and October 2024. Four validated self-report scales were used to collect data. Structural equation modeling analysis was used to examine the study variables' interrelationships.
Organizational culture significantly predicted authentic leadership (β = 0.91, p = 0.004), while authentic leadership significantly influenced both self-efficacy (β = −0.16, p = 0.041) and work engagement (β = 0.57, p = 0.001). Meanwhile, self-efficacy directly and positively influences work engagement (β = 0.24, p = 0.002). Organizational culture had significant indirect effects on both self-efficacy (β = −0.14, p = 0.042) and work engagement (β = 0.48, p = 0.001) through the mediation of authentic leadership. Finally, self-efficacy mediated the association between authentic leadership and work engagement (β = −0.04, p = 0.002).
The study shed light on the complex and interwoven relationships among several essential constructs—specifically, authentic leadership, organizational culture, self-efficacy, and work engagement. These factors collectively contribute to the creation and maintenance of a dynamic and supportive working environment for nurses.
Quality improvement is a well-known and commonly utilized approach to improving care and outcomes that is built on process improvement methods but not practice improvement methods. Because quality care includes both process and practice elements, process improvement alone cannot ensure quality outcomes will be achieved. This calls for a new approach.
To share an innovative, synergistic, and collaborative quality framework: Evidence-based Quality in Practice and Process: The EQUiPP Framework.
The EQUiPP Framework's intent is to provide structure for collaborative efforts to effectively identify best practices/processes, implement and sustain change, and improve outcomes. The framework provides guidance to decrease the frequency of implementing ineffective changes by deriving effective solutions … the first time, every time.
A team of experts used a consensus approach to develop the framework.
A precursor to this framework, the Practice and Process Improvement = Quality (PPQ) Model, was evaluated by individual expert review and a two-day beta test workshop. Feedback was obtained during the workshop when participants applied the model in activities reflecting real-world healthcare scenarios. When used in both DNP student work and real-world health systems, fundamental flaws were identified which resulted in the necessity to develop a different conceptualization. The framework described here is a new approach to improving quality care.
The EQUiPP Framework is a tool that provides the synergistic integration of both practice improvement (EBP) and process improvement methodologies to successfully implement and sustain best practices to achieve and sustain quality outcomes.
The EQUiPP Framework aligns EBP and process improvement, allowing clinicians and students to work collaboratively to identify and effectively, as well as efficiently, implement and sustain best practices to deliver quality outcomes.
In clinical oncology nursing practice, the preservation of quality of life is an essential component. E-health interventions have been proven effective in improving quality of life in patients with cancer, but the optimal content and delivery format remain undetermined.
To compare the efficacy of e-health interventions with varying contents and delivery formats in improving quality of life in patients with cancer.
Network meta-analysis of randomized controlled trials.
Six databases, including Medline, Web of Science, Embase, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO, were searched from inception to October 25, 2025.
Two reviewers independently screened studies and extracted data. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer.
A total of 50 studies included e-health interventions with eight contents and five delivery formats. The results identified health education (SUCRA = 82.2%), symptom management (SUCRA = 72.2%), and rehabilitation interventions (SUCRA = 71.1%) as the three most effective e-health intervention contents for improving quality of life in patients with cancer. Among delivery formats, app-based (SUCRA = 82.1%), internet/web-based (SUCRA = 71.5%), and telephone-based e-health interventions (SUCRA = 53.3%) ranked among the top three.
This study explored the efficacy of different contents and delivery formats of e-health interventions in improving quality of life in patients with cancer. These results are expected to provide an evidence-based basis for clinical oncology nursing practice.
PROSPERO number: CRD42025638829
Venous leg ulcers (VLU) account for the majority of chronic wounds, with an estimated rise in prevalence due to demographic change. Care often does not comply with evidence, and patients remain passive and uninformed. To support general practice VLU care, the ‘UlcusCrurisCare’ (UCC) project developed a multimodal intervention comprising provider training, software-supported case management and standardised patient education. Experts from the medical community (physicians, nurses, association of medical assistants), health insurance and patient representatives provided their assessment of barriers in VLU care, requirements for intervention components and their expected effects. Semi-structured interviews and questionnaires were used at two measuring points. Qualitative data analysis was based on the Theoretical Domains Framework. Quantitative data were analysed descriptively. Ten experts named a lack of knowledge and application regarding compression therapy, reluctance to assume role as primary care provider, and inadequate remuneration as barriers for evidence-based VLU care. To effectively address these barriers, interventions are required to foster the use of compression therapy and patient education. A multimodal approach such as pursued in UCC is expected to effectively address deficits in VLU care at general practitioner level by promoting provider knowledge about evidence-based treatment and supporting patient adherence.
A lack of murine models that mimic impaired wound healing in people with type 2 diabetes has hindered research. The commonly used leptin-receptor knockout model (db/db) fails to accurately reflect the pathophysiology of human disease. This study aimed: (i) to investigate whether our novel murine model of diabetes, whilst less hyperglycaemic and obese than db/dbs, effectively demonstrated impaired wound healing, and (ii) to identify the most robust methods for quantifying wound closure. C57BL/6J mice were high-fat diet fed for a total of 11 weeks and injected with three doses of streptozotocin (65 mg/kg body weight) at week 5 with chow-fed mice as controls. All mice received four excisional wounds and were euthanised at day-4 or day-10 post-wounding (n = 8/group/timepoint). Wound healing was evaluated by digital planimetry, histology, Micro-CT, and tensiometry. Histological analysis was the most sensitive method for identifying impaired wound healing. Our high-fat diet/low-dose streptozotocin model had significantly higher non-fasting blood glucose (25.7 ± 5.4 mmol/L vs. 8.7 ± 0.8 mmol/L) and lower wound quality scores (day-4 post-wounding: 2.6 ± 1.9 vs. 4.4 ± 0.8) than healthy controls (both p < 0.05). At day-10 post-wounding, a linear trend in wound healing was observed between healthy controls, our novel model and the db/db model, indicating that our diabetic murine model may be clinically relevant for studying diabetes-related wound healing.
Parents of adolescents with a mental disorder describe having overwhelming feelings regarding the psychiatric diagnosis, which they respond to with grief. Existing research indicates that these parents face unique challenges, such as self-blame and stigma. Parents are crucial in adolescent care, and healthcare professionals should find interventions that educate parents about the disorder, treatment and symptom management. The aim of this study was to explore and describe parents' experiences in having an adolescent with a mental disorder admitted to the psychiatric unit of a public hospital in Gauteng, South Africa.
The study used Heidegger's interpretive phenomenological design.
A qualitative, exploratory, descriptive and contextual method was used. Data were collected through semi-structured telephonic interviews with 10 parents who had an adolescent with a mental disorder admitted to a public hospital in Gauteng, South Africa. Tesch's thematic coding steps were used for data analysis.
The themes arising from the findings reflected (1) parents experienced that their lives were stuck amid grief for the loss of what their adolescent child used to be, and anxiety about what the future holds, (2) parents experienced that when they reached out for professional help, the healthcare system failed them due to a lack of guidance, information and support, (3) parents experienced that they prayed for divine intervention as a coping strategy, and (4) parents experienced stigma from the community.
The findings illustrate the need for psychiatric nurses to facilitate the mental health of parents of adolescents with a mental disorder. Furthermore, positive attitudes among parents are improved once they are empowered and receive the necessary support, and stigmatization will also be reduced. It is recommended that further research be conducted to explore the effectiveness of emotional and professional support in addressing the challenges parents experience with an adolescent who has a mental disorder.
This paper contributes knowledge to nursing practice by exploring the experiences of parents who have an adolescent with a mental disorder in the South African context.
Venous ulcers are the most prevalent among those affecting the lower limbs, with high economic and quality of life impact. Due to the chronicity of venous disease, healing and recurrence cycles are common. Patient adherence to self-care activities to prevent recurrence is very low, so it is crucial to reflect on nurses' experiences with this phenomenon. A qualitative and descriptive study was developed to analyse nurses' perceptions about preventing venous ulcer recurrence. According to the inclusion criteria, focus groups with nurses were implemented. Three focus groups were conducted through the Colibri platform, ensuring all ethical assumptions. Content analysis was performed according to thematic criteria, using the WebQda software. Three main themes emerged: integration of care, context of care, and relationship. The participants emphasised the importance of holistic assessment and the establishment of common goals to promote adherence to fundamental recurrence prevention care. Understanding and respecting individual values, empathy and active listening, considering the established relationship, anticipating the person's needs, and trust are essential to overcoming barriers to implementing recurrence prevention care and to its continuity. Taking these aspects into consideration implies that the professional is part of the process of preventing the recurrence of venous ulcers.
Venous leg ulcers occur due to chronic venous insufficiency in the lower extremities and are often difficult to heal. Platelet-rich plasma and platelet-rich fibrin are products that contain high concentrations of platelets. This systematic review evaluated the effectiveness, safety and cost-effectiveness of these products for the treatment of venous leg ulcers. Guided by the 2020 Joanna Briggs Institute systematic review of effectiveness guideline, this review included original studies that investigated platelet-rich plasma and platelet-rich fibrin in the treatment of venous leg ulcers from databases including the Cochrane Library, Embase, Medline, CINAHL, PubMed, World Health Organisation International Clinical Trials Registry, Clinical Trials.gov and Australian New Zealand Clinical Trials Registry. Methodological quality was assessed using relevant appraisal checklists. Information related to general characteristics of included articles and relevant outcomes of interest were extracted and synthesised narratively. Of thirty-six eligible studies, 24 studies used platelet-rich plasma, eleven investigated fibrin-rich plasma and one study used both platelet-rich plasma and fibrin-rich. Most studies reported these products were effective in promoting wound healing, reducing other symptoms, and were safe to use. The use of platelet-rich plasma and platelet-rich fibrin resulted in significantly higher healed venous leg ulcers compared to control using conventional treatment (RR: 2.93, 95% CI, 1.90–4.53, p = 0.01). These products were safe to used topically and promoted to wound healing, reduced pain, either along or combined with other treatments. Platelet-rich plasma and fibrin-rich plasma improves wound healing and appears to be safe to use in the treatment of venous leg ulcers.
We aimed to investigate the learning needs of general practitioners and their preferences as regards the most appropriate teaching session for continuing medical education in wound management. A survey targeting general practitioners at the public health centres in the City of Helsinki. Twenty-seven general practitioners participated in the study. The majority (74.1%) had received education in medical school, 40.7% from wound care nurses, and 40.7% from colleagues. Participants felt the most competent in wound diagnosis (59.3%) and etiological tests (55.6%) and requested training in these topics (74.1% and 74.1%). A peer-led lecture (88.9%) was the most preferred technique, followed by lectures by wound care nurses (55.6%), an educational video (44.4%), a specialist-led lecture (37.0%), an interactive wound product session (29.6%), and digital self-study (29.6%). Wound diagnostics and etiological tests are recognised as crucial topics for continuing medical education. Peer-led lectures were preferred over other techniques; however, we observed varying preferences regarding the most optimal technique. Based on our results, we propose a half-day training including lectures, interactive and hands-on activities, and reflection, led by a peer and a wound care nurse with supporting video materials. Future studies could assess its impact on learning outcomes and wound care quality.
Chronic limb-threatening ischemia (CLTI) compounded by diabetic foot ulceration remains a leading precursor to major lower-extremity amputation. Transverse tibial transport (TTT) can improve perfusion but requires corticotomy and bulky external fixation. We report what is, to our knowledge, the first application of fully automated tibial periosteal distraction (PD) for limb preservation. A 65-year-old man with recurrent forefoot gangrene underwent tibial PD using a miniaturised, programmable motor to gradually elevate the periosteum. Through a 1 cm incision, a low-profile subperiosteal plate was implanted and linked to the motor, which advanced 0.031 mm hourly (0.75 mm/day) up to 10 mm. Distraction was completed uneventfully over 13 days, and the device was removed at the bedside on Day 21. Skin temperature increased by 2°C, and digital systolic (toe) pressure rose from 22 to 50 mmHg. The wound progressed to healing without complication. Automated PD may offer a minimally invasive, biologically driven alternative for high-risk CLTI patients, eliminating the need for patient-adjusted screws and standardising adherence. Prospective studies are required to validate its safety, durability, optimal distraction parameters and cost-effectiveness.
The COVID-19 pandemic exacerbated burnout, isolation, and disconnection among healthcare workers, leading to national calls to address workplace mental health. Storytelling has emerged as an effective strategy to build belonging, resilience, and connection. In response, a pediatric healthcare system launched an evidence-based storytelling initiative rooted in narrative medicine and visual symbolism.
To strengthen workplace culture by fostering connection, psychological safety, and meaning through structured storytelling.
Developed in partnership with Dear World, the intervention integrated guided reflection, peer sharing, and professional photography. Initially focused on staff, the initiative expanded to include adolescent and young adult patients. Implementation included phased rollout, train-the-trainer models, onboarding integration, and multimedia engagement. Evaluation methods included pre- and post-surveys and organizational metrics, with the Connection During Conversations Scale (CDCS) used to assess effectiveness across different session formats.
Over 2 years, 1818 participants attended 60 events. Significant improvements in perceived connection and belonging were observed (p < 0.001), with 94% reporting stronger connections to colleagues and 93% to organizational values. CDCS analysis of Year 2 participants (n = 148) demonstrated comparable effectiveness between full and abbreviated session formats, with slightly stronger outcomes in full sessions. As part of broader workforce engagement efforts, nurse turnover declined from 21% to 13%, contributing to $2.3 million in projected cost avoidance.
This scalable, low-cost initiative offers a sustainable model for rehumanizing healthcare. Its integration into orientation, leadership development, and wellness programs underscores its value in fostering connection, resilience, and retention across high-stress care settings.
Patient participation improves patient outcomes, but factors that predict participation in pressure injury prevention (PIP) are relatively unknown. This study aimed to identify patient-related factors predictive of patient participation in pressure injury prevention (PPPIP) in hospitalised medical and surgical patients and to assess the psychometric properties of the PPPIP scale. This observational substudy recruited consenting adults at risk of pressure who participated in a parent trial. The seven-item PPPIP scale was administered within 48 h of recruitment, with higher scores reflecting more participation. Multiple regression was used to identify patient-related factors predictive of patient participation. The scale's psychometric properties were assessed using confirmatory factor analysis and Cronbach's alpha. In total, usable data were obtained from 856 patients. Mean PPPIP scale scores were relatively high, with 571 (66.7%) scores reflecting agreement or strong agreement. The Cronbach's alpha was 0.81, and most confirmatory factor analysis criteria for construct validity were met. Only the use of mobility aids was statistically significant in the model, but it predicted a small amount of variability in PPPIP score (adjusted R 2 = 0.017; p < 0.001). Targeting patients with limited mobility may be a useful strategy when trying to engage patients in PIP if resources are limited.
Investigate the epidemiological characteristics of outpatients initially diagnosed with skin ulcers who were ultimately confirmed to have cutaneous malignant tumours, and provide a diagnostic and therapeutic basis for the occurrence of secondary diseases in chronic wounds. We conducted a retrospective study analysing clinical data from patients initially diagnosed with skin ulcers at our hospital between July 2021 and February 2025, and analysed the epidemiological characteristics of malignant transformation in these ulcer cases. Among 128 patients initially diagnosed with skin ulcers, 16 cases (12.5%) were confirmed with cutaneous malignancies. The malignant group had a significantly higher mean age (69.44 ± 11.30 years) compared to the non-malignant group (58.39 ± 17.88 years; t = 5.752, p = 0.01). The distribution of lesion sites differed significantly between the malignant and non-malignant groups (χ2 = 30.498, p < 0.01). In the malignant group, the head and neck (41.2%) and trunk & extremities (41.2%) were the predominant sites. The most common malignancy was squamous cell carcinoma (SCC). The trunk & extremities was the most frequent site (62.5%). The second was basal cell carcinoma, which mainly occurs in the head and neck (80.0%). The mean duration of ulceration was 4.5 years. The primary treatment modality was surgical excision (11 cases, 68.8%). Approximately one-seventh of skin ulcer cases were confirmed as cutaneous malignancies. This finding underscores the significance of skin ulcers as potential malignant lesions, highlighting the need for clinicians to maintain a high index of suspicion and promptly perform histopathological examinations to improve early detection rates of skin cancers.
Preventing central line associated bloodstream infections is feasible; although numerous hospitals continue to face challenges in achieving this important patient safety goal.
The aim of this project was to reduce the incidence of central line associated bloodstream infections in the intensive care unit.
This evidence-based practice quality improvement project was conducted in the general intensive care unit with 35 beds in King Abdullah Medical City in response to an increase in reported central line associated bloodstream infections cases. A searchable clinical question was formulated, and the relevant literature was reviewed and critically appraised to identify effective prevention strategies. Multimodal Interventions were then implemented and evaluated. The Plan, Do, Study, Act methodology was integrated with an evidence-based practice model to enhance the effectiveness, sustainability, and overall quality of the initiatives.
Central line associated bloodstream infection rates decreased from 1.37 to 0.62 per 1000 central line days in the intensive care unit following implementation of the interventions. Moreover, the project generated a total cost savings of $244,201 USD (915,756 SAR), reflecting reduced costs associated with central line associated bloodstream infection cases over the subsequent 18 months.
Implementation of multimodal interventions is essential to decrease central line associated bloodstream infection rate in intensive care units.
The handover process is a critical component of patient safety, enabling effective communication and the transfer of responsibility among nurses. However, despite their critical role, it is often compromised by interruptions, lack of standardization, and variability in practice, which may reduce quality and nurse satisfaction. Existing tools primarily measure information transfer and efficiency but rarely incorporate nurses' perspectives on safety and satisfaction. This gap underscores the need for a validated instrument that comprehensively assesses handover quality from both a professional and safety perspective.
To develop and validate the Handover Quality Questionnaire (HAND-Q), a tool assessing nurses' satisfaction with handovers and their perceived impact on patient safety.
HAND-Q development included a conceptualization phase (literature review, expert discussions) and a validation phase (pilot and large-scale testing). Exploratory and Confirmatory Factor Analyses (EFA, CFA) assessed psychometric properties.
EFA revealed four factors: Satisfaction, Patient Safety, Care Pathway Safety, and Handover Content. CFA confirmed good model fit. Inter-factor correlations showed strong links between handover quality and safety, alongside discrepancies between satisfaction and objective standards.
The HAND-Q offers a practical tool to assess handover quality, support standardization, enhance patient safety, and inform training and digital solutions.
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