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AnteayerInternacionales

A systematic review of reasons and risks for acute service use by older adult residents of long‐term care

Abstract

Aims and Objectives

To identify the reasons and/or risk factors for hospital admission and/or emergency department attendance for older (≥60 years) residents of long-term care facilities.

Background

Older adults' use of acute services is associated with significant financial and social costs. A global understanding of the reasons for the use of acute services may allow for early identification and intervention, avoid clinical deterioration, reduce the demand for health services and improve quality of life.

Design

Systematic review registered in PROSPERO (CRD42022326964) and reported following PRISMA guidelines.

Methods

The search strategy was developed in consultation with an academic librarian. The strategy used MeSH terms and relevant keywords. Articles published since 2017 in English were eligible for inclusion. CINAHL, MEDLINE, Scopus and Web of Science Core Collection were searched (11/08/22). Title, abstract, and full texts were screened against the inclusion/exclusion criteria; data extraction was performed two blinded reviewers. Quality of evidence was assessed using the NewCastle Ottawa Scale (NOS).

Results

Thirty-nine articles were eligible and included in this review; included research was assessed as high-quality with a low risk of bias. Hospital admission was reported as most likely to occur during the first year of residence in long-term care. Respiratory and cardiovascular diagnoses were frequently associated with acute services use. Frailty, hypotensive medications, falls and inadequate nutrition were associated with unplanned service use.

Conclusions

Modifiable risks have been identified that may act as a trigger for assessment and be amenable to early intervention. Coordinated intervention may have significant individual, social and economic benefits.

Relevance to clinical practice

This review has identified several modifiable reasons for acute service use by older adults. Early and coordinated intervention may reduce the risk of hospital admission and/or emergency department.

Reporting method

This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

Patient or public contribution

No patient or public contribution.

Nurturing healthy futures: unveiling promising policy avenues to tackle root causes of poor health in early years

Por: Ospina · M. B. · Bailleux · M.

Commentary on: Stewart E, Pearce A, Given J, Gilbert R, Brophy S, Cookson R, Hardelid P, Harron KL, Leyland A, Wood R, Dundas R. Identifying opportunities for upstream evaluations relevant to child and maternal health: a UK policy-mapping review. Arch Dis Child. 2023 Jul;108(7):556-562. doi: 10.1136/archdischild-2022-325219. Epub 2023 Mar 31.

Implications for practice and research

  • Prioritising policies targeting social determinants of health is crucial for improving early-life health outcomes. Public involvement in policy prioritisation is vital for equitable and effective policies.

  • Investing in comprehensive evaluations using harmonised and accessible administrative data is necessary to understand long-term effects of policy effectiveness.

  • Context

    Reducing early-life health inequalities is a critical challenge amid the COVID-19 socioeconomic impact.1 Sociostructural policies addressing upstream determinants are important, but evidence is limited compared with individual interventions—a discrepancy known as the inverse evidence law.2 3 To...

    The effectiveness of brief reminiscence‐based psychosocial interventions for cancer patients: A systematic review and meta‐analysis

    Abstract

    Aim

    To determine the effectiveness of brief reminiscence-based psychosocial interventions in alleviating psychological distress in cancer patients.

    Background

    Cancer patients suffer tremendous psycho-spiritual pain, which affects their quality of life. Brief reminiscence-based psychosocial interventions have demonstrated positive effects on the mental health of cancer patients; however, the efficacy of these interventions has been inconsistent.

    Design

    A systematic review and meta-analysis.

    Methods

    This review was conducted and reported in accordance with the PRISMA 2020 checklist provided by the EQUATOR network. The Cochrane Library, Web of Science, PsycINFO, PubMed, Embase, CINAHL and Scopus databases were systematically searched from inception to 27 November 2022 to identify randomised controlled trials (RCTs) published in English.

    Results

    Twenty studies involving 1744 cancer participants were included. The meta-analysis showed statistically significant effects of brief reminiscence-based psychosocial interventions on hope, anxiety and depression at post-intervention. A separate analysis revealed that brief reminiscence-based psychosocial interventions had a sustainable effect on hope, spiritual well-being, anxiety and depression at 1 month after the intervention. However, no statistically significant effect on quality of life was found in our study either immediately after the intervention or at 1 month.

    Conclusions

    Brief reminiscence-based psychosocial interventions can significantly reduce anxiety and depressive symptoms and improve hope and spiritual well-being in cancer patients.

    Relevance to Clinical Practice

    This study further supports that brief reminiscence-based psychosocial interventions should be incorporated into the routine care of cancer patients to address their psychosocial distress.

    Patient or Public Contribution

    All authors of this article contributed to the study conception and design. All authors of the included studies provided original data for this paper.

    Interventions to improve nurse–family communication in the emergency department: A scoping review

    Abstract

    Aim

    To determine and describe what interventions exist to improve nurse–family communication during the waiting period of an emergency department visit.

    Background

    Communication between nurses and families is an area needing improvement. Good communication can improve patient outcomes, satisfaction with care and decrease patient and family anxiety.

    Design

    Scoping Review.

    Methods

    A scoping review was conducted following the Joanna Briggs Institution methodology: (1) identify the research question, (2) define the inclusion criteria, (3) use a search strategy to identify relevant studies using a three-step approach, (4) select studies using a team approach, (5) data extraction, (6) data analysis, and (7) presentation of results.

    Data Sources

    Medline, CINAHL, EMBASE, PsychInfo and grey literature were searched on 3 August 2022.

    Results

    The search yielded 1771 articles from the databases, of which 20 were included. An additional seven articles were included from the grey literature. Paediatric and adult interventions were found targeting staff and family of which the general recommendations were summarised into communication models.

    Conclusion

    Future research should focus on evaluating the effectiveness of interventions using a standardised scale, understanding the specific needs of families, and exploring the communication models developed in this review.

    Implications for Clinical Practice

    Communication models for triage nurses and all emergency department nurses were developed. These may guide nurses to improve their communication which will contribute to improving family satisfaction.

    Reporting Method

    PRISMA-ScR.

    Trial and Protocol Registration

    Protocol has been registered with the Open Science Framework, registration number 10.17605/OSF.IO/ETSYB.

    Patient or Public Contribution

    No patient or public contribution.

    How does gratitude relate to nurses' job satisfaction? The mediating role of resilience and stress

    Abstract

    Background

    Nurse job satisfaction is a critical area of study with far-reaching implications for healthcare organizations, patient care, and the retention of nursing staff.

    Aims

    This study aimed to investigate the association of gratitude with job satisfaction among Chinese nurses and examine the potential mediating roles of resilience and stress in this relationship.

    Methods

    Two separate studies were conducted to examine our research hypotheses. In Study 1, a total of 460 nurses completed the questionnaire related to gratitude, resilience, stress, and job satisfaction. A validation study was conducted in Study 2, which consisted of 709 nurses who also completed the same measures of gratitude, resilience, and stress to ensure the repeatability of the Study 1 results. Furthermore, a different scale was used to measure nurses' job satisfaction.

    Results

    The two studies consistently found that both resilience and stress mediated gratitude–job satisfaction independently among Chinese nurses. Furthermore, resilience was found to be a significantly stronger mediator than stress in the association of gratitude with job satisfaction. Finally, we found that gratitude predicted nurses' job satisfaction via the serial mediating effects of resilience and stress.

    Conclusion

    These findings highlight the complex interplay between gratitude, resilience, stress, and job satisfaction by demonstrating that resilience and stress act as parallel and sequential mediators between nurses' gratitude and job satisfaction. The healthcare sector can improve nurses' job satisfaction by increasing gratitude, building resilience, and reducing feelings of stress.

    Linking Evidence to Action

    Nurse managers have the potential to enhance job satisfaction among nurses by implementing measures that increase gratitude, build resilience, and reduce stress levels.

    Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study

    Abstract

    Aim

    To construct a nursing assessment framework for patients in anaesthesia recovery period.

    Design

    A three-round modified Delphi method was employed to capture the consensus of 22 panellists.

    Methods

    The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini-clinical evaluation exercise (mini-CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post-anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework.

    Results

    This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History-taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern.

    Conclusion

    The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts’ opinions.

    Implications for the profession and patient care

    The assessment framework constructed in this study could be used for the process evaluation of post-anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills.

    Reporting method

    The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.

    Patient or public contribution

    No patient or public contribution.

    Sense of coherence moderates job demand‐resources and impact on burnout among nurses and midwives in the context of the COVID‐19 pandemic: A cross‐sectional survey

    Abstract

    Aim

    This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic.

    Design

    Cross-sectional quantitative survey.

    Data Sources

    The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia.

    Results

    156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample.

    Conclusion

    It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support.

    Patient or Public Contribution

    There was no patient or public contribution in this study, as the focus was on nurses and midwives.

    Conducting family meetings on families with dementia: An integrative review

    Abstract

    Aim

    To explore the role of family meetings for individuals living with dementia and their family caregivers.

    Design

    Integrative review.

    Methods

    We conducted searches in the Cochrane Library, PubMed, CINAHL, and Embase databases (up to December 2022). Additionally, an ancestry search strategy was employed to supplement the retrieval of published literature related to family meetings or family conferences for people with dementia and their family caregivers.

    Results

    The review integrated 11 articles, comprising seven quantitative studies, two qualitative studies, and two case reports. The findings did not indicate a significant improvement in end-of-life quality for individuals with dementia in the family meetings group compared to those receiving usual care. Limited evidence suggested some improvement in mental health outcomes for family caregivers. Both intervention and control groups incurred high care costs. However, family meetings appeared to delay nursing home placements for individuals with dementia. Two qualitative studies provided insights into the experiences of families and healthcare professionals participating in family meetings, highlighting opportunities and challenges in implementing such meetings. Additionally, two case reports offered specific and illustrative accounts of typical family meetings.

    Conclusion

    Family meetings can delay nursing home placements for elderly individuals with dementia. Families dealing with dementia perceive family meetings as an opportunity to collaborate with professionals in providing comprehensive care. Further research is needed to explore the effectiveness of family meetings in decision-making for families affected by dementia. Additionally, addressing timing and process coordination issues in family meetings is crucial for optimising their practices among families dealing with dementia.

    Relevance to Clinical Practice

    In order to make family meetings more accessible to families of individuals with dementia, we offer the following recommendations for future research and practice: Rather than a blanket rejection, the decision regarding the participation of individuals with dementia in family meetings should be based on their specific condition and the needs of their family. Coordination and harmonisation of opinions and perceptions among family members of individuals with dementia can sometimes be complex for healthcare professionals. The involvement of family coordinators may simplify this process. To determine the optimal timing for holding family meetings that can better assist families dealing with dementia, we propose that the right to initiate a meeting be granted to the family. This allows them to convene with healthcare professionals and address their concerns at their convenience.

    Longitudinal study of changes observed in quality of life, psychological state cognition and pulmonary and functional capacity after COVID‐19 infection: A six‐ to seven‐month prospective cohort

    Abstract

    Aims

    To investigate the health-related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID-19 patients at long-term, and to identify factors to predict a poor HRQoL in this follow-up.

    Background

    Studies have focused on persistent symptoms of hospitalised COVID-19 patients in the medium term. Thus, long-term studies of nonhospitalised patients are urgently required.

    Design

    A longitudinal cohort study.

    Methods

    In 102 nonhospitalised COVID-19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow-up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement.

    Results

    HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post-traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7-months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)).

    Conclusion

    A high proportion of nonhospitalised patients with COVID-19 experience an impaired HRQoL, cognitive and psychological function at long-term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID-19 who will have impaired quality of life at long-term.

    Relevance to clinical practice

    Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post-COVID-19 patients could be necessary to prevent the patients’ HRQoL from being impaired at 6–7 months after their reported recovery.

    An examination of retracted articles in nursing literature

    Abstract

    Introduction

    The output of scholarly publications in scientific literature has increased exponentially in recent years. This increase in literature has been accompanied by an increase in retractions. Although some of these may be attributed to publishing errors, many are the result of unsavory research practices. The purposes of this study were to identify the number of retracted articles in nursing and reasons for the retractions, analyze the retraction notices, and determine the length of time for an article in nursing to be retracted.

    Design

    This was an exploratory study.

    Methods

    A search of PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, and Retraction Watch databases was conducted to identify retracted articles in nursing and their retraction notices.

    Results

    Between 1997 and 2022, 123 articles published in the nursing literature were retracted. Ten different reasons for retraction were used to categorize these articles with one-third of the retractions (n = 37, 30.1%) not specifying a reason. Sixty-eight percent (n = 77) were retracted because of an actual or a potential ethical concern: duplicate publication, data issues, plagiarism, authorship issues, and copyright.

    Conclusion

    Nurses rely on nursing-specific scholarly literature as evidence for clinical decisions. The findings demonstrated that retractions are increasing within published nursing literature. In addition, it was evident that retraction notices do not prevent previously published work from being cited. This study addressed a gap in knowledge about article retractions specific to nursing.

    Re‐imagining of an undergraduate, second‐degree entry, accelerated nursing program's curriculum utilizing a postmodern, learner‐centred lens and a concept‐based framework

    Abstract

    Introduction

    It is necessary to re-imagine nursing curriculums utilizing a postmodern approach, as outdated teacher-centred methods of nursing education with emphasis on memorization versus critical thinking no longer meet the needs of the contemporary learner and the current challenges of the healthcare environment. There is an explicit need to redesign nursing curriculums that are future-oriented, adaptive and flexible and serve the learners' best interests.

    Background

    Distilled from a decade of teaching experience in an undergraduate, second-degree entry, accelerated nursing program, this paper describes the construction of a learner-centred, postmodern, concept-based nursing curriculum that aims to foster learners' inquiry skills, critical thinking, problem-solving, and experiential learning—all which develop learners' autonomy, self-direction, and lifelong learning. The objective is to foster learners' transformational and emancipatory learning and metacognition.

    Discussion

    An extensive review of the current trends, contemporary nursing knowledge for the past decade (2013–2023), and seminal literature on theories and frameworks paralleled with the review of current and future trends in Canadian and global health care, including the socio-economic, politico and environmental contexts, led to the formulation of a concept-based curriculum. Grounded in the constructivist paradigm, the curriculum applies interperetivist, critical, feminist, and indigenous lenses. The Strength-Based Nursing framework was selected as the core guiding framework. The curriculum's four curricular themes and foundational pillars were adopted directly from the framework to provide a starting point for concept development. These initial themes were then juxtaposed with relevant nursing, and social theories, policies, and frameworks, ensuring a robust coverage of modern nursing knowledge and allowing for the core concepts of the curriculum to emerge. A total of 21 concepts and 192 sub-concepts were developed.

    Conclusion

    Implications for future practice require nursing educators to receive support and professional development opportunities in developing skills and confidence in entering a classroom as co-learners and facilitators.

    The enrichment process for family caregivers of persons living with dementia: A grounded theory approach

    Abstract

    Aim

    Many persons living with dementia (PLWD) reside in the community and are cared for by family members. The aim of this qualitative study was to gain an understanding the enrichment process for family caregivers of PLWD in Taiwan.

    Design

    A grounded theory approach with face-to-face semi-structured interviews was conducted with family caregivers of PLWD in Taiwan.

    Methods

    Interview data from 30 family caregivers of PLWD recruited from dementia clinics or support groups in Taiwan were obtained from the first wave of a larger study conducted from January 2018 to September 2021. Glaser's grounded theory approach with theoretical sampling was used to understand the enrichment process of family caregivers of PLWD.

    Results

    Analysis indicated the core category that characterized the process of enrichment was ‘holding together’. Caregivers were able to maintain their connection to the person with dementia through activities that deepened their relationship and strengthened their bond. ‘Holding together’ included four components: maintaining continuity, creative interactions, interacting with humour and sharing pleasurable activities. Through these components, family caregivers generated positive interactions and relationships with the person living with dementia and sustained their motivation for caregiving. Three modifying elements facilitated or impeded the process of holding together: ‘previous daily interactions’, ‘caregiving beliefs’ and ‘filial piety’.

    Conclusion

    Through the enrichment process of ‘holding together’, family caregivers used different strategies to conduct pleasurable and meaningful activities with the person living with dementia to maintain and improve their relationship and enhance their happiness in life.

    Impact

    To facilitate the enrichment process, health care providers should encourage activities between family caregivers and PLWD that promote continuity, increase interactions, provide humour and foster pleasurable activities.

    Reporting Method

    This study adhered to the COREQ guideline checklist.

    Patient or Public Contribution

    No patient or public contribution.

    Comparison of anaesthesia‐related outcomes in patients monitored by newly recruited nurse anaesthetists and anaesthesiologists: An observational study

    Abstract

    Aims

    To compare anaesthesia-related outcomes between patients monitored by newly recruited nurse anaesthetists and those monitored by newly recruited anaesthesiologists.

    Design

    This was a retrospective study.

    Methods

    We conducted a retrospective study that collected demographic information on newly recruited nurse anaesthetists and anaesthesiologists between 2017 and 2022 and recorded information on patients within 6 months of monitoring. Postoperative pain, emergency agitation, nausea, and vomiting were designated anaesthesia-related outcomes. Propensity score matching was used to adjust for covariates. The study adhered to the STROBE guidelines.

    Results

    The study's statistical analysis included 4483 patients monitored by 22 newly recruited nurse anaesthetists and 4959 patients monitored by 23 newly recruited anaesthesiologists. Compared with patients monitored by newly trained anaesthesiologists, the patients monitored by nurse anaesthetists were younger (42.07 ± 20.00 vs. 47.39 ± 18.45 years, p < 0.001) and had a lower body mass index (23.56 ± 4.46 vs. 24.19 ± 4.25, p < 0.001). Patients monitored by anaesthesiologists had a greater proportion of women (61.62% vs. 59.25%, p < 0.001), a high proportion of ASA III and ASA IV (17.1% vs. 8.88%, p < 0.001), and a longer mean surgery duration (78.65 ± 59.01 vs. 70.70 ± 60.65 min, p < 0.001). After propensity score matching was used to adjust for covariates, no statistically significant differences were found in the prevalence of postoperative pain, emergency agitation, or postoperative nausea and vomiting between the two groups (p < 0.05).

    Conclusion

    Nurse anaesthetists monitoring alone during anaesthesia maintenance is feasible and safe. The two groups had no significant differences in the incidence of postoperative pain, emergency agitation, or postoperative nausea and vomiting.

    Relevance to Clinical Practice

    The shortage of anaesthesiologists leads to heavy work burden and high incidence of occupational burnout among anaesthesiologists. The study found that it was safe for nurse anaesthetists to perform anaesthetic monitoring alone in the operating room under the supervision of the attending anaesthesiologist and did reduce the burden of anaesthesiologists’ work. The results of the current study contribute to the expansion of occupational categories for nurse anaesthetists in countries where anaesthesiologists are in short supply. It provides new ideas for hospital administrators and policy-makers to formulate medical and nursing service policies.

    Factors affecting colonoscopy screening among first‐degree relatives of colorectal cancer patients: A mixed‐method systematic review

    Abstract

    Background

    First-degree relatives (FDRs) of colorectal cancer (CRC) patients have a higher risk of developing CRC than the general population. Ensuring that these at-risk populations receive colonoscopy screening is an effective strategy for reducing the increased risk, but the rates remain low. Colonoscopy screening behavior is influenced by factors at multiple levels. However, most previous reviews failed to review them and their interactions systematically.

    Aims

    To explore factors influencing FDRs' colonoscopy screening behavior according to the ecological model.

    Method

    A mixed-method systematic review was performed in accordance with The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. A comprehensive literature search was conducted using eight bibliographic databases (Medline, EMBASE, PubMed, the Cochrane Library, Scopus, China National Knowledge Infrastructure, Wan Fang Data, and China Biology Medicine) for the period from January 1995 to February 2023. The Joanna Briggs Institute critical appraisal checklists were applied to assess studies qualities. A convergent integrated approach was used for data synthesis and integration.

    Results

    In total, 24 articles reporting on 23 studies were included. Only one study was rated low quality, and the other 22 studies were rated moderate to high quality. The findings revealed that certain factors and their interactions affected FDRs' colonoscopy screening behaviors according to the ecological model, including misconceptions about CRC and colonoscopy, concerns about the procedure, perceived susceptibility to developing CRC, health motivation, fear of CRC, fatalism, the recommendation from CRC patients, and recommendations from physicians, colonoscopy schedules, cancer taboo, health insurance and cost of colonoscopy.

    Link evidence to action

    Family communication-centered multilevel interventions are recommended to promote colonoscopy screening behavior among FDRs of CRC patients.

    Nurse experiences of partnership nursing when caring for children with long‐term conditions and their families: A qualitative systematic review

    Abstract

    Aim

    To explore the experiences of partnership nursing among nurses when caring for children and young people with long-term conditions, and their families.

    Background

    Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision-making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing.

    Design

    A qualitative systematic review followed Joanna Briggs Institute meta-aggregation approach and has been reported according to PRISMA guidelines.

    Methods

    A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre-determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted.

    Findings

    A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision-making principles to deliver individualised care.

    Conclusion

    Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three-way triadic partnership may aid therapeutic relationships and shared decision-making.

    Implications for clinical practice

    Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision-making.

    Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed‐method study

    Abstract

    Objective

    To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings.

    Design

    A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR).

    Methods

    An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme.

    Results

    Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting.

    Conclusions

    To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption.

    Implications for the Profession and/or Patient Care

    What problem did the study address? The adoption of upright positions during the second stage of labour could promote better maternal and neonatal outcomes and a positive childbirth experience. However, the adoption of upright positions during the second stage of labour is suboptimal in healthcare settings in China. Barriers and facilitators of implementing upright positions during childbirth are unclear. What were the main findings? A range of barriers and facilitators within the CFIR framework to promote upright positions during childbirth from healthcare professionals' perspectives were identified, and the major barriers included safety concerns towards and unfamiliarity with an upright position birth, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. Where and on whom will the research have an impact? This study will enable a better understanding of the barriers and facilitators to promoting upright positions in the second stage of labour in China. The smooth and effective implementation of the UPSSL programme could help to promote better maternal and neonatal outcomes and improve women's childbirth experiences.

    Reporting Method

    The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Good Reporting of A Mixed Methods Study (GRAMMS) guidelines.

    Patient or Public Contribution

    In this study, healthcare professionals were involved in refining the topic guides and survey questions. Additionally, findings from the interviews were returned to them for comments and corrections.

    Undergraduate nursing students challenge misconceptions towards men in nursing: A mixed‐method study

    Abstract

    Aims

    To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing.

    Design

    A convergent parallel mixed-method study.

    Methods

    A national survey was conducted (July–September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting.

    Results

    Undergraduate nursing students (n = 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) ‘This is a very misandristic viewpoint’; (2) ‘Compassion and intelligence are distributed in men and women equally’; (3) ‘Men bring a different quality to nursing’ (4) ‘Anyone can be whatever they want to be’.

    Conclusion

    Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society.

    Impact

    Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments.

    Patient or Public Contribution

    No patient or public contribution.

    Instruments for assessing the spiritual needs of cancer patients: A systematic review of psychometric properties

    Abstract

    Aims and Objectives

    To identify available instruments for assessing cancer patients' spiritual needs and to examine their psychometric properties using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology.

    Background

    Cancer patients frequently have significant spiritual needs. The nurse plays an integral role in assessing the patient's spiritual needs as part of providing holistic care. It is crucial to assess these needs using appropriate and reliable instruments.

    Design

    A systematic review based on COSMIN methodology.

    Methods

    Seven electronic databases (PubMed, EMBASE, CINAHL, Web of Science, ProQuest, CNKI and WANFANG) were systematically searched from inception until 14 February 2023. Two authors independently screened eligible literature, extracted data and evaluated methodological and psychometric quality. This systematic review was conducted following the PRISMA checklist.

    Results

    Sixteen studies have reported 16 different versions of the instruments. None of the instruments were properly assessed for all psychometric properties, nor were measurement error, responsiveness and cross-cultural validity/measurement invariance reported. All of the instruments failed to meet the COSMIN quality criteria for content validity. The quality of evidence for structural validity and/or internal consistency in five instruments did not meet the COSMIN criteria. Eventually, five instruments were not recommended, and 11 were only weakly recommended.

    Conclusion

    Instruments to assess spiritual needs exhibited limited reliability and validity. The Spiritual Care Needs Scale is provisionally recommended for research and clinical settings, but its limitations regarding content validity and cross-cultural application must be considered in practice. Future research should further revise the content of available instruments and comprehensively and correctly test their psychometric properties.

    Relevance to Clinical Practice

    The review findings will provide evidence for healthcare professionals to select instruments for recognising spiritual needs in cancer patients.

    No Patient or Public Contribution

    This study is a systematic review with no patient or public participation.

    Meta-Analysis of Effects of Early Palliative Care on Health-Related Outcomes Among Advanced Cancer Patients

    imageBackground Early palliative care (PC) has received more attention for improving health-related outcomes for advanced cancer patients in recent years, but the results of previous studies are inconsistent. Objectives This study aimed to use meta-analysis and trial sequence analysis to evaluate the effect of early PC on health-related outcomes of advanced cancer patients. Methods All English publications were searched in PubMed, Web of Science, Embase, and the Cochrane Library from inception to March 2023, with a restriction that the study type was a randomized controlled trial. Results The results showed that early PC positively affected quality of life, satisfaction with care, and symptom burden reduction. However, early PC had no significant effect on anxiety or survival. Trial sequence analysis results showed that the effect of early PC on the quality of life was stable. Discussion This systematic review suggested that early PC could positively affect health-related outcomes for advanced cancer patients. Early PC can be used widely in clinical settings to improve health-related outcomes of advanced cancer. However, because of the trial sequence analysis results, further well-designed, clinical, randomized controlled trials with larger sample sizes are necessary to draw definitive conclusions.

    Factors associated with the core dimensions of spiritual health among older adults with chronic obstructive pulmonary disease: A cross‐sectional study

    Abstract

    Aims

    To investigate the level of spiritual health in older patients with chronic obstructive pulmonary disease (COPD) from the core dimensions and to explore its associated factors.

    Design

    A cross-sectional study.

    Methods

    Participants were recruited from four hospitals between September 2020 and June 2021, using a convenience sampling. Older patients with COPD (n = 162) completed the demographic and disease-related information questionnaires, Function Assessment of Chronic Illness Therapy Spiritual Scale, 10-item Connor-Davidson Resilience Scale, General Self-efficacy Scale, Social Support Rating Scale, COPD Assessment Test, 15-item Geriatric Depression Scale and modified Medical Research Council Dyspnea Scale. Descriptive statistics, Pearson and Spearman correlation analyses, t-tests, one-way ANOVA and multiple linear regression models were used.

    Results

    Older patients with COPD have a moderate level of spiritual health. The multiple linear regression analysis showed that psychological resilience, general self-efficacy, social support, symptom burden and monthly income were associated with the core dimensions of spiritual health.

    Conclusion

    Chinese older patients with COPD have a moderate level of spiritual health. Psychological resilience, general self-efficacy, social support, monthly income and symptom burden were associated with the core dimensions of spiritual health.

    Impact

    This study is the first to investigate the level of spiritual health in older patients with COPD from the core dimensions and to explore its associated factors, providing a basis for developing spiritual intervention programs. Our findings can help us realize that intervention strategies of psychological resilience, general self-efficacy and social support can all be used to enhance spiritual health. Nurses should focus on the spiritual health of older COPD patients with high symptom burden and low monthly income.

    Patient or Public Contribution

    Although we did not directly involve patients and the public because of the COVID-19 pandemic, the results of the study will be disseminated to patients and the public through WeChat and seminars.

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