FreshRSS

🔒
☐ ☆ ✇ Journal of Advanced Nursing

Intensive Care Unit Nurses' Perceptions of Work Environments: A Cross‐Sectional Study From Five European Counties

ABSTRACT

Aim

To explore intensive care nurses' perceptions of their work environments at the unit and organisational levels according to the American Association of Critical Care Nurses standards, their impact on care quality, national differences, and demographic associations.

Design

Cross-sectional study using a survey design.

Methods

Study conducted between January 2021 and April 2022, using a convenience sample of intensive care unit nurses across Cyprus, Spain, Croatia, and Poland, Romania. The Critical Elements of a Healthy Work Environment Scale (CEHWES) developed by the American Association of Critical Care Nurses and cross-culturally adapted by the authors was used, which included four sections, including sociodemographic data and a total of 50 questions. The core section of the tool comprised 16 questions using Likert-type response (1—strongly disagree—4 strongly agree). Perception of fulfilment of healthy work environment standards was calculated using the aforementioned Likert-type scale.

Results

A total of 1183 nurses participated reporting moderate perception of fulfilment of the standards, with mean scores ranging from 2.6 to 2.8. Skilled communication and effective decision making were the highest rated. 56% (n = 662) reported awareness of some standards and while 25.8% (n = 305) reported full or significant implementation in their unit. Significant differences related to the perception of all standards were observed across countries. Implementation of the standards was significantly associated with higher quality of care having better perception when standards were fully implemented.

Conclusions

This study shows moderate perception of healthy work environment standards among intensive care nurses. Country differences highlight the need for more awareness, training, and further implementation of the standards, which is linked to better care quality.

Implications for the Profession

Work environment still need to improve and needs to be prioritised by organisations, considering local and national particularities. Having a measuring tool available in multiple languages facilitates comparisons and getting a global picture.

Impact

The questionnaire used is validated in different languages, allowing results to be compared with other countries. Novel data from countries that were poorly investigated is now available. More evidence points out the need to prioritise work environment for maintaining quality in patient care.

Reporting Method

The study has been reported following the STROBE checklist.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

Technologies in Intensive Care Therapy and the Obstacles in Nursing Practice: Systematic Review

ABSTRACT

Aim

To identify obstacles faced by nurses when using health technologies in Intensive Care Units (ICUs).

Design

Systematic review following PRISMA and registered in PROSPERO.

Methods

Six databases were searched. Two reviewers independently screened studies and appraised methodological quality using the Joanna Briggs Institute tool. Data were synthesized narratively.

Results

Eight studies met eligibility criteria. Barriers clustered around limited training and technical competence, shorter professional experience, increased workload with multiple devices, organizational culture, and reduced direct patient contact, which may undermine patient-centered care. Heterogeneity of study designs precluded meta-analysis.

Conclusions

Obstacles to technology use in ICUs arise from individual and organizational factors. Addressing these barriers requires structured education, mentoring for novice nurses, workload management, and supportive policies that integrate technology without displacing bedside care.

Linking Evidence to Action

Nursing leaders and educators should implement ongoing, ICU-specific technology training and mentoring. Managers and policymakers must ensure adequate staffing and promote Health Technology Assessment to align device implementation with clinical needs, safeguarding patient safety and the human dimensions of care.

☐ ☆ ✇ Journal of Advanced Nursing

Professionals' Perceptions of the Management of Digital Competence Sharing in Healthcare and Associated Background Factors: A Cross‐Sectional Study

Por: Mira Hammarén · Tarja Pölkki · Outi Kanste — Febrero 16th 2026 at 06:39

ABSTRACT

Aims

To describe professionals' perceptions of the management of digital competence sharing in healthcare and associated background factors.

Design

A descriptive cross-sectional study.

Methods

The study used an online survey involving 227 healthcare professionals from three public and one private healthcare organisation in Finland. Data was collected using the management of digital competence sharing (MDCS) instrument and analysed using descriptive statistics, independent sample t-tests and one-way ANOVA.

Results

Based on the professionals' perceptions, the overall management of digital competence sharing was weak. They perceived the highest level of creation of a friendly and safe digital organisational atmosphere while the lowest level of provision of resources and opportunities for digital competence sharing. Background factors, including gender, age, work experience in healthcare, organisation and clinical environment, showed statistically significant differences in how professionals perceived the management of digital competence sharing.

Conclusion

The results emphasised the need for increased managers' attention to digital competence development, prioritising and supporting digital competence sharing among healthcare professionals.

Implications

The results can be utilised in healthcare management to enhance the digital competence sharing among healthcare professionals and the use of existing digital competence to benefit the work community.

Impact

The importance of digital competence is increasing among healthcare professionals, but at the same time, they perceive inadequate management support in this area. This study revealed limited management of digital competence sharing in healthcare organisations, particularly among older professionals and those in inpatient and primary care settings. These results can be applied in managers' training to support and promote digital competence among healthcare professionals.

Reporting Method

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist.

Patient or Public Contribution

There is no patient or public contribution.

☐ ☆ ✇ Journal of Clinical Nursing

Preventing Child Maltreatment in Early Childhood: The Clinical Role of Public Health Nurses in Primary Care

ABSTRACT

Aim and Objective

To explore how public health nurses at child and family health clinics work to prevent maltreatment and the experiences of public health nurses in the maltreatment prevention efforts.

Background

Child maltreatment is a serious societal issue with major consequences. Preventive efforts are increasing and have broad political support. A key objective of the child and family health clinic services is to prevent, identify, and stop maltreatment, abuse, and neglect. National clinical guidelines outline, in general terms, how such work should be conducted. However, limited research exists on how public health nurses prevent maltreatment and the effectiveness of their methods.

Design and Method

A qualitative and explorative design was used, based on semi-structured interviews with 14 public health nurses conducted as part of the project ‘Public Health Nurses in Child and Family Clinics' Role in Preventing and Detecting Child Maltreatment’ at Oslo Metropolitan University. The interviews were carried out between August and November 2021. We used qualitative content analysis with an inductive approach to analyse the data.

Result

Three main categories were developed: 1. Structure and system: weaving prevention into daily practice; 2. To dare and endure: a negotiation of courage and understanding, and 3. To empower and uphold: the goal of strengthening and supporting parents. The results show the importance of early intervention, barriers to discussing maltreatment with parents, and the importance of building trust and empowering parents.

Conclusion

Preventing maltreatment is a key part of public health nurses' clinical work, focusing on early risk identification and parental guidance. While building trust with families is prioritised, structural, resource, and guideline-related challenges persist.

Implications for Practice

This study provides knowledge about Norwegian public health nurses clinical work with child maltreatment at the child and family health clinics, which can serve as a valuable foundation for further research as well as for collaborating services.

Reporting Method

EQUATOR guidelines were followed, using the COREQ checklist.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Experiences of Nurses With Power‐Structures in Hospital Care: A Qualitative Study

ABSTRACT

Aim

To explore nurses' experiences with power structures in hospital care and to develop policy recommendations for transforming disempowering structures.

Design

A three-phased critical ethnographic design.

Method

Data were collected in a general teaching hospital in the Netherlands between December 2022 and June 2024 through (1) ethnographic diaries kept by nurses, (2) semi-structured interviews, (3) partial participant observations, (4) one focus group discussion with only nurses and (5) one multistakeholder focus group. Thematic analysis was used to identify themes.

Findings

Twenty-eight nurses of thirteen different departments and nine stakeholders participated. Four themes emerged from the analysis: (1) power in cooperation, (2) hierarchical relationships, (3) aggression and (4) insufficient decision-making power in hospital policies. The first theme was experienced as an empowering structural condition, while the last three were identified as disempowering structures.

Conclusion

Job satisfaction and quality of care among nurses are at risk and elicit feelings of burnout because of nurse–doctor hierarchies, aggression and insufficient decision-making power in hospital policies. Therefore, improving interprofessional cooperation and including nurses in decision-making is crucial to structurally empower nurses.

Implications

Hospital administrators need to create empowering conditions for nurses by furthering inclusion in policy making and setting department goals, implementing interprofessional education for effective collaboration, increasing nurse representation throughout hospital management layers and ensuring strong support systems. These interventions are important in addressing aggression, hierarchies, nurse turnover and burnout.

Reporting Method

COREQ guidelines were used for reporting qualitative studies.

Patient or Public Contribution

None.

☐ ☆ ✇ Journal of Advanced Nursing

Care Needs of Community‐Dwelling Older Adults Living in Poverty and Their Relationship With Other Biopsychosocial Variables: A Cross‐Sectional Study

ABSTRACT

Aim

To assess the care needs of older adults living in poverty in a high-income country and to analyse their relationship with other outcome variables.

Design

A cross-sectional study.

Method

Data were collected between September 2022 and February 2024 from 384 older adults in southeastern Spain. Descriptive statistics were calculated to assess older adults' care needs. A multiple linear regression analysis was carried out to determine the percentage by which the socio-demographic or outcome variables could explain the number of met care needs among older adults in poverty.

Results

Around 20% of the care needs amongst older adults living in poverty were unmet. The most frequently unmet care need was related to money (53.6%). Almost 30% of participants were at risk of malnutrition, 18% felt lonely, and 80% perceived a low level of social support. Age, history of falls, emergency room visits, functionality, perceived social support, quality of life and nutritional status significantly predicted the number of needs met.

Conclusion

The health conditions of older adults living in poverty are suboptimal and may negatively influence their care needs. Nurses should consider these factors when designing, implementing and evaluating interventions to promote the biopsychosocial health of this population.

Implications for the Profession and/or Patient Care

Nursing interventions to promote health amongst older adults living in poverty should focus on identifying unmet care needs, particularly those related to financial and social support. Interventions should prioritise improving nutritional status, enhancing social support networks and addressing loneliness.

Impact

Living in poverty increases older adults' vulnerability due to unmet financial, nutritional and social support needs. These unmet needs can negatively affect older adults' physical and mental health.

Reporting Method

The study has been reported following the STROBE guidelines.

Patient or Public Contribution

The study's participants only participated in the data collection process.

☐ ☆ ✇ Journal of Advanced Nursing

Healthcare Professionals' Perceptions of Future Leadership in Digital Healthcare: A Qualitative Study

Por: Marika Määttä · Mira Hammarén · Suvi Kuha · Outi Kanste — Enero 16th 2026 at 16:16

ABSTRACT

Aim

To describe and enhance the understanding of healthcare professionals' perceptions of future leadership in digital healthcare.

Design

A qualitative descriptive study.

Methods

The data were collected remotely between February and November 2022 through semi-structured interviews. A total of 26 healthcare professionals were interviewed individually or in focus group interviews at the university hospital and university in Finland. The data were analysed using inductive content analysis.

Results

Results revealed seven main categories that described the professionals' perceptions of future leadership in digital healthcare: building a future-oriented healthcare, strengthening a digitally minded organisational culture, being interactive in a digital environment, leading sustainably in digital healthcare, leading expertise in digital healthcare, leading collaboratively in digital healthcare and using artificial intelligence in leadership in digital healthcare.

Conclusion

Future leadership in digital healthcare will be about leading people in a humane way. Leaders will be at the forefront of digital solutions, sharing their expertise and enabling stakeholders' engagement. Through collaboration, future leaders will be building a future-led digital health system.

Impact

Digital healthcare is improving due to the implementation of new digital solutions and the possibility of artificial intelligence. Thus, leaders' competencies in digital healthcare need to be further developed through education and guided by policy to meet the expectations of future professionals, nurses and customers.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used in the reporting.

☐ ☆ ✇ Journal of Advanced Nursing

The Journey to First‐Line Nursing Management: A Qualitative Study in a Spanish University Hospital

ABSTRACT

Aim

To explore nurse managers' perceptions at first-line, middle and executive levels regarding their transition to first-line management in two divisions of a highly specialised university hospital in Spain.

Design

A qualitative descriptive study.

Method

A purposive sampling technique was employed to conduct four focus groups and two semi-structured interviews with 31 nurse managers across three hierarchical levels in two divisions of a highly specialised university hospital in Spain. Participants included two Chief Nursing Officers, four Nursing Directors and 25 first-line nurse managers. Data were analysed thematically.

Results

Three themes emerged: ‘Bridging the Readiness Gap: Training, Role Clarity, and Institutional Alignment’, revealing the lack of structured transition plans, role ambiguity and gaps in managerial skills, such as human resources, financial management and leadership; ‘Fighting Loneliness: A Common Challenge in Care Management’, highlighting the isolation of first-line nurse managers due to the absence of structured mentorship and peer support; ‘Clinical Expertise as a Cornerstone: The Role of Prior Experience in Nurse Management’, examining how clinical expertise facilitates leadership transitions but also presents challenges, particularly for managers promoted within their teams, where authority negotiation and role redefinition become critical.

Conclusions

Findings underscore the need for structured training and mentorship to address role ambiguity, enhance managerial competencies and support nurse managers' transitions through targeted education.

Implications for Profession and Patient Care

Structured transition programmes focusing on role clarity, training and institutional alignment can ease transitions, boost leadership confidence and enhance peer collaboration. Providing mentoring and training tailored to first-line nurse managers can improve team dynamics, support professional integration and strengthen organisational cohesion.

Impact

Tailored educational interventions are essential in supporting nurse managers' transitions. Structured mentorship and targeted training enhance leadership readiness, adaptability and institutional alignment, strengthening healthcare leadership, efficiency and patient care quality.

Patient and Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

A Primer of Data Cleaning in Quantitative Research: Handling Missing Values and Outliers

Por: Amir Masoud Sharifnia · Daniel Edem Kpormegbey · Deependra Kaji Thapa · Michelle Cleary — Diciembre 23rd 2025 at 00:53

ABSTRACT

Aims

This paper discusses data errors and offers guidance on data cleaning techniques, with a particular focus on handling missing values and outliers in quantitative datasets.

Design and Methods

Methodological discussion.

Results

This paper provides an overview of various techniques for identifying and addressing data anomalies, which can arise from incomplete, noisy, and inconsistent data. These anomalies can significantly affect data quality, leading to biased model parameter estimates and evidence-based decisions. Data cleaning, particularly the appropriate handling of missing values and outliers, is essential to improving data quality before analysis. Data cleaning includes screening for anomalies, diagnosing errors, and applying appropriate corrective measures.

Conclusion

Proper handling of missing values and the identification and correction of outliers are crucial aspects of data cleaning in ensuring data quality and the reliability of statistical analyses. Effective data cleaning enhances the validity and accuracy of research findings for evidence-based decision making that leads to optimal patient outcomes.

Implications for the Profession

The quality of study results depends on how a dataset and its complexities are processed or handled before the analysis. Nursing researchers must use a framework to identify and address important data anomalies and produce reliable results.

Impact

This paper describes data cleaning, often overlooked during the data mining process, as a crucial step before conducting data analysis. By addressing missing values and outliers, identifying and fixing data anomalies, and enhancing data quality prior to analysis, data cleaning techniques can produce precise research findings for evidence-based decision making.

Reporting Method

In this methodological paper, no new data were generated.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Doctoral Education in Nursing in Ibero‐America: An Analysis of Its Evolution and Perspectives for the Future

ABSTRACT

Aim

To provide an overview of doctoral programs in nursing offered in Ibero-American countries to inform regional collaboration and academic development.

Design

This study was a descriptive, document analysis.

Methods

A systematic mapping was conducted using data obtained from official university and program websites, national postgraduate databases, and academic documents. The variables analysed included country, institution, year of implementation, number of faculty and students, course duration, delivery modality, costs, scholarship availability, internationalisation activities, and research lines.

Results

A total of 94 active nursing doctoral programs were identified. Brazil emerged as the pioneer, launching the first doctoral program in 1982, and remains the regional leader, accounting for 43 programs. Most programs are offered by public institutions (76.6%), delivered primarily in face-to-face format (64.1%), and emphasise research (90.4%). There has been a consistent upward trend in the establishment of programs since 2000, with notable expansion between 2011 and 2025. Despite this progress, regional disparities persist, along with a lack of data standardisation and a limited presence of professional doctorates. While 69.1% of programs reported international activities, few offer joint or dual degrees. The most common thematic axis, “Health Care and Nursing,” proved to be broad and non-specific.

Conclusion

The study reveals the expanding landscape of nursing doctoral education in Ibero-America, while also exposing persistent challenges regarding access, curricular clarity and regional articulation.

Implications for the Profession and/or Patient Care

Doctoral programs are essential for developing research capacity, academic leadership and evidence-based care. Strengthening these programs could enhance nursing responses to local health needs and promote scientific progress in care delivery.

Impact

This study provides the first comprehensive mapping of nursing doctoral programs in Ibero-America, highlighting regional disparities and areas for academic collaboration, with potential impact on policy-making, curriculum development, and the strengthening of research capacity in nursing education.

Reporting Method

STROBE (Strengthening the Reporting of Observational Studies in Epidemiology).

Patient or Public Involvement

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Timely Implementation of Patient‐Reported Outcomes in Clinical Care: Insights From Clinicians and Health Informatics Experts

ABSTRACT

Aim

To explore the optimal timing of patient-reported outcome assessment, defined as the collection and use of patient-reported outcomes at clinically meaningful points such as before or during encounters, treatment initiation and follow-up, and to identify the facilitators and barriers to timely use.

Design

A qualitative analysis of semi-structured interviews with healthcare professionals across diverse US health systems.

Methods

Thematic analysis was used to identify key themes related to the timing and implementation of patient-reported outcomes assessments. Interviews were analysed iteratively to develop a coding framework and synthesise overarching themes.

Results

Fourteen healthcare professionals, including nurse practitioners, cardiologists and health informatics experts across seven U.S. health systems from academic and community hospitals, were interviewed in February 2024. Three major themes emerged: (1) value proposition of timely patient-reported outcome data collection (2) key facilitators for timely implementation and (3) multilevel barriers. The value proposition focused on the use of patient-reported outcomes for prevention and active disease management. Critical facilitators for the timely implementation of patient-reported outcomes included the involvement of research and clinical coordinators, strategies for pre-visit and on-site patient-reported outcome collection, the use of standardised templates within EHRs and the alignment of patient-reported outcome collection with patients' long-term treatment goals. Finally, multilevel barriers included time constraints, patient-level challenges (e.g., fatigue, literacy, language) and systemic issues (e.g., technical limitations, lack of reimbursement and unclear guidelines).

Conclusion

Timely collection and use of patient-reported outcomes is critical for improving symptom monitoring and supporting patient-centered clinical decision-making. However, multilevel barriers hinder consistent implementation across health care settings.

Implications for the Profession and/or Patient Care

Integrating patient-reported outcomes into clinical workflows can improve the patient-centeredness of patient-healthcare professional interactions, and provide a more holistic picture of a patient's health status. Addressing barriers to patient-reported outcome implementation, including lack of time, poor health literacy and workflow integration barriers, is crucial for improving clinical outcomes.

Reporting Method

This study adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist, in accordance with EQUATOR Network 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.

☐ ☆ ✇ Journal of Advanced Nursing

Climate change effects in older people's health: A scoping review

Abstract

Background

Climate change has serious consequences for the morbidity and mortality of older adults.

Objective

To identify the effects of climate change on older people's health.

Methods

A scoping review was conducted following the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist. Quantitative research and reports from organizations describing the effects of climate change on older people were selected.

Results

Sixty-three full-text documents were selected. Heat and air pollution were the two factors that had the most negative effects on cardiovascular and respiratory morbidity and mortality in older people. Mental health and cognitive function were also affected.

Conclusions

Climate change affects several health problems in older individuals, especially high temperatures and air pollution. Nursing professionals must have the necessary skills to respond to the climate risks in older adults. More instruments are required to determine nursing competencies on climate change and the health of this population group.

Patient of Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

A Comprehensive Assessment of the Environmental Impact of Different Infant Feeding Types: The Observational Study GREEN MOTHER

ABSTRACT

Aim(s)

To observe and compare the environmental impacts of different types of infant feeding, considering the use of formula, infant feeding accessories, potentially increased maternal dietary intake during breastfeeding (BF) and food consumption habits.

Design

An observational cross-sectional multicentre study conducted in the Barcelona Metropolitan Area of the Catalan Institute of Health.

Methods

Data were collected from 419 postpartum women on infant feeding type (formula milk and accessories), maternal dietary intake (24-h register) and food consumption habits from November 2022 to April 2023. The environmental impacts (climate change (CC), water consumption and water scarcity) of the infant feeding types and maternal diet were calculated using the IPCC, ReCiPE and AWARE indicators, respectively. The differences in impacts were calculated by Kruskal–Wallis test.

Results

Significant differences for the three environmental impacts were observed. The CC impact of formula milk and feeding accessories was 0.01 kg CO2eq for exclusive BF, 1.55 kg CO2eq for mixed feeding and 4.98 kg CO2eq for formula feeding. While BF mothers consumed an extra 238 kcal, no significant differences were found related to maternal diet across feeding types.

Conclusion

Exclusive BF was the most sustainable type of infant feeding, considering formula and infant feeding accessories. In our study, the difference between the impacts of BF and non-BF mothers' diet was insignificant.

Implications for the Profession and/or Patient Care

Offer informative and educational support for midwives and other healthcare professionals on BF and a healthy, sustainable diet to transfer this knowledge to the general public.

Impact

Raise the general public's awareness about BF and a healthy, sustainable diet. To reduce environmental impacts through behavioural changes.

Reporting Method

STROBE.

Patient or Public Contribution

Patients of the Catalan Health Service reviewed the content of the data collection tools.

Trial Registration: (for the whole GREEN MOTHER project): NCT05729581 (https://clinicaltrials.gov)

☐ ☆ ✇ Journal of Nursing Scholarship

Response

Por: Miriam J. Hirschfeld — Diciembre 31st 2025 at 05:58
Journal of Nursing Scholarship, Volume 58, Issue 1, February 2026.
☐ ☆ ✇ Journal of Advanced Nursing

Describing a programme of implementation‐effectiveness research on the organization and implementation of frontline nursing care delivery into diverse health systems

Por: Miriam Bender · Marjory (Micki) Williams — Octubre 18th 2025 at 19:05

Abstract

Aims

The longitudinal programme of research described in this paper seeks to generate knowledge about factors influencing the implementation of a system-level intervention, the clinical nurse leader care model, involving nurses as leaders at the frontlines of care and the outcomes achievable with successful implementation. The research programme has the following aims, (a) to clarify clinical nurse leader practice, (b) develop and empirically validate a translational model of frontline care delivery that includes clinical nurse leader practice and (c) delineate the patterns of and critical outcomes of successful implementation of the clinical nurse leader care model.

Design

This programme of research follows a knowledge-building trajectory involving multiple study designs in both qualitative (grounded theory, case study) and quantitative (descriptive, correlational and quasi-experimental) traditions.

Methods

Multiple mixed methods within a system-based participatory framework were used to conduct this programme of implementation–effectiveness research.

Results

Findings are demonstrating how the clinical nurse leader care model, as a complex system-level intervention, can be implemented in diverse healthcare contexts to make a difference to patient care quality and safety. Findings also contribute to implementation science, helping to better understand the dynamic interdependencies between implementation, the interventions implemented and the contexts in which they are implemented.

Conclusion

Findings translate into sets of evidence-informed implementation ‘recipes’ that health systems can match to their specific contexts and needs. This allows health systems to take on strategies that both maximize resource impact within their existing structures and support achieving intended outcomes.

Implication

This programme of research is producing actionable implementation and outcome evidence about ways to organize nursing knowledge and practice into care models that can be successfully adopted within real-world healthcare settings to achieve safer and higher quality patient care.

☐ ☆ ✇ Journal of Advanced Nursing

Recent Advances in Non‐Invasive Digital Nursing Technologies for Chronic Pain Assessment and Management: An Integrative Review

Por: James Lee · Rebecca Mowat · Julie Blamires · Mandie Foster — Octubre 18th 2025 at 19:05

ABSTRACT

Aim

This integrative review aims to identify what nurses currently offer through digital technology and their success in managing chronic pain.

Design

An integrative review guided by Whittemore and Knafl was conducted.

Data Sources

Five databases—CINAHL, Medline, PsycINFO, PubMed, and Scopus—were utilised to gather relevant studies from January 2018 to November 2024.

Review Methods

Selected studies were assessed using the Mixed Methods Appraisal Tool and the Joanna Briggs Appraisal Tool. Braun and Clarke's thematic analysis was applied to identify pertinent themes.

Results

Digital nursing technologies such as telehealth and web-based interventions effectively deliver interventions to assess and manage chronic pain; these technologies can reduce healthcare resource utilisation and increase accessibility. This review highlights that nurses commonly deliver exercise, cognitive-behavioural therapy, acceptance and commitment therapy and self-management techniques through digital technology.

Conclusion

This review indicates that web-based interventions and telemedicine are the primary digital technologies employed by nurses for chronic pain management providing psychosocial interventions, with evidence supporting their effectiveness. Digital and web-based technology is essential to bridge healthcare access gaps as nurses can provide this successfully with minimal nursing support and cost to the patient.

Impact

Evidence supports nurses in providing psychosocial interventions for the management of chronic pain, particularly web-based psychosocial interventions. Nurses need to adopt digital technology to improve access to care and patient outcomes and to maintain professional development in an increasingly digital world.

Patient or Public Contribution

No patient or public contribution was used for this study.

☐ ☆ ✇ Journal of Advanced Nursing

What Enables Implementation of Pain Management Interventions in Intensive Care Units and Why: A Realist Evaluation to Refine Program Theory

Por: Samira Hamadeh · Georgina Willetts · Loretta Garvey — Octubre 18th 2025 at 19:05

ABSTRACT

Aim

To uncover perspectives and refine 12 initial program theories concerning the implementation of pain management interventions in intensive care units. Contexts enabling implementation are delineated, and causal mechanisms within these contexts are described.

Design

A realist evaluation approach was employed.

Methods

Fourteen purposively selected Australian nurses of variant roles were virtually and individually interviewed between July and September 2023. Participants were presented with initial program theory, and their perspectives were collated. Data were analysed using an integrated approach of context (C), mechanism (M), outcome (O) categorisation coding, CMO configurations connecting and pattern matching.

Findings

Pain management interventions work if perceived to be beneficial, precise, comprehensive and fit for purpose. Nurses should be willing to change attitudes and update knowledge. Unit leaders should nurture the development of nurses' professional identity, access to learning, autonomy and self-determination. Organisations should change the infrastructure, provide resources, mitigate barriers, develop shared mental models, update evidence and institute quality assurance. Adherence to interventions is affected by the outcomes of implementation and intrinsic merits of interventions. In these contexts, confidence is boosted; feelings of empowerment, self-efficacy, reflective motivation, trust, awareness and autonomy are developed; and capacity is built. Furthermore, frustration from the variability of practices is reduced, accountability and ownership are augmented, yielding positive implementation outcomes.

Implications for the Profession

Findings have implications on nurses, team leaders and organisations concerned with implementation.

Impact

The findings provided a fortified understanding of conditions favouring successful implementation of pain management interventions. Actions should be undertaken at an individual, unit and organisation level to ensure successful implementation.

Reporting Method

RAMESES II Reporting Standards for Realist Evaluations informed presentation of study.

Patient or Public Contribution

Intensive care nurses contributed insights to refine the program theory.

☐ ☆ ✇ Journal of Advanced Nursing

Cultivating Compassion in Students for End‐Of‐Life Processes: A Mixed‐Methods Participatory Research Protocol

ABSTRACT

Aims

To analyse the impact of a participatory process of awareness and reflection on compassion, in the face of end-of-life processes, in students aged 12–23 years in six Spanish regions, and to understand how the participatory process can transform their compassion.

Design

Mixed sequential transformative methodology with different phases. In the first phase, a prospective quasi-experimental design with evaluation pre-post in a single group will be adopted. The second phase is the intervention under study, which will consist of a Participatory Action Research with concurrent evaluations.

Methods

In the quantitative phase, 1390 students aged 12–23 from a Public University and a Public Secondary Education Institute across six different Spanish regions will be included. A single questionnaire will be administered before and after the Participatory Action Research to contribute to the process evaluation, incorporating four scales (compassion for others' lives, Death Anxiety Scale, basic empathy modified for adolescents and self-compassion). Responses will be recorded in the Research Electronic Data Capture system. For data analysis, comparison groups, change evolution and associations between variables will be examined, along with multivariate logistic regression models. In the qualitative phase of participatory action research, a promoter group will be established in each university and secondary school in every region. Qualitative data will be analysed following the authenticity, transferability, auditability and neutrality criteria. Discourse analysis triangulation will be conducted to achieve data saturation.

Conclusions

Implementing participative action research in the educational environment to improve students' compassion makes them capable of founding compassion communities to help those who have a terminal illness.

Reporting Method

This study will adhere to the relevant EQUATOR guidelines, such as the Good Reporting of a Mixed Methods Study guideline, to efficiently report its results through the different steps of this mixed-methods study.

Patient or Public Contribution

Participatory action research is a method that enables participants to act as researchers of the phenomenon under study, facilitating the immediate application of results within the context. Although students did not participate in the writing of the proposal grant or the research design.

Trial and Registration

This study registered on Clinical Trials (NCT06310434), was initiated in January 2024, and it will continue up to December 2026.

Nursing Implications

This multicentre study will contribute to the nursing community with an overview of compassion for those at the end of their lives among young people and provide the knowledge needed to cultivate compassion at universities and schools.

Impact

Implementing compassion programmes and death education in the educational environment will empower students to create a compassionate community. The double evaluation of the process will contribute to the qualitative databases.

☐ ☆ ✇ Journal of Clinical Nursing

Navigating the Storm: Exploring Triggers, Preventive Strategies, and Sociocultural Dynamics of Violence in Healthcare Settings—A Cross‐Sectional Study in Damietta Governorate, Egypt

Por: Ateya Megahed Ibrahim · Donia Elsaid Fathi Zaghamir — Octubre 4th 2025 at 12:20

ABSTRACT

Aim

Explore and describe the triggers, preventive strategies, and sociocultural dynamics of violence in healthcare settings, focusing on the experiences and perspectives of nurses Damietta Governorate, Egypt.

Design

A cross-sectional design.

Methods

A stratified random sampling approach was followed to ensure representation from all departments by recruiting 424 nurses from several hospitals in Egypt. Self-administered questionnaires were applied, using validated instruments such as the Hospital Safety Climate Scale, the Coping Strategies Inventory, the Maslach Burnout Inventory, the Perceived Causes of Workplace Violence Questionnaire, and the Workplace Violence Scale to collect data. Data analysis using SPSS version 26 was carried out with descriptive statistics including means and standard deviations. STROBE reporting guidelines were followed.

Results

Nurses had a moderate level of verbal abuse (mean 3.50) and bullying/harassment (mean 3.00) and lesser incidences of physical violence (mean 2.80) and sexual harassment (mean 2.70). The most common cause was perceived as organisational factors (mean 3.80) and then environmental (mean 3.60) and sociocultural (mean 3.40). Problem-focused coping strategies, which were used mostly (mean 3.45), emotional exhaustion (mean 4.20), making the overall burnout level moderate (mean 3.83). The safety climate had positive perceptions concerning management support (mean 3.80), an area needing improvement in safety communication (mean 3.70) and staff training (mean 3.60).

Conclusion

The study underscores the prevalent issues of workplace violence and emotional exhaustion among nurses, highlighting the need for targeted interventions and support systems to address these challenges.

Implications for the Profession and/or Patient Care

Implementing comprehensive support programs, enhancing safety protocols, and focusing on both problem-focused and emotional support strategies are essential for improving nurse well-being and reducing workplace violence. These measures will contribute to a safer working environment and better patient care outcomes.

Impact

What problem did the study address? The study explored and described the high incidence of workplace violence and its impact on nurses' emotional well-being and job satisfaction in Egyptian healthcare settings.

What were the main findings? Prevalent verbal abuse and bullying were noted in the study, with the organisational factors identified as the most important cause. High levels of emotional exhaustion and moderate burnout, coupled with positive but improvable perceptions of safety climate, were reported.

Where and on whom will the research have an impact? Impacts from the research would touch every nurse working in hospitals around the cities of Damietta Governorate in Egypt, including Damietta General Hospital, Central Hospital in Faraskour, Elzarqa General Hospital, and probably other healthcare settings in the locale. It is anticipated that the results will give way to new hospital policies and practices on improving nurse safety and job satisfaction, which could lead to enhanced overall patient care.

Reporting Method

The STROBE checklist was followed.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Professional Self‐Realisation of Diabetes Nurse Practitioners: A Descriptive Study Using Quantitative and Qualitative Data

Por: Bushra Yunis · Pnina Shimoni · Rachel Shental · Orit Waizinger · Miriam Shpigelman · Ilya Kagan — Octubre 1st 2025 at 07:20

ABSTRACT

Introduction

To examine the personal characteristics, promoting factors and organisational barriers to the professional realisation of diabetes nurse practitioners in Israel.

Design

A descriptive study using quantitative and qualitative data.

Methods

The participants self-completed an electronic questionnaire, which included questions on demographic and professional characteristics and a self-realisation questionnaire constructed by the authors. Researcher-led focus groups were conducted, guided by a semi-structured guide. The discussions were recorded, transcribed and analysed by qualitative methods.

Results

Forty-one diabetes nurse practitioners (median age 50 years, 98% females) participated in the study. On average, the participants reported a relatively high self-realisation of their professional role, especially those who have been working in this role for many years. While some of them work independently and are supported by their organisation, their managers and other healthcare team members, specifically physicians, many feel that there are barriers to the full implementation of the role and achieving professional realisation. These include multitasking challenges and insufficient remuneration. Self-realisation was viewed by the participants as an opportunity to provide excellent care to patients as well as being professional beyond caring for patients. They wanted to expand their knowledge as well as guide and teach. Furthermore, they also associated self-realisation with the autonomy to carry out procedures and make decisions independently of physicians. Internal motivation was perceived as an important factor for personal self-realisation, which stems from personal creativity, aspiration for excellence, a subjective sense of freedom, self-guidance, desire for self-development and aspiration for personal growth at the highest levels.

Conclusion

Recognition and fostering of diabetes nurse practitioners' role contribute to nurses' self-realisation and professional growth.

Implications for the Profession

Personal and organisational factors should be aligned to support diabetes nurse practitioners in delivering high-quality care to patients with diabetes.

Reporting Method

COREQ (COnsolidated criteria for REporting Qualitative research).

Patient or Public Contribution

No patient or public contribution.

❌