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To investigate adherence and non-adherence to treatment regimens among heart failure patients and to explore relationships with symptom burden and hospitalisation frequency.
The research employed a cross-sectional survey study design.
The online survey “Living with heart failure”, was conducted among patients attending the Cardiac outpatient clinic at a Swedish University Hospital over the course of a calendar year. Data analysis employed descriptive statistics using the statistical processing program SPSS.
The survey was made accessible to 1395 respondents; 479 individuals participated. The response rate was 34.3%. 73.6% were classified as non-adherent and 26.4% as adherent. Among the non-adherent, a statistically significantly higher symptom burden was observed. Lower hospitalisation frequency was associated with higher adherence and lower symptom burden. Frequent hospitalisations correlated with lower adherence and more severe symptoms.
This study underscores the prevalence of non-adherence in the heart failure population and emphasises the importance of addressing this issue.
Non-adherence to treatment regimens remains a global challenge, historically underestimated and challenging to quantify. Non-adherence to medical treatment in the heart failure population is about 50%; non-adherence from a wider perspective implicates a gap of knowledge. The principal discoveries from this study underscore the extensive non-adherence and its exacerbating effects on symptom burden and hospitalisation. The primary significance of this research will manifest among caregivers in multidisciplinary teams providing support to the heart failure population.
The Equator Guidelines Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were adhered to.
No patient or public contribution.
Teaching nursing theories is essential to structure and guide clinical practice, yet their integration into initial training courses remains a challenge.
To map the educational practices used to teach nursing theories and conceptual models in initial nursing training programmes.
A scoping review.
Is review was conducted following the guidelines of the Joanna Briggs Institute and the PRISMA-ScR. A comprehensive search of five databases and in the grey literature was conducted to find studies from the inception of the databases to January 2024. A total of 32 articles meeting the inclusion criteria were selected for analysis.
The findings reveal a wide variety of educational techniques, ranging from traditional lectures to innovative Methods such as simulation and virtual games. The analysis also shows that these educational practices cover a broad Spectrum of theories, from well-established theories that have stood the test of time, such as watson's, to more recent Theories like the fundamentals of care.
While integrating nursing theories into initial training programmes is crucial, further research is needed to assess the effectiveness of the pedagogical strategies used to teach them. The mapping of educational practices carried out in this review serves as a valuable resource for educators, providing a structured basis to diversify and enrich the teaching of nursing theories.
This scoping review explores for the first time the range of pedagogical practices used in the teaching of nursing theories on an international scale. It provides a valuable resource for educators, allowing them to enrich their pedagogical approach. It offers a structured overview of the various possible methods, thus facilitating the adaptation of teaching strategies to different contexts. This methodological diversity can also serve as a source of inspiration for developing new concepts for teaching disciplinary fundamentals. The renewed interest in teaching disciplinary fundamentals underscores the relevance of this review in the current context.
Through this mapping of pedagogical strategies, this scoping review contributes to improving the quality of teaching nursing disciplinary fundamentals internationally. The results provide a foundation for developing specific courses on nursing conceptual models and theories, offering educators various possibilities to enrich their teaching methods while adapting to local contexts and student needs.
No patient or public contribution. This is a scoping review.
To identify the competencies required for hospital-based WOC nurses to provide direct pressure injury (PI) care in home care settings in Japan.
Mixed methods convergent design.
The qualitative strand used a descriptive design to explore competencies for overcoming barriers faced by hospital-based WOC nurses when providing PI care at home. The quantitative strand used a cross-sectional design to assess competencies in organising the hospital PI management system.
Six competencies were identified: (1) Establish relationships with home healthcare professionals; (2) Promote hospital-based WOC nurse's expertise to home healthcare professionals; (3) Collaborate with the regional medical liaison office in WOC nurse's hospital; (4) Involve hospital administrators in home PI management; (5) Utilise social media/Information and Communication Technology for patient or home-visiting nurse communication; and (6) Utilise public or academic support projects to facilitate home-based activities. The median scoring rate for each medical staff domain on the revised Collaboration Competency Scale for WOC Nurses ranged from 80% to 91%.
The results of this study can serve as a practical resource to help WOC nurses expand their activities into home-care settings.
Their ability to coordinate with staff and manage PI care within hospitals supports active engagement in home care, improving continuity and quality.
This study addressed the issue that many hospital-based WOC nurses cannot visit patients at home. The competencies identified may enable these nurses to expand their role into home care.
This study followed EQUATOR guidelines, with the STROBE Statement applied to the quantitative part and the COREQ checklist to the qualitative part.
Patients or the public were not involved in the study's design, conduct, or reporting.
To explore the process of how nurses experience and deal with workplace violence based on nurses' perceptions and experiences in Iran.
An exploratory qualitative study was conducted using grounded theory approach. Participants included 17 nurses working in 4 hospitals in 2 urban areas in Iran with at least 1 year of clinical experience in emergency departments and intensive care units. Data were collected through in-depth, semi-structured individual interviews conducted between August 2024 and March 2025. The constant comparative analysis approach was used for data analysis. This research method was carried out in five stages: open coding to identify concepts; development of concepts in terms of their characteristics and dimensions; contextual analysis; integration of the process to data analysis; and final category integration.
The main concern of participants in dealing with workplace violence was a ‘multidimensional security threat’. ‘Perpetrator response to nursing care’ (at the individual level) and ‘organisational inefficiency’ (at the organisational level) provided the context for this threat. A general theme entitled ‘tensive adaptation’ was the core category in this research and included four main categories: ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ were the outcomes.
The theoretical model of ‘tensive adaptation’ provides a new perspective on ‘what’ and ‘how’ nurses experience and manage workplace violence. Effective strategies for managing violence such as effective communication, empathy, providing appropriate care, anger management, self-care, effective teamwork and requesting support can be considered by nursing administrators and incorporated into training programmes for nurses and nursing students. The adverse consequences of nurses' exposure to workplace violence should receive greater attention, as the entire healthcare system is affected by this exposure.
Workplace violence leads to physical and psychological problems, reduced job satisfaction, diminished performance, negative effects on personal and family life and decreased quality of patient care. The main concern of participants in dealing with workplace violence was ‘multidimensional security threat’. This concept includes three characteristics: ‘psychological health threats’, ‘physical health threats’ and ‘professional position threat’. ‘Perpetrator response to nursing care’ (individual level) and ‘organisational inefficiency’ (organisational level) served as contextual conditions that expose nurses to workplace violence. In ‘tensive adaptation’, nurses attempt to respond to workplace violence through strategies such as ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ are the consequences of nurses' exposure to workplace violence.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this study.
This study did not include patient or public involvement in its design, conduct, or reporting.
To examine the relationship between weight loss and problems with oral intake in institutionalised older adults.
A 1-year longitudinal observational study.
Data were obtained from a prospective study conducted in three nursing homes and two long-term care facilities in Japan. Participants' problems with oral intake were assessed using items published in 2021 by the Japanese Ministry of Health, Labour and Welfare. Baseline and follow-up factors were compared between individuals who experienced a weight loss of 5% or more and those who did not. Separate multivariable logistic regression models were constructed for each oral intake assessment item to examine its independent association with weight loss of 5% or more, accounting for transitions in each item between baseline and the 1-year follow-up.
In total, 172 institutionalised older adults were included in the analysis. Among them, 57 (33.1%) participants experienced a weight decrease of 5% or more. The emergence of somnolence or clouding of consciousness during meals at the 1-year follow-up in participants without these signs at baseline was independently associated with a weight loss of 5% or more, after adjustment for baseline characteristics.
Recognising signs of somnolence or clouding of consciousness during meals may be useful for the early detection and prevention of weight loss in institutionalised older adults.
Early detection of individuals at risk is essential to prevent significant weight loss and its associated adverse outcomes. Recognising somnolence or clouding of consciousness during meals may enable earlier detection and intervention to prevent weight loss and improve the quality of care for older adults.
Strengthening the Reporting of Observational Studies in Epidemiology.
No patient or public contribution.
Global organizations have pronounced about the importance of involving people in health care, however, this process is challenging. Given the availability of evidence that addresses people's experiences of involvement in nursing care, it is important to produce recommendations at this point by synthesizing the evidence. So, this review aims to synthesize the available qualitative evidence about people's experiences of their involvement in nursing care in a hospital setting.
Systematic review of qualitative evidence.
This systematic review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A comprehensive search strategy was conducted in nine databases/resources. The selection process, methodological quality assessment, and data extraction were conducted independently by two reviewers. The data were synthesized using the meta-aggregation approach, and the results were graded according to ConQual.
A total of 75 findings and 141 illustrations were extracted from the 15 included studies. These findings were aggregated into 12 categories and generated into three synthesized findings: (1) People who are hospitalized conceptualize and attribute importance to involvement in nursing care as an active process of participation and monitoring of care, decision-making, opinion, and partnership; (2) The establishment of a relationship between hospitalized people and nurses, trust, communication, and information are essential for participation in care; (3) People's participation in care is affected by the person's own constraints and preference for assuming a passive role, by barriers associated with a lack of information, the organization of care, the relationship established between nurses, and paternalistic attitudes.
People who were admitted to hospital conceptualized and attached importance to this phenomenon, perceived the conditions necessary to promote it, and the barriers they experienced.
This systematic review provides recommendations for nurses' clinical practice (with grade B). It recommends that nurses should establish a partnership relationship with hospitalized people, through trust, communication and information; give people the opportunity to monitor care, participate in decision-making and give their opinion; assess the person's preferences for involvement and other factors; and that the barriers to this process identified here should be assessed and addressed in each context. As such, this review provides very valuable information for nurses' clinical practice and should also be incorporated into health policy.
Protocol Registration: PROSPERO CRD42024506501.
To achieve an in-depth understanding of the challenges associated with diabetes management when having both schizophrenia and type 2 diabetes, while also identifying the needs for improved diabetes self-care.
The study employed a qualitative explorative design utilizing a phenomenological-hermeneutic inspired approach, involving field observations and individual semistructured interviews.
Data were collected during 2020–2021 through 17 field observations of outpatient consultations and 13 individual semistructured interviews. Data, including field notes and verbatim transcribed interviews, underwent analysis following Ricoeur's interpretive philosophy, encompassing three levels: naïve reading, structural analysis and critical interpretation and discussion. This study adheres to the COREQ guidelines for qualitative research.
Three key themes emerged: ‘Diabetes when life is noisy’, ‘Sacrifices and compromises in life’ and ‘The double silence’. Everyday life is significantly affected when having both schizophrenia and T2D. The mental health state dominates in relation to diabetes self-care and individuals experience challenges balancing between the two conditions. However, there exists a general acknowledgement for diabetes and its long-term complications as a serious medical condition demanding careful attention and treatment.
Self-managing two such complex conditions can be overwhelming and make it difficult for the individual to differentiate symptoms and prioritize diabetes care. Moreover, the existing fragmentation within healthcare systems poses communication challenges, resulting in disjointed patient pathways.
The study emphasizes the need for a holistic re that addresses the physical, emotional and social challenges. There is also a need for increased awareness and education among informal caregivers and healthcare professionals to foster better understanding and support.
Delirium is a common disorder for patients after cardiac surgery. Its manifestation and care can be examined through EHRs. The aim of this retrospective, comparative, and descriptive patient record study was to describe the documentation of delirium symptoms in the EHRs of patients who have undergone cardiac surgery and to explore how the documentation evolved between two periods (2005-2009 and 2015-2020). Randomly selected care episodes were annotated with a template, including delirium symptoms, treatment methods, and adverse events. The patients were then manually classified into two groups: nondelirious (n = 257) and possibly delirious (n = 172). The data were analyzed quantitatively and descriptively. According to the data, the documentation of symptoms such as disorientation, memory problems, motoric behavior, and disorganized thinking improved between periods. Yet, the key symptoms of delirium, inattention, and awareness were seldom documented. The professionals did not systematically document the possibility of delirium. Particularly, the way nurses recorded structural information did not facilitate an overall understanding of a patient's condition with respect to delirium. Information about delirium or proposed care was seldom documented in the discharge summaries. Advanced machine learning techniques can augment instruments that facilitate early detection, care planning, and transferring information to follow-up care. 
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