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☐ ☆ ✇ Journal of Advanced Nursing

Exploring Subjective Cognitive Decline and Its Related Factors Among Young‐Old Adults: A Perspective on Social Network Types

Por: Lilu Wang · Shuting Sun · Chenxi Zhu · Yiqian Tang · Lianlian Zhu · Yechun Gu · Hongbo Xu — Octubre 2nd 2025 at 08:59

ABSTRACT

Aims

To identify distinct social network types among young-old adults based on the characteristics of social network structure and to explore the relationship between different types, socio-demographic characteristics and subjective cognitive decline.

Design

A cross-sectional study was conducted from July 2022 to October 2023.

Methods

A total of 652 young-old adults aged 60–74 years completed the sociodemographic questionnaire, the subjective cognitive decline questionnaire-9 and the self-designed egocentric social network questionnaire. The types of social networks were identified by latent profile analysis. Univariate analysis and binary logistic regression were used to analyse the influencing factors of subjective cognitive decline.

Results

The incidence of subjective cognitive decline was 38%. Social networks of young-old adults tended to be large, predominantly family-centred and characterised by strong contact strength, high density and significant demographic heterogeneity among network members. Four social network types were identified: diverse-moderate, family-dense, family-strong and friend-loose. Young-old adults embedded in the family-dense and family-strong types were more likely to develop subjective cognitive decline than those in the diverse-moderate type. Additionally, age, education level, previous occupation, daily sleep duration and exercise were related to the incidence of subjective cognitive decline.

Conclusions

The findings highlight the relatively high incidence of subjective cognitive decline in young-old adults that is notably influenced by the type of social network they are embedded in. More attention needs to be paid to identifying and supporting young-old adults at high risk of subjective cognitive decline, especially to promote their social integration and friend network building, to improve their subjective cognitive function.

Implications for the Profession and/or Patient Care

The findings emphasise the importance of considering the structure and composition of social networks when addressing subjective cognitive decline among young-old adults. A diversified social network incorporating both familial and friendship ties may provide enhanced cognitive protection. Therefore, interventions targeting subjective cognitive decline should promote the expansion of friendship-based relationships and foster the development of more heterogeneous and multi-source networks.

Reporting Method

STROBE checklist.

Patient or Public Contribution

Not applicable.

☐ ☆ ✇ 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.

☐ ☆ ✇ Journal of Advanced Nursing

Investigating Healthcare Educators' Interprofessional Socialisation Following an Interprofessional Simulation Facilitator Training Programme: A Mixed Methods Study

Por: Sara Dolan · Lorelli Nowell · Nancy Moules · Alyshah Kaba · Meredith Brockway — Octubre 1st 2025 at 07:20

ABSTRACT

Aim

Interprofessional socialisation can contribute to collaborative patient care. Although there is research regarding interprofessional socialisation of healthcare students and frontline staff, there is limited literature regarding healthcare educators in practice settings. Our aim was to examine interprofessional socialisation of healthcare educators in the practice setting following an interprofessional simulation facilitator training programme.

Design

Explanatory sequential mixed methods study.

Methods

Quantitative provincial simulation programme evaluation data from 2022 and 2023 (n = 87) were analysed and used to inform qualitative interviews (n = 17). Qualitative and quantitative data were integrated following independent analysis.

Results

There was a statistically significant increase in attitudes toward interprofessional socialisation following the simulation facilitator training programme. Qualitative findings revealed themes regarding interprofessional socialisation: (a) benefits gained through interprofessional socialisation, (b) interprofessional, uniprofessional or both, (c) facilitators to interprofessional socialisation, (d) barriers to interprofessional socialisation and (e) opportunities to strengthen interprofessional socialisation.

Conclusion

Despite positive views of interprofessional socialisation, socialisation behaviours may not be consistent in a variety of contexts. Interprofessional education may increase interprofessional socialisation among educators.

Implications for the Profession

It is important to provide interprofessional socialisation opportunities for educators to promote more interprofessional education initiatives.

Impact

The findings of this study provided insights into how to foster interprofessional socialisation in existing structures and how new pathways might be built to connect educators.

Reporting Method

This study is reported in congruence with the Journal Article Reporting Standards—Mixed Methods, Quantitative, and Qualitative Standards provided on the Equator Network.

Public Contribution

Members of the provincial simulation team were consulted regarding study design and data collection to optimise participation.

☐ ☆ ✇ Journal of Advanced Nursing

Barriers and Enablers to Pre‐Registration Nurses Providing Safe Care for Individuals Experiencing Suicidal Distress: A Scoping Review

Por: Renee Molloy · Brent Hayward · Samantha Scott · Alison Hansen · Adam Searby — Octubre 1st 2025 at 07:19

ABSTRACT

Aims

To identify research gaps by mapping what is known about the barriers and enablers to pre-registration nursing students identifying signs of suicidal distress in healthcare consumers and providing clear pathways of support.

Design

Scoping review.

Methods

This scoping review was conducted using Arksey and O'Malley's (2005) five stage framework and the Levec et al. (2010) extensions of this framework.

Data Sources

The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete and Ovid MEDLINE databases were searched to identify relevant articles, keywords and search terms to inform the full search strategy for CINAHL. This search strategy was then adapted for Scopus, PsychInfo, Emcare, Medline and ERIC, searched in November 2024.

Results

Studies eligible for inclusion (N = 28) represented research from 14 countries; most (53.5%, n = 15) used a quantitative design, 11 (39.3%) were qualitative and two (7.1%) used a mixed-methods design. Barriers found from the scoping review included a low level of knowledge of suicidality, stigma preventing students from assessing and acting on suicidal ideation, and a lack of confidence in providing care to healthcare consumers expressing suicidality. Enablers included lived experience, exposure to individuals expressing suicidal ideation and education, simulation and role play. This review also contributes to the existing literature about the relationship of nursing to existing suicide prevention frameworks and suggests revision of these frameworks to address staff attitudes and beliefs, as well as lived and living experience.

Conclusion

Nurses are ideally placed to assess and respond to suicidality among healthcare consumers, and preparation should begin during pre-registration studies. Our scoping review indicates that further research work is needed to address the barriers to working with healthcare consumers expressing suicidality and to enhance the enablers to provide safe care.

Implications for the Profession and/or Patient Care

Addressing the barriers and enablers to pre-registration nursing students providing safe care for healthcare consumers expressing suicidality is essential. Further research is required to address the barriers and enhance the enablers identified in this scoping review.

Impact

What problem did the study address? This scoping review summarised the literature on pre-registration student ability to work with healthcare consumers expressing suicidality, identifying barriers and enablers. What were the main findings? Barriers include poor knowledge of suicidality, stigma, fear and a lack of confidence in working with healthcare consumers expressing suicidality. Enablers include lived experience, exposure to clinical settings where healthcare consumers express suicidality and simulation and education. Where and on whom will the research have an impact? The research will have an impact on providers of pre-registration nursing degrees, where the inclusion of content addressing suicidality and exposure to settings where individuals express suicidal ideation is shown to improve attitudes and knowledge of suicidality assessment.

Reporting Method

PRISMA checklist for scoping reviews.

Patient or Public Involvement

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

☐ ☆ ✇ Journal of Advanced Nursing

The Symptoms and Impacts Experienced by Healthcare Professionals as Second Victims After a Safety Incident: A Scoping Review

Por: Laura Jukarainen · Sanu Mahat · Saija Koskiniemi · Tiina Syyrilä · Albert W. Wu · Virpi Jylhä · Marja Härkänen — Octubre 1st 2025 at 07:08

ABSTRACT

Aim

This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.

Design

Scoping review.

Methods

JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.

Data Sources

The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.

Results

A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.

Conclusions

This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.

Implications for the Profession and/or Patient Care

By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.

Impact

The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.

Patient or Public Contribution

No patient or public contribution.

Protocol Registration

Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1

☐ ☆ ✇ Journal of Advanced Nursing

The Experiences of Women With Polycystic Ovary Syndrome of the Healthcare They Receive: A Qualitative Systematic Review

Por: Baoying Zhang · Joan Lalor — Octubre 1st 2025 at 05:30

ABSTRACT

Background

More than 12% of women worldwide are affected by polycystic ovary syndrome (PCOS), whose symptoms are similar to those of puberty, often leading to delayed diagnosis and missing the opportunity for early intervention. This not only puts PCOS women under physical and mental stress but also reduces their trust in doctors and makes them dissatisfied with the healthcare they receive, which in turn affects their quality of life. Therefore, to improve the doctor-patient relationship and promote health, it is essential to investigate and understand the healthcare experiences that women with polycystic ovary syndrome (PCOS) receive.

Aim

To explore the experiences of women with PCOS when they receive healthcare.

Design

Qualitative systematic review.

Methods

Data were collected and screened using the systematic review management system Covidence, based on the established inclusion criteria. The Critical Appraisal Skills Programme Checklist was used for critical appraisal, and thematic analysis was used for data analysis.

Data Sources

The databases searched included CINAHL, MEDLINE, PsycINFO, and Scopus. The search was limited to studies published in English between 2002 and May 2024.

Results

Seven studies were selected for final inclusion. Three themes were identified: (1) responsive care from healthcare practitioners, (2) managing polycystic ovarian syndrome, and (3) polycystic ovary syndrome and its impact on self-image.

Conclusion

The development of a multidisciplinary PCOS clinic, the establishment of online support groups, and the creation of comprehensive patient-centered treatment plans are vital to enhancing the health outcomes of women with PCOS.

Impact

Multidisciplinary PCOS clinics, online support groups, and comprehensive patient-centered treatment plans can improve health outcomes for women with PCOS.

Reporting Method

The EQUATOR guidelines for PRISMA have been utilised.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Weight Stigma and Nurse Wellness: A Call to Action

Por: Stephanie Moore — Octubre 1st 2025 at 05:25
Journal of Advanced Nursing, EarlyView.
☐ ☆ ✇ Journal of Advanced Nursing

On the Move to Surgery: A Scoping Review of Patient‐Reported Outcomes for Preoperative Walking Into the Operating Theatre

ABSTRACT

Introduction

Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.

Aim

In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.

Design

This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.

Methods

Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.

Data Sources

Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.

Results

Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.

Conclusion

Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.

Patient or Public Contribution

No patient or public involvement.

☐ ☆ ✇ Journal of Advanced Nursing

International Competencies of Advanced Practice Nurses in Critical Care: An Integrative Review

Por: Verena‐Katrin Buchner · Kathrin Pann · Roland Essl‐Maurer · Manela Glarcher · Andre Ewers — Septiembre 29th 2025 at 12:39

ABSTRACT

Aim

This review explores the roles, competencies, and scope of practice of APNs in critical care based on international literature. It also derives implications for the development of advanced nursing roles in Austria.

Design

Integrative review.

Data Sources

The research team conducted a systematic search of PubMed, CINAHL, and Web of Science to identify relevant peer-reviewed publications from 2007 to 2023.

Review Methods

A systematic search of electronic databases was undertaken, following Whittemore and Knafl's five-step methodology. The included publications met the defined inclusion criteria and were appraised for quality using the Joanna Briggs Institute critical appraisal checklists. Relevant data were extracted and thematically analysed.

Results

The analysis of 14 international studies revealed recurring themes related to APN core competencies and scope of practice in critical care. These were structured according to Hamric's model. However, Austria faces several challenges, including limited legal frameworks, missing educational structures, and a lack of role clarity. These factors hinder the implementation of APN roles.

Conclusions

Internationally, APNs demonstrate advanced clinical skills, provide leadership in team-based care, and integrate evidence-based practice. These attributes enhance patient outcomes and system efficiency. In Austria, restrictive regulations, limited education, and unclear roles hinder these competencies. Reform is needed to align with international standards, and further research should explore their implementation in Austria.

Implications

A gap exists between internationally demonstrated APN competencies and the current state of advanced nursing practice in Austria. This highlights the need for clearer role definitions, regulatory frameworks, and educational strategies. Addressing this gap would strengthen APN roles and improve healthcare quality. This study highlights the need to bridge this disparity.

Reporting Method

This review follows the PRISMA 2020 guidelines for systematic reviews Page et al. (2021).

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Master's Degree Nurses: A Mixed‐Methods Study on Supply, Demand, and Utilisation

Por: Zeming Zhuang · Huiling Nong · Mingzhe Zhang · Xuhao Guo · Longfei Ji · Wenjie Deng · Lifang Zhang — Septiembre 29th 2025 at 12:35

ABSTRACT

Aims

To assess the supply, demand, and utilisation of master's degree nurses in China's top-tier hospitals and identify recruitment and retention challenges.

Design

A convergent parallel mixed-methods design.

Methods

From January and September 2022, eight top-tier hospitals in mainland China were selected using convenience sampling. The proportion of master's degree nurses, turnover rates, and recruitment outcomes were investigated and analysed using descriptive statistics. Concurrently, seven nursing administrators from these eight hospitals were interviewed using semi-structured interviews, and transcribed data were thematically analysed through inductive content analysis.

Results

Among the eight hospitals surveyed, the average proportion of master's degree nurses was 3.58% (range: 0.58%–9.43%). The average ratio of planned to actual recruitment was 3.28, with four hospitals showing near parity (approximately 1:1) and three institutions failing to recruit any master's degree nurses. The annual turnover rate of master's degree nurses was 1.18%. Three themes emerged from the qualitative analysis: (1) shortages coexisting with oversupply; (2) nursing leaders' retention efforts versus limited institutional policy support; and (3) prioritisation of research and management over advanced clinical roles.

Conclusion

In China, even among top-tier hospitals, the proportion of master's degree nurses remains relatively low. There is an overall shortage of these nurses, juxtaposed with localised oversupply in specific institutions. Promotion to nursing supervisor or administrative roles is the only developmental pathway, while structured career progression pathways for advanced nursing practice remain conspicuously absent.

Implications for the Profession and/or Patient Care

The study highlights the need to develop targeted policies that support the career advancement of master's degree nurses, particularly by expanding career options in Advanced Practice Nurses (APNs) rather than limiting roles to nursing management or education. This shift would better leverage their clinical expertise and strengthen healthcare systems through specialised practice and innovation.

Impact

What problem did the study address?: This study maps the supply–demand dynamics of master's degree nurses in leading hospitals and identifies retention, utilisation, and motivation policies and strategies from the perspective of nursing administrators. What were the main findings?: The proportion of master's degree nurses is low in China's top hospitals. There is both an oversupply and a shortage of master's degree nurses. Neither the government nor hospitals have policies in place to encourage the clinical involvement of master's degree nurses, and their career progression is limited to managerial roles. Where and on whom will the research have an impact?: Nursing administrators and other health policy makers in China and comparable global health systems will be affected. It will also influence nursing associations, nursing educators, and general nurses.

Reporting Methods

This study adhered to the Mixed Methods Article Reporting Standards.

Patient or Public Contribution

No contributions from patients or the public were involved in this study.

☐ ☆ ✇ Journal of Advanced Nursing

Stemming the Tide: Tackling Retention and Attrition Challenges in Rural and Northern Healthcare to Sustain Canada's Nursing Workforce

Por: Andrea Raynak · Vanessa Mihaljevic · Brianne Wood · Hunter Polonoski · Shawn Seagris — Septiembre 29th 2025 at 12:30

ABSTRACT

Aim

This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.

Design

This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.

Methods

An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.

Results

Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.

Conclusion

This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.

Impact

The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.

Patient or Public Contribution

No patient or public contribution.

Implications for the Profession and/or Patient Care

This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.

Reporting Method

This study is reported according to STROBE guidelines.

☐ ☆ ✇ Journal of Advanced Nursing

Perspectives of Healthcare Professionals, Patients and Family Members on Managing Regular Medications Across the Perioperative Pathway: An Exploratory Qualitative Study

Por: Atefeh Mehrabifar · Elizabeth Manias · Thomas E. Poulton · Bernhard Riedel · Janelle Penno · Patricia Nicholson — Septiembre 29th 2025 at 12:29

ABSTRACT

Aim

To explore healthcare professionals', patients', and family members' experiences of managing regular medications across the perioperative pathway in a specialist cancer hospital in Melbourne.

Design

An exploratory qualitative study using a descriptive-interpretive approach.

Methods

Interviews were conducted with 11 patients and seven family members, and focus groups with 10 anaesthetists, seven surgeons, four nurses, and 10 pharmacists (N = 49) between October 2024 and April 2025. Transcripts were analysed using Braun and Clarke's reflexive thematic approach and mapped into the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 human factors framework.

Results

Three interrelated themes were constructed: (1) Work system elements shaping perioperative medication management, encompassing medication and surgical contexts, documentation gaps, reliable medication information, communication infrastructures, roles and responsibilities, and perioperative area resources; (2) Processes influencing medication management practice, characterised by continuity of care at transition points and flagging processes, interdisciplinary collaboration and role interpretation in medication management, patient involvement, family member involvement, and healthcare professional perspectives; and (3) Outcomes of medication management, including patient and organisational outcomes, such as workflow inefficiencies, procedure cancellations, and unplanned readmissions.

Conclusion

Findings indicated that addressing the complexity of perioperative medication safety demands coordinated contributions across multiple professional disciplines. Strengthening interdisciplinary collaboration, clarifying shared responsibilities, embedding structured reconciliation processes at transitions of care, standardizing communication protocols, and involving patients and families are all critical strategies.

Implications for the Profession and/or Patient Care

This study highlights the need for interdisciplinary coordination and clear role definitions, with nurses as the key contributor, to support collaborative medication decisions in perioperative cancer care.

Impact

This study explored challenges in managing regular medications during cancer surgery, offering insights to guide safer practices for perioperative teams, patients, and families in cancer care settings.

Reporting Method

COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.

Patient or Public Contribution

None.

☐ ☆ ✇ Journal of Advanced Nursing

Emotions in Nursing Care Prioritisation Decisions: A Critical Incident Debriefing Study of Missed Nursing Care

Por: Mirit Cohen · Yosur Massalha · Anat Drach‐Zahavy · Einav Srulovici — Septiembre 29th 2025 at 12:23

ABSTRACT

Aim

To examine the decision-making processes underlying missed nursing care.

Design

A qualitative study using Critical Incident Debriefing interviews.

Methods

Fifteen nurses from inpatient wards in a general hospital participated in semi-structured interviews following their morning shifts. Interviews focused on care prioritisation incidents leading to missed nursing care. Data were analysed using thematic analysis.

Results

Analysis revealed a central theme of emotions as crucial determinants in care prioritisation decisions. Two subthemes emerged: emotions as drivers of care prioritisation decisions and emotions as responses to these decisions. Positive emotions motivated nurses to prioritise care for specific patients, while negative emotions sometimes led to care delays. Successful care completion generated professional satisfaction, while care omissions produced complex emotional responses, including guilt, frustration and helplessness.

Conclusion

The dual emotional processes identified in this study—emotions functioning as both drivers and responses in care decisions—challenge purely structural explanations of missed nursing care. This perspective reframes nurses as emotionally engaged decision-makers who actively navigate care priorities rather than passively react to contextual constraints, offering a more comprehensive framework for understanding the complexity of clinical judgement in real-world settings.

Implications for the Profession and/or Patient Care

This study positions emotions as legitimate components of clinical decision-making rather than cognitive biases. For nursing practice, this necessitates integrating emotional awareness into professional development. For patient care, recognising emotional underpinnings may promote equitable care distribution through interventions that engage with the emotional realities of nursing work.

Impact

This study addressed limited understanding of decision-making in missed nursing care, particularly emotions' role. Findings reveal how emotions influence nurses' prioritisation decisions and wellbeing, with implications for nurses, educators and administrators seeking interventions addressing structural and emotional dimensions.

Reporting Method

This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines (Appendix S1).

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Perceptions of Recurrence Risk Among Patients With Atrial Fibrillation: A Qualitative Study

Por: Yunxia Li · Jing Lu · Zhanhong You · Xiu Tao · Fan Wu · Yue Zhu · Xiaoran Chen · Guozhen Sun — Septiembre 29th 2025 at 12:20

ABSTRACT

Aims

The study aims to investigate patients' perceptions of recurrence risk associated with atrial fibrillation, with the goal of establishing a theoretical foundation for developing future measurement scale and intervention strategies.

Design

A qualitative interview study.

Methods

Seventeen patients diagnosed with atrial fibrillation at a Grade-A tertiary hospital participated in semi-structured, in-depth interviews conducted between October and December 2024. Participants were selected via purposive sampling. The data were analysed employing thematic analysis in accordance with Colaizzi's method. The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.

Results

The perceptions of recurrence risk among patients with atrial fibrillation can be summarised into five themes: (1) perceived likelihood of recurrence, (2) perceived severity of recurrence, (3) perceived triggers of recurrence, (4) emotional reaction to recurrence, and (5) efficacy perception of managing recurrence risk.

Conclusion

Perceptions of recurrence risk among patients with atrial fibrillation are diverse and often underestimated due to limited knowledge and subjective symptom interpretation, affecting health behaviours. Understanding patients' subjective appraisals, emotions, and perceived efficacy is essential. Validated assessment tools and tailored risk communication may enhance self-management and support targeted interventions.

Impact

This study provides critical insights into how atrial fibrillation patients perceive their risk of recurrence. It also provides a theoretical foundation for creating validated assessment tools and tailoring individualised health education and intervention programmes.

Patient Contribution

Patients were involved in the study design, data collection, and interpretation of findings. Their contributions included providing feedback on the initial interview guide to ensure relevance and clarity, participating in in-depth interviews to share their lived experiences with atrial fibrillation recurrence, and offering reflections on key themes emerging from the data.

☐ ☆ ✇ Journal of Advanced Nursing

The Relationship Between Chinese Nurses' Subjective Age and Career Satisfaction: The Mediating Role of Role Breadth Self‐Efficacy

Por: Zhaoping Liu · Siyao Ni · Qunli Zeng · Liuyi Zhang · Xiaojing Dai · Huifang Lu · Jie Zheng · Suyu Luo — Septiembre 29th 2025 at 12:15

ABSTRACT

Aim(s)

To assess career satisfaction among Chinese nurses, explore influencing factors, and examine the mediating role of role breadth self-efficacy (RBSE) in the relationship between subjective age and career satisfaction.

Design

A multi-centre, cross-sectional study.

Methods

Between June and October 2024, 2033 questionnaires were distributed to nurses across seven geographic regions in China, collecting data on demographics, subjective age, RBSE, and career satisfaction. Descriptive statistics, Pearson correlation analysis, multiple linear stepwise regression, and path analysis were used to identify determinants of career satisfaction and test the mediating effect of RBSE.

Results

The effective response rate was 97%. Chinese nurses reported moderate-to-high career satisfaction, younger subjective age relative to chronological age, and moderate RBSE levels. Multivariate linear regression analysis identified education level, work institution, salary, weekly working hours, subjective age, and RBSE as significant predictors of career satisfaction. Path analysis revealed a significant negative association between subjective age and career satisfaction (β = −0.23, p < 0.001), which was partially mediated by RBSE (indirect effect = −0.11, 95% CI: −0.18 to −0.05).

Conclusions

The career satisfaction of Chinese nurses is at a moderately high level; the influencing factors include the intensity of nursing work and salary levels. There is a certain difference between the subjective age and the chronological age of Chinese nurses. RBSE partly mediates the relationship between subjective age and career satisfaction.

Implications for the Profession and/or Patent Care

Valuing the breadth of nurses' roles, self-efficacy, and subjective age may help improve job satisfaction.

Impact

What problem did the study address?: This study elucidates the present level of career satisfaction among nurses in China and the variables affecting it. What were the main findings?: The subjective age of Chinese nurses influences career satisfaction, with RBSE partly mediating the connection between subjective age and career satisfaction. Where and on whom will the research have an impact?: This study presents novel variables of subjective age and RBSE in the investigation of factors influencing career satisfaction among Chinese nurses, offering new avenues for enhancing career satisfaction in this demographic in the future.

Reporting Method

We adhered to STROBE guidelines for cross-sectional research.

Patient or Public Contribution

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

☐ ☆ ✇ Journal of Advanced Nursing

The Mediating Role of Death Coping Between Moral Resilience and Vicarious Posttraumatic Growth Among ICU Nurses

Por: Ting Ye · Yunman Huang · Yi Chen · Yu Ni · Xuantong Zhang · Baomei Song · Junao Lan · Liguo Feng · Changjun Liao · Zheng Yang — Septiembre 29th 2025 at 12:03

ABSTRACT

Aim

This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.

Study Design

A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.

Methods

Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.

Results

Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.

Conclusion

Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.

Impact

This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.

☐ ☆ ✇ Journal of Advanced Nursing

Evaluation of Nurses' Perceptions and Readiness for Artificial Intelligence Integration in Healthcare: A Cross‐Sectional Study in Turkey

Por: Orkun Erkayıran · Rahime Aslan — Septiembre 27th 2025 at 07:30

ABSTRACT

Aim

To determine the perceptions and readiness of nurses regarding the integration of artificial intelligence (AI) into healthcare services.

Design

A descriptive cross-sectional study.

Methods

Data were collected from 388 nurses across Turkey using an online questionnaire designed to gather sociodemographic information, perceptions (measured by attitudes) and readiness (assessed by AI knowledge and confidence) toward artificial intelligence. Statistical analyses, including independent t-tests and ANOVA, were used to examine group differences. The study adhered to ethical principles and followed the STROBE Statement guidelines for cross-sectional research.

Results

Findings revealed that nurses' knowledge of AI in healthcare was generally limited, though many participants expressed optimism about its potential to improve efficiency, enhance patient care quality and alleviate nurse burnout. However, concerns about patient privacy and ethical challenges were identified as significant challenges to AI integration in healthcare settings.

Conclusion

The study underscores that while nurses recognise the potential benefits of AI, there is a significant need to address their limited knowledge and concerns regarding ethical and privacy issues. Educational initiatives and ethical frameworks are essential to facilitate AI's successful implementation in nursing practice.

Impact

This study emphasises the necessity of incorporating AI-related education into nursing curricula and highlights the importance of developing policies that mitigate ethical challenges, thereby preparing nurses for a future that integrates AI into patient-centred care.

Patient or Public Contribution

The study involved practicing nurses as participants to provide real-world insights into their perceptions and readiness for AI in healthcare, ensuring that findings reflect the practical implications of AI integration in clinical settings.

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