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The aim was to validate the stoma self-efficacy scale and assess the psychometric properties of the Czech version of the scale in patients with intestinal stoma. Another aim was to assess self-efficacy in patients with intestinal stoma.
Descriptive, cross-sectional and validation study.
Two hundred and ninety patients with intestinal stoma participated in the study during 2023. The original SSES instrument was linguistically validated into Czech. Content validity of the scale, test–retest, intraclass coefficient, Cronbach's alpha, McDonald's ω, construct and convergent validity were assessed for psychometric properties. The study followed STROBE guidelines.
The stoma self-efficacy scale was adopted into Czech, demonstrating excellent content validity. An intraclass correlation coefficient was calculated to establish test–retest reliability, showing excellent reliability of the Czech version. Cronbach's alpha and McDonald's ω showed high reliability. Factor analysis was applied for construct validity. Exploratory factor analysis was used to extract three factors on the Czech version of the scale: Stoma care self-efficacy, social self-efficacy and burden self-efficacy. The factors accounted for 62.05% of the total variance and showed strong internal consistency. Confirmatory factor analysis was applied separately to the data of respondents with colostomy and respondents with ileostomy. The fit indices were satisfactory for respondents with colostomy after adjustment. The composite reliability coefficient showed acceptable values in each factor.
The Czech version of the stoma self-efficacy scale has excellent psychometric properties in patients with intestinal stoma. It is a reliable tool for use in patients with intestinal stoma to assess self-efficacy. The scale can also be used by nurses who care for these patients and based on this, meet the individual needs related to patients' self-efficacy.
To develop theories about how Nursing Associate (NA) roles are implemented and working within NHS practice: What works, for whom, in what contexts and how?
Rapid realist synthesis of: (1) empirical and grey literature; (2) realist interviews with stakeholders. Sources were analysed using a realist approach that explored the data for novel or causal insights to generate initial programme theories.
Empirical and grey sources (n = 15) and transcripts from stakeholder interviews (n = 11) were synthesised which identified three theory areas relating to NA implementation: (1) Scope of NA role: Communication and expectations; (2) Variations to the NA model of working; and (3) Career progression: Entry point, stepping stone and career in itself.
The NA holds the potential to improve nursing workforce stability by encouraging locally based, non-registered healthcare staff to transition to an NA. However, the lack of collective understanding of the NA scope of practice can cause staff friction. It is unknown whether this friction will reduce over time or if staff divisions will lead to further deterioration of the workforce.
Ongoing clear communication regarding NA scope of practice needs to be provided to aid understanding of their supplementary role and its potential contribution to nursing teams.
This work represents a first step to support both researchers and nursing workforce leaders in furthering knowledge of the impact of integrating NAs in diverse healthcare contexts and to unearth the mechanisms underpinning the success or failure of this new role.
Realist and meta-narrative evidence syntheses: Evolving standards.
Planning of the research design and interpretation of the results was completed with nurse clinicians with experience in the NA role.
This study aimed to develop and validate a standardised transitional care programme for postoperative gynaecologic cancer patients utilising the Omaha system framework.
A preliminary transitional care programme was constructed through literature review, semi-structured interviews and multidisciplinary team discussions. The programme was refined via two rounds of Delphi expert consultations involving 17 oncology nursing specialists. Consensus criteria included expert authority coefficient (Cr), Kendall's W test and coefficient of variation (CV).
The Delphi consultation demonstrated robust expert consensus, with high authority coefficients (Cr: 0.886 in Round 1; 0.906 in Round 2), exceptional participation rates (88.2% and 100% response rates across two rounds) and statistically significant concordance as evidenced by Kendall's W values (0.233–0.358 and 0.326–0.383; all p < 0.01). All coefficients of variation (CV) metrics fell within acceptable ranges (0.09–0.42 in the initial phase; 0.08–0.27 post-refinement).
The Omaha system-based transitional care programme exhibits strong expert consensus, scientific rigour and clinical applicability, providing a structured approach to improving postoperative recovery in gynaecologic cancer patients.
This protocol standardises postoperative care transitions for gynaecologic oncology patients by integrating multidimensional assessments (physiological, psychosocial and health behaviour domains) and family-centred education. Clinicians can utilise its evidence-based framework to reduce preventable complications, enhance caregiver preparedness and improve continuity of care between hospital and home settings.
Six postoperative gynaecologic cancer patients and eight family caregivers participated in semi-structured interviews to identify unmet transitional care needs. Their insights informed the design of intervention components, including self-management education and psychosocial support strategies. Patients reviewed draft materials for clarity and cultural appropriateness during Delphi Round 2.
The aim of this integrative review is to critically appraise and synthesise empirical evidence on the clinical applications, outcomes, and implications of generative artificial intelligence in nursing practice.
Integrative review following Whittemore and Knafl's five-stage framework.
Systematic searches were performed for peer-reviewed articles and book chapters published between 1 January 2018 and 30 June 2025. Two reviewers independently screened titles/abstracts and full texts against predefined inclusion/exclusion criteria focused on generative artificial intelligence tools embedded in nursing clinical workflow (excluding nursing education-only applications). Data were extracted into a standardised matrix and appraised for quality using design-appropriate checklists. Guided by Whittemore and Knafl's integrative review framework, a constant comparative analysis was applied to derive the main themes and subthemes.
CINAHL, MEDLINE, and Embase.
Included literature was a representative mix of single-group quality improvement pilots, mixed-method usability and feasibility studies, randomised controlled trials, qualitative descriptive and phenomenological studies, as well as preliminary and proof-of-concept observational research. Four overarching themes emerged: (1) Workflow Integration and Efficiency, (2) AI-Augmented Clinical Reasoning, (3) Patient-Facing Communication and Education, and (4) Role Boundaries, Ethics and Trust.
Generative artificial intelligence holds promise for enhancing nursing efficiency, supporting clinical decision making, and extending patient communication. However, consistent human validation, ethical boundary setting, and more rigorous, longitudinal outcome and equity evaluations are essential before widespread clinical adoption.
Although generative artificial intelligence could reduce nurses' documentation workload and routine decision-making burden, these gains cannot be assumed. Safe and effective integration will require rigorous nurse training, robust governance, transparent labelling of AI-generated content, and ongoing evaluation of both clinical outcomes and equity impacts. Without these safeguards, generative artificial intelligence risks introducing new errors and undermining patient safety and trust.
PRISMA 2020.
To examine residential aged care staff's experience of death and grief, and their support needs.
A mixed-methods sequential explanatory design, using an online cross-sectional survey that included the Texas Revised Inventory of Grief and the Grief Support in Health Care Scale. Followed by semi-structured interviews with direct care workers and managers working in residential aged care homes were conducted.
Over 60% of participants experienced five or more resident deaths in the previous 12 months. Although, different levels of grief were experienced among different roles, the importance of open communication and opportunities for farewells after resident death was highlighted. Participants suggested support and education to normalise grief and promote self-care.
Recognising staff grief following the resident death is important. Providing support and education may help improve staff wellbeing and contribute to the delivery of high-quality care for both residents and their families.
Staff grief after a resident death needs to be recognised, and continuing education and support are required for their wellbeing.
The STROBE and SRQR checklists were applied.
No Patient or Public contribution.
The use of technology to support nurses' decision-making is increasing in response to growing healthcare demands. AI, a global trend, holds great potential to enhance nurses' daily work if implemented systematically, paving the way for a promising future in healthcare.
To identify and describe AI technologies for nurses' clinical decision-making in healthcare settings.
A systematic literature review.
CINAHL, PubMed, Scopus, ProQuest, and Medic were searched for studies with experimental design published between 2005 and 2024.
JBI guidelines guided the review. At least two researchers independently assessed the eligibility of the studies based on title, abstract, and full text, as well as the methodological quality of the studies. Narrative analysis of the study findings was performed.
Eight studies showed AI tools improved decision-making, patient care, and staff performance. A discharge support system reduced 30-day readmissions from 22.2% to 9.4% (p = 0.015); a deterioration algorithm cut time to contact senior staff (p = 0.040) and order tests (p = 0.049). Neonatal resuscitation accuracy rose to 94%–95% versus 55%–80% (p < 0.001); seizure assessment confidence improved (p = 0.01); pressure ulcer prevention (p = 0.002) and visual differentiation (p < 0.001) improved. Documentation quality increased (p < 0.001).
AI integration in nursing has the potential to optimise decision-making, improve patient care quality, and enhance workflow efficiency. Ethical considerations must address transparency, bias mitigation, data privacy, and accountability in AI-driven decisions, ensuring patient safety and trust while supporting equitable, evidence-based care delivery.
The findings underline the transformative role of AI in addressing pressing nursing challenges such as staffing shortages, workload management, and error reduction. By supporting clinical decision-making and workflow efficiency, AI can enhance patient safety, care quality, and nurses' capacity to focus on direct patient care. A stronger emphasis on research and implementation will help bridge usability and scalability gaps, ensuring sustainable integration of AI across diverse healthcare settings.
Post-intensive care syndrome (PICS) is defined as mental, physical, cognitive, and social sequelae in survivors of critical illness. Survivors of liver transplantation exhibit a complex clinical condition following discharge from the intensive care unit (ICU). There is a lack of knowledge about the lived experience of PICS in survivors after liver transplantation.
Describe the lived experiences of PICS in ICU survivors following liver transplantation.
A phenomenological study was carried out using interpretative phenomenological analysis (IPA). Semi-structured interviews were conducted with ICU survivors one month after discharge.
Twenty ICU survivors were enrolled and interviewed after critical illness. The main themes that emerged from the data analysis were: (1) Profound life reorientation, (2) Physical impairment, (3) Psychological distress experiences, (4) Human-Centred Nursing Care, and (5) Return to daily life. Our results showed a particular impact of the dimensions of PICS, such as mental, physical, and social dimensions, on ICU survivors after liver transplantation.
The study concludes that ICU survivors experience profound life reorientation, physical impairment, and psychological distress experiences, yet benefit from human-centred nursing care, which facilitates their eventual return to daily life.
The findings highlight the importance of human-centred nursing care in the post-ICU recovery process, where the multidisciplinary team plays a critical role in addressing both psychological distress and physical rehabilitation, supporting survivors' reintegration into daily life.
Post-liver transplant ICU survivors experience profound physical, psychological, and social impacts. Life reorientation, altered body image, and emotional distress emerge. Human-centred nursing facilitates rehabilitation, reintegration, and overall recovery.
Reporting was structured based on the COREQ checklist.
Prot. N. 00014635–31/05/2023
To explore the caregiving experiences and support needs of fathers of children with medical complexity in Canada.
A qualitative study guided by interpretive description methodology and informed by a Gender-Based Analysis Plus (GBA+) lens.
Data were collected through 60-min semi-structured interviews with seven fathers of children with medical complexity and analyzed using thematic analysis. The study followed the COREQ guidelines and checklist.
Thematic analysis identified fathers' key roles as financial providers, hands-on caregivers, and as playing a key role in supporting their partners emotionally with the challenges of caregiving. Fathers prioritised the need for peer support, flexible workplace policies and improved access to mental health services.
The findings indicate that there is a critical need for more inclusive and flexible support systems and workplace policies that acknowledge and accommodate the important caregiving roles of fathers of children with medical complexity.
The implications for healthcare professionals include actively involving fathers in care planning and providing targeted support services that recognise their roles to enhance child and family outcomes.
We worked closely with our community advisory team, comprised of a physician, social worker and community organisation leader, who contributed to the study design, supported participant recruitment, and assisted in disseminating the findings back to the community, helping to ensure the research was grounded in and responsive to the needs of families of children with medical complexity.
To summarise current research that defines cardiopulmonary resuscitation and to provide a succinct conceptual definition of cardiopulmonary resuscitation.
Scoping review using JBI guidelines to develop the study protocol.
The most recent (2024) research papers on cardiopulmonary resuscitation were evaluated for inclusion. Individual definitions of cardiopulmonary resuscitation extracted from 25 papers were summarised and then analysed to conceptualise a single definition for cardiopulmonary resuscitation.
CINAHL, Medline and Scopus databases were evaluated for inclusion.
Definitions of cardiopulmonary resuscitation focused on interventions, mainly chest compressions and ventilation. Defibrillation was inconsistently included. There was less emphasis on criteria for initiating cardiopulmonary resuscitation and desired outcomes.
This scoping review found limited consensus between definitions of cardiopulmonary resuscitation. Analysis of the range of perspectives found in the review enabled the researchers to propose definitions in three areas: cardiopulmonary resuscitation, basic life support and advanced life support.
Nurses working in hospitals and responding to cardiac arrests are guided by Advanced Resuscitation Plans and Do Not Resuscitate orders. In turn, these documents should communicate a clear definition of cardiopulmonary resuscitation in policies, procedures and standards. This is important for clinical nurses to ensure patients' consent for cardiopulmonary resuscitation and defibrillation is informed.
Currently cardiopulmonary resuscitation is inconsistently defined. Cardiopulmonary resuscitation includes compressions and ventilation. A standardised definition of cardiopulmonary resuscitation supports professional nursing practice and has wider implications for patient consent and research practice.
This scoping review adheres to and is reported according to PRISMA-ScR.
No patient or public contribution.
The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.
According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.
A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.
This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.
Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.
This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.
This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823
To evaluate the effectiveness of aromatherapy on agitation and aggression in patients with cognitive impairment.
The impact of aromatherapy on agitation and aggression has been evaluated in various studies, but there is uncertainty about their impact.
A meta-analysis of randomised controlled trials was undertaken.
This meta-analysis was conducted under PRISMA guidelines. Following eight electronic literature databases were searched: Web of Science, PubMed, PsycINFO, Embase, Cochrane Library, Chinese Wanfang database, CNKI and VIP digital database from the inception of the databases up to 27 February 2021. Two reviewers assessed the risk of bias of the included studies independently using the Cochrane Collaboration tool. Overall, meta-analysis and three subgroup analyses regarding the type of aroma preparations, delivery mode and session length were performed using RevMan5.3 and stata14.0. Publication bias was assessed by visual inspection of the funnel plot asymmetry and Egger's regression test.
Fifteen studies comprising 693 participants were included. The meta-analysis indicated that aromatherapy could ameliorate agitation and aggression for cognitive impairment. The subgroup analysis based on the type of aroma preparations showed that lavender oil could significantly improve agitation and aggression. Most delivery modes of aromatherapy, including smearing and inhalation, were effective. Moreover, less length (≤4 weeks) aromatherapy showed a better effect on agitation behaviour than aromatherapy more than 4 weeks.
Despite the meta-analysis indicating that aromatherapy could alleviate agitation and aggression especially short-term (≤4 weeks) aromatherapy inhalation in different conditions, further researches are needed to investigate the appropriate dosage of essential oils and the side effects. More well-designed randomised controlled trials containing participants from more countries are needed to verify our findings before we can make strong recommendations.
This meta-analysis suggested that aromatherapy should be considered as a complementary programme for patients with cognitive impairment patients. Medical workers could apply aromatherapy into daily routine cares for cognitive impairment patients.
To establish cultural considerations for people from culturally or linguistically diverse backgrounds at the end-of-life in Australia.
Globally, there is a rapidly increasing proportion of the ageing population, and high levels of migration to Australia, the Australian healthcare community must recognise individualised and cultural needs when approaching death and end-of-life care. Many people from culturally and linguistically diverse backgrounds do not traditionally practice the palliative care approaches that have been developed and practised in Australia.
A Critical Interpretive Synthesis.
A review protocol was established using PRISMA 2020 guidelines and the literature searched using CINAHL, PubMed, Psych INFO and Medline from January 2011 to 27th February 2021. This search protocol results in 19 peer-reviewed results for inclusion in critical analysis.
Included studies were qualitative (14), quantitative (4) and mixed methods (1). Four themes were identified from the literature: (i) communication and health literacy; (ii) access to end-of-life care services; (iii) cultural norms, traditions and rituals; and (iv) cultural competence of healthcare workers.
Healthcare workers have an essential role in providing care to people with life-limiting illnesses. Cultural considerations during end-of-life care are imperative for the advancement of nursing practice. To achieve effective care for people of culturally and linguistically diverse backgrounds during end-of-life care, healthcare workers need to increase their education and cultural competency. There is inadequate research conducted within specific cultural groups, rural and remote Australian communities and individual cultural competence of healthcare workers.
Continuing advancement within nursing practice relies on health professionals adopting a person-centred and culturally appropriate approach to care. To ensure individualised person-centred care is provided in a culturally appropriate way, healthcare workers must learn to reflect on their practice and actively advocate for people with culturally and linguistically diverse backgrounds during end-of-life care.
Around 2 billion people globally were affected by natural disasters between 2008–2018. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times.
To conduct an integrative review of literature of emergency healthcare workers’ perceived preparedness for disaster management.
An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services and allied medical professionals’ preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.
The initial search yielded 9589 articles. Twenty-seven articles were included following application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East and the Asia Pacific. Most studies (n = 24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries’ reporting a higher perceived preparedness for disasters than low-income countries.
The majority of the emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers preparedness for disasters.
Clinical research nurses work at the fulcrum of clinical trials with clearly defined roles and responsibilities. In England, the National Institute for Health Research (the main funder of health research) has broadened its scope to encompass social care research. The expectation is that clinical research nurses will expand their skill set to support these new studies, many of which will employ qualitative and mixed methods. This discussion paper explores the challenges of facilitating this clinical academic workforce development through a case study of a homeless health and social care research project. This was one of the first studies to engage clinical research nurses in this new and expanded role.
Much of what is known about the research nurse workforce has been generated through studies of clinical trials in oncology. The ‘caring-recruiting’ dichotomy has been used as a heuristic device for identifying workforce issues that can impact on study delivery such as how intense pressure to recruit study participants leads to low job satisfaction.
This case study reflects on the authors' experiences of employing a clinical research nurse in a social care research project concerned with the discharge of homeless people from hospital. The ‘caring-recruiting’ dichotomy is used to generate new information about the relationship between workforce development and the successful delivery of social care research.
The case study illuminates how social care research can generate different pressures and ethical challenges for research nurses. The time and skill it took to recruit study participants identified as ‘hard to reach’ was suggestive of the need to move beyond performance measures that prioritise recruitment metrics. The need for different types of staff supervision and training was also warranted as supporting study participants who were homeless was often distressing, leading to professional boundary issues.
This study highlights that performance management, training and supervisory arrangements must be tailored to the characteristics of each new study coming onto the portfolio to ensure research nurses are fully supported in this new and expanded role.
FreshRSS 