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Gender biases in healthcare approaches lead to inequities in patient health outcomes, historically affecting women and gender minorities the most. In medicine, the concept of gender medicine explicitly addresses these disparities. Although Miers introduced the term gender-sensitive care in nursing two decades ago, there is still no consensus on how to define this phenomenon within the nursing discipline.
To conduct an operational concept analysis of gender-sensitive nursing.
A systematic literature review was performed using Walker and Avant's concept analysis method. This approach allowed for the identification of antecedents, defining attributes, empirical referents and consequences, as well as the proposal of model cases to illustrate the findings.
A total of 34 articles were analysed. Three antecedents were identified: healthcare system accessibility, organizational commitment to equity and education from a gender perspective. Four defining attributes emerged: gender-aware nurses, legitimization of care, implementation of a gender-sensitive approach in nursing management and leadership, and the integration of gender assessment in the nursing process. Three key consequences were also identified: patient empowerment, harm prevention and minimization, and improvement in the quality and effectiveness of nursing care. Additionally, various instruments and strategies were found to operationalize the empirical referents of the concept. Model cases were proposed to exemplify the synthesized evidence.
Far from being an abstract concept, gender-sensitive nursing is a measurable and actionable phenomenon that can be promoted in clinical practice through various empirical indicators.
Gender-sensitive nursing legitimizes individual experiences shaped by gender identity and fosters structural improvements that empower patients. Gender-sensitive nursing is a measurable and actionable phenomenon that can be promoted in clinical practice through various empirical indicators.
To clarify the concept of prison abolition in the context of United States mass incarceration and to discuss its implications for nursing ethics, knowledge production, and practice.
A critical literature review using Rodger's evolutionary concept analysis.
We coded and thematically analysed sources to identify associated terms, attributes, antecedents, and consequences of the concept of prison abolition.
We searched six databases and a book catalogue between May 2024 and April 2025 to yield a sample of 30 interdisciplinary academic texts. No date limits were set.
We identified nine attributes: Counterhegemonic, Recognizing Carceral Harm and Failure, New Public Discourse, Incremental, Culture of Care, Equitable Justice, Elimination Not Reform, Evolving, and Grassroots with consistent interdisciplinary and temporal characterization. There is a relative absence of this concept in nursing literature even though it addresses health concerns.
Prison abolition aligns with the American Nursing Association's Nursing Code of Ethics and could inform and guide nurses toward improvements in health equity.
Nursing in the United States has not engaged with abolition as much as other disciplines, but our Code of Ethics compels us to. Prison abolition is concerned with health equity, and marginalized populations could benefit if we incorporate the concept into our practice, scholarship, and advocacy.
This review addressed a potential lack of understanding or awareness of the concept of prison abolition within nursing discourse. The main finding is that this concept aligns with U.S. nursing ethics. This research may impact nurses looking to incorporate a theory and practice to improve approaches to health equity.
We were unable to find an EQUATOR reporting method for concept analyses.
No patient or public contribution.
Despite decades of research, we still know surprisingly little about how best to bring about lasting recovery from anorexia nervosa (AN). Furthermore, there is a lack of consensus in the research and treatment communities about what constitutes recovery from AN, or whether “recovery” is even an appropriate term to use in this context. The aim of this study was to analyse the concept of AN recovery from the perspectives of various stakeholders.
Concept analysis.
Walker and Avant's eight-stage concept analysis method.
There continues to be a lack of consensus around the defining criteria for AN recovery. However, there are certain clinical, psychological and quality-of-life attributes that are recurrent in those defined as being in recovery.
Though BMI and rate of weight gain are the primary criteria used to define recovery from AN, in recent years it has become clear that the definition of healthy weight varies and that weight alone is insufficient to fully define recovery. With recent advancements in biomarker and genetics research, there is hope that more objective measures of recovery will be defined. Quality of life as defined by both patients and caregivers is also critical to recovery; however, it is often not adequately assessed in studies of AN. Though the path to recovery is highly individualised, and there are risks in implementing strict criteria for recovery, in research, consensus is needed for adequate comparison of studies evaluating different treatment modalities. Additionally, such criteria are needed to help clinicians with decision-making authority, including advanced practice nurses, provide the most effective treatment options to their patients. Future research should focus on better defining recovery from AN and on facilitating nurse-led system-level advocacy to educate and equip advanced practice nurses in helping those with AN move toward recovery.
This concept analysis provides an overview of recovery from AN from the perspectives of a wide array of stakeholders and the last 20 years of published data.
This study did not include patient or public involvement in its design, conduct, or reporting.
To clarify the definition and evolution of Patient and Public Involvement and Engagement (PPIE) and identify its attributes, antecedents, and consequences in health-related research.
This study follows Rodgers' evolutionary concept analysis with a seven-step framework.
Datasets were searched using terms related to PPIE and key categories (i.e., attributes, antecedents, and consequences). Data were sourced from CINAHL, PsycInfo, Scopus, PubMed, and Web of Science covering publications from inception to October 31, 2024. Document titles, abstracts, and keywords were manually screened to identify relevant studies for full-text review.
A total of 1751 documents were screened, resulting in 38 eligible studies included in the final analysis. PPIE has evolved from a narrow focus on patient inclusion and participation, where patients had minimal influence on research and researchers resisted sharing control of research, to a collaborative model emphasising sustained partnerships, shared contributions, equitable power distribution, and active involvement across research stages. This shift has been driven by research innovation, a growing emphasis on healthcare equity and patient-centred care, technological advances, and stakeholder advocacy (e.g., patients, funders, ethics committees). While PPIE enhances research relevance and impact, barriers, such as resource constraints, power imbalances, patient limited research capabilities and increased researcher workload persist. Facilitators, such as training programmes, standardised guidelines, flexible arrangements and transparent communication can enable meaningful partnerships.
The concept of PPIE is evolving toward greater clarity and consistency in research, positioning patients and the public as active, essential contributors rather than passive participants. Barriers and facilitators were identified to inform its utilisation in research.
This study clarifies the conceptual ambiguities of PPIE, informs theory development, and provides actionable insights. Healthcare and nursing researchers can draw on its findings to utilise PPIE to enhance collaborative and inclusive research practices that align with the needs of patients and the public.
This study adheres to the PRISMA (2020) reporting guidelines for systematic reviews.
One of our co-authors is a patient with lived experience of cancer, who contributed valuable comments and suggestions to enhance this paper.
To conduct a concept analysis of ‘safe mobility’, with specific application in hospitalised older adults, identifying its defining attributes, antecedents and consequences.
The promotion of safe mobility is essential for maintaining the functionality of hospitalised older adults. However, this idea is not yet clearly defined in the scientific literature, requiring a conceptual analysis for better understanding and applicability in nursing practice.
Concept analysis.
The concept analysis methodology of Walker and Avant was employed, consisting of eight steps. Sources from the scientific literature (BDENF/VHL, Scopus, CINAHL/EBSCO, Embase, Web of Science, PEDro, MEDLINE/PubMed and CAPES Thesis and Dissertation Catalogue, as outlined in a scoping review previously published by the authors) and terminologies from dictionaries and nursing practice, such as SNOMED CT, ICNP, NANDA, NIC and NOC, were analysed.
The concept of ‘safe mobility’ does not have a consolidated definition but was identified through three defining attributes: active movement, prevention of fall-related harm and prevention of immobility-related harm. The antecedents include the older adults' conditions, adaptation of the hospital environment, training of the multidisciplinary team, patient behaviour and family involvement. The consequences involve the maintenance of functionality, improvement of quality of life, reduction of hospital length of stay and costs, as well as a decrease in rates of readmission, referrals to long-term care institutions and mortality.
The concept analysis revealed that safe mobility involves promoting active movement and preventing harm related to both immobility and falls.
Strategies based on this concept can improve the quality of life of older adults, reduce complications and optimise hospital costs.
This concept analysis examines existing literature and does not require patient-related data collection. The methodological approach does not necessitate collaboration with the public.
Healthcare systems are undergoing major transformation driven by technological progress, growing patient involvement, workforce shortages, complex care needs, and rising costs. Against this backdrop, value-based healthcare has gained traction, yet the notion of ‘value’ remains ambiguously defined.
To clarify the concept of ‘value’ in value-based healthcare.
We conducted a concept analysis using Walker & Avant's eight-step method: (1) Select a concept; (2) Determine the aims; (3) Identify uses; (4) Define the concept's attributes; (5) Identify the model case(s); (6) Identify additional cases; (7) Identify antecedents and consequences; and (8) Define empirical referents. Data Sources: Scoping review methods following the Joanna Briggs Institute (JBI) recommendations were used to introduce rigour in locating, screening, and extracting data. We used a deductive thematic analysis for data analysis.
We selected the concept of value in value-based healthcare because it lacked conceptual clarity to support healthcare systems transformations. We propose that value arises when outcomes-to-costs ratios (empirical referents) are considered in processes (uses) addressing healthcare systems transformations, characterised by more informed and engaged patients and rising costs (antecedents). Model case included consideration for all components (health, non-health outcomes, and direct, indirect, social costs) of the ratio, whereas additional cases showed that consideration for most, not all, or none of these components led to partial or no value creation. Value is used from individual to collective dimensions and at clinical, organisational and system levels (attributes) to improve patient experience, care team well-being, health equity, and population health, and to reduce costs (consequences).
A shared understanding of ‘value’ can guide its design, measurement, and implementation to support successful transformations toward value-based healthcare. Implications: Our conceptual proposition of ‘value’ within value-based healthcare establishes a framework for a common understanding of ‘value’ that enables the successful transformation of health systems toward value-based healthcare.
To analyse the concept of psychological burnout among nurses in the context of terminal care.
Concept analysis.
The study was conducted according to the eightstep conceptual analysis procedure suggested by Walker and Avant.
Articles published in English or Korean between January 2014 and 2024 were reviewed in March 2024. A total of eight search engines were used for the literature review, including PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO. A total of 19 articles were finally selected for the analysis based on criteria.
The attributes of psychological burnout among nurses providing terminal care are depletion of energy, emotional numbness, disengagement, sense of powerlessness and emotional repression. Seven antecedents and six consequences of the concept were identified in this study.
The result of this study provides a foundation for the development of tailored interventions and further research related to the occurrence of psychological burnout among nurses providing terminal care. Additionally, considering the characteristics of terminal care, we suggest additional studies to confirm the attributes of burnout in this context across various cultural and religious backgrounds.
This study helps clarify the concept of psychological burnout among nurses in terminal care and informs the development of various interventions, educational programmes and related policies.
No patients or public contribution.
To clarify the concept of disempowerment in adults with chronic illness.
The Walker and Avant approach to concept analysis was used.
A systematic literature search was performed on 14 February 2024, using the following databases: CINHAL, PubMed, PsycINFO, Sociological Abstracts and ProQuest Dissertations & Theses Global A&I: The Humanities and Social Sciences Collection. Studies examining adults' experience of individual disempowerment stemming from chronic illness were included. Definitions and descriptions of the concept in the included studies were extracted and synthesised into defining attributes, antecedents, and consequences.
Forty-five articles were included. Two defining attributes were identified: (1) diminishing opportunities to take control and (2) clients' dissatisfaction with diminishing control. Antecedents were changes in health status related to chronic illness and expectation mismatch within the client, or between clients and their care partners. The consequence of disempowerment was disengagement in the context of disempowerment.
Disempowerment was found as the state of dissatisfaction with diminishing opportunities to control personal lives, which stems from changes in health status and expectation mismatch and leads to disengagement in the context of disempowerment. Contrary to prior studies, where disempowerment was often considered an outcome of an imbalanced relationship between clients and care partners, the present findings showcased disempowerment as a holistic illness experience, involving changes in health status. The understanding of disempowerment as the dissatisfaction with the situation of diminishing opportunities to take control differentiates this concept from the opposite of empowerment, which is conceptualised as clients' ability to make decisions or manage diseases. Findings further highlight the importance of understanding clients' illness experience comprehensively and providing care in a manner that is matched with clients' abilities, expectations and needs. It is suggested that operationalising the concept based on this understanding is necessary in order to understand correlations between disempowerment, its causes and consequences.
Disempowerment has been applied to describe interruptions in their states of being, perceived role performances, and independence in adults with chronic illness from diverse perspectives in the extant literature, such as the opposite of empowerment, action to take away control over personal lives and a state of diminishing ability to tackle problems. Through clarifying the concept, this article will guide the communication, measurement tool development and response in clinical practice.
No patient or public contribution.
This article investigates school vaccination for adolescents with intellectual and developmental disability through the lens of person-centred care principles.
This is a theoretical framework analysis in which qualitative interview data were mapped to the principles of a Person-Centred Practice Framework.
Data were drawn from Vax4Health, an empirical study that aims to improve vaccination uptake and experiences for adolescents with disabilities.
Our four-step process included: identifying elements of the school vaccination programme that relate to the Framework domains; mapping programme capacities and challenges by each domain; identifying key factors influencing person-centredness; and synthesising these key influencing factors into three themes.
We extrapolated three themes: (1) Parents and students expressed strong support for the programme, but there is potential to enhance their participation in vaccination decision-making processes. (2) Nurses bring high levels of motivation, clinical experience, empathy and creativity to vaccinate students, but opportunities remain to enhance disability-specific training and knowledge of individual students' needs. (3) Special schools are committed to supporting families and facilitating the programme, but limited resourcing and unclear responsibilities present challenges that need addressing. We discuss how these themes relate to the five domains of the Framework. Key considerations for vaccination programme improvement towards a more person-centred approach are highlighted.
Applying the Framework to the findings of the Vax4Health study identified a range of opportunities to improve person-centred school-based vaccination for adolescents with IDD. Future research could involve engagement with all stakeholders to co-design interventions aimed at applying person-centred care principles to vaccinating students with IDD.
The findings from this analysis could be used to inform future implementation research into person-centred approaches to school vaccination aiming for positive outcomes for adolescents with IDD, their families and schools and health professionals.
To clarify the concept of anticipated stigma and examine its relevance to cannabis use disclosure in nursing using an evolutionary concept analysis approach.
Concept analysis guided by Rodgers and Knafl's evolutionary method.
An interdisciplinary purposive literature review was conducted using empirical and theoretical sources drawn from nursing, public health, psychology and sociology. Literature published between 1963 and 2024 was included, with specific emphasis on health-related stigma, disclosure and cannabis use.
Rodgers and Knafl's evolutionary method was used to identify the defining attributes, antecedents, consequences, related concepts and contextual variations of anticipated stigma. Empirical and conceptual literature were synthesised to reflect cross-disciplinary themes. A model case was constructed to illustrate the concept's application in a nursing context, followed by a critical synthesis of implications for nursing theory, research and practice.
Anticipated stigma is a future-oriented expectation of devaluation or discrimination associated with disclosing a stigmatised identity or behaviour. Five core attributes were identified. Antecedents include individual identity salience, sociocultural norms and structural factors. Consequences include psychological distress, concealment and reduced healthcare engagement.
Anticipated stigma is a dynamic and under-theorised concept that hinders therapeutic communication and person-centred care in nursing settings.
This analysis offers conceptual clarity and supports stigma-informed approaches to assessment and communication in nursing education and practice, especially when addressing cannabis use and other stigmatised health behaviours.
No patient or public contribution.
Exploring the concept of patient agitation in the intensive care unit.
Patient agitation in the intensive care unit is of widespread concern and linked to negative outcomes for patients, staff, and family members. There is currently no consensus on what constitutes agitation in the intensive care context, hindering effective and tailored prevention and management.
Concept Analysis.
Walker and Avant's eight-step concept analysis approach.
A comprehensive search was carried out in the databases MEDLINE, PsychINFO and CINAHL. A total of 32 papers published between 1992 and 2023 were included, reviewed, and analysed to explore definitions, attributes, antecedents and consequences of patient agitation.
Patient agitation in the intensive care unit is characterised by excessive motor activity, emotional tension, cognitive impairment, and disruption of care, often accompanied by aggression and changes in vital signs. Antecedents encompass critical illness, pharmacological agents and other drugs, physical and emotional discomfort, patient-specific characteristics and uncaring staff behaviours. Consequences of agitation range from treatment interruptions and poor patient outcomes to the psychological impact on patients, families, and staff.
Agitation in the intensive care unit is a complex issue which significantly impacts patient treatment and clinical outcomes. For healthcare professionals, patient agitation can contribute to high workloads and job dissatisfaction. Due to the complex nature of agitation, clinicians must consider multifaceted strategies and not rely on medication alone. Further research is needed to fully understand patient agitation in the ICU. Such understanding will support the development of improved strategies for preventing and managing the behaviours.
A clearer understanding of patient agitation supports the development of tailored interventions that improve patient care, guide ICU training, and inform future research.
This concept analysis was developed with input from a patient representative.
To analyse the dimensions of the omission of nursing care in emergency departments, including its attributes, antecedents, and consequences, using Walker & Avant's concept analysis method.
Methods: Walker and Avant's eight-step method defined attributes, antecedents, and consequences of the omission of nursing care in emergency departments.
A comprehensive literature review was conducted using CINAHL, MEDLINE, Embase, Health Management Database, and Cochrane Library, covering publications from 2001 to 2024. The search was conducted in August 2024.
Key attributes were delayed, incomplete, or interrupted care, mostly due to insufficient staffing or unpredictable patient volumes. Antecedents included high workloads, inadequate skill mixes, and understaffing. Consequences were increased patient morbidity and mortality, nurse burnout, and job dissatisfaction. A research gap exists in paediatric-specific measurement tools.
Identifying dimensions of omitted nursing care in emergency departments informs interventions to improve patient safety and care quality. Developing paediatric-specific measurement tools is essential.
The findings emphasise the need for improved staffing and resource allocation policies, reducing risks to patients and enhancing nurse satisfaction.
This study addressed the gap in understanding omitted nursing care specifically in emergency departments. Findings highlight systemic issues impacting patient outcomes and nurse well-being. The results will guide organisational improvements and future research globally.
This study adhered to EQUATOR guidelines, following Walker and Avant's method for concept analysis.
This study did not include patient or public involvement.
This study underscores the critical impact of the omission of nursing care (ONC) in emergency departments (EDs) on patient safety, nurse well-being, and healthcare efficiency. ONC contributes to increased morbidity, mortality, and adverse events, highlighting the urgent need for improved staffing models and resource allocation. Training programmes should equip emergency nurses with prioritisation strategies to mitigate care omissions. Policymakers must recognise ONC as a key quality indicator, ensuring adequate workforce support. Additionally, this study identifies a gap in measuring ONC in paediatric EDs, calling for the development of tailored assessment tools and further research on intervention strategies.
To define and clarify the concept of emotional intelligence in healthcare leadership.
Walker and Avant's concept analysis model.
The study was conducted using Walker and Avant's concept analysis model. In the search of the relevant literature, the Joanna Briggs Institute's methodology and search protocol for scoping reviews were applied. Searches were conducted in May 2023 with no time or geographical limits on Scopus, CINAHL, ProQuest, the Web of Science, Medic and Mednar and 42 studies were included. The data were analysed using narrative synthesis by categorising results using the steps of concept analysis.
Concept analysis identified defining attributes of emotional intelligence in healthcare leadership, including leadership qualities, management competencies, and sets of leadership styles which were related to supportive and transformational leadership behaviour. The antecedents were socio-demographic factors, well-being, and workplace resources. Finally, employee-, manager-, organisation- and patient-related consequences were identified, such as the well-being of both employees and managers, organisational performance and patient care quality.
Emotional intelligence in healthcare leadership contributes to better performing organisations, as emotionally capable leaders can inspire and empower their employees. Holistic management of organisational duties and people-oriented leadership is a crucial resource in healthcare organisations. Well-being and workplace resources can be vitally important for leaders to manifest emotional intelligence in their work.
Emotional intelligence can contribute to efficient leadership behaviour and have positive outcomes at the employee, manager, organisation and patient levels. Therefore, emotional intelligence should be addressed in leadership education, training programmes and recruitment procedures. Finally, policymakers should be encouraged to acknowledge the role of sufficient resources in health care to ensure effective leadership.
Emotional intelligence is a widely studied concept in the healthcare field. However, thorough conceptualisation regarding emotional intelligence in healthcare leadership has been lacking. Conceptualising this phenomenon was therefore outlined, providing a deeper understanding of the concept. The findings can be utilised in healthcare leadership development and research.
N/A.
No patient or public contribution.
Analyse the concept of expertise among practicing clinical nurses in hospital settings.
The generational loss of expert clinical nurses was exacerbated globally by the novel coronavirus. This ongoing loss combined with the increased complexity of hospitalised patients has prompted an urgent need to understand expertise among clinical nurses who practice in hospital settings.
Walker and Avant's concept analysis method was used. PubMed, Medline, CINAHL and Access Medicine were searched (1982–2025) for research studies and literature reviews published in English that addressed clinical nursing expertise in hospitals.
Expertise is the knowledge and skills that are enculturated from immersion in a domain. Common attributes include obtaining salient information from different sources, interpreting patient situations rapidly and holistically, and performing actions that are individualised, immediate and appear instinctive. Common antecedents include deliberate accumulation of relevant experience and contextual connections within the hospital. Facilitating improved outcomes and facilitating improved outcomes are common consequences.
The attributes, antecedents and consequences of clinical nursing expertise are complementary and cross specialties. Experts' apparently instinctive actions are not intuitive but rather related to relevant past experiences, pattern recognition and skilled know-how. The requirements to develop expertise have evolved with the increased volume of available knowledge.
Expertise requires cultivating relevant experiences through active engagement with patients and creating contextual connections with others regarding hospital systems and processes. Experts should be formally included when developing processes and guidelines. Low-fidelity proxy measures like years of experience should be replaced with psychometrically validated instruments to measure expertise.
This concept analysis addresses the ambiguity of clinical nursing expertise by synthesising over 40 years of literature and provides insights for clinical nurses and researchers regarding the importance of context and the growing complexity of care delivery.
No patient or public involvement.
To examine and define the concept of moral distress among family caregivers by identifying its key attributes, antecedents and consequences.
Concept analysis.
This study was guided by Walker and Avant's concept analysis framework. A comprehensive literature search was conducted to identify relevant studies, with 12 articles included in this analysis.
PubMed, CINAHL, Scopus and PsycINFO databases were searched for articles published between February 2000 and May 2025.
Three defining attributes of moral distress in family caregivers were identified: self-directed negative emotions, internal conflict and feelings of powerlessness and helplessness. Antecedents included caregiving burden, role conflict, ethical dilemmas, complex decision-making and internal and external constraints. Consequences encompassed long-term health effects, social withdrawal, burnout and moral residue. These findings led to a conceptual definition of moral distress in family caregivers.
Moral distress in family caregivers is a significant and underrecognised issue that affects caregiver well-being and the quality of care they provide. This concept analysis offers a clear conceptual definition, providing a foundation for developing research instruments and interventions.
Healthcare professionals should recognise moral distress in family caregivers as a key factor impacting both caregiver well-being and patient care. Support through education, counselling and peer groups can reduce moral distress and foster more ethical, collaborative care environments.
This study addressed the lack of clarity surrounding moral distress in family caregivers. It identified key attributes, antecedents, and consequences, and developed a clear conceptual definition. These insights will inform research, practice and policy. The findings will benefit caregivers, improve patient care and support healthcare teams.
This study followed Walker and Avant's framework and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in article selection.
No patient or public involvement.
The purpose of this concept analysis is to clarify the meaning of digital health equity beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape.
With the growing spread of digital health, digital health equity should be at the center of healthcare. Health outcomes for equity-deserving groups may be compromised without a clear understanding of digital health equity. Although the concept of ‘health equity’ has been analysed before; no concept analysis has been completed for the concept of ‘digital health equity’.
Concept analysis using Walker and Avant's method.
Articles from PubMed, Scopus and Google Scholar with no limitation on the period of data collection.
Walker and Avant's concept analysis method was used to outline attributes, antecedents, consequences, and empirical referents of the concept digital health equity.
The main attribute of digital health equity is digital health technology that benefits everyone fairly. The antecedents include: (1) appropriate infrastructure; (2) cognitive abilities including digital literacy; (3) intersectionality of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the social determinants of health; and (6) co-creation of digital health technologies. The main consequences are improved patient health outcomes and elimination of the digital divide.
This analysis explored the concept of digital health equity as a means to promote positive health outcomes for equity-deserving groups, highlighting the critical role of nursing practice and research in addressing digital health disparities.
This paper can have an impact on nursing practice, education and wider social and economic issues. First, various barriers encountered by patients when utilising digital health technologies can be understood. Second, clinicians can be encouraged to assess digital health equity, improve interventions for equity-deserving groups, and evaluate the effectiveness of digital health interventions to ensure they are equitable. In the context of educational implications, the understanding of digital health equity can be used to facilitate the creation of appropriate education materials for clinicians. Finally, on a wider social and economic scale, understanding digital health equity can aid in the creation of policies to enable equitable digital health technologies.
No patient or public contribution because this paper is a concept analysis.
To clarify the concept of life space in community-dwelling older adults to provide a clear and standardised conceptual basis for further research.
Rogers' evolutionary approach was used to identify surrogate terms, related terms, attributes, antecedents and consequences.
Literature from 1936 to 2025 was searched from PubMed, CINAHL, ProQuest, Cochrane databases, Scopus, Web of Science and CNKI.
A total of 46 articles were included for further analysis and synthesis. The attributes of life space in community-dwelling older adults were dynamic variability, multidimensionality and interaction between intrinsic abilities and external environmental demands. Antecedents were classified into four categories, namely, individual, physical, psychological and social factors. Life space can bring positive consequences, promoting walking, assessing the risk of falling, predicting cognitive decline, facilitating rehabilitation and improving quality of life, as well as negative consequences, causing diminished subjective well-being, heightened loneliness, increased risks of hospital readmission and mortality.
Life space, as a spatial indicator of a person's range of mobility, reflects older adults' physical range of motion, the frequency of activity, their need for assistance and the level of social participation. Older adults with adequate life space in the community are more likely to engage in outdoor activities. In contrast, restricted life space can lead to adverse outcomes.
Surrogate terms, related terms, attributes, antecedents and consequences identified by the concept analysis approach will contribute to a greater understanding of life space. These analytical findings establish an essential conceptual framework for future research while offering evidence-based theoretical guidance to improve life space in community-dwelling older adults, ultimately enhancing health outcomes and quality of life.
No patient or public contribution.
To introduce a novel conceptual framework that differentiates peripheral intravenous catheters according to their dwell time and therapeutic purpose, in order to improve the suitability of material choice, safety and cost-effectiveness.
Concept based on clinical guidelines, expert consensus and recent peer-reviewed evidence.
A literature search was conducted in PubMed on November 25, 2024, using defined keywords related to peripheral intravenous catheters, device complications and duration of use. This search was supplemented by manual screening of references from relevant articles.
The analysis followed the SANRA quality criteria for narrative reviews. Evidence and recommendations from clinical guidelines, randomised trials and qualitative studies were synthesised using the Australian Clinical Care Standards to structure the proposed classification into ‘procedural’ and ‘therapy’ catheters.
Procedural catheters are used for less than 24 h, typically during procedures or short treatments, and are mainly linked to immediate risks like insertion failure and local trauma. Therapy catheters, defined as devices used beyond 24 h or expected to remain while the patient sleeps, carry cumulative risks, including delayed complications such as phlebitis, occlusion and infection. The framework supports more nuanced decisions on device choice, insertion site and maintenance.
This framework introduces a practical differentiation between short- and longer-term peripheral venous catheters, addressing a major oversight in existing guidelines and supporting context-sensitive vascular access decisions.
Tailoring catheter management to expected dwell time may reduce complications and costs, enhance workflow, and improve patient comfort.
By addressing the lack of temporal distinction in current practice, this framework offers a simple yet transformative tool applicable across care settings, with the potential to improve patient outcomes, resource utilisation and costs.
This project is a concept analyses; no patient or public contribution was necessary.
To clarify the concept of quiet quitting in nursing practice.
Concept analysis using Walker and Avant's concept analysis methodology.
The eight-step method by Walker and Avant guided the concept analysis.
A systematic literature search was conducted in CINAHL, PsycINFO, Scopus and MEDLINE without date restrictions, identifying 36 empirical and theoretical articles published in English.
Quiet quitting in nursing is defined by four key attributes: minimal compliance with job expectations, psychological and emotional detachment, withdrawal of discretionary effort and lingering in role despite dissatisfaction. Antecedents include unhealthy work environments, psychosocial strain (e.g., burnout, moral distress) and individual/demographic influences (e.g., age, coping strategies). Consequences include impaired team dynamics, reduced care quality and organisational decline and increased turnover intentions. Twenty-five studies used validated measurement tools, notably the Quiet Quitting Scale.
Quiet quitting is a subtle form of disengagement distinct from burnout and turnover. It reflects an adaptive coping response to sustained dissatisfaction and unmet expectations. It is both widespread and underrecognized, with implications for healthcare sustainability.
Understanding and addressing quiet quitting is essential for safeguarding professional standards, promoting nurse engagement and ensuring high-quality patient care. Early identification and systemic reforms are critical to mitigating its impact.
This study addresses the emerging challenge of nurse quit quitting. Findings can inform leadership, education and policy development globally, particularly in healthcare settings facing workforce strain, moral distress and retention challenges.
This article adheres to the PRISMA-ScR reporting guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
To examine the concept of obstetric violence culture and establish a working definition for application to practice, research, and policy in perinatal care.
Concept analysis.
Rodgers' evolutionary method guided the analysis and data organisation into antecedents, attributes, and consequences.
A systematic search using the phrase ‘obstetric violence’ was conducted in CINAHL and PubMed databases. Articles published in English between November 1, 2020, and December 31, 2024, were included.
Sixty-two articles were included. Antecedents reflected the historical medicalisation of birth, professional hierarchies, and structural inequities. Attributes—disbelief of harm, victim blaming, revictimisation, and disempowerment—mirror those identified in rape culture. Consequences spanned birthing people, clinicians, and systems, including mistrust, moral distress, and institutional silence. The resulting definition frames obstetric violence culture as an embedded and normalised set of practices and beliefs that sustain mistreatment in perinatal care.
Obstetric violence culture is not an outlier, but a pervasive and institutionalised framework to be systematically dismantled.
Nurses have an ethical obligation to recognise and disrupt obstetric violence culture. Structural change, clinical education, and institutional accountability are necessary to uphold patient autonomy and dignity.
This study followed Rodgers' evolutionary method and adheres to relevant EQUATOR guidelines for conceptual research.
This study did not include patient or public involvement.
FreshRSS 