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Tobacco use in the context of natural disasters: a scoping review pertinent to tobacco control in Indonesia

Por: Kodriati · N. · Wijaya · O. · Affan · A. · Nursholihah · U. F. · Rosemary · R.
Objective

In Indonesia, the second most natural disaster-prone country in the world, the tobacco industry exploits such crises via corporate social responsibility. The objective of this study was to map existing evidence on natural disasters and tobacco use in order to understand how tobacco control policies could be optimised in disaster-prone regions.

Design

Scoping review.

Data sources

ScienceDirect, PubMed and Google Scholar, with searches conducted twice: between January and April 2024 and again in August 2025.

Study selection

All studies examining natural disasters, smoking behaviours and the tobacco industry.

Data extraction

Studies were assessed primarily on reports of tobacco use change, tobacco control policy enforcement, tobacco industry interference and mention of the role of stress. Data on country, disaster type, type of research study and sample details were also collated.

Results

27 of the 611 identified studies were included in the final analysis. Two-thirds of studies reported an increase in smoking rates following disasters. No studies mentioned tobacco control policy enforcement or tobacco industry interference during disasters. Most of the studies (74%) which examined the relationship between disaster-related stress and smoking found a positive association. About half (51.9%) of the studies described disasters in the Americas.

Conclusions

Smoking rates often rise after stress-inducing disasters. More evidence is urgently required to assist countries like Indonesia in enforcing tobacco control and preventing tobacco industry interference.

Comparisons of healthcare personnel relating to awareness, concern, motivation, and behaviours of climate and health: A cross‐sectional study

Abstract

Aim(s)

To describe a sample of healthcare professionals' responses to the valid and reliable Climate and Health Tool and compare participant characteristics relating to Climate and Health Tool subscales.

Design

Observational, cross-sectional, multi-site study.

Methods

An electronic survey containing the Climate and Health Tool was administered to healthcare professionals across a large, multi-state health system in the Western United States with a committed effort to reducing carbon emissions.

Results

One thousand three hundred and sixty-three participants reported moderately elevated levels of awareness and concern around climate impacts on health and motivation to participate in climate protective actions. Respondents reported moderate levels of climate-protecting behaviours at home and low levels at work. Females were more concerned and motivated. Medical staff and respondents reporting familiarity with system environmental initiatives reported more awareness and behaviours at home to preserve climate health.

Conclusion

Healthcare professionals are concerned and motivated to decrease climate impacts on health yet take little action at work to preserve the climate. Because of the intersection of climate change, health, and healthcare, healthcare organizations should prioritize and support meaningful action for healthcare professionals to meet community climate health needs.

Implications for the Profession and/or Patient Care

Healthcare organizations committed to contributing to climate solutions can use this research to increase healthcare professionals' education, engagement, and impact to preserve the climate and health of communities.

Impact

Healthcare is a major contributor to carbon emissions, yet healthcare professionals' awareness, motivation, concern, and behaviours related to climate change and health were not clear. Our research showed healthcare professionals are aware and concerned about climate impacts on health but reported low levels of workplace behaviours to protect the climate. The findings of our research will impact healthcare professionals and healthcare organizations to focus efforts on climate-preserving behaviours.

Reporting Method

This manuscript followed the STROBE guidelines.

Patient or Public Contribution

None.

Patient Perception of Involvement in Nursing Bedside Handover: A Cross‐Sectional Study

ABSTRACT

Background

In Australia, aligned to safety and quality standards, the health system implements standardised practices that include patient involvement in nursing bedside handover. Despite this mandate, it remains unclear whether patients are genuinely participating in nursing bedside handovers and whether their perspectives are being considered.

Aim

To explore patient perceptions of their involvement in nursing bedside handovers.

Methods

A cross-sectional survey study was conducted in two acute metropolitan hospitals in Western Australia from July 2021 to March 2022. The survey administered to patients, comprised three sections: demographic information; involvement in bedside handover; and perceptions of bedside handovers; utilising close-ended and Likert scale questions. Open-ended questions further explored participation in bedside handovers. Descriptive statistics and comparative analyses were performed and responses to open-ended questions underwent summative deductive content analysis.

Results

Of the 390 participants, over half reported five or more bedside handovers (n = 197, 50.7%). Most perceived the importance of (n = 334, 79.0%), and expressed their satisfaction with (n = 327, 89.6%), involvement in bedside handover. Perceptions of handover were mostly positive. There were a few significant differences throughout based on type of hospital, gender and age-group. Open ended responses shared perceptions on the perceived benefits, challenges and barriers and ways to enhance involvement in bedside handover. Patients expressed several challenges, including lack of awareness of their right to participate, the approach of nurses and the timing of handovers as hindering their participation in bedside handovers.

Conclusion

Patients perceived the importance of, were mostly satisfied with, and had positive perceptions of bedside handover. However, several challenges hindered effective patient participation. Further research is needed into bedside handover as it is essential to enhance patient-centred quality care that aligns with national safety and quality healthcare standards.

Impacts

Understanding the significance of patient involvement in bedside handovers motivates patients to actively share information about their care, leading to increased patient satisfaction and the promotion of patient-centred care. Addressing challenges through targeted strategies can enhance patient participation, communication, increased patient satisfaction and foster a more patient-centred approach to care.

Patient or Public Contribution

The conduct of this study was supported by the consumer advisory group in the participating hospitals who also reviewed the survey questionnaires and conducted face validity of the survey.

‘All we've ever known is Covid’: A follow‐up study with newly qualified nurses who worked as student nurses during the pandemic

Abstract

Aims and Objectives

To explore the experiences of nursing students in England who had worked through the first wave and transitioned to qualification in the ongoing pandemic.

Background

Experiences of health professionals and student nurses during the pandemic are now well documented, but the transition of students to qualification is less well understood. In Summer 2020, we interviewed 16 student nurses who had worked as health care assistants on paid extended placements as part of the COVID-19 response in the East of England, finding surprisingly positive experiences, including perceived heightened preparedness for qualification. A year later, we re-interviewed 12 participants from the original study to hear about transitioning to qualification during the ongoing pandemic. This study provides novel insights into their experiences.

Design

A qualitative study design was used.

Methods

Twelve newly qualified nurses who had participated in the original study took part in qualitative, online interviews where they shared their experiences of working and transitioning to qualification during the ongoing pandemic since we spoke to them a year earlier. The data was analysed using thematic analysis. COREQ guidelines were used in developing and reporting this study.

Results

Three themes were identified. Constant change: in the clinical environment and arising out of the transition to newly qualified nurse, mental health and well-being and reflecting on the past to learn for the future.

Conclusions

Participants experienced a unique transition to qualification. The perceived heightened preparedness for qualification that participants who had worked as students during the first wave of the pandemic had become a reality, ameliorating some of the known effects of transition. However, increased expectations and added responsibilities in extremely busy, fluctuating clinical environments with minimal support add weight to calls for mandatory preceptorship programmes. While heightened resilience was evident, provision of ongoing mental health and well-being support is strongly recommended.

Relevance to Clinical Practice

We need a partnership approach with nurse educators and practice colleagues which ensures preparation for qualified practice is appropriate. If we do not effectively prepare students for qualified nurse posts, patient care will almost certainly be compromised.

Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

Abstract

Aims

To explore and summarise the literature on the concept of ‘clinical deterioration’ as a nurse-sensitive indicator of quality of care in the out-of-hospital context.

Design

The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews.

Methods

Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded.

Data Sources

Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute.

Results

Thirty-four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting.

Conclusions

Little is known about the work of nurses or midwives in out-of-hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non-acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings.

Implications for the profession and/or patient care

Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out-of-hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care.

Impact

What Problem Did the Study Address?

Factors that impact a nurse's ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting are not examined to date.

What Were the Main Findings?

A range of factors were identified that impacted a nurse's ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation.

Where and on whom will the research have an impact?

Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out-of-hospital setting. This in turn will impact patient survival and satisfaction.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines guided this review. The PRISMA-Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study.”

No Patient or Public Contribution

Not required as the Scoping Review used publicly available information.

Factors associated with risk of falling among younger inpatients in a mental health setting—A systematic review

Abstract

Aim

To synthesise evidence related to risk factors of falls among younger mental health inpatients age ≤65 years old.

Background

Hospitalised patients with mental illness are at increased risk of falling. Specific risk factors for falls for younger inpatients are poorly understood.

Design

Systematic review.

Methods

Medline, CINAHL, APA PsycINFO, Scopus and Web of Science were searched for studies published in English till December 2022. The review followed the 2020 PRISMA checklist. Odds ratios and P values of significant risk fall factors and the frequency of factors related to circumstances of falls were extracted.

Results

Nine studies were included and 95 risk factors, across seven categories were extracted. These categories included socio-demographic, fall-related factors, functional status, health and mental status, psychiatric diagnosis and assessment, medication, and staff related factors. Factors related to medication, health and mental status are most reported. Majority of the patients sustained minor or no injury from the fall and circumstances of fall vary across studies.

Conclusion

Factors strongly associated with risk of falls were dizziness, use of psychotropics and antihypertensive drugs. A meta-analysis of risk factors was not possible due to different dependent variables studied, controlled confounding variables and control groups used.

Relevance to clinical practice

Fall prevention is relevant to all patients in mental health settings. Approaches to fall risk assessment and management need to be better tailored to younger mental health patients in the psychiatric setting.

Patient and public contribution

Patient or public contribution was not possible because of the study design.

Relación dialógica en el proceso de muerte/morir en un entorno hospitalario

Objetivo: conocer cómo se produce la relación dialógica entre los trabajadores del equipo de enfermería, los miembros de la familia y las personas en el proceso de muerte e morir en entorno de atención. Metodología: investigación cualitativa, desarrollada en un Hospital Universitario de marzo a junio de 2016, inspirada en la metodología de Leininger. Los datos se recopilaron mediante observaciones y entrevistas, con 24 familiares cuidadores y 47 trabajadores del equipo de enfermería como informantes clave, 18 trabajadores de enfermería y 15 familiares cuidadores. Resultados: se delimitaron las categorías: interrelaciones en el entorno hospitalario: mirar el proceso de muerte y morir del otro y de uno mismo y estrategias recursivas para repensar relacionadas con el proceso de muerte y morir. Conclusión: reitera la importancia de capacitar la equipe de enfermería para cuidar a los seres que experimentan el proceso de muerte y morir como una necesidad no solo organizativa, sino ética.

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