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This meta-synthesis of qualitative studies aimed to explore the experiences and perspectives of healthcare providers in the Intensive Care Unit (ICU) setting regarding the implementation of early mobilization.
A qualitative systematic review and meta-synthesis was conducted. The review protocol was registered with PROSPERO (CRD420251057721).
Six databases (PubMed, EMBASE, Web of Science, CINAHL, CNKI and Wanfang Data) were searched from inception to March 5, 2025. A total of 759 records were identified, and 34 studies met the eligibility criteria and were included in the final meta-synthesis.
We evaluated the quality of the included studies using the Critical Appraisal Skills Programme-Qualitative Research Checklist.
Thirty-four studies conducted in 13 countries and involving 699 ICU healthcare providers were included. Four analytical themes were generated: characteristics of early mobilization, the inner setting of implementation, the key role system and core determinants of successful implementation.
Early mobilization in ICUs should be understood as a multidimensional implementation process rather than a single rehabilitation task. Sustainable practice depends on the characteristics of the intervention, organizational readiness, clearly defined interprofessional roles, patient engagement and process-level strategies such as preplanning, real-time monitoring, debriefing and feedback. The findings support the development of context-sensitive implementation strategies to translate early mobilization evidence into routine ICU care.
This review underscores the critical importance of organizational support, team collaboration mechanisms and the professional capacity building of healthcare providers in advancing early mobilization within ICU settings. Frontline clinicians should be equipped with targeted training and structured planning tools, while leadership is encouraged to foster a culture of shared responsibility and continuous improvement.
This qualitative systematic review did not involve original patients or the public. Therefore, this is not applicable.
The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care.
Explore the experiences of patients and families during the transition from the intensive care unit to the general ward.
A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis.
PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024.
Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method.
Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories.
Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being.
Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications. The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care. Identify patient and family needs when designing transition interventions. Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings.
This is a meta- synthesis without direct patient involvement.
To explore the mediating effect of team job crafting on the transformational leadership–occupational well-being association in newly graduated nurses.
A multicentre cross-sectional study was conducted in three tertiary hospitals in China. Using convenience sampling, 677 newly graduated nurses were recruited between August 2024 and September 2024, and completed the transformational leadership questionnaire, team job crafting scale for nurses, and healthcare providers' occupational well-being scale. Data analysis was performed using IBM SPSS 27.0 software and the PROCESS 4.2 plugin. Hayes' mediation model (Model 4) was employed to test the indirect effect. The significance of the mediating effect was assessed using the bias-corrected bootstrap method (5000 resamples).
Ultimately, 546 valid questionnaires were collected. The participants' transformational leadership, nurse team job crafting and healthcare providers' occupational well-being scores were all above average. Linear regression analysis revealed that transformational leadership and team job crafting positively predicted occupational well-being (β = 0.549, p < 0.001; β = 0.695, p < 0.001). Mediating analysis revealed that the indirect effect of transformational leadership on occupational well-being was 0.276 (95% confidence interval: 0.174, 0.377), indicating the presence of an indirect effect. Additionally, team job crafting accounted for 33.5% of the effect of transformational leadership on occupational well-being.
Perceived transformational leadership among newly graduated nurses could positively influence their occupational well-being, with team job crafting playing a partial mediating role between the two. Therefore, it is recommended that nursing managers strengthen their transformational leadership practices to promote the accumulation and internalisation of job resources among newly graduated nurses, thereby enhancing their ability and level of team job crafting and further promoting their occupational well-being.
To systematically analyse international empirical literature and establish a comprehensive understanding of the push and pull factors influencing retention and turnover among mid-career nurses.
An integrative review.
PubMed, Web of Science, Scopus, EMBASE (Ovid), and CINAHL (EBSCO) were searched for studies published between January 2001 and November 2024.
An integrative literature review was conducted following the five-step process outlined by Whittemore and Knafl. Articles were screened by title, abstract, and full text based on predefined inclusion and exclusion criteria. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and synthesised narratively, and the findings were presented according to the socio-ecological framework.
A total of 1930 studies were identified, with 14 included for analysis: 10 qualitative, 3 quantitative, and 1 mixed-methods study. Guided by the socio-ecological framework, four themes and 10 subthemes emerged: (1) Intrapersonal (professional knowledge/skills, health issues, work-family balance); (2) Interpersonal (professional collaborative relationships, supervisor support); (3) Organisational (organisational characteristics, work characteristics, career development); and (4) Societal (salary/benefits, Social/governmental recognition).
This review reveals the heterogeneity of research on this topic and confirms previous findings. It identifies certain push-and-pull factors common to nurses across all stages of their careers. However, mid-career nurses face unique challenges, including more complex healthcare demands, declining health status, growing family caregiving responsibilities, unclear organisational roles, underutilisation of professional skills, career stagnation, and limitations on salary growth. These findings highlight the need for tailored retention strategies for mid-career nurses.
A “one-size-fits-all” retention strategy does not meet the needs of all nurses. To improve nurse retention rates, it is essential to address the shifting demands and priorities that arise as nurses reassess and transition through different career stages. For mid-career nurses, acknowledging and valuing their expertise and capabilities, providing sufficient resources, and fostering a supportive work environment that promotes career development may be effective strategies for retaining these experienced professionals.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
No Patient or Public Contribution.
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