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AnteayerInternacionales

Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses

ABSTRACT

Background

School nurses are sometimes the sole healthcare professionals in schools, highlighting their significant role in delivering emergency care and the vital necessity of their competence in emergency nursing care. The scope of practice and ongoing professional development are hypothesized to play significant roles in enhancing these competencies.

Aim

Investigate the direct and indirect effects of the scope of current practice and the importance of training on the emergency nursing care competency of school nurses, with career growth serving as a potential mediator.

Methods

A multi-center cross-sectional study was conducted with a convenient sample of 219 school nurses. Data were collected using the career growth of nurses' scale, the emergency nursing care competency scale for school nurses and the scope of school nursing practice tool. Mediation analysis was used to explore the direct and indirect effects of studied variables.

Results

Mediation analysis indicated that the scope of current practice had a significant direct effect on career growth (β = 0.179) and emergency nursing care competency (β = 0.389). The importance of practice also had significant direct effects on career growth (β = 0.164) and emergency nursing care competency (β = 0.220). Additionally, career growth significantly mediated the relationship between both the scope of current practice (β = 0.110) and the importance of practice (β = 0.120) with emergency nursing care competency.

Conclusions

The findings emphasis the critical role of career growth as a mediator between the scope and importance of practice and emergency nursing care competency among school nurses. Expanding the scope of practice and emphasising the importance of professional activities can enhance career growth and improve emergency nursing care competencies.

Implications

Nurses scope of practice and clear career advancement through mentorship, advanced certifications, further education and enforcing policies mandating regular emergency care is crucial. Establishing a regulatory framework to define and expand the scope of practice for school nurses is also important.

Patient or Public Contribution

No patient or public contribution.

Exploring Resilience in Nursing: Multilevel Strategies for Enhancing Workplace Well‐Being

ABSTRACT

Aims

To explore how nurses working in a high-pressure academic healthcare setting in Saudi Arabia conceptualise, experience and sustain resilience in the face of professional stressors.

Design

A qualitative, descriptive phenomenological study.

Methods

Semi-structured interviews were conducted with 17 nurses from diverse clinical and academic backgrounds between March and May 2025. Data were analysed using reflexive thematic analysis, incorporating both inductive and interpretive approaches. Researcher reflexivity and methodological rigour were maintained throughout.

Results

Four major themes were identified: (1) Navigating Emotional Demands, which captured nurses' experiences of compassion fatigue and emotional resilience; (2) Support Systems and Collegial Ties, emphasising peer collaboration and mentorship; (3) Organisational Culture and Leadership, which highlighted the role of managerial support, workload policies and institutional climate; and (4) Adaptive Coping Strategies and Personal Development, including mindfulness, spirituality and continuous learning. These themes demonstrate the multilevel nature of resilience, shaped by personal attributes, interpersonal relationships and systemic factors.

Conclusion

Nurses develop resilience through an interplay of individual, relational and organisational strategies. Supportive leadership, collegial networks and opportunities for professional growth are critical in mitigating stress and preventing burnout. Findings underscore the need for culturally responsive, system-wide interventions that embed emotional safety, reflective practice and mentorship into healthcare settings. Future research should evaluate the impact of resilience-oriented policies on workforce retention and patient care outcomes.

Factors Influencing Mistriage Based on the Korean Triage and Acuity Scale: A Retrospective Cross‐Sectional Study

ABSTRACT

Introduction

Mistriage is important because of its potential for serious consequences, notwithstanding the beneficial effects of the emergency patient classification system employed to alleviate overcrowding in emergency departments (EDs). This study aimed to assess mistriage using the Korean Triage and Acuity Scale (KTAS) and identify factors influencing it.

Design

Retrospective cross-sectional study.

Methods

We examined the factors influencing mistriage in the KTAS and rates of under- and over-triage. Participants were obtained by combining electronic health records with registry data from the National Emergency Department Information System. We assessed the eligibility of patients aged ≥ 15 years who visited the ED between July 1, 2022, and June 30, 2023. Using the KTAS classification criterion, two experienced experts determined the final acuity level. We employed multivariate logistic regression analysis to evaluate the factors that predict under- and over-triage.

Results

Of 53,947 ED encounters, 1110 participants were enrolled in this study. Mistriage occurred in 207 (18.6%) patients: 88 (7.9%) had under-triage, and 119 (10.7%) had over-triage. In adjusted analyses, under-triage was associated with lower mean arterial pressure (odds ratio [OR], 5.42; 95% confidence interval [CI], 1.45–20.32) and presenting complaints of immunity or fever (OR, 3.41; 95% CI, 1.38–8.45), while over-triage was associated with advanced age (OR, 0.52; 95% CI, 0.28–0.98), pain (OR, 1.96; 95% CI, 1.18–3.25), lower KTAS experience (OR, 1.95; 95% CI, 1.08–3.51), and several specific present complaints.

Conclusions

By improving mistriage, the quality of emergency medical services may be enhanced through reduced costs, increased operational efficiency, and improved patient safety and satisfaction. Implementation of standardized criteria, validated triage tools, and enhanced provider training is crucial for achieving more accurate emergency triage. Additionally, establishing regulatory and financial incentives and developing realistic standards for mistriage management will optimize triage processes and ensure prompt, prioritized care.

Nurses' Experiences of Using Nursing Care Plans in the Electronic Medical Record in an Acute Medical Setting: A Mixed-Methods Study

imageNursing care plans within electronic medical record systems have the potential to support nurses in planning and prioritizing patient care; however, there is a gap in the literature related to nurses' experiences of how this may occur. The aims of this mixed-methods study included exploring nurses' documentation adherence, identifying barriers and enablers to care plans documentation, and making recommendations to enhance nurses' use of care plans within electronic medical records. An audit of 142 patients revealed the majority had at least one care plan initiated in the electronic medical record (n = 120, 84.5%), 63 patients had a care plan initiated within 24 hours of admission (n = 63, 44.4%), and only three had care plans documented against in the previous 48 hours (2.11%). Data from six focus groups were developed into two themes (each with two subthemes): “Mind the Gap” and “Making It Work for Us.” Barriers and enablers were identified and mapped to 10 of the 14 domains of the Theoretical Domains Framework. There was large variability in nurses' knowledge and understanding related to the need for care plans documentation. Assessment of usability and/or redesign of care plans within electronic medical records must align to nursing workflows to support clinical care delivery.

Applying Evidence to Improve Practice: Qualitative Insights Into Nurses' Experiences With Organizational Support for Mental Health Recovery

ABSTRACT

Background

The mental health and well-being of nurses are critical issues in health care, particularly following the increased stressors introduced by the COVID-19 pandemic. Nurses frequently experience burnout, stress, and emotional exhaustion due to systemic issues such as staffing shortages, heavy workloads, and limited access to mental health resources. These challenges not only affect nurses' well-being but also impact the quality of patient care. Organizational support plays a pivotal role in mitigating these issues, yet the lived experiences of nurses regarding such support remain underexplored.

Aim

This Study Aimed to Explore Nurses' Lived Experiences of Organizational Support and Its Impact on Their Mental Health Recovery, With a Focus on Identifying Actionable Strategies for Improvement.

Methods

A qualitative phenomenological approach was employed, using Interpretative Phenomenological Analysis (IPA) to gain deep insights into nurses' experiences. Twenty nurses from various healthcare facilities in the Asir region, Saudi Arabia, were recruited through purposive sampling. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis to identify recurring patterns and themes.

Results

Three main themes emerged: (1) Supportive Leadership, highlighting the critical role of empathetic and communicative leadership in fostering well-being; (2) Systemic Barriers, including staffing shortages, heavy workloads, and limited access to mental health resources; and (3) Workplace Wellness Culture, reflecting the influence of stigma, peer support, and the practicality of wellness programs on mental health recovery. These themes underscore the interconnected nature of leadership, systemic issues, and workplace culture in supporting nurses' mental health.

Linking Evidence to Action

The findings suggest several actionable strategies, including leadership training programs to foster empathy and communication, policies to address systemic barriers, tailored and accessible wellness programs, and initiatives to reduce mental health stigma. These interventions are essential for creating supportive environments that prioritize nurses' well-being and enhance their ability to deliver high-quality care.

Digital Bridges and Emotional Anchors: Nurses Facilitating Social Connectivity in Virtual Age‐Friendly Communities

ABSTRACT

Aim

To explore how nurses facilitate social connectivity among older adults in virtual age-friendly communities in Al-Ahsa, Saudi Arabia by serving as digital bridges and emotional anchors. Additionally, the study aimed to identify the factors that influence the effectiveness of nurse-led interventions in enhancing digital literacy and reducing social isolation among older adults.

Design

A qualitative study.

Method

Semi-structured interviews were conducted between June and August 2024 with 12 older adult participants and 10 nurse participants involved in virtual age-friendly community initiatives in Al-Ahsa, Saudi Arabia. Data were analysed using a hybrid approach that combined deductive thematic analysis—guided by socio-technical systems theory and relationship-centred care principles—with inductive analysis to identify key themes related to digital facilitation, emotional support and social connectivity.

Results

The findings indicate that nurse-led digital and emotional support significantly enhances older adults' digital literacy and emotional well-being, leading to improved social connectivity. Nurses acting as digital bridges provided essential technical guidance, while their role as emotional anchors offered empathetic support that mitigated feelings of isolation. However, challenges such as technical issues, resource limitations and cultural factors moderated the overall effectiveness of these interventions.

Conclusion

The study underscores the pivotal role of nurse-led interventions in promoting social connectivity among older adults in virtual settings. Future research should explore strategies to overcome technical and resource-related barriers and further integrate culturally sensitive approaches to optimise the benefits of digital health initiatives.

Implication for the Profession and/or Patient Care

Healthcare practitioners and policymakers should prioritise the implementation of nurse-led digital and emotional support programmes to reduce social isolation and improve the overall quality of life for older adults. Culturally tailored interventions are essential to address the unique needs of ageing populations in the digital era.

Reporting Method

The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or Public Contribution

The insights obtained from older adult participants and nurses provided critical understanding of the dynamics and impact of digital and emotional support within virtual age-friendly communities.

Climate Anxiety and COPD: Unveiling Its Impact on Patients' Quality of Life Through a Multivariate Lens

ABSTRACT

Objective

To examine the impact of climate anxiety on the quality of life (QoL) of patients with COPD. It also explores how climate anxiety interacts with clinical factors, such as disease severity and comorbidities, to influence QoL.

Design

Cross-sectional.

Methods

A total of 270 COPD patients were recruited using a convenience sampling method. Data were collected through structured interviews and clinical assessments, incorporating the Climate Anxiety Scale, the St. George's Respiratory Questionnaire and the BODE Index. Hierarchical multiple regression analysis was performed to determine the predictors of QoL.

Results

The study found a statistically significant association between climate anxiety and both QoL (r = 0.81, p < 0.01) and COPD severity (r = 0.76, p < 0.01). COPD severity (B = 4.68, p < 0.01) and climate anxiety (B = 0.28, p < 0.01) were predictors of QoL. Among the covariates, former smokers, older patients and multiple comorbidities reported significantly worse QoL (B = 4.80, p = 0.03; B = 0.43, p < 0.01; B = 0.85, p = 0.02, respectively). Collectively all predictors explained 86% of the variance in QoL.

Conclusion

Climate anxiety significantly contributes to reduced QoL in COPD patients, beyond disease severity and demographic factors. Addressing psychological distress in COPD management is essential to improving patient outcomes.

Implications for Practice

Nurses should recognise climate anxiety as a key variable influencing COPD management. Incorporating climate anxiety screening into nursing assessments and providing targeted interventions can enhance patient support and improve overall COPD care.

Impact

Climate anxiety is an emerging concern in COPD. While previous research has focused on physical and clinical determinants of COPD-related QoL, climate anxiety remains underexplored. This study provides new evidence that climate anxiety is a predictor of poorer QoL, highlighting the need for holistic nursing interventions that address both physical and psychological health.

Reporting Method

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Patient or Public Contribution

Patients with COPD were involved in this study.

Mindfulness for Menopausal Women: Enhancing Quality of Life and Psychological Well‐Being Through a Randomized Controlled Intervention

ABSTRACT

Background

Menopause is associated with significant physical, psychosocial, and emotional changes that can negatively affect women's quality of life (QoL). In response to this, psychological interventions like mindfulness-based interventions have shown promise in alleviating menopausal symptoms and improving psychological well-being.

Methods

A comprehensive randomized controlled trial was conducted from May to August 2024 at Damanhour University, Egypt. One hundred and twenty menopausal women were randomly assigned to either the intervention group (n = 60), which participated in seven mindfulness sessions, or the control group (n = 60), which received general health education. Pre and postintervention data were collected using the Menopause-Specific QoL questionnaire, the Depression Anxiety Stress Scale-21, and the Mindful Attention Awareness Scale. Independent samples t-tests were performed to compare groups, while paired t-tests assessed within-group changes post-intervention. Effect sizes were calculated using Cohen's d, ensuring a robust and reliable data analysis.

Results

The intervention group showed significant improvements across all domains of menopause-specific QoL, including vasomotor (d = 0.788, p < 0.01), psychosocial (d = 1.042, p < 0.01), physical (d = 0.809, p < 0.01), and sexual (d = 0.794, p < 0.01). Additionally, significant reductions were observed in anxiety (d = 1.221, p < 0.01), stress (d = 1.030, p < 0.01), and depression (d = 0.880, p < 0.01), along with a significant increase in mindfulness (d = 1.335, p < 0.01) postintervention.

Conclusion

The MBIS significantly improved menopause-specific QoL and reduced anxiety, stress, and depression while enhancing mindfulness in menopausal women. These findings suggest that mindfulness-based interventions could be game changers in managing menopausal symptoms and improving overall psychological well-being, offering hope for a better QoL for menopausal women.

Clinical Relevance

The research will primarily impact healthcare providers working with menopausal women, particularly those offering psychological support or nonpharmacological treatments. It also impacts menopausal women themselves by providing evidence-based intervention options that could alleviate menopausal symptoms. Furthermore, researchers and policymakers focusing on women's health and mental well-being may use these findings to inform future studies and healthcare strategies.

Patient or Public Contribution

Women from Damanhur University.

Trial Registration

This trial was registered with the ClinicalTrials.gov database under the registration number NCT06421909

Reducing sedentary behavior improves depressive symptoms among patients with heart failure enrolled in a home‐based mobile health app cardiac rehabilitation

Abstract

Background

Depressive symptoms are common, worsening heart failure (HF) progression and reducing quality of life. While supervised structured exercise training is effective for managing depressive symptoms, it often demands a substantial time commitment or intensive activity that may discourage participation.

Objective

Evaluate the impacts of reducing sedentary time with short bouts of light physical activities or greater intensity levels on depressive symptoms after HF patients' enrollment in a home-based intervention.

Methods

A total of 127 HF patients participated in an experimental two-group design, randomly allocated to either delayed or immediate decreasing sedentary time intervention. The immediate group started the intervention immediately, while the delayed group began after the first group finished their intervention. The 8-week intervention, guided by the Theory of Planned Behavior, focused on interrupting 30 min of sedentary behavior with short bouts of light- or greater intensity physical activities. Demographic and clinical variables were collected at baseline. Depressive symptoms were assessed at baseline, pre-intervention, and post-intervention. Physical activity (daily steps) was monitored daily during the study period using the Samsung mobile health app.

Results

Both groups demonstrated reduced sedentary time during the intervention, with improvements in HF symptom burden. Repeated measures analysis of variance revealed a significant reduction in depressive symptoms in both groups post-intervention, with a greater reduction seen in the immediate group before the delayed group began the intervention.

Conclusion

The study highlights the effectiveness of interrupting sedentary behavior with light- or greater intensity activities in managing depressive symptoms among HF patients. The home-based intervention, facilitated by mobile technology, provides a feasible and accessible approach to improving mental well-being.

Clinical Relevance

The findings support the broader implementation of home-based interventions addressing sedentary time reduction as a valuable strategy for enhancing the mental health of HF patients, particularly those facing challenges with traditional rehabilitation programs or intense exercise.

Using Collective Intelligence to Develop Design Requirements for a Complex Intervention for Advance Care Planning in the Community

ABSTRACT

Background

Engaging people in advance care planning is a challenging systemic problem that requires a social innovation approach and a conceptual framework to guide behavioural and social change efforts.

Aim

To identify stakeholders' perspectives on barriers to advance care planning engagement, options for overcoming these barriers, and user needs. The findings will inform the design of a health behaviour change intervention for engaging older adults (50+) in advance care planning.

Design

To advance co-production and intervention design goals, the study used collective intelligence and scenario-based design methods.

Methods

Following a systematic stakeholder analysis, 22 participants were recruited to three online collective intelligence sessions. The socioecological perspective informed framing of integrated findings and specifying factors at the individual, interpersonal, service, and system levels.

Results

Identified barriers (n = 109) were grouped into seven categories: (i) Psychological, (ii) Advance Care Planning Literacy, (iii) Interpersonal and Interprofessional, (iv) Service-Related, (v) Resources and Supports, (vi) Advance Care Planning Process and Methods, (vii) Cultural and Societal. Stakeholders generated 222 options for overcoming these barriers and specified 230 service user needs. The need to change perceptions of advance care planning, increase psychological readiness, and target advance care planning literacy was highlighted (individual-level). Timely, focused, and meaningful interaction between the key ACP actors must be facilitated using creative strategies (interpersonal-level). Need- and value-based services, including high quality resources, support systems, and infrastructure, should be co-designed (service-level). Cultural and societal transformation is required (system-level).

Conclusion

Findings integration offered insight into the complexity of the design context and problem situation and identified directions for context-specific advance care planning intervention development. The use of design thinking methodologies is recommended for the next phase of complex intervention development.

Implications

The study presents a roadmap of actions required from policy-makers, practitioners, and researchers to ensure the design of adequate advance care planning interventions.

Reporting Method

Quality of reporting was assured by adherence to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (International Journal for Quality in Health Care, 19, 2007, 349).

Patient or Public Contribution

Patient and public representatives participated in the collective intelligence sessions. Members of the All Ireland Institute of Hospice and Palliative Care Voices4Care facilitated that process. Findings from the first CI session (involving patients and caregivers) informed the content, format, and methods used in subsequent CI sessions.

The efficacy of behavioral sleep intervention on sleep problems among children with attention‐deficit hyperactivity disorder: A randomized controlled trial

Abstract

Background

Attention-deficit hyperactivity disorder (ADHD), affecting 5% of global children, presents inattention, hyperactivity, and impulsivity. Sleep problems, prevalent in 70% of cases, exacerbate long-term psychosocial challenges.

Aim

This study aimed to assess the efficacy of behavioral sleep intervention in alleviating sleep problems, enhancing quality of life (QoL), and reducing ADHD symptom severity among children diagnosed with ADHD.

Method

A randomized controlled trial was conducted from June 2022 to April 2023. The intervention group (n = 47) engaged in a hybrid approach, participating in both face-to-face and Zoom sessions, while the control group (n = 45) received standard care. Data collection involved administering the Children's Sleep Habits Questionnaire (CSHQ), Pediatric Quality of Life Inventory (PedsQL), and ADHD Rating Scale IV (ADHD-RS-IV).

Results

Significant enhancements were observed in CSHQ (p ≤ 0.001, effect size = 1.913), PedsQL (p ≤ 0.001, effect size = 1.862), and a notable reduction in ADHD-RS-IV (p ≤ 0.001, effect size = 1.548). These findings highlight the intervention's efficacy in improving sleep quality, QoL, and reducing ADHD symptomatology.

Conclusion

This trial contributes substantially to understanding behavioral sleep interventions' impact on ADHD-affected children, enhancing quality of life and ADHD symptomatology. The study highlights the importance of individualized care for optimal outcomes in children with ADHD.

Clinical Relevance

The study's findings underscore the potential for integrating behavioral sleep interventions into routine nursing practices, offering a valuable approach to address sleep-related challenges in children with ADHD. By focusing on sleep improvement, nurses can contribute to enhancing overall well-being and emotional regulation in these children within the context of comprehensive healthcare.

Navigating transition shock: The role of system thinking in enhancing nursing process competency among early career nurses

Abstract

Background

Building nursing process competency among beginner nurses is a pivotal need in contemporary, complex, fast-paced nursing practice. However, transitioning from the educational phase to practicing as a nurse can be a significant adjustment. New practitioners often experience a period of shock, which may present challenges in developing nurse competency. Fostering system thinking among those nurses could buffer the negative signs of transition shock and cultivate nursing process competencies at earlier times.

Aim

This study explores the relationship between transition shock and nursing process competency among early career nurses and investigates the moderating effect of system thinking on this relationship.

Method

This cross-sectional correlational exploratory study was conducted at four large hospitals in Egypt. Data were collected from 393 nurses from the first of February 2024 to the end of April 2024 using the transition shock scale, the competency of nursing process questionnaire, and the system thinking scale. Correlational and hierarchical regression analyses were used to test the study variables.

Results

A statistically significant negative correlation exists between transition shock, nursing process competency, and system thinking among early-career nurses. System thinking is positively associated with nursing process competency. System thinking positively moderates the relationship between transition shock and nursing process competency among early-career nurses. Transition shock and system thinking account for 23.9% of the variance in nursing process competency among early-career nurses.

Linking Evidence to Action

Transition shock is an inevitable phenomenon among early-career nurses, negatively affecting their competency in the nursing process. System thinking buffers this adverse effect and significantly augments nursing process competency among this set of nurses. Predicting and mitigating transition shock among early-career nurses is pivotal in building nursing process competency. Nurse educators must develop curricula that cultivate system thinking skills among nursing students, which enables them to buffer transition shock after graduation.

The effects of applying artificial intelligence to triage in the emergency department: A systematic review of prospective studies

Abstract

Introduction

Accurate and rapid triage can reduce undertriage and overtriage, which may improve emergency department flow. This study aimed to identify the effects of a prospective study applying artificial intelligence-based triage in the clinical field.

Design

Systematic review of prospective studies.

Methods

CINAHL, Cochrane, Embase, PubMed, ProQuest, KISS, and RISS were searched from March 9 to April 18, 2023. All the data were screened independently by three researchers. The review included prospective studies that measured outcomes related to AI-based triage. Three researchers extracted data and independently assessed the study's quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) protocol.

Results

Of 1633 studies, seven met the inclusion criteria for this review. Most studies applied machine learning to triage, and only one was based on fuzzy logic. All studies, except one, utilized a five-level triage classification system. Regarding model performance, the feed-forward neural network achieved a precision of 33% in the level 1 classification, whereas the fuzzy clip model achieved a specificity and sensitivity of 99%. The accuracy of the model's triage prediction ranged from 80.5% to 99.1%. Other outcomes included time reduction, overtriage and undertriage checks, mistriage factors, and patient care and prognosis outcomes.

Conclusion

Triage nurses in the emergency department can use artificial intelligence as a supportive means for triage. Ultimately, we hope to be a resource that can reduce undertriage and positively affect patient health.

Protocol Registration

We have registered our review in PROSPERO (registration number: CRD 42023415232).

The effect of virtual reality versus standard‐of‐care treatment on pain perception during paediatric vaccination: Study protocol for a randomised controlled trial

Abstract

Aims and Objectives

To study the effects of virtual reality (VR) on pain perception among a paediatric population while being vaccinated. We will also investigate the effects of VR on the fear experienced by children during the vaccination procedure, as well as parental satisfaction levels.

Background

Many studies, for example, in the fields of oncology, dermatology or plastic surgery, have described the benefits of using VR to reduce the perception of pain among paediatric populations. These results are encouraging, but their main limitations were the small sample sizes they included or their methodological design.

Design

This will be a randomised clinical trial.

Methods

SPIRIT guidelines were followed to report this protocol, and we will use the CONSORT and CONSORT-EHEALTH guidelines to report the randomised clinical trial. The sample will comprise 148 children aged 3–14 years who will come for vaccination at the Tres Forques Health Center. The participants will be randomly allocated into intervention group (VR; n = 74) or (the control group standard-of-care; n = 74) at a 1:1 ratio. The intervention group will view experiences with a VR headset as a distraction measure. The study variables will be the level of pain and fear perceived by the child during vaccination, parental satisfaction with the vaccination procedure, and sociodemographic and vaccination variables.

Results

The start of the study is planned for September 2020, and the results will be expected in September 2021.

Conclusions

This study aims to identify what measures reduce pain and fear in children during vaccination, which in turn, can help to improve the degree of parental satisfaction with these procedures.

Relevance to Clinical Practice

Vaccination is an independent function of the nursing profession. Identifying which distraction measures reduce the perception of pain and fear in the paediatric population will not only improve children's experiences but will also improve the satisfaction of both parents and children, thus increasing the degree of compliance with the vaccination schedule.

The effect of virtual reality versus standard‐of‐care treatment on pain perception during paediatric vaccination: A randomised controlled trial

Abstract

Aims and Objectives

To determine the effect of immersive virtual reality (VR) on perceived pain and fear in children during vaccination and parental satisfaction with the procedure.

Background

Virtual reality can reduce the perception of pain by children but only three studies have analysed its use during vaccination to date; these had small sample sizes and imperfect methodological designs.

Design

A randomised controlled clinical trial.

Methods

One hundred and sixty participants from the Tres Forques Health Center were randomly assigned to the intervention group (IG) (n = 82) in which distraction with immersive VR was used during the vaccination, while standard distraction techniques were used for the control group (n = 80). The primary outcome was pain (Wong–Baker FACES). Secondary outcomes included (Children's Fear Scale) and parental satisfaction with the vaccination procedure. Chi-squared tests were used for qualitative variables, relationships between quantitative variables were tested with Spearman correlations, and Mann–Whitney U- or Student t-tests were employed to assess the relationship between quantitative and qualitative variables.

Results

Compared to the controls, the children in the IG reported significantly less pain and fear, while parental satisfaction was significantly higher. Reported pain and fear did not differ according to the sex of the patient. Child age was not linked to fear but was related to pain: the younger the patient, the greater the pain they described.

Conclusions

Immersive VR effectively controlled pain and fear in children during vaccination and increased parent satisfaction with the vaccination process. Patient sex did not influence the level of pain and fear but age did.

Relevance to clinical practice

Improving vaccination experiences can reduce perceived pain and fear in children and increase parent satisfaction, thereby enhancing vaccination schedule adherence and improving group immunity.

Reporting Method

The CONSORT Statement for non-pharmacological randomised clinical trials were followed.

Modifiable work stress factors and psychological health risk among nurses working within 13 countries

Abstract

Introduction

Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psychological health among nursing workforce and needed to inform targeted practice and policy change.

To determine which occupation-related or personal stress factors precipitate higher risk for burnout, depression, anxiety, job satisfaction or intention to leave one's position among nurses globally.

Design

A cross-sectional anonymous survey was administered via email using a snowball recruitment strategy.

Methods

Academic researchers and clinical industry leaders across 3 global regions collaborated to generate an email listserv of professional nursing contacts for survey distribution. The survey included valid and reliable measures to scale stress factors (Work Stress Questionnaire), and screen for burnout (single item), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2), resilience (Brief Resilience Scale) and intention to leave one's job (single item). We used logistic regression, first unadjusted and then adjusted for personal and professional characteristics, to determine associations between stress factors and psychological health risk.

Results

The final sample consisted of responses from 2864 nurses working across 13 countries. Most respondents reported working as a clinical nurse in the Philippines (n = 2275), United States (n = 424) and Saudi Arabia (n = 104). One third of nursing respondents endorsed high burnout and intention to leave their job. Those reporting work conflict had significantly higher odds of burnout (odds ratio 3.18; 95% CI 2.22–4.54) and three times more likely to screen positive for depression (odds ratio 3.02; 95% CI 1.36–6.72) and anxiety (odds ratio 2.92; 95% CI 1.57–5.43). Those endorsing difficulty sleeping were 15 times more likely to screen positive for depression (odds ratio 15.63; 95% CI 2.09–117.06). Lack of social support was significantly associated to higher risk for burnout, job dissatisfaction, depression, anxiety, and intention to leave one's position.

Conclusions

Nurses remain at risk for burnout and poor psychological health stemming from work stress. Factors such as clear workplace goals and assignments, increased engagement, good sleep health and social support may serve as protective factors against suboptimal psychological health, and in-turn poor workforce retention.

Clinical Relevance

Nurses reporting conflict in the workplace are three times more likely to screen positive for burnout, depression, and anxiety. Nurses reporting difficulty sleeping are 15 times more likely to screen positive for depression. Several modifiable factors can be targeted to reduce poor psychological health and high workforce turnover among nurses across countries.

Analysing the patient experience of COVID‐19: Exploring patients' experiences of hospitalisation and their quality of life post discharge

Abstract

Aims and Objectives

We sought to gain an understanding of the patient experience during their hospital stay for COVID-19, and the impact of COVID-19 on quality of life post discharge.

Background

Symptoms of COVID-19 include a persistent cough, dyspnoea and fatigue. Individuals with comorbidities such as cardiovascular disease have a higher risk of contracting COVID-19 and approximately 20% of those diagnosed with COVID-19 are admitted to hospital. Following discharge from hospital, 40% of patients report a worsened quality of life and up to 87% of those discharged from hospital have experienced ‘long COVID’.

Design

A qualitative design was used to understand patient experience of hospitalisation following a diagnosis of COVID-19, and their experiences following discharge from hospital.

Methods

Ten patients with a previous diagnosis of COVID-19 took part in semi-structured interviews regarding their experiences of hospitalisation and the impact on quality of life post-discharge.

Results

The results identified three key themes from the interviews: communication and the inpatient experience, symptoms following discharge and regaining independence. Patients discussed their experience of hospitalisation and how this continued to impact their emotional well-being post-discharge. However, patients appeared to push themselves physically to improve their health, despite continued COVID-19 symptoms.

Conclusion

Patients hospitalised following a diagnosis of COVID-19 experienced psychological distress during their hospital stay, as well as 3-months post-discharge. We suggest the use of psychosocial interventions to support patients post-discharge.

Relevance to Clinical Practice

The results of this study provide a greater understanding of the patient experience during their hospital stay, which can support nursing staff practice. Additionally, the study provides in depth knowledge of personal experiences of patients diagnosed with COVID-19 and the impact following hospital discharge.

Patient or Public Contribution

Patient's took part in semi-structured interviews via telephone to support the aims and objectives of this study.

Factors related to preoperative anxiety in older patients with sensory impairment: A cross‐sectional study

Abstract

Aim

To identify the factors related to preoperative anxiety in older adults with sensory impairment.

Design

Descriptive quantitative research design.

Methods

Study participants were 120 older adults admitted to a tertiary hospital in Seoul, South Korea to undergo eye or ear surgery. Data were collected from 11 February to 30 April 2023. The collected data were analysed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis using SPSS 28.0. The study was reported following the STROBE checklist.

Results

Preoperative anxiety differed significantly according to gender (p = .002), average monthly household income (p < .001), subjective health status (p = .003), subjective vision loss (p = .004), one-sided or both-sided eye discomfort (p = .002), use of glasses (p = .010), subjective hearing loss (p = .022) and anxiety coping mechanisms (p < .001). The results of a multiple regression analysis on the significant variables identified that gender (β = .178, p = .036) and anxiety coping mechanisms (β = .336, p < .001) had the most significant effect on preoperative anxiety, with an explanatory power of 34.5%.

Conclusion

The development and practical application of tailored nursing interventions catering to specific genders and anxiety coping mechanisms would contribute to reducing preoperative anxiety and providing efficient nursing care for older adults with sensory impairment.

Does a program‐based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

Abstract

Background

Menopausal women often complain of a range of physical and psychological symptoms known as menopausal syndrome. These symptoms are associated with fluctuating hormone levels, sleep disturbances, and mood swings.

Aim

This study aimed to examine the efficacy of a program-based cognitive behavioral group therapy (CBT) for insomnia and depression among women experiencing menopause.

Methods

A randomized controlled trial of 88 women experiencing menopause was conducted in Egypt from June to September 2022 in outpatient clinics at Mansoura University Hospitals in Egypt. Participants were randomly assigned to a control group (45 women) and an intervention group (43 women). The intervention group received 7 weeks of CBT sessions. Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory 2nd Edition (BDI-II) were administered before and after the intervention.

Results

In the intervention group, there was a significant difference in scores of the subdomains of PSQI, including sleep efficiency, daytime dysfunction, subjective sleep quality, and sleep disturbance (t = 8.911, 11.77, 7.638, and 11.054, respectively), while no significant difference in domains of using sleep medication, sleep duration, and sleep latency. Significant improvements were observed between pre-and-post-intervention in the intervention group for the total scores of PSQI, ISI, and BDII-II (t = 12.711, 16.272, and 12.384, respectively), indicating a large effect size for the three studied variables (r = .81, .87, .8, respectively).

Linking Evidence to Action

This study demonstrated the efficacy of group CBT for lowering insomnia and depression in women experiencing menopause. Thus, results indicated the need of considering prompt and appropriate interventions such as CBT as a safe treatment option to prevent the aggravation of sleep and emotional problems for menopausal women.

Trial Registration

ClinicalTrials.gov Identifier: NCT05920460.

Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery

Abstract

Aim(s)

To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery.

Design

This scoping review was conducted according to the JBI scoping review framework.

Methods

Review included systematic reviews that evaluated any nurse-initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a ‘certainty (quality) of evidence’ according to the Grading of Recommendations, Assessment, Development and Evaluations criteria.

Data Sources

Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023.

Results

A total of 428 articles were identified; following screening, 81 reviews underwent full-text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%).

Conclusions

This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice.

Implications for the profession and/or patient care

Implementing up-to-date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes.

Patient or public contribution

No patient or public involvement in this scoping review.

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