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AnteayerJournal of Clinical Nursing

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.

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 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.

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.

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.

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.

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