Conectar
This paper responds to the recently published article on nurses' turnover intentions and their lived experiences of disempowerment, moral distress and organisational neglect. While the study illuminates important workplace realities, it overlooks the perspectives of nurses who have left not only their institutions but also their countries of origin. From the vantage point of Filipino nurses in the diaspora, the decision to migrate mirrors the dynamic, cumulative processes described in the article. Migration is seldom the result of one critical incident; rather, it arises from entrenched systemic issues—understaffing, lack of respect and persistent undervaluing of nursing contributions—that transcend borders. Diaspora nurses bring with them narratives of resilience, yet their departure reflects health system fragility in their home countries and exposes new challenges in host nations. This commentary highlights the urgent need for global cooperation, stronger leadership and policy innovations that recognise migration as part of the retention equation, not apart from it.
Explore the care escalation process initiated by parents concerned about their hospitalised child's deterioration and healthcare providers' response to parental concerns.
A qualitative study using Charmaz's constructivist grounded theory.
Participants included healthcare providers, cultural mediators and parents of children hospitalized for ≥ 3 days, who had experienced previous urgent intensive care admission or parental concern during hospitalization, in a tertiary pediatric hospital. Data were collected through focus groups, and analyzed using a grounded theory methodology with NVivo Software.
A total of 13 parents, 7 cultural mediators and 68 healthcare providers participated in 16 focus groups. Two main categories were identified: (1) Parents navigating the uncertainty of the escalation system to get a response; (2) Healthcare providers balancing parents' concerns, their own situation awareness, escalation processes and team relations. We developed a Grounded theory called ‘Parents Supporting Timely Escalation Processes’ (P-STEP). By monitoring their children, parents identify early signs of deterioration and advocate for escalation. Reasons for concern are their child's behaviour, communication failure and admission on an off-service ward. Parents escalate by contacting ward providers, their child's specialist or the most trusted staff and, only selected parents, the Rapid Response Team. Staff escalate parents' concern according to their own situation awareness, parent evaluation and ward escalation practices. Parent's emotions and trust are influenced by the timeliness and type of staff response.
While some parents effectively advocate for their child, others face obstacles due to unclear and lack of formal care escalation systems. Understanding how parents escalate care and healthcare providers respond is essential to identify facilitators, barriers, key stakeholders, and implement a formal system for parent-initiated escalation of care.
Integrating parents into processes of escalation and rapid response systems could optimise early recognition and improve responsiveness in paediatric deterioration.
The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) guidelines.
Parents and HCPs participated as interview respondents.
To evaluate the predictive capacity of the Integrated Care for Older People screening tool for the risk of falls in older people receiving care at a healthcare service.
A cross-sectional study.
This study was conducted in a geriatric healthcare service in the southeast region of Brazil. The convenience sample included older people aged 60 and over living at home. The study used the Fall Risk Score to assess the risk of falls and the Integrated Care for Older People screening tool to track intrinsic capacity. The data was analysed using logistic regression to analyse the association between the six Intrinsic Capacity domains, for the early detection of impairment and risk of falls.
A total of 253 older adults participated in the study, most of whom were identified as having a high risk of falls. Logistic regression analysis across six association models revealed that the models including the Intrinsic Capacity domains of locomotion and hearing had a significant association with having a higher risk of falls. Care plans should prioritise the domains most strongly associated with fall risk, guiding targeted strategies to enhance older adults' safety.
The Integrated Care for Older People screening tool, in the locomotion and hearing domains, is associated with the risk of falls in older people from the community receiving care in a geriatric healthcare service. Future longitudinal studies could show whether other domains of intrinsic capacity can predict the occurrence of falls.
This study highlights the Integrated Care for Older People screening tool as essential in nursing practice, especially for assessing the locomotion and hearing domains of intrinsic capacity. Early detection of impairments helps identify increased fall risk in older adults, enabling nurses to implement targeted, person-centred interventions that enhance safety, autonomy and overall quality of life.
No patient or public contribution.
This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
To evaluate the effect of mutuality on self-care in people with CHD and the contribution of their caregivers, and whether such relationships can be mediated by self-efficacy.
Secondary analysis of baseline data from a multi-centre longitudinal study.
Patients at the onset of coronary artery disease who underwent angioplasty, along with their caregivers, were included in the sample. Data from 136 patients and 136 caregivers were used for the analysis. Mutuality between patients and caregivers was measured using the Mutuality Scale. Self-care was measured using the Self-Care of Coronary Heart Disease Index and the Caregiver Contribution to Self-Care of Coronary Heart Disease Index. The actor–partner interdependence mediation models were used to assess the mediating role of self-efficacy for self-care between perceived mutuality and self-care behaviours.
An actor indirect effect was found between patient mutuality and their self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on their contribution to self-care maintenance, self-care monitoring, and self-care management, through the mediation of their self-efficacy. Caregiver mutuality had a positive indirect effect on patient self-care maintenance and on patient self-care monitoring, through the mediation of patient self-efficacy. All models demonstrated satisfactory fit to the data.
Mutuality between patients and caregivers enhances self-care behaviours in patients with coronary heart disease, and self-efficacy is a crucial mediator in this relationship. Interventions targeting both mutuality and self-efficacy within patient–caregiver dyads may improve self-care outcomes.
We adhered to STROBE guidelines.
Patients and members of the public were not involved in the design, conduct, reporting, or dissemination plans of this research.
Develop and simulate test a digital alert dashboard drawing from existing data to support nurses, care workers and managers in residential aged care.
Participatory action research, co-designing for an Australian 64-bed residential site.
Qualitative data were collected through focus groups and analysed using reflective thematic analysis.
Nursing-theory and evidence-based Nursing Data Domain Standards (NDDS) were developed to support internal triaging of fundamental and clinical care in a non-clinical environment. A co-designed retrospective digital alert dashboard (Aged Care Electronic Dashboard Information Tool—ACED-IT) representing the Standards was created and tested. Twenty aged care nurses, care workers and managers found it had promise in enhancing quality of care, improving resident health and reducing adverse events.
Maximising efficient use of resident-level data with a system that empowers nurse decision-makers is crucial to support effective care design and harm prevention.
ACED-IT has the potential to improve visibility of resident needs, support staff to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care and reduce preventable complications.
Digital systems that enable nursing care escalation and triaging for early intervention are needed in residential aged care settings. The co-designed system was perceived by registered nurses, care workers and managers to have the potential to improve care quality and efficiency. Using an evidence-informed nursing framework to identify day-to-day care indicators can be widely implemented by government regulators, software providers and residential care providers on an international scale to improve resident experience.
This study adhered to the relevant EQUATOR guidelines, specifically the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist.
A member of the public participated in the Advisory Group, observed and contributed to the co-design process and reviewed the manuscript.
To examine competencies, attitudes, barriers and factors that influence the provision of mental health services by nurses in schools and higher education institutions in the post COVID-19 era in Taiwan.
This cross-sectional study used nationwide proportionate stratified random sampling to recruit nurses from K–12 schools and higher education institutions.
Data were collected through an online survey administered between July and December 2024, with 305 responses received (response rate = 46.4%).
Among the respondents, 55.1% provided advanced mental health services, while 38.3% delivered basic mental health services. The main barriers to the delivery of mental health services were lack of mental health-screening training (63.3%), insufficient brief screening tools (46.2%) and time constraints (42.6%). Nurses in junior and senior high schools were 5.78 and 3.07 times more likely, respectively, to provide advanced mental health services compared to those in universities. Furthermore, significant predictors of the provision of advanced mental health services included working in junior or senior high school, higher competence, and more positive attitudes; perceiving time constraints was a significant barrier.
Working in junior and senior high school settings was the most significant predictor of delivering advanced mental health services. These results underscore the need for targeted professional training, enhanced resources, and inter-professional collaboration to improve the quality of school-based mental health services.
Enhancing the attitudes and competencies of nurses in schools and higher education institutions towards mental health care is essential. Training should target nurses working in junior and senior high schools. Administrators must improve workflows, provide better tools and address barriers such as time constraints and limited referrals to support students' mental well-being.
This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.
No Patient or Public Contribution.
This study examined the barriers to mental health service delivery among nurses in schools and higher education institutions and identified key determinants influencing their provision of such services. Nurses in schools and higher education institutions face challenges in providing mental health services due to a lack of mental health training, insufficient brief screening tools and time constraints. Advanced services were more common in junior and senior high schools, with competence and attitude being key predictors of their delivery.
To explore the latent categories and influencing factors of dyadic decision self-efficacy among stroke patients and their caregivers.
A cross-sectional survey involving 305 patient-caregiver pairs was conducted using standardised questionnaires. Latent profile analysis was used to identify dyadic self-efficacy categories and multinomial logistic regression was employed to analyse influencing factors.
The dyadic decision self-efficacy of stroke patients and their caregivers was classified into three categories: low common decision self-efficacy group (35.6%), patients' high decision self-efficacy and caregivers' moderate decision self-efficacy group (38.6%), and high common decision self-efficacy group (25.8%). Influencing factors included patients' education level, income and health literacy, as well as caregivers' education, caregiving duration and social support.
The levels of dyadic decision self-efficacy among stroke patients and their caregivers are heterogeneous. Clinicians can develop targeted interventions involving both patients and caregivers, based on the population's characteristics and influencing factors, to improve their dyadic decision self-efficacy.
This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.
This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.
A descriptive qualitative study was employed.
This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.
Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.
Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.
The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.
Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.
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.
This study aimed to systematically review Clinical Practice Guidelines (CPGs) for nutritional management of dementia and use evidence mapping to highlight research trends and identify gaps to inform future research.
A systematic review of guidelines using the PRISMA statement.
Systematically collect literature on dementia management CPGs from PubMed, Embase, Web of Science and guideline databases. Extract basic information, recommendations, methodological quality and reporting quality of the CPGs. Four researchers independently evaluated eligible CPGs using the AGREE II instrument and the RIGHT checklist. All recommendations from the CPGs were summarised and analysed, and evidence mapping bubble charts were created in Excel.
After excluding 5541 records, 10 CPGs were eventually proved eligible, 5 of which were of high quality and 5 of high quality. With 10 CPGs that combined 18 recommendations. The nutrition screening and assessment were summarised on the basis of the dementia recommendations for 4 major items, 7 items on nutritional interventions, 5 items on caring and 2 on education.
This review provides an evidence map and offers new perspectives on CPGs for nutritional management in dementia. However, there are improvements to the included CPGs, but most CPGs have a number of key recommendations that can help guide clinical practice.
The currently available guidelines on dementia nutritional management have room for methodological improvement.
Artificial intelligence-based conversational agents (CAs) have shown transformative potential in healthcare, yet their application in cancer health education has remained underexplored, particularly regarding usability and patients' experiences. Existing reviews lack a dedicated focus on user perspectives, limiting insights into how CAs can be optimised for patient needs.
To explore the usability and experience of artificial intelligence-based conversational agents in health education for cancer from the user perspective.
A scoping review was conducted with the Joanna Briggs Institute Scoping Reviews conduct guidance and reported according to the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist.
A search was performed in PubMed, Embase, CINAHL, Web of Science, PsycINFO, IEEE Xplore Digital Library and ACM Digital Library from their inception to March 6, 2024. The references to the articles included were also searched. The Pillar Integration Process was employed to chart data.
A total of 12 studies were included in this scoping review, which revealed that CAs supported diverse educational contexts, including cancer-related knowledge (41.7%), pretest genetics (33.3%), self-management (16.7%) and psychological skills (8.3%). Three studies reported that patients preferred interactions with multiple options or ‘read more’ functions. Patients were generally optimistic about the CAs and reported that CAs provided informational, physical, and psychological support for them. However, limitations such as insufficient customisation, lack of empathy, and defects in understanding free-input questions were noted.
This review demonstrated that CAs are promising complementary tools in cancer education, alleviating healthcare burdens while enhancing patient engagement, which was particularly critical in resource-limited settings. However, clinical implementation requires more rigorous validation of safety protocols and high-quality original studies.
Nurses and policymakers should consider CAs valuable tools to enhance cancer health education, provided that they align with patient needs and institutional safety standards.
To evaluate the effectiveness of multidisciplinary transitional care interventions on functional status, quality of life and readmission rates of stroke patients.
Quantitative systematic review and meta-analysis.
Studies with interventions to ease the hospital-to-home transition of stroke patients that were delivered by multidisciplinary teams consisting of registered healthcare professionals from at least two disciplines were included. Cochrane Risk of Bias tool was used for quality appraisal.
Seven electronic databases (PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science) were searched for randomised controlled trials delivering transitional care interventions to hospitalised stroke patients.
Thirty-one randomised controlled trials were included in the final review. The studies featured multidisciplinary teams of two to nine professionals, most commonly nurses, physicians and physiotherapists. Although multidisciplinary care improved functional status and quality of life scores, the impact on readmission rates was inconclusive. Meta-analysis revealed significant improvements in functional status when care involved physicians, care coordinators (often nurses) or had teams of more than two healthcare professionals. Significant improvement in quality of life was also reported when care involved physicians or in teams with more than two healthcare professionals.
Multidisciplinary transitional care interventions show promise in improving functional status and quality of life after stroke. Their effectiveness depends on team composition and coordination, particularly the inclusion of physicians and care coordinators. Future research should address reporting gaps and evaluate broader strategies to reduce hospital readmissions.
Impact (Addressing)
What problem did the study address? ○
The effectiveness of multidisciplinary transitional care interventions for stroke patients.
○Evaluated the role of various healthcare professionals within these teams.
What were the main findings? ○
Multidisciplinary transitional care interventions significantly enhance stroke patients' functional status, especially within the first 3 months.
○Teams with care coordinators (often nurses) and supportive physicians improve functional outcomes, with effective communication being crucial despite underreporting of specific practices.
○Teams comprising of more than two health professionals can significantly improve stroke patients' functional status.
Where and on whom will the research have an impact? ○
Healthcare institutions and providers: The findings can guide healthcare institutions in developing and implementing effective transitional care services for stroke patients.
○Stroke patients: Patients receiving multidisciplinary transitional care are likely to experience enhanced functional recovery and improved ability to perform daily activities.
○Policymakers and researchers: The study highlights the need for more detailed reporting and research on communication practices within multidisciplinary teams and the importance of evaluating underreported outcomes like readmission rates.
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) checklist.
No Patient or Public Contribution.
Vaccinations are essential to ensure protection for healthcare professionals, patients and communities. However, vaccination hesitancy has been reported among healthcare professionals. Nurses are the main, first and direct point of contact for patients and citizens in most healthcare services, but only a minority of studies investigated vaccination hesitancy and uptake specifically in this population. Thus, this study aimed to explore the determinants and motivations of vaccination hesitancy and uptake among nurses.
Systematic review with a narrative synthesis approach.
We included primary research exploring determinants or motivations of vaccination hesitancy or uptake among nurses. No time or geographical limit was applied. Generalised random-effects linear models with a logit link were used to calculate the pooled estimated proportions for vaccine uptake among nurses.
We explored nine databases (2023).
The initial search identified 3452 records; 42 records were eventually included in this review. Older age, longer professional experience, lack of confidence in vaccine safety and effectiveness and cost associated with the vaccine were among the most common determinants of vaccine hesitancy. Safety concerns, complacency (e.g., beliefs of not needing the vaccine), and accessibility (e.g., logistics) were among the most common motivations for being vaccine hesitant. Having strong confidence in the vaccine, a high sense of collective responsibility, previous vaccination uptake/positive intentions towards future vaccination, weaker vaccine complacency, and older age were among the most common determinants of vaccine uptake. Willingness to protect themselves and/or others, contribute to the herd immunity, and comply with recommendations were among the most common motivations for vaccine uptake. The pooled prevalence of influenza vaccine uptake among nurses was 44% (95% CI: 35–73).
The findings of this systematic review with meta-analysis could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
This study contributes to further understanding nurses' beliefs, barriers, and facilitators towards vaccination. By doing so, these results could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
We have adhered to relevant EQUATOR guidelines, in particular to the PRISMA checklist.
No patient or public contribution.
PROSPERO number: CRD42020212252
To explore flight nurses' experiences with interhospital transportation of critically ill patients in fixed-wing aircraft.
The study had a qualitative explorative and descriptive design.
Nine flight nurses working at five different air bases across Norway were interviewed. Systematic text condensation was used to analyse the data. The study was reported according to the COREQ checklist.
The data analysis resulted in three categories: Flight nurses being one step ahead when preparation for transporting patients in out-of-hospital environments, Flight nurses' strategies for effective and safe patient transport within the aircraft environment, and Flight nurses' need for a structured and organised handover of patients.
The flight nurses emphasised the need for extensive preparation prior to aeromedical transport to enhance patients' safety. The aircraft environment was a challenge that required them to be creative with the limited resources available and to have a well-functioning interprofessional teamwork.
Knowledge about flight nurses' experiences with interhospital transportations could provide a path to standardisation and inform strategies to enhance interprofessional teamwork. Such knowledge could also contribute to humanising nursing practice during the transportation of critical care patients.
There were no patient or public contributions.
To determine the treatment effectiveness associated with mobile health-delivered cognitive behavioural therapy for insomnia (mCBT-I) interventions for adults with insomnia and to identify the potential characteristics associated with better treatment outcomes.
A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines.
Seven English- and two Chinese-language databases were searched, without restrictions on publication dates, up to July 2024. Reference lists of relevant reviews and grey literature were included in the search. Randomised controlled trials evaluating mCBT-I in adults with insomnia and published in either English or Chinese were included in this meta-analysis. A random-effects model was used for data analysis, accompanied by additional subgroup analyses and meta-regression.
Sixteen studies involving 2146 participants were included in this meta-analysis. mCBT-I interventions were associated with significantly reduced insomnia symptoms and improved sleep quality at post intervention, at 1–3-month follow-up, and at 4–6-month follow-up. Interventions that included five components of CBT-I, were delivered for 6 weeks or longer, and were conducted in a group format were linked to better treatment outcomes; the differences in other subgroup categories were not statistically significant. Studies involving participants with comorbid conditions showed a greater effect in reducing insomnia symptoms than those without such participants. In addition, mCBT-I interventions delivered by healthcare professionals resulted in statistically larger effect sizes for improving sleep quality than self-help regimens.
The systematic review and meta-analysis identified the effectiveness of mCBT-I in reducing insomnia symptoms and improving sleep quality and offered practical implications for the development of effective mCBT-I interventions in clinical practice. However, future robust studies are needed to explore the long-term effects of mCBT-I interventions.
No patient or public contribution.
PROSPERO CRD: 42023454647
The aim of this study was to investigate the effect of postoperative thirst on patient comfort and quality of recovery in patients undergoing colorectal surgery.
This study is an analytical cross-sectional study.
This study was conducted between July 2022 and January 2023 in the general surgery clinics of a university hospital in Ankara, Türkiye. The study sample consisted of 110 patients. Patient Identification Form, Thirst Symptom Assessment Scale (TSAS), Numeric Rating Scale (NRS), Perianesthesia Comfort Scale (PCS) and Quality of Recovery-40 questionnaire (QoR-40) were used for data collection. The severity of thirst was assessed three times: at the time of arrival to the postoperative clinic, at the 8th hour, and at the 24th hour, and the PCS and QoR-40 scales were administered at the 24th hour.
In this study, more than half of the patients were male (62.7%) and the mean age was 61.35 ± 13.79 years. The mean thirst severity of the patients was 12.25 ± 4.65, 12.36 ± 4.49 and 11.27 ± 4.76 according to the TSAS, 7.27 ± 2.39, 7.27 ± 2.01 and 6.17 ± 2.89 according to the NRS, respectively. The mean total score of PCS was 5.12 ± 0.43 and the mean total score of QoR-40 was 171.58 ± 10.33. Postoperative 8th hour thirst severity according to NRS, PCS total score level and postoperative thirst severity measured by TSAS at three times were found to have a significant effect on QoR-40 total score level in a decreasing direction. PCS total score was found to have a significant effect on QoR-40 total score level in an increasing direction.
The results obtained in this study showed that the thirst symptom experienced by the patients was moderate. It was determined that an increase in the severity of thirst decreased patients' comfort and quality of recovery levels, whereas an increase in comfort level increased the level of quality of recovery.
It is recommended that the severity of thirst should be assessed frequently with appropriate scales and appropriate nursing care should be provided for thirst management in order to increase the postoperative comfort of patients and to improve their recovery more positively.
No study has been found to describe and compare the effect of postoperative thirst on comfort and quality of recovery in patients undergoing colorectal surgery. In this study, it was found that an increase in the severity of postoperative thirst decreased the level of postoperative comfort and quality of recovery, whereas an increase in the level of postoperative comfort increased the level of quality of recovery. This information can be used to optimally manage the symptom of thirst after colorectal surgery, develop evidence-based nursing interventions, and improve the quality of care.
This study was reported according to the STROBE checklist.
Patients answered the scales with their voluntary consent. There is no public contribution.
To examine the feasibility of using a large language model (LLM) as a screening tool during structured literature reviews to facilitate evidence-based practice.
A proof-of-concept study.
This paper outlines an innovative method of abstract screening using ChatGPT and computer coding for large scale, effective and efficient abstract screening. The authors, new to ChatGPT and computer coding, used online education and ChatGPT to upskill. The method was empirically tested using 400 abstracts relating to public involvement in nursing education from four different databases (CINAHL, Scopus, ERIC and MEDLINE), using four versions of ChatGPT. Results were compared with a human nursing researcher and reported using the CONSORT 2010 extension for pilot and feasibility trials checklist.
ChatGPT-3.5 Turbo was most effective for rapid screening and had a broad inclusionary approach with a false-negative rate lower than the human researcher. More recent versions of ChatGPT-4, 4 Turbo, and 4 omni were less effective and had a higher number of false negatives compared to ChatGPT-3.5 Turbo and the human researcher. These more recent versions of ChatGPT did not appear to appreciate the nuance and complexities of concepts that underpin nursing practice.
LLMs can be useful in reducing the time nurses spend screening research abstracts without compromising on literature review quality, indicating the potential for expedited synthesis of research evidence to bridge the research–practice gap. However, the benefits of using LLMs can only be realised if nurses actively engage with LLMs, explore LLMs' capabilities to address complex nursing issues, and report on their findings.
Nurses need to engage with LLMs to explore their capabilities and suitability for nursing purposes.
No patient or public contribution.
This study explored the multiple mediating roles of sense of coherence (SOC) and coping styles in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.
A cross-sectional study of 347 family caregivers of patients with stroke was conducted in China. Data were collected using a general information questionnaire, Zarit Caregiver Burden Interview and other questionnaires, and were analysed using descriptive, Pearson's correlation and path analyses.
SOC–positive and SOC–negative coping styles played a fully parallel chain-mediating role in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.
Improving caregivers' SOC and encouraging them to adopt positive coping styles are crucial for reducing the negative impact of caregiver burden on family adaptation.
This study provides a new perspective for medical staff to improve the family adaptation of family caregivers of patients with stroke. Targeted interventions aimed at improving the SOC level and enhancing positive coping styles of the family caregivers of patients with stroke are necessary to improve their family adaptation.
Our study provides insights into the potential influencing mechanism of caregiver burden on family adaptation in family caregivers of patients with stroke, providing a new perspective for developing effective and precise intervention strategies to maintain better family adaptation.
This study adhered to the STROBE checklist.
Promoting SOC and focusing on the transformation of negative coping styles into positive ones may be crucial in developing nursing programmes for family adaptation.
No patient or public contribution.
To examine the evidence from systematic reviews on the development, implementation, and/or sustainability of age-friendly cities and communities programmes.
This review was informed by the Joanna Briggs Institute umbrella review methodology.
Critical appraisal, data extraction, and synthesis were carried out according to the Joanna Briggs protocol for undertaking umbrella reviews.
An extensive CINAHL, MEDLINE, PsychINFO, PubMed and Scopus search was conducted for literature published from January 2007 to July 2024. Finalised search terms included ‘age-friendly’, ‘age-friendly cities and communities’ ‘systematic review’, meta-analysis', ‘integrative review’, ‘narrative review’, ‘scoping review’, ‘rapid review’ and ‘scientometric review’ in combination with index terms were utilised to locate relevant literature.
Ten reviews were included comprising 4 scoping reviews, 1 interpretive review, 1 integrative review, 2 systematic reviews, 1 rapid review and 1 structured literature review. Synthesised findings were presented under the categories of ‘Development’; ‘Implementation’; and ‘Sustainability’.
The findings are relevant to policy, practice and research. Longitudinal and evaluation research is needed to determine the long-term sustainability of AFCC programmes. More evidence is required on the success of programmes in marginalised communities and low to middle-income countries. Designing appropriate environments for ageing in place has far-reaching implications for the health and well-being of communities, especially our oldest citizens. This is particularly salient in this time of unprecedented population ageing. Nurses must have an in-depth understanding of the broader determinants of health, including ensuring environments are fit for purpose and meet the needs of older communities.
Understanding the importance of ensuring our cities and communities are age-friendly will positively influence the health and social care provided by nurses to older adults.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyse checklist were used to report the screening process.
There was no patient or public contribution to this umbrella review.
The PROSPERO registration number: CRD42023413096 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=413096)
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