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Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.
To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.
Meta-research study.
A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.
A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16–22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having “some concerns”, largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were “Delivery of care” and “Physical functioning”.
Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
Family caregivers of children receiving pediatric palliative care (PPC) play a crucial role in their care and wellbeing, especially during the early stages of life.
To explore the experience of family caregivers of children aged 1–23 months who are receiving pediatric palliative care (PPC).
A systematic review of qualitative studies was conducted using the databases PubMed, Scopus, Web of Science, CINAHL, PsycINFO, and Cuiden. The studies were appraised using the Critical Appraisal Skills Programme tool. The selected studies were synthesized using Noblit and Hare's meta-ethnographic method.
Eleven studies, 169 themes, 36 metaphors and four main themes were identified. Caregivers develop coping strategies related to meaning-making, faith, maintaining hope, and decision-making abilities. They perceive limited time with the child due to structural constraints and the child's deteriorating health, which sometimes prevents them from recognizing their child's identity. Caregivers strive to remain united and rebuild the daily family life they long for, but face challenges related to self-care, maintaining employment, and caring for siblings and their partner. In many cases, they are unsatisfied with the care they receive, attributed to a lack of technical training and understanding of the principles of pediatric palliative care (PPC) by healthcare staff, poor communication skills, and inadequate coordination. Caregivers highlight the role of nurses and the PPC team, advanced care planning, and post-mortem care as positive aspects.
Caregivers' experiences reveal coping strategies, active decision-making, constant challenges, healthcare interactions, and a need for improved comprehensive support.
This study underscores the importance of addressing the unique needs of family caregivers of children aged 1–23 months receiving pediatric palliative care (PPC), highlighting their struggles with social isolation, neglected self-care, and disrupted family life. Healthcare providers should prioritize age-specific approaches to PPC, focusing on improving communication, care coordination, and understanding of palliative care principles to better support these caregivers.
To deliver palliative care, it is important to understand what a “good death” means to the relevant people. Such studies have mostly occurred in high-income settings that usually live by Western ideals. What matters to people is likely to vary across different regions of the world, influenced by multiple factors. Although there is a great need for palliative care in South Asia, there is a lack of comprehensive understanding of what a good death means in this setting. This study aimed to increase understanding of what is considered a good death in South Asia.
Systematic review and narrative synthesis.
A systematic search was conducted across eight databases, an Advanced Google search, and a bibliography search of selected articles. A data-based convergent synthesis was performed, along with quality appraisal.
Twenty-five empirical studies were selected for analysis from India, Pakistan, Bangladesh, Sri Lanka, and Bhutan. Four themes emerged. Mutual care and connection support a continued sense of self: contributing to others, while receiving connection through relationships and spiritual practices, was important for patients and supported by families and healthcare workers. Freedom to choose—privilege or burden?: the choice to participate in care was necessary for some patients but a burden for others, who preferred the family to lead their care. Severe uncontrolled pain and financial distress precluded choice for some patients, who felt death was the only option. Decisions regarding artificial prolongation of life were complex for patients and healthcare workers. Opportunities in the last days: when actively dying, there was general agreement on the importance of being pain-free, feeling safe, and having family present. Home was not always the preferred place of death. For family, it was critical to perform last rites. After death matters: What happens after death—influenced by leaving a legacy and religious beliefs—affected all parties before, during, and post-death.
To our knowledge, this is the first review of what a good death means in South Asia. There is a dearth of research from most South Asian countries. Although the South Asian perspective has similarities with the Western perspective, we note important nuances around decision-making, prolongation of life, prognostic awareness, and wanting to end one's life, moderated by culture, religion, and poverty. We support policies that account for these variations. Ongoing work is required to provide good symptom management, thus increasing opportunities for patient participation in care. Further research is needed in areas of ethics and religion at the end of life in South Asia.
The rapid evolution of artificial intelligence (AI) technology has revolutionized healthcare, particularly through the integration of AI into health information systems. This transformation has significantly impacted the roles of nurses and nurse practitioners, prompting extensive research to assess the effectiveness of AI-integrated systems. This scoping review focuses on machine learning (ML) used in nursing, specifically investigating ML algorithms, model evaluation methods, areas of focus related to nursing, and the most effective ML algorithms.
The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines.
A structured search was performed across seven databases according to PRISMA-ScR: PubMed, EMBASE, CINAHL, Web of Science, OVID, PsycINFO, and ProQuest. The quality of the final reviewed studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI).
Twenty-six articles published between 2019 and 2023 met the inclusion and exclusion criteria, and 46% of studies were conducted in the US. The average MERSQI score was 12.2, indicative of moderate- to high-quality studies. The most used ML algorithm was Random Forest. The four second-most used were logistic regression, least absolute shrinkage and selection operator, decision tree, and support vector machine. Most ML models were evaluated by calculating sensitivity (recall)/specificity, accuracy, receiver operating characteristic (ROC), area under the ROC (AUROC), and positive/negative prediction value (precision). Half of the studies focused on nursing staff or students and hospital readmission or emergency department visits. Only 11 articles reported the most effective ML algorithm(s).
The scoping review provides insights into the current status of ML research in nursing and recognition of its significance in nursing research, confirming the benefits of ML in healthcare. Recommendations include incorporating experimental designs in research studies to optimize the use of ML models across various nursing domains.
The scoping review demonstrates substantial clinical relevance of ML applications for nurses, nurse practitioners, administrators, and researchers. The integration of ML into healthcare systems and its impact on nursing practices have important implications for patient care, resource management, and the evolution of nursing research.
While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.
This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.
A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, p < 0.001) and a lower frequency of missed nursing care (β = −0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = −0.055, p < 0.001).
Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.
Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.
Systematic reviews are considered the highest level of evidence that can help guide evidence-informed decisions in nursing practice, education, and even health policy. Systematic review publications have increased from a sporadic few in 1980s to more than 10,000 systematic reviews published every year and around 30,000 registered in prospective registries.
A cross-sectional design and a variety of data sources were triangulated to identify the journals from which systematic reviews would be evaluated for adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines and scope. Specifically, this study used the PRISMA 2020 reporting guidelines to assess the reporting of the introduction, methods, information sources and search strategy, study selection process, quality/bias assessments, and results and discussion aspects of the included systematic reviews.
Upon review of the 215 systematic reviews published in 10 top-tier journals in the field of nursing in 2019 and 2020, this study identified several opportunities to improve the reporting of systematic reviews in the context of the 2020 PRISMA statement. Areas of priority for reporting include the following key areas: (1) information sources, (2) search strategies, (3) study selection process, (4) bias reporting, (5) explicit discussion of the implications to policy, and lastly, the need for (6) prospective protocol registration.
The use of the PRISMA 2020 guidelines by authors, peer reviewers, and editors can help to ensure the transparent and detailed reporting of systematic reviews published in the nursing literature.
Systematic reviews are considered strong research evidence that can guide evidence-based practice and even clinical decision-making. This paper addresses some common methodological and process issues among systematic reviews that can guide clinicians and practitioners to be more critical in appraising research evidence that can shape nursing practice.
Research on structural empowerment has typically adopted a variable-centered perspective, which is not ideal to study the combined effects of structural empowerment components. This person-centered investigation aims to enhance our knowledge about the configurations, or profiles, of healthcare employees' perceptions of the structural empowerment dimensions present in their workplace (opportunity, information, support, and resources). Furthermore, this study considers the replicability and stability of these profiles over a period of 2 years, and their outcomes (perceived quality of care, and positive and negative affect).
Participants completed the same self-reported questionnaires twice, 2 years apart.
A sample of 633 healthcare employees (including a majority of nurses and nursing assistants) participated. Latent transition analyses were performed.
Five profiles were identified: Low Empowerment, High Information, Normative, Moderately High Empowerment, and High Empowerment. Membership into the Normative and Moderately High Empowerment profiles demonstrated a high level of stability over time (79.1% to 83.2%). Membership in the other profiles was either moderately stable (43.5% for the High Empowerment profile) or relatively unstable (19.7% to 20.4% for the Low Empowerment and High Information profiles) over time. More desirable outcomes (i.e., higher positive affect and quality of care, and lower negative affect) were observed in the High Empowerment profile.
These results highlight the benefits of high structural empowerment, in line with prior studies suggesting that structural empowerment can act as a strong organizational resource capable of enhancing the functioning of healthcare professionals. These findings additionally demonstrate that profiles characterized by the highest or lowest levels of structural empowerment were less stable over time than those characterized by more moderate levels.
From an intervention perspective, organizations and managers should pay special attention to employees perceiving low levels of structural empowerment, as they experience the worst outcomes. In addition, they should try to maintain high levels of structural empowerment within the High Empowerment profile, as this profile is associated with the most desirable consequences. Such attention should be fruitful, considering the instability of the High Empowerment and Low Empowerment profiles over time.
NCT04010773 on ClinicalTrials.gov (4 July, 2019).
Ensuring patient safety is a critical component of healthcare delivery, and nurses play a vital role in adhering to patient safety protocols to prevent adverse events. However, studies linking nurses' adherence to these protocols with patient outcomes is scarce. This study has two-fold purposes: (1) to examine determinants of nurses' adherence to patient safety protocols, and (2) to investigate the relationship between nurses' adherence to patient safety protocols and adverse patient events.
A cross-sectional design.
A total of 343 clinical nurses from five hospitals in the Philippines were included in this study. Two standardized scales were used to collect data, including the Patient Safety Adherence Scale and the Adverse Patient Events Scale. Data collection took place from April 2022 to August 2022.
Adherence to patient safety protocols was generally moderate to high (M = 4.483), while nurse-reported adverse events occurred at a lower frequency (M = 1.150). Lower adherence rates were identified in areas such as reporting safety errors (M = 3.950), conducting fall risk assessments (M = 4.299), and adhering to pressure ulcer prevention guidelines (M = 3.979). Patients' and their families' complaints (M = 2.129) and abuses (M = 1.475) were the most frequently reported adverse events. Increased adherence to safety protocols was associated with higher reporting of adverse patient events (β = 0.115, p < 0.001).
Higher adherence to patient safety protocols resulted in an increased reporting of adverse patient events. The factors identified that contributed to nurses' adherence to patient safety protocols can be utilized in the development of strategies aimed at improving compliance, especially in areas where adherence is currently low.
Healthcare organizations should prioritize efforts to enhance adherence to patient safety protocols, particularly in areas with lower compliance rates, through relevant trainings, resource provision, and support systems. Promoting a culture of open communication and reporting can significantly contribute to reducing adverse events and improving patient safety.
Metaphors are one of the most effective linguistic tools that are used to reveal how society describes nursing and what their vision of nursing is and to understand how effective the roles and responsibilities assumed by nurses in a multidisciplinary healthcare team are in protecting and maintaining the health of individuals, families, and society.
The aim of this study was to reveal the perceptions of society about “nurses” through metaphors.
The study was planned with a mixed design involving qualitative and quantitative research methods. It was carried out with 810 people living in Turkey who were between the ages of 15 and 65 and voluntarily participated in the study. Each participant was asked to fill in the blanks in the sentence, “A nurse is like a/an………………because…………” The data were analyzed by using qualitative (content analysis) and quantitative (chi-squared) data analysis methods.
It was determined that the participants produced 194 metaphors related to the concept of a “nurse.” It was observed that they frequently used metaphors of “angel,” “parent,” “doctor's assistant/right hand,” “lifesaver,” and “confidant” regarding the concept of nurse and conceptualized a nurse as “Beneficial/Helpful/Healer/Facilitator.”
The results showed that the awareness and perception of society toward nurses should be improved on the basis of the opportunity created by the COVID-19 pandemic period, and the concepts should be introduced to younger generations in a wider framework under the leadership of nursing faculties.
Trans youth experience significantly higher rates of societal violence and ill-health compared to their cisgender peers. Although recent clinical guidelines for trans young people in health have paved the way for revolutionizing care, many trans young people still experience adversity in clinical settings. This discursive literature review provides a novel approach in exploring why trans young people experience violence in health care despite the availability of evidence-based resources and guidelines.
Databases (CINAHL and Scopus) were systematically searched to identify qualitative literature on the experiences of trans young people (<18 years) in health care settings.
Rather than synthesizing and presenting the literature, Fairclough's (2001) CDA methodology was used to critically analyze the literature as texts in a data corpus. The authors engaged with the data from a critical social theory perspective.
Fifteen qualitative articles and one report (n = 16) on the experiences of trans young people (3–24 years) in health care settings were included. Two key discourses were identified in the literature. First, discourses that constituted the trans young person were identified in the definitions of ‘trans’ as a pathological incongruence and as alternate, self-determined ways of being. Further discourses were identified in the constitution of trans young people as victims, extra-pathological, and alternatively problematised as socially dysphoric. Second, discourses in health provider responses were identified in dismissive, gatekeeping, regulatory, and respectful practices.
The discursive constitution of the trans young person as incongruent, vulnerable, and pathological is constituted and generated by dismissive, gatekeeping, and regulatory practices of health care providers. The analysis reveals how trans young people are considered pathological and deemed treatable (at the site of the body), in the interest of ‘protecting’ them from a perceived abject future of trans adulthood. The logic and violence of cisgenderism is uncovered as the foundation of these dominant discourses, whereby growing up cisgender is often presented as the only option in health care settings. The dominant discourses that constitute the trans young person in health care as incongruent, pathological, and vulnerable, alongside the reifying health care responses of dismissal, gatekeeping, and regulation contribute to the erasure of the young trans person.
This paper identified key discourses in the literature in how trans young people are constituted and regulated in health care. This review highlights an urgent need for further critical scholarship in trans health by trans researchers, from critical perspectives. Furthermore, it provides a starting point for critical reflection of health care provider and researcher practices and the re-imagination of trans-futurity for all young people in health care.
Nurses are situated at the forefront of health care delivery and play a crucial role in the advocacy and provision of culturally safe care. With this ideal proximity to clients, nurses can powerfully affect change through better understanding and reflecting on how regulatory practices constitute and position trans young people in health care. Nursing knowledge, such as cultural safety, can offer novel approaches in working towards safer ways of meeting the needs of trans young people.
Transgender and nonbinary young adults (TNB YA) report high rates of depression and more suicidality than their cisgender counterparts. Parental rejection is a known predictor of worse mental health among TNB YA; however, less is known about TNB YA experiences of sibling acceptance-rejection. The purpose of this study was to determine how TNB YA perception of sibling and parental acceptance-rejection are related to TNB YA depression and suicidality.
Cross-sectional.
TNB YA (ages 18–25) who had disclosed their gender identity to an adult sibling were recruited to take part in an online study and completed measures of sibling and parent acceptance-rejection, depression, as well as lifetime and past year suicidality. Stepwise regressions were conducted to evaluate associations between acceptance-rejection and TNB YA depression and suicidality.
The sample consisted of 286 TNB YA (Mage = 21.5, SD = 2.2) who were predominantly White (80.6%) and assigned female sex at birth (92.7%). Each family member's acceptance-rejection was associated with increased TNB YA depression scores when considered independently and combined. Independently, high rejection from each family member was associated with greater odds of reporting most suicidality outcomes. When all family members were considered together, only high rejection from a male parent was associated with four times greater odds of reporting lifetime suicidality. High rejection from both parents was associated with greater odds of reporting past year suicide attempt (OR: 3.26 female parent; 2.75 male parent).
Rejection from family members is associated with worse depression and suicidality, and rejection from male parents may be particularly damaging. Sibling acceptance uniquely contributes to TNB YA's depression symptoms alone and in the context of parental support.
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