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☐ ☆ ✇ Journal of Nursing Scholarship

Quality and Bias in Randomized Controlled Trials Published in Latin American Nursing Journals: A Meta‐Epidemiological Study

ABSTRACT

Introduction

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.

Objective

To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.

Design

Meta-research study.

Methods

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.

Results

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”.

Conclusions

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.

☐ ☆ ✇ Journal of Advanced Nursing

Implementation of the ‘Countdown to Theatre’ Approach to Bridge the Evidence–Practice Gap in Paediatric Preoperative Fasting: A Quality Improvement Initiative

ABSTRACT

Aim

To evaluate the ‘Countdown to Theatre’ intervention, a co-designed nurse-led approach developed using the COM-B framework to address context-specific barriers and facilitators to preoperative fasting practices.

Design

A prospective mixed-method, pre–post study assessed the intervention's impact on fasting adherence and patient experience.

Methods

Participants included children booked for a procedure under general anaesthesia. Adherence was assessed through audited fasting duration, and patient experience was evaluated using caregiver/patient surveys. The intervention was implemented and monitored by nursing staff as a part of a structured quality improvement process. Nurses played a central role in embedding the approach into daily workflows and reinforcing fasting timelines

Results

Over 9 months, 901 observations were undertaken from 774 patients. Fasting duration decreased from 7.6 to 5.7 h (mean difference −1.94; 95% CI −3.04, −0.86). Parent-reported patient experience surveys showed improvement in many areas, including an increase in overall satisfaction (from 44.7% to 68.8%).

Conclusion

The intervention successfully reduced prolonged fasting and improved patient experiences, demonstrating the value of co-designed approaches in addressing evidence–practice gaps in perioperative care.

Implications for Patient Care

The principles of co-design, structured implementation and the application of the COM-B framework provide a replicable model for addressing similar challenges in healthcare. The study highlights the pivotal role of nurses in improving perioperative practices, supporting both patient safety and satisfaction. Future research should explore the intervention's applicability across diverse settings and patient populations.

Impact

Despite evidence-based guidelines, excessive preoperative fasting remains prevalent in practice. This study demonstrates that a structured, nurse-led intervention can successfully reduce fasting durations and enhance patient experience, reaffirming the nursing profession's capacity to lead meaningful change in perioperative care.

Reporting Method

Standards for quality improvement reporting excellence (SQUIRE 2.0).

Patient or Public Contribution

Patients and caregivers contributed to the co-design of the intervention, ensuring that it addressed practical challenges related to preoperative fasting.

☐ ☆ ✇ Journal of Advanced Nursing

Moving Beyond the Scale: Guidance for Food Equity‐Oriented Nurse Engagement in Education, Research and Community Care

Por: Lucine Francis · Laura J. Samuel · Shafkat Meraj · Diana Baptiste · Divya Konduru · Yeeli Mui · Eliana M. Perrin — Julio 19th 2025 at 08:52

ABSTRACT

Aim

To provide guidance on food equity-oriented nurse engagement in education, research, and practice and to develop a glossary of food equity terms to serve as a resource to nurse educators and to fuel nurse engagement in food equity work.

Design

A discussion paper outlining guidance for nurse engagement in food equity efforts.

Conclusions

We provide guidance for nurse engagement in three areas: Education, Research and Community Care. Additionally, through literature review, we created a glossary of food-related terms that can be used in nurse advocacy for food equity. Although not an exhaustive list, we compiled and provided definitions of equity-oriented food-related concepts across three categories: food environment, consumer/community-based and social safety net/anti-hunger terms.

Implications for the Profession

Nurses can be instrumental in advancing food equity, thereby helping to prevent chronic diseases related to poor nutrition, yet nutrition and food equity content are not typically integrated into nursing education.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Black Women as Superwomen; Health Disparities and the Cost of Strength: A Discursive Paper

ABSTRACT

Aim

Historically, Black women have been positioned as primary caretakers and problem-solvers, often expected to bear disproportionate responsibility during times of crisis. There is an enduring image of Black women possessing exceptional strength handed down through generations, captured in the sociocultural phenomenon known as the superwoman schema, or SWS. The aim of this discursive review is to explore health disparities among Black women related to the SWS.

Design

A discursive paper.

Methods

A literature search was conducted in PubMed, Scopus and Google Scholar to identify relevant papers published from 2016 to 2025 that addressed health disparities among Black women.

Discussion

Through literature review, we identified three critical areas of health disparities associated with mental health disorders, maternal mortality and breast cancer, reflecting the influence of inequitable practices embedded within healthcare systems and society. Nurses, advanced practice nurses and other healthcare providers must prioritise identifying and addressing barriers that hinder access to quality healthcare for Black women. Many providers remain unaware of how depressive symptoms, chronic stress and social determinants impact maternal, mental and breast health outcomes. Encouraging Black women to prioritise mental health, engage in routine prenatal care and seek early breast cancer screening is critical to improving health outcomes. By understanding the historical, societal, and personal contexts of the SWS, nurses can clarify both its benefits and challenges for Black women.

☐ ☆ ✇ Journal of Clinical Nursing

The Psychometric Properties of the Braden Scale to Assess Pressure Injury Risk in Acute Care: A Systematic Review

Por: Adam Burston · Jacob Butterworth · Aldiana Mehicic · Paul Fulbrook — Junio 17th 2025 at 05:04

ABSTRACT

Aim

To analyse existing knowledge on the psychometric properties of the Braden Scale when used within the acute care setting.

Design

Systematic review and narrative synthesis.

Methods

A database search was conducted in June 2023 and updated in February 2024, seeking studies testing the psychometric properties of the Braden scale in the acute care setting. Data were sourced from five electronic databases (CINAHL, EMBASE, MEDLINE, Scopus and Web of Science). Study selection, data extraction and assessment of risk of bias were completed, with two reviewers independently conducting each stage and an independent reviewer arbitrating discrepancies. Data were extracted using a customised template and synthesised narratively. Risk of bias was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

Results

Thirty-seven studies met the inclusion criteria. Internal consistency was reported between 0.64 and 0.78 (Cronbach's alpha). Inter-rater reliability was high, reported as ranging from 0.946 to 0.964 (intra-class correlations) or 0.86 to 0.949 (Pearson's correlation). Most validity studies tested predictive validity with wide variances reported.

Conclusion

The Braden Scale is reliable for assessing the risk of PI in acute care, but the validity of the scale is variable. Further research investigating validity beyond predictive validity is required.

Relevance to Clinical Practice

Nurses working in acute care can use the Braden Scale with confidence of scale reliability. However, validity is variable and warrants a cautious approach. The true value resides in the capacity to trigger recognition of pressure injury risk.

Trial Registration: The protocol was registered a priori with the International Prospective Register of Systematic Reviews PROSPERO ref: CRD42023407545

☐ ☆ ✇ Journal of Nursing Scholarship

People's Experiences of Their Involvement in Nursing Care: A Qualitative Systematic Review With Meta‐Aggregation Synthesis

ABSTRACT

Introduction

Global organizations have pronounced about the importance of involving people in health care, however, this process is challenging. Given the availability of evidence that addresses people's experiences of involvement in nursing care, it is important to produce recommendations at this point by synthesizing the evidence. So, this review aims to synthesize the available qualitative evidence about people's experiences of their involvement in nursing care in a hospital setting.

Design

Systematic review of qualitative evidence.

Methods

This systematic review was conducted according to the JBI methodology for systematic reviews of qualitative evidence. A comprehensive search strategy was conducted in nine databases/resources. The selection process, methodological quality assessment, and data extraction were conducted independently by two reviewers. The data were synthesized using the meta-aggregation approach, and the results were graded according to ConQual.

Results

A total of 75 findings and 141 illustrations were extracted from the 15 included studies. These findings were aggregated into 12 categories and generated into three synthesized findings: (1) People who are hospitalized conceptualize and attribute importance to involvement in nursing care as an active process of participation and monitoring of care, decision-making, opinion, and partnership; (2) The establishment of a relationship between hospitalized people and nurses, trust, communication, and information are essential for participation in care; (3) People's participation in care is affected by the person's own constraints and preference for assuming a passive role, by barriers associated with a lack of information, the organization of care, the relationship established between nurses, and paternalistic attitudes.

Conclusion

People who were admitted to hospital conceptualized and attached importance to this phenomenon, perceived the conditions necessary to promote it, and the barriers they experienced.

Clinical Relevance

This systematic review provides recommendations for nurses' clinical practice (with grade B). It recommends that nurses should establish a partnership relationship with hospitalized people, through trust, communication and information; give people the opportunity to monitor care, participate in decision-making and give their opinion; assess the person's preferences for involvement and other factors; and that the barriers to this process identified here should be assessed and addressed in each context. As such, this review provides very valuable information for nurses' clinical practice and should also be incorporated into health policy.

Protocol Registration: PROSPERO CRD42024506501.

☐ ☆ ✇ Journal of Advanced Nursing

Referral for Diabetes Self‐Management Education and Support in Adult Primary Care: An Integrative Review

ABSTRACT

Aims

The purpose of this integrative review was to identify effective diabetes self-management education and support for increasing adult primary care referrals, participation rates and improving health outcomes for persons with diabetes.

Design

Integrative review.

Methods

A systematic literature search of PubMed/MEDLINE, Embase and CINAHL was performed by applying the PRISMA guidelines. Following Whittemore and Knafl's method, 11 papers were included for review.

Results

Integration of diabetes self-management education and support in primary care clinics and a multifaceted approach resulted in improved referral and participation rates, ameliorated glycated haemoglobin A1C and boosted patient, provider and staff satisfaction.

Conclusion

Patient-centred multifaceted interventions can boost current diabetes self-management education referrals and participation rates and enhance health outcomes for persons with diabetes. Nurses in their role as primary care providers, diabetes educators and clinic staff are well-positioned to undertake this intervention. Further investigation is needed to explore the impact of these interventions among individuals with type 1 diabetes, gestational diabetes and those living across various global regions.

Implications for Patient Care

Along with other healthcare providers, nurses are qualified to advocate for, and lead programmes that increase referrals for persons with diabetes to improve health outcomes. Additionally, as primary care providers, nurse practitioners are well placed to positively impact the outcomes of individuals with diabetes by referring them to diabetes self-management education. Nurses, as diabetes educators, are well positioned to implement diabetes self-management education which can improve patient outcomes.

Impact

Improved referral of persons with diabetes to diabetes self-management education and increased participation have the propensity to contribute to the achievement of positive health outcomes for individuals living with Type 2 Diabetes.

Patient or Public Contribution

There is no patient or public contribution for this review.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

Treatment adherence and wellness, nutrition, and physical activity outcomes of diabetic patients with comorbid depression during the 18‐month follow‐up of the TELE‐DD study

Abstract

Background

A good adherence to pharmacological treatment in chronic pathologies such as type 2 diabetes and clinical depression is essential to improve illness prognosis.

Aims

The main goal of the TELE-DD study was to analyze the effectiveness of a telephone, psychoeducational, and individualized intervention carried out by nurses in patients with type 2 diabetes mellitus and comorbid clinical depression with prior nonadherence to pharmacological treatment. In this paper, we describe and analyze secondary outcomes of the trial intervention.

Methods

A prospective cohort study was used to assess the effectiveness of a telephonic intervention (IG) in n = 191 participants with a similar control group (CG). Adherence to pharmacological treatment was assessed using the patient's self-perceived adherence questionnaire. In addition to clinical (HbAc1, HDL, LDL), physical (body mass index, blood pressure) and psychological measures (Patient Health Questionnaire-9 affective state), and psychosocial distress due to Diabetes Distress Scale Questionnaire at 3, 6, 12, and 18 months of follow-up were also analyzed.

Results

The proportion of “Total Adherents” in the IG was higher throughout the study. This was particularly true at month 18 of the intervention. Self-perceived adherence rates increased by 27.1% in the IG and by 1.1% in the CG. Results of clinical and physical measures were higher in the IG than in the CG at month 18 of the intervention.

Linking Evidence to Action

The interview based on positive reinforcement as well as individualized attention and flexibility in making telephone calls and dissemination of the intervention in the media closest to the patients were key to achieving good participation and collaboration as well as continuity in adherence to treatment and self-care.

☐ ☆ ✇ CIN: Computers, Informatics, Nursing

Efficacy of a Telemonitoring System as a Complementary Strategy in the Treatment of Patients With Heart Failure: Randomized Clinical Trial

imageEpisodes of decompensation are the main cause of hospital admissions in patients with heart failure. For this reason, the use of mobile apps emerges as an excellent strategy to improve coverage, real-time monitoring, and timeliness of care. ControlVit is an electronic application for early detection of complications studied within the context of a tertiary university hospital. Patients were randomized to the use of ControlVit versus placebo, during a 6-month follow-up. The primary outcome was the difference in numbers of readmissions and deaths for heart failure between both groups. One hundred forty patients were included (intervention = 71, placebo = 69), with an average age of 66 years old; 71% were men. The main etiology of heart failure was ischemic (60%), whereas the main comorbidities were arterial hypertension (44%), dyslipidemia (42%), hypothyroidism (38%), chronic kidney disease (38%), and diabetes mellitus (27%). The primary outcome occurred more frequently in the control group: readmission due to decompensation for heart failure (control group n = 14 vs intervention group n = 3; P = .0081), and death (control group n = 11 vs intervention group n = 3; P = .024). In heart failure patients, ControlVit is a useful and supplementary tool, which reduces hospital admissions due to episodes of decompensation.
☐ ☆ ✇ Journal of Nursing Scholarship

Randomized controlled trials in nursing conducted by Latin American research teams: A scoping review

Abstract

Introduction

Randomized controlled trials (RCTs) are the cornerstone of systematic reviews and other evidence synthesis. RCT identification remains challenging because of limitations in their indexation in major databases and potential language bias. Scientific production in Latin American nursing is steadily increasing, but little is known about its design or main features. We aimed to identify the extent of evidence from RCTs in nursing conducted by Latin American research teams and evaluate their main characteristics, including potential risk of bias.

Design

Scoping review with risk of bias assessment.

Methods

We conducted a scoping review including a comprehensive electronic search in five relevant databases. We completed a descriptive data analysis and a risk of bias assessment of eligible studies using Cochrane's guidance.

Results

We identified 1784 references of which 47 were RCTs published in 40 journals. Twenty (42.6%) RCTs were published in journals in English. Chronic diseases were the most common health conditions studied (29.7%). Fifteen (31.9%) RCTs had a high risk of bias. Thirty (75%) journals were included in the Journal Citation Report (JCR) catalog and 5 (16.7%) were journals classified under nursing category. Twenty-one (52.5%) journals explicitly required CONSORT checklist recommendations for RCTs reporting.

Conclusion

Publication of RCTs in nursing by Latin American authors has increased. Most journals where RCTs are published are in English and not specific to nursing. Searches in journals of other disciplines may be necessary to facilitate identification of RCTs in nursing. CONSORT statements need to be actively promoted to facilitate rigorous methodology and reporting of RCTs.

Clinical Relevance Statement

This study highlights the need for an increased research focus on RCTs in nursing in Latin America, and the importance of enhancing the reporting quality of these studies to support evidence-based nursing practice.

☐ ☆ ✇ Journal of Clinical Nursing

Professionalism in pre‐licensure nursing education: Core values, didactic coursework and clinical training

Por: Jessica Zemlak · Tamar Rodney · Emma Mangano · Diana‐Lyn Baptiste — Noviembre 9th 2023 at 07:19

Abstract

Aim

To discuss professionalism for pre-licensure nursing students and identify recommendations for inclusion in core values, didactic coursework and clinical training.

Background

Professionalism is part of the nursing identity that encompasses integrity and honesty. This concept has been difficult to translate into formal education in nursing programs and clinical practice.

Design

A discursive paper.

Data Sources

A search of national literature without date restrictions in PubMed, CINAHL, Google Scholar and frameworks for nursing education. We explored principles of professionalism in nursing education and practice.

Discussion

Evidence-based literature supports the integration of core values of altruism, autonomy, human dignity, integrity, honesty and social justice into didactic curricula, and clinical training. Principles of professionalism can be incorporated intentionally in nursing education to maintain patient safety and trust.

Conclusion

The principles of professionalism, related to core values of the nursing profession, are abundantly described in the literature. However, these principles represent core values that have not been formally conceptualized. With the changing landscape of healthcare, there is a need for deliberate, measurable integration of professionalism into pre-licensure education.

Patient or Public Contribution

There was no patient or public involvement in the design or drafting of this discursive paper.

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