Conectar
To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN).
A qualitative study employing focused ethnography.
Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis.
Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection.
Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations.
Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse–patient relationships, enhancing patient care and emotional support.
This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care.
Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines.
This study did not involve patient or public participation in its design, conduct or reporting.
To analyse current Glasgow Coma Scale practice among emergency nurses in China and identify factors influencing assessment quality.
A quantitative, multicenter cross-sectional design.
A convenience sample of 1740 emergency nurses from secondary and tertiary hospitals across 21 provinces completed a validated structured questionnaire between March and April 2025. Participants had at least 6 months of emergency nursing experience. Data analysis included descriptive statistics, chi-square tests, and multiple logistic regression to examine factors influencing correct Glasgow Coma Scale application.
Participants had a mean age of 29.8 years (SD = 6.2). Only 52.5% of nurses demonstrated correct Glasgow Coma Scale application despite 97.0% having theoretical knowledge of scoring criteria. While 56.8% had received Glasgow Coma Scale training, significant standardisation deficiencies emerged. Notably, 41.8% of departments lacked operational guidelines, and 53.7% of nurses experienced scoring disagreements with colleagues. Clinical utilisation varied substantially by patient population: traumatic brain injury (97.8%), neurological diseases (96.9%), and systemic critical illness (85.8%). Multivariate analysis identified six significant factors influencing correct application: standardised training (OR = 2.252, 95% CI: 1.789–2.825), manageable workload ≤ 4 patients/shift (OR = 1.652, 95% CI: 1.327–2.057), departmental guidelines (OR = 1.523, 95% CI: 1.233–1.881), extensive work experience ≥ 9 years (OR = 1.534, 95% CI: 1.182–1.992), while multidisciplinary collaboration issues (OR = 0.559, 95% CI: 0.439–0.712) and special patient experience (OR = 0.520, 95% CI: 0.406–0.666) were associated with reduced accuracy.
Substantial standardisation challenges exist in Glasgow Coma Scale practice among Chinese emergency nurses, characterised by significant gaps between theoretical knowledge and clinical application. Major barriers include insufficient standardised guidelines, inconsistent training approaches, and inadequate interdisciplinary collaboration.
Healthcare administrators should develop national standardised guidelines, implement simulation-based training programs, optimise emergency workflows, and integrate alternative assessment tools to enhance consciousness assessment accuracy and improve patient safety.
STROBE statement adherence.
No patient or public contribution.
To critically synthesise current literature on the nurses' experiences in providing care for people presenting with mental health issues to the emergency department (ED).
Mental health-related presentations to EDs are increasing. Understanding nurses' experiences of providing care for this patient group will inform future strategies to enhance the care delivered in the ED.
CINAHL, MEDLINE, APA PsycInfo and Psychology and Behavioural Sciences Collection were searched from 2009 to 2024 for peer-reviewed qualitative papers exploring emergency nurses' perspectives of providing care for people with mental health issues, published in the English language. Quality was appraised using the JBI Critical Appraisal tool. This review follows the PRISMA checklist for reporting.
Nine papers, reporting eight studies, were included in the review. Three themes emerged: attitudes towards mental illness, education limitations impacting confidence and structural barriers impacting care quality. The review reveals a disconnect between nurses' compassionate intentions and barriers such as unconscious stigma and prioritising physical illness over mental health concerns. The findings highlight the need for targeted mental health education to enhance ED nurses' confidence and competence. Inadequate local mental health policies also impact care delivery, contributing to suboptimal patient outcomes.
This review provides a deeper understanding of ED nurses' experiences of caring for people with mental health issues. A need to implement a multifaceted approach to mental health education, clear policies to guide care delivery and systems that promote prioritisation of patients presenting with mental health concerns was identified.
Insights into nurses' experiences can shape future ED practices and enhance outcomes for patients. Building ED nurses' capacity to deliver high-quality mental health care is critical.
As a review paper, no patient or public consultation took place.
Interprofessional socialisation can contribute to collaborative patient care. Although there is research regarding interprofessional socialisation of healthcare students and frontline staff, there is limited literature regarding healthcare educators in practice settings. Our aim was to examine interprofessional socialisation of healthcare educators in the practice setting following an interprofessional simulation facilitator training programme.
Explanatory sequential mixed methods study.
Quantitative provincial simulation programme evaluation data from 2022 and 2023 (n = 87) were analysed and used to inform qualitative interviews (n = 17). Qualitative and quantitative data were integrated following independent analysis.
There was a statistically significant increase in attitudes toward interprofessional socialisation following the simulation facilitator training programme. Qualitative findings revealed themes regarding interprofessional socialisation: (a) benefits gained through interprofessional socialisation, (b) interprofessional, uniprofessional or both, (c) facilitators to interprofessional socialisation, (d) barriers to interprofessional socialisation and (e) opportunities to strengthen interprofessional socialisation.
Despite positive views of interprofessional socialisation, socialisation behaviours may not be consistent in a variety of contexts. Interprofessional education may increase interprofessional socialisation among educators.
It is important to provide interprofessional socialisation opportunities for educators to promote more interprofessional education initiatives.
The findings of this study provided insights into how to foster interprofessional socialisation in existing structures and how new pathways might be built to connect educators.
This study is reported in congruence with the Journal Article Reporting Standards—Mixed Methods, Quantitative, and Qualitative Standards provided on the Equator Network.
Members of the provincial simulation team were consulted regarding study design and data collection to optimise participation.
To identify research gaps by mapping what is known about the barriers and enablers to pre-registration nursing students identifying signs of suicidal distress in healthcare consumers and providing clear pathways of support.
Scoping review.
This scoping review was conducted using Arksey and O'Malley's (2005) five stage framework and the Levec et al. (2010) extensions of this framework.
The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete and Ovid MEDLINE databases were searched to identify relevant articles, keywords and search terms to inform the full search strategy for CINAHL. This search strategy was then adapted for Scopus, PsychInfo, Emcare, Medline and ERIC, searched in November 2024.
Studies eligible for inclusion (N = 28) represented research from 14 countries; most (53.5%, n = 15) used a quantitative design, 11 (39.3%) were qualitative and two (7.1%) used a mixed-methods design. Barriers found from the scoping review included a low level of knowledge of suicidality, stigma preventing students from assessing and acting on suicidal ideation, and a lack of confidence in providing care to healthcare consumers expressing suicidality. Enablers included lived experience, exposure to individuals expressing suicidal ideation and education, simulation and role play. This review also contributes to the existing literature about the relationship of nursing to existing suicide prevention frameworks and suggests revision of these frameworks to address staff attitudes and beliefs, as well as lived and living experience.
Nurses are ideally placed to assess and respond to suicidality among healthcare consumers, and preparation should begin during pre-registration studies. Our scoping review indicates that further research work is needed to address the barriers to working with healthcare consumers expressing suicidality and to enhance the enablers to provide safe care.
Addressing the barriers and enablers to pre-registration nursing students providing safe care for healthcare consumers expressing suicidality is essential. Further research is required to address the barriers and enhance the enablers identified in this scoping review.
What problem did the study address? This scoping review summarised the literature on pre-registration student ability to work with healthcare consumers expressing suicidality, identifying barriers and enablers. What were the main findings? Barriers include poor knowledge of suicidality, stigma, fear and a lack of confidence in working with healthcare consumers expressing suicidality. Enablers include lived experience, exposure to clinical settings where healthcare consumers express suicidality and simulation and education. Where and on whom will the research have an impact? The research will have an impact on providers of pre-registration nursing degrees, where the inclusion of content addressing suicidality and exposure to settings where individuals express suicidal ideation is shown to improve attitudes and knowledge of suicidality assessment.
PRISMA checklist for scoping reviews.
This study did not include patient or public involvement in its design, conduct or reporting.
This study aimed to describe the types of psychological and physical symptoms experienced by healthcare professionals who became second victims after a patient safety incident and the impact of the incident on their social and professional lives.
Scoping review.
JBI methodology for scoping reviews and PRISMA-ScR for reporting were followed.
The search was conducted on June 13, 2024, using the CINAHL (EBSCO), Scopus, PubMed (Medline), Medic and PsycInfo (EBSCO) databases. A grey literature search was also conducted.
A total of 96 papers were included. Healthcare professionals experienced psychological symptoms such as anger, sadness and guilt after a safety incident. Physical symptoms were reported, including symptoms related to sleep and gastrointestinal symptoms. At the professional and social levels, the incident affected their work, relationships and well-being. Positive impacts were also noted.
This study provides a comprehensive overview of healthcare professionals' experiences after safety incidents. In addition, this study also captured the positive impacts of safety incidents, such as learning from mistakes.
By recognising the symptoms and impacts associated with the second victim syndrome, appropriate support can be provided for healthcare professionals.
The findings of this study can be used to identify the relevant harm to professionals after a safety incident, which could help to improve the well-being of these workers.
No patient or public contribution.
Open Science Framework, https://archive.org/details/osf-registrations-5cdmu-v1
More than 12% of women worldwide are affected by polycystic ovary syndrome (PCOS), whose symptoms are similar to those of puberty, often leading to delayed diagnosis and missing the opportunity for early intervention. This not only puts PCOS women under physical and mental stress but also reduces their trust in doctors and makes them dissatisfied with the healthcare they receive, which in turn affects their quality of life. Therefore, to improve the doctor-patient relationship and promote health, it is essential to investigate and understand the healthcare experiences that women with polycystic ovary syndrome (PCOS) receive.
To explore the experiences of women with PCOS when they receive healthcare.
Qualitative systematic review.
Data were collected and screened using the systematic review management system Covidence, based on the established inclusion criteria. The Critical Appraisal Skills Programme Checklist was used for critical appraisal, and thematic analysis was used for data analysis.
The databases searched included CINAHL, MEDLINE, PsycINFO, and Scopus. The search was limited to studies published in English between 2002 and May 2024.
Seven studies were selected for final inclusion. Three themes were identified: (1) responsive care from healthcare practitioners, (2) managing polycystic ovarian syndrome, and (3) polycystic ovary syndrome and its impact on self-image.
The development of a multidisciplinary PCOS clinic, the establishment of online support groups, and the creation of comprehensive patient-centered treatment plans are vital to enhancing the health outcomes of women with PCOS.
Multidisciplinary PCOS clinics, online support groups, and comprehensive patient-centered treatment plans can improve health outcomes for women with PCOS.
The EQUATOR guidelines for PRISMA have been utilised.
No patient or public contribution.
Although healthcare infrastructure has improved in recent years, the preoperative journey of patients is often accompanied by anxiety. Allowing patients to walk to the operating theatre is a simple, yet underexplored strategy that may enhance their sense of autonomy and reduce anxiety. As patient-centred care gains importance, evaluating the effects of this approach on patient-reported outcomes may be more relevant than widely assumed.
In this scoping review, we aim to analyse the published literature on preoperative walking into the operating theatre and patient-reported outcomes, such as anxiety and satisfaction.
This study was a scoping review that followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Scoping Review extension guidelines.
Inclusion criteria were adult patients undergoing elective surgery and walking to the operating theatre. Data were extracted using a standardised form, and critical appraisal was performed by using ROBINS-I V2.0, RoB2 and ROB-E tools.
Embase, MEDLINE, Cochrane databases (OVID) and CINAHL (EBSCOhost) were searched up to 31st January 2025.
Our search identified 958 articles, with seven trials included in the final analysis. The studies, published between 1994 and 2022, involved 3001 patients from North America, Asia and Europe. The interventions varied, but most patients reported improved satisfaction and reduced anxiety when walking to the operating theatre. No adverse events were reported, although patient preferences varied, with younger patients more likely to prefer walking.
Walking to the theatre positively impacts patient satisfaction and autonomy. However, patient selection is key, as not all individuals are physically or mentally prepared for walking. Future research could explore unaccompanied walking and its effects on hospital resource utilisation. Preoperative walking is a beneficial intervention that enhances patient satisfaction and reduces anxiety, providing a feasible alternative to bed transport for many elective surgical patients.
No patient or public involvement.
To assess the supply, demand, and utilisation of master's degree nurses in China's top-tier hospitals and identify recruitment and retention challenges.
A convergent parallel mixed-methods design.
From January and September 2022, eight top-tier hospitals in mainland China were selected using convenience sampling. The proportion of master's degree nurses, turnover rates, and recruitment outcomes were investigated and analysed using descriptive statistics. Concurrently, seven nursing administrators from these eight hospitals were interviewed using semi-structured interviews, and transcribed data were thematically analysed through inductive content analysis.
Among the eight hospitals surveyed, the average proportion of master's degree nurses was 3.58% (range: 0.58%–9.43%). The average ratio of planned to actual recruitment was 3.28, with four hospitals showing near parity (approximately 1:1) and three institutions failing to recruit any master's degree nurses. The annual turnover rate of master's degree nurses was 1.18%. Three themes emerged from the qualitative analysis: (1) shortages coexisting with oversupply; (2) nursing leaders' retention efforts versus limited institutional policy support; and (3) prioritisation of research and management over advanced clinical roles.
In China, even among top-tier hospitals, the proportion of master's degree nurses remains relatively low. There is an overall shortage of these nurses, juxtaposed with localised oversupply in specific institutions. Promotion to nursing supervisor or administrative roles is the only developmental pathway, while structured career progression pathways for advanced nursing practice remain conspicuously absent.
The study highlights the need to develop targeted policies that support the career advancement of master's degree nurses, particularly by expanding career options in Advanced Practice Nurses (APNs) rather than limiting roles to nursing management or education. This shift would better leverage their clinical expertise and strengthen healthcare systems through specialised practice and innovation.
What problem did the study address?: This study maps the supply–demand dynamics of master's degree nurses in leading hospitals and identifies retention, utilisation, and motivation policies and strategies from the perspective of nursing administrators. What were the main findings?: The proportion of master's degree nurses is low in China's top hospitals. There is both an oversupply and a shortage of master's degree nurses. Neither the government nor hospitals have policies in place to encourage the clinical involvement of master's degree nurses, and their career progression is limited to managerial roles. Where and on whom will the research have an impact?: Nursing administrators and other health policy makers in China and comparable global health systems will be affected. It will also influence nursing associations, nursing educators, and general nurses.
This study adhered to the Mixed Methods Article Reporting Standards.
No contributions from patients or the public were involved in this study.
This study was an investigation of the key factors influencing nurse retention and attrition focusing on the perspectives of current and former nurses within the context of the ongoing nursing shortage exacerbated by the COVID-19 pandemic.
This descriptive, cross-sectional study was designed to explore the complex dynamics of nurse retention and attrition in a rural and northern academic hospital in northwestern Ontario.
An online survey was administered to current and former nurses to compare the perspectives of those with no intention of leaving the organisation, those contemplating departure within the next year, and those who had reduced their work hours in the past 5 years.
Of the 288 respondents, 47% indicated no intention to leave and 17% reported having already left the organisation. The primary reasons for attrition included excessive workload demands, challenges maintaining a healthy work-life balance and dissatisfaction with management practices and organisational support. Respondents recommended improving leadership effectiveness, increasing staffing levels and implementing retention-focused initiatives to enhance job satisfaction and reduce turnover.
This study underscored the urgent need for strategic interventions tailored to retain nursing staff, particularly in rural and northern communities already facing significant recruitment and retention challenges. By addressing workload pressures, enhancing work-life balance, strengthening leadership and offering retention initiatives, health care organisations can improve job satisfaction and reduce attrition. System-level changes are essential to creating a sustainable and supportive environment for nursing professionals.
The findings highlight the critical need for immediate action to address the nursing crisis in rural and northern health care settings. They emphasise the importance of systemic interventions aimed at improving staffing levels, leadership practices and overall work conditions to safeguard the future of nursing in these underserved regions.
No patient or public contribution.
This research will contribute to the extant literature on the retention and attrition levels of nursing by offering a unique perspective from a rural and northern academ. The findings may help to guide hospital administrators to develop targeted strategies to enhance nurse retention rates within their organisations. By prioritising nurse satisfaction, these efforts will foster positive nurse–patient interactions and improve overall care outcomes.
This study is reported according to STROBE guidelines.
To explore healthcare professionals', patients', and family members' experiences of managing regular medications across the perioperative pathway in a specialist cancer hospital in Melbourne.
An exploratory qualitative study using a descriptive-interpretive approach.
Interviews were conducted with 11 patients and seven family members, and focus groups with 10 anaesthetists, seven surgeons, four nurses, and 10 pharmacists (N = 49) between October 2024 and April 2025. Transcripts were analysed using Braun and Clarke's reflexive thematic approach and mapped into the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 human factors framework.
Three interrelated themes were constructed: (1) Work system elements shaping perioperative medication management, encompassing medication and surgical contexts, documentation gaps, reliable medication information, communication infrastructures, roles and responsibilities, and perioperative area resources; (2) Processes influencing medication management practice, characterised by continuity of care at transition points and flagging processes, interdisciplinary collaboration and role interpretation in medication management, patient involvement, family member involvement, and healthcare professional perspectives; and (3) Outcomes of medication management, including patient and organisational outcomes, such as workflow inefficiencies, procedure cancellations, and unplanned readmissions.
Findings indicated that addressing the complexity of perioperative medication safety demands coordinated contributions across multiple professional disciplines. Strengthening interdisciplinary collaboration, clarifying shared responsibilities, embedding structured reconciliation processes at transitions of care, standardizing communication protocols, and involving patients and families are all critical strategies.
This study highlights the need for interdisciplinary coordination and clear role definitions, with nurses as the key contributor, to support collaborative medication decisions in perioperative cancer care.
This study explored challenges in managing regular medications during cancer surgery, offering insights to guide safer practices for perioperative teams, patients, and families in cancer care settings.
COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.
None.
To examine the decision-making processes underlying missed nursing care.
A qualitative study using Critical Incident Debriefing interviews.
Fifteen nurses from inpatient wards in a general hospital participated in semi-structured interviews following their morning shifts. Interviews focused on care prioritisation incidents leading to missed nursing care. Data were analysed using thematic analysis.
Analysis revealed a central theme of emotions as crucial determinants in care prioritisation decisions. Two subthemes emerged: emotions as drivers of care prioritisation decisions and emotions as responses to these decisions. Positive emotions motivated nurses to prioritise care for specific patients, while negative emotions sometimes led to care delays. Successful care completion generated professional satisfaction, while care omissions produced complex emotional responses, including guilt, frustration and helplessness.
The dual emotional processes identified in this study—emotions functioning as both drivers and responses in care decisions—challenge purely structural explanations of missed nursing care. This perspective reframes nurses as emotionally engaged decision-makers who actively navigate care priorities rather than passively react to contextual constraints, offering a more comprehensive framework for understanding the complexity of clinical judgement in real-world settings.
This study positions emotions as legitimate components of clinical decision-making rather than cognitive biases. For nursing practice, this necessitates integrating emotional awareness into professional development. For patient care, recognising emotional underpinnings may promote equitable care distribution through interventions that engage with the emotional realities of nursing work.
This study addressed limited understanding of decision-making in missed nursing care, particularly emotions' role. Findings reveal how emotions influence nurses' prioritisation decisions and wellbeing, with implications for nurses, educators and administrators seeking interventions addressing structural and emotional dimensions.
This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines (Appendix S1).
No patient or public contribution.
The study aims to investigate patients' perceptions of recurrence risk associated with atrial fibrillation, with the goal of establishing a theoretical foundation for developing future measurement scale and intervention strategies.
A qualitative interview study.
Seventeen patients diagnosed with atrial fibrillation at a Grade-A tertiary hospital participated in semi-structured, in-depth interviews conducted between October and December 2024. Participants were selected via purposive sampling. The data were analysed employing thematic analysis in accordance with Colaizzi's method. The study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.
The perceptions of recurrence risk among patients with atrial fibrillation can be summarised into five themes: (1) perceived likelihood of recurrence, (2) perceived severity of recurrence, (3) perceived triggers of recurrence, (4) emotional reaction to recurrence, and (5) efficacy perception of managing recurrence risk.
Perceptions of recurrence risk among patients with atrial fibrillation are diverse and often underestimated due to limited knowledge and subjective symptom interpretation, affecting health behaviours. Understanding patients' subjective appraisals, emotions, and perceived efficacy is essential. Validated assessment tools and tailored risk communication may enhance self-management and support targeted interventions.
This study provides critical insights into how atrial fibrillation patients perceive their risk of recurrence. It also provides a theoretical foundation for creating validated assessment tools and tailoring individualised health education and intervention programmes.
Patients were involved in the study design, data collection, and interpretation of findings. Their contributions included providing feedback on the initial interview guide to ensure relevance and clarity, participating in in-depth interviews to share their lived experiences with atrial fibrillation recurrence, and offering reflections on key themes emerging from the data.
To assess career satisfaction among Chinese nurses, explore influencing factors, and examine the mediating role of role breadth self-efficacy (RBSE) in the relationship between subjective age and career satisfaction.
A multi-centre, cross-sectional study.
Between June and October 2024, 2033 questionnaires were distributed to nurses across seven geographic regions in China, collecting data on demographics, subjective age, RBSE, and career satisfaction. Descriptive statistics, Pearson correlation analysis, multiple linear stepwise regression, and path analysis were used to identify determinants of career satisfaction and test the mediating effect of RBSE.
The effective response rate was 97%. Chinese nurses reported moderate-to-high career satisfaction, younger subjective age relative to chronological age, and moderate RBSE levels. Multivariate linear regression analysis identified education level, work institution, salary, weekly working hours, subjective age, and RBSE as significant predictors of career satisfaction. Path analysis revealed a significant negative association between subjective age and career satisfaction (β = −0.23, p < 0.001), which was partially mediated by RBSE (indirect effect = −0.11, 95% CI: −0.18 to −0.05).
The career satisfaction of Chinese nurses is at a moderately high level; the influencing factors include the intensity of nursing work and salary levels. There is a certain difference between the subjective age and the chronological age of Chinese nurses. RBSE partly mediates the relationship between subjective age and career satisfaction.
Valuing the breadth of nurses' roles, self-efficacy, and subjective age may help improve job satisfaction.
What problem did the study address?: This study elucidates the present level of career satisfaction among nurses in China and the variables affecting it. What were the main findings?: The subjective age of Chinese nurses influences career satisfaction, with RBSE partly mediating the connection between subjective age and career satisfaction. Where and on whom will the research have an impact?: This study presents novel variables of subjective age and RBSE in the investigation of factors influencing career satisfaction among Chinese nurses, offering new avenues for enhancing career satisfaction in this demographic in the future.
We adhered to STROBE guidelines for cross-sectional research.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study aimed to examine the level of vicarious posttraumatic growth among intensive care unit nurses in China and explore the mediating role of death coping ability in the relationship between moral resilience and vicarious posttraumatic growth.
A multicentre, cross-sectional study was conducted in accordance with the STROBE guidelines.
Between January and March 2025, a questionnaire survey was conducted among 666 intensive care unit nurses from nine tertiary Grade A hospitals across five provinces in China. Participants completed three standardised instruments: the Rushton Moral Resilience Scale, the Coping with Death Scale–Short Version, and the Vicarious Posttraumatic Growth Inventory. We used IBM SPSS 27.0 for descriptive statistics, univariate analyses, and correlation analyses, and employed AMOS 27.0 to perform structural equation modelling for testing mediation effects.
Intensive care unit nurses demonstrated a moderate level of vicarious posttraumatic growth. Moral resilience was positively associated with both death coping ability and vicarious posttraumatic growth. Death coping ability was found to play a partial mediating role in the relationship between moral resilience and vicarious posttraumatic growth.
Moral resilience and death coping ability are key factors associated with vicarious posttraumatic growth among intensive care unit nurses. Nurses with stronger moral resilience are more likely to cope constructively with death-related stress, which may support psychological growth in trauma-intensive environments.
This study highlights the need to enhance intensive care unit nurses' moral and emotional capacities through ethics education, emotional coping training, and institutional support strategies. Strengthening these competencies may foster professional development and mental wellbeing in critical care settings.
To systematically identify and appraise existing risk prediction models for EN aspiration in adult inpatients.
A systematic search was conducted across PubMed, Web of Science Core Collection, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biomedical Literature Database (CBM) and VIP Database from inception to 1 March 2025.
Systematic review of observational studies.
Two researchers independently performed literature screening and data extraction using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS). The Prediction Model Risk of Bias Assessment Tool (PROBAST) was employed to evaluate both the risk of bias and the clinical applicability of the included models.
A total of 17 articles, encompassing 29 prediction models, were included. The incidence of aspiration was 9.45%–57.00%. Meta-analysis of high-frequency predictors identified the following significant predictors of aspiration: history of aspiration, depth of endotracheal intubation, impaired consciousness, sedation use, nutritional risk, mechanical ventilation and gastric residual volume (GRV). The area under the curve (AUC) was 0.771–0.992. Internal validation was performed in 12 studies, while both internal and external validation were conducted in 5 studies. All studies demonstrated a high risk of bias, primarily attributed to retrospective design, geographic bias (all from different parts of China), inadequate data analysis, insufficient validation strategies and lack of transparency in the research process.
Current risk prediction models for enteral nutrition-associated aspiration show moderate to high discriminative accuracy but suffer from critical methodological limitations, including retrospective design, geographic bias (all models derived from Chinese cohorts, limiting global generalisability) and inconsistent outcome definitions.
Recognising the high bias of existing models, prospective multicentre data and standardised diagnostics are needed to develop more accurate and clinically applicable predictive models for enteral nutrition malabsorption.
Not applicable.
PROSPERO: CRD420251016435
To evaluate the research capability of clinical nurses in China and identify the determinants associated with their capability.
As nursing evolves into an increasingly independent discipline, the research capability of clinical nurses has become critical for the development of the profession, advancing evidence-based practice and improving patient care quality.
A multicentre cross-sectional survey was conducted using convenience sampling from September 2023 to February 2024, among clinical nurses in tertiary hospitals across three provinces in China. The Nursing Research Capability Self-Assessment Scale was used to assess the research capability of the nurses. Chi-square tests, one-way analysis of variance and multiple linear regression were used to examine factors associated with research capability. The Strengthening the Reporting of Observational Studies in Epidemiology was followed.
A total of 1074 clinical nurses participated. The mean research capability score was 89.11 ± 27.69, reflecting a moderate level of research capability. However, two dimensions of research questions and literature review received lower scores. Multiple linear regression analysis identified that education level, professional title, administrative position and nursing job title (all p < 0.05) were independent predictors of research capability.
Clinical nurses exhibit moderate research capability, with notable deficiencies in formulating research questions and conducting literature reviews. Key factors influencing research capability include education, professional title, administrative position, and job title. Targeted training and development programmes should address these factors to enhance nurses' research competence and advance nursing science.
Nurses play vital roles in healthcare systems, especially in competitive environments that must meet diverse stakeholder expectations, improve quality and foster innovation. However, these efforts are often challenged by workforce issues such as nurse turnover intention, which is a critical concern requiring effective leadership and management. Despotic leadership is harmful and may lead to negative nurse behaviours, including intentions to leave their positions.
This study explored the correlations and differences in the clinical nurse managers' despotic leadership and nurse turnover intention based on the sample characteristics as perceived by registered nurses (RNs) working in the selected hospitals in Jordan.
This study employed a quantitative cross-sectional correlational comparative design to measure the relationships and differences between the perceived despotic leadership of nurse managers and nurse turnover intention. In 2024, a paper-format survey was distributed to nurses working in various hospitals. Five governmental and private hospitals in Jordan were purposively chosen to recruit 301 nurses using non-probability convenience snowball sampling techniques. Sample size was collected using G* power, and data were collected using a highly psychometric instrument of the Toxic Leadership Behaviours of Nurse Managers Scale (The ToxBH-NM Scale) and the Turnover Intention Scale (TIS-6 Items).
The overall score for clinical nurse managers' despotic indicated a moderate level of despotic leadership among nurse managers. Among the nurses surveyed, 53 (17.60%) expressed an intention to stay in their positions, while 248 (82.30%) indicated they intended to leave those positions. There was a statistically significant weak positive correlation between the total score of perceived clinical nurse managers' despotic leadership and the total score of perceived nurse turnover intention (r = 0.215, p = 0.01). This correlation suggests a small effect size (Cohen's guidelines: small = 0.10, medium = 0.30, large = 0.50), indicating that while the relationship was statistically significant, the practical impact was at a small level. No significant differences were found in the perceived despotic leadership of nurse managers or nurse turnover intention.
The findings highlighted the critical roles of leaders, policymakers and organisations in reducing the perceived despotic leadership of nurse managers. These roles are crucial in decreasing nurses' intentions to leave their jobs.
Accurately identifying despotic management behaviours is crucial. To improve nurse retention, healthcare organisations should implement evidence-based interventions targeting job satisfaction, workload management and ongoing professional development.
This study did not include patient or public involvement in its design, conduct or reporting.
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