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To explore challenges parents of children with cancer encounter while providing complex medical care at home.
Design: Cross-sectional convergent mixed-methods study. Instruments: Questionnaire and open interviews that mirrored and complemented each other.
Parents (n = 32), with no prior medical training, were expected to remain constantly vigilant as they monitored and managed rapidly changing situations. Regardless of time from diagnosis, they detected a mean of 3.3 ± 1.4 (0–6) symptoms, reported administering up to 22 daily medications, including cytotoxics, narcotics and injections, and dealt with many related challenges. Parents described needing responsive communication channels, especially when dealing with bleeding and infection emergency situations during off-hours.
Findings highlight the constantly shifting demands when managing a child with cancer at home. Educational programmes that address parental needs throughout treatment, tailored to protocol changes and individual circumstances, should be expanded and further developed.
Parents need continual education regarding home management throughout their children's illness and treatment.
This study addresses challenges parents of children with cancer encounter while providing complex medical care at home. The findings demonstrated that parents, responsible for administering numerous medications via various routes and managing symptoms and side effects, did not feel confident performing these tasks regardless of time from diagnosis. Nurses should adapt ongoing parental education regarding complex medical tasks, symptoms, side effects, emergency detection and management for children with cancer at home. The study adhered to the Mixed Methods Appraisal Tool (MMAT) and STROBE reporting method.
Parents of children with cancer participated in the design and questionnaire validation.
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.
To analyse the level of patient satisfaction regarding the care received in triage and its relationship with the competency level of clinical nurses in a hospital setting.
A cross-sectional, prospective and multicentre study of nurses in hospital emergency triage and the patients they attended.
Data were collected between October and November 2019 using two questionnaires; one collected sociodemographic factors, professional experience of the nurse and the competency assessment questionnaire for clinical nurses in the hospital setting (COM_VA). The other questionnaire recorded the age of patients, reason for consultation, pain and the Patient Satisfaction with Emergency Nursing Care Scale (CECSS). The abstract includes an indication of the chosen checklist, specifically the STROBE checklist for descriptive observational studies.
The study included a sample of 624 patients and 77 nurses. The findings indicated that the nurses' level of competence, with an average score of 8.61, is significantly correlated with patient satisfaction. A total of 90.2% of patients reported being satisfied with the care they received during triage, highlighting the technical competence and empathy of the nurses as highly valued attributes. However, areas for improvement were identified, particularly in pain management and addressing the emotional needs of patients. Other factors related to nursing competence that influenced patient satisfaction included perceived safety in clinical practice and the sense of respect from the multidisciplinary team. Additionally, the intensity of pain experienced by patients during triage was a significant determinant of their overall satisfaction.
The results of this study indicate that the higher the level of nursing competence, the more satisfied the patients. In addition to knowledge and skills in triage, aspects such as empathy, concern and assertive listening influence patient satisfaction, and, therefore, perceived quality of care.
In preparing the manuscript, the authors adhered to the relevant EQUATOR guidelines and the STROBE checklist for descriptive observational studies.
No public or patient or professional contribution outside of participation for data collection purposes.
Trial Registration: N/A. This was not a clinical trial
To evaluate the accuracy of the Emergency Severity Index (ESI) assignments by GPT-4, a large language model (LLM), compared to senior emergency department (ED) nurses and physicians.
An observational study of 100 consecutive adult ED patients was conducted. ESI scores assigned by GPT-4, triage nurses, and by a senior clinician. Both model and human experts were provided the same patient data.
GPT-4 assigned a lower median ESI score (2.0) compared to human evaluators (median 3.0; p < 0.001), suggesting a potential overestimation of patient severity by the LLM. The results showed differences in the triage assessment approaches between GPT-4 and the human evaluators, including variations in how patient age and vital signs were considered in the ESI assignments.
While GPT-4 offers a novel methodology for patient triage, its propensity to overestimate patient severity highlights the necessity for further development and calibration of LLM tools in clinical environments. The findings underscore the potential and limitations of LLM in clinical decision-making, advocating for cautious integration of LLMs in healthcare settings.
This study adhered to relevant EQUATOR guidelines for reporting observational studies.
We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults.
This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015–2020).
A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals.
Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength.
Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults.
The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients.
Patients were involved in the sample of the study.
This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.
To explore (a) the associations between individual social responsibility and the public intention to use violence against nurses; and (b) the relationship between individual social responsibility, personal variables and the public's intention to employ violence against nurses.
Workplace violence against nurses is a significant widespread occupational health issue. To date, no reference has been found to the association between personality traits such as individual social responsibility and the public's intention to use violence against nurses.
A cross-sectional survey design with a convenience sample of 667 Israeli participants from among the public. A structured self-report questionnaire was distributed, including socioeconomic variables, individual social responsibility and responses to four vignettes describing incidents of violence directed at nurses. Multiple linear regressions were calculated for intention to employ violence, with demographic variables and individual social responsibility as independent variables. The STROBE checklist for cross-sectional studies was used for reporting.
Negative correlations were found between individual social responsibility and the intention to employ violence against nurses. Gender, having witnessed physical violence and individual social responsibility explained 19% of the variance in the intention to employ violence against nurses. Demographic variables and having witnessed verbal or physical violence were found to moderate the association between individual social responsibility and the intention to employ violence against nurses.
Witnessing a violent incident in a healthcare setting is a risk factor for the intention to employ violence against nurses. Our findings point to the role of individual social responsibility as one of the strategies to help reduce violent events.
Educating and promoting values of social responsibility among the public can reduce incidents of violence in healthcare settings, thus contributing to the safety and quality of care provided.
The public contributed via study participation.
To describe and interpret the sexual health experiences of men with IBD.
Interpretive qualitative study.
In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis.
Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals.
Inflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population.
This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention.
Reporting follows the COREQ checklist.
A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.
This study examines the intricate language and communication patterns of nurse-to-nurse handoffs across three units with varying patient acuity levels and nurse–patient ratios, seeking to identify linguistic factors that may affect the quality of information transfer and patient outcomes.
A mixed-methods cross-sectional design.
This study used the Nurse-to-Nurse Transition of Care Communication Model to explore the content and meaning of language in nursing handoffs within a large academic medical centre. Data were collected on three units through digital audio recordings of 20 handoffs between June and September 2022, which were transcribed and analysed using the Linguistic Inquiry Word Count programme. Trustworthiness was established by adhering to COREQ and STROBE guidelines for qualitative and quantitative research, respectively.
Analysis revealed a preference for casual, narrative language across all units, with ICU nurses demonstrating a higher confidence and leadership in communication. Cognitive processes such as insight and causation were found to be underrepresented, indicating a potential area for miscommunication. Communication motives driven by affiliation were more pronounced in ICU settings, suggesting a strong collaborative nature. No significant differences were observed among the units post multiple testing adjustments. Speech dysfluencies were most pronounced in ICU handoffs, reflecting possible stress and cognitive overload.
The study highlights the need for improved communication strategies such as interventions to enhance language clarity and incorporating technological tools into handoff processes to mitigate potential miscommunications and errors. The findings advance nursing science by highlighting the critical role of nuanced language in varied-acuity hospital settings and the necessity for structured nurse education in handoff communication and standardized handoff procedures.
This study underscores the critical role of language in nurse-to-nurse handoffs. It calls for enhanced communication strategies, technology integration and training to reduce medical errors, improving patient outcomes in high-acuity hospital settings.
Nurses only.
This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL.
Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome.
A cross-sectional survey design using the STROBE checklist.
Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL.
The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors.
Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society.
Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns.
No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.
To codesign a cancer personalised activity and lifestyle tool (CAN-PAL) based on an existing tool. To help cancer care workers support people affected by cancer to plan and integrate physical activity into lifestyles.
Mixed-methods codesign study.
Phase 1: Focus groups with people affected by cancer (n = 10) or interviews (n = 2) to discuss suitable physical activities and adaptation of the existing tool. Data were recorded, transcribed and analysed thematically. Themes informed the design of the prototype CAN-PAL and user guide. Phase 2: Healthcare professionals considered the potential use of the CAN-PAL prototype and completed an online survey including the system usability scale and free text responses.
Phase 1: Identified suitable physical activities and four themes were identified including: Capability, benefits, barriers and resources which informed the prototype CAN-PAL and user guide. Phase 2: The user survey was completed by 12 healthcare professionals. Median (range) system usability scale was 80 (50–95) (best score 100), scores >68 indicate good or better usability. Themes from the free text comments included strengths, amendments, considerations and limitations. Results were used to finalise CAN-PAL and the user guide.
The codesigned CAN-PAL tool had good usability. Further work is needed to evaluate the impact of CAN-PAL on activity levels and behaviour in people affected by cancer.
People affected by cancer need support to undertake physical activity. The purpose of CAN-PAL is to assist cancer care workers to support people affected by cancer to plan and integrate physical activity into lifestyles.
Public partners considered the findings from Phase 1 and 2 and informed the design of the prototype, final CAN-PAL and user guide and coauthored the paper.
The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist.
To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation.
Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life-ending drugs. They play a central role in guiding patients through the euthanasia application process.
Observational descriptive study.
A study of Andalusian Public Health System nurses was carried out using non-probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio-demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used.
The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories ‘Ethical considerations’, ‘Practical considerations’ and ‘Treasuring life’. On the other hand, there was a significant positive correlation between age and work experience and ‘Spiritual beliefs’ category.
The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application.
It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession.
No patient or public contribution.
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