The objective of this systematic review was to evaluate the measurement properties of pressure injury risk assessment tools for cancer patients using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology, and to serve as a reference for clinical nurses in their hospital duties when choosing high-quality assessment tools.
A systematic review based on COSMIN methodology.
The English literature in PubMed, Embase, Web of Science, Cochrane Library, CINAHL and the search period ranged from the inception of the database to September 30, 2024.
Two reviewers independently screened the studies, extracted the data, and evaluated the methodological quality and measurement properties of the included studies.
Seven studies met the inclusion criteria. Two tools—the PUSO (Pressure Ulcer Scale in Oncology) and the Cuire scale—demonstrated sufficient evidence of content validity and structural validity, meeting the COSMIN quality standards. None of the studies reported the cross-cultural validity, stability, and measurement error of the assessment tool.
Following the COSMIN assessment, the PUSO and the Cuire were developed using rigorous procedures, ensuring sufficient overall quality for content validity, structural validity, and other measurement properties. We recommend their use across various environments, based on the quantity and content of specific items. The PUSO was recommended for clinical screening, whereas the Cuire scale was deemed more suitable for use in outpatient, community, and scientific research settings. However, these measurement properties are not without flaws, and their clinical application requires further validation.
Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context.
The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context.
The Schwartz and Kim's three-stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords “nurs*”and “vicarious trauma*”, resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi-structured in-depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing.
Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post-trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development.
The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field.
Nurses contributed to the conduct of the study by participating in the data collection via interviews.