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The Effects of Perceived Managerial Care From Head Nurses and Individual Resilience on Nurse‐To‐Nurse Lateral Violence Among Newly Graduated Nurses

ABSTRACT

Aim

This study examines the effects of perceived managerial care from head nurses and individual resilience on nurse-to-nurse lateral violence among newly graduated registered nurses and determines whether individual resilience mediates the effect of perceived managerial care from head nurses and nurse-to-nurse lateral violence.

Background

Previous studies have examined how managerial care contributes to lateral violence among nurses. However, few studies have examined how individual resilience contributes to reducing lateral violence among newly graduated registered nurses.

Methods

This cross-sectional survey study used a three-stage, stratified convenient sampling method, which involved 425 newly graduated registered nurses. Participants completed the Chinese version of the Management Caring Assessment Scale, the Connor–Davidson Resilience Scale, and the Nurse-to-Nurse Negative Behaviour Scale. Structural equation modelling and mediation effect analysis were used to explore the relationships among perceived managerial care from head nurses, individual resilience, and nurse-to-nurse lateral violence.

Results

New nurses experienced moderate levels of lateral violence. The final model accounted for 76.4% of the total variance of lateral violence. Managerial care and individual resilience both had a direct effect on lateral violence. Individual resilience mediated the correlations between managerial care and lateral violence.

Conclusions

Newly registered nurses, especially from rural areas with low levels of education and an inability to perform night shifts independently, are a special group that requires higher attention from nursing management.

Relevance to Clinical Practice

Head nurses' managerial care plays an important role in ensuring that new nurses adapt well to their new role and promoting the formation of psychological resilience among nurses. Nursing managers should increase the level of concern they display for new nurses, especially those from rural areas, those with low levels of education, and those who are unable to perform night shifts independently.

Patient or Public Contribution

Patients contributed to data collection through completing questionnaire surveys.

Establishment of a risk prediction model for peripherally inserted central catheter‐related bloodstream infections based on a systematic review and meta‐analysis of 20 cohorts

Abstract

Background

Peripherally inserted central catheters (PICCs) are commonly used for extended intravenous therapy but are associated with a significant risk of bloodstream infections (BSIs), which increase morbidity and healthcare costs.

Aim

The aim of this study was to identify patients at high risk of developing PICC-related bloodstream infections (PICC-RBSIs) to establish new and more specific targets for precise prevention and intervention.

Methods

A search was conducted from the earliest available record to May 2024 among the following databases: Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Scopus, and Chinese National Knowledge Infrastructure (CNKI). Hand searching for gray literature and reference lists of included papers was also performed. We assessed the quality of the studies using the Newcastle–Ottawa Scale (NOS) checklist. Two reviewers screened all the retrieved articles, extracted the data, and critically appraised the studies. Data analysis was performed using RevMan statistical software.

Results

A total of 20 cohort studies involving 51,907 individuals were included in the analysis. The statistically significant risk factors identified were hospital length of stay, line type (tunneled), history of PICC placement, multiple lumens, previous infections, chemotherapy, total parenteral nutrition, hematological cancers, delays in catheter care, local signs of infection (e.g., localized rashes), previous BSIs, and diabetes mellitus. Due to high heterogeneity among studies regarding previous BSIs, this factor was excluded from the final predictive model, while all other risk factors were included.

Conclusions

The present meta-analysis identified risk factors for PICC-RBSIs and developed a predictive model based on these findings, incorporating 10 risk factors that integrate both patient-specific and procedural factors.

Linking Evidence to Action

Integrating the risk prediction model for PICC-RBSI into clinical guidelines and training is essential. Healthcare providers should be trained to use this model to identify high-risk patients and implement preventive measures proactively. This integration could enhance personalized care, reduce infection incidence, and improve patient outcomes. Future research should update the model with new risk factors and validate its effectiveness in diverse clinical settings.

Psychological‐Distress Factors in Patients With Breast Cancer: A Qualitative Meta‐Synthesis

ABSTRACT

Aims

To systematically review and integrate qualitative-research results pertaining to psychological distress in patients with breast cancer and to clarify its causes and drivers.

Background

Patients with breast cancer experience psychological distress in the stages of diagnosis, treatment, and rehabilitation, which seriously affects their quality of life. Through comprehensive qualitative research, the study comprehensively describes the experiences of patients with breast cancer to guide medical personnel in taking better care of them.

Design

A systematic review and synthesis of qualitative studies.

Methods

Qualitative studies were included if they were related to the psychological-distress experiences of patients with breast cancer. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. Data were synthesised using the Thomas and Harden method of thematic and content analysis.

Data Sources

Nine electronic databases (PubMed, Embase, Cochrane Library, CINAL [via EBSCO], and PsycINFO, China Knowledge Resource Integrated Database, Wanfang, Chinese Biomedical, and Weipu) were searched from inception until February 2024.

Results

Thirteen studies were included in the meta-synthesis. Four analytical themes were identified: diagnostic and therapeutic, individual, environmental, and interpersonal factors.

Conclusions

Psychological distress is a subjective feeling influenced by interactions among individual, therapeutic, environmental, and interpersonal factors, and it is commonly encountered among patients with breast cancer. Therefore, to optimise the management of psychological distress, the characteristics and external environment of patients with breast cancer should be carefully considered when delivering routine nursing care.

Impact

Patients experience psychological distress at different stages of breast cancer; however, the causes of psychological distress at different stages differ. Medical staff should implement targeted psychological-distress intervention measures based on factors relevant to different stages.

Reporting Method

The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement.

Registration

The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023417364).

Barriers and facilitators in implementing early essential newborn care of well‐born babies in low‐ and middle‐income countries: A mixed‐method systematic review

Abstract

Background

Evidences have demonstrated the effectiveness of early essential newborn care. However, the implementation of early essential newborn care is suboptimal. The aim is to identify and synthesise the barriers and facilitators impacting the implementation of early essential newborn care in low- and middle-income countries.

Data Sources

PubMed, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, CNKI, Wan Fang Data, SinoMed and Google Scholar.

Methods

Two authors independently screened, performed quality assessment using the Mixed Methods Appraisal Tool and extracted data. This review includes papers that reported the barriers and facilitators of implementing early essential newborn care in low- and middle-income countries from the view of healthcare providers. Barriers and facilitators were coded according to the consolidated framework for implementation research in a deductive way and then been inducted into five common themes. This review followed synthesis without meta-analysis reporting guideline.

Results

A total of 28 studies were included. Five inductive common themes influencing implementing early essential newborn care in low- and middle-income countries were system-level healthcare factors, healthcare providers’ knowledge and beliefs, the requirements of mothers or families, adapting to routine practice and the working climate of organisation.

Conclusion

The factors were from system level, facility level and individual level and were inducted into five themes. Based on this review, decision-makers could tailor implementing strategies to narrow the gap between the evidence and implementation.

Relevance to Clinical Practice

The study offers guidance for health professionals to identify barriers and facilitators in implementing early essential newborn care and make tailored strategies when implementing early essential newborn care.

Patient or Public Contribution

No patient or public contributions.

Psychological distress in adult women of reproductive age at different stages after breast cancer diagnosis: A qualitative study

Abstract

Aim

To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis.

Design

Qualitative.

Methods

Eighty-one patients with breast cancer-related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1-, 3-, 6-, 9- and 12-month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted.

Results

Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post-diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1-, 3-, 6-, 9- and 12 months post-diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns.

Conclusion

Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns.

Implications for the Profession and/or Patient Care

During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions.

Impact

To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence-based professional guidance on reproductive preservation techniques.

Reporting Method

The study was reported using the consolidated criteria for reporting qualitative research guidelines.

Patient or Public Contribution

Patients contributed to data collection through interviews.

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