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The transition from the intensive care unit to the general ward is complex. Understanding patients' and families' experiences during this period is essential for optimising nursing care.
Explore the experiences of patients and families during the transition from the intensive care unit to the general ward.
A qualitative meta-synthesis integrated and interpreted studies on intensive care unit patients' and families' experiences during transitions to general wards, involving systematic searches, appraisal, and integration analysis.
PubMed, Web of Science, Embase, EBSCO, CNKI, Wanfang, and VIP databases were searched using subject and free-text strategies, covering inception to July 2024.
Inclusion criteria included qualitative studies in English and Chinese that fit the study topic. Two researchers independently reviewed 42 full-text articles, of which 26 met the criteria. Quality appraisal used the JBI qualitative research assessment tool, and data were synthesised by the pooled integration method.
Three key themes emerged from the analysis: (1) emotional duality of hope and anxiety before transfer, (2) heightened vulnerability and disorientation during ICU-to-ward transition, and (3) unmet needs. These themes were further divided into nine subcategories.
Transitions from intensive care units to general wards present patients and families with mixed emotions and challenges in adaptation. Continuity of care, family engagement, and tailored health education are vital to supporting patient recovery and family well-being.
Assessing patient and family anxiety during ICU transitions and using evidence-based interventions to manage emotions can improve recovery and reduce complications. The healthcare team should prioritise early intensive care unit rehabilitation to prevent functional decline, particularly in lower-intensity ward care. Identify patient and family needs when designing transition interventions. Use personalised, targeted health education tailored to different patient and family characteristics to enhance effectiveness across varied healthcare settings.
This is a meta- synthesis without direct patient involvement.
by Li Wang, Yibing Wang
This study is aimed to evaluate the association between statin therapy and intermediate-term survival in critically ill patients with heart failure (HF). Using a real-world retrospective cohort from the MIMIC-IV database, we assessed all-cause mortality at 90 and 180 days following ICU admission. To reduce confounding factors, we applied a triangulated analytic framework incorporating propensity score matching, inverse probability of treatment weighting and standardized mortality ratio weighting. Survival outcomes were additionally examined across different statin types, including atorvastatin, rosuvastatin, simvastatin and pitavastatin, using stratified Kaplan–Meier analysis. Among over 8,000 eligible patients, statin use during hospitalization was consistently associated with reduced mortality at both time points across all models. Stratified survival curves showed comparable trends among the different statin types. These findings suggest a potential class-wide survival benefit of statin therapy in the ICU setting for HF patients and highlight the need for further studies to determine whether specific statin selection offers additional clinical advantages.To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults.
A systematic review and meta-analysis.
We searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.
Randomised controlled trials and non-randomised studies of interventions involving integrated care for community-dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta-Analysis software.
This review included 12 studies involving 6819 community-dwelling frail older adults from high-income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost-effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.
Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.
This implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.
PRISMA 2020 Checklist.
No patient or public contribution.
CRD42024568811
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.
Preventing skin tears (STs) in older adults is an urgent public health concern, especially in long-term care (LTC) facilities. However, limited research on ST prevention among care workers exists due to a lack of suitable assessment tools. This study aims to develop and psychometrically evaluate the Knowledge, Attitude and Practice instrument for care workers in preventing Skin Tears (KAP-ST) in older adults.
The KAP-ST was developed and validated in four phases during May–October 2024. First, an item pool was generated through a comprehensive literature review. Second, a preliminary instrument was developed through a Delphi expert consultation and pilot testing. Third, the items and the final instrument were optimised through a cross-sectional survey involving 317 care workers from 29 LTC facilities in China. Finally, a psychometric evaluation was conducted in another cross-sectional survey involving 373 care workers from 18 LTC facilities.
The final KAP-ST contains 35 items across knowledge, attitude and practice dimensions. Exploratory factor analysis (EFA) revealed a nine-factor structure (factor loadings ranging from 0.451 to 0.799, accounting for 61.35% of total variance). The Item-Level Content Validity Index (I-CVI) values ranged from 0.926 to 1.000, and the Scale-Level Content Validity Index (S-CVI/Ave) was 0.991. The instrument's Cronbach's α, split-half, and test–retest reliability coefficients were 0.887, 0.744, and 0.934, respectively. The CFA analysis revealed an ideal absolute fit validity (RMSEA = 0.068; RMR = 0.029) and parsimony fit validity (PGFI = 0.684).
The KAP-ST demonstrates strong reliability, structural validity and content validity. It is well-suited for assessing care workers' knowledge, attitudes and practices in preventing STs among older adults. Further research is required to enhance and confirm its validity.
STs in the spotlight recently necessitate the use of appropriate investigative tools to facilitate in-depth research, especially for care workers, who should prioritise access to specialised knowledge. Introducing professional guidance in LTC facilities is recommended to enhance the knowledge, attitude and practice of care workers.
Standardised Guidelines for Scale Construction and COSMIN checklist.
No patient or public contributions.
To examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information–motivation–behavioural (IMB) skills model from a behavioural perspective.
Cross-sectional study.
A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.
The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.
Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.
Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.
The STROBE checklist was used as a guideline.
Nurses completed questionnaires.
Trial Registration: Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216
This study aimed to synthesise current evidence about the experiences and needs of informal caregivers of community-dwelling frail older adults to inform targeted interventions for improving their caregiving situations.
This was a mixed methods systematic review using the convergent integrated analysis framework.
We conducted systematic searches across 11 databases, including CINAHL, CNKI, EMBASE, OpenGrey, ProQuest, PsycINFO, PubMed, SinoMed, VIP, WanFang and Web of Science, as well as reference lists, for studies published between January 1, 2000 and March 12, 2025. Quality appraisal was performed using the Mixed Methods Appraisal Tool. Findings were synthesised using a narrative approach.
Of the 5297 citations, 2905 were screened for titles and abstracts, 176 were further screened for full-texts and eight studies were included (n = 6 quantitative, n = 2 qualitative; 1949 caregivers). The themes of caregiving experiences related to (1) influential factors contributing to negative, (2) or positive caregiver outcomes; (3) coping strategies or resources that caregivers employed to address caregiving situations; the outcomes that could be (4) negatively, (5) or positively impacted by caregiving; and (6) difficulties they encountered related to caring for frail older adults. Caregivers expressed needs for psychological support, detailed information on available resources, and family-centred and integrated public services with self-advocacy and coordinators.
This review highlights broad areas that require more attention for enhancing the well-being of these caregivers. More research is warranted on caregivers' experiences, needs, and interventions, especially their support needs. A theoretical framework, comparative analyses between child caregivers and spousal caregivers, as well as emphasising both mastery and competence, is recommended for future research and practice.
Our findings hold the potential to guide the development of needs-oriented and evidence-based interventions tailored to the unique challenges faced by caregivers, thereby supporting them in their caregiving roles.
This review followed the PRISMA 2020 guidelines.
No patient or public contribution due to design.
The objective of this study was to identify symptom clusters in lung cancer patients receiving immunotherapy and explore their impact on the quality of life of patients.
Immunotherapy is widely used in lung cancer; however, there is little understanding of symptom clusters and their impacts on the quality of life of this population.
Cross-sectional study.
The survey contained the Memorial Symptom Assessment Scale (MSAS), Quality of Life Questionnaire-Lung Cancer 43 and a self-designed General Information Evaluation Form. Symptom clusters were identified using exploratory factor analysis (EFA) based on the symptom scores. Spearman correlation analysis was performed to evaluate the associations between each symptom cluster and the patients' quality of life. Multiple linear regression analysis was employed to examine the impact of the symptom clusters on quality of life. This study adhered to the STROBE guidelines.
In total, 240 participants completed the survey. Five symptom clusters were identified and named according to their characteristics: emotional-related symptom cluster, lung cancer-related symptom cluster, physical symptom cluster, skin symptom cluster and neural symptom cluster. All symptom clusters, except for the neural symptom cluster, had a significantly detrimental impact on patient quality of life.
Lung cancer patients undergoing immunotherapy experience a range of symptoms, which can be categorized into five clusters. These symptom clusters have a negative impact on patients' quality of life. Future research should focus on developing interventions for each symptom cluster and their influencing factors.
In the data collection phase, lung cancer patients undergoing immunotherapy were recruited to participate in the survey.
To investigate the prevalence of dysphagia in patients with COPD, identify the risk factors for dysphagia, develop a visual clinical prediction model and quantitatively predict the probability of developing dysphagia.
Patients with COPD are at high risk of dysphagia, which is strongly linked to the acute exacerbation of their condition. The use of effective tools to predict its risk may contribute to the early identification and treatment of dysphagia in patients with COPD.
A cross-sectional design.
From July 2021 to April 2023, we enrolled 405 patients with COPD for this study. The clinical prediction model was constructed according to the results of a univariate analysis and a logistic regression analysis, evaluated by discrimination, calibration and decision curve analysis and visualized by a nomogram. This study was reported using the TRIPOD checklist.
In total, 405 patients with COPD experienced dysphagia with a prevalence of 59.01%. A visual prediction model was constructed based on age, whether combined with cerebrovascular disease, chronic pulmonary heart disease, acute exacerbation of COPD, home noninvasive positive pressure ventilation, dyspnoea level and xerostomia level. The model exhibited excellent discrimination at an AUC of .879. Calibration curve analysis indicated a good agreement between experimental and predicted values, and the decision curve analysis showed a high clinical utility.
The model we devised may be used in clinical settings to predict the occurrence of dysphagia in patients with COPD at an early stage.
The model can help nursing staff to calculate the risk probability of dysphagia in patients with COPD, formulate personalized preventive care measures for high-risk groups as soon as possible to achieve early prevention or delay of dysphagia and its related complications and improve the prognosis.
No patient or public contribution.
Lateral violence is a global social problem that has attracted considerable attention in the field of public health. This has seriously affected the quality of care, the safety of patients' lives and the career development of nurses.
To systematically evaluate the factors influencing of nursing lateral violence and provide evidence for preventing and reducing inter-nursing lateral violence.
A systematic review of qualitative study was performed in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. We collected qualitative studies on the factors influencing of inter-nursing lateral violence by searching PubMed, EMbase, The Cochrane Library, Web of Science, CINAHL, Science Direct, WanFang Data, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP) and Chinese Biomedical Literature Database (CBM). Data from inception to September 2023. Literature screening and data extraction were independently conducted by two reviewers. The Critical Appraisal Skills Program (CASP) scale was employed to assess the quality of the studies, including objectives, methodologies, designs, results and contributions.
A total of 25 studies involving 882 participants were included. The results of the thematic analysis indicated that inter-nursing lateral violence was influenced by hospital management, perpetrators, victims and sociodemographic factors.
Inter-nursing lateral violence was influenced by multidimensional factors. To reduce the occurrence of horizontal violence among nurses, hospitals need to explore the establishment and improvement of a horizontal violence resolution mechanism, and schools should pay attention to the joint support and education of nursing students, create a good working environment and harmonious nursing culture, and promote mutual respect among nurses.
This review emphasises the importance of the influencing factors of horizontal violence among nurses, analyses the importance of influencing factors from different perspectives, and proposes corresponding measures to reduce inter-nursing lateral violence.
This study was mostly a literature review; neither patients nor pertinent staff were involved in either the design or conduct of the investigation.
FreshRSS 