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Aim A discussion which aims to explore the diversity of decision-making during teenage and young adult cancer treatment. The discussion will be related to the concepts of autonomy, dependence and decision-making in this age group. Background The experience of cancer involves a significant series of treatment decisions. However, other non-treatment decisions also have to be made which can relate to any aspect of everyday life. These decisions occur against the backdrop of young people's disease experience. Design Discussion paper. Data sources A literature search for the period 1990-2013 was undertaken. This included searching the following databases: Cumulative Index for Nursing and Allied Health Literature ( CINAHL), SCOPUS, Medline, DARE, Applied Social Sciences Index and Abstracts ( ASSIA), (Psych Info) and The Cochrane Library. Implications for nursing There is a lack of evidence into the experience of everyday decisions made by young people during cancer treatment. This may affect them in the form of unmet needs that nurses, or other professionals, fail to appreciate. Conclusion Further exploration of how teenagers and young adults experience the range and process of decision-making during cancer treatment could be useful in helping to provide effective supportive care for this age group. [ABSTRACT FROM AUTHOR]

Aims: To explore healthcare professionals' perceptions and experiences of take‐home naloxone initiatives in acute care settings to gain an understanding of issues facilitating or impeding dispensing. Design: Systematic literature review. Data Sources: Cochrane, MEDLINE and CINAHL were searched from 15/03/2021 to 18/03/2021, with a follow‐up search performed via PubMed on 22/03/2021. The years 2011 to 2021 were included in the search. Review Methods: A systematic literature review focused on qualitative studies and quantitative survey designs. Synthesis without meta‐analysis was undertaken using a thematic analysis approach. Results: Seven articles from the United States of America (5), Australia (1) and Canada (1) with 750 participants were included in the review. Results indicate ongoing stigma towards people who use drugs with preconceived moral concerns regarding take‐home naloxone. There was confusion regarding roles and responsibilities in take‐home naloxone dispensing and patient education. Similarly, there was a lack of clarity over logistical and financial issues. Conclusion: Take‐home naloxone is a vital harm reduction initiative. However, barriers exist that prevent the optimum implementation of these initiatives. Impact: What is already known:Deaths due to opioid overdose are a global health concern, with take‐home naloxone emerging as a key harm reduction scheme.Globally, less than 10% of people who use drugs have access to treatment initiatives, including take‐home naloxone.An optimum point of distribution of take‐home naloxone is post‐acute hospital care. What this paper adds:There is role confusion regarding responsibility for the provision of take‐home naloxone and patient education. This is exacerbated by inconsistent provision of training and education for healthcare professionals.Logistical or financial concerns are common and moral issues are prevalent with some healthcare professionals questioning the ethics of providing take‐home naloxone.Stigma towards people who use drugs remains evident in some acute care areas which may impact the use of this intervention. Implications for practice/policy:Further primary research should examine what training and education methods are effective in improving the distribution of take‐home naloxone in acute care.Education should focus on reduction of stigma towards people who use drugs to improve the distribution of take‐home naloxone.Standardized care guidelines may ensure interventions are offered equally and take‐home naloxone 'champions' could drive initiatives forward, with support from harm reduction specialists. Reporting Method: This has adhered to the PRISMA reporting guidelines for systematic reviews. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. Design: Rodgers and Knafl's evolutionary concept analysis approach. Methods: The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. Data Sources: Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. Results: A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non‐specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. Conclusions: Oral frailty is an age‐related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. Impact: Oral frailty is increasingly recognized as an age‐related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. What does this paper contribute to the wider global clinical community?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied.Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults. [ABSTRACT FROM AUTHOR]

Aim: To determine the effects of collaborative health management of congestive heart failure through the rigorous evaluation and extraction of evidence. Background: Over the past two decades, cardiovascular disease has been the leading cause of death worldwide. Multidisciplinary team intervention for congestive heart failure has increased with population ageing and congestive heart failure incidence rate as well as cost of care. However, the effectiveness and feasibility of collaborative health management need to be explored. Design: Systematic review and meta‐analysis. Methods: We conducted systematic literature searches in the Cochrane Library, PubMed, CINAHL and Medline for articles published between 2002 and 2022. After screening based on the inclusion and exclusion criteria, 13 articles were included in a rigorous review and evidence extraction process, evaluated methodological quality using the Jadad Quality Scale. Statistical heterogeneity was evaluated using Review Manager (RevMan Version 5.4) for the meta‐analysis. Results: In this study, a systematic review and meta‐analysis were performed on 13 studies regarding the collaborative health management of people with congestive heart failure. The common result is that the collaborative health management model enables the enhancement of self‐care and monitoring abilities, the strengthening of cardiac function, the alleviation of physiological and psychological symptoms and the improvement of readmission rates, mortality rate and quality of life. Conclusion: The congestive heart failure collaborative health management model could decrease the hospitalization rate related to congestive heart failure, all‐cause mortality rate, and all‐cause hospitalization rate, and improve the quality of life. Implications for Practice: The collaborative health management model could effectively coordinate interdisciplinary team cooperation and provide information, which decreases hospitalization and mortality risks and improves their quality of life. No patient or Public Contribution: Our paper is a systematic review and meta‐analysis, and such details do not apply to our work. What does this paper contribute to the wider global clinical community?: The Collaborative Health Management Model provides in‐depth insights, aiding in the design tailored to the specific circumstances of each country. Highlighting its critical role in the context of a global shortage of nursing staff, the model emphasizes the integration of multidisciplinary professional roles and the strengthening of collaboration as essential elements in addressing challenges posed by workforce shortages.Implementation of the Collaborative Health Management Model not only enhances patient care outcomes but also relieves pressure on healthcare systems, lowers medical costs, and addresses challenges arising from the shortage of nursing staff. Consequently, this model not only contributes to individual patient care improvement but also holds broader implications for enhancing the efficiency and sustainability of global healthcare systems. Trial and Protocol Registration: The detailed study protocol can be found on the PROSPERO website. [ABSTRACT FROM AUTHOR]

Aim: To explore undergraduate nursing and midwifery student perspectives of using digital patient systems on clinical placements. Design: This was an interpretative qualitative design study. Methods: Undergraduate nursing and midwifery students in a large Australian metropolitan university were invited to participate in two focus groups from April to June 2019. Twenty (20) students participated and data on their perspective of using digital systems on placement were collected. Thematic analysis using NVivo 12 software was undertaken. Findings: Students identified benefits and challenges when moving between paper records and digital systems. Whilst paper reporting was more efficient for some processes, the students recognised the advantages of digital technology, such as enabling greater confidentiality and consolidation of patient data in one place. However, they also reported difficulty with student access and the size of the portal digital workstation at the bedside. Generally, the lack of preparation and access was considered frustrating and mitigated some of the benefits described when using digital systems. Conclusions: Nursing and midwifery students prefer to be prepared for both paper and digital record keeping. Whilst students identify the benefits of digital platforms, not having direct access mitigates the benefits of these systems. Students identified the use of simulation and interactive modules prior to commencement of clinical practice to enable them to feel more confident with using the systems in patient care. Impact: Health care students require direct access to digital health platforms whilst on clinical placement to facilitate their learning. Higher Education Institutions (HEIs) are in a unique position to work with health care providers to better prepare health care professionals, including nurses and midwives, to work with digital health care systems. Further research is needed to develop the educational preparation for nurses, midwives, and other health care professionals to work with digital systems in practice. [ABSTRACT FROM AUTHOR]

Aim To explore the use and application of case study research in midwifery. Background Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. Design A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. Data Sources An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. Review Methods Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. Results The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. Conclusion This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify the nature and extent of scientific research addressing continuing education for advanced practice nurses. Design: A scoping review. Review Methods: The Joanna Briggs Institute's methodology for scoping reviews. Data Sources: Electronic search was conducted on 17 September 2023 via CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Cochrane Library and the Joanna Briggs Institute's Evidence‐Based Practice Database for research articles published between 2012 and 2023. Results: Nineteen papers were included in this review. Scientific research on continuing education for advanced practice nursing roles (i.e. nurse practitioner, clinical nurse specialist) has primarily been conducted in the United States and mostly addresses online‐delivered continuing education interventions for clinical care competency. Most of the interventions targeted nurse practitioners. Conclusion: Continuing education has a pivotal role in supporting advanced practice nursing competency development. In addition to clinical care, future continuing education research should focus on other advanced practice nursing competencies, such as education, leadership, supporting organizational strategies, research and evidence implementation. Implications for the Profession and/or Patient Care: Continuing education programmes for advanced practice nurses should be rigorously developed, implemented and evaluated to support the quality and effectiveness of patient care. Impact: Continuing education for advanced practice nursing roles is an understudied phenomenon. This review highlights future research priorities and may inform the development of continuing education programmes. Reporting Method: PRISMA‐ScR. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to present the evidence on the effectiveness of non‐surgical interventions to improve health and well‐being in women living with Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome. Design: Systematic review guided by Preferred Reporting Items for Systematic Reviews checklist. Data Sources: The search was conducted between June and September 2022 across the following databases: CINAHL, EMBASE, Medline, PsycINFO and Cochrane. Trial registries (clinicaltrials. gov, World Health Organization International Clinical Trials Registry Platform (ICTRP), Cochrane Controlled Trials Register‐CCTR), Google scholar, dissertations, conference proceedings and reference lists of included studies were also searched. Corresponding authors, formal and informal MRKH groups were contacted to obtain any significant studies or reviews. Review Methods: Eligible were only English‐language empirical studies of any time period. The review followed narrative synthesis. Results: Twenty‐three studies were identified that fit the inclusion criteria which included 1540 MRKH syndrome affected women. Four studies were on psychological interventions (n = 85) and 19 studies (vaginal dilation therapy n = 897, coital dilation n = 57) focused on non‐surgical vaginal dilation as a measure to vaginal agenesis in MRKH syndrome. Conclusions: Clearly, vaginal dilation is a viable initial treatment option for women with MRKH syndrome. There is limited evidence that 'coital dilation' is an effective method of dilation for vaginal agenesis. The literature, however, supports the need for psychological intervention to improve health and well‐being. Impact: Women with MRKH syndrome who require dilation can receive guidance and support from their healthcare providers, particularly sexual and reproductive health nurses, clinical nurse specialists and gynaecologists. From the point of diagnosis, clinical psychologists should be involved. As much as feasible, family and partner support can be encouraged. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To describe dyadic psycho‐social intervention measures and to evaluate their influence on stroke survivors and caregiver's functional independence, quality of life, depression, anxiety, self‐efficacy and coping ability. Background: Because of the importance of dyadic intervention and the seriousness of the psycho‐social problems of stroke survivors and caregivers, understanding the influence of dyadic psycho‐social interventions is vital. Design: A systematic review and meta‐analysis based on PRISMA guidelines. Data Sources: Nine databases were systematically searched for randomized controlled trials submitted from 1910 to 4 July 2022. Methods: The included papers were evaluated for quality, and quantitative data were standardly extracted and analysed by meta‐analysis, followed by synthesis. The meta‐analysis was carried out using Review Manager 5.4 software. Results: Fifteen randomized controlled trials were included (n = 2190 for patients, and n = 1933 for caregivers). Study results showed that dyadic psycho‐social interventions significantly alleviated the depressive symptoms of patients, obviously improved the ability to function independently of patients and more quickly alleviated the care burden of caregivers. Conclusions: This study provided moderate support for the benefits of dyadic psycho‐social intervention in improving survivor and caregiver's functional independence, quality of life, depression, anxiety, self‐efficacy and care burden. Nevertheless, due to limitations of the study, it was deemed necessary that this topic is studied further. Relevance to Clinical Practice: This review suggests that dyadic psycho‐social interventions should be considered as effective strategies for decreasing psycho‐social problems of stroke survivors and caregivers, and provides evidence for the formulation of targeted intervention programs. The personalized implementation of such interventions should be the focus of clinical practice. No Patient or Public Contribution: There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

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Aims: Identify and synthesize evidence of nurses' competency in electrocardiogram interpretation in acute care settings. Design: Systematic mixed studies review. Data sources: Cumulative Index to Nursing and Allied Health Literature, Medline, Scopus and Cochrane were searched in April 2021. Review methods: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta‑Analysis framework. A data‐based convergent synthesis design using qualitative content analysis was adopted. Quality appraisal was undertaken using validated tools appropriate to study designs of the included papers. Results: Forty‐three papers were included in this review. Skills and attitudes were not commonly assessed, as most studies referred to 'competency' in the context of nurses' knowledge in electrocardiogram interpretation. Nurses' knowledge levels in this important nursing role varied notably, which could be partly due to a range of assessment tools being used. Several factors were found to influence nurses' competency in electrocardiogram interpretation across the included studies from individual, professional and organizational perspectives. Conclusion: The definition of 'competency' was inconsistent, and nurses' competency in electrocardiogram interpretation varied from low to high. Nurses identified a lack of regular training and insufficient exposure in electrocardiogram interpretation. Hence, regular, standard training and education are recommended. Also, more research is needed to develop a standardized and comprehensive electrocardiogram interpretation tool, thereby allowing educators to safely assess nurses' competency. Impact: This review addressed questions related to nurses' competency in electrocardiogram interpretation. The findings highlight varying competency levels and assessment methods. Nurses reported a lack of knowledge and confidence in interpreting electrocardiograms. There is an urgent need to explore opportunities to promote and maintain nurses' competency in electrocardiogram interpretation. [ABSTRACT FROM AUTHOR]

Aim: To appraise and synthesize empirical studies exploring undergraduate nursing students' education and training in aseptic technique. Design: Mixed methods, systematic literature review adopting Joanna Briggs Institute methodology. Data sources: Thirteen electronic databases were searched 1996–2020, followed by searches with a general browser, hand‐searching key journals and reviewing reference lists of retrieved papers. Review methods: Potentially eligible papers were scrutinised by two reviewers. Those eligible were critically appraised and quality assessed using the Critical Appraisal Skills Programme and Specialist Unit for Review Evidence checklists. Results: Of 538 potentially eligible studies, 27 met the inclusion criteria. There was limited evidence of the effectiveness of different teaching methods. Students' knowledge, understanding and competency varied and were often poor, although they reported confidence in their ability to perform aseptic technique. Students and qualified nurses perceived that education and training in aseptic techniques might be improved. Conclusion: Education and training in aseptic technique might be improved but the review findings should be viewed cautiously because the studies lacked methodological rigour. Impact: This appears to be the first systematic review to explore undergraduate nursing students' education and training in relation to aseptic technique. There was limited evidence to support the effectiveness of different teaching methods and scope for improving nursing students' knowledge, understanding and competency in aseptic technique. Students and qualified nurses suggested that education and training might be enhanced. More robust studies are required to support education, practice and policy. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses' use of electronic health records impacts on the quality of nurse–patient interactions and communication. Design: An integrative review. Data sources MEDLINE®, CINAHL®, PscyINFO, PubMed, BNI and Cochrane Library databases were searched for papers published between January 2005 and April 2022. Review methods: Following a comprehensive search, the studies were appraised using a tool appropriate to the study design. Data were extracted from the studies that met the inclusion criteria relating to sample characteristics, methods and the strength of evidence. Included empirical studies had to examine interactions or communication between a nurse and patient while electronic health records were being used in any healthcare setting. Findings were synthesized using a thematic approach. Results: One thousand nine hundred and twenty articles were initially identified but only eight met the inclusion criteria of this review. Thematic analysis revealed four key themes, indicating that EHR: impedes on face‐to‐face communication, promotes task‐orientated and formulaic communication and impacts on types of communication patterns. Conclusion: Research examining nurse–patient interactions and communication when nurses' use electronic health records is limited but evidence suggests that closed nurse–patient communications, reflecting a task‐driven approach, were predominantly used when nurses used electronic health records, although some nurses were able to overcome logistical barriers and communicate more openly. Nurses' use of electronic health records impacts on the flow, nature and quality of communication between a nurse and patient. Impact The move to electronic health records has taken place largely without consideration of the impact that this might have on nurse–patient interaction and communication. There is evidence of impact but also evidence of how this might be mitigated. Nurses must focus future research on examining the impact that these systems have, and to develop strategies and practice that continue to promote the importance of nurse–patient interactions and communication. Patient or Public contribution: Studies examined within this review included patient participants that informed the analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Aims: To synthesize available data on the impact of the COVID‐19 pandemic on clinical supervision practices of healthcare workers and students in healthcare settings. Design: A quantitative rapid review of the literature. Data Sources: A search of MEDLINE, Embase, PsycINFO, the Cochrane Library and Scopus for English language papers published between December 2019 (initial onset of the pandemic) to March 2021. Review methods: Using the World Health Organization and Cochrane guidelines for rapid reviews, following an identification of relevant papers and data extraction, a narrative synthesis approach was used to develop themes. Results: Eight studies met the inclusion criteria. Four themes identified from data synthesis were nature and extent of disruptions to clinical supervision, unmet need for psychological support, supervisors also need support and unpacking telesupervision. Findings highlight the extent and nature of disruption to clinical supervision at the point of care. Further information on factors that facilitate high‐quality telesupervision have come to light. Conclusion: The COVID‐19 pandemic has placed tremendous burden on healthcare workers compromising their own health and well‐being. It is essential to restore effective clinical supervision practices at the point of care, so as to enhance patient, healthcare worker and organizational outcomes into the post‐COVID‐19 pandemic period. Impact This review has provided initial evidence on the adverse impacts of the COVID‐19 pandemic on clinical supervision of healthcare workers and students at the point of care. Available evidence indicates the urgent need to restore effective and high‐quality clinical supervision practices in health settings. The review has highlighted a paucity of studies in this area, calling for further high‐quality studies. [ABSTRACT FROM AUTHOR]

Aims: To describe current foodservice systems and mealtime care utilized in the rehabilitation setting. A secondary aim was to identify commonly used outcome measures in foodservice research in the rehabilitation setting. Design: A scoping review. Data sources: PubMed, CINAHL, Scopus, Embase, PsycINFO and Cochrane were searched until January 2022. Review methods: The review was conducted according to Joanna Briggs Institute's methodology for scoping reviews. Included studies were conducted in the inpatient rehabilitation setting, adult population ≥18 years old and provided a description of at least one element of the foodservice system, food and menu, waste and/or eating environment. Results: Of 5882 articles screened, 37 articles were included, reporting 31 unique studies. Most rehabilitation units had cook‐fresh production methods (50%), used decentralized bulk delivery methods (67%) had a communal dining room (67%) and had a 3‐week menu cycle (71%). Mealtime care was predominantly provided by nursing staff, however few studies reported on specific activities. Nutritional intake was a key outcome measure across included studies (43%), with only six papers reporting on rehabilitation outcomes. Of the intervention studies (n = 9), all were aimed at improving nutritional intake through menu or mealtime care modifications; few (n = 3) studied changes in rehabilitation outcomes. Conclusion: This scoping review identified a considerable lack of reporting of foodservice and mealtime care systems used in rehabilitation settings in the available literature. Further investigation is required to understand what models of mealtime care are provided to patients and to understand the impact of changes to foodservice and mealtime systems on patient outcomes. Patient or public contribution: No patient or public contribution was necessary for this review. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of a virtual reality (VR) intervention on adult patients' preoperative anxiety, heart rate, respiration rate and blood pressure. Design: A systematic review and meta‐analysis of randomized controlled trials (RCTs). Data Sources: A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify research studies in English or Chinese on RCTs from their inception to 31 May 2022. Detailed search strategies and the checklist are provieded in Supplementary files S1 and S2. Review Methods: Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test. Results: This study included 11 articles with a total of 892 participants. VR distraction comprised five studies, and VR exposure consisted of six studies. The results indicated that VR could reduce preoperative anxiety in adult patients and VR exposure seems to be more effective. The results also indicated that VR intervention can effectively reduce patients' heart rate and blood pressure compared to traditional intervention methods, but had no significant effect on respiration rate. Conclusion: VR technology could relieve preoperative anxiety in adult patients through distraction or exposure. More well‐designed RCTs containing a wider range of surgical types are needed to verify our findings before we can make strong recommendations. Impact: Our systematic review and meta‐analysis show a positive effect of VR distraction and exposure interventions in reducing preoperative anxiety in adult patients. We suggest incorporating VR into preoperative procedures as an auxiliary way to reduce negative emotions in eligible patients. No Patient or Public Contribution: Our paper is a systematic review and meta‐analysis and such details do not apply to our work. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has highlighted the importance of transparency and scientific rigour in the development of clinical guidance. Rapid review methodologies were widely used in the development of guidance, and in the United Kingdom, COVID‐19 guidance was criticized for methodological inadequacy and erroneous conclusions. Aims: To summarize the evidence looking at the use of face masks to prevent COVID‐19 infection in clinical practice areas, and to show how this can be used in decision‐making. Design: Overview of systematic reviews. Method: Systematic reviews which included meta‐analyses were sought, and data on the protective effect of face masks on COVID‐19 transmission were extracted. A total of 15 papers yielded 44 effect sizes suitable for quantitative presentation, which showed wide variation in effect depending on the outcome and intervention chosen. Conclusions: Guideline development groups need to take care to choose outcomes that are of most importance to those who are the target of guidance. Quantification of the protective effect of interventions such as different types of face mask will help nurses and others decide on the utility of their use, alongside consideration of the other factors that go into informing clinical recommendations. Implications for Patient Care and the Profession: COVID‐19 has been an unprecedented public health issue, but much clinical guidance was lacking in transparency. Nurses and other healthcare professionals have often expressed a lack of confidence in guidance. Systematic reviews reported a wide range of effect sizes. However, there was a high degree of indirectness and heterogeneity in methods and findings. To produce transparent guidance, those for whom guidance is intended should have evidence of effect where this is available. Impact Guideline authors should reflect these outcomes in their recommendations, clearly balancing both the benefits and harms of recommending face masks to prevent COVID‐19. [ABSTRACT FROM AUTHOR]

Aim To identify facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general (family) practice. Background Internationally, a shortage of doctors entering and remaining in general practice and an increasing burden of chronic disease has diversified the nurse's role in this setting. Despite a well-established general practice nursing workforce, little attention has been paid to the ways doctors and nurses collaborate in this setting. Design Integrative literature review. Data sources CINAHL, Scopus, Web of Life, Cochrane Library, Joanna Briggs Institute Library of Systematic Reviews and Trove (dissertation and theses) were searched for papers published between 2000 and May 2014. Review methods This review was informed by the approach of Whittemore and Knafl (2005). All included papers were assessed for methodological quality. Findings were extracted, critically examined and grouped into themes. Results Eleven papers met the inclusion criteria. Thematic analysis revealed three themes common to the facilitators of and barriers to collaboration and teamwork between GPs in general practice: (1) roles and responsibilities; (2) respect, trust and communication; and (3) hierarchy, education and liability. Conclusion This integrative review has provided insight into issues around role definition, communication and organizational constraints which influence the way nurses and general practitioners collaborate in a team environment. Future research should investigate in more detail the ways doctors and nurses work together in general practice and the impact of collaboration on nursing leadership and staff retention. [ABSTRACT FROM AUTHOR]

Aim To report an analysis of the concept of concordance. Background Adherence-based medicines interventions are known to be of limited success. Concordance appears to offer an alternative approach consistent with person-centred approaches to decision-making. However, the application of the principle of concordance appears inconsistent. This article considers the extent to which any of this confusion may be a function of the different usage of the term concordance in the disciplines of nursing, general medicine, psychiatry and pharmacy. Design Rodger's evolutionary method of concept analysis. Data sources CINAHL, Medline, Psych INFO, Cochrane library, Psychology and Behavioural Sciences Collection were searched for publications between 2000 and 2012 with combinations of key words including concord*, adherence, compliance, medic*, psychiatr*, pharm*, nurs*. Review methods Rodgers' evolutionary analytic method was used to identify and explore the concept of concordance across healthcare disciplines. A representative sample of papers was identified from the source disciplines. Over 500 papers were identified. Exclusion criteria limited the final sample to 60 papers in total, entailing 15 per discipline. Each discipline's papers were analysed for references, antecedents, consequences, attributes and surrogates separately. The team then worked together to cross-check these interpretations. Results There was minimal agreement between the disciplines suggesting each discipline practised a different conceptualization of concordance. The main point of agreement was that better research is required to articulate the scope and value of partnership working. Conclusion The results clarified a distinct and currently missing research agenda. [ABSTRACT FROM AUTHOR]

Aim: To examine how school nurse practice evolved as a result of the Covid‐19 pandemic. Design: A scoping review of international literature, conducted and reported in line with Arksey and O'Malley's (2005) framework. Data Sources: Searches were conducted in September 2021. Ten databases were searched: The British Nursing Database, CINAHL, Cochrane Library, Consumer Health Database, Health and Medicine, Nursing and Allied Health, Public Health, PsycINFO, PubMed and Web of Science. Relevant grey literature was identified through hand searching. Review Methods: A minimum of three reviewers independently screened articles and two reviewers independently undertook data extraction, with any decisions made collaboratively with the wider team. Much of the literature was not empirical work and so it was not possible to apply a traditional quality appraisal framework. Results: Searches identified 554 papers (after deduplication) which were screened against title and abstract. Following the full‐text review, 38 articles underwent data extraction and analysis. The review findings highlighted that school nurses adapted their practice to ensure they were able to continue providing their formal and informal school health offer to children, young people and their families and continued working closely with the multidisciplinary team. In addition, the expanded public health role generated by Covid‐19 for school nurses' work was considerable, multi‐layered and added to their routine workload. School nurses displayed resilience, adaptability and creativity in their response to delivering services during Covid‐19. Conclusion: School nurses took on a leading public health role during the Covid‐19 pandemic. Some developments and practices were highlighted as beneficial to continue beyond the pandemic. However, formal evaluation is needed to identify which practices may merit integration into routine practice. Continued investment in staff and infrastructure will be essential to ensuring school nurses continue to expand their practice and influence as public health experts. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of virtual reality (VR) intervention in the management of pain, anxiety and fear in paediatric patients undergoing needle‐related procedures. Design: A systematic review and meta‐analysis of randomized controlled trials (RCTs). Data sources A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI, and Wanfang databases was conducted to identify research articles in English or Chinese on RCTs up to February 28, 2022. Review methods: Two researchers independently screened eligible articles. The Cochrane Handbook for Systematic Reviews was used to assess the risk of bias in the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test. Results: A total of 2269 articles were initially screened. The meta‐analysis included data from 27 studies representing 2224 participants. Compared with the non‐VR group, the VR intervention group significantly reduced pain, anxiety, and fear in paediatric patients who underwent puncture‐related procedures. Subgroup analysis showed that VR has advantages over conventional and other distraction methods. Conclusion: Paediatric patients undergoing needle‐related procedures would benefit from VR interventions for pain, anxiety and fear management. Impact VR intervention has the potential to reduce pain, anxiety and fear in paediatric patients undergoing puncture‐related procedures. Future clinical interventions could incorporate VR into puncture procedures as an effective method to reduce negative emotions in children eligible for VR distractions. Patient or Public Contribution: Our paper is a systematic review and meta‐analysis and such details don't apply to our work. [ABSTRACT FROM AUTHOR]

Aim: To synthesize and present the currently available literature on the experiences of spousal and adult child caregivers of stroke patients in transitional care. Design: This is a qualitative systematic review. Data Sources: Eight electronic databases (PubMed, CINAHL, Cochrane, Embase, Web of Science, PsychINFO, ProQuest and Scopus) were searched from September 2020 to April 2022 for relevant literature and grey literature. Qualitative studies exploring the experiences of sspousal or adult child caregivers of stroke survivors up till 1 year after discharge were included. Review Methods: The selection of articles was done by two independent reviewers who screened the titles and the abstracts of studies, and the full texts of selected articles. Quality appraisal and data extraction of selected articles were undertaken by two independent reviewers using Joanna Briggs Institute (JBI) critical appraisal tools. Data synthesis was conducted using a meta‐aggregative approach recommended by JBI. Results: A total of 19 papers were included in this review. A total of three synthesized findings centred around caregivers' experience with healthcare professionals, changes in their life roles and needs, effects of caregiving and how they adapted to their changes were aggregated. Conclusion: Spousal and adult child caregivers faced multiple barriers during transitional care, such as the lack of resources and an inability to cope with changes in their lives. Support and adequate preparation were key facilitators in easing stroke caregivers into their role. Impact The findings from this review can be used to guide future implementations of caregiver education programmes and comprehensive discharge planning for stroke survivors. [ABSTRACT FROM AUTHOR]

Aims: To describe and synthesize diverse empirical evidence regarding physical activity (PA) in the context of advanced breast cancer (ABC). Design: Integrative review guided by the work of Whittemore and Knafl (2005). Data sources: Six electronic databases were systematically searched to identify relevant literature published between January 2007–June 2019. Review methods: Abstracts of papers that met the inclusion criteria were reviewed by two researchers and full texts of eligible papers were assessed. Data were extracted by two independent researchers and inter‐rater reliability of data extraction established. Quality of papers was evaluated using the Mixed Methods Appraisal Tool. Data were organized according to comprehensive thematic analysis and the biobehavioural model for the study of exercise interventions. Results: Of the 532 abstracts, 18 studies met the inclusion criteria which included six randomized controlled trials, one quantitative non‐randomized study, seven quantitative descriptive studies, three mixed method studies and one qualitative study. Results from studies enrolled fell into four domains: PA performance and its influence on survival; barriers and preferences for PA; interventions to enhance PA; perceived benefits of PA from qualitative feedback. Conclusion: Evidence suggests that ABC patients are physically inactive. Main barriers of PA are less aerobic fitness and heavy symptom burden. Simple, tailored and specialist‐supervised PA is preferred by ABC patients. Form of joint self‐instructed and group accompanying is advocated as well. PA intervention programmes identified in this review vary on type, intensity, duration and frequency, while generally, are found to be feasible, safe and beneficial to patients' physical and psychosocial well‐being. Impact: The results propose tailored, supervised, group‐based PA programmes are in urgent need for ABC patients. Clinical professionals should manage more feasible and safer PA interventions to help improve patients' overall health. More research with rigorous methodology design is warranted to explore PA's effect on long‐term health outcomes. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the role and impact of advanced practice nurses (APNs) in care of patients following fragility hip fracture by systematically reviewing the available evidence. Review Design: Systematic review. Data sources: A search of the databases Ovid Medline, CINAHL, Embase, Emcare, Cochrane Library, and Google Scholar was conducted from January–February 2019. Method: This systematic review adhered to The PRISMA Statement. Study selection was managed using the Covidence software platform and quality was assessed using JBI Critical appraisal tools. Studies included adults >18 years and described the role and impact of APNs in care of patients following fragility hip fracture on clinical and non‐clinical outcomes. Results: There were 19 papers identified that met the inclusion/exclusion criteria. Quality was graded as moderate to low risk of bias. Six characteristics of APNs were identified: (1) coordination; (2) collaboration; (3) education; (4) assessment, investigation and treatment recommendations; (5) discharge planning, support and follow up; and (6) documentation. Overall mortality and LOS improved when characteristics of the APN role were present. Conclusion: Key findings from this systematic review showed: (1) The APN title and role are not clearly defined, but characteristics of the APN role are evident; (2) characteristics of APNs promote the delivery of best practice hip fracture care and have a positive impact on mortality and LOS; and (3) innovative service delivery models involving APNs should be considered to address future projections of hip fracture rates and improve outcomes. Impact: This systematic review provides evidence of the role characteristics of APNs in fragility hip fracture and the impact of the role on outcomes. Findings from this research could be used to develop service delivery models using APNs to care for patients following fragility hip fracture and to inform practice where APN roles may improve outcomes for other patient cohorts. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a review of the science of intervention development for type 1 diabetes in childhood and its implications for improving health outcomes in children, adolescents, and/or their families. Background. Previous reviewers have identified insufficient evidence to support the application of effective interventions for type 1 diabetes in clinical practice. The need for quality randomized controlled trials to address shortcomings in previous study designs has been highlighted as a priority for future intervention research. However, there is also a need to consider the scientific development of interventions, which to date has received little attention. Data source. A search for published randomized controlled trials over 5 years (2004-2008) was conducted in electronic databases (Medline, CINAHL, Cochrane Library, Psychinfo, ERIC). Reference lists of papers identified from electronic searches were examined for additional papers. Methods. A systematic review was conducted. Studies were included if (i) an intervention for managing any aspect of type 1 diabetes was implemented, (ii) children, adolescents and/or their families were sampled, (iii) a randomized controlled trial, (iv) published in English. Results. Fourteen randomized controlled trials were reviewed on education (n = 7), psychosocial (n = 5) and family therapy (n = 2) interventions. Compared to education interventions, family therapy and most psychosocial interventions were developed with greater scientific rigour, and demonstrated promising effects on more health outcomes measured. Conclusion. Interventions developed within clearly-defined scientific criteria offer potential for improving health outcomes in children and adolescents with type 1 diabetes and their families. Future reviews on interventions for type 1 diabetes in childhood need to include criteria for assessing the science of intervention development. [ABSTRACT FROM AUTHOR]

Aim The aim of this paper was to provide a concept analysis of 'pandemic influenza'. Background Pandemic influenza can have a devastating impact as individuals have little to no immunity towards the newly encountered virus. It is a persistent societal threat due to the advancement of multiple technological processes. Nurses work in multiple roles in pandemics. As such, a thorough understanding of the concept and its implications from a nursing perspective is required. Design Rodgers' Evolutionary Method was used to conduct the concept analysis of the term 'pandemic influenza'. Data sources Forty-nine papers were examined from the disciplines of public health, medicine, law, bioethics and healthcare policy. Papers were found from the PubMed, CINAHL and Google Scholar databases all dates up to December 2013. Limits were set to include peer-reviewed, English language articles. Methods Identified papers were critically analyzed to explore the concept's antecedents, attributes and consequences. Surrogate and related terms, and an exemplar, were identified. Results Attributes of pandemic include original viral structure, increased human susceptibility, younger vulnerable populations and unpredictable time frames. Antecedents include processes that enable the increased geographical transmission of a newly created influenza. Consequences include higher morbidity and mortality rates and the need for an efficient pandemic response. Conclusions This analysis identified the attributes of pandemic influenza through a synthesis of the current pandemic literature. However, no articles were identified as specifically nursing in nature. Therefore, more research is required to examine the impact of a pandemic declaration on the nursing profession. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: This review assessed the effectiveness of interventions using a goal‐setting approach on glycaemic control for people diagnosed with prediabetes or type 2 diabetes. Design: A systematic review guided by the Joanna Briggs Institute methodology for conducting systematic reviews of primary research studies was conducted. Data Sources: Randomized controlled trials and experimental studies with a minimum follow‐up period of 6 months were considered for inclusion. The primary outcome was change in glycaemic control as measured by glycated haemoglobin (%) and/or fasting plasma glucose (mg/dl). A systematic search of seven electronic databases was completed in October 2020. Review Methods: Papers meeting the inclusion criteria were critically appraised using the Joanna Briggs Institute tools for critical appraisal followed by data extraction. A Grading of Recommendations Assessment, Development and Evaluation assessment was conducted to assess the overall certainty of the evidence. Fixed‐effect meta‐analyses were completed to demonstrate the mean effect for each outcome of interest. Results: Twenty one studies were included in this review. Goal setting was more effective than usual care for glycaemic control in prediabetes at 6 months and at 12 months for fasting plasma glucose (mg/dl) and glycated haemoglobin (%). Goal setting was more effective than usual care for glycaemic control in type 2 diabetes for fasting plasma glucose (mg/dl) at 6 months, fasting plasma glucose (mg/dl) at 12 months, glycated haemoglobin (%) at 6 months and glycated haemoglobin (%) at 12 months. Conclusion: The evidence suggests goal setting is effective in supporting people to achieve glycaemic targets in prediabetes and type 2 diabetes. [ABSTRACT FROM AUTHOR]

Aim: To synthesize evidence on the ability of specialist care home support services to prevent hospital admission of older care home residents, including at end of life. Design: Systematic review, without meta-analysis, with vote counting based on direction of effect. Data sources: Fourteen electronic databases were searched from January 2010 to January 2019. Reference lists of identified reviews, study protocols and included documents were scrutinized for further studies. Review methods: Papers on the provision of specialist care home support that addressed older, long-term care home residents' physical health needs and provided comparative data on hospital admissions were included. Two reviewers undertook study selection and quality appraisal independently. Vote counting by direction of effect and binomial tests determined service effectiveness. Results: Electronic searches identified 79 relevant references. Combined with 19 citations from an earlier review, this gave 98 individual references relating to 92 studies. Most were from the UK (22), USA (22) and Australia (19). Twenty studies were randomized controlled trials and six clinical controlled trials. The review suggested interventions addressing residents' general health needs (p < .001), assessment and management services (p < .0001) and non-training initiatives involving medical staff (p < .0001) can reduce hospital admissions, while there was also promising evidence for services targeting residents at imminent risk of hospital entry or post-hospital discharge and training-only initiatives. End-of-life care services may enable residents to remain in the home at end of life (p < .001), but the high number of weak-rated studies undermined confidence in this result. Conclusion: This review suggests specialist care home support services can reduce hospital admissions. More robust studies of services for residents at end of life are urgently needed. Impact: The review addressed the policy imperative to reduce the avoidable hospital admission of older care home residents and provides important evidence to inform service design. The findings are of relevance to commissioners, providers and residents. [ABSTRACT FROM AUTHOR]

Aim: To summarise the psychological impacts of social isolation amongst older adults during COVID-19 and review the benefits and limitations of online interventions used to combat social isolation. Design: A scoping review was performed. Data Sources: A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar. Review Methods: Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes. Results: Totally, 33 studies were included. Four themes and eight sub-themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID-19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention. Conclusion: The COVID-19 pandemic has taken an emotional toll on older adults' psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions. Impact: With the COVID-19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long-term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID-19 response and support system, and an overall better road to recovery from this crisis. [ABSTRACT FROM AUTHOR]

scope a., booth a. & sutcliffe p. (2012) Women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression: a qualitative synthesis. Journal of Advanced Nursing 68(9), 1909-1919. Abstract Aim. This paper is a report of a systematic review that aimed to synthesize qualitative evidence relating to women's perceptions and experiences of group cognitive behaviour therapy and other group interventions for postnatal depression. Background. Postnatal depression may occur in women following childbirth, resulting in a range of distressing symptoms such as sadness, fatigue, and feelings of inability to look after their baby. Women tend to prefer psychological interventions. However, access to individual psychological therapy is limited by cost, waiting times, and availability of therapists. Data sources. A comprehensive literature search was conducted in 17 major psychological, medical, health-related and health economics electronic bibliographic databases. Design. A qualitative evidence synthesis was conducted using thematic synthesis. Review methods. Databases were searched from 1966-January 2008. A total of 116 full papers were screened against the inclusion criteria. Included papers were quality assessed. The original review protocol was restricted to evidence on group cognitive behaviour therapy. However, due to the paucity of evidence, the inclusion criteria were broadened to include other group interventions. A thematic synthesis was undertaken of the data extracted from the included papers. Results. Six studies were included. Specific benefits were that treatment enabled women to develop better relationships with their baby and understand postnatal depression. Negative aspects of treatment included difficulties in applying cognitive behavioural techniques, and unfavourable social comparisons with other group members. Conclusions. Women have contrasting perceptions and experiences of group treatment. This suggests that greater attention should be focused on identifying those most likely to benefit from these treatments in a group environment. [ABSTRACT FROM AUTHOR]

Aim. This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Background. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Data sources. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. Review methods. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Findings. Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Conclusion. Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. [ABSTRACT FROM AUTHOR]

Aim. This paper is a review of the effectiveness of non-surgical, non-pharmaceutical interventions designed to promote weight loss in people with a learning disability and how qualitative evidence on people's experiences and motivations can help understanding of the quantitative research outcomes. Background. The health risks of obesity underline the importance of effective evidence-based weight loss interventions for people with learning disabilities as they are at increased risk of being overweight. Data sources. Papers published from 1998 to 2009 were identified through searches of the Cumulative Index for Nursing and Allied Health Literature, Proquest, Medline (PubMed), PSYCHINFO databases, and the Cochrane Library. Review methods. An integrative review method was used. Studies included were non-surgical or non-pharmaceutical interventions aimed at weight reduction for people with a learning disability. Synthesis of the findings related to study design, participants, types of interventions, outcome measures and participant perspectives. Results. Twelve studies met the inclusion criteria. The most common research design was quasi-experimental pretest and post-test. Few researchers used a clinical trial approach, and there was only one predominantly qualitative study. Interventions were mainly focused on energy intake, energy expenditure or health promotion. Only a few studies incorporated behaviour modification approaches. Conclusion. Nurses who work with clients with learning disabilities have a key role to play in the management of obesity. Future research needs to focus on qualitative studies of the perceptions of clients and their families, controlled trials investigating the effectiveness of interventions and their costs and sustainability, and longitudinal studies examining weight loss over time. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a review conducted to identify (a) best practice in information transfer from the emergency department for multi-trauma patients; (b) conduits and barriers to information transfer in trauma care and related settings; and (c) interventions that have an impact on information communication at handover and beyond. Background. Information transfer is integral to effective trauma care, and communication breakdown results in important challenges to this. However, evidence of adequacy of structures and processes to ensure transfer of patient information through the acute phase of trauma care is limited. Data sources. Papers were sourced from a search of 12 online databases and scanning references from relevant papers for 1990-2009. Review methods. The review was conducted according to the University of York's Centre for Reviews and Dissemination guidelines. Studies were included if they concerned issues that influenced information transfer for patients in healthcare settings. Results. Forty-five research papers, four literature reviews and one policy statement were found to be relevant to parts of the topic, but not all of it. The main issues emerging concerned the impact of communication breakdown in some form, and included communication issues within trauma team processes, lack of structure and clarity during handovers including missing, irrelevant and inaccurate information, distractions and poorly documented care. Conclusion. Many factors influence information transfer but are poorly identified in relation to trauma care. The measurement of information transfer, which is integral to patient handover, has not been the focus of research to date. Nonetheless, documented patient information is considered evidence of care and a resource that affects continuing care. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an analysis of the concept of vulnerability in homeless adolescents. Background. Caring for vulnerable populations and reduction of health inequities are top international healthcare priorities. Homeless adolescents experience health disparities as compared to their housed counterparts and are among the most vulnerable of all populations. Understanding the concept of vulnerability as it relates to the homeless adolescent population will assist nurses in addressing the health and social concerns of this population. Data sources. The PubMed, Medline, Cochrane and CINAHL electronic databases were used to search for research papers published between 1980 and 2009. The keywords 'vulnerable', 'vulnerability' and 'homeless', 'adolescent', 'street' and 'youth' were used. Twenty-three papers from multiple disciplines were reviewed in an effort to arrive at a global definition of homeless adolescents' vulnerability. Method. Rodgers' evolutionary method of concept analysis was used for the analysis. Results. Based on this analysis, vulnerability in homeless adolescents is defined as the constellation of past, present and future risk, perceived or real, because of the common human experience of risk, the increased vulnerability of the adolescent period, the consequences of family disruption, and the increased risks of life on the street. Conclusion. There was agreement in the literature regarding the antecedents, attributes, consequences and surrogate terms of the concept. However, differentiation between the concepts of risk and vulnerability, as suggested by seminal nurse researchers, was not supported. More research is needed into self-perceptions of vulnerability and vulnerability in subgroups of homeless adolescents. [ABSTRACT FROM AUTHOR]

Aim: To explore the barriers to healthy eating among nurses working in hospitals. Design: Meta‐synthesis. Data sources: Published and unpublished papers were identified through electronic searches on PubMed, CINAHL, PsycINFO, Embase, Scopus, COCHRANE Library, Food Science and Technology Abstract, ProQuest Dissertations and Theses and OpenGrey from inception until 6 September 2020. English‐language primary qualitative or mixed‐method studies on barriers to healthy eating among hospital nurses were included. Mixed‐method studies were eligible if their qualitative data were distinguishable. Studies on nursing assistants, enrolled nurses, nursing students, and patient‐care assistants were excluded, as well as studies without full‐texts, correlational studies, quantitative surveys, exploratory studies, conference abstracts and reviews. Methods: The studies were appraised using Critical Appraisal Skills Programme checklist. Qualitative data were extracted using Joanna Briggs Institute Qualitative Data Extraction Tool. Data synthesis followed two stages, meta‐summary and meta‐synthesis, proposed by Sandelowski & Barroso. Results: Twelve studies published from 2008 to 2020 involving 618 hospital nurses were included. The meta‐summary generated 10 themes, which were meta‐synthesized into three interrelated themes: personal barriers (e.g. nonchalance towards unhealthy eating), interprofessional and patient‐related barriers (e.g. sharing unhealthy food), and organizational barriers (e.g. overwhelming work demands). Conclusion: Insufficient self‐control and self‐confidence, nonchalance and negligence towards healthy eating and cultural beliefs that oppose the practice of healthy eating (personal barriers), exposure of unhealthy food practices in wards (interprofessional and patient‐related barriers) and hospital cafeterias, overwhelming work exigencies and institutional constraints (organizational barriers) hindered nurses to achieve wholesome healthy eating. Impact: Many hospital nurses' encountered challenges in healthy eating, thereby potentially jeopardizing their health and work performance. The findings emphasized the need of a joint effort by hospital nurses, families and colleagues, and hospital institutions to overcome the barriers to healthy eating faced by the hospital nurses. [ABSTRACT FROM AUTHOR]

Aims: To examine the accuracy of diagnostic responses and types of information provided on online health forums. Design: Qualitative descriptive study. Methods: This paper reports the findings of a thematic analysis of peer responses to posts included on heart failure online health forums, to understand the quality and types of information provided. Responses posted between March 2016 and March 2019 were screened, collected and analysed thematically using Braun & Clarke. Themes were conceptually underpinned by Normalization Process Theory. Responses were assessed for quality against the NICE and SIGN guidelines to determine whether they were evidence based or not. Results: The total number of responses collected for analysis was 639. Five main themes were identified: diagnostic, experiential, informational, peer relations and relationships with healthcare professionals. Out of 298 diagnostic responses, 5% were guideline evidence‐based and 6% had information that were partly evidence‐based. Non‐evidence based and potentially dangerous responses were 10%. Experiential responses were 10%; 23% included advice that was not supported with any clinical evidence; and 46% signposted users to other online references/healthcare professionals. Conclusion: Online health communication largely focuses on provision of experiential responses to assist those in need of pre‐ or post‐diagnosis advice and support. However, there is evidence of inaccurate information provision which suggests the use of a moderator would be beneficial. Impact: This study suggests heart failure online health forums are a source of support, however, there are potential risks. Increasing nurses and other health care professional's awareness of online health forums will be important. Additional training is needed to help them learn more about patient's use of online health forums, to gain a better understanding about the types of information sought, and how best to address such knowledge deficits. Healthcare systems must ensure sufficient time and resources are available to meet information needs for people with heart failure. [ABSTRACT FROM AUTHOR]

Aims: To examine the effectiveness of targeted nursing interventions on mobilization, nutrition and cognitive engagement to reduce functional and hospital‐associated decline (HAD) in older patients. Design: Systematic review of experimental studies using randomized and quasi‐experimental designs. Data sources: We searched electronic databases CINAHL, MEDLINE, EMBASE, Cochrane library, google scholar and BMJ quality reports from January 2009 to February 2020. Review methods: We reviewed intervention studies that targeted ward nursing teams to increase mobilization, nutrition or cognitive engagement of older adults. Inclusion criteria included older patients, acute care (medical, surgical and older adult wards) and reporting patient level outcomes. Quality appraisal included the Joanna Briggs Critical Appraisal Checklist for Quasi‐Experimental Studies. Results: From 1729 papers, 18 studies using quasi‐experimental and pre‐post designs were selected. Study heterogeneity necessitated a narrative synthesis. The quality of evidence was low to moderate. All studies used multicomponent strategies, and 10 studies used evidence translation frameworks to align interventions to local barriers. Overall, 74% (n = 14) of studies reported a significant improvement in the stated primary outcome. Eight studies reported a significant increase in mobilization (e.g., sitting in a chair or walking), and four reported improved functional outcomes. Five studies improved nutrition outcomes (e.g., protein or energy intake), and three studies reported a significant reduction in delirium. Conclusion: Acknowledging methodological limitations, the evidence indicates that nursing teams using evidence‐translation frameworks can improve mobilization, nutrition and cognitive engagement in acute care settings. Future research requires higher‐quality pragmatic trial designs, standardized outcomes, staff co‐designed interventions, evidence‐translation frameworks and patient engagement to make more confident inference about effectiveness. Impact: Nursing teams with the support of hospital management have to address ward and system barriers to prioritize fundamental care to improve patient outcomes. There is sufficient evidence on multicomponent interventions and implementation strategies to inform nurse‐led quality improvement. [ABSTRACT FROM AUTHOR]

Aims: To analyse the effect of decision aids (DAs) used by pregnant women on prenatal testing decisions. Design: Systematic review and meta‐analysis. Data resources: We searched Embase, PubMed, Web of Science and the Cochrane Central Library ending October 2020. Review methods: Papers were selected for analysis in accordance with the PRISMA guidelines. The meta‐analysis was carried out using Review Manager 5.3 software. The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook. The result is knowledge, decision conflict, anxiety and other secondary outcomes. Results: A total of 18 studies were included in the systematic review and meta‐analysis. Comprehensive analysis showed that DAs could significantly improve knowledge and decision‐making satisfaction, reduce decision conflict, increase the proportion of women who make informed choice and had no influence on anxiety and decision regret. Conclusions: This article systematically reviewed the positive effect of DAs on the decision‐making of pregnant women facing prenatal testing. In the future, nurses should be encouraged to develop DAs in accordance with strict standards and apply them to pregnant women of different backgrounds. Impact: There is a growing consensus that health care should be patient‐centred, and the values and preferences of pregnant women who undergo prenatal testing need to be incorporated into the clinical decision‐making process. This review reports that the use of DAs can increase pregnant women's chances of participating in prenatal testing decisions and may improve the quality of their decision‐making. It also provides information on the role and practice of nurses in promoting evidence‐based prenatal testing for DAs. [ABSTRACT FROM AUTHOR]

Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To assess the effectiveness of non‐pharmacological interventions for pregnant women with symptoms of mild to moderate anxiety. Background: Many pregnant women experience mild to moderate symptoms of anxiety and could benefit from additional support. Non‐pharmacological interventions have been suggested for use during pregnancy. Design: A systematic review of randomized controlled trials. Data sources: Randomized controlled trials published since 1990, identified from electronic databases: Medline; CINAHL; Maternity and Infant Care; PsycINFO; Cochrane Database of Systematic Reviews; CENTRAL; EMBASE; Centre for Reviews and Dissemination; Social Sciences Citation Index; ASSIA; HTA Library; Joanna Briggs Institute Evidence‐Based Practice database; Allied and Complementary Medicine. Review methods: Conducted according to the Centre for Reviews and Dissemination procedure. Papers were screened (N = 5,222), assessed for eligibility (N = 57) and selected for inclusion (N = 25). The Cochrane Collaboration's tool for assessing risk of bias was used. Papers were assessed for clinical and statistical heterogeneity and considered for meta‐analysis. Descriptive analysis of the data was conducted. Results: Psychological, mind‐body, educational and supportive interventions were delivered individually and to groups of pregnant women over single or multiple sessions. The State‐Trait Anxiety Inventory was the most commonly used anxiety measure. In 60% of studies there were fewer than 40 participants. Meta‐analysis of three studies indicated no observed beneficial effect in the reduction of anxiety. Conclusion: There was insufficient evidence from which to draw overall conclusions regarding the benefit of interventions. Results were predominantly based on small samples. Many papers provided an inadequate description of methods which prevented a full assessment of methodological quality. [ABSTRACT FROM AUTHOR]

Aims This systematic quantitative review identifies and summarizes the current knowledge and effects of training interventions for managing patients' challenging behaviour. Background Challenging behaviour is an acknowledged worldwide healthcare problem and its management can have a huge impact on quality of care. Evidence-based training interventions that focus on managing challenging behaviour are needed, but few tools for the systematic evaluation of these interventions are currently offered. Design A quantitative systematic review following the 2008 Centre for Reviews and Dissemination guidelines. Data Sources CINAHL, Scopus, PsycInfo, PubMed and Cochrane were searched using the same terms for papers published in English from 2005-2015. Review Methods Studies were assessed for quality and risk of bias, according to the Cochrane Effective Practice and Organisation of Care Group criteria. A narrative summary was conducted. Results We included 17 studies and evaluated 16 training interventions. Interventions were classified into four key themes: disengagements, communication, controlling behavioural symptoms and restrictive measures. Our review showed that interventions were more likely to decrease violent incident rates and increase staff confidence than change staff attitudes or increase knowledge. The elements of competence used to manage challenging behaviour were measured unilaterally. The evidence provided by studies was largely weak. Conclusion The variety of measurements used in the studies made comparing the effectiveness of the training interventions difficult. An individual's competence to manage challenging behaviour needs to be defined and a comprehensive scale for evaluating competence is also needed. Patient safety should be included in future evaluations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim The aim of this study was to determine and explore the relationship between risk perception and health-protective behaviour in individuals with family history of breast cancer. Background Women with increased risk of breast cancer due to inherited predisposition can use health-protective behaviours to facilitate prevention or early detection of cancer. Data sources Four scientific literature databases ( CINAHL, Medline, AMED, PsychInfo) and three systematic review databases were searched. Design Mixed method systematic review. Review methods The systematic review of peer-reviewed literature was conducted following the method described by the Centre of Reviews and Dissemination. Research studies published in English between January 2004-December 2014 focussing on individuals with family history of breast cancer were included. Of 210 papers identified, 10 studies were eligible for inclusion. Studies were assessed for their quality. Due to the diversity of the studies, a three-step analysis was undertaken involving narrative summary of the quantitative data, thematic analysis and presentation of integrated results in narrative form. Results A clear link between breast cancer risk perception and some health-protective behaviour was identified. Screening administered by health professionals (mammogram screening, chemoprevention) were appropriately adopted. However, behaviours requiring high individual input (breast self-examination, lifestyle changes) were not as appropriately adopted and the decision process was not as clearly linked to risk perception. Conclusions There is limited understanding about the complex relationship between risk perception and health-protective behaviour. Risk communication and health promotion need to be further developed to assist individuals to better engage with their actual risk and risk-appropriate behaviours, particularly those that require regular personal effort. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications. Background Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal. Design A systematic quantitative review of intervention effects. Data Sources We conducted systematic searches for English-language, peer-reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004-December 2014. Review methods According to pre-determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers; 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool; and included in the review. Results Study findings were presented descriptively; due to the heterogeneity of studies meta-analysis was not possible. Included papers described interventions categorized as: (1) multifaceted; and (2) behavioural and educational, comprising: (a) text message and mail message; (b) telephone calls; (c) motivational interviewing and (d) nurse-led counselling and education. Conclusions Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target individual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review. [ABSTRACT FROM AUTHOR]

kennedy f., mcdonnell a., gerrish k., howarth a., pollard c. & redman j. (2011) Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review. Journal of Advanced Nursing 68(4), 721-742. Abstract Aim. This paper reports a mixed methods systematic review examining the impact of nurse consultant roles in adult healthcare settings, with a view to identifying indicators for demonstrating their impact on patient and professional outcomes. Background. Nurse consultants were introduced in England in 2000 with the intention to achieve better outcomes for patients by improving quality and services. Previous studies have investigated the impact of nurse consultants, but attempts to amalgamate this evidence have been methodologically limited. Since these reviews were published, the importance of demonstrating the contribution of nurse consultants has prompted new research. A robust review of the evidence is now required. Data sources. A broad search strategy was adapted for eight databases. Grey literature was sought from various sources. Review methods. Quantitative and qualitative studies were included. Study quality was assessed using appropriate instruments. Cross-study synthesis combined the quantitative and qualitative findings in relation to the dimensions of impact identified. Measures of impact were mapped against a framework for assessing clinical and professional outcomes. Results. Thirty-six studies were included. The findings suggest a largely positive influence of nurse consultants on a range of clinical and professional outcomes, which map onto the proposed framework of impact. However, there was very little robust evidence and the methodological quality of studies was often weak. Conclusion. Further robust research is required to explore nurse consultants' impact on patient and professional outcomes. The proposed framework for assessing impact could be used to guide future research and assist nurse consultants assess their impact. [ABSTRACT FROM AUTHOR]

tropea s. (2011) 'Therapeutic emplotment': a new paradigm to explore the interaction between nurses and patients with a long-term illness. Journal of Advanced Nursing 68(4), 939-947. Abstract Aims. This paper presents a discussion of the use of 'therapeutic emplotment' during health professional-patient interactions when caring for patients with a long-term illness, with implications for nursing. Background. 'Therapeutic emplotment' develops from two philosophical strains: one emphasizing the connection of speech to actions, the other the linguistically mediated nature of human experience. Mattingly defines therapeutic emplotment as the creation of story-like structures through therapist-patient interactions which encourage the patient to see therapy as integral to healing. Data Sources. A literature search for the period 1994-2010 was undertaken using the keywords therapeutic emplotment, chronic illness, illness narratives, nursing narratives and nurse-patient interaction in the following databases: CINAHL, MEDLINE, COCHRANE, Social Care online, PsycInfo and AnthroSource. Reference lists of papers and books were examined for relevant studies published before 1994. Discussion. Differing from other social scientists, Mattingly highlights potential of narratives to create experiences in clinical practice. With therapeutic emplotment, narratives become 'tools' in the hands of health professionals to shape the interaction with patients with a long-term illness and are constructed by them together. This introduces changes in the way health professionals, including nurses, look at their practice. Implications for nursing. Therapeutic emplotment may provide nurses with a way of improving communication and relationship skills to help patients reach therapeutic goals; its use may also help qualitative research that explores the impact of nurses' interactions with patients on the quality of care. Conclusion. Therapeutic emplotment may be used by a broader range of health professionals, including nurses, for clinical and research purposes. [ABSTRACT FROM AUTHOR]

desborough j., forrest l. & parker r. (2012) Nurse-led primary healthcare walk-in centres: an integrative literature review. Journal of Advanced Nursing 68(2), 248-263. Abstract Aims. This paper is a report of an integrative review of the international literature examining established nurse-led primary healthcare walk-in centres and their outcomes to understand whether they are effective in improving access to primary health care. Background. Reviews of nurse-led primary care walk-in centres have included centres staffed by family physicians and general practitioners. There is a paucity of evidence about walk-in centres staffed solely by nurses. Data sources. Studies were identified through an electronic search using the databases Medline, Cinahl and EBSCO from 1990 until July 2010. Papers were included if they examined walk-in centres providing nurse-led primary care for the general community. Only peer reviewed studies published in English were included. Review methods. An integrative approach utilizing Bowling's checklist facilitated a systematic appraisal of studies in regard to clarity of aims, objectives, methods and appropriate analysis of data. Results. Thirteen publications were categorized into five themes: 'users of walk-in centres', 'quality of care provided at walk-in centres', 'impact on other healthcare providers', 'perceptions of walk-in centres' and 'satisfaction with walk-in centres'. Conclusion. The possibility that walk-in centres create demand highlights the need for clearer evidence of the drivers of demand for health care in walk-in centres. Innovations in healthcare provision need to be matched with adaptation to nursing education to ensure an adequately prepared nursing workforce. Improvement in access to primary healthcare needs to be measured in terms of equity and the capacity this access has to fill identified gaps in primary healthcare provision in the community. [ABSTRACT FROM AUTHOR]

kelo m., martikainen m. & eriksson e. (2011) Self-care of school-age children with diabetes: an integrative review. Journal of Advanced Nursing 67(9), 2096-2108. Abstract Aim. This paper is a report of an integrative review of findings from empirical studies on self-care in school-age children with type 1 diabetes. The purpose is to generate insight into opportunities to develop empowering patient education. Background. Managing diabetes is demanding and requires parental involvement in care. Good self-care forms the basis for diabetes management and self-care patterns are established at school age, but how and to what extent school-age children increase their self-care capabilities is unclear. Data sources. A search for studies from 1998 to 2010 focusing on self-care in school-age children with diabetes was conducted through electronic databases. Review methods. Using integrative methods, quantitative and qualitative papers surveyed were analysed separately, but the themes that arose were combined at the end of the analysis. Findings. Self-care is formed in a learning process involving the objectives of normality, being able to cope and independence. The content of self-care is a combination of knowledge and skills. Children have the technical skill, but they need their parents to participate in the care and share responsibility for it. The factors related to self-care comprised the characteristics of the child; the nature of the illness and care; and support from the parents, school environment, peers and healthcare team. Conclusion. A balance between diabetes care requirements and a child's maturity should be found. Nurses must adopt an empowering manner of education and recognize and assess a child's readiness to learn diabetes care and bear responsibility for it. Nurses must also help parents and other adults to gradually shift the responsibility to the children. [ABSTRACT FROM AUTHOR]

wang n., hailey d. & yu p. (2011) Quality of nursing documentation and approaches to its evaluation: a mixed-method systematic review. Journal of Advanced Nursing 67(9), 1858-1875. Abstract Aims. This paper reports a review that identified and synthesized nursing documentation audit studies, with a focus on exploring audit approaches, identifying audit instruments and describing the quality status of nursing documentation. Introduction. Quality nursing documentation promotes effective communication between caregivers, which facilitates continuity and individuality of care. The quality of nursing documentation has been measured by using various audit instruments, which reflected variations in the perception of documentation quality among researchers across countries and settings. Data sources. Searches were made of seven electronic databases. The keywords 'nursing documentation', 'audit', 'evaluation', 'quality', both singly and in combination, were used to identify articles published in English between 2000 and 2010. Review methods. A mixed-method systematic review of quantitative and qualitative studies concerning nursing documentation audit and reports of audit instrument development was undertaken. Relevant data were extracted and a narrative synthesis was conducted. Results. Seventy-seven publications were included. Audit approaches focused on three natural dimensions of nursing documentation: structure or format, process and content. Numerous audit instruments were identified and their psychometric properties were described. Flaws of nursing documentation were identified and the effects of study interventions on its quality. Conclusion. Research should pay more attention to the accuracy of nursing documentation, factors leading to variation in practice and flaws in documentation quality and the effects of these on nursing practice and patient outcomes, and the evaluation of quality measurement. [ABSTRACT FROM AUTHOR]