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Aim: To describe the co‐designing process of an online support programme with and for informal carers of people with heart failure. Design: A co‐design process built on core concepts and ideas embedded in co‐design methodology. Data sources: Our co‐design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. Outcomes: The co‐design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. Conclusion: Co‐design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. Relevance to clinical practice: Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person‐centred care and provides a valuable learning opportunity for those involved. Furthermore, a co‐designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self‐care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. Reporting methods: Consolidated criteria for reporting qualitative research (COREQ). Patient or public contribution: Both informal carers and content creators were involved in developing the support programme. [ABSTRACT FROM AUTHOR]

Aim: To describe and discuss clinical strategies for nurses working in partnership with substitute decision‐makers for people living with advanced dementia. Background: By providing person‐centred care to patients living with advanced dementia, nurses are positioned to work in partnership with substitute decision‐makers who make healthcare decisions related to advanced care. Because the experience of being substitute decision‐makers is complex and stressful, nurses need skillsets for working in partnership with substitute decision‐makers. Design: In this discursive paper, an innovative framework for working in partnership with substitute decision‐makers is proposed. Method: Evidence‐based findings from a systematic review provided five domain foci for the partnership framework. In each domain, two clinical strategies were discursively proposed. Clinical strategies were hypothesised from research findings and insights from the authors' nursing experiences. Then, topical literature was searched, and findings were used to support the discursively argued strategies. Discussion: To deal with complexities and reduce stress for substitute decision‐makers, an innovative Nurse–Substitute Decision‐Maker Partnership Framework for use in the context of advanced dementia is proposed and discussed. The partnership framework consists of five domains: Building trust, Exploring emotions, Translating quality of life, Encouraging proactivity and Negotiating families. Within these domains, ten strategies to support the practices of clinical nurses to work in partnership with substitute decision‐makers are discussed. Relevance to Clinical Practice: In the framework, the ten clinical nursing strategies are designed to provide targeted care to substitute decision‐makers in areas that are known to cause complexity and stress to them. The Nurse–Substitute Decision‐Maker Partnership Framework has been designed to improve nurse–substitute decision‐maker partnerships and reduce the stress experienced by substitute decision‐makers as they work through the complexities associated with advanced dementia. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

Abstract: Aims: A discussion of methodological issues and social media recruitment to a feasibility study to investigate mHealth resources for asthma and pregnancy care. Background: Pregnant women with asthma are reported to be poorly supported according to an international research. We sought to establish if a mHealth intervention might be feasible and acceptable to them. Design: A Phase I or modelling study. Methods: A project team designed an intervention to address UK national guidelines for the management of asthma during pregnancy, using other resources already accessible on the web. This was made available on a project website optimized for mobile phone usage. Links were Tweeted and advertised on Facebook, asking participants to access the project website, which included links to the resources and before‐ and after‐use questionnaires to establish baseline symptom data and participant views of the resources. Results: Despite 55,700 Twitter impressions in a 76‐day period over winter 2016–2017, this recruitment strategy garnered 402 engagements but only seven respondents for questionnaire 1 and zero respondents for questionnaire 2. Conclusions: We could not recruit to this study despite believing that social media recruitment would be effective and we recommend that social media recruitment be used cautiously. Apparently, we did not sufficiently address the theoretical aspects of communications theory and were not clear enough about our key messages. Publication bias may exist about the non‐publication of other failed telemedicine studies using social media; this goes largely unreported in some systematic reviews and may influence researchers’ decision‐making about social media recruitment. [ABSTRACT FROM AUTHOR]

Aim: To map existing evidence and identify gaps in the literature concerning psychosocial impacts of being nil by mouth (NBM) as an adult. Design: A scoping review of the literature was undertaken using JBI guidance. A protocol was registered on the Open Science Framework (osf.io/43g9y). Reporting was guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR). Methods: A comprehensive search of six databases (CINAHL, Embase, MEDLINE, PsycINFO, SCOPUS and Web of Science) was performed for studies published up to February 2023, with no restriction to study type. A scope of the grey literature was also undertaken. Two authors independently assessed eligibility and extracted data. Descriptive statistical analysis and narrative synthesis were used, and patient and public involvement included in funding discussions. Results: A total of 23 papers were included in the review, consisting of 14 primary studies (7 qualitative and 7 quantitative) and 9 grey literature. Both global psychological distress and distress specific to being NBM (thirst, missing food and drink) were reported. Caregivers also experience distress from their family member being NBM. Furthermore, social impacts were reported for both patient and caregiver, primarily social isolation and subsequent low mood. Conclusion: Furthermore, research is needed to understand the prevalence of this population, how best to measure psychosocial impacts and to explore whether (and how) psychosocial impacts change over time. Advancement in this area would enable better service development to optimize care for this patient group. What is known about this topic?: Eating and drinking provides more than nutrition and hydration.A wide range of conditions can lead to recommendations for no longer eating and drinking (nil by mouth).Being nil by mouth (NBM) for short periods such as pre‐operative fasting causes distress; however, little is understood about impact on longer‐term abstinence from eating and drinking. What this paper adds?: Psychosocial consequences of being nil by mouth (NBM)have been investigated by both quantitative and qualitative studies.Being NBM impacts both patients and caregivers in various psychosocial aspects, including distress and social isolation.Several gaps remain, however, regarding ways to measure psychosocial impact of being NBM. [ABSTRACT FROM AUTHOR]

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 review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Background Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Design Discussion paper. Data sources Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Implications for nursing Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Conclusion Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction. [ABSTRACT FROM AUTHOR]

Current advances in technology have enabled the development of a computer-based questionnaire that provides advantages over the paper-based mode of administration, such as automatic data entry, storage and calculations. However, before implementing a computer-based questionnaire, its equivalence with the original paper-based questionnaire must first be demonstrated. The purpose of this study was to evaluate the measurement equivalence of the computerized Diabetes- Specific Quality-of- Life questionnaire ( cD- QOL) with its original paper-based counterpart. A two-period crossover design was used in this study. The measurement equivalence was evaluated using quadratic weighted kappa coefficients, intraclass correlations and Cronbach's alpha comparisons. The cD- QOL was equivalent to its original paper-based counterpart. Participants preferred the cD- QOL over the paper-based questionnaire and reported that it was easy to use. [ABSTRACT FROM AUTHOR]

Aim To present a discussion on theoretical frameworks in infection prevention and control. Background Infection prevention and control programmes have been in place for several years in response to the incidence of healthcare-associated infections and their associated morbidity and mortality. Theoretical frameworks play an important role in formalizing the understanding of infection prevention activities. Design Discussion paper. Data sources A literature search using electronic databases was conducted for published articles in English addressing theoretical frameworks in infection prevention and control between 1980-2012. Results Nineteen papers that included a reference to frameworks were identified in the review. A narrative analysis of these papers was completed. Two models were identified and neither included the role of surveillance. Discussion To reduce the risk of acquiring a healthcare-associated infection, a multifaceted approach to infection prevention is required. One key component in this approach is surveillance. The review identified two infection prevention and control frameworks, yet these are rarely applied in infection prevention and control programmes. Only one framework considered the multifaceted approach required for infection prevention. It did not, however, incorporate the role of surveillance. We present a framework that incorporates the role of surveillance into a biopsychosocial approach to infection prevention and control. Conclusion Infection prevention and control programmes and associated research are led primarily by nurses. There is a need for an explicit infection prevention and control framework incorporating the important role that surveillance has in infection prevention activities. This study presents one framework for further critique and discussion. [ABSTRACT FROM AUTHOR]

Aim This paper presents a discussion of the history of nurse imagery in the context of recent career choice research and the need for contemporary images for nursing recruitment. Background The critical and growing shortage of nurses is a global concern. Understanding how individuals come to know nursing as a career choice is of critical importance. Stereotypical imaging and messaging of the nursing profession have been shown to shape nurses' expectations and perceptions of nursing as a career, which has implications for both recruitment and retention. Data Sources Relevant research and literature on nurse imagery in relation to career choice and recruitment were identified through a search of the CINAHL, PsychINFO, Sociological Abstracts, PubMed; Medline and Embase databases from 1970-2012. Discussion Historical images of nurses and nursing remain prevalent in society today and continue to influence the choice of nursing as a career among the upcoming generation of nurses. Students interested in nursing may be dissuaded from choosing it as a career based on negative, stereotypical images, especially those that position the profession as inferior to medicine. Implications for Nursing Understanding the evolution and perpetuation of popular images and messages in relation to the profession has implications for not only how we recruit and retain future generations of professional nurses but also holds implications for interprofessional collaboration between nursing and other health disciplines. Conclusion Strategies for future recruitment and socialization within the nursing and the health professions need to include contemporary and realistic imaging of both health professional roles and practice settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this integrative review was to investigate current literature exploring relationships between general self‐efficacy and the healthy ageing of older people. Background: Enhancing the health and well‐being of older adults, while mitigating consequences of illness and frailty are important priorities in healthy ageing. General self‐efficacy is closely associated with human behaviour and has been linked with improved health and well‐being. Design: An integrative review using the five‐stage method described by Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546). Methods: Academic databases CINAHL, MEDLINE and APA PsycInfo were searched between 2010 and 2020 for original, peer‐reviewed papers, published in English that investigated general self‐efficacy and factors associated with the healthy ageing of older people. Included papers were critically appraised using the Appraisal tool for Cross‐Sectional Studies (AXIS tool) and Critical Appraisal Skills Programme, and underwent data abstraction and synthesis via a constant comparative method. This review was also evaluated using the PRISMA checklist. Results: Twenty‐one papers were included in this review. Two main themes emerged. The first highlights positive relationships between general self‐efficacy and health and ageing perceptions, with subsequent influence on health behaviours. The second includes two sub‐themes, which explores general self‐efficacy's role in maintaining well‐being through its effects on psychological health and overcoming physical decline through adaption to changing physical and health conditions. Conclusions: Promoting general self‐efficacy has potential benefits for the healthy ageing of older people through positive effects on ageing and health perceptions, health behaviours, psychological health and overcoming physical decline. Relevance to clinical practice: Understanding how general self‐efficacy facilitates healthy ageing can guide nursing practices that reduce or mitigate consequences of illness and physical decline on the health and well‐being of older people. Strategies aimed at increasing older people's general self‐efficacy can help to facilitate subsequent positive effects on factors that promote healthy ageing. [ABSTRACT FROM AUTHOR]

Aims: To explore how parents experienced their child with delirium and how parents viewed our delirium management bundle. Design: We conducted a qualitative exploratory descriptive study using semi‐structured individual or dyad interviews. Methods: Twelve semi‐structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis. Findings: We generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long‐term consequences, (4) adding insight to the bundle, and (5) family engagement. Conclusion: The parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium. Impact: This paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit. Reporting Method: The consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting. Patient or Public Contribution: No patient or public contribution to the research design. What does this Paper Contribute to the Wider Global Community?: ‐ It increases awareness of the parent's perspective on PD in critically ill children.‐ It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage.‐ It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child. [ABSTRACT FROM AUTHOR]

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. Methods: We conducted individual semi‐structured interviews with unit‐level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi‐modal training activities such as group work, experience‐sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID‐19 pandemic, and support from senior organizational leadership. Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally. [ABSTRACT FROM AUTHOR]

Aim: To obtain a deeper understanding of peoples' experiences of cancer treatments with immune checkpoint inhibitors (ICIs). Background: ICIs are transforming survival outcomes for many with certain advanced cancers. Given the possibility of unique immune‐related adverse events (irAEs), understanding treatment experiences is crucial to identify support needs and provide safe and effective person‐centred care. Design: A systematic review of qualitative research and thematic synthesis. To report this review, the Preferred Reporting Items for Systematic Analysis and Meta Analysis (PRISMA) checklist and Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidance have been used. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science databases were searched in January 2022 for eligible studies published in English from database inception. Review Methods: Two reviewers independently screened records, identified papers for inclusion and appraised methodological quality using the Critical Appraisal Skills Programme checklist. Themes were developed using thematic synthesis. Results: Eighteen papers were included and three analytical themes developed: immune checkpoint inhibitor treatment decision‐making; the experience and impact of immune checkpoint inhibitor treatments; and appraising and responding to irAEs. Conclusion: The synthesis renders visible individuals' unmet information, psychological and practical support needs. It identifies shortcomings in immune checkpoint inhibitor treatment decision‐making processes and highlights the need for healthcare professionals to recognise and sensitively handle individuals' treatment expectations. Individuals' understandings of and responses to irAEs are also illustrated, and attention drawn to patients' concerns about healthcare professionals' checkpoint inhibitor and irAEs knowledge. Implications for Patient Care: To sensitively manage treatment expectations and uncertainties, and optimise health outcomes, there are distinct points in treatment trajectories where care and support might require adapting and enhancing. Impact: This review addresses people's experiences of immune checkpoint inhibitor treatments. The core findings reveal unmet information, psychological and practical support needs. Insights derived from this review will enhance individuals' experiences and outcomes and healthcare professionals' practice. Patient or Public Contribution: No patient or public involvement. [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]

Accessible Summary: What Is Known about the Subject?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment.Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. What this Paper Adds to Existing Knowledge?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1‐day workshop for PPD.Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. What Are the Implications for Practice?: One‐day CBT‐based workshops may be an effective, low‐intensity treatment option that provides helpful skills and builds social networks for individuals with PPD.Additional post‐workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re‐connect with other birthing parents. Introduction: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. Aim: The aim of the study was to understand participants' experiences attending an in‐person or online 1‐day cognitive behavioural therapy (CBT)‐based workshop for PPD and compare their experiences participating in either modality. Method: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1‐day CBT‐based workshops for PPD delivered in‐person or online. Responses were provided by 94 in‐person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. Results: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post‐workshop support. Online participants identified additional barriers to workshop engagement. Discussion: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. Implications for Practice: One‐day CBT‐based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post‐workshop support. [ABSTRACT FROM AUTHOR]

Aim: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. Background: Pregnant nurses, like non‐pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. Design and Methods: This cross‐sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. Results: One‐fifth of participants were working night shifts, and more than two‐thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. Conclusion: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses. Summary statement: What is already known about this topic? Nurses in early pregnancy are exposed to work environments that can affect their reproductive health.The relationship between mental health and work environment among nurses in early pregnancy is poorly understood. What this paper adds? Despite legal guidelines, some pregnant nurses performed potentially harmful work such as night shifts, overtime and heavy lifting.There were differences in the occupational risks to which the study participants were exposed depending on hospital size.Overtime and heavy lifting were related to anxiety and fatigue in study participants. The implications of this paper: To protect nurses in early pregnancy, an appropriate maternal safety programme should be developed for hospital work environments.Education programmes should be implemented for nurses in early pregnancy on safety guidelines such as the use of personal protective equipment (PPE).Physically difficult tasks can increase fatigue and anxiety among nurses in early pregnancy, so legal and institutional regulations focusing on safe working environments should be strengthened. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses. Background: Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear. Methods: A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale‐Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T‐test and one‐way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research. Results: Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth. Conclusions: Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth. Summary statement: What is already known about this topic? Psychiatric patients generally have complex and special conditions, which makes psychiatric nursing work high‐risk and stressful, which often poses significant challenges for psychiatric nurses, such as compassion fatigue.There is a correlation between compassion satisfaction, compassion fatigue and posttraumatic growth among nurses. What this paper adds? Psychiatric nurses have low levels of posttraumatic growth and moderate levels of compassionate satisfaction, burnout and secondary traumatic stress, and posttraumatic growth is influenced by sleep hours per day, marital status, children and job satisfaction.Compassion satisfaction and secondary traumatic stress have a positive impact on posttraumatic growth of psychiatric nurses, whereas burnout has a negative impact on posttraumatic growth of psychiatric nurses. The implications of this paper: This study emphasizes that policy makers should clarify the relationship between posttraumatic growth, compassion satisfaction and compassion fatigue as soon as possible to support the rapid growth of psychiatric nurses in nursing work.This study provides a basis for nursing managers to explore and implement interventions to improve compassion satisfaction among psychiatric nurses, reduce burnout and promote personal psychological growth. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the effect of the Roy adaptation model‐based strengthening program (RAMBSP) applied to nursing students on social media addiction, healthy lifestyle behaviours and self‐esteem. Methods: One hundred five nursing students studying at a nursing faculty of a university were included in this prospective, two‐armed (1:1), randomized controlled study. The study group (n:54) had 12 weeks of RAMBSP online group sessions. No intervention was made to the control group (n:51). The social media addiction level, which was the primary outcome of the study, was evaluated with the Bergen Social Media Addiction Scale (BSMAS) and healthy lifestyle behaviours and self‐esteem, which were secondary outcomes, were evaluated with the Healthy Lifestyle Behaviours Scale II (HLBS‐II) and the Rosenberg Self‐Esteem Inventory (REI). Students filled out BSMAS, HLBS‐II, and REI online via Google Forms before and after RAMBSP. Findings: At the end of the programme, there was no significant difference between the groups in terms of BSMAS scores of the students in the study group (p > 0.05); however, the difference was significant in terms of HLBS‐II and REI scores (p < 0.05). It was determined that the empowerment programme increased students' awareness of social media addiction. Conclusion: It is recommended to implement programmes that will increase students' awareness of social media addiction and its effects and to conduct new research that will cover large and different sample groups. Trial registration: It was registered at ClinicalTrials.gov in March 2021 (NCT04820517). Summary statement: What is already known about this topic? With the development of technology, social media addiction is widely seen in nursing students, who are a fragile group.Biopsychosocial approaches should be presented together in practices aimed at reducing or controlling the use of social media.It is not known whether an empowerment programme based on the nursing model (Roy adaptation model) to reduce social media addiction in nursing students is effective. What this paper adds? This programme constitutes an example of how to combine Roy adaptation model, one of the nursing models related to reducing social media addiction and providing controlled social media use, with the empowerment programme.The strengthening programme based on Roy adaptation model helped student nurses to acquire and maintain healthy lifestyle behaviours by increasing their awareness of social media addiction and improving their self‐esteem. The implications of this paper Roy adaptation model‐based psychoeducation should be conducted to enable nursing students to gain awareness of social media addiction and its consequences.Roy adaptation model‐based activities should be planned and implemented to intervene in students with social media addiction and to lead them to healthy social media use.Course contents should be added to the nursing curriculum to encourage the use of social media in a way that is effective, safe and contributes to personal development. [ABSTRACT FROM AUTHOR]

Aim: Advanced Practice Nurses are expected to provide lifesaving care to patients with complex acute illnesses in emergency and critical care settings. However, little is known about their competencies and barriers to practice in emergency and critical care settings. This review investigated these nurses' competencies to practice. Methods: A scoping review was conducted in accordance with Arksey and O′Malley's framework. Extensive research searches were conducted using seven electronic databases: MEDLINE, CINAHL, Scopus, Web of Science, Ichushi Web, Mednar and GreyNet International. Definitions and explanations of Advanced Practice Nurse competencies were categorized into elements and grouped according to similarity. Results: The database searches identified 2,483 studies, and data were extracted for 23 studies. Analysed studies were published between 2000 and 2021 and conducted in eight countries. Seven competencies were identified: performing advanced practice nursing, acute patient care, diagnostic assessment, interdisciplinary collaboration and consultation, leadership and system management, documenting patient care and supporting patient and family decision‐making. Conclusion: This review identified competencies unique to Advanced Practice Nurses in emergency and critical care settings. Further research is required to facilitate understanding of the crucial roles of advanced care nurses among healthcare providers. Summary statement: What is already known about this topic? Advanced practice nurses contribute to patient outcomes in emergency and critical care settings.There is no review of the competencies to practice required or experienced by these nurses.What this paper adds? Advanced practice nursing competencies include performing advanced practice nursing, acute patient care, diagnostic assessment, interdisciplinary collaboration and consultation, leadership and system management, documenting patient care and supporting patient and family decision‐making.The implications of this paper: Further qualitative studies may be needed to better understand the types and status of Advanced Practice Nurses' competencies to practice in emergency and critical care settings. [ABSTRACT FROM AUTHOR]

Aims: This study intended to explore the workplace bullying, self‐efficacy and emotional distress of the nursing staff and determine the predictors of nursing staff's emotional distress. Methods: Cross‐sectional and correlation designs were used, collecting data including socio‐demographic data, workplace bullying, self‐efficacy and emotional distress scales. Results: Results showed that the frequency of poor sleep quality in the recent 2 weeks, working in the intensive care centre or emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress in nursing staff. Conclusion: Nursing supervisors are advised to design suitable shift schemes to allow adequate time for nurses to maintain proper rest and develop a safety notification system to give bullied victims the assurance of safety. The design and implementation of the programs are encouraged to improve self‐efficacy among nurses by strengthening the training of social skills, improving employees' communication skills and their relationships with other employees. Summary statement: What is already known about this topic? Nursing workplace bullying can lead to health problems and patient safety problems.What this paper adds? This study provides information about workplace bullying, self‐efficacy and emotional distress in nurses.Poor sleep quality in the recent 2 weeks, working in the intensive care centre or the emergency room, high workplace bullying and low self‐efficacy were the main predictors of emotional distress among nurses.The implications of this paper for policy/practice/research/education Hospital managers should arrange education programs to improve nurses' self‐efficacy to avoid emotional distress.Suitable shift schemes should be designed for the nurses to maintain proper rest, and a safety notification system should be provided to the bullied victims for the assurance of safety. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this systematic review was to determine the levels and influencing factors of mental workload in intensive care unit nurses. Background: Intensive care unit nurses have a high mental workload level. To our knowledge, no meta‐analytic research investigating the levels of mental workload in intensive care unit nurses and related factors has yet been performed. Design: This article is a systematic review and meta‐analysis. Methods: Eleven electronic databases were searched from the database setup dates until 31 December 2022. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The PRISMA guideline was used to guide reportage of the systematic review and meta‐analysis. Results: Seventeen studies were included. In these studies, the pooled mean score of mental workload was 68.07 (95%CI:64.39–71.75). Furthermore, subgroup analyses indicated that intensive care unit nurses' mental workload differed significantly by countries, sample size and publication year. The mental workload influential factors considered were demographic, work‐related and psychological factors. Conclusion: Hospital administrators should develop interventions to reduce mental workload to enhance the mental health of intensive care unit nurses and nursing care quality. Hospital managers should pay attention to the mental health of nurses and guide them to correctly relieve occupational stress and reduce mental workload. Summary statement: What is already known about this topic? The prevalence of mental workload among ICU nurses is higher than in other departments in hospital.There are no published systematic review and meta‐analysis studies that synthesize the current evidence. What this paper adds? This review estimated overall mental workload scores, which indicated that ICU nurses have a high level of mental workload.The levels of mental workload among ICU nurses may be influenced by multiple factors, classified for this review in terms of demographic, work‐related and psychological factors. The implications of this paper: Demographic, work‐related and psychological variables should be taken into account in developing comprehensive interventions to reduce nurses' mental workload.Similar meta‐analyses in the future can evaluate other healthcare workers and those in other regions to determine in what departments the level of mental workload is high. [ABSTRACT FROM AUTHOR]

Aim: To present the development, implementation and evaluation of a theoretically grounded novel virtual dissemination evaluation (VDE) framework. Background: Care of intensive care unit patients requires access to the most up‐to‐date knowledge and best practices. To address this challenge, we present the development, implementation and evaluation of a theoretically grounded novel VDE framework. This framework is applied to a dissemination strategy, NeoECHO, in neonatal intensive care units. Evidence‐based virtual education is implemented to prevent, detect and treat necrotizing enterocolitis in neonates. Design: Research Methodology: Discussion Paper—Methodology. Methods: The virtual dissemination evaluation framework is a sequential combination of Integration of Integrated‐Promoting Action on Research Implementation in Health Services and Moore's Expanded Outcomes frameworks. The framework's conceptual determinants, virtual facilitators and implementation evaluations were operationalized in the NeoECHO dissemination strategy and evaluated for feasibility. The virtual dissemination evaluation framework was conceptually mapped, and operational activities were examined including theoretical constructs drawing on insights of nursing theorists, especially Fawcett's criteria (2005) for frameworks with practical application (significance, internal consistency, parsimony, testability and design fit). The NeoECHO strategy was evaluated for virtual dissemination evaluation adherence, operationalization and feasibility of implementation evaluation. Results: The virtual dissemination evaluation framework meets the criteria for a practical application and demonstrates feasibility for adherence and operationalization consistency. The implementation evaluation was usable in the virtual dissemination of best practices for neonatal care for necrotizing enterocolitis and healthcare providers were actively engaged in using NeoECHO as an implementation strategy. Conclusion: This examination of the foundational aspects of the framework underscores the rigour required for generalization of practical application. Effective virtual dissemination of evidence‐based practices to hospital units requires structured delivery and evaluation, enabling engaged healthcare providers to actualize education rapidly. The virtual dissemination evaluation frameworks' potential for narrowing the evidence‐based practice gap in neonatal care showcases its wider significance and applicability. Implications: Care of neonates in NICUs requires a multidisciplinary approach and necessitates access to the most up‐to‐date knowledge and best practices. More than traditional dissemination methods are required to bridge the implementation gap. Impact: The effective use of the VDE framework can enhance the design, implementation and evaluation of knowledge dissemination, ultimately elevating neonatal care quality. Clinical Relevance: This paper introduces the VDE framework, a sequential combination of the iPARIHS and Moore's EO frameworks—as a methodological tool for designing, implementing and evaluating a neonatal strategy (NeoECHO) for virtual dissemination of education in NICUs. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

Aim: We aimed to evaluate the quality of clinical practice guidelines (CPGs) for breast cancer related lymphoedema (BCRL) and compare the similarities and differences in recommendations. Background: Many CPGs of BCRL have been developed; however, their recommendations and quality are controversial. Methods: Relevant papers were retrieved from electronic databases, professional associations and guideline development organizations, from 1 January 2015 to 30 September 2021. The Appraisal of Guidelines Research and Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Intraclass correlation coefficient (ICC) analysis was used to evaluate the overall consistency among evaluators. Results: Eight CPGs were included. The ICC values evaluation for CPGs ranged from 0.76 to 0.95, with good consensus among evaluators. The highest median score was 68.75% (61.46, 72.22%) for clarity, and the lowest was 37.50% (25.78, 51.30%) for applicability. The NICE, ACS/ACSO and APTA CPGs were rated well in most areas. Professional health education, individualized exercise programme and regular surveillance are the main methods to prevent lymphoedema. Conclusion: In the past 6 years, the quality of BCRL guidelines has varied greatly, especially in the domains of rigour and applicability. Interrater agreement was excellent, but recommendation showed some inconsistencies in the details. Summary statement: What is already known about this topic? Providing recommendations based on evidence‐based guidelines for care of cancer treatment‐related lymphoedema will help to improve outcomes for patients with this chronic condition. What this paper adds? The rigour of the guidelines needs to be improved.Guideline‐making organizations have the responsibility to promote the application of guidelines into practice using a variety of methods.Multifactorial reasons were responsible for the differences inguidelines' recommendations The implications of this paper Nurses need to be more aware of guideline recommendations.There are inconsistencies in the details, despite many similarities.The formulation of individual nursing care programmes should be tailored to the local clinical situation and working environment. [ABSTRACT FROM AUTHOR]

Aims: This work aims to investigate the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients. Background: Day surgeries are well received and developing rapidly. Associations between obesity and delayed discharge and unplanned readmission, which are clinically relevant outcomes in day surgeries, are complex. Design: A systematic review and meta‐analysis was conducted. Data Sources: The PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, VIP, and Wan Fang databases were comprehensively searched from inception until January 2021. Review Methods: Two independent reviewers assessed the studies and extracted data. Pooled estimates were obtained using a random‐effects model. Results: Eleven articles published between 2007 and 2020 were finally included. Obesity appeared not to increase the risk of delayed discharge. However, morbid obesity seemed to be associated with a higher risk of delayed discharge. The meta‐analysis revealed no relationship between higher body mass index (BMI) and unplanned readmission for day surgery patients. Conclusions: Obesity appeared not to increase the risk of delayed discharge except in patients with morbid obesity. Additionally, a higher BMI was not associated with increased risk of unplanned readmission after day surgery. Future studies are required to address this issue further in different types of surgery and areas. Summary statement: What is already known about this topic? The complexity and flexibility of day surgeries have gradually broadened, but selecting the most suitable patients for day surgery is important for safety.Controversies exist on the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients. What this paper adds? This systematic review and meta‐analysis suggests that obesity did not significantly increase the risk of delayed discharge except in patients with morbid obesity.A higher BMI was not associated with increased risk of unplanned readmission after day surgery. The implications of this paper: Obesity should not be regarded as a contraindication to day surgery although patients with morbid obesity should be scheduled with caution and evaluated on a case‐by‐case basis. Future studies are required to address this issue further in more types of surgery and in different areas. [ABSTRACT FROM AUTHOR]

Background: High cognitive load in nurses is a common problem in the intensive care unit (ICU). However, it remains unclear what different types of cognitive load the ICU nurses have experienced during the implementation of delirium interventions. Aim: To describe the characteristics and explore the effect of implementing a delirium intervention on the cognitive load of nurses working in the ICU. Methods: A cluster‐randomized controlled clinical trial was conducted. Six ICUs were randomized in a 1:1 ratio, and eligible nurses from these units provided either a delirium bundle intervention in addition to usual care (27 nurses) or usual care alone. An instrument was used to measure different types of cognitive load (MDT‐CL), assessing intrinsic, extraneous and germane cognitive load. The repeated measures analysis of variance was used to detect between‐group differences. Results: Among these nurses, significant between‐group differences were identified in terms of their overall (P < 0.001), intrinsic (P < 0.001) and extraneous (P < 0.001) cognitive load. There was no significant change observed in the germane cognitive load (P = 0.489) in the delirium intervention group. Conclusion: It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses, in order that tailored strategies can be applied to reduce cognitive load in ICU nurses. Summary statement: What is already known about the topic? ABCDEF bundle interventions are effective to reduce ICU delirium incidence and improve clinical outcomes.Nursing care in the intensive care units is characterized by elevated demand on workloads and increased cognitive load.Cognitive load has been identified to include three different types: intrinsic cognitive load, extraneous cognitive load and germane cognitive load. What this paper adds? The application of a delirium intervention in ICU nurses can increase the intrinsic, extraneous and overall cognitive load but had no effect on the germane cognitive load in ICU nurses.It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses so that tailored strategies can be applied to reduce cognitive load in ICU nurses. The implications of this paper: Evaluating different types of cognitive load in ICU nurse is helpful to support appropriate allocation of nursing resources and improvement of patient safety.This study highlights the necessity of improving efforts focusing on reduction of the intrinsic and extraneous cognitive load related to nursing care for delirium in ICUs. [ABSTRACT FROM AUTHOR]

Aims: To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention. Design: Ethnographic study. Methods: Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi‐structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach. Results: Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses. Conclusions: Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient‐facing staff. Implications for Profession and Patient Care: Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non‐nursing staff, with potential to reduce pressures on busy nurses and improve patient safety. Reporting Method: The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research. Patient or Public Contribution: Patient/public contributors were involved in study design, evaluation and data analysis. They co‐authored this manuscript. [ABSTRACT FROM AUTHOR]

Aim: This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia. Methods: A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes. Results: Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention. Conclusion: A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes. Summary statement: What is already known about this topic? Family‐supported diabetes self‐management education intervention produced inconclusive effects on self‐management behaviour and quality of life. What this paper adds? A social‐cognitive theory‐guided, culture‐tailored, and community‐based diabetes self‐management education and support programme resulted in a preliminary effect on improving self‐management behaviour and quality of life.A nurse‐led diabetes self‐management education and support programme intervention, including the families of patients, may be an option to boost the self‐management practise and quality of life of people with diabetes. The implications of this paper: Culturally tailored diabetes self‐management education and support programme could be an option to improve self‐management behaviour and enhance quality of life.Community‐based nurse‐delivered diabetes self‐management education and support can improve self‐management behaviours and enhance quality of life in 2 months duration. [ABSTRACT FROM AUTHOR]

Background: Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. Aims: The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. Methods: A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. Results: The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Conclusions: Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health. Summary statement: What is already known about this topic? Limited studies have explored core somatic symptoms in patients with chronic heart failure using network analysis.There is a lack of a holistic perspective when studying symptoms in patients with chronic heart failure and their association with various factors. What this paper adds? This study identifies daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping as the four core symptoms of chronic heart failure.Targeting these core symptoms in treatments and management can potentially lead to improvements in patients' overall health.The network analysis highlights the importance of psychological and environmental factors, suggesting that interventions targeting these factors may contribute to overall health improvement. The implications of this paper: It provides evidence of core symptoms of chronic heart failure.It provides evidence of the complex interconnections among symptoms and related factors in chronic heart failure.It provides implications for future interventions and strategies in managing chronic heart failure. [ABSTRACT FROM AUTHOR]

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

Aims: Psychological insulin resistance is a common barrier to initiation and persistence with insulin therapy that affects approximately 42.7% of people living with type II diabetes mellitus, which may negatively impact self‐management. This study aimed to assess patients' levels of psychological insulin resistance and to identify factors associated with self‐management in patients with type II diabetes mellitus treated with insulin therapy. Methods: We adopted a cross‐sectional design. Subjects from the metabolism and endocrinology outpatient departments of a regional teaching hospital in central Taiwan were recruited by consecutive sampling. Patients were assessed for psychological insulin resistance and self‐management using the barriers to insulin treatment questionnaire and the partners in health scale. Results: A total of 222 patients with type II diabetes mellitus were recruited. Patients had an average psychological insulin resistance score of 3.14 (maximum of 8). Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age. Conclusion: Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy. Insulin therapy education should be offered to improve patients' beliefs about insulin therapy and enhance patients' ability to perform self‐management. Summary statement: What is already known about this topic? Psychological insulin resistance is a common psychological barrier to initiation and persistence with insulin therapy.Psychological insulin resistance causes poor glycaemic control and diabetes‐related complications.Psychological insulin resistance may negatively impact self‐management in patients with type II diabetes mellitus. What is the contribution of this paper? Positive self‐management was associated with insulin therapy injection by patient, fewer expectations regarding positive insulin‐related outcomes, no diabetes‐related complications, less fear of injection and self‐testing, no hypoglycaemia within the previous year, and younger age.Insulin therapy injection by patient and no diabetes‐related complications were the most common factors associated with overall self‐management and with each domain of self‐management in patients with type II diabetes mellitus treated with insulin therapy.Patients with poor self‐management had statistically significantly higher levels of overall psychological insulin resistance, fear of injections and self‐testing, expectations regarding positive insulin‐related outcomes, and stigmatization by insulin injections, compared to those with appropriate self‐management. What are the implications of this paper? Knowing in advance the factors associated with diabetes self‐management will allow healthcare professionals prevent psychological insulin resistance in patients with type II diabetes mellitus treated with insulin therapy.Healthcare professionals can design and provide patient‐centred diabetes education based on education level to enhance self‐management. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between medication literacy and blood pressure control among hypertensive patients. Background: Blood pressure control is a challenge for global health systems. Medication literacy is essential for medication self‐management in hypertensive patients and a basis for managers to develop comprehensive intervention strategies for hypertension medication use. Design: A cross‐sectional observational study was conducted. Methods: A total of 378 hypertensive patients was selected by convenience sampling from two tertiary hospitals and four community health service centres from December 2021 to January 2022 in Changsha, China. Associations between medication literacy and blood pressure control were identified with chi‐square, independent samples t‐tests and logistic regression analyses. Results: The average medication literacy score of the hypertensive patients investigated was low. Over a third of patients had uncontrolled blood pressure. Logistic regression analysis showed that medication literacy was an influencing factor for blood pressure control rate in hypertensive patients. Conclusions: Medication literacy and blood pressure control among hypertensive patients was poor. Medication literacy was a facilitator of blood pressure control so improving medication literacy may be of value to improve blood pressure control in hypertensive patients. Summary statement: What is already known about this topic? Medication literacy is essential for medication self‐management in hypertensive patientsThe association between medication literacy and blood pressure control in hypertensive patients is unclear. What this paper adds? Medication literacy and blood pressure control rates among hypertensive patients were poor and in need of urgent improvement.Medication literacy was a facilitator of blood pressure control in hypertensive patients. The implications of this paper: Clinical nurses may enhance hypertension management by improving medication literacy.Findings provide a base for implementing medication literacy intervention strategies and promoting blood pressure management. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses work in mental health services around the world, constituting the largest professional group.Nurses have been identified as being potentially able to carry out a much wider range of functions than are typically allowed in practice, when provided with suitable training.There are long‐term concerns regarding shortages of mental health nurses in England and many other countries.Workforce data is rarely subject to analysis in peer‐reviewed journals. What the paper adds to existing knowledge?: This paper provides a case study of the workforce patterns of a national mental health nurse (MHN) workforce overtime allowing comparison with other countries and specialities.MHN numbers reduced from 2011 to 2017, then increased to near the 2011 level by 2021, not meeting ambitious national plans for increasing numbers.The mental health nursing proportion of the total NHS nursing workforce decreased through this period.Advanced practice roles and skills are widely, but unevenly, distributed and are provided by a small proportion of nurses.The proportion of nurses working in community settings has increased to constitute more than half of all nurses for the first time.The ratio of support workers to nurses increased in inpatient settings and will continue to change. What are the implications for practice?: Historical challenges in recruiting MHNs suggest that future plans to expand the profession are overly optimistic.To support the development of advanced practice roles and new skill sets, clearer research evidence of impact is required and clearer national guidance regarding best practice models.Good workforce data are essential to inform good workforce planning. Introduction: Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer‐reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aim: The aim of the study was to characterize changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy. Method: Analysis of nationally published workforce data, peer‐reviewed publications and governmental policy/planning documents. Results: Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for Practice: This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim was to conduct a synthesis of the literature on value‐creating care for older persons with incontinence provided with toileting assistance and containment strategies, from the perspectives of older persons and healthcare professionals. Background: Incontinence is a health problem for many persons worldwide and the problem will increase as the global population ages. It can have a profound impact on a person's wellbeing, and assistance with toileting and containment strategies is common in home care settings and nursing homes. Design: The design was a literature review with an iterative, reflexive and critical approach. Methods: A critical interpretive synthesis was conducted. Ten papers published between 2011 and 2019 were analysed. The PRISMA ‐ScR Checklist was used in this review. Results: Based on the findings, the conceptual construct 'The art of connectedness' was developed, built on co‐created care, personalised care and reflective care between the older person and healthcare professionals. Co‐created care is based on establishing a relationship, building trust and respecting preferences. Personalised care consists of meeting the person's needs, promoting comfort and maintaining self‐determination. Reflective care entails showing empathy, upholding the person's dignity and developing professional competence. Conclusions: Value‐creating care consists conceptually of a connectedness that starts with co‐creating the care together with the older person in a close relationship. Assistance is given and received based on the older person's individual needs and is highly valued by the older person as it helps them maintain self‐determination. Reflective care is of importance for healthcare professionals. Relevance for practice: The findings are hoped to enhance healthcare professionals' understanding of how to improve the clinical encounter in nursing when providing assistance. They may also stimulate critical reflection among healthcare professionals on how to improve assistance to meet the older person's values. [ABSTRACT FROM AUTHOR]

Objective: To synthesise the evidence relating to the contribution nurses make during respiratory infectious disease pandemics. Background: Pandemics are known for their abrupt and contagious nature, as well as their impact on individuals and society. Nurses are more likely to work closely with patients experiencing illness and disease during pandemics, and studies on the role of the profession have mainly focused on the challenges, barriers and shortfalls in nursing care provision. The nursing role in service delivery and their contribution in improving patient well‐being has received far less attention. Methods: In May 2020, three review registers, grey literature and the following databases were searched: Medline via Ovid, Web of Science, CINAHL via EBSCO and Cochrane Library. The specific focus was on qualitative literature that considered the experiences and perceptions of nurses providing care during several respiratory pandemics. Selected papers were appraised using CASP checklist. ENTREQ checklist was used to inform stages associated with the synthesis of selected papers. Results: From 5553 retrieved citations, the analysis of 24 eligible papers resulted in three key themes: the implications of working during pandemics on nurses' personal and family life, nursing contribution in challenging conditions, and working above and beyond. Considering nurses' role in healthcare system, research on their contribution found to have received little appreciation in peer‐reviewed journals. Conclusions: This review pertains to nurses' work in global context and highlights the huge contribution made by the profession in the context of respiratory pandemics. It confirms that nurses' experiences outweighed economic, social and psychological implications of providing care during the pandemic crisis. Acknowledging nurses' resilience and professional motivations, we also argue that the nurse contribution during pandemics can be enhanced when resources, support and training are provided. Further research on contexts and conditions which mitigate nurses the potential for sustained contribution is needed. [ABSTRACT FROM AUTHOR]

Aim: To review the evidence of how nurse and pharmacist roles have been incorporated into the management of patients undergoing systemic anti‐cancer therapy (SACT) services and their impact on patient experience and care provision. Design: Systematic Review. Data Sources: Seven databases were searched on 10 April 2022. Review Methods: Research studies that met defined inclusion criteria were included. Quantitative findings were converted into textual descriptions and combined with qualitative results for thematic analysis. Data were categorized and aggregated into themes. Heterogeneity of studies meant meta‐analysis was not possible. Results: Fifteen papers were included. Three main themes were identified: advanced clinical practice (ACP) SACT service development; ACP skills and qualifications; and the impact of ACP SACT services on patient care and outcomes. There is a variation in tasks undertaken by nurses and pharmacists and role integration is restricted by limited physician engagement. Role titles used and skills and qualifications acquired differ and professional autonomy is variable. Qualitative studies were limited. Conclusion: Evidence of how nursing and pharmacist ACP roles are implemented, what skills are essential and how roles are impacting patient experience and outcomes is limited. More research is required to explore patient and physician experience of, and satisfaction with multi‐professional care, alongside further evaluation of clinical delivery models. [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: This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. Design: Integrative review. Data Sources: Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. Review Methods: 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. Results: This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. Conclusion: The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. Impact: This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at‐risk emergency nurses. No Patient or Public Contribution: This project was an integrative review of the literature therefore no patient or public contribution was necessary. What Already is Known: Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. What this Paper Adds: This review specifically examines violence‐targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. Implications for Practice/Policy: The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses. [ABSTRACT FROM AUTHOR]

Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Aim: This review investigated the outcomes and methodological quality of infant sleep intervention studies utilizing actigraphy. Background: Parents need appropriate support for infant sleep from nurses. There are few methodological reports of actigraphy in infant sleep intervention studies that objectively measure infant sleep in a natural setting. Design: This was a systematic review study. Data Sources Ovid MEDLINE, Embase, Cochrane, CINAHL and PsycINFO were searched from database establishment to 30 December 2021. Review Methods: This systematic review utilized the Cochrane Collaboration review guidelines. Results: Eleven sleep intervention studies were reviewed. Three used extinction‐based behavioural interventions, and eight included parental education programs. The infant sleep interventions positively affected the sleep outcomes of both infants and parents. Fairly consistent effects were found on infants' number of awakenings and sleep onset latency. However, parental psychosocial outcomes were inconsistent. All studies reported device placement, the algorithm for analysis, the use of a sleep diary and number of days/nights, but external movements affecting infants' sleep records were insufficiently reported. Only two studies had a low risk of bias. Conclusions: The infant sleep interventions had positive effects on both infants and their parents. Comprehensive methodological considerations are required for more standardized assessments using actigraphy for infant sleep evaluation. Summary statement: What is already known about this topic? Strong evidence exists that behavioural interventions improve infant sleep.Infant sleep interventions using actigraphy have gradually increased in paediatric sleep research. What this paper adds: Behavioural interventions were found to be fairly effective for infants' sleep onset latency and night‐wakings.Parental education programs were inconsistent in their effectiveness on infant sleep outcomes, compared to extinction‐based behavioural interventions. Infant behavioural sleep interventions also did not show consistent positive effects on parental variables.The use of actigraphy with infants is challenging in terms of comparability across studies due to the lack of standardized criteria for defining and scoring daytime and nighttime sleep data, and unexpected external movement detection due to variability of infants' sleep conditions. The implications of this paper: This study contributes to nursing knowledge and practice by increasing the feasibility of implementing infant behavioural sleep interventions using actigraphy and considering family contexts.Meta‐analysis is needed to clarify the effectiveness of infant sleep interventions, and further studies should investigate the long‐term effects of infant sleep interventions.In infant sleep intervention studies using actigraphy, it is necessary to use subjective and objective measures as complementary modalities. Follow‐up studies are needed to establish standards in actigraphic measurement and reporting methodology. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the impact of bronchial asthma‐related factors on the emotional well‐being of adolescents with bronchial asthma and their primary caregivers. Background: Bronchial asthma is a common chronic disease in childhood and adolescence that can have a psychological impact on both patients and their primary caregivers. Methods: The study used a cross‐sectional design and included 150 patient–caregiver dyads diagnosed with bronchial asthma, aged between 12 and 16 years and collected between 2018 and 2020. It assessed the emotional adjustment of both patients and caregivers and recorded variables related to the disease. Qualitative and quantitative analyses were conducted to perform statistical analyses. Results: Caregivers had higher anxiety and depression scores than patients. Good adherence to treatment was necessary for the emotional adjustment of the dyad. Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. Conclusions: The study highlights the importance of assessing anxiety and depression levels in both patients and caregivers because the presence of these symptoms can lead to the misuse of medication, inadequate inhalation techniques, the omission of medication and reduced confidence in controlling asthma symptoms. Summary statement: What is already known about this topic? Certain variables related to asthma, such as its degree of control, severity, duration of diagnosis and adherence, have been linked to adjustment to the disease by the adolescent–caregiver dyad. What this paper adds? Caregivers had higher anxiety and depression scores than patients.Good adherence to treatment was necessary for the emotional adjustment of the dyad.Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. The implications of this paper: The study evaluated the variables in combination to identify risk and healthier profiles in the dyad's emotional adjustment and identified variables related to the disease most associated with emotional adjustment to the disease in the dyad.Identifying the risk and health profiles in emotional adjustment in both the adolescent and his or her caregiver may be used to mitigate future consequences related to poor adjustment to asthma.Knowledge of these variables allows health professionals to design psychoeducational programmes to ensure better adaptation to the disease. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Aim: Develop evidence‐based recommendations for managers to support primary healthcare nurses to thrive at work. Design: A mixed‐methods sequential explanatory design. Methods: National data were collected in 2020 via an e‐survey based on a meta‐analysis of antecedents of thriving from 213 primary healthcare nurses across New Zealand. Structural equation modelling analysis identified the key factors supporting primary healthcare nurses to thrive. This informed a second open‐ended e‐survey in 2022 of 19 nurses from one primary healthcare organization. The thematic analysis provided recommendations for improving management strategies to support thriving primary healthcare nurses. Results: The vitality component of thriving significantly reduced burnout and intention to leave organization and profession. In contrast, the learning component of thriving had a significant positive effect on burnout. The key factors that support thriving at work are empowering leadership and perceived organizational supports (decreases burnout and intention to leave organization and profession through enhanced vitality). Recommendations for improving thriving were made in eight key areas: communication, effective management, professional development, scope of practice, autonomy, effective orientation, reward and work–life balance. Conclusions: Vitality is important in reducing burnout and turnover intentions. While learning was identified as increasing burnout, professional development and training for managers were identified as essential. Hence, the vitality dimension of the thriving at work construct should be studied at the dimension level, but more research is needed into the impact of learning on thriving over time. Primary healthcare nurses have identified that empowering leadership and perceived organizational support are critical factors in supporting them to thrive, and they provide specific recommendations for managers to improve these factors in the clinical setting. No Patient or Public Contribution: This study collected data from Registered Nurses only. What Is Already Known: A plethora of existing research focuses on resilience in nurses rather than thriving at work.Enabling employees to thrive at work contributes to improved well‐being and sustainable organizational performance. What This Paper Adds: Empowering leadership and perceived organizational support are the key factors that support primary healthcare nurses to thrive at work.The vitality dimension of the thriving at work construct should be studied at the dimension level, and further research is needed into the impact of learning on thriving over time.Primary healthcare nurses recommend that managers focus on improving communication, management efficiency, professional development, scope of practice, autonomy, orientation, reward and work–life balance. [ABSTRACT FROM AUTHOR]

Background: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. Aim: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. Methods: A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. Results: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. Conclusion: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. Implications: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. Impact: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. Reporting Method: COREQ guidelines. Patient or Public Contribution: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. What does this paper contribute to the wider global clinical community?: Family members perceive additional value from the use of video calls on hospital wards.For family, use of video calls needs to be facilitated with clear instruction materials and support. Trial and Protocol Registration: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560). [ABSTRACT FROM AUTHOR]

Background: Advance care planning is a process through which people communicate their goals and preferences for future medical care. Due to the complexity of the decision‐making process, decision aids can assist individuals in balancing potential benefits and risks of treatment options. Objective: While decision aids have the potential to better promote advance care planning, their characteristics, content and application effectiveness are unclear and lack systematic review. Therefore, we aimed to explore these three aspects and establish a foundation for future research. Design: Scoping review. Methods: This scoping review adheres to the framework proposed by Arksey and O'Malley and the PRISMA‐ScR list. Six English‐language databases were systematically searched from the time of construction until 1 December 2023. Two researchers conducted the article screening and data extraction, and the extracted data was presented in written tables and narrative summaries. Results: Of the 1479 titles and abstracts, 20 studies fulfilled the inclusion criteria. Types of decision aids were employed, mainly websites and videos. Decision aid's primary components center around 11 areas, such as furnishing information, exploring treatment and care preferences. The main manifestations were a significant increase in knowledge and improved recognition of patients' target value preferences. Among the aids, websites and videos for advance care planning have relatively high content acceptability and decision‐making process satisfaction, but their feasibility has yet to be tested. Conclusions: Decision aids were varied, with content focused on describing key information and exploring treatment and care preferences. Regarding application effects, the aids successfully facilitated the advance care planning process and improved the quality of participants' decisions. Overall, decision aids are efficient in improving the decision‐making process for implementing advance care planning in cancer and geriatric populations. In the future, personalised decision aids should be developed based on continuous optimization of tools' quality and promoted for clinical application. Reporting Method: The paper has adhered to the EQUATOR guidelines and referenced the PRISMAg‐ScR checklist. No Patient or Public Contribution: This is a review without patient and public contribution. Registration: https://doi.org/10.17605/OSF.IO/YPHKF, Open Science DOI: 10.17605/OSF.IO/YPHKF. [ABSTRACT FROM AUTHOR]