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Background Research theses can have a significant impact on the development of applied sciences, especially when their results are published. Objective This study aims to determine publication rate of papers extracted from the medical residency and master’s degree theses of Guilan University of Medical Sciences (GUMS) during 2008-2018. Methods This is a descriptive cross-sectional study. The data were collected from the medical residency and master’s degree theses of GUMS from 2008 to 2018. Then, they were searched in international and national databases according to the title, keywords, and names of supervisors, advisors, and students. Results Of 774 theses, 449 (58 %) papers had been extracted and published in journals indexed by ISI/ PubMed (41.2%), Scopus (11.8%), BIOSIS, Chemical Abstract, and Embase (0.44%) and others (46.56%). Most of them (98.66%) were original research. Moreover, in 383(85.3%) of the theses, there was no statistician or data advisor. The median time from defending theses to the publication of a paper from them was two years. Conclusion The publication of papers extracted from the theses of GUMS has increased, and more than 50% of them have been published in journals indexed by ISI, PubMed, and Scopus. However, the factors associated with the publication of papers need to be surveyed. [ABSTRACT FROM AUTHOR]

Paper-based visual analogue scale (VAS) items were developed 100 years ago. Although they gained great popularity in clinical and medical research for assessing pain, they have been scarcely applied in other areas of psychological research for several decades. However, since the beginning of digitization, VAS have attracted growing interest among researchers for carrying out computerized and paper-based data assessments. In the present study, we investigated the research question "Which different design characteristics of paper-based VAS items are preferred by women and men?" Based on a sample of 115 participants (68 female), our results revealed that the respondents preferred a paper-based VAS item with a horizontal, 8-cm long, 3 DTP ("desktop publishing point") wide, black line, with flat line endpoints, and the ascending numerical anchors "0" and "10", both for women and men. Although we did not identify any gender difference in these characteristics, our findings uncovered clear preferences on how to design paper-based VAS items. [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]

Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Aim: This work aims to evaluate the relationship between the fear of hypoglycaemia, treatment adherence, and the quality of life in patients with type 2 diabetes mellitus (T2DM) and its determinants. Methods: This descriptive and cross‐sectional study sample recruited 1060 T2DM outpatients in a health centre between January and July 2022. The Hypoglycemia Fear Survey (HFS), Type 2 DM Treatment Patient Compliance Scale, and the 5‐Level EuroQol 5‐Dimension (EQ‐5D‐5L) were used for data collection. Results: There was a positive correlation between age, duration of T2DM, and the scores obtained from the HFS and its subscales (p < 0.001). There was a positive, moderate correlation between the total HFS score and the TCS (p < 0.001). There was a negative correlation between the scores obtained from the HFS and the EQ‐5D‐5L (p < 0.001). The multiple regression analysis showed that the quality of life scores of the patients were significantly predicted by hypoglycaemia fear, duration of T2DM diagnosis, and age. (F = 91.691, p < 0.001). Hypoglycaemia fear, duration of T2DM diagnosis, and age explained 38.1% of the quality of life of patients. Conclusion: We determined that the increase in hypoglycaemia fear resulted in a decrease in treatment adherence. Besides, hypoglycaemia fear increased with increasing age and duration of T2DM diagnosis. Summary statement: What is already known about this topic? In a limited literature, it has been reported that patients with diabetes experience hypoglycaemia fear. However, almost all of these studies focus on the hypoglycaemia fear in type 1 diabetes mellitus patients. What this paper adds? There was a positive correlation between the level of treatment adherence and hypoglycaemia fear in patients with T2DM. It was observed that adherence with treatment declined because of the increased fear of hypoglycaemia in patients with T2DM.Hypoglycaemia fear increased with increasing age and duration of T2DM diagnosis.Hypoglycaemia fear, duration of T2DM diagnosis, and age explained 38.1% of the quality of life scores of patients. The implications of this paper: This study reveals a new perspective on hypoglycaemia fear, treatment adherence, and the quality of life scores in patients with T2DM and its determinants.In nursing practice, it was determined that it is important to control hypoglycaemia fears to increase the treatment adherence and quality of life of T2DM patients. [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]

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]

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices–such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future. [ABSTRACT FROM AUTHOR]

Aim: To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. Design: Cross‐sectional descriptive survey. Methods: Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage‐related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. Results: There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. Conclusion: The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. Implications for the Profession and/or Patient Care: Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. Impact: Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. Reporting Method: The reporting of this paper has followed SQUIRE guidelines. Patient or Public Contribution: Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study. [ABSTRACT FROM AUTHOR]

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices–such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Nurses' turnover intention has increased since the COVID-19 pandemic. Emotional labor is reportedly high among nurses in Korea, and a positive psychological capital can help reduce turnover intention. This cross-sectional study investigated the factors influencing turnover intention in nurses during the COVID-19 pandemic. Survey data were collected from 155 nurses caring for patients with COVID-19 at a university hospital in South Korea in March 2022. Self-reported and paper-based questionnaires on emotional labor, positive psychological capital, and turnover intention were employed. The mean values for emotional labor, positive psychological capital, and turnover intention were 54.52/80, 58.03/90, and 38.92/50, respectively, and 77.8% of nurses reported planning to quit working. Turnover intention correlated with emotional labor (r = 0.17; p = 0.041) and had no significant relationship with positive psychological capital. Sex (β = 0.24; p = 0.003) and emotional labor (β = 0.18; p = 0.019) affected turnover intention, with 9% explanatory power. Female nurses caring for patients with COVID-19 had a higher turnover intention than male nurses. Finally, the higher the emotional labor of nurses caring for patients with COVID-19, the higher the turnover intention. To reduce the turnover intention of nurses, hospitals need to help them enhance their emotional labor and positive psychological capital by establishing measures such as emotional coaching programs or psychological capital interventions. [ABSTRACT FROM AUTHOR]

This paper aims to provide knowledge on medical trainees' considerations about specialisation as they move from undergraduate to postgraduate medical education; especially their interest in general practice compared to other specialities. We developed and content-validated a questionnaire to examine medical trainees' speciality considerations and conducted a descriptive, cross-sectional study. All medical trainees initiating their internship in Denmark in 2022 (N = 1,188) were invited to participate in the study. Medical specialities were categorised as hospital service specialities, internal medicine specialities, primary care, psychiatry specialities and surgery and emergency specialities. Descriptive statistics were used to describe the cohort and examine the participants' speciality considerations by assigning them to one of the following three orientations: committed, undecided or non-committed to a speciality. The response rate was 38.8% (n = 461), and participants' mean age was 27.4 years with a majority of females (68.1%). Nearly 25% of the participants had general practice as speciality preference, and only 13.9% had excluded general practice for future specialisation. Overall, around half of the participants had general practice as a first, second or third preference for specialisation. Danish medical trainees show considerable interest in general practice at the time of their transition from undergraduate to postgraduate education. However, to meet future demands on the primary care, further recruitment of general practitioners is still needed. This knowledge of the specialities' recruitment potential will likely be of interest to medical educators and healthcare planners alike. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: The nurse–patient relationship in mental health care is an important focus of mental health nursing theories and research.There is limited evidence about which factors influence nurse‐sensitive patient outcomes of the nurse–patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse–patient relationship in nursing practice and nursing education. What this paper adds to existing knowledge?: To our best knowledge, this is the first study to examine associations between nurse‐sensitive patient outcomes of the nurse–patient relationship and a range of patient characteristics and relationship‐contextual factors.In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse‐sensitive patient outcome scale. What are the implications for practice?: Having insight into the factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse–patient relationship, trying to influence outcomes of nursing care. Introduction: The lack of evidence on patient characteristics and relational‐contextual factors influencing nurse‐sensitive patient outcomes of a nurse–patient relationship is a possible threat to the quality and education of the nurse–patient relationship. Aim: To measure nurse‐sensitive patient outcomes of the nurse–patient relationship and to explore the associations between nurse‐sensitive patient outcomes and a range of patient characteristics and relational‐contextual factors. Method: In a multicenter cross‐sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse‐Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results: Overall, patient‐reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion: The results may help nurses to become more sensitive and responsive to factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship. Implications: The nurse‐sensitive results can support nurses in designing future nurse–patient relationships. [ABSTRACT FROM AUTHOR]

Background: Taiwan's higher education institutions prioritize interdisciplinary knowledge and cultural competence in cultural design, emphasizing the value of immersion in the local environment to develop cultural competence. However, challenges arise from the disappearance of traditional local lifestyles and limitations of traditional outdoor lectures such as group size and learning environment. Mobile augmented reality technology serves as a personal learning tool to overcome these challenges, enabling learners to uncover hidden knowledge in scenic locations and improving learning efficiency. Objective: The study utilized learning analytics to investigate the impact of using mobile augmented reality on enhancing learners' cultural competence. Methods: The study used both qualitative and quasi‐experimental quantitative research to evaluate the effects of mobile augmented reality on cultural competence. A total of 78 third‐year university students participated in the study, with 37 of them using mobile augmented reality to learn about culture. The researchers utilized both the Mann–Whitney U test and interviews to compare the effectiveness of mobile augmented reality with that of a 'real' tour guide in field courses. Results: The experimental results indicate that learners were able to continuously seek and find information about local culture through field exploration with mobile augmented reality, resulting in similar effects to those of attending a live lecture. Conclusions: It showed that incorporating mobile AR into field visits can create gamified and active learning scenarios that enhance immersion and drive active learning in local culture. The results in greater cultural knowledge and understanding, leading to the development of cultural competence in students. Lay Description: What is already known about this topic: There is a heightened emphasis on cultivating and demonstrating cultural competence across various fields due to the significantly grow of cultural and creative industries.Relying solely on traditional classroom teaching for learning about local culture may result in a diminished impact, as a comprehensive understanding of culture necessitates a keen sense of life.To address the limitations of traditional classroom lectures, educators continuously strive to enhance teaching methodologies by developing innovative approaches, such as experiential learning and community‐based learning, which involve hands‐on activities and real‐world engagement to foster increased learning motivation and improved effectiveness.Augmented reality (AR), a technology that overlays virtual images onto real scenes in real time, has gained extensive usage in diverse fields such as medicine, national defence, education, and entertainment, offering interactive gaming experiences and providing an opportunity to experience the culture and past lives of locals in the field, enhancing learners' understanding of cultural history and creating immersive encounters during visits.Particularly in digital learning, the integration of AR enables learners to engage with additional content through mobile devices, fostering an immersive and gamified learning experience. What this paper adds: The use of the AR app for learning about the local culture yielded comparable outcomes to traditional guided tours.Participants actively engaged in self‐directed learning and demonstrated a sense of initiative while utilizing AR.The flexibility and autonomy provided by field learning, which extended beyond the course period, allowed participants to revisit the field and explore at their own pace using AR.Demonstrates that participants took control and responsibility for their own learning, leading to an enhancement in learner autonomy.Participants who utilized the Roaming Jingliao AR system to explore cultural scenarios exhibited enhanced knowledge and attitudes regarding cultural competence, specifically in areas such as cultural understanding, rice food cultural knowledge, Songjiang folk arts, and skills and practices, which can be attributed to the immersive and autonomous nature of AR‐based knowledge learning in outdoor guided courses, minimizing the influence of external environmental factors and facilitating a deeper understanding of the content compared to traditional guided tours. Implications for practice and/or policy: The findings of this study highlight the importance of considering the limitations associated with a relatively small sample size when conducting research within a university curriculum. To enhance the validity and reliability of future studies, practitioners and policymakers should prioritize the inclusion of larger and more diverse samples, enabling a more comprehensive understanding of the impact of AR technology on cultural learning and informing evidence‐based practices and policies.The study's focus on a specific group of participants and their contextual background highlights the need for future research to include participants from diverse educational settings and cultural backgrounds, ensuring that the findings are more applicable and relevant to a broader population. Practitioners and policymakers should consider the importance of inclusivity and diversity when designing and implementing cultural learning interventions using AR technology.The recognition of technological limitations highlights the importance of considering the specific AR system used in cultural learning interventions. Practitioners and policymakers should be cautious when adopting AR technologies and recognize that different AR systems or platforms may yield different outcomes. Future research should focus on evaluating the effectiveness of various AR systems and platforms to inform decision‐making regarding the selection and implementation of AR technologies for cultural learning initiatives. [ABSTRACT FROM AUTHOR]

Objectives: A new patient-reported outcome (PRO) instrument to measure fatigue symptoms and impacts in relapsing multiple sclerosis (RMS) was developed in a qualitative stage, followed by psychometric validation and migration from paper to an electronic format.Methods: Adult patients with relapsing-remitting multiple sclerosis (RRMS) were interviewed to elicit fatigue-related symptoms and impacts. A draft questionnaire was debriefed in cognitive interviews with further RRMS patients, and revised. Content confirmation interviews were conducted with patients with progressive-relapsing multiple sclerosis (PRMS) and relapsing secondary-progressive multiple sclerosis (RSPMS). Psychometric analyses used data from adult patients with different RMS subtypes and matched non-RMS controls in a multicenter, observational study. After item reduction, the final instrument was migrated to a smartphone (eDiary) and usability was confirmed in interviews with additional adult RMS patients.Results: The qualitative stage included 37 RRMS, 5 PRMS, and 5 RSPMS patients. Saturation of concepts was reached during concept elicitation. Cognitive interviews confirmed that participants understood the instructions, items, and response options of the instrument-named FSIQ-RMS-as intended. Psychometric validation included 164 RMS and 74 control patients. Internal consistency and test-retest reliability were demonstrated. The symptoms domain discriminated along the RMS symptom-severity continuum and between patients and controls. Patients were able to attribute fatigue-related symptoms to RMS. Usability and conceptual equivalence of the eDiary were confirmed (n = 10 participants).Conclusions: With 7 symptom items and 13 impact items (in 3 impacts subdomains: physical, cognitive and emotional, and coping) after item reduction, the FSIQ-RMS is a comprehensive, valid, and reliable measure of fatigue-related symptoms and impacts in RMS patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine prenatal attachment and foetal health locus of control in pregnant women and factors affecting these parameters. Methods: This cross‐sectional study was conducted with 156 pregnant women (77 low‐risk and 79 high‐risk pregnancies). The study was carried out between August 2015 and February 2016. The data collection instruments included a Participant Information Form, the Prenatal Attachment Inventory and the Foetal Health Locus of Control Scale. Results: Pregnant women's education and foetal health locus of control levels had positive and significant effects on prenatal attachment, and education had an effect on foetal health locus of control. Foetal health locus of control explained 6.3% of the total variance in prenatal attachment levels. Conclusion: As the educational statuses of pregnant women affected their prenatal attachment and foetal health locus of control, information, counselling and care should be prioritized for women with low education levels, in line with their needs. This is particularly important in terms of improving the control of pregnant women with lower prenatal attachment levels or internal locus of control over foetal health. Summary statement: What is already known about this topic? The first relationship established with the baby in the prenatal period is the bond between the pregnant woman and the foetus.The pregnancy process is of critical importance for women to develop motherhood roles and to establish their bond with the newborn immediately in the postpartum period.There is a limited number of studies on prenatal attachment, foetal health locus of control and influencing factors that reflect only certain populations.What this paper adds (research findings/key new information)? Prenatal attachment is a significant predictor of foetal health locus of control.The education levels of pregnant women affect both prenatal attachment and foetal health locus of control.The implications of this paper (how findings influence or can be used to change policy/practice/research/education) Periconceptional care should be given priority in maternity services.In order for the expectant mother to control the pregnancy process, her internal locus of control should be developed and strengthened. [ABSTRACT FROM AUTHOR]

Aims: This exploratory study, using mixed methods research, aimed to (1) examine the associations among self‐efficacy, social support and regular leisure‐time physical activity of nursing staff, and (2) identify motivators and barriers to leisure‐time physical activity. Background: It is important to engage nursing staff in regular leisure‐time physical activity as a countermeasure against high occupational stress and poor health. Limited research has examined nursing staff's participation in leisure‐time physical activity and associated factors. Methods: Nursing staff employed at a community hospital in the northeastern United States were invited to participate in this cross‐sectional survey with close‐ and open‐ended questions in March 2016. Results: A total of 363 nurses and nursing assistants responded, among whom, 59.8% reported regular leisure‐time physical activity. Poisson regression models suggested that self‐efficacy and social support had an interactive association with increased prevalence of regular leisure‐time physical activity. Conclusion: Self‐efficacy and social support have an important synergistic association with regular leisure‐time physical activity of nursing staff. Effective interventions intending to facilitate nursing staff's leisure‐time physical activity should consider improving their self‐efficacy and social support. Qualitative comments suggested that work‐out areas in the workplace with release time and organized activity may promote regular leisure‐time physical activity of nursing staff. Summary statement: What is already known about this topic? Leisure‐time physical activity is beneficial to both physical and mental health.Self‐efficacy and social support have been reported as independent predictors of leisure‐time physical activity in the general population.There is limited evidence regarding nursing staff's level of participation in leisure‐time physical activity and associated factors. What this paper adds? There is a higher level of participation in leisure‐time physical activity among nursing staff than the general population.Exercise self‐efficacy and social support have a synergistic association with regular leisure‐time physical activity among nursing staff.Support and promoting physical and mental fitness are motivators, whereas lack of time and energy and physical illnesses are barriers to regular leisure‐time physical activity reported by nursing staff. The implications of this paper: Findings indicate effective interventions designed to improve both self‐efficacy and social support might help facilitate nursing staff's participation in regular leisure‐time physical activity.Findings suggest organizational support through installing work‐out areas in the workplace with release time and organized activity might enhance nursing staff's capacity to engage in leisure‐time physical activity. [ABSTRACT FROM AUTHOR]

Although individual factors play a vital role in determining professional autonomy, their specific impact during the coronavirus disease 2019 (COVID-19) pandemic has not been studied. This study aimed to compare nurses' professional autonomy when caring for patients with COVID-19 and for other patients and explore factors related to autonomy when caring for these patients. A paper-based questionnaire survey was conducted from June to August 2022 among nurses working at a university hospital in Japan. The survey included demographic factors (10 items, including, age, section, years of nursing experience, position, educational background, ladder level, and having certified nurse specialists or certified nurse qualifications) and individual experience factors (4 items: number of COVID-19 patients experienced, frequency and contents of searching for the latest information about COVID-19, frequency of using scientific sources, and frequency of training/study sessions on COVID-19 attended at the hospital). Additionally, basic knowledge of COVID-19 was evaluated. The scale for nurses' professional autonomy was developed based on a previous study. A paired t-test and stepwise multiple linear regression were used for the analyses. Overall, 241 nurses participated in the survey. The average length of nursing experience was 10.3 ± 9.2 years. The total scores for nurses' professional autonomy in all 5 factors 27 items were significantly lower (t = −12.1, p < 0.001) when caring for COVID-19 patients than when caring for other patients. Specifically, Factor 1 (Cognition) exhibited the most decreased scores when caring for COVID-19 patients than when caring for other patients. Factor 4 (Abstract judgment) differed the least between caring for COVID-19 and for other patients, but the average score was the lowest. More years of nursing experience (β = 0.208, p = 0.001) and a higher number of patients with COVID-19 cared for (β = 0.140, p = 0.026) were associated with higher autonomy scores. In conclusion, to enhance professional autonomy during an unprecedented pandemic, nurses must enhance cognition and abstract judgment. In the event of a future pandemic, nurses need to create an environment in which they routinely access and utilize the latest information and scientific evidence to provide high-quality nursing care based on their professional judgment and competence. [ABSTRACT FROM AUTHOR]

In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as 'good' or 'excellent'; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Family‐involved interventions can result in better outcomes than traditional mental health care for both service users and their families.Nurses' attitudes towards family involvement can affect family participation in care.Earlier studies on psychiatric nurses' attitudes towards family involvement in care report ambiguous findings. Hong Kong's unique integrated cultures may influence Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care. What the paper adds to existing knowledge?: The majority of psychiatric nurses had positive views on family involvement in care in Hong Kong.Four variables (i.e. gender, clinical experience, nature of working unit and family nursing training) of psychiatric nurses are associated with their attitudes towards family involvement in care in Hong Kong. What are the implications for practice?: Policy makers should develop strategies to increase psychiatric nurses' awareness of the importance of family involvement in patient care.Nurse educators help to design family nursing training to enhance psychiatric nurses' competence in collaborating with families of people suffering from mental disorders. Introduction: In Hong Kong, involving the family in nursing care is still optional and mainly depends on nurses' attitudes and the willingness of the family. Hong Kong psychiatric nurses' attitudes towards family involvement in nursing care may be influenced by the unique integrated Eastern and Western cultures, however earlier studies report ambiguous findings. Aims: This study aimed to assess Hong Kong psychiatric registered nurses' attitudes towards family involvement in care and its associated factors. Methods: This study is a cross‐sectional descriptive online survey with convenience sampling based on the Families' Importance in Nursing Care‐Nurses' Attitudes (FINC‐NA) instrument. Results: Most of the psychiatric nurses had supportive attitudes towards family involvement in care. Females with more clinical experience, working in a rehabilitation‐related unit and having attended a family nursing education course were associated with positive attitudes towards family involvement in care. Discussion: The supportive attitude of psychiatric nurses may be explained by the shift of mental health nursing care from hospital care to community care in recent decades. Implications for practice: Mental health nurse education and training in Hong Kong could place more emphasis on building family work skills, particularly for newly qualified nurses and those working in acute inpatient settings. [ABSTRACT FROM AUTHOR]

Context: Sport specialization among youth athletes has been associated with increased risk of overuse injuries . Previous research demonstrates that children perceive specialization to be beneficial in making their high school team and receiving athletic college scholarships. Previous research demonstrates that parents play a significant role in their child's sport experience. However, it is unknown if parents and children answer questions related to specialization factors in a similar manner . Objective: To evaluate the beliefs of youth athletes and parents on factors related to sport specialization and evaluate the level of agreement between dyads on sports specialization . Design: Cross-sectional . Setting. Online and paper surveys . Patients or Other Participants : Aim 1 : 1998 participants (993 children and 1005 parents ). Aim 2 : 77 paired parent-child dyads . Interventions : Sel f-administered survey . Main Outcome Measures : The responses were summarized via frequency and proportions (%). Chi - squares were calculated between parent and child responses. Kappa coefficients were calculated for dyads to determine level of agreement. Sport specialization was classified using a common 3-point scale. Results: The parents were more concerned about risk of injury in sports compared with children (P < .001, X2 = 231.4; parent: extremely: 7.1%; child: extremely: 3.7%). However, children were more likely to believe that specialization was associated with their chances of obtaining an athletic college scholarship compared with parents (P < .001, %2 = 201.6; parent: very/extremely likely: 13.7%; child: very/extremely likely: 15.8%). Dyad subanalysis indicated a moderate level of agreement for "quitting other sports to focus on one sport" (E= .50) and a low level of agreement for " identifying a primary sport " (x =. 30) and "training >8 months per year in primary sport" (K =. 32 ). Conclusions : Parents and youth athletes had differing beliefs on the factors related to sport specialization. Dyad analysis shows that parents and children answer sport specialization classification questions differently. Health care providers should be aware of these differences, and messaging should be individualized to the audience. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health care workers face a wide range of chemical, physical, and biological occupational hazards in their jobs. OBJECTIVE: The present study aimed to investigate research trends on post-exposure prophylaxis (PEP) against blood-borne viral infections among health care workers. METHOD: Keywords related to health care workers, PEP, and blood-borne viruses were entered in the Scopus database for the period from 1950 to 27 January 2022. RESULTS: The search query returned 271 papers. The earliest publication was in 1984. The ranked first (n = 8, 3.0%), followed by the and with 6 (2.2%) papers for each. One hundred ninety-one journals took part in publishing the retrieved papers. Authors from 63 different countries took part in publishing the retrieved papers. The United States (US) ranked first (n = 53, 19.6%) followed by India (n = 26, 9.6%). The United States Centers for Disease Control and Prevention contributed the most (n = 9, 3.3%) and ranked first in the top active institutions. The mean number of authors per paper was 4.4 and the mean number of citations per paper was 17.0. The most frequent author keywords focused on PEP, health care workers, occupational exposure, HIV, hepatitis B, anti-retroviral and needle-stick injuries. Research themes in the retrieved papers focused on knowledge/attitude/practice and management and epidemiology of occupational exposure and PEP. There was a limited number of research publications in this field. CONCLUSION: Research activity in this field needs to be strengthened in low- and middle-income countries through reporting and training of HCWs. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of minor and serious cyberloafing behaviours among nurses and examine the impact of the nursing stressors on nurses' cyberloafing behaviours. Background: Cyberloafing could have a negative influence on employees' job performance, but it also has been argued that it could serve as a coping mechanism to deal with stressful work environments. Design: A cross‐sectional descriptive, correlational design. Methods: Data were collected between September and December 2020 from a convenience sample of staff nurses (N = 291) providing care at a tertiary hospital in Saudi Arabia. Sample characteristics, nursing stressors and cyberloafing behaviours information were collected using self‐reported questionnaires. Descriptive, bivariate and multivariate analyses were performed. Findings Nurses in Saudi Arabia exhibited low levels of minor and serious cyberloafing behaviours. However, they engaged more frequently in minor cyberloafing behaviours more than serious cyberloafing behaviours. Stressors and Internet usage frequency influenced the frequency of minor and serious cyberloafing behaviours. Level of education and nationality impacted serious cyberloafing behaviours only. Conclusion: Nursing stressors were associated with cyberloafing behaviours. Other studies on cyberloafing and job stress yielded inconsistent results. Efforts should be taken to avoid the adverse effects of cyberloafing by establishing a clear policy on using the advanced technology for non‐work purposes. Summary statement: What is already known about this topic? Job characteristics and stress have been linked to increased cyberloafing behaviours among employees.Cyberloafing can serve as a coping mechanism to deal with stressful work environment.No studies have been conducted to describe the association between nursing stressors and cyberloafing behaviours. What this paper adds? Nurses in Saudi Arabia exhibited low levels of cyberloafing behaviours.The frequency of minor and serious cyberloafing behaviours among nurses is influenced by their stress and Internet usage frequency.Nurses' level of education and nationality impacted serious cyberloafing behaviours only. The implications of this paper Efforts should be taken to minimize the impact of nursing stressors by creating a healthy work environment and promoting nursing practice.Establishing a clear policy regarding using the Internet and advanced technology for non‐work purposes is essential to avoid the adverse effects of cyberloafing.Providing education for nurses on cyberloafing associated risks might reduce the amount of cyberloafing during working hours. [ABSTRACT FROM AUTHOR]

Aim: To explore the validity and reliability of the Missed Nursing Care Survey after translating it into the Arabic language. Methods: We employed a cross‐sectional design. We recruited 260 Jordanian nurses, and data were collected between May and July 2020. Translation, acceptability, construct, convergent, discriminant validity and reliability were investigated. Results: The factor analysis showed an adequate fit (three subscales) between the proposed missing care survey model and the observed data. This model reflected the survey's construct, convergent and discriminant validity, explaining 58.88% of the variance collectively. Confirmatory factor analyses showed adequate goodness‐of‐fit results (goodness of fit index = 0.91, comparative fit index = 0.94, increment fit index = 0.94, Tucker Lewis index = 0.92 and root mean square error of approximation = 0.06). The total Cronbach alpha and composite reliability achieved the criterion for all constructs in this survey. Conclusion: This Arabic version of the Missed Nursing Care Survey achieved the required level of validity and reliability. Measuring missed care and its reasons may help to improve quality of health services and assist nurse managers in designing appropriate interventions to reduce it. Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety. Summary statement: What is already known about this topic? The Missed Nursing Care Survey was designed to identify reasons for missed nursing care.The Missed Nursing Care Survey has been shown to be a reliable and valid measure among various populations and different languages. What this paper adds? The Arabic version of the Missed Nursing Care Survey was shown to be a valid and reliable tool.Measuring the quality and procedures of nursing care in the Arabic region will aid in understanding the differences between countries. The implications of this paper: Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety.Measuring missed care and its reasons may help to improve the quality of health services and assist nurse managers in designing appropriate interventions to reduce it. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate the prevalence and associated factors for compassion fatigue among nurses in Fangcang Shelter Hospitals in Wuhan. Studies have shown that compassion fatigue was more common among nurses than other health‐care providers, and its predictors were also different. In recent years, most studies have investigated compassion fatigue in emergency and oncology nurses, whereas there is little information on compassion fatigue among nurses from the frontline of Fangcang Shelter Hospitals during the COVID‐19 pandemic. Methods: A descriptive, cross‐sectional design was used in this study. An online survey was conducted among nurses (n = 972) of five Fangcang Shelter Hospitals in Wuhan, Hubei province, China, from 6 March to 10 March 2020. A self‐administered questionnaire including demographic information, work‐related information, General Health Questionnaire, Perceived Stress Scale and Compassion Fatigue Scale was used. Results: The prevalence of compassion fatigue among nurses in Fangcang Shelter Hospitals was moderate, and most cases were mild. There was a significant relationship between compassion fatigue and work‐related factors, mental health and perceived stress among nurses working in Fangcang Shelter Hospitals. Conclusions: Various factors contribute to compassion fatigue, including lower job satisfaction and job adaptability, less praise from patients, more fear of infection and more perceived stress. A good working atmosphere, organizational support and psychological consultation are essential to alleviate nurses' compassion fatigue during the anti‐epidemic period. Summary statement: What is already known about this topic? Nurses are particularly vulnerable to compassion fatigue among health‐care providers, and it causes billions of dollars in productivity losses to economies in different countries every year.Personal factors (professional cognition, health condition, gender etc.), working environment (working hours, working load, working system problems, professional roles etc.), mental health and stress may affect nurses' compassion fatigue. What this paper adds? Both extrinsic and intrinsic factors played a crucial role in nurses in Fangcang Shelter Hospitals who are exposed to adverse events, leading to compassion fatigue. The implications of this paper: This paper reveals a new perspective on the factors influencing compassion fatigue of nurses working in Fangcang Shelter Hospitals.We suggest that compassion fatigue among nurses in Fangcang Shelter Hospitals could be reduced by maintaining a good working atmosphere, providing organizational support, helping nurses keep a healthy mental state and reducing stress levels. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey. Methods: This descriptive and cross‐sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey‐Turkish and the MISSCARE Survey‐Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data. Results: The total occurrence of missed nursing care was 2.93 (on a scale of 1.00–4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient–nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care. Conclusions: The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient–nurse ratio and nursing teamwork to reduce the incidence of missed nursing care. Summary statement: What is already known about this topic? Missed nursing care is a globally common patient safety issue that threatens quality nursing care.Although there are many studies from different countries in the international literature on missed nursing care, studies on this subject in Turkey have been limited. What this paper adds? Missed nursing care correlated with age, tenure in hospital, tenure in unit, weekly work hours, satisfied in current position, satisfaction with being a nurse, satisfaction with salary, technological, educational and career opportunities of the hospital, satisfaction with the level of teamwork in the unit, and satisfaction with support of first‐line nurse manager.Nurses' tenure in the profession, patient–nurse ratios, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. The implications of this paper: Strategies to improve nurses' work environment characteristics, especially teamwork, should be organized to prevent or reduce missed nursing care.Hospital administrators and nurse managers should address levels of missed nursing care through balancing patient–nurse ratios, providing adequate human and material resources, increasing technological, educational, and career opportunities of hospitals, meeting nurses' needs and providing support and performing activities to reduce absenteeism. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to translate the Stoma‐quality of life into Chinese and evaluate its psychometric properties in Chinese patients. Background: Quality of life is an important issue for patients with colostomy, and its appropriate and precise measurement is beneficial to promoting better care. The Stoma‐quality of life questionnaire has been widely used; however, the validity and reliability of its Chinese version has not been determined. Design A cross‐sectional validation study was conducted. Methods: We translated the Stoma‐quality of life into Chinese using standardized methods. Then it was psychometrically tested on a convenience sample of 513 patients with colostomy. Construct validity was evaluated via exploratory factor analysis and confirmatory factor analysis. Reliability was measured with Cronbach's alpha and the split‐half Spearman–Brown coefficient. Results: The content validity, the Cronbach's α coefficient and the Spearman–Brown split‐half reliability coefficient indicated adequate validity and reliability. The exploratory factor analysis yielded four common factors, and the cumulative variance contribution rate was 67.5%. Moreover, the confirmatory factor analysis showed a good model fit. Conclusion: This study confirmed that the Chinese version of Stoma‐quality of life is an effective and reliable measurement for evaluating the quality of life of patients with colostomy. Summary statement: What is already known about this topic? Quality of life (QOL) is an important issue for patients with colostomy, and it is conducive to evaluate the effect of specific treatment and nursing interventions. However, a tailored instrument measuring QOL in Chinese patients with colostomy is lacking.The Stoma‐QOL is a widely used stoma‐specific instrument based on Hunt and McKennal's basic QOL demand model and has shown acceptable psychometric properties. What this paper adds? This study provides evidence of the construct validity and internal consistency reliability of the Stoma‐QOL‐C.The four‐factor structure of the scale shows the aspects and complexity of QOL of patients with colostomy.The study proves the Stoma‐QOL‐C a valid and reliable measure of assessing QOL of patients with colostomy. The implication of this paper: The Stoma‐QOL‐C could be used as a disease‐specific scale to evaluate the QOL of patients with colostomy.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

To evaluate the reliability, internal consistency, and construct validity of the Swedish versions of PROMIS-29 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) instruments in patients with systemic sclerosis (SSc). In a cross-sectional study, consecutive SSc patients completed a paper-based survey. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was tested employing weighted Kappa (Kw) and intra-class correlation coefficient (ICC). Construct validity was evaluated by hypotheses testing using RAND-36, MRC Dyspnea score, Scleroderma Health Assessment Questionnaire (SHAQ) and clinical measurements. Forty-nine patients (86% female; 73% limited cutaneous SSc) completed the survey. The mean disease duration was 11 years and mean SHAQ was 0.5. Internal consistency and test–retest reliability were good with the exception of PROMIS-29 anxiety. PROMIS-29, FACIT-Dyspnea, and Functional limitation showed strong correlations to corresponding RAND-36 domains (|rs|=0.67 to −0.85). Relevant PROMIS-29 domains, FACIT-Dyspnea and Functional limitation correlated strongly to SHAQ and VAS overall disease severity (|rs|=0.60 to −0.75). Ceiling effects (>15%) were found in six PROMIS-29 domains and in both FACIT-Dyspnea and Functional limitations. Four (4/5) hypotheses were confirmed. PROMIS-29 and FACIT-Dyspnea meet the requirements for reliability and have adequate construct validity in Swedish patients with SSc. PROMIS-29v2 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) Index are patient outcome measures that gain increasing interest for the evaluation of patient with rheumatologic diseases. PROMIS-29v2 and FACIT-Dyspnea Index meet the requirements for reliability and have adequate construct validity compared to legacy measures in Swedish patients with systemic sclerosis. Translation and validation of PROMs is important for studies of rare diseases in multi-center collaborations. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was a clinical validation of the NANDA‐I nursing diagnosis "Impaired Resilience (00210)" in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics. Methods: A cross‐sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility‐related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee. Findings: The "Impaired Resilience (00210)" had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are "decreased interest in vocational activities," "depression," "impaired health status," "ineffective coping strategies," "low self‐esteem," "renewed elevation of distress," and "social isolation." No item showed differential item functioning. "Renewed elevation of distress" and "low self‐esteem" were the most sensitive defining characteristics and had the highest negative predictive value. "Shame" was the most specific one. Conclusions: The nursing diagnosis "Impaired Resilience (00210)" was validated, and results may improve its accuracy in people going through fertility treatment. Implications for nursing practice: This paper contributes by raising knowledge regarding NANDA‐I nursing diagnosis and enhancing the quality of nurses' critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field. [ABSTRACT FROM AUTHOR]

Introduction: This paper provides a summary of findings on the public's knowledge and attitudes towards dementia. We aim to investigate if the attitudes of Singaporeans towards dementia have changed over the years by adopting a questionnaire used in a similar study in 2012. Methods: A cross-sectional, descriptive study was conducted through the dissemination of an existing, online questionnaire to participants above 16 years of age. Out of 1,500 subjects, results from 1,373 participants were analysed. Descriptive statistics were used to analyse and compare results from the 2012 study while a latent class analysis was performed to understand the categories of study participants based on varying levels of attitudes, knowledge and stigma. Results: The mean age of study participants was 43.8 (SD = 15.7). Majority of the participants were females (76.5%), between 51 and 60 years of age (29.6%) and belonged to the Chinese ethnic group (77.8%). Results demonstrated that there were significant differences in attitudes towards dementia between 2012 and 2021. There was a 70.2% improvement in stigma-associated attitudes and an increase in correct responses to 4 out of 5 questions in the knowledge section. Conclusion: Findings of this study suggest that the general public has a better knowledge and more positive attitude towards dementia. This could have been attributed to higher literacy levels of the current study population and effectiveness of established outreach initiatives in Singapore. However, further research with a more balanced representation of ethnic and cultural groups would offer more comprehensive insights into dementia health literacy. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recurrence is common in patients diagnosed with major depressive disorder (MDD). Psychological resilience has been shown to be a protective factor against recurrence of depression. It has important clinical nursing significance to analyse the influencing factors of psychological resilience in major depressive disorder in remission (MDDR) patients. What the paper adds to existing knowledge?: There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with MDDR. We found the education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience in patients diagnosed with MDDR. What are the implications for practice?: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. Nurses should strengthen the nursing of patients with <12 years of education, and patients with personal monthly income less than 5000 RMB. In addition, nurses should cultivate patients' awareness of social support and identity, cultivate their ability to strive for social support, cultivate interpersonal skills and positive emotional experience to improve subjective well‐being and carry out self‐efficacy training to improve psychological resilience by enhancing patients' internal protective factors. Aim: Psychological resilience is closely related to recurrence of depression. There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with major depressive disorder in remission (MDDR). Here, we investigated the current status of resilience in patients diagnosed with MDDR and its influencing factors. Methods: A descriptive cross‐sectional study was conducted from June 2019 to April 2021. One hundred and forty‐two patients diagnosed with MDDR were recruited from the Department of Psychiatry and Psychology of the General Hospital of Northern Theater Command. Demographic information, social support, well‐being, self‐efficacy and psychological resilience were collected using self‐reported questionnaires. Results: The psychological resilience of MDDR patients was lower than that of the healthy Chinese adults in China. Multiple logistic regression analysis showed that education, personal monthly income, social support, well‐being and self‐efficacy were associated with psychological resilience. Receiver operating characteristic (ROC) curve analysis further confirmed that social support, well‐being and self‐efficacy were associated with psychological resilience. Conclusion: The psychological resilience of MDDR patients was lower than that of the general population in China. The education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience. Implications for Practice: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. [ABSTRACT FROM AUTHOR]

Background: Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi. Methods: The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.9%). The study used a paper version questionnaire to collect the data. The data were analysed using both descriptive and inferential statistics in the Statistical Product and Service Solutions version 23. Descriptive statistics were calculated to summarise overall knowledge levels, attitudes, and use of nurse-midwives as percentages based on their scores on the assessment scale (1 to 7 Likert scale) in the EBP questionnaire. Non-parametric Mann-Whitney and Kruskal-Wallis tests were carried out to compare evidence-based practice scores based on demographics. Pearson's correlation (r) and stepwise regression analysis were further performed to analyse the relationship between the knowledge, attitude and use of nurse-midwives on the overall EBP of nurse-midwives. Results: The average scores (mean±SD) of evidence-based practice amongst nurse-midwives were 78.7 ± 19.6 for attitude, 70.6 ± 15.1 for knowledge levels, 57.8 ± 23 for use, and 68.9 ± 14.2 for the overall EBP. Higher educational qualification was associated with higher scores in knowledge levels (P = 0.02). Research experience was associated with higher scores in nursing use (P = 0.005), and higher overall evidence-based practice were associated with both research experience (P = 0.035) and educational qualification (P = 0.004). Nurse-midwives attitude was affected by clinical experience (P = 0.006) and the hospital where nurse-midwives worked (P = 0.016). There was no significant difference in the EBP scores of nurse-midwives based on gender and/or their administrative roles in their respective central hospitals. Conclusion: It is important to develop the knowledge or skills of nurse midwives in order to enhance evidence-based practice amongst nurse-midwives in Malawian hospitals. The results can be used by nurse managers, nurse educators, policy makers at the Ministry of Health and Nurses and Midwives Council of Malawi to enhance implementation of EBP. [ABSTRACT FROM AUTHOR]

Background: Multiple chronic conditions (MCCs) are highly prevalent in primary care. Coping is an important psychological factor that influences patients' ability to adapt physically and mentally to MCCs. Testing a reliable and valid psychometric inventory is necessary to identify coping strategies before developing coping‐oriented interventions. Purpose The purpose of this study is to examine the psychometric properties of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) inventory in patients with MCCs. Method: This study adopted a cross‐sectional design. A convenience sample of 290 Chinese patients with MCCs was recruited from a tertiary hospital in East China. The Brief COPE‐CN, sociodemographic characteristics and clinical data were collected using a self‐reported questionnaire from November 2017 to May 2018. Factor analysis and reliability analysis were performed. Results: The mean age of the participants was 58.5 years (range from 23 to 95 years), and approximately half of the participants were female (49.3%). Most participants had two chronic conditions (82.1%) and reported having had MCCs for more than 2 years. The explanatory factor analysis (EFA) identified five factors in the Brief COPE‐CN that explained 58.4% of the total variance. The Cronbach's α coefficients ranged from.65 to.85 for the five subscales. Conclusions: The psychometric properties of the Brief COPE‐CN were acceptable for use with Chinese patients with MCCs. With further evaluation, this instrument may help health‐care professionals understand patients' coping and develop coping‐based interventions to promote coping in this population. Summary statement: What is already known about this topic? There is a growing predominance of chronic diseases in China, with many Chinese patients living with multiple chronic conditions (MCCs) that can adversely impact physical and psychological health.Coping‐oriented interventions that address and enhance patients' coping strategies are beneficial in terms of improving their health.There is no valid and reliable Chinese tool to measure coping strategies among patients with MCCs. What this paper adds? This study reports a five‐factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced (Brief COPE‐CN) established by explanatory factor analysis.The five‐factor structure of the Brief COPE‐CN has good internal consistency. The implications of this paper: The five‐factor Brief COPE‐CN has the potential to measure coping strategies effectively in Chinese patients with MCCs.With further evaluation, this instrument may be a useful tool for developing specific interventions to promote coping in Chinese patients with MCCs. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to evaluate whether stress communication and supportive dyadic coping moderate the effects of occupational stress on dyadic adjustment and the quality of work‐life of nurses. Background: Nurses are at higher risk for occupational stress, work–family conflict, and the challenge of balancing job and family roles. However, in recent studies, the impact of dyadic coping strategies in dealing with work–family stress in those couples has not received adequate attention. Design This study was a cross‐sectional study. Methods: The research sample comprised 591 nurses recruited through announcements in hospitals and health centres in Iran between May 2018 and February 2019. They completed the Expanded Nursing Stress Scale, the Dyadic Coping Inventory, the Dyadic Adjustment Scale, and the Quality of Nursing Work Life questionnaire. Hierarchical regression was utilized. Results: Results indicated that there was a negative relationship between occupational stress and dyadic adjustment, and quality of work‐life. Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment as well as the quality of work‐life. Conclusion: The current findings suggest that the nurses who use dyadic coping strategies to deal with occupational stress report a higher level of adjustment and quality of work‐life. Summary statement: What is already known about this topic? Nurses face much stress in their workplace.Occupational stress can negatively affect the quality of work‐life and marital adjustment of nurses.Coping strategies can reduce the negative effects of occupational stress on couples' life. What this paper adds? Negative associations between occupational stress and dyadic adjustment, and quality of work‐life were found.Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment.Stress communication and supportive dyadic coping moderated the association between occupational stress and the quality of work‐life. The implications of this paper: The results of the current study suggest the importance of adding teaching dyadic coping skills to the nursing curricula.This finding is relevant for clinical experts to consider training coping skills as a beneficial way to experience higher dyadic adjustment.Efforts towards increasing dyadic coping in nurses may influence the effects of work–family stress on dyadic adjustment. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics. Methods: A descriptive study was conducted using a self‐designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018. Results: The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant. Conclusion: Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals. Summary Statement: What is already known about this topic? Nurses are susceptible to developing compassion fatigue (CF) due to multiple challenges and harsh environments in practice.Although previous studies have highlighted that haemodialysis nurses across the globe face issues with the work environment, stress and burnout, there are few reports of CF among haemodialysis nurses.At present, many countries have both publicly and privately funded hospitals, and it is not known whether the CF of haemodialysis nurses differs by hospital type. What this paper adds? Haemodialysis nurses have high levels of CF, and haemodialysis nurses in public hospitals have higher CF and lower job satisfaction than those in private hospitals.The main factors associated with CF among haemodialysis nurses in public hospitals were years worked, type of employment, and intrinsic and extrinsic satisfaction.The main factors associated with CF in haemodialysis nurses in private hospitals were education level, years worked, and intrinsic and extrinsic satisfaction. The implications of this paper: There is a need to raise awareness among both nurses and nursing management staff of haemodialysis units regarding the existence of CF among haemodialysis nurses, especially in public hospitals.Different targeted interventions or solutions should be considered according to various factors associated with CF in different types of hospitals (public and private). [ABSTRACT FROM AUTHOR]

People who hear voices that others do not often rely on mainstream mental health services. Several alternatives to treatment have grown in popularity including "Hearing Voices Groups" and other self-help groups for voice hearers. The aim of this systematic review is to evaluate the current evidence relating to the use of Hearing Voices Groups (HVGs) and other self-help groups for voice hearers, and identify the benefits felt by those attending such groups. The following databases were searched for relevant academic articles: CINAHL; APA PsycArticles; APA PsycInfo; Social Sciences; SocINDEX; UK & Ireland Reference Centre and Medline, with 13 papers identified for inclusion. Participants reported several benefits of attending a HVG/self-help group, which reduced isolation, improved social and coping skills, and gave them a better understanding of the meaning and context of their voices. The groups also provide hope for the future and act as a catalyst for recovery. These study findings suggest that voice hearers find some benefits from attending HVGs/self-help groups. Evidence indicates that voice hearers can live meaningful lives and continue to hear voices once context and meaning to their voices become clear. HVGs/self-help groups provide a vital service to voice hearers, which they felt was not available within mainstream mental health services. If mental health providers gained a better understanding of the HVN, they may be able to integrate the values and ethos of the HVN into groups for voice hearers within mainstream mental health services or signpost voice hearers to these groups. [ABSTRACT FROM AUTHOR]

Introduction: Population health initiatives rely on the availability and skills of an appropriate workforce to meet required goals. One global workforce initiative with demonstrated ability to expand health care services and improve access to care is the development of Advanced Nursing Practice and Advanced Practice Nursing roles. Given the sparse published information about these roles in Low and Lower‐Middle‐Income countries, this study seeks to describe their development and application in these countries. Design: The researchers developed a descriptive cross‐sectional multilingual survey for online distribution to nursing experts within the targeted countries. Survey questions addressed demographic information on the population served, Advanced Nursing Practice and Advanced Practice Nursing titles, the time frame and rationale for creating the title, and how the roles relate to the International Council of Nurses' Advanced Practice Nursing guidelines characteristics of education, practice, and regulation. Results: Of the 167 responses received, only 24 participants met the inclusion criteria. This represented five low‐income countries and nineteen lower‐middle‐income countries from four World Bank regions. Seventy‐one roles were identified. Roles emerged predominantly over the last 20 years, focusing on care for underserved populations, with an almost even spread across primary and acute care settings. There were differences in education, practice, and regulation amongst the roles. Roles that required a master's education or higher with practice‐related characteristics had a broader scope of practice, which is consistent with international guidelines. Conclusion: This paper describes how Advanced Nursing Practice and Advanced Practice Nursing roles from Low and Lower Middle‐Income Countries have been implemented to address gaps in service and highlights disparities in education, practice and regulation compared to international guidelines. Maintaining and increasing support from organizations and universities internationally may be required to assist in developing and expanding educational programs for advanced nursing roles in these countries. Clinical Relevance: Understanding how these advanced nursing roles are operationalized in relation to education, practice, and regulation in Low and Lower‐Middle‐Income countries can provide baseline information that will inform workforce development policies to address healthcare needs in similar jurisdictions. [ABSTRACT FROM AUTHOR]

Objective: Study 5, from a series of six, examines the influence of attendance rates and personal attendance preferences on the effectiveness of Reflective Practice Groups (RPGs). It also explores participant perceptions regarding benefits and barriers of RPG. This article presents the current study in context of associated research and attempts to synthesise the collective findings. Background: Nursing can be associated with burnout, secondary traumatic stress (STS) and compassion fatigue. RPGs might help mitigate these negative impacts. Study Design/Methods: This cross-sectional study surveyed a cohort of 190 nurses (88% female) using validated scales to assess professional quality of life (ProQOL), job satisfaction (JS) and psychological distress, alongside perceived effectiveness of RPG, attendance rates and preferences. Open-ended questions explored perceived barriers and benefits to attendance. Results: Nurses who attended less RPGs reported higher STS. Those who preferred to go more frequently also reported higher STS however level of attendance and personal preference did not affect each other. Nurses attending 'as often as groups are run' also rated the effectiveness of RPG more highly. Other outcome measures were not significant for either variable. Perceived benefits of RPG included sharing, support, cohesiveness, skills development and facilitatory alliance. Barriers included workloads, rostering, time constraints and discomfort in a group setting. Discussion: The majority of nurses reported higher STS, preferred to attend RPGs more frequently, and rated them as more effective. Nurses who attended more RPGs reported significantly lower STS, indicating a restorative benefit. The lack of significance for Compassion Satisfaction (CS) ratings contrasted with findings of earlier studies. Logistical issues and discomfort in groups were barriers to RPG attendance. Perceived benefits related to personal and workgroup development. Alongside findings from the overarching project, results indicate a positive correlation between effective RPGs, personal and job resources, and aspects of ProQOL. Conclusion: Nurses with higher STS find RPGs more useful and want to attend more often. Higher RPG attendance is associated with lower STS. Voluntary attendance, facilitatory alliance, promotion of psychological safety, and organisational support are key considerations. In context of the overarching project, RPG attendance has been positively correlated with various aspects of ProQOL, personal and job resources. Cause and effect are still not clear and further research is required. What is already known about the topic? * RPGs are positively correlated with personal and job resources and CS. * Barriers to reflecting in RPGs include workplace logistical issues. What this paper adds: * Greater RPG attendance is associated with lower STS. * Nurses with higher STS prefer to attend more often and find RPGs more useful. * Discomfort in a group setting is an important consideration and should be addressed through effective facilitation and management of group process to promote psychological safety. * RPGs have now been positively associated with a greater number of personal resources, job resources and aspects ProQOL. [ABSTRACT FROM AUTHOR]

Background: Mental capacity legislation in the UK is designed to safeguard the rights of people who may need support, or may be unable, to make autonomous decisions. Very limited evidence has been published about the impact of the COVID‐19 pandemic on the application of mental capacity legislation and, to our knowledge, none on the ability of speech and language therapists (SLTs) to support people with communication disabilities to engage in decision‐making. Aims: To describe how UK SLTs supported people with communication disabilities to make decisions and participate in mental capacity assessments, best interests decision‐making and advance care planning during the COVID‐19 pandemic. Methods & Procedures: This descriptive, cross‐sectional study used an online survey to collect quantitative and qualitative data about SLTs' practice experiences between August and November 2020. SLTs working with a range of adult clinical populations in different care settings were sampled purposively from all UK jurisdictions. Participants were recruited through professional networks and social media. Quantitative data were summarized using descriptive statistics. Qualitative data were analysed thematically. Outcomes & Results: Data were collected from 107 SLTs working in a range of settings across all four UK nations. The sample included SLTs working with people with neurological conditions, learning disabilities, mental health conditions and acute confusion. The need for SLT support appeared to increase during the pandemic. Most respondents were still able to offer support; however, the amount and nature of support varied. Quality of support was impacted by adjustments associated with social distancing and infection control restrictions. Personal protective equipment (PPE) was identified as a barrier to communication. Indirect working methods (e.g., telehealth) were inaccessible to some people with communication disabilities. Most respondents felt confident that legal requirements were upheld, but suggested this group was less able to engage in decision‐making and had reduced access to support to manage their own health conditions. Conclusions & Implications: Some SLT services were limited in their ability to meet the decision‐making support needs of people with communication disabilities during the COVID‐19 pandemic due to structural and systemic barriers. This suggests that existing inequities in the provision of care for people with communication disabilities in the UK were amplified during the pandemic. What this paper adds: What is already known on the subject: People with communication disabilities may require support from healthcare professionals, including SLTs, to make decisions and communicate their wishes and preferences about their care, in line with mental capacity legislation. There is a lack of published evidence relating to how changes in staff deployment and resource during the COVID‐19 pandemic may have impacted on the ability of SLTs to provide this support. What this paper adds to existing knowledge: This study provides novel evidence about the ways in which UK SLTs supported people with communication disabilities to engage in mental capacity assessments, best interests decision‐making and advance care planning during the COVID‐19 pandemic. In some cases, the amount and quality of decision‐making support available was affected negatively due to changes in healthcare delivery and resource management and SLT working practices. What are the potential or actual clinical implications of this work?: This study suggests that some people with communication disabilities experienced greater barriers to receiving professional support to maximize their autonomy and manage their health conditions during the COVID‐19 pandemic. Speech and language therapy services and healthcare commissioners should consider how best to ensure equitable service delivery to this population in resource‐limited situations. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test the validity and reliability of a four‐item patient health questionnaire as a psychological distress screening tool for patients with type 2 diabetes in Indonesia. Methods: This cross‐cultural adaptation study was applied in five public health‐care centres in Indonesia in August–October 2018 using a four‐item patient health questionnaire. The content, convergent and factorial validity were assessed, and Cronbach's alpha coefficient was the reliability indicator. Results: A total of 147 participants were involved. Content validity resulted in acceptable outcomes (item and scale content validity indexes were 0.95 and 0.75, respectively). Anxiety and depression were associated with total score and psychological distress status (P < 0.001), supporting the convergent validity outcomes. Principal component analysis using varimax rotation revealed two factors, explaining 76.14% of variance (P < 0.001). Cronbach's alpha coefficients for anxiety, depression and total score were 0.780, 0.500 and 0.713, respectively. Conclusions: The study demonstrated adequate validity and reliability for the Indonesian version of a four‐item patient health questionnaire among patients with type 2 diabetes. Therefore, it is applicable as a screening tool for psychological distress in this population. Summary statement: What is already known about this topic? Anxiety and depression are common forms of psychological distress among patients with type 2 diabetes.Early identification of potential problems in diabetes benefits patients for prevention and treatment.A four‐item patient health questionnaire (PHQ4) is a valid tool for screening psychological distress. What this paper adds? The paper presents a psychometric evaluation of PHQ4 to assess psychological distress among patients with type 2 diabetes.Incidence of anxiety, depression and psychological distress for patients with diabetes in Indonesia was identified. The implications of this paper: Diabetes nurse specialists or nurse managers could consider using the Indonesian version of PHQ4 in their units.The availability of this screening tool in Indonesia makes identification of psychological distress possible.Further research and education related to psychological distress among patients with diabetes may use the valid PHQ4. [ABSTRACT FROM AUTHOR]

Background: Many national studies have shown that nurses have a high turnover rate. The key to maintaining the stability of nursing staff is to explore the factors that affect their turnover intention; however, no research has been performed to explore the influencing factors and mechanisms of nurses' turnover intention based on the Theory of Planned Behaviour. Aim: Based on the Theory of Planned Behaviour, examining the relationships among resilience, job satisfaction, social support and turnover intention of nurses, a structural equation model was constructed to examine the mediating role of job satisfaction and social support between resilience and turnover intention. Methods: In this descriptive cross‐sectional study, a total of 350 questionnaires were distributed to participants from three tertiary hospitals in Changchun, Jilin Province, between December 2018 and March 2019. Results: The final model fits well. Job satisfaction and social support directly influences turnover intention. Resilience indirectly influences turnover intention through job satisfaction and social support. Conclusion: Turnover intention is a complex variable, which is directly and indirectly affected by many factors. In this study, a new structural equation model was proposed, which laid a foundation for future longitudinal studies. Summary statement: What is already known about this topic? Globally, the high rate of nurse turnover is one of the major reasons for the shortage of nurses.The turnover intention of nurses is influenced by many factors.Few studies have examined the influencing factors of turnover intention based on theory or constructed a structural equation model to clarify the mechanism. What does this paper contribute? The Theory of Planned Behaviour presents the key determinants of behaviour and can guide our understanding of the behavioural mechanism of the turnover intention of nurses.Three influencing factors of turnover intention based on the Theory of Planned Behaviour (resilience, job satisfaction and social support), directly or indirectly affected turnover intention. The implications of this paper: Future interventions should consider the indirect role of resilience. A positive effect of increased social support and job satisfaction on turnover intention occurs through improved resilience.Longitudinal studies with larger samples are needed in the future to verify the effectiveness of the mediating effect. [ABSTRACT FROM AUTHOR]

Background: Contemporary society has led to the increasing use of electronic equipment that is very much responsible for the burden of electronic waste (e-waste). E-waste contains very hazardous substance that harms health and environmental conditions. There is no delicate mechanism for the management of e-waste in Lucknow city, Uttar Pradesh. This study assessed knowledge, practice, and awareness of e-waste management among residents of this city. Material and methods: The study was conducted amongst users of electronic equipment living in the Lucknow City of Uttar Pradesh. The study was a cross-sectional descriptive study. Multi-stage random sampling was done for the selection of participants for the study. A predesigned and pretested questionnaire was administered in a single setting for all phases. The total optimum sample size is 700 individuals who participated in the study. Data were entered in MS Excel 2016 and descriptive statistics such as frequencies and percentages were calculated, applying the chi-square test for association using R-4.2.1 Statistical software. Aim and objectives: To assess the knowledge, attitude and practices regarding the management of electronic waste among users of electronic equipment residing in Lucknow city. Results: Only 37% of users are aware that e-waste adversely affects health. Only 34.3% of users knew that e-waste should be given to the seller or manufacturer for recycling while rest told that it should be stored at home, sold to a scrap dealer, or disposed with normal waste. 87.3% users are not aware about e-waste govt guidelines. In the current study electronic and print media like television, radio and news paper were not found to be source of information for e-waste disposal. Conclusion: Education regarding the ill effects of e-waste is essential for people and awareness of proper disposal of e-waste is the need of the hour. Electronic and print media as well as companies producing electronic equipment should play a significant role to awaken the respondent about the disposal of e-waste. [ABSTRACT FROM AUTHOR]

This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy. The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK). Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities. Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement. [ABSTRACT FROM AUTHOR]

We aim to study the the reliability and factorial structure of the Postpartum Bonding Questionnaire (PBQ)administered through two different formats, offline (paper-and-pencil) and online. We also compared clinical, obstetrical, reproductive, and psychopathological variables related to poor mother infant bonding (MIB). A cross-sectional study was conducted on 1,269 mothers. The offline group included 812 women who attended a 40-day postpartum clinical appointment. The online group consisted of 457 women recruited during admission for delivery who volunteered to carry out the online protocol 40 days postpartum. All the participants individually completed the PBQ, the Edinburg Postnatal Depression Scale (EPDS) and other clinical and sociodemographic variables. The 4-factor solution proposed in the PBQ and its Spanish validation showed good model fit for both samples. Online participants reported higher levels of stress, depressive symptoms, and poor bonding, specifically on PBQ scores and the Rejection and Anger subscales. No differences were found in both samples regarding the type of statistical associations between PBQ and sociodemographic, reproductive, obstetric and psychological outcomes. Online assessment may be an appropriate option for detecting possible alterations in MIB due to the reduction of desirability bias, the increased perception of anonymity, and being a more cost-effective method. [ABSTRACT FROM AUTHOR]

Background: Nurses are at a high risk of developing abnormal eating behaviour. However, few studies have attempted to identify the factors that influence such behaviour. Aim: This study identifies factors that can predict abnormal eating behaviour in hospital nurses. Design This study adopted a cross‐sectional, descriptive correlational research design. Methods: A literature review was used to establish a hypothetical model, comprising the eight factors of shift work, job stress, depression, sleep quality, fatigue, coping strategy (active coping and passive coping) and abnormal eating behaviour. A convenience sample of 298 nurses aged less than 45 was recruited from two university hospitals, and structured questionnaire was administered between March and April 2017. The hypothesized model was tested using structural equation modelling. Results: Sleep quality and passive coping directly affect abnormal eating behaviour, which implies that poor sleep quality and increased passive coping worsens the behaviour. Shift work and depression indirectly affect abnormal eating behaviours. Conclusion: Nursing managers and health policy makers should adopt strategies such as improving the shift‐work pattern, providing adequate rest time after a night shift and enabling coping strategies by providing educational programs for hospital nurses. Summary Statement: What is already known about this topic? The prevalence of abnormal eating behaviour, a form of eating disorder, has been continually rising in recent years.Nurses may be at high risk of developing abnormal eating behaviour due to their job characteristics.Few previous studies have attempted to identify the factors that influence abnormal eating behaviour among hospital nurses. What this paper adds? In this study, 8% of the participants demonstrated clinical‐level abnormal eating behaviour.Sleep quality and passive coping were the main factors influencing abnormal eating behaviours among hospital nurses.Shift work and depression show significant indirect effects on abnormal eating behaviour among hospital nurses. The implications of this paper: Study findings could inform development of strategies to minimize the impact of nurses' job‐related health risks by verifying the relationship between sleep quality, passive coping and abnormal eating behaviours.It is necessary to examine the various health problems shift work causes for nurses and conduct research to establish strategies that can support policies to improve them.Nursing managers should adopt strategies such as improving the shift‐work pattern, ensuring adequate rest time after a night shift and enabling the use of coping strategies by providing educational programs to hospital nurses. [ABSTRACT FROM AUTHOR]

Aim: The study aims to examine the psychometric properties of the Pittsburgh Sleep Quality Index‐Indonesian version. Background: The Pittsburgh Sleep Quality Index has never been translated into Bahasa. Design This study employs a cross‐sectional and correlational study. Methods: Data were collected from 528 adolescents of junior high school age (13–16 years) during August to September 2014. All participants agreed on the Indonesian version of Pittsburgh Sleep Quality Index and Beck Depression Inventory‐II. Psychometric properties were examined including internal consistency, construct validity and known group validity, and the receiver operating characteristic curve was used to measure the cut‐off point. Results: The Cronbach's alpha for the Pittsburgh Sleep Quality Index‐Indonesian version was adequate. There were positive correlations between the total score and seven component scores. Construct validity revealed that the total score of the Pittsburgh Sleep Quality Index‐Indonesian version was correlated with the total score of the Indonesian version of the Beck Depression Inventory‐II. Known group validity indicated that adolescents without depression risk had better sleep quality. According to receiver operating characteristic curve analysis, the cut‐off point at a score of 6.5 indicated the best possible relationship of sensitivity and specificity. Conclusion: The Pittsburgh Sleep Quality Index‐Indonesian version has high reliability and validity for screening sleep quality among adolescents. SUMMARY STATEMENT: What is already known about this topic? The original Pittsburgh Sleep Quality Index has adequate internal consistency and favourable reliability.It is easy for patients and health‐care providers to use for interpreting sleep disturbances. What this paper adds? The results support the validity and reliability of the Pittsburgh Sleep Quality Index‐Indonesia in screening sleep quality among adolescents.The cutoff score for the Pittsburgh Sleep Quality Index‐Indonesian version for adolescents was 6.5. The implications of this paper: The cut‐off point could detect poor sleep quality among Indonesian adolescents.This simple tool is capable of quickly assessing sleep quality for health‐care providers. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to characterize the type of support provided to victims of violence against women and domestic violence (VAWDV) during the first lockdown, assessing the training of professionals to use remote support (RS). Design/methodology/approach: This cross-sectional study involves a sample of 196 support professionals, mainly women (91.8%) and who integrate the Portuguese National Support Network for victims of domestic violence (NSNVDV) (Mean age = 36.49; SD = 10.52). Findings: Telephone emerges as the main RS communication media used in the lockdown (43.9%) and the emergency state periods (57.1%). Participants reported to have never used any social applications (41.8% vs 41.8%) or videoconference (46.4% vs 58.2%), in both periods assessed, i.e. lockdown and emergency state, respectively, and 82.7% assumed to have no training with RS to assist VAWDV victims. However, support professionals recognized several advantages in using RS such as dealing with isolation, reducing inhibition, fear and shame and in promoting the victims' empowerment. Research limitations/implications: Given the exploratory nature of this study, only descriptive analyzes were conducted. Originality/value: During the COVID-19 pandemic, little is known about effective RS given by professionals to victims of VAWDV in the Portuguese context. The paper aims to add knowledge to the studied field. [ABSTRACT FROM AUTHOR]

Context: The motivational climate created by the athletic trainer in rehabilitation may be critical in influencing athletes’ intrinsic motivation and other psychosocial outcomes in the rehabilitation and the recovery processes. Objective: To examine intercollege athletes’ perceptions of the motivational climate in the rehabilitation setting. Specifically, examining if perceptions of the motivational climate can predict athletes’ levels of intrinsic motivation with rehabilitation as well as the relationship between perceptions of the motivational climate and athlete demographics (gender, starter status, athletic trainer gender, etc). Design: Cross-sectional, descriptive research. Setting: College sport team and athletic training center. Participants: National Collegiate Athletic Association Division II intercollege athletes from one institution (n = 187; 125 males and 62 females). Main Outcome Measures: Paper-based survey measuring mastery and performance perceptions of the motivational climate in rehabilitation, athletes’ goal orientation in sport, and athletes’ levels of motivation in rehabilitation. Results: Perceptions of a performance climate were positively related to intrinsic motivation effort–improvement (effect size = 25.34%). Perceptions of a mastery climate were positively related to interest–enjoyment and perceived competence and negatively related to tension–pressure (effect size = 39.03%). In general, female athletes, as well as athletes with a female athletic trainer, had significantly higher perceptions of mastery motivational climate effort–improvement than male athletes and athletes with male athletic trainers. While male athletes and athletes with male athletic trainers had higher perceptions of intrateam member rivalry in rehabilitation. Conclusions: The athlete’s gender and goal orientation, as well as the gender of the athletic trainer creating the motivational climate, can influence whether the environment is perceived as more mastery or performance. The recovering athletes’ perceptions of the climate in rehabilitation can, in turn, affect their intrinsic motivation toward the therapeutic interventions. [ABSTRACT FROM AUTHOR]