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Background: While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. Aim: To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. Design: An observational longitudinal study. Methods: A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time‐invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. Results: Throughout the follow‐up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. Conclusions: Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. Relevance to Clinical Practice: Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. Patient or Public Contribution: The Guidance for Reporting Involvement of Patients and the Public‐Short Form reporting checklists were used to improve patient and public involvement. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. Design: A cross‐sectional survey. Methods: This descriptive cross‐sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third‐class general hospital in Chongqing, China. Results: The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. Conclusion: The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. Impact: We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. No Patient or Public Contribution: There was no patient or public involvement. Impact Statement: Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance. [ABSTRACT FROM AUTHOR]

Aims: The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift‐related factors predispose nurses to higher levels of occupational stress and anxiety. Design: This is a cross‐sectional study. Methods: From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety. Results: The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non‐Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night‐shift frequency of 3–4 times per month, night‐shift durations of 9–12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift‐related factors that increased the levels of occupational stress and anxiety. Conclusion: The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety. Impact: By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well‐being and work schedules. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim(s): To assess the effectiveness of sub‐epidermal moisture (SEM) assessment technology in the detection of early‐stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital‐acquired pressure injury (HAPI) incidence. Design: Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. Methods: The study evaluated 140 adult patients admitted to the CCU over a 24‐week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12‐week pre‐implementation period. Fifty patients were admitted through the subsequent 12‐week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. Results: Pre‐implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre‐implementation group. Conclusion: Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early‐stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. Implications: PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. Impact: Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy‐specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety. [ABSTRACT FROM AUTHOR]

Aims: To explore illegitimate tasks as a potential mechanism that links permanent nurses' perceived exposure to temporary nurses to lower levels of affective organizational commitment. Design: A time‐lagged cross‐sectional survey study. Methods: Survey data from N = 239 permanent nurses in the German‐speaking part of Switzerland were analysed via Structural Equation Models. Results: The study revealed a negative relationship between permanent nurses' perceived exposure to temporary nurses and their level of organizational commitment that was mediated by perceptions of unreasonable and unnecessary tasks. Conclusion: Healthcare institutions increasingly depend on temporary nurses to fill staffing vacancies. Our data suggest that the deployment of temporary nurses may have adverse effects on permanent nurses' affective organizational commitment via perceptions of illegitimate tasks. Impact: Our quantitative survey study provides a novel, theory‐driven understanding of how perceived exposure to temporary nurses may impact work‐related attitudes of permanent nurses. Implications for the Profession and/or Patient Care: Our findings suggest that the clinical community should limit permanent nurses' exposure to temporary nursing staff to protect their commitment. If this is not possible, we encourage strategies to counteract associated feelings of illegitimacy, for example, by showing appreciation for permanent nurses' willingness to take over responsibility for temporary nurses. Reporting Method: The study adheres to the STROBE reporting guidelines for cross‐sectional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is highly prevalent among post‐operative cardiac patients, with negative impacts on surgical recovery and rehabilitation. Post‐operative pain and anxiety commonly seen in cardiac surgery patients are associated with poor sleep. Sleep medications commonly used are not ideal with prolonged usage, and non‐pharmacological interventions can be good alternatives or complements. Aim: To examine effectiveness of non‐pharmacological interventions in post‐operative cardiac settings on sleep quality, pain intensity and anxiety. Design: Systematic review and meta‐analysis. Methods: PubMed, CENTRAL, Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were searched on 12 October 2022. Randomised controlled trials of non‐pharmacological interventions examining sleep quality for adult post‐operative cardiac patients were included. Included studies were appraised using Cochrane Risk of Bias tool version 1. Meta‐analysis was conducted using RevMan version 5.4.1, and heterogeneity was assessed using I2 statistics and Cochran Q's test. Results: Eighteen studies involving 1701 participants were identified. Coronary artery bypass graft was most common. Non‐pharmacological interventions varied in types and duration. All intervention groups were compared to usual care, placebo, no interventions or active comparators. Statistically significant improvement in sleep quality (SMD = −.91, 95% CI = −1.17 to −.65) was found among intervention groups that explored cognitive behavioural therapy, relaxation techniques, exercise, massage, acupressure, aromatherapy, music, eye mask and earplugs. Pain intensity was reduced (SMD = −.63, 95% CI = −1.05 to −.20) with cognitive behavioural therapy, relaxation techniques, massage, music and eye mask. Anxiety was improved (SMD = −.21, 95% CI = −.38 to −.04) with exercise and music. Conclusion: The overall use of non‐pharmacological interventions can optimise sleep after cardiac surgery. Further research with greater methodological rigour is needed to investigate different intervention‐related characteristics while considering potential confounders. Relevance to Clinical Practice: Post‐operative cardiac settings can consider incorporating non‐pharmacological interventions. Patients and healthcare providers can be better informed about the use of such interventions to improve sleep. Registration: PROSPERO CRD42022384991. [ABSTRACT FROM AUTHOR]

Aims: To comprehensively examine the prevailing condition of care dependence among middle‐aged individuals who have experienced hemiplegia subsequent to a stroke and were currently undergoing post‐acute rehabilitation. Additionally, the study sought to analyse the determinants that impacted this phenomenon. Design: A single‐centre, cross‐sectional study design. Methods: During the period from January 2020 to October 2022, a cohort of 196 hemiplegic stroke patients, aged between 40 and 65, and within 6 months of their stroke onset, was selected from the cerebrovascular outpatient clinic at a tertiary hospital in Hangzhou. The demographic and disease‐related data, care dependence level, mental state, nutrition and depression status were collected. Furthermore, all collected data were analysed by descriptive and correlative statistical methods. Results: The care dependence level was 51.04 ± 9.42, with an incidence of care dependence of 78.1%. Multivariate regression analysis showed that age, history of falls, physical dysfunction, chronic comorbidities, depression, nutritional status and cognitive dysfunction were influencing factors for care dependence in the participants after a stroke. Conclusion: The incidence of care dependence among hemiplegic patients aged from 40 to 65 years old in the early stage after a stroke was high. Nursing staff should focus on these patients with a history of falling, physical dysfunction, comorbidity, depression status, nutritional status and cognitive dysfunction in clinical practice. Relevance to Clinical Practice: The incidence of care dependence in middle‐aged hemiplegic patients following a stroke is significantly increased. Some risk factors should be assessed, monitored, and controlled by nursing staff as early as possible in order to reduce the dependence levels in post‐acute rehabilitation period and improve the quality of life of hemiplegia patients. Reporting Method: Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross‐sectional studies (see Table S1). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects of COVID‐19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. Design: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Methods: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non‐parametric chi‐square test were used for analysis. STROBE checklist was used for the preparation of this paper. Results: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre‐pandemic values, HbA1c levels improved in T3, but HDL levels worsened. Conclusions: COVID‐19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Impact: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium‐term. [ABSTRACT FROM AUTHOR]

Aim: To describe the development of the Actualisation of Evidence‐Based Nursing instrument targeted at nurses working in clinical practice (ActEBN‐nurses), meant for evaluating the actualisation of individual and organisational‐level support structures for evidence‐based nursing within social and healthcare organisations, and to test its validity and reliability. Design: Cross‐sectional survey. Methods: The FinYHKÄ model was used as the theoretical background of the instrument development and supplemented with the JBI Model of Evidence‐Based Healthcare, previous literature and items from a previous instrument, the Evidence‐Based Practice Process Assessment Scale, with permission of the copyright holders. After two rounds of expert panel and piloting, a national survey was conducted with the instrument in 2021. The target group consisted of nurses working in clinical practice. Psychometric testing included internal consistency (Omega, item analysis) confirmatory factor analysis and t‐test for comparison of two groups' differences (sensitivity). Results: A new instrument, ActEBN‐nurses was developed, comprising two parts: Individual‐level (32 items, 5‐point Likert‐scale) and Organisational‐level support structures for evidence‐based nursing (37 items, 5‐point Likert‐scale). In total, 1289 nurses participated in the survey. The ActEBN‐nurses proved to have good internal consistency in both parts (Omega ω.931 and.966), structural validity and sensitivity based on the two educational levels within the sample. The structure of both parts was slightly modified, based on the CFA modification indices, considering the impact of the reverse worded items in part Individual and redundant items within both parts. Conclusion: The ActEBN‐nurses has promising psychometrics, and it can be used for evaluating individual and organisational‐level support structures for evidence‐based nursing within social and healthcare organisations. Implications for the profession and/or patient care: Evaluation of the support structures within social and healthcare organisations is needed to recognise shortcomings in current structures and advance evidence‐based nursing across different contexts. Reporting Method: The authors state that they have adhered to relevant EQUATOR guidelines: STROBE statement for cross‐sectional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: Fear of cancer recurrence (FCR) is a multifaceted concept influenced by individual characteristics, social support, psychological factors. This study aims to identify distinct FCR profiles among breast cancer patients and explore the associated variables with these patterns. Design: A cross‐sectional study was conducted from April 2022 to March 2023. Methods: A convenience sample of 339 patients completed a questionnaire that assessed general and disease‐related data, including the Fear of Progression Questionnaire‐Short Form, Social Support Rating Scale, Medical Coping Modes Questionnaire. Statistical analysis involved latent profile analysis (LPA) and multinomial logistic regression. Results: Three latent patterns of FCR were found: the low fear (28.9%), the moderate fear (51.3%), and the high fear (18.0%). The study identified the social support, family monthly income, employment status, utilization of confrontation coping mode and avoidance coping mode, as factors that impacted the FCR. Conclusions: Social support, family monthly income, employment status, and medical coping modes have been found to impact the FCR among newly diagnosed breast cancer patients. Healthcare professionals should focus on addressing FCR at diagnosis and implement effective interventions, such as promoting social support and encouraging adaptive coping, to alleviate this concern. Impact: Urgently addressing the FCR in Chinese breast cancer patients is imperative due to its profound influence on their holistic health. Through advanced LPA, we categorized the FCR progression, highlighting risks. These findings have implications for healthcare strategies, offering new insights to manage the FCR and improve patient well‐being. Our study adds a fresh perspective to the factors underlying the FCR in breast cancer patients, contributing to the broader comprehension and management of this complex survivorship issue. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The study explores the experiences of women with low‐risk pregnancies and no complications who planned a home birth. Design: A cross‐sectional study was conducted using an online questionnaire. Methods: The questionnaire included socio‐demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home‐birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS. Results: A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife. Conclusions: Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births. Implications for the Profession and Patient Care: Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home. Impact: Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home‐birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home‐birthing women. Reporting Method: The study followed the STROBE checklist guidelines for cross‐sectional studies. Public Contribution: Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means. [ABSTRACT FROM AUTHOR]

Aims: To identify health literacy profiles in individuals receiving haemodialysis and to explore how these profiles interact with individuals' self‐efficacy, engagement with traditional dietary habits, self‐reported fluid restriction and relative‐interdialytic weight gain. Design: A cross‐sectional study engaging nephrology departments from four hospitals in Guangdong Province, China. Methods: A sample of 433 individuals receiving haemodialysis participated between December 2018 and July 2019. We assessed health literacy, self‐efficacy and self‐reported fluid restriction using the Health Literacy Questionnaire, the Fluid Self‐efficacy Scale and the Fluid Adherence Subscale, respectively. Traditional dietary habits, including daily tea drinking, soup drinking and preserved food consumption, were measured using three yes/no questions. Relative‐interdialytic weight gain was calculated by dividing the mean interdialytic weight gain (from three recent intervals) by dry weight. Latent profile analysis and structural equation modelling were performed. Results: Three health literacy profiles were identified: low, moderate and high. Compared to those in the low health literacy profile, individuals in high and moderate health literacy profiles demonstrated an indirect association with reduced relative‐interdialytic weight gain. This reduction can be attributed to their higher self‐efficacy levels, decreased reliance on dietary habits and higher self‐reported fluid restrictions. Conclusions: Most participants exhibited either low or moderate levels of health literacy. Improving health literacy has the potential to promote self‐efficacy and foster effective fluid restriction, ultimately leading to a reduction in relative‐interdialytic weight gain in individuals receiving haemodialysis. Impact: This study reveals heterogeneity in health literacy levels among individuals receiving haemodialysis and illuminates the connections between an individual's entire spectrum of health literacy and fluid management. These findings provide valuable insights for developing person‐centred fluid management interventions, especially for individuals with diverse cultural dietary backgrounds within the haemodialysis population. Reporting Method: We adhered to the STROBE guideline. Patient or Public Contribution: Patients were included only for collecting their data. [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]

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

Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexually transmitted diseases (STDs) remains high worldwide in today's society, especially among young people. Youth education on STDs could help to reduce the prevalence of the condition in society and prevent new cases. Aim: The aim of this study is to assess the effectiveness of peer‐based short‐form educational videos on youths' knowledge of STDs. Methods: This quasi‐experimental study was conducted in Turkey. The sample consisted of 121 students divided into experimental and control groups. Pre‐ and post‐test control group quasi‐experimental research design was employed in this study during the spring semester of the academic year 2021–2022. Peer‐based short‐form educational videos created by nursing students were used as an intervention. The survey form and Sexually Transmitted Disease Knowledge Questionnaire were used to collect data. Results: Participants with parental responsibilities and had previous STD experience had higher knowledge score than the other subgroups. There was a significant main effect of peer‐based short‐form educational video on participants overall knowledge score of STDs. Additionally, the effect of intervention continued at 12‐week follow‐up measurement. Conclusion: Peer‐based short‐form educational videos increase young people's knowledge of STD, and the impact of the intervention continued at 12‐week follow up. Summary statement: What is already known about this topic? Sexually transmitted diseases continue to be prevalent in society, particularly among young people.Sexually transmitted diseases can lead to serious health conditions and have a significant impact on sexual and reproductive health.The effectiveness of internet‐based education and lectures on sexually transmitted diseases has already been investigated.Little research has been addressed to determine the impact of educational materials, which are short videos on knowledge of sexually transmitted diseases created by utilizing nursing students' peer assessment. What this paper adds? Peer‐based short‐form educational videos increase young people's sexually transmitted disease knowledge.People with parental responsibilities and a previous sexually transmitted infections responded to interventions more favourably.The effects of peer‐based short‐form educational videos persisted 3 months afterwards. The implications for this paper: This cost‐free method has a potential to be widely used as a public health intervention to educate young people on sexually transmitted diseases.The peer‐based short‐form educational videos can be combined with other interventions to increase young people's knowledge of sexually transmitted diseases. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine‐related information and have a primary role in building confidence regarding vaccines. Aim: The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID‐19) and their attitudes towards the COVID‐19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated. Methods: A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling. Results: Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID‐19. Age and fear were also positively associated with anxiety related to COVID‐19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine. Conclusion: Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination. Summary statement: What is already known about this topic? The COVID‐19 pandemic significantly affected the psychological health of nurses.Nurses have a fundamental function in the general acceptance of vaccines. What this paper adds? Relationships were found between COVID‐19‐related fear, anxiety and attitudes towards the COVID‐19 vaccine.Anxiety and a positive attitude towards the vaccine were found to be predictors of fear related to COVID‐19.Fear related to COVID‐19 and being vaccinated against COVID‐19 were predictors of attitudes towards vaccination. The implications of this paper: Nursing managers could organize programmes to improve the coping skills of nurses in responding to situations that cause psychological burden.Nursing managers could support nurses through education to develop positive attitudes towards vaccines. [ABSTRACT FROM AUTHOR]

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

Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

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

Aim: This study compared the effects of web‐based and face‐to‐face education given to office workers on health beliefs and physical activity levels towards obesity. Methods: The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846. Results: A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05). Conclusion: It was determined that web‐based and face‐to‐face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level. Summary statement: What is already known about this topic? Beliefs about obesity and physical activity are changed by face‐to‐face education methods.Along with the changing and developing technology, web‐based education has gained importance as well as face‐to‐face education.Studies on the effect of web‐based education compared with face‐to‐face education are limited. What this paper adds? This study determined that face‐to‐face education and web‐based education had an effect on beliefs about effecting change in obesity and the duration of physical activity.Web‐based education can be as effective as face‐to‐face education for this. The implications of this paper: Individuals' beliefs about reducing obesity can change with face‐to‐face education and also with web‐based education, which can be accessed more easily in desired time periods.Web‐based education can be used to improve obesity in cases where face‐to‐face education cannot be applied. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the predictive validity and reliability of the Waterlow scale in critically adult hospitalised patients. Design: A multi‐centre cohort study. Methods: This study was conducted in 72 intensive care units (ICUs) in 38 tertiary hospitals in Gansu Province, China. All adults admitted to the ICU for greater than or equal to 24 h without pressure injury (PI) on admission were screened by the Waterlow scale on admission, during ICU stay and ICU discharge from April 2021 to February 2023. Receiver operating characteristic (ROC) curves were used to determine a potential cut‐off value for critical adult hospitalised patients. Cut‐off values were then determined using Youden's index, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated based on these cut‐off values. Test–retest reliability was used to evaluate inter‐rater reliability. Results: A total of 5874 critical patients on admission were included, and 5125 of them were assessed regularly. The area under curve (AUC) was 0.623 (95% CI, 0.574–0.690), with a cut‐off score of 19 showing the best balance among sensitivity of 62.7%, specificity of 57.4%, positive predictive value of 2.07% and negative predictive value of 99.08%. The test–retest reliability between the first assessment and the regular assessment was 0.447. Conclusions: The Waterlow scale shows insufficient predictive validity and reliability in discriminating critical adults at risk of PI development. To further modify the items of the Waterlow scale, exploring specific risk factors for PI in the ICU and clarifying their impact degree was necessary. Risk predictive models or better tools are inevitable in the future. Patient or Public Contribution: Patients or family members supported nurses with PI risk assessment, skin examination and other activities during the inquiry. [ABSTRACT FROM AUTHOR]

Background: Post‐operative diarrhoea is a common adverse event after pancreatic surgery. While the risk factors for this condition have been identified, the increasing trend of administering chemotherapy before surgery might change these factors. This study aimed to identify the risk factors of post‐operative diarrhoea in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent neoadjuvant chemotherapy. Design: A retrospective cohort study. Methods: Patients who underwent neoadjuvant chemotherapy and pancreatectomy because of PDAC between 2021 and 2023 were included. The preoperative characteristics of, operative details of and post‐operative outcomes in patients with and without post‐operative diarrhoea were collected and compared. The independent risk factors of post‐operative diarrhoea were identified using logistic regression analysis. STROBE checklist was used. Results: Post‐operative diarrhoea occurred in 65 out of 145 (44.8%) patients during hospitalization. Elevated white blood cell count, advanced tumour stage, and late abdominal drain removal were independent risk factors for post‐operative diarrhoea (p <.001, p =.006 and p =.009, respectively). Conclusions: Some perioperative factors influence post‐operative diarrhoea in patients who undergo neoadjuvant chemotherapy. More attention should be paid to patients at a higher risk of post‐operative diarrhoea, with an emphasis on high‐quality management for these patients. [ABSTRACT FROM AUTHOR]

Aims: To assess French nursing home nurses' opinions on the potential evolution of their antibiotic stewardship role, facilitators and barriers, and nurses' characteristics associated with their opinion toward new roles regarding antibiotic prescribing. Design: We conducted a cross‐sectional study in French nursing homes with ≥20 beds and for which an email address was available in a national database managed by the French government between May and June 2022. Methods: A self‐administered internet‐based questionnaire of 43 closed‐ended Likert items was sent to directors of eligible nursing homes by email asking them to forward the link to the questionnaire to the nurses and head nurses of their institution. Data analysis included descriptive statistics and χ2 tests. Results: 7215 nursing homes were sent the online questionnaire; 1090 participants completed it partially or totally and 923 fully filled in the questionnaire. A majority of nurses supported strengthening and expanding their antibiotic stewardship role. Regarding new roles, over 70% agreed that nurses could collect urine samples to perform a urine culture on their own initiative, prescribe microbiological laboratory tests, and change the drug formulation or the administration route of the antibiotic prescribed by the general practitioner. One‐third declared that they could initiate antibiotics for some infections and/or change the empirical antibiotic treatment prescribed by the general practitioner. Nurses from public nursing homes with connection to a hospital (27.5% vs. >35% for other status) and with recent experience in nursing homes (31% for <5 years of practice vs. 41% for 10 years or more) were less likely to agree to prescribe antibiotics. Conclusions: This quantitative questionnaire survey identified potential new nurses' roles in antibiotic stewardship that seem to be acceptable and feasible for participants. These new nurses' roles need to be explored in future experimentations before considering implementation. Reporting Method: The study adhered to relevant EQUATOR guidelines and followed the STROBE reporting guidelines. Patient or Public Contribution: A self‐administered internet‐based questionnaire was sent to directors of eligible nursing homes by email asking them to forward the link to the questionnaire to the nurses and head nurses of their institution. Nurses and head nurses who were interested and willing could complete the questionnaire online partially or fully. Trial and Protocol Registration: This study is not a clinical trial and is not eligible for trial registration. We used another suitable study registration site, the Center for Open Science. [ABSTRACT FROM AUTHOR]

Background: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. Aim: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). Research Design and Setting: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. Results: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital‐acquired pressure ulcers. Conclusions: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital‐acquired ulcers at hospital discharge. Relevance to Clinical Practice: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. No Patient or Public Contribution: No direct patient contact was made during the data collection. [ABSTRACT FROM AUTHOR]

Background: The first step in preventing pressure injuries (PIs), which represent a significant burden on intensive care unit (ICU) patients and the health care system, is to assess the risk for developing PIs. A valid risk assessment scale is essential to evaluate the risk and avoid PIs. Objectives: To compare the predictive validity of the Braden scale and Waterlow scale in ICUs. Design: A multicentre, prospective and cross‐sectional study. Methods: We conducted this study among 6416 patients admitted to ICUs in Gansu province of China from April 2021 to October 2022. The incidence and characteristics of PIs were collected. The risk assessment of PIs was determined using the Braden and Waterlow scale. The sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve of the two scales were compared. Results: Out of 5903 patients, 72 (1.2%) developed PIs. The sensitivity, specificity, positive and negative predictive, and the area under the curve of the Braden scale were 77.8%, 50.9%, 0.014 and 0.996, and 0.689, respectively. These values for the Waterlow scale were 54.2%, 71.1%, 0.017, 0.994 and 0.651. Conclusions: Both scales could be used for risk assessment of PIs in ICU patients. However, the accuracy of visual inspection for assessment of skin colour, nursing preventive measures for patients and scales inter‐rater inconsistency may limited the predictive validity statistics. Relevance to Clinical Practice: Both scales could be used for PIs risk assessment. The low specificity of the Braden scale and low sensitivity of the Waterlow scale remind medical staff to use them in combination with clinical judgement and other objective indicators. Patient or Public Contribution: This study was designed to enhance the management of PIs. Patients and the general public were not involved in the study design, analysis, and interpretation of the data or manuscript preparation. [ABSTRACT FROM AUTHOR]

Aim: To analyse fall prevalence, risk factors and perceptions among Thai older adults to design a prevention model. Design: Quantitative and qualitative data were collected using a convergent parallel mixed‐methods design. Methods: A cross‐sectional analysis was conducted using secondary data from health screenings of older adults in 20 subdistrict hospitals in southern Thailand from January 2018 to September 2019 (n = 12,130). In‐depth interviews (IDIs) and focus group discussions (FGDs) were conducted with purposively sampled participants who were representatives of older adults and stakeholders (n = 50). Results: The quantitative analysis showed that the prevalence of falls was 12.1%. The independent risk factors were female gender, employment status, cognitive impairment, semi‐dependent functional ability, balance problems, vision impairment, hearing difficulties, use of medications, reliance on assistive devices and access to outdoor toilets. The qualitative analysis revealed misconceptions on falls and fall prevention measures among older adults and community stakeholders. In Thailand, healthcare providers and community nurses play a crucial role in providing primary advice and conducting interventions, yet they encounter obstacles due to lack of personnel, time constraints, limited resources, inadequate support and unclear policies. Stakeholders stress the urgency of improving practice guidelines, developing evidence‐based strategies and aligning with government policies. Conclusions: Fall risk factors and prevention challenges among older adults were identified. Effective fall prevention programmes are needed. Impact: The identified fall events may guide public health agencies and local administrations in planning fall prevention programmes. For implementation in Thai communities, teamwork among leaders and stakeholders is key. Patient or Public Contribution: IDIs and FGDs were conducted with older adults, village health volunteers, nurses, healthcare providers, local organization administrators and village headmen. [ABSTRACT FROM AUTHOR]

Aims: To describe Indonesian nurses' educational experience regarding care for people with intellectual disability and/or autism and to explore if these educational experiences are associated with their self‐perceived confidence, comfort, knowledge and preparedness to care for these cohorts. Design: Cross‐sectional descriptive survey. Methods: A descriptive survey tool utilized in a study of Australian registered nurses was replicated and adapted for this study. Following descriptive analysis, chi‐square analyses were undertaken to explore associations between educational experiences, and self‐rated measures of confidence, comfort and knowledge to work with people with intellectual disability and/or autism. Although there was no end‐user involvement in the design of the study, the concepts explored have all been raised by those with lived insights of intellectual disability and/or autism as being critical to their healthcare experiences. Results: There were 544 complete responses, and 51.7% were not exposed to any educational or clinical content relevant to caring for people with intellectual disability and/or autism. Moderate to low levels of self‐perceived confidence, comfort, knowledge and preparedness to address healthcare needs of these cohorts were reported. Significant associations were identified between educational and clinical experiences during undergraduate training, and higher levels of self‐perceived confidence, comfort and knowledge. Conclusion: Mirroring international literature, the findings of this study highlight a large proportion of Indonesian nurses had little educational experience relevant to caring for people with intellectual disability and/or autism, and have relatively low levels of self‐reported capability. Impact: This study highlights gaps in the educational experiences, and self‐perceived confidence, comfort, knowledge and preparedness of Indonesian nurses regarding caring for people with intellectual disability and/or autism. Given that internationally, people with intellectual disability and/or autism have disproportionately negative health outcomes and experiences, these findings have substantial implications for nursing curriculum, policy and professional development. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify different profiles of chronic disease resource utilization among patients with coronary heart disease in Tibet and explore the relationship between these profiles and quality of life. Design: A cross‐sectional study. Methods: Patients with coronary heart disease who were treated in a tertiary hospital in Tibet and its cooperative points from January 2021 to July 2021 were selected as the study participants. All participants completed a general information questionnaire, the Chronic Disease Resource Utilization Questionnaire (CIRS) and the Health Status Survey Short Form (SF‐36). Chronic disease resource utilization was profiled, and its relationship to quality of life was explored using hierarchical linear regression. Results: A total of 382 patients were enrolled in this study. Regarding chronic disease resource utilization, the participants were divided into three latent profiles: 'Poor utilization group' (n = 151), 'Effective utilization group' (n = 155) and 'Full utilization group' (n = 76). Different profiles of chronic disease resource utilization of patients were significantly associated with quality of life (R2 =.126, p <.001). Conclusion: Healthcare providers should identify patients with different profiles, define their utilization features of chronic disease resources and adopt targeted interventions to guide them in acquiring enough disease support resources to improve their quality of life. Implication: Understanding different resources using preferences of coronary heart disease patients can help healthcare providers and related sectors to provide other supports based on different profiles of patients, thus enhancing their quality of life. Reporting Method: The study followed the STROBE guideline. No Patient or Public Contribution: There was no patient or public involvement in the design of the study. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the impact of nurse care changes in implementing a blood pressure management protocol on achieving rapid, intensive and sustained blood pressure reduction in acute intracerebral haemorrhage patients. Design: Retrospective cohort study of prospectively collected data over 6 years. Methods: Intracerebral haemorrhage patients within 6 h and systolic blood pressure ≥ 150 mmHg followed a rapid (starting treatment at computed tomography suite with a target achievement goal of ≤60 min), intensive (target systolic blood pressure < 140 mmHg) and sustained (maintaining target stability for 24 h) blood pressure management plan. We differentiated six periods: P1, stroke nurse at computed tomography suite (baseline period); P2, antihypertensive titration by stroke nurse; P3, retraining by neurologists; P4, integration of a stroke advanced practice nurse; P5, after COVID‐19 impact; and P6, retraining by stroke advanced practice nurse. Outcomes included first‐hour target achievement (primary outcome), tomography‐to‐treatment and treatment‐to‐target times, first‐hour maximum dose of antihypertensive treatment and 6‐h and 24‐h systolic blood pressure variability. Results: Compared to P1, antihypertensive titration by stroke nurses (P2) reduced treatment‐to‐target time and increased the rate of first‐hour target achievement, retraining of stroke nurses by neurologists (P3) maintained a higher rate of first‐hour target achievement and the integration of a stroke advanced practice nurse (P4) reduced both 6‐h and 24‐h systolic blood pressure variability. However, 6‐h systolic blood pressure variability increased from P4 to P5 following the impact of the COVID‐19 pandemic. Finally, compared to P1, retraining of stroke nurses by stroke advanced practice nurse (P6) reduced tomography‐to‐treatment time and increased the first‐hour maximum dose of antihypertensive treatment. Conclusion: Changes in nursing care and continuous education can significantly enhance the time metrics and blood pressure outcomes in acute intracerebral haemorrhage patients. Reporting Method: STROBE guidelines. Patient and Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors. Background: Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking. Design: Multicentre cross‐sectional study. Methods: Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care‐Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence. Results: In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care‐related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence. Conclusions: There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses. Relevance to Clinical Practice: The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training. Reporting Method: EQUATOR guidelines, STROBE checklist: cross‐sectional studies. Patient or Public Contribution: All participants were clinical nurses. Participants were informed they could withdraw from the study at any time. [ABSTRACT FROM AUTHOR]

Aims: To compare anaesthesia‐related outcomes between patients monitored by newly recruited nurse anaesthetists and those monitored by newly recruited anaesthesiologists. Design: This was a retrospective study. Methods: We conducted a retrospective study that collected demographic information on newly recruited nurse anaesthetists and anaesthesiologists between 2017 and 2022 and recorded information on patients within 6 months of monitoring. Postoperative pain, emergency agitation, nausea, and vomiting were designated anaesthesia‐related outcomes. Propensity score matching was used to adjust for covariates. The study adhered to the STROBE guidelines. Results: The study's statistical analysis included 4483 patients monitored by 22 newly recruited nurse anaesthetists and 4959 patients monitored by 23 newly recruited anaesthesiologists. Compared with patients monitored by newly trained anaesthesiologists, the patients monitored by nurse anaesthetists were younger (42.07 ± 20.00 vs. 47.39 ± 18.45 years, p < 0.001) and had a lower body mass index (23.56 ± 4.46 vs. 24.19 ± 4.25, p < 0.001). Patients monitored by anaesthesiologists had a greater proportion of women (61.62% vs. 59.25%, p < 0.001), a high proportion of ASA III and ASA IV (17.1% vs. 8.88%, p < 0.001), and a longer mean surgery duration (78.65 ± 59.01 vs. 70.70 ± 60.65 min, p < 0.001). After propensity score matching was used to adjust for covariates, no statistically significant differences were found in the prevalence of postoperative pain, emergency agitation, or postoperative nausea and vomiting between the two groups (p < 0.05). Conclusion: Nurse anaesthetists monitoring alone during anaesthesia maintenance is feasible and safe. The two groups had no significant differences in the incidence of postoperative pain, emergency agitation, or postoperative nausea and vomiting. Relevance to Clinical Practice: The shortage of anaesthesiologists leads to heavy work burden and high incidence of occupational burnout among anaesthesiologists. The study found that it was safe for nurse anaesthetists to perform anaesthetic monitoring alone in the operating room under the supervision of the attending anaesthesiologist and did reduce the burden of anaesthesiologists' work. The results of the current study contribute to the expansion of occupational categories for nurse anaesthetists in countries where anaesthesiologists are in short supply. It provides new ideas for hospital administrators and policy‐makers to formulate medical and nursing service policies. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationships among occupational stress, recovery experience and turnover intention among nurses caring for patients with coronavirus disease 2019 (COVID‐19). Background: The high turnover intention among nurses affect patient safety quality of patient care. Design: The cross‐sectional study design was used. This study was guided by STROBE. Methods: Convenience sampling identified 202 registered nurses working in the COVID‐19 wards of three tertiary general hospitals in two cities in South Korea. The collected data were analysed using SPSS version 26.0, and the PROCESS macro in SPSS was employed to estimate path coefficients and assess the adequacy of the model. The moderating effects of recovery experience on the pathway in which occupational stress of the participants affects turnover intention were verified using model 1 of the SPSS PROCESS macro proposed by Hayes. Results: The recovery experience did not significantly mediate the relationship between occupational stress and turnover intention. However, it had significant moderating effect on the relationship between occupational stress and turnover intention (β =.005, 95% CI [.001,.010]). The effect of occupational stress on turnover intention was dependent on recovery experience. Conclusion: The results revealed that occupational stress among nurses caring for patients with COVID‐19 affect the turnover intention and the level of recovery experience moderates this relationship. Thus, not only during the COVID‐19 pandemic but also during challenging times of various infectious disease outbreaks, hospitals can enhance the health and well‐being of nurses and promote the retention of nursing staff. Implications for the profession: During the COVID‐19 pandemic, nurses have been exposed to understaffing and overwhelming workloads. However, policies for nurses' welfare and benefits are still insufficient, even as the pandemic comes to an end. The results of this study indicate that sufficient rest and appropriate nursing personnel are of utmost importance to nurses. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: Drawing on the conservation of resources theory, this study examines the underlying process through which servant leadership is associated with nurses' in-role performance. Specifically, we test the indirect effect of servant leadership on in-role performance via a sequential mediating mechanism of job autonomy and emotional exhaustion. Design: A time-lagged design was implemented using data gathered from two-wave online surveys (1 week apart) of registered nurses from Jiangsu Province, China. Methods: Between September 2022 and February 2023, we used Wenjuanxing and Credma, which are two powerful and user-friendly data collection platforms, to distribute online surveys to potential participants. We received a total of 220 usable responses and employed the PROCESS Model 4 and Model 6 to assess our proposed hypotheses. Results: Our proposed model was supported. Servant leadership has a positive indirect effect on nurses' in-role performance through job autonomy and emotional exhaustion. Job autonomy has a negative effect on emotional exhaustion. Additionally, job autonomy mediates the negative relationship between servant leadership and emotional exhaustion. Conclusion: The present research extends existing nursing studies by unravelling the complex mechanisms underlying the relationship between servant leadership and nurses' in-role performance. Our study also identifies the underlying mechanism of how servant leadership mitigates emotional exhaustion by supporting nurses' job autonomy. Impact: The sequential mediation results provide us with a more fine-grained understanding of the relationship between servant leadership and nurses' in-role performance. It further promotes job autonomy and decreases emotional exhaustion, which supports the UN Sustainable Development Goal #3 (Good Health and Well-being). [ABSTRACT FROM AUTHOR]

Aims: To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing. Design: A convergent parallel mixed-method study. Methods: A national survey was conducted (July–September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting. Results: Undergraduate nursing students (n= 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) ‘This is a very misandristic viewpoint’; (2) ‘Compassion and intelligence are distributed in men and women equally’; (3) ‘Men bring a different quality to nursing’ (4) ‘Anyone can be whatever they want to be’. Conclusion: Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society. Impact: Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments. [ABSTRACT FROM AUTHOR]

Aim: Patients with heart failure experience multiple co-occurring symptoms that lower their quality of life and increase hospitalization and mortality rates. So far, no heart failure symptom cluster study recruited patients from community settings or focused on symptoms predicting most clinical outcomes. Considering physical and psychological symptoms together allows understanding how they burden patients in different combinations. Moreover, studies predicting symptom cluster membership using variables other than symptoms are lacking. We aimed to (a) cluster heart failure patients based on physical and psychological symptoms and (b) predict symptom cluster membership using sociodemographic/clinical variables. Design: Secondary analysis of MOTIVATE-HF trial, which recruited 510 heart failure patients from a hospital, an outpatient and a community setting in Italy. Methods: Cluster analysis was performed based on the two scores of the Hospital Anxiety-Depression scale and two scores of the Heart-Failure Somatic Perception Scale predicting most clinical outcomes. ANOVA and chi-square test were used to compare patients' characteristics among clusters. For the predictive analysis, we split the data into a training set and a test set and trained three classification models on the former to predict patients' symptom cluster membership based on 11 clinical/ sociodemographic variables. Permutation analysis investigated which variables best predicted cluster membership. Results: Four clusters were identified based on the intensity and combination of psychological and physical symptoms: mixed distress (high psychological, low physical symptoms), high distress, low distress and moderate distress. Clinical and sociodemographic differences were found among clusters. NYHA-class (New York Heart Association) and sleep quality were the most important variables in predicting symptom cluster membership. Conclusions: These results can support the development of tailored symptom management intervention and the investigation of symptom clusters' effect on patient outcomes. The promising results of the predictive analysis suggest that such benefits may be obtained even when direct access to symptoms-related data is absent. Implications: These results may be particularly useful to clinicians, patients and researchers because they highlight the importance of addressing clusters of symptoms, instead of individual symptoms, to facilitate symptom detection and management. Knowing which variables best predict symptom cluster membership can allow to obtain such benefits even when direct access to symptoms-data is absent. Impact: Four clusters of heart failure patients characterized by different intensity and combination of psychological and physical symptoms were identified. NYHA class and sleep quality appeared important variables in predicting symptom cluster membership. Reporting Method: The authors have adhered to the EQUATOR guidelines STROBE to report observational cross-sectional studies. [ABSTRACT FROM AUTHOR]

Aims: To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents. Design: A cross-sectional study design. Methods: In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage= 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis. Results: All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females. Conclusion: Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours. Impact: Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

Aim: To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. Design: A descriptive cross-sectional survey design was used. Methods: A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. Results: Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. Conclusion: Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. Implications for the Profession and Patient Care: Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. Impact: • This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. • It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. • These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. Reporting Method: The STROBE reporting method was used in the preparation of the manuscript. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim of this was to psychometrically adapt and evaluate the Tilburg Frailty Indicator to assess frailty among older people living in Slovenia's community and nursing home settings. Design: A cross- cultural adaptation and validation of instruments throughout the cross- sectional study. Methods: Older people living in the community and nursing homes throughout Slovenia were recruited between March and August 2021. Among 831 participants were 330 people living in nursing homes and 501 people living in the community, and all were older than 65 years. Results: All items were translated into the Slovene language, and a slight cultural adjustment was made to improve the clarity of the meaning of all items. The average scale validity index of the scale was rated as good, which indicates satisfactory content validity. Cronbach's α was acceptable for the total items and subitems. Conclusions: The Slovenian questionnaire version demonstrated adequate internal consistency, reliability, and construct and criterion validity. The questionnaire is suitable for investigating frailty in nursing homes, community dwelling and other settings where older people live. Impact: The Slovenian questionnaire version can be used to measure and evaluate frailty among older adults. We have found that careful translation and adaptation processes have maintained the instrument's strong reliability and validity for use in a new cultural context. The instrument can foster international collaboration to identify and manage frailty among older people in nursing homes and community-dwelling homes. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology checklist for reporting cross-sectional studies was used. No Patient or Public Contribution: No patient or public involvement in the design or conduct of the study. Head nurses from nursing homes and community nurses helped recruit older adults. Older adults only contributed to the data collection and were collected from nursing homes and community dwelling. [ABSTRACT FROM AUTHOR]

Introduction: During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America. Methods: An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers. Results: Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005). Conclusion: Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to determine the prevalence and risk factors for subsyndromal delirium in the postoperative patient. Design: A systematic review and meta- analysis. Methods: The Review Manager 5.3 statistics platform and the Newcastle- Ottawa Scale were used for quality evaluation. Data Sources: The following databases were searched: PubMed, Web of Science, EMBASE, The Cochrane Library, Scopus and EBSCO from January 2000 to December 2021. Additional sources were found by looking at relevant articles' citations. Results: A total of 1744 titles were originally identified, and five studies including 962 patients were included in the systematic review, with a pooled prevalence of postoperative subsyndromal delirium (PSSD) of 30% (95% CI: 0.28-0.32). Significant risk variables for PSSD were older age, low levels of education (≤9 years), cognitive impairment, higher comorbidity score, and the duration of operation. Conclusion: PSSD is prevalent and is associated with a variety of risk factors as well as low academic performance. Impact: Identification and clinical management of patients with PSSD should be improved. Future research on PSSD risk factors should look at a wider range of intraoperative and postoperative risk factors that can be changed. Patient and Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: (i) To estimate the national incidence of unplanned removal of peripherally inserted central catheters (PICCs) in China. (ii) To explore the associated risk factors to provide evidence for the prevention. Design: A multi‐centre prospective cohort study. Methods: A representative sample of 3222 Chinese adult patients with successful PICC insertion was recruited for the PICC Safety Management Research (PATH) using a two‐stage cluster sampling method from December 2020 to June 2022. Sixty hospitals from seven Chinese provinces representing all geographical regions were selected. Demographic information and PICC characteristics were collected using a standard online case report form. Risk factors for the unplanned removal of PICCs were assessed using a cause‐specific hazard model and verified using a sub‐distribution hazard model. STROBE guidelines were followed in reporting this study. Results: Three thousand one hundred and sixty‐six patients were included in the final analysis with a mean age of 59 years and a total of 344,247 catheter days. The incidence of unplanned removal was 10.04%. Female, with thrombosis history, PICC insertion due to infusion failure, valved catheter and double‐lumen catheter were risk factors, whereas longer insertion and exposure length were protective factors in the cause‐specific hazard model. Higher BMI became an independent risk factor in the sub‐distribution hazard model. Conclusions: Unplanned removal of PICCs is a serious clinical challenge in China. Our findings call for prevention strategies targeting the identified risk factors. Relevance to Clinical Practice: Our study characterised the epidemiology of unplanned removal of PICCs among Chinese adult inpatients, highlighting the need for prevention among this population and providing a basis for the formulation of relevant prevention strategies. Patient or Public Contribution: Patients contributed through sharing their information required for the case report form. Healthcare professionals who provide direct care to the patient at each medical centre contributed by completing the online case report form. [ABSTRACT FROM AUTHOR]

Aims: To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks. Design: Retrospective study. Methods: The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single‐Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs. Results: Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care. Conclusions: The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes. Implications for the profession and/or patient care: HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge. Patient or Public Contribution: No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the predictors and outcomes of patient safety culture (PSC) among oncology nurses working in public Saudi hospitals according to participant characteristics and evaluate the relationship between PSC domains. Background: PSC is crucial in healthcare systems, particularly in oncology and chemotherapy units, and its assessment can enhance the standard service provided and cancer care quality. There is currently limited research on the status, predictors and outcomes of PSC in cancer care settings in developing countries, including Saudi Arabia. Design: A cross‐sectional correlational study. Methods: A convenience sample of 101 oncology nurses working in two large Saudi tertiary care hospitals participated in this study. The Hospital Survey on Patient Safety Culture validated instrument and demographic and work surveys were completed by the participants. The study methods were compliant with the STROBE checklist. Descriptive statistics and multiple linear regressions were used to analyse the data. Results: The areas of PSC strength were related to organizational learning–constant improvement, feedback and communication about errors, and transitions and handoffs. Manager/supervisor actions and expectations, hospital management support, communication openness, experience in the current unit and oncology unit/area were the predictors of PSC. In terms of PSC outcomes, the oncology nurses reported either no or one to two adverse events and a substantially good patient safety rating. Conclusion: The level of PSC was lower than expected. Communication openness, experience in the current unit and oncology unit/area were the strongest predictors of PSC. Investing in oncology nursing practice that addresses these concerns and prioritizes patient safety is critical in Saudi cancer care settings to increase patient safety. Relevance to clinical practice: The findings contribute to a better understanding of the predictors and outcomes of PSC, which should be considered when establishing effective nursing interventions or strategies for PSC in cancer care settings. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Abusive supervision has detrimental effects on nurses, but the mechanisms connecting abusive supervision to negative outcomes for nurses have not been well‐established in the nursing literature. Aim: This study aimed to investigate whether work alienation mediates the relationship between abusive supervision and nurses' service sabotage. Methods: This descriptive cross‐sectional study was conducted from November to December 2021 with 204 nurses working at a teaching hospital in Damanhour, Egypt. Data were collected using a demographic information form, the Abusive Supervision Scale, the Work Alienation Scale and the Service Sabotage Scale. Study hypotheses were evaluated using structural equation modelling. Results: Our findings revealed a significant association between abusive supervision, work alienation, and service sabotage among nurses. Abusive supervision was found to be linked to nurses' service sabotage through work alienation. Conclusion: Our study suggests that nurses who are subject to abusive supervision are more likely to feel alienated, which increases the probability of them engaging in behaviours that have a negative impact on the quality of care they provide. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles. Design: A descriptive, explorative cross‐sectional study. Methods: Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K‐means cluster algorithm was employed to identify different cultural orientation competence profiles. Results: The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title. Conclusion: Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture. Implications for Profession and/or Patient Care: Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. Design: This study was designed as an instrument development study. Methods: This study aimed to develop a scale to measure the attitudes of parents with children aged 0–5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item‐level test–retest analyses for reliability. Results: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28‐item two factors = 62.47%). Conclusion: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health‐care services based on the results of the measurement. Summary statement: What is already known about this topic? Vaccination plays an important role in health practice.Parents' attitudes towards vaccination affect their children's vaccination status.Increasing vaccination rates in children will contribute to the reduction of infectious diseases and mortality. What this paper adds? A new valid and reliable measurement tool for determining vaccine hesitancy has been developed.The validity and reliability of the scale of attitudes towards vaccination among parents of children aged 0–5 years were tested.The tool could be used to determine the attitudes of parents of children aged 0–5 years towards vaccination. The implications of this paper The scale may help in determining factors affecting parents' attitudes on vaccination.The scale can generate data to guide nursing practices to increase vaccination rates.The scale can be used to influence nursing practices to increase vaccination rates and promote vaccine awareness, trust and acceptance. [ABSTRACT FROM AUTHOR]