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Aim: Using an integrated model of health literacy, we discuss the importance of health literacy among foreign domestic workers in the provision of informal caregiving during outbreaks of communicable diseases. COVID‐19 pandemic is used as an example. Background: Adequate health literacy in the population is known to be important for the prevention of communicable diseases. Foreign domestic workers, a group of marginalised caregivers in private households, are generally presumed to have limited health literacy because of numerous socio‐cultural disadvantages. To date, there is limited evidence that these informal healthcare providers receive support from community‐based nurses. Design: A discursive paper. Conclusion: Foreign domestic workers, with varying levels of health literacy, may be viewed either as a resource to break the chain of infection or as a potential reservoir of communicable diseases in the community. Meanwhile, restrictions imposed in response to diseases transmissions (e.g. stay‐at‐home measures for COVID‐19) may directly exacerbate the social support received by these foreign domestic works and their ability to access health‐related information. There are also concerns about their ability to appraise and evaluate information related to communicable diseases at a time when fake news and misinformation are being disseminated through social media. Language and cultural barriers are important issues that need to be addressed to ensure that foreign domestic workers are in a position to follow public health recommendations. Relevance to clinical practice: Nurses hold an important position in empowering foreign domestic workers with adequate health literacy, by engaging groups of foreign domestic workers in the community and their consulates in planning educational programmes and effectively disseminating information. At a time of global pandemic, an assessment of the health literacy levels of foreign domestic workers in places like Hong Kong is urgently required. [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]

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: We aimed to assess the impact of Tai Chi interventions on individuals with essential hypertension and to compare the effects of Tai Chi versus control in this population. Background: Tai Chi has been extensively utilized in the prevention of essential hypertension. Nevertheless, there is a lack of consensus regarding its benefits for treating essential hypertension. Design: A systematic review and meta‐analysis was conducted. Data Sources We conducted a systematic literature search of the Medline, Scholar, Elsevier, Wiley Online Library, Chinese Academic Journal (CNKI) and Wanfang databases from January 2003 to August 2023. Review Methods: Using the methods of the Cochrane Collaboration Handbook, a meta‐analysis was conducted to assess the collective impact of Tai Chi exercise in controlling hypertension. The primary outcomes measured included blood pressure and nitric oxide levels. Results: The participants consisted of adults with an average age of 57.1 years who had hypertension (mean ± standard deviation systolic blood pressure at 148.2 ± 12.1 mmHg and diastolic blood pressure at 89.2 ± 8.3 mmHg). Individuals who practiced Tai Chi experienced reductions in systolic blood pressure of 10.6 mmHg, diastolic blood pressure of 4.7 mmHg and an increase in nitric oxide levels. Conclusions: Tai Chi can be a viable lifestyle intervention for managing hypertension. Greater promotion of Tai Chi by medical professionals could extend these benefits to a larger patient population. Summary statement: What is already known about this topic? Hypertension is the primary risk factor for cardiovascular disease.Essential hypertension accounts for 90% of the overall prevalence of hypertension.Tai Chi has been employed for the prevention and treatment of essential hypertension. What this paper adds: The study reveals that the efficacy of 24‐style Tai Chi intervention in combating hypertension surpasses that of traditional aerobic exercises and conventional drug therapy.The statistical significance of anti‐hypertensive effects is notably higher when practicing middle‐intensity 24‐style Tai Chi for 1 h. Implications of this paper: The findings suggest that 24‐style Tai Chi holds clinical significance for patients, nurses and healthcare decision‐makers involved in the prevention and treatment of hypertension. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. What the paper adds to existing knowledge?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized.This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. What are the implications for practice?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception.Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. Introduction: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in‐depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge‐eating attacks and prevent relapse. Aim: It is aimed to provide an in‐depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. Implication for Practice: The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted. [ABSTRACT FROM AUTHOR]

Aim: To conduct a discursive review on continuous glucose monitoring use among Black older adults and to address the issue of racial disparities in diabetes management and outcomes. Type 2 diabetes mellitus is a global health concern with significant complications and mortality rates. Black older adults are disproportionately affected. Initially designed for type 1 diabetes, continuous glucose monitoring has emerged as an innovative tool for type 2 diabetes mellitus management. Despite its potential, there are challenges related to adherence and digital literacy among Black older adults for managing Diabetes. Design: A discursive review. Methods: Searching literature in PubMed, Scopus, and Google Scholar for papers published from 2017 to 2023, we explored the use of continuous glucose monitoring in Black older adults with type 2 diabetes mellitus, examining barriers, facilitators and challenges. Discussion: We highlight recommendations from the literature which included barriers, facilitators, and cultural factors associated with continuous glucose monitoring use. Findings underscore the importance of addressing these challenges to reduce racial–ethnic disparities in type 2 diabetes mellitus management among Black older adults. Nurses and advanced practice registered nurses are at the forefront and can play a pivotal role in exploring and implementing interventions to promote access and proper use of continuous glucose monitoring among Black older adult patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Introduction: The role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role. Aims: The aim was to gain consensus opinion to answer the research question: 'What is the role of the clinical nurse specialist in stoma care?' Design: Delphi consensus. Methods: Previous data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session. Results: All 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one. Conclusions: The four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously. Implications for Practice: Consideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred. Patient or Public Contribution: No patients or public were involved in any aspect of this paper—in hindsight this might have been useful. [ABSTRACT FROM AUTHOR]

Aims A discussion on the case for nurse-led community delivery of health and social care interventions to ex-offenders. Background Ex-offenders re-enter their communities with limited pre-release preparation for the continuity of access to health care once outside prison. Once released, these individuals become hard to reach, do not consider health a priority and consequently use services to address their health and social care needs in a crisis-led way. Nevertheless, how nurses can best support these health-excluded group of individuals in the community remains vague and requires discussion. Design Discussion paper. Data sources Several databases were searched for papers published in English from 1990-2012 using the Population, Intervention and Outcome framework to help structure search. Discussion It is argued that current dominant discourses around equity of care are contradicted in the provision of health and social care services to ex-offenders in the community. Effective engagement with community interventions may be achieved if ex-offenders maintain contact with frontline providers who can support both their structural and health needs. Implication for nursing Nurses are uniquely positioned to initiate and sustain contact with ex-offenders, intervening at points of greatest need in the community to address the socially significant health and social care issues that plague them. Conclusion The use of nurses in the provision of health and social care interventions to ex-offenders is a strategy, which could increase equity in access to health care, reduce reoffending and improve both the health and life chances of these individuals. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking. Background: Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour. Design: A cross sectional, comparative study was conducted. Methods: A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires. Results: Mental health nurses were less likely to consider quitting smoking within the next 6 months (P < 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P < 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040). Conclusion: Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke. Summary statements: What is already known about this topic? Smoking prevalence among nursing staff is high.Cultural variances may determine nursing staff's variability in their behaviour.Nurses can play a pivotal role in influencing their patients' smoking attitudes. What this paper adds? Mental health nurses are less likely to quit smoking compared with ward nurses.Specialized strategies that emphasize mental health nurses' perceptions and attitudes towards smoking are considered essential. The implications of this paper: It is imperative that educational institutes of nurses include in their bachelor programmes, courses that emphasize the importance of preventing smoking initiation along with smoking cessation strategies.Nurses who smoke should be supported by public health organizations in practice through tobacco cessation centres and several specialists. [ABSTRACT FROM AUTHOR]

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

Aims: To (a) explore risk indicators related to interpersonal violence occurring under the influence of alcohol and to (b) search for interventions addressed towards violence perpetrators to prevent violence occurring under the influence of alcohol. Design: Mixed method systematic review. This study has been registered in the International Prospective Register of Systematic Reviews with register number CRD42021217848. Data sources A systematic search was conducted on PubMed, CINAHL, PsycINFO and Scopus in October 2021. Review methods: Two researchers independently examined 1076 papers following the inclusion criteria. After three rounds of selection (title, abstract and full text), the quality and bias assessments were conducted independently by two reviewers. The data were analysed with inductive and deductive content analyses. Results: Of the 1076 papers retrieved, 16 papers were eligible for inclusion, addressing 13 different interventions. Interventions were divided into three types (individual‐, group‐ and family‐level) and were constructed on several background frameworks, with cognitive behavioural therapy being the most common framework. Family‐level interventions seemed to yield the most effective results. Violence occurring under the influence of alcohol was mostly researched as men being the perpetrators and women being the victims of violence. Several indicators that increased the risk of violence victimization or perpetration, such as trait jealousy and disparity in education, were identified. Conclusion: Interventions emerging from the systematic review were heterogenous, and the outcomes of the interventions were versatile. The disparity between interventions and outcome measures made it challenging to reliably compare the effectiveness between interventions. Using standardized outcome measure instruments and unifying research on interventions are needed to reliably assess the effectiveness of different interventions. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the incidence of facial pressure injuries in health‐care professionals during the COVID‐19 pandemic in a meta‐analysis. Methods: Related studies were obtained through electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) Chinese Scientific Journal (VIP) China Biomedical Literature service systems (CBM) and Wanfang Data (from inception to 27 November 2021). The pooled incidence and the 95% confidence interval of facial pressure injuries were calculated with Review Manager v5.4 software. Results: Overall, 16 studies with 14 430 health‐care professionals were included. Pooled results showed that the pooled incidence of facial pressure injury in health‐care professionals was 58.8% (95% CI: 49.0%–68.7%; p < 0.01). The results of the subgroup analysis showed that the incidence of facial pressure injury in these staff was high, and predominantly stage I pressure injury, in the following cases: in health‐care professionals who wore personal protective equipment for longer than 4 h, in those without any training experience, and on the nose. Conclusion: Administrators and researchers should pay attention to preventing facial pressure injury related to the wearing of personal protective equipment (PPE) by ensuring all health‐care professionals receive training and by limiting prolonged periods of use. Summary statement: What is already known about this topic? Facial pressure injury was one of the most common effects experiencedby health‐care professionals wearing facial PPE during COVID‐19, which seriously affected their facial comfort and self‐image.A number of studies have reported the incidence of facial pressure injury in health‐care professionals, but the evidence is inconsistent.Medical staff are the main force during the COVID‐19. What this paper adds? This study showed that the pooled incidence of facial pressure injury in health‐care professionals was 56.8% during COVID‐19.This study showed that there was a higher incidence of facial pressure injury in staff who wore PPE for longer than 4 h and in those without any training experience.This study showed that the nose was the most common part of the face with pressure injury, and Stage I pressure injury was the most prevalent injury type in health‐care professionals. The implications of this paper: This study may provide evidence for managers about the development of guidelines for health‐care professionals to prevent and manage facial pressure injuries and promote the health of health‐care professionals. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is Known on the Subject?: Staff working with other people's mental health are in more danger of experiencing high stress at work.These members of staff are more likely to have mental health problems themselves.Previous research has suggested that training these members of staff to deal with their daily stress and become mentally tougher can protect them. What this Paper Adds to Existing Knowledge?: The findings showed that higher levels of perceived stress and reduced quality of life in mental health workers were related to lower levels of mental toughness.This research provides a detailed understanding of the current issues experienced in a range of different mental health settings, which may contribute to stress and quality of life.The research highlights the importance of protecting staff mental wellbeing, controlling and reducing levels of stress and suggests that one route to doing this is improving mental toughness. What are the Implications for Practice?: These findings suggest a need to increase the awareness of and further protect the mental health of staff working in the mentioned settings.Staff working in mental health settings should be provided with information about how to enhance mental toughness and how to reduce stress.This will lead to a better quality of life for mental health staff and in turn improve the quality of care provided. Introduction: Clinicians working in mental health services are at increased risk of stress at work. Previous work suggests that mental toughness is a protective mechanism for stress in other professions. This has not yet been examined in mental health workers. Aim/Question: To examine whether mental toughness predicts perceived stress and quality of life in mental health workers, to develop an understanding of the factors contributing to and techniques used to deal with stress in this population. Method: Sixty‐two workers completed measures of mental toughness, perceived stress, quality of life and answered questions regarding their personal experience of stress at work. Results: Mental toughness was a predictor of stress (F(7, 54) = 10.58, p <.001) and quality of life (F(6, 55) = 7.58, p <.001, F(7, 54) = 7.15, p <.001 and F(7, 54) = 6.81, p <.001, for compassion satisfaction, burnout and secondary traumatic stress, respectively), with particular roles for the interpersonal confidence and control of life components. Qualitative analysis revealed sources of stress for health workers and a variety of stress management techniques to cope with workplace stress. The findings suggested that mental toughness develops in some but not all health workers due to the demands of their role. Discussion: The findings provide an insight into stress, quality of life and protective factors for stress in mental health workers and suggest that future research should consider mental toughness training in mental health workers. Implications for Practice: There is a need to increase the awareness of factors contributing to stress in mental health workers, such as a lack of resources and staff, and to promote organizational change to improve their professional quality of life. Future research should also explore the potential of mental toughness training in this population. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Physical restraint is widely used in the elderly at home, and cognitive impairment is an important risk factor. Family caregivers of people with dementia are the main decision makers and implementers of physical restraint at home.Most people with dementia in China receive home care, and family caregivers face enormous care and moral pressures influenced by Confucian culture.Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. There is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. What the paper adds to existing knowledge?: Many family caregivers face approach – avoidance conflict and moral dilemmas when making decisions to restrain, and they make difficult choices in these dilemmas.In China, family caregivers are influenced by many unique factors, including traditional Confucian culture, family affection, and rural home environment.Inadequate laws and policies provide the ground for abuse of physical restraints, and family caregivers rarely consider legal and policy restrictions when using physical restraints. What are the implications for practice?: With limited medical resources, nurse‐led dementia management is the hope to reduce physical restraints in home.Mental health nurses need to assess for the appropriateness of physical restraints associated with psychiatric symptoms in people with dementia.At both organizational and community levels, improving effective communication and relationships between professionals and family caregivers are important to address. Improvements in this context require education and time for staff to develop skills and experience which is necessary to provide family caregivers with ongoing information and psychological support within their communities.Considering Confucian culture will be of value for mental health nurses working in other countries where there are Chinese communities to better understand perceptions of family caregivers. Introduction: The use of physical restraints is a common practice in home care. Family caregivers face care‐related and moral pressures due to the influence of Confucian culture in China. The use of physical restraints in the Chinese cultural environment may differ from the use of such restraints in other cultures. Scientific Rationale: Current research on physical restraints focuses on quantitative analysis of its prevalence and reasons within the institutions. However, there is little research on how family caregivers perceive physical restraints in home care context, especially under Chinese culture. Aim: To explore the perceptions of family caregivers on physical restraints in people diagnosed with dementia receiving home care. Method: A descriptive, qualitative study of Chinese family caregivers of people diagnosed with dementia in home care. Framework method analysis was adopted using the multilevel socio‐ecological model. Results: Beliefs about benefit lead to a dilemma for family caregivers. Cherishing family's affection encourages caregivers to reduce physical restraints, but lack of help from family members, professionals and the community forces them to restrain their loved ones. Discussion: Future research should explore the complex issue of culturally specific physical restraints decisions. Implications for Practice: Mental health nurses must receive education regarding the negative outcomes of the use of physical restraints for family members of people diagnosed with dementia. A more liberal approach to mental health and relevant legislation, which is an emerging global phenomenon that is currently in an early phase of development in China, grants human rights to people diagnosed with dementia. Effective communication and relationships between professionals and family caregivers can contribute to the establishment of a dementia‐friendly community in China. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to investigate the effect of health belief model‐based short interviews on preventive behaviours for osteoporosis in postmenopausal women. Design and methods: A randomized pretest, posttest and follow‐up design was used. The study was conducted between June 2016 and June 2017 with an intervention (n = 41) and a control group (n = 41). The intervention group applied the Short Interviews Model for 12 weeks as a short interview programme that was created based on the health belief model. The study data were collected by the researcher using a descriptive information form, the Osteoporosis Health Belief Scale, the Osteoporosis Self‐efficacy Scale and the Osteoporosis Knowledge Test. Results: In the posttest and follow‐up measurements, the mean scores of the intervention group on the total Osteoporosis Health Belief Scale and its self‐efficacy and exercise sub‐dimensions and the total Osteoporosis Knowledge Test and its sub‐dimensions were significantly higher than those of the control group. Conclusion: The short interviews held in this study provided evidence to guide women and nurses in the prevention of osteoporosis in postmenopausal women. It is recommended that the prevention of osteoporosis should be integrated into women's health programmes at the primary health‐care level. Summary statement: What is already known about this topic? Osteoporosis is a critical public health problem that is common among women all over the world. It causes deaths, different disabilities and economic losses every year.Nurses can make important contributions to the prevention of osteoporosis through the health education that they will provide for women. What this paper adds? Sending short messages to women to protect them against the risks of osteoporosis, holding short interviews to improve bone health, sending motivating messages to their phones and teaching them appropriate exercises increased their health beliefs, self‐efficacy and knowledge in preventing osteoporosis. The implications of this paper: This article brings a new perspective that holding health belief model‐based short interviews with postmenopausal women is an effective method of preventing osteoporosis.It is recommended that nurses should conduct interventions to maintain and develop bone health by holding short interviews with women for whom they will provide health‐care services and by using social media tools (giving booklets and sending text messages and videos about strengthening bones via WhatsApp) in the provision of primary health‐care services. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This paper describes the development of a SBHC with an innovative model of care that grew out of a partnership between a public‐school district and a university nursing programme in the midwestern region of the United States. Background and Purpose: Persistent barriers to health and health care experienced by youth are well documented. School‐based health centres (SBHCs) can improve educational and health outcomes, positively impacting health equity. Academic systems are positioned to address health care needs of the school‐aged population, yet educators face challenges of accessing quality learning placements for students and faculty practice sites. Methods: A community‐based collaborative methodology guided the planning phases that were driven by priority needs identified by families and stakeholders. With the mission of "partnering with students, families, and communities in the promotion of health and wellness through engagement in practice, education, and research," an ongoing dialogue over a two‐year period led to articulating a vision, designing a plan and implementing a nurse‐managed SBHC. The Standards for Reporting Qualitative Research (SRQR) checklist was considered in the preparation of this paper. Results: In three years, this SBHC has addressed and identified priority needs and served individual youth and families. The SBHC provides opportunities for the faculty to fulfil a practice requirement for certification and accreditation. Nursing students engage with youth and families in health education and health promotion while strengthening their technical and relational skills. Family nurse practitioner students gain valuable clinical experience. Faculty with expertise in family nursing guide family assessments, support family resiliency and direct therapeutic conversations with family units. Conclusion: SBHCs serve youth, families, and community. This academic–practice partnership has the added benefit of providing faculty practice opportunities and nursing student experiential learning. Relevance to Clinical Practice: SHBCs provide practice opportunities that address needs in individuals, families, and communities. Partnerships should be considered at academic nursing programmes to support their needs and fulfil commitments to address health equity gaps. [ABSTRACT FROM AUTHOR]

Aims: To explore nurses' knowledge, attitudes and practices related to improving hospitalized patients' sleep. Design: Integrative review. Data Sources: We searched CINAHL, PubMed and PsycInfo electronically including a manual search of references listed within the relevant studies. Original, peer‐reviewed studies published in English between 2000 and 2022 evaluating nurses' sleep knowledge, attitudes, or practices to improve inpatients' sleep were reviewed. Review Methods: This review was guided by Whittemore and Knafl method and followed PRISMA guidelines to search the literature. Fifteen articles reporting nurses' sleep knowledge, attitudes or practices to improve inpatients' sleep were included. The quality appraisal was done using the Mixed Methods Appraisal Tool version 2018. Results: Inadequate training of nurses regarding sleep hygiene and insufficiency in sleep‐promoting practices were apparent. Most studies reported that nurses hold positive attitudes about sleep. The acuity of patients' health conditions affected their perception of sleep priorities. Lack of organizational sleep policies/protocols and coworkers' attitudes negatively impacted nurses' motivation to implement sleep hygiene interventions. Interventions reported in the studies were reducing noise and nursing interventions at night, using a clock for time orientation, earplugs, reducing light, keeping patients awake during the daytime, maintaining comfortable room temperature and managing patients' stress. These practices were hindered by poor knowledge, negative attitudes, patients' acuity and lack of sleep assessment tools. Conclusion: It is essential to support nursing practice to improve patients' sleep in hospitals through interventions that target nurses' knowledge, attitudes and confidence towards implementing sleep hygiene interventions to improve patients' sleep and, consequently, their health outcomes during hospitalization. Impact: This integrative review explored nurses' knowledge, attitudes and practices to improve patients' sleep during hospitalization. It revealed that expanding nurses' sleep knowledge and empowering them to implement sleep promotion practices are needed. Nursing educators and leaders need to be involved. No Patient or Public Contribution: This paper is an integrative review and does not include patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To report an analysis of the concept of community empowerment. Design: Concept analysis. Data Sources: Literature published in the CINAHL, PubMed, Scopus and Medline electronic databases from 2016 to 2022 were systematically searched from 30 July to 1 October 2022. Method: The amended guideline from Walker and Avant's approach (2011) to concept analysis was performed in nine stages: choosing a concept, determining the purpose of analysis, identifying definitions of the concept, defining attributes, identifying a model case, identifying antecedents, identifying consequences, defining empirical referents and applying the concept to nursing practice. Results: Community empowerment is a fundamental idea in health promotion that may assist communities in defining priorities, making choices, developing strategies and executing them to improve health and minimize inequalities in health. Community empowerment is an effective tool that advanced practice nurses (APNs) may employ to eliminate health inequities and promote community health. Conclusion: This concept analysis is one step towards broadening nurses' understanding of one of the ideas of health promotion. Additionally, the concept of community empowerment represents an opportunity for additional research in nursing that is applicable to communities. Impact Community empowerment has served as a guiding paradigm for both theory and practice in health promotion. Also, it is recognized that social, economic and environmental elements have a direct effect on health status. However, community empowerment research in advanced nursing practices is limited. This paper will guide future nursing research on community empowerment that goes beyond involvement and engagement, for this is an effective strategy APNs can use to address health disparities and improve community health. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore the relationship between regular exercise, social support and depression in community‐dwelling older people and find out the predictors of depression. Methods: Cross‐sectional and correlation designs were used. The participants were recruited from August to October in 2020. The STROBE was used as a checklist for this study. Results: The study found that female gender, older age, poor sleep quality, irregular exercise and low social support were the main predictors of depression among the community‐dwelling older people. Conclusion: It is suggested that healthcare professionals motivate the older people to exercise regularly in the community using individualized exercise routines designed according to their physical conditions such as different types, frequencies and intensity of exercise. Providing social support to each other at the community care site should be encouraged, and regular assessment of the mental health of community‐dwelling older people should be done. It is also recommended to organize a timely depression‐related education course for older people in the community. Summary statement: What is already known about this topic? In older people depression can lead to further physical and psychological problems. What this paper adds? This study provides information about regular exercise, social support and depression in community‐dwelling older people.Female gender, older age, poor sleep quality, irregular exercise and low social support were the main predictors of depression among these community‐dwelling older people. The implications of this paper for policy/practice/research/education It is suggested that healthcare professionalss motivate older people to exercise regularly in the community care site using individualized exercise routines designed according to their physical condition. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to determine predictors of COVID‐19 preventive behaviours in a sample of the Turkish population. Methods: The study was conducted with 575 individuals. COVID‐19 preventive behaviours were evaluated with a 19‐item scale scored from 19 to 95. Knowledge on COVID‐19 was evaluated with a 22‐item scale scored from 0 to 22. General health literacy was evaluated with the Turkey Health Literacy Scale (THLS), which was scored from 0 to 50. Results: The average COVID‐19 preventive behaviours score was moderately high in this sample of the Turkish population. Being female, having a higher level of education, better economic status, being a non‐smoker, having a higher level of COVID‐19 knowledge and better general health literacy score were significant predictors of COVID‐19 preventive behaviours (P < 0.05). Conclusion: Sociodemographic characteristics, knowledge of COVID‐19 and general health literacy are crucial in preventing COVID‐19 infections in a sample of the Turkish population. Summary statement: What is already known about the topic? To reduce the risk of transmission and prevent the spread of the COVID‐19, it is necessary to comply with COVID‐19 preventive behaviours.Sociodemographic characteristics, knowledge of COVID‐19 and general health literacy are crucial in preventing the COVID‐19 disease. What does this paper add? COVID‐19 preventive behaviours scored moderately high among a sample of the Turkish population.Being female, having higher level of education, better economic status, being a non‐smoker, having higher level of knowledge about COVID‐19 and better general health literacy are significant predictors of COVID‐19 preventive behaviours in a sample of the Turkish population, accounting for 22.4% of the variance in COVID‐19 preventive behaviours. The implications of this paper: Attempts should be made to increase the COVID‐19 knowledge and health literacy to increase COVID‐19 preventive behaviours among the Turkish population.In particular, attempts should be made to increase the COVID‐19 preventive behaviours for men, individuals with low education and poor economic conditions, and smokers. [ABSTRACT FROM AUTHOR]

Aims: Nursing is a highly stressful occupation where irregular shifts and working overtime lead to unhealthy behaviours. This qualitative systematic review and meta‐synthesis aims to examine nurses' barriers in adopting health‐promoting behaviours. Methods: Six electronic databases were searched from their respective inception dates to October 2021: EMBASE, Web of Science, PubMed, PsycINFO, CINAHL and ProQuest Dissertations and Theses. The Critical Appraisal Skills Program checklist was used to appraise the quality of included studies. Data synthesis followed Sandelowski's and Barroso's two‐step approach. Results: Fourteen studies were included in this review, and three themes were generated as follows: (1) work environment and workplace culture, (2) nature of the job and (3) intrinsic factors. Conclusion: This review synthesized available evidence on the barriers nurses experienced while adopting health‐promoting behaviours. Health‐care institutions should target these factors when providing facilities and services to support nurses in adopting health‐promoting behaviours. Policies should focus on workplace health promotion by advocating for healthy lifestyle policies. Future research should be conducted in more multicultural and geographically diverse regions to obtain a more global view of nurses' barriers to adopt health‐promoting behaviours. Summary statement: What is already known about this topic? Nursing is a highly stressful occupation that may create stress‐induced unhealthy lifestyle behaviours.Nurses encounter major barriers to participate in health‐promoting behaviours. What this paper adds? The health‐promoting behaviours were negatively influenced by workplace culture, occupational factors such as job stress and rotating shift and intrinsic factors (e.g., absence of motivation and financial constraints). The implications of this paper: Policies should focus on workplace health promotion by advocating for healthy lifestyle policies.Future research should be conducted in more multicultural and geographically diverse regions to obtain a more global view of nurses' barriers to adopt health‐promoting behaviours. [ABSTRACT FROM AUTHOR]

Aim: To review the literature exploring how general practice nurses support lifestyle risk reduction. Design: Integrative literature review. Sources: CINAHL, Emcare, MEDLINE, Proquest and Scopus were searched for peer‐reviewed primary research published in English from 2010 to 2022. Methods: Sixteen papers met the inclusion criteria and were assessed for methodological quality using the Mixed Methods Appraisal Tool. Findings were extracted and thematically analysed. Results: Four themes described general practice nurses: (1) Establishing relational connections; (2) Empowering active participation; (3) Engaging mutual motivation and (4) Enabling confident action. General practice nurses used complex interpersonal, risk communication and health coaching skills to build collaborative partnerships that supported patients' self‐determination and self‐efficacy. While mutual motivation and confidence were reciprocally enabling, gaps in skills, experience and knowledge plus time, resource and role constraints limited general practice nurses' ability to support lifestyle risk reduction. Conclusion: General practice nurses play a key role in lifestyle risk reduction. Ongoing education, funding, organizational and professional support are needed to enhance their commitment, confidence and capacity. Impact: What problem did the study address?While general practice nurses play a key role in health promotion and risk reduction, their potential is yet to be fully realized. Research examining methods by which nurses working in general practice support lifestyle risk reduction is limited.What were the main findings?Successful interactions depended on personal, professional, organisational and systemic factors which either enhanced or inhibited relational quality, shared decision‐making, mutual commitment, and nurses' confidence and capacity to address lifestyle risks. Targeted professional development and peer mentoring are needed to build proficient practice.Where and on whom will the research have impact?Understanding how general practice nurses support risk reduction can inform policy and identify training and support needs to advance their skills and role. Research exploring synergies between themes may illuminate this process. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Individuals with a severe mental illness (SMI) are less physically active and have a lower life expectancy than the general population due to increased risks of cardiometabolic diseases (obesity, diabetes and respiratory diseases) and other health risks.Physical activity has been used as an adjunct therapy for individuals with SMI yielding improvements in cognitive functioning, quality of life and a reduction in psychiatric symptoms.Individuals with SMI residing within a secure forensic setting have reduced physical activity opportunities, possibly due to a number of factors including low motivation and restricted access to exercise facilities combined with a lack of knowledge and/or confidence in staff members to assist in physical activity programmes. What the paper adds to existing knowledge?: This review demonstrates that little is known around the effects of physical activity for people with SMI who reside in secure forensic settings, with little to no long‐term effects reported.Physical activity interventions have shown some positive results through decreasing weight and waist circumference as well as a reduction in negative symptom scores in an exercise group compared with the "no treatment" control group post‐intervention. What are the implications for practice?: Service users' reluctance to engage in physical activity may be overcome by improving staff commitment, creating a motivational atmosphere and promoting service user decision making. Introduction: Participating in physical activity has many benefits, yet those with severe mental illness (SMI) living in forensic settings are less likely to be active, and more likely to experience ill‐health. The aim of this study was to systematically review the effectiveness of physical activity programmes on mental and physical health and specifically on reducing symptoms of SMI in forensic settings. Method: A systematic search of six databases was conducted, in addition to a grey literature search. Studies were included if they had participants with SMI; were based in a forensic setting; involved a physical activity programme and reported physical and mental health outcomes. Results: A total of 112 participants were included in four studies. One study showed a significant improvement in negative symptom scores in the exercise group compared with a treatment as usual group. Two studies reported improvements in psychiatric symptoms with no significant difference between groups; however, statistically significant changes in weight and waist circumference were evident (p <.001). No adverse effects were reported. Conclusion: Only a small number of studies were included and of limited design and quality, with no follow‐up assessments; therefore, more research is needed to determine the true effects of physical activity for improving SMI symptoms in a forensic setting. This review highlights the need for further studies exploring the barriers and facilitators of physical activity in secure forensic settings. Studies are required that include a more thorough research design. Furthermore, interventions if designed with patients and caring staff in mind may lead to lowered psychiatric symptoms and increased physical health benefits for all in forensic settings. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness (SMI): Live 10 to 20 years less than the general population, and this can be related to lifestyle factors such as poor diet and low levels of physical activity.Have a good understanding of what healthy lifestyle comprises of, but face barriers and challenges related to their mental health, treatment, and life situation. There is limited participatory research that considers the specific beliefs of people diagnosed with SMI about what "being healthy" means to them. What this paper adds to existing knowledge: People diagnosed with SMI value health and are often already engaged in activities that promote both physical and mental health.They experience the "vicious cycle" of barriers to engage in healthier lifestyle, including medication effects, poor sleep routines, fatigue, low mood and establishing a routine, but this shows how healthy activities can improve their mental health.The importance of meaningful places and their role in supporting healthy lifestyles was identifiedSome people diagnosed with SMI face significant socio‐economic challenges (such as lack of cooking facilities; limited money for purchasing healthy food) to support healthy lifestyles.To truly understand the perspectives of people with SMI, who are typically voiceless and disempowered, research methods need to allow the participants to set the agenda for discussion, to not only provide rich data but also have the added benefit of empowerment and enhanced engagement. What are the implications for practice?: Mental health nurses should: Explore the practical barriers to healthy lifestyle such as financial concerns and ensure that people can access support to obtain what they need from the local community resources.Instigate a mental health and/or medication review if mental health symptoms or medication side effects are a barrier to healthy lifestylesExplore what places have meaning and consider how to use meaningful places as motivating factors for healthy lifestyles and promoting mental well being. Introduction: People diagnosed with serious mental illness (SMI) live 10–20 years less than the general population, due in part to co‐existing physical illness linked to lifestyle factors. To inform individualized care plans to promote healthy lifestyles, it is important to understand the views of people diagnosed with SMI. To truly understand their lived experience, research methods should allow participants to set the agenda for discussion, enhancing engagement and empowerment in the research process. Aim: To use a participatory research approach to capture what healthy lifestyle means to people who are diagnosed with SMI. Method: Eight people diagnosed with SMI participated in six, weekly focus groups using Photovoice. Data were analysed using thematic analysis. Results: The overarching theme was 'mental health is the main priority', and the other themes were barriers to a healthy lifestyle, represented as a vicious cycle, and three themes, which were facilitators ‐ the importance of place, meaningful activities, and the importance of others. Discussion: The methodology allowed participants to choose images that reflected their lived experience. The themes describe the interaction of physical and mental health and practical barriers and will inform the design of individualized care plans. Implications for Practice: In co‐designing care plans, mental health nurses should draw on peoples' preferences and explore the barriers identified in this study. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses.Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams. What does this paper add to existing knowledge: The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers.The results showed that having more children, between 31 and 39 years old, and having a part‐time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased. What are the implications for practice: Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part‐time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover.Experience‐sharing meetings and mindfulness‐based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part‐time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens. Introduction: Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims: To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods: Data were collected from 2355 psychiatric Chinese nurses using a cross‐sectional design with an online questionnaire investigation. Results: Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part‐time jobs, education, income and patient‐to‐nurse ratio. Discussion: Demographics and job‐related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice: Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family‐friendly policies, increasing their occupational possibilities and promoting mental health. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the electronic health (e‐health) literacy level of high school students and its relationship with their health‐promoting behaviours. Methods: This was a cross‐sectional study conducted between April and May 2018. The study sample consisted of 409 students, who were aged between 14 and 19 years old, in three high schools located in the city centre of Denizli. Multiple regression analyses were performed to examine the predictive variables for six dimensions of health‐promoting behaviours. Results: In this study, the mean (SD) e‐health literacy score of 27.89 (6.19) was slightly above moderate level. e‐Health literacy was found to significantly predict all six dimensions of health‐promoting behaviours positively, that is, e‐health literacy was determined to predict the dimensions of nutritional behaviours (β = 0.64, P < 0.001), life appreciation (β = 0.55, P < 0.001), social support (β = 0.72, P < 0.001), exercise (β = 0.36, P < 0.001), stress management (β = −0.22, P < 0.001) and health responsibility (β = 0.68, P < 0.001). Conclusion: With e‐health literacy significantly predictive of health‐promoting behaviours, nurses are recommended to consider the e‐health literacy levels of adolescents in the health‐promoting programs they design. [ABSTRACT FROM AUTHOR]

SUMMARY STATEMENT: What is already known about this topic? The population is ageing rapidly and consistently worldwide.Health‐promoting behaviours are crucial in enabling older adults to function independently and to ensure a better quality of life.The instruments commonly used to measure health‐promoting behaviours are not tailored to the specific needs of the older people. What this paper adds? The Turkish version of the GHP scale is usable for evaluating health‐promoting behaviours in older adults.The Turkish version of the GHP scale for older people showed statistically acceptable levels of reliability and validity for use in the Turkish population.The presence of distinct subscales within this scale serves to identify the areas where the older adults require additional support. The implications of this paper: The Turkish version of the GHP scale could be an appropriate instrument for nurses to measure the health‐promoting behaviours of older people.This scale can be used to establish health promotion programmes that encourage the adoption of healthy lifestyle practices that are specifically tailored to the needs of older people.This scale can be used in future studies that are planned for health promotion among the older individuals. Background: A measure for healthy lifestyle behaviours of older adults would enable the development of effective and target‐based health promotion strategies. Aim: This study aimed to test the validity and reliability of the Turkish version of Geriatric Health Promotion scale among older people in Turkey. Design This was a methodological study that was conducted between June and August 2018. Methods: A total of 321 volunteer older individuals, who were admitted to local health centres, participated in this study. A questionnaire, including sociodemographic data form, and the Geriatric Health Promotion scale were used to collect data. Content and construct validity was established using validity analyses. Results: The reliability of the scale was confirmed by its internal consistency (α =.82) and test‐retest reliability (0.86). Exploratory factor analysis for the six‐factor construct explained 64.7% of the total variance. Factor loads of each item ranged from 0.44 and 0.91. Confirmatory factor analysis indicated that the theoretical constructs had a perfect fit with data obtained. These data establish that the Turkish version of the Geriatric Health Promotion scale was valid and reliable. Conclusion: The Turkish version of the Geriatric Health Promotion scale is a reliable and valid instrument that can be used in the evaluation of health‐promoting behaviours among older individuals. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to compare the evolution of health risk behaviours between undergraduate nursing and social work students. Background: Nursing includes the promotion of health and the shaping of healthy behaviours. An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. Design Longitudinal comparative study. Measurements We compared lifestyle risk behaviours (binge drinking, cannabis/hashish/marijuana use, smoking, oral hygiene/toothbrushing, breakfast/fruit/vegetable consumption, physical activity and screen time/sedentary behaviours) using a self‐administered standardized questionnaire in nursing (n = 121) and social work (n = 140) students at the beginning (2012) and the end of their studies (2015). Adjusted multivariable logistic/Poisson regression models were performed. Results: There were no statistically significant differences between the departments in most risk factors in both assessments. However, in relation to their first year, both nursing and social work students displayed higher relative risk of engaging in more behavioural risk factors at the end of their studies (in delivery/junk food consumption, sunburns, hashish/marijuana use and multiple sexual partners). Social work students displayed better behaviours in physical activity and breakfast intake. Conclusion: Nursing students share the patterns of their nonnursing peers in behavioural risk factors compromising their future health and health‐promoting role. We need strategies to safeguard the professional nursing practice. SUMMARY STATEMENT: What is already known about this topic? Nursing includes the promotion of health, the prevention of illness and the shaping of healthy behaviours.Nurses are in a unique position to help individuals and communities modify their health risk behaviours.An important determinant for providing lifestyle advice is the lifestyle of nurses themselves. What this paper adds? Using a longitudinal comparative study design, we recorded no major differences in behavioural health risk factors between nursing students and nonnursing peers at the beginning and the end of their studies.In relation to their first year of studies, both nursing students and nonnursing peers engaged in more health risk behaviours during their final year in delivery/junk food consumption, sunburns, hashish/marijuana use and number of sexual partners. The implications of this paper: Multiple strategies are needed to target norms regarding the scope of professional practice of nursing and advance undergraduate nursing curricula to explicitly provide the required knowledge for health promotion, lifestyle counselling and behaviour change interventions. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The Health Improvement Profile (HIP) is a one‐page form developed in the United Kingdom as a tool for mental health nurses to assess service user's physical health needs.The HIP screens service users' physical health and provides recommendations that clinicians can provide service users with in order to improve their physical health.There was evidence supporting the effectiveness of the HIP; however, the majority of HIP studies to date involve the screening tool being completed by nurses. In Australia, a large proportion of mental health clinicians providing case management to service users in community settings are not nurses. What the paper adds to existing knowledge?: This paper shows that the HIP can be adjusted to suit the needs of Australian service users and can be utilized by clinicians from a variety of disciplines.It also shows that both clinicians and Australian service users find the HIP helpful and argues for it being made available for all service users.It has clearly shown a need to target flu vaccine programmes at service users. What are the implications for practice?: The HIP has been shown to be a suitable and acceptable screening tool for different clinicians to assess multiple lifestyle risk factors at once, which can be used across different diagnoses and settings. This study, for example, demonstrated a need to focus on promoting the flu vaccine and smoking cessation, as well as encouraging service users to visit eye and dental health services. Introduction: Health Improvement Profile (HIP) studies to date primarily focused on the screening tool being completed by nurses. This paper explores the HIP in two different settings, with an emphasis on expanding physical health roles for all mental health clinicians. Aim: The aim of the present study was to adapt the HIP to Australian standards and implement it at a large mental health service. Method: This is an evaluation of the implementation of the HIP over a two‐month pilot period. Clinicians and service users were surveyed on their experience of the HIP. Results: The community team completed the HIP with 34 (15%) service users. The inpatient unit completed the HIP with 137 (54%) service users. Results from the HIP clearly show priority areas for health interventions. Feedback from clinicians and service users was predominately positive. Discussion: We found the HIP to be an acceptable screening tool that encompasses multiple lifestyle risk factors. Implications for practice: This study clearly demonstrates the utility of the HIP as a workable and acceptable screening tool with real world applicability. In our pilot, for example, we identified the need for the promotion of influenza vaccinations amongst service users, as well as the ongoing need to target smoking cessation and substance use. [ABSTRACT FROM AUTHOR]

Aim: The present study aimed to evaluate the effectiveness of individualized exercise counselling in changing exercise behaviour and relieving pregnancy‐related distress symptoms in pregnant women. Methods: A quasi‐experimental design and convenience sampling technique were used. Participants were recruited from the prenatal outpatient departments of medical centre hospitals in Taipei, Taiwan. The experimental group (n = 52) received face‐to‐face exercise counselling followed by 8 weeks of exercise sessions in their homes. The control group (n = 49) received no exercise counselling. Pregnancy‐related distress symptoms were assessed before and after 8 weeks in both groups. Results: The after‐counselling scores of total (t = 2.46, P < 0.05) and physical (t = 3.18, P < 0.01) distress symptoms were significantly lower than the before‐counselling scores in the experimental group. The total, physical and psychological distress scores significantly differed between groups and before and after counselling. The adjusted R2 values for total, physical and psychological distress symptoms ranged from 0.59 to 0.70. Participants' exercise habits increased from prepregnancy (19.2%) to after counselling (71.2%). Conclusion: Exercise counselling may effectively increase exercise habits and reduce pregnancy‐related distress symptoms among pregnant women. Women with higher pretest symptom distress scores also had higher posttest symptom distress scores. Based on our outcomes, health care providers should routinely provide exercise counselling to pregnant women. SUMMARY STATEMENT: What is already known about this topic? Previous studies have found that exercise can be very beneficial for pregnant women by relieving pregnancy‐related distress.Women also commonly reported that advice regarding exercise during pregnancy is generally vague (not individualized), constantly changing and often limited to a continuation of their previous routine or simply increased walking.Studies on the effectiveness of individual face‐to‐face exercise counselling for pregnant women for relieving their pregnancy‐related distress symptoms are limited. What this paper adds? Individual face‐to‐face exercise counselling can reduce pregnancy‐related symptoms in pregnant women.The pretest score was a significant factor that influenced the degree of relief from symptom distress. The implications of this paper: This study could help health care providers to provide pregnant women with exercise counselling as part of their routine prenatal care to relieve pregnancy‐related distress. [ABSTRACT FROM AUTHOR]

Aim: To develop a comprehensive, hands‐on assessment tool for assessing health in children under five in underserved regions. Design Methodological study design and usability testing were used. Sample Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. Measurement The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. Results: The Hands‐on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow‐up plans. Usability testing revealed high scores on the facets "valuable," "useful," "desirable," and "findable." Conclusions: Considering the demand for hands‐on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes. SUMMARY STATEMENT: What is already known about this topic? Many child health problems are preventable with early detection and intervention. Health problems in children under five affect the growth and development of the whole life.Community nurses in underserved regions need comprehensive and hands‐on assessment tools with point‐of‐care to identify child health problems and provide right care.Currently developed assessment tools for child health have limitations for use in underserved areas. What this paper adds? The Hands‐on Assessment Tool for Child Health (HATCH) helped community nurses to identify the child's health status and nurses to establish a proper care plan.The tool provided clinical judgement process of assessment, interpretation, and nurses' intervention strategies. The implications of this paper: The result of the research can contribute to a concrete intervention strategy for child health promotion by assessing health and development in underserved regions. [ABSTRACT FROM AUTHOR]

Aims: To explore the feasibility and effects of the programme based on information‐motivation‐behavioural skills (IMB) model (IMB programme) on adherence to inhalation therapy and other health outcomes in chronic obstructive pulmonary disease (COPD) patients. Background: Poor adherence to inhalation therapy is common among COPD patients. The IMB model is supported by previous studies as useful in promoting adherence to health behaviours. Methods: This pilot randomized controlled trial randomized 35 COPD patients to receive either the IMB‐based programme or usual care. The 4‐week IMB programme consisted of a face‐to‐face and two telephone sessions to empower patients with skills and knowledge on using inhalation therapy and support their goal attainment for treatment compliance. Outcome evaluation including adherence to inhalation therapy, inhalation techniques, disease impact, and quality of life was conducted at baseline and at 6 weeks after randomization. Feasibility of the IMB programme was evaluated by a satisfaction survey and implementation experience. Results: Thirty patients completed the study, with an attrition rate of 14.3%. The intervention group (n = 15) had significant improvements in inhalation adherence, inhalation techniques, and quality of life than the control group over the evaluation period. Patient satisfaction survey results and observations on programme implementation suggested the feasibility of the IMB programme. Conclusion: A IMB model is a feasible and potentially effective intervention for improving COPD patients' adherence to inhalation therapy. SUMMARY STATEMENT: What is already known about this topic? Information‐motivation‐behavioural skills (IMB) models have produced positive effects on adherence behaviour in patients with acquired immune deficiency syndrome, coronary heart disease, and diabetes. What this paper adds? No study has evaluated the effects of the IMB model on an intervention for adherence behaviour in patients with chronic obstructive pulmonary disease (COPD).The pilot randomized controlled trial (RCT) showed that the IMB model used in the intervention was effective in improving COPD patients' adherence to inhalation regimen and techniques.The pilot study found that the IMB intervention programme was feasible for implementation in outpatient settings and was highly accepted by COPD patients. The implications of this paper: This programme may be effective in improving COPD patients' adherence to inhalation regimen and inhalation techniques.The programme is feasible and acceptable.There is need to conduct an adequately powered multisite RCT to provide stringent outcome evaluation of the IMB intervention programme. [Correction added on 28 January 2020: 'The implications of this paper' section has been amended.] [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine whether implementation of a healthy lifestyle education programme resulted in improved health literacy levels and healthy life style behaviours. Methods: A one‐group pretest‐posttest study design was used. This study was carried out with 30 women who were enrolled in a family health centre. A questionnaire comprising the Adult Health Literacy Scale, Healthy Lifestyle Behaviour Scale‐II, Perception of Health Scale, and Short Test of Functional Health Literacy was used for data collection. Eight home visits including training and follow‐up followed the first interview at the family health centre. The healthy lifestyle training was applied once per week during home visits. After the training sessions were completed, women were followed‐up through four home visits biweekly in the second and the third months. Results: The difference between the Adult Health Literacy Scale and Short Test of Functional Health Literacy pretest‐posttest mean scores was statistically significant (P <.05). Although the Perception of Health Scale and the Healthy Lifestyle Behaviour Scale‐II posttest scores were higher than the pretest scores, the difference between the groups was not statistically significant. Conclusion: The training and counselling intervention visits increased health literacy but did not significantly change the healthy life style behaviours and health perceptions of the women. SUMMARY STATEMENT: What is already known about this topic? Health literacy is an essential issue to consider in planning programmes to decrease inequalities and increase health promotion in disadvantaged groups.Women are one disadvantaged group who play a key role in protecting and promoting the health of both their society and their family. What this paper adds? Unlike many studies with disease‐specific samples, this was a community‐based study, conducted with community‐dwelling women without any co‐morbidity, using both national and global measurement tools.The health literacy levels of the women was increased via a training and counselling intervention delivered during home visits by public health nurses.The intervention did not have a significant effect on women's healthy life styles and health perceptions. The implications of this paper: The findings of our study indicate that public health nurses as educators and counsellors can impact health literacy levels of women.Public health nurses can improve women's health literacy by empowering women. More health literate women means more healthy generations, families, and communities. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this paper is to describe a model to guide nursing science in a clinical practice‐based setting. Exemplars are provided to highlight the application of this nursing research model, which can be applied to other clinical settings that aim to fill evidence gaps in the literature. Background: Nurse scientists are well positioned to develop new knowledge aimed at identifying global health solutions to multiple disparities. The generation and application of this knowledge are essential to inform and guide professional nursing practice. While a number of evidence‐based practice models exist to guide the integration of literature findings and other sources of evidence into practice, there is a need for additional models that serve as a guide and focus for the conduct of research in distinct scientific areas in practice‐based settings. Design: Model development and description. Methods: Mayo Clinic is a large, comprehensive healthcare system with a mission to address unmet patient needs through practice, research and education. PhD‐prepared nurse scientists engage in practice‐based research as an integral component of Mayo Clinic's mission. A practice‐based nursing research model was developed with the intent to advance nursing research in a clinical setting. Results: The components of the Mayo Clinic Nursing Research model include symptom science, self‐management science and caregiving science. The generation of nursing science is focused on addressing needs of patients with complex health conditions, inclusive of caregivers. Conclusions: While clinical settings provide rich opportunities for the conduct of research, priorities need to be established in which to focus scientific endeavours. The Mayo Clinic Nursing Research model may be applicable to nurses around the globe who are engaged in the generation of knowledge to guide practice. Relevance to Clinical Practice: The Mayo Clinic Nursing Research model can be used by nurse scientists embedded in healthcare settings to address clinically relevant questions, advance the generation of new nursing knowledge and ultimately improve the health and well‐being of patients and caregivers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about this topic?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge?: It appears feasible to use the HIP to profile and compare physical health‐related risks in people with SMI across different international settings.The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?: The HIP could be used to identify unique clusters of health promotion needs in different countries.Use of HIP health checks may support implementation of individualized interventions. Introduction: To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim: To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method: An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results: Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion: This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi‐national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice: It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand Black women's perspectives on a pre‐exposure prophylaxis (PrEP) education intervention in a salon setting. Background: Black women have a significant lifetime risk of acquiring HIV. Pre‐exposure prophylaxis (PrEP) is an effective prevention approach in reducing that risk. Despite this, Black women are least likely to use PrEP. Design: This was a qualitative study to identify Black women's perspectives on acceptability of a PrEP education intervention in a salon setting using hair stylists. The paper adhered to the COREQ checklist in reporting. Methods: Seven focus groups among Black women (n = 44) living in north‐central North Carolina were conducted. Ethical approval was obtained. The interview guide included questions on knowledge of PrEP and barriers and facilitators to a PrEP promotion programme in a salon setting. Results: Conventional content analysis considered content in relation to themes of facilitators, barriers and women's preferences for intervention delivery. Facilitators included the salon characteristics, social culture and relationship with the stylist. Women noted concerns of accuracy of content from stylists and privacy as barriers. Conclusions: Participants' trust with their stylists make a PrEP education salon‐based intervention feasible. Salon‐based interventions are not one‐size‐fits‐all and researchers interested in this setting should tailor interventions to the individual salon. Interventions for PrEP in a salon setting should be culturally appropriate, confidential and consider the potential reach to the social networks of Black women in the salon. Relevance to clinical practice: The insights shared by Black women can contribute to developing a PrEP uptake intervention as a way of reducing new cases of HIV. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the nurses' perceptions of their role with respect to promoting physical activity in adult patients and factors related to this role perceptions. Background: Ageing and chronic diseases are often accompanied by a decrease in physical activity. Nurses are in an excellent position to promote physical activity, because of their close and frequent interactions with patients. However, they often fail to actively stimulate patients to physical activity due to a lack of time, competing priorities and their focus on acute problems. Unclear was how nurses view their professional role in the promotion of physical activity. Design: Systematic literature review. Methods: PubMed, COCHRANE and CINAHL EBSCO were searched for papers published from 2006 to September 2019. Two reviewers independently assessed the methodological quality, using MMAT criteria. Thematic synthesis was used to analyse the data. The PRISMA statement was followed for reporting. Results: Overall, 10 quantitative, eight qualitative and one mixed methods study were included in the review. Analyses of these studies resulted in six themes: (1) active and professional role; (2) the recognised importance; (3) fear of patient falling; (4) patient's present health and need; (5) interdisciplinary context and responsibility; and (6) nurses' knowledge. Conclusions: Nurses perceive they have an active role in the promotion of physical activity and consider it as important and part of their professional role. Clear guidance increased education and stronger awareness of guidelines might enable nurses to translate their perceived role into daily practice. This will enhance professional fulfilment as well as patients' physical activity. Relevance to clinical practice: The findings guide the development of interventions that aim to improve nursing care with respect to the promotion of physical activity and help managers and educators to provide appropriate resources and education. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject: People with mental disorders have increased risk of dying from diabetes and cardiovascular diseases compared to the general population. Diabetes and cardiovascular diseases are preventable by improved lifestyle regarding smoking, alcohol consumption, physical activity and dietary behaviours.Forensic mental health service users are treated for longer periods of time compared to non‐forensic mental health service users, giving the opportunity to affect the lifestyle for a substantial period of time. What the paper adds to existing knowledge: This review gathers existing research on forensic mental health service users' lifestyle regarding smoking, alcohol consumption, physical activity, and dietary behaviours and factors influencing it. The lifestyle was found to be unfavourable with many patients being smokers, having problematic alcohol consumption, being physically inactive and eating a diet of poor nutritional value and rich in calories. Therefore, it seems likely that an unfavourable lifestyle is one reason for the excess mortality from diabetes and cardiovascular diseases.Smoking cessation and improving dietary habits was perceived difficult, but nicotine replacement and practical advice was suggested to support a change. What are the implications for practice: The treatment period gives an opportunity to improve the lifestyle of forensic mental health service users to prevent diabetes and cardiovascular diseases in this high‐risk group.We recommend a holistic approach, when planning the prevention activities, since activities that are perceived fun are more likely to succeed. Introduction: People with mental disorders have increased risk of dying from diabetes and cardiovascular diseases, both of which can be prevented by lifestyle. Aim: To review existing research, in order to investigate the characteristics of, and factors that influence forensic mental health service users' (FMU) health behaviours. Method: We searched PubMed, CINAHL, PsycInfo and Scopus for primary research on FMU's health behaviours regarding smoking, alcohol consumption, physical activity and dietary behaviours, and factors that influence them. Results: We found 13 eligible studies. The findings consistently indicated the presence of unfavourable health behaviours in FMU: Smoking, problematic alcohol consumption, physical inactivity and a high‐calorie diet of poor nutritional value. Changing smoking and dietary habits was perceived as difficult, but nicotine replacement and practical advice were suggested to support change. Discussion: The existing research on FMU's health behaviours is sparse. In particular, there is a lack of research on factors that influence health behaviours. From our findings, it seems likely that FMU's unfavourable health behaviours contribute to their increased risk of dying from diabetes and cardiovascular diseases. Implications for practice: FMU's health behaviours should be improved to prevent diabetes and cardiovascular diseases in this high‐risk group. [ABSTRACT FROM AUTHOR]

Aim: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions. Background: Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments. Design: Integrative literature review. Data Sources: Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016. Review methods: Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo. Results: Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity. Conclusion: Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership. [ABSTRACT FROM AUTHOR]

Background: Role confusion is hampering the development of nurses' capacity for health promotion and prevention. Addressing this requires discussion to reach agreement among nurses, managers, co‐workers, professional associations, academics and organisations about the nursing activities in this field. Forming a sound basis for this discussion is essential. Aims and objectives: To provide a description of the state of nursing health promotion and prevention practice expressed in terms of activities classifiable under the Ottawa Charter and to reveal the misalignments between this portrayal and the ideal one proposed by the Ottawa Charter. Methods: A critical interpretive synthesis was conducted between December 2018 and May 2019. The PubMed, CINAHL, Scopus, PsychINFO, Web of Science and Dialnet databases were searched. Sixty‐two papers were identified. The relevant data were extracted using a pro‐forma, and the reviewers performed an integrative synthesis. The ENTREQ reporting guidelines were used for this review. Results: Thirty synthetic constructs were developed into the following synthesising arguments: (a) addressing individuals' lifestyles versus developing their personal skills; (b) focusing on environmental hazards versus creating supportive environments; (c) action on families versus strengthening communities; (d) promoting community partnerships versus strengthening community action; and (e) influencing policies versus building healthy public policy. Conclusions: There are notable misalignments between nurses' current practice in health promotion and prevention and the Ottawa Charter's actions and strategies. This may be explained by the nurses' lack of understanding of health promotion and prevention and political will, research methodological flaws, the predominance of a biomedical perspective within organisations and the lack of organisational prioritisation for health promotion and prevention. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Adolescents who partake in one health risk behaviour (HRB) easily adopt other HRBs, simultaneously or subsequently.Multiple HRBs might threaten adolescents' future health in adulthood.Adolescents with psychological problems have higher rates of smoking, alcohol use, early sexual initiation and activity, and illicit substance use compared with others. What does this paper add to existing knowledge?: A considerable number of Korean adolescents with mental health problems were engaged in multiple HRBs. For those with mental health problems, more than half of the Korean adolescents with multiple HRBs tended to use alcohol and cigarettes concurrently.Korean adolescents who felt depressed and had suicidal ideation were more likely to engage in a greater number of HRBs.Substance abuse is the most prevalent problem that is combined with other HRBs among those with depression and suicidal ideation compared to those who exhibited other HRBs. What are the implications for practice?: When mental health nurses working in schools and community centres for mental health identify Korean adolescents with significant depression and suicide ideation levels, they should also assess adolescents' engagement in multiple HRBs.Population‐based campaigns and policy changes that emphasize both psychological health and risky behaviour reduction among adolescents should be provided simultaneously to students and school nurses. Introduction: There is limited understanding about whether poor mental health is associated with certain combinations of multiple health risk behaviours (HRBs) such as smoking, drinking, early sexual activity and substance abuse. Aim: To determine the prevalence of multiple HRBs and to identify associations between poor mental health and multiple HRBs as the number of HRBs increases. Methods: This cross‐sectional study was conducted using the 2016 Korea Youth Risk Behavior Web‐based Survey (N = 65,528). Descriptive statistics and multinomial logistic regression analyses were conducted using the complex sample data. Results: Overall, 28.6% and 13.9% of Korean adolescents were involved in one or multiple HRBs, respectively. Adolescents who were depressed (OR = 1.43–4.47, 95% CI = 1.37–1.49 to 3.23–6.20) and/or who had suicidal ideation (OR = 1.33–3.19, 95% CI = 1.25–1.42 to 2.25–4.51) were more likely to engage in multiple HRBs. Discussion: A considerable numbers of Korean adolescents are engaged in multiple HRBs. When adolescents self‐reported depression and suicidal ideation, they were more likely to engage in a greater number of HRBs than single HRB. Implications for practice: Tailored interventions to decrease multiple HRBs should be designed and provided by considering adolescents' mental health status and needs. [ABSTRACT FROM AUTHOR]

Aim: To analyse the effect of mindfulness training on levels of burnout among nurses. Background: Burnout syndrome is a common occupational hazard for nursing staff. Mindfulness training has been proposed as a valid intervention for burnout. Design: Systematic review and meta‐analysis. Data sources: The CINAHL, LILACS, Medline, ProQuest, PsycINFO, Scielo and Scopus databases were consulted, using the search equation 'Nurs * AND burnout AND mindfulness'. There was no restriction on the year of publication. Review methods: Papers were selected for analysis in accordance with the PRISMA guidelines. The meta‐analysis was carried out using Review Manager 5.3 software. Results: The sample was of 17 articles including 632 nurses. Mindfulness training reduces levels of burnout, producing lower scores for emotional exhaustion and depersonalization and higher for personal accomplishment. The differences in the means were 1.32 (95% CI: −9.41–6.78), 1.91 (95% CI: −4.50–0.68) and 2.12 (95% CI: −9.91–14.14), respectively, between the intervention and control groups. Conclusion: Mindfulness training reduces the emotional burden and hence levels of burnout, among nurses. However, further randomized clinical trials are required. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: A clear association exists between serious mental illness (SMI) and poor physical health.Individuals with SMI have markedly higher risks for mortality and morbidity.Mental health nurses play an important role in enhancing service users' mental and physical well‐being.The attitudes of mental health nurses towards physical health care have been explored in the western part of the world. However, cross‐country differences should be determined to reveal the importance of this global issue. What the paper adds to existing knowledge?: This study adds new data to the literature on the Physical Health Attitude Scale's (PHASe) validity and nurses' attitudes when working in acute mental health services in different cultures.Nurses in acute mental health wards mostly focus on the basic physiological indicators of patients' existing physical health problems, so health promotion practices such as sexual health and eye/dental examinations are neglected for individuals with SMI.Nurses' higher level of confidence about their delivery of physical health care is due to their familiarity with basic nursing practices (e.g. monitoring blood pressure and checking blood glucose levels).Differences that exist between countries in relation to smoking habits are probably due to different regulations. What are the implications for practice?: To improve patients' physical healthcare outcomes, nurses should be provided with additional training and supervision to strengthen their skills and confidence.Nurses' perceived need for additional training reflects the importance of physical health care in mental health settings, in which training could substantially improve patient outcomes.Authors believe that standard protocols must be established in acute psychiatric care to eliminate obstacles to holistic patient care.Training needs of mental health nurses on health promotion practices should be considered by administrators of mental health settings. Introduction: Nurses play an important role in improving the physical health of individuals with serious mental illnesses. The literature on the attitudes of mental health nurses towards physical health care provides a small amount of data. Assessing trends in nurses' attitudes through suitable surveys is important to ensure holistic care. Aim/Question: This study sought to examine the Turkish version of the Physical Health Attitude Scale's (PHASe) validity and reliability and to survey Turkish mental health nurses' attitudes towards physical health care. Method: The sample consisted of 174 nurses working in acute psychiatric wards. Firstly, the psychometric properties of the scale were analysed using factor analysis and measures of internal consistency and reliability. Then, the survey results of the attitudes of mental health nurses towards the physical health of patients with serious mental illnesses were determined using the Physical Health Attitude Scale (PHASe). Results: The translated PHASe functioned best as a 24‐item version and 4‐factor solution that explains 51.3% of the variance. The internal consistency value was 0.83. The respondents' attitudes were generally positive about their role. There was less agreement for the involvement of nurses in practices of health promotion, such as sexual health, eye and/or dental examinations. The nurses surveyed also tended to use smoking for therapeutic purposes. Implications for practice: Mental health nurses' knowledge and attitudes should be enhanced by additional training in the ways of meeting patients' biopsychosocial needs. Obstacles to physical health care can be removed by implementing standard protocols nationwide. [ABSTRACT FROM AUTHOR]

Aims and objectives The purpose of this paper is to provide recommendations to strengthen cardiovascular disease research with lesbian, gay and bisexual adults, and highlight implications for practice. Background Lesbian, gay and bisexual individuals face significant discrimination that negatively impacts their health. Health disparities research in lesbian, gay and bisexual adults have focused on mental health, sexually transmitted infections and substance use. Although cardiovascular disease is the leading cause of death and many lesbian, gay and bisexual adults report increased risk factors for cardiovascular disease, there has been limited research in this area. Design This paper is a critical review. Methods A literature search was conducted that compared cardiovascular disease risk and/or prevalence between lesbian, gay and bisexual and heterosexual adults. Results Measures to assess cardiovascular disease risk factors and diagnoses varied widely across the 31 included studies. There was a lack of standardisation in definitions used for alcohol consumption, illicit drug use, mental health and self-rated physical health. Most studies that reported body mass index relied on participant self-report. Few studies included measures of physical activity and diet and those that did lacked standardisation. Only seven studies used laboratory data to establish diagnosis of cardiovascular disease. Conclusions This study is the first comprehensive review on this topic. In cardiovascular disease research with lesbian, gay and bisexual adults, there is a need for: (1) inclusion of stress as a risk factor for cardiovascular disease, (2) standardised measures, (3) objective measures for determining the presence of cardiovascular disease, (4) data from electronic health records to strengthen the study of cardiovascular disease in this population. Relevance to clinical practice Strengthening cardiovascular disease research in lesbian, gay and bisexual adults is an important step in addressing health disparities in this population. Nurses and other healthcare professionals should assess sexual orientation in routine health assessments. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine perceived social and environmental barriers and facilitators for healthy eating and activity before and after knee replacement. Background: Many patients undergoing knee replacement surgery are overweight or obese. While obesity treatment guidelines encourage diet and activity modifications, gaps exist in understanding social and environmental determinants of these behaviours for knee replacement patients. Identifying these determinants is critical for treatment, as they are likely amplified due to patients' mobility limitations, the nature of surgery and reliance on others during recovery. Design: This qualitative study used semi‐structured interviews. Methods: Twenty patients (M = 64.7 ± 9.8 years, 45% female, 90% Caucasian, body mass index 30.8 ± 5.5 kg/m2) who were scheduled for or had recently undergone knee replacement were interviewed. Participants were asked to identify social and environmental factors that made it easier or harder to engage in healthy eating or physical activity. Deidentified transcripts were analysed via constant comparative analysis to identify barriers and facilitators to healthy eating and activity. This paper was written in accordance with COnsolidated criteria for REporting Qualitative research standards. Results: Identified social and environmental healthy eating barriers included availability of unhealthy food and attending social gatherings; facilitators included availability of healthy food, keeping unhealthy options "out of sight," and social support. Weather was the primary activity barrier, while facilitators included access to physical activity opportunities and social support. Conclusions: Results provide salient factors for consideration by clinicians and behavioural programmes targeting diet, activity, and weight management, and patient variables to consider when tailoring interventions. Relevance to clinical practice: Practitioners treating knee replacement patients would be aided by an understanding of patients' perceived social and environmental factors that impede or facilitate surgical progress. Particularly for those directly interacting with patients, like nurses, physiotherapists, or other professionals, support from health professionals appears to be a strong facilitator of adherence to diet and increased activity. [ABSTRACT FROM AUTHOR]

Aim: This paper describes the design and rationale of multicenter practice‐based research that aims to develop and evaluate an innovative mobile health (mHealth) intervention programme directed to promote healthy behaviours and prevent adolescent obesity. Design: This study is designed as a non‐randomized controlled trial with a three‐arm structure. Methods: Twelve to 16 years old participants will be recruited from schools, with access to the Internet and smartphone/tablet devices. The intervention group will be invited to engage in the TeenPower mHealth programme and divided into two subgroups: Group A (additionally engaged in a structured school‐based intervention programme) and Group B (only engaged in the mHealth programme). The mHealth app includes educational resources, self‐monitoring, social support, interactive training modules and motivational tools. The control group will only follow the structured school‐based intervention programme. The intervention length will be 3 months, including the direct support of an interdisciplinary team (nursing, nutrition, sports, psychology, among others). This research was approved and funded in August 2017. Discussion: The positive evaluation of the intervention programme will stimulate the inclusion of technologies in the promotion of salutogenic behaviours and obesity prevention. Impact: Adolescent obesity reached epidemic proportions. It is urgent to find effective prevention strategies to induce change at the individual, family and community level. If effective, this protocol can be used by health and exercise professionals in improving community interventions tailored to teenagers. [ABSTRACT FROM AUTHOR]

Introduction: Preconception care promotes better maternal outcomes, may assist in preventing birth defects and improves fertility awareness among healthy childbearing couples. Yet, the significance of preconception care for infertile couples is undeveloped area of practice in Europe. Aims and objectives: To discuss the importance of nurses and midwives in providing preconception care to infertile couples in the United Kingdom and Spain. Design: Discursive paper. Method: A comparison of different midwifery and nursing approaches to preconception care for infertile couples in two European countries. Findings: At present, infertile couples' needs for preconception care are not routinely identified or understood. There is an opportunity for these needs to be considered and identified by nurses at the time of investigation for infertility or when planning pregnancy with assisted conception. Conclusions: We argue that, by providing preconception care, nurses and midwives have an opportunity to deliver important advice to infertile couples in both primary care and specialist infertility services. [ABSTRACT FROM AUTHOR]

Abstract: Aims and objectives: To provide a five‐step conceptual framework to promote community inclusivity among nurses and nursing students, using the example of nursing student with a disability. Background: The value of cultural diversity, including characteristics such as socioeconomic status, ability/disability, sexual affection and ethnicity and/or race, is integrated into bachelor's nursing programmes. Yet, often the focus centres on patient care rather than to fellow nursing students or registered nurses. Design: Discursive paper describing a five‐step health promotion course framework to promote inclusion for students with disabilities into the nursing community. Methods: Using the health promotion course platform, this framework demonstrates the integration of important issues such as well‐being to those of cultural diversity, inclusivity and feeling belonging to a community, which are essential prerequisites towards achieving cultural competence. Findings: Health promotion courses provide an optimal platform to teach students about the social environment, well‐being and inclusivity, and gives students the opportunity to reflect on the impact of their attitudes and behaviours on social inclusivity in their student community, and later, on their nursing community. Conclusions: Using the example of nursing students with disabilities, the five‐step framework incorporates the concepts of social well‐being, health and community inclusivity. Nursing students belong to a culturally diverse community including individuals with disabilities. A single course on community inclusivity is insufficient; the approach of inclusivity must be woven throughout the nursing curriculum. Relevance to clinical practice: As approximately 15% of the world's population has a disability, nurses must possess an understanding of individuals with a disability as an aspect of cultural diversity. It is the responsibility of programmes to instil in nursing students, the ability to appreciate and work with culturally diverse student and registered nurses. Such goals not only reflect nursing goals, but also strengthen the cohesion and inclusivity of the nursing community. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To explore the impact of culture on health, healthcare provision and its contribution towards health inequity experienced by some marginalised communities. Background: Health inequity is a global issue, which occurs across and within countries, and is the greatest barrier to worldwide health and the development of the human race. In response to this challenge, there is an international commitment to ensure universal health coverage based on the fundamental principle that individuals should be able to access healthcare services they need. Despite this, there is clear evidence that indigenous and other cultural minorities such as New Zealand Māori and Gypsy Roma Travellers still experience far poorer health outcomes when compared to the majority population. Furthermore, when they do access health care, their experiences are often not positive and this in turn results in reluctance to access preventative health care, instead accessing health services much later, reducing treatment options and compounding higher mortality rates. What is often not explored or examined is the impact of the different cultural beliefs of individuals in these communities and the nurses caring for them. Design: This is a position paper drawing upon research experience with New Zealand Māori and Gypsy Roma Travellers. We critically review the experiences of health inequity of marginalised communities. It does so by examining how these communities may have a different world view to the nurses caring for them, and it is this lack of understanding and valuing of alternative worldviews that contributes to the poorer health outcomes both communities face. Conclusion and relevance to clinical practice: As nurses work with many different individuals and groups, we have to find ways of ensuring a more embracing, culturally responsive healthcare environment which respects and values the beliefs of others. [ABSTRACT FROM AUTHOR]