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Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

Background: Family caregivers have a vital role to play in palliative care for chronically ill patients. In Taiwan, caregiver demographics are evolving, with the number of male caregivers increasing. Gender differences influence psychosocial behaviours, thought processes and communication styles. In healthcare, acknowledgement of gender differences facilitates effective delivery of high‐quality care. Aim: The aim of this study is to explore male caregivers' decision‐making process for palliative care for chronically ill family members. Methods: This study employed grounded theory to generate a substantive theory of male caregivers' decision‐making process for palliative care for chronically ill family members. We recruited 22 male participants from three inner‐city teaching hospitals in Taiwan. Findings: Regarding the decision‐making process of palliative care of chronic ill family, where male caregivers do not want their loved ones suffering anymore, the male caregivers' decision‐making process was impacted, first, by caregivers' views on the last stage of life; second, by their wish for good care during the end of life; and third, by their conviction that the patients' wishes should be respected. Furthermore, caregivers' philosophy of life and death is also a supportive ground for decision‐making. This philosophy was influenced by their education in palliative care, financial status and religious beliefs and practices. The core category emerging from this study is encapsulated by a participant's assertion, 'How difficult is it? There are no male and female differences'. Conclusion: We found that palliative care experiences of male caregivers are important for the decision‐making process for palliative care for their chronically ill family members. Caregivers want their loved ones to receive good care as the last step in life, to respect their wishes and no more suffering for the patient. Therefore, health professionals should be familiar with the palliative care process that caregivers go through to offer updated information when needed. Summary statement: What is already known about this topic? Taiwanese philosophy of end‐of‐life care focuses on family values and shares the power of making critical decisions between patients and their relatives.Due to cultural preferences, the dedicated family caregiver often becomes the only channel for honouring the patient's wishes.Male and female caregivers can have different coping mechanisms; males are less likely to seek support and are more stressed by financial burdens. What this paper adds? The patient and the whole family should be considered in the discussion of end‐of‐life care.Male caregivers indicated palliative care should be linked to comfort care, avoidance of suffering and respecting patients' wishes. The implication of this paper: Male caregivers should be well supported, good care for their loved ones and fulfil the patient's wishes and no more suffering.Education in palliative care and religious and financial support should be provided along with palliative care services to both male caregivers. [ABSTRACT FROM AUTHOR]

Aim: To assess the psychometric properties of the Thai version of Caregiver Contribution to Self‐Care of Chronic Illness Inventory version 2 (CC‐SC‐CII‐v2) among primary caregivers of individuals with any single or multiple chronic illnesses. Background: The instrument encompasses three scales that evaluate Caregiver Contribution to Self‐Care (CC‐SC) Maintenance, Monitoring and Management. Methods: The English version CC‐SC‐CII‐v2 was translated and adapted for Thai context, and a cross‐sectional multicenter study involved 430 caregivers from 16 primary care centres in Thailand. Structural validity, internal consistency reliability and test–retest reliability were examined. Results: The original two‐factor CC‐SC Maintenance scale required a re‐specified model for good fit, while the CC‐SC Monitoring and CC‐SC Management scales fit well. The simultaneous model of three scales demonstrated satisfactory fit. The CC‐SC Maintenance and CC‐SC Management scales both had a composite reliability index of 0.85, with omega coefficients of 0.86 and 0.83, respectively. CC‐SC Monitoring had an alpha coefficient of 0.89. The intraclass correlation coefficients ranging from 0.84 to 0.91, indicating good test–retest reliability. Conclusion: The Thai CC‐SC‐CII‐v2 is a valid and reliable instrument that can provide clinicians and investigators with an evaluation of the contributions of caregivers to the self‐care of patients with chronic illnesses. Summary statement: What is already known about this topic? The Caregiver Contribution to Self‐Care of Chronic Illness Inventory (CC‐SC‐CII) is a theoretical‐based instrument initially created in the Western context.This inventory consists of three separate but interconnected scales for assessing caregiver involvement in patient self‐care maintenance, monitoring and management.Rigorous psychometric assessments conducted in Western contexts have affirmed the validity, reliability and effectiveness of the CC‐SC‐CII. What this paper adds? The introduction of the updated version, CC‐SC‐CII‐v2, likely presents challenges linked to cultural adaptation when applying it within the Thai context.This research constitutes a novel contribution to the field of caregiving studies in Thailand and the broader Asian region.The study offers new insights into the validity and reliability of the CC‐SC‐CII‐v2 within the context of Thai caregiving. The implications of this paper: The CC‐SC‐CII‐v2 proves to be a valid and reliable instrument for evaluating caregiver involvement in the self‐care of patients with chronic illnesses.Its applicability extends to various culture, including Thai context, and it may be considered suitable for application in other Asian backgrounds as well. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationship among secondary traumatic stress, compassion fatigue, and meaning in life in nurses during the COVID‐19 pandemic. Background: Changes in working conditions during the pandemic also changed the needs of nurses. In addition to physical health, the COVID‐19 pandemic led to many psychosocial health problems such as sleep disturbances, depression, and traumatic stress. This makes nurses vulnerable to psychological side effects of the pandemic. Design: A cross‐sectional study was conducted. Methods: This study was conducted with 166 nurses. Data were collected online at May–June 2021. A Personal Information Form, the Secondary Traumatic Stress Scale, Compassion Fatigue Scale, and Meaning in Life Scale were used. The STROBE reporting checklist was followed. Results: As secondary traumatic stress levels increase, compassion fatigue increases, meaning in life decreases, and the search for meaning in life increases. Conclusion: Predictors of secondary traumatic stress were shown to be compassion fatigue, change in sleep habits, meaning in life, marital status, and having a chronic illness. This suggested that working during the pandemic posed significant risks in terms of manifesting negative consequences on mental health in the long term. Summary statement: What is already known about this topic? Nurses often face stressful situations such as personal life challenges, the nature of the job that requires focus, and patient care.Nurses are exposed to the detrimental psychological effects of the pandemic because they are among the first medical professionals to meet COVID‐19 infected individuals.The pandemic has created many positive and negative effects on nurses. What this paper adds? This study reports that the mental health of nurses should be protected and strengthened by identifying the psychosocial health problems experienced by nurses due to the COVID‐19 pandemic.Findings inform on choice of effective interventions to protect the mental health of nurses. The implications of this paper: Failure to manage global crisis such as pandemics will cause traumatic stress, compassion fatigue, decreased meaning in life, and burnout in nurses.In order to protect nurses from the long‐term negative effects of pandemics, necessary programmes should be developed to strengthen their mental, physical, and spiritual health, to support their personal life habits and to improve their working conditions.Protective interventions, such as assessment and monitoring of nurses' mental health, can support strengthened crisis management practices. Preventive interventions and programmes based on individual needs should be implemented in order to improve nurses' ability to cope with difficult emotions. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. Background: HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV‐related cancers in men and women. Methods: The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Results: It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. Conclusion: These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education. Summary statement: What is already known about the topic? Although HPV vaccination is recommended to prevent HPV infections and HPV‐related cancers in men and women, vaccination rates are far behind the target, especially for men. What this paper adds? Findings showed that male nurses' HPV vaccination rates were relatively low.Male nurses' knowledge about HPV and HPV vaccine was not sufficient.HPV knowledge affected the attitudes and beliefs of these male nurses. The implications of this paper: Nurses need to be aware of the HPV vaccine during their undergraduate education. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: This paper aims to inform nursing and other healthcare disciplines by clearly defining patient competence and the skills required to improve self‐care behaviours. Background: Competence has been defined in education and leadership. However, competence in persons with chronic disease has not been expanded upon since one publication in 1983. Patient competence needs to be developed and defined so that healthcare disciplines can understand the attributes necessary for a patient to be deemed competent to promote self‐care behaviours. Design: A concept derivation. Methods: Walker and Avant's approach to concept derivation was used to identify a base concept (competence) that is well‐defined in another field, define the concepts associated with the parent field, and transpose that definition to a new field to formulate a redefined concept. PsycINFO, Scopus, Web of Science and Medline were searched, and 21 articles were included. Results: Patient competence is defined as the ability of a person with a chronic illness to reach skill mastery, achieve knowledge, maintain a positive attitude and develop trust in themselves and in healthcare providers that will facilitate active engagement to improve self‐care behaviours. Conclusions: Defining patient competence is important in assisting nurses and other healthcare providers in understanding the attributes needed to deem a patient competent, especially those living with chronic illnesses requiring lifelong self‐care behaviours. More research is needed to aid in the designing of a precise instrument for measuring this phenomenon. Relevance to Clinical Practice: Concept derivation of patient competence provides a framework for nurses and other members of the healthcare profession to understand the attributes needed to determine patient competence. [ABSTRACT FROM AUTHOR]

Aim: To identify culturally related stressors that influence self‐care in Chinese older adults with multiple chronic conditions. Background: Effective self‐care can improve health outcomes for chronic conditions, but implementing self‐care is challenging. Individuals with multiple chronic conditions face even more self‐care complexity than those with single chronic conditions, generating additional stressors. Although stressors have been found to negatively influence self‐care in multiple chronic conditions, the role of culture in generating stressors has been neglected. Design: This paper reports on the qualitative component of a larger mixed‐methods study. Two free‐response items in a survey were used to identify culturally related stressors that influence self‐care. This report adhered to the SRQR guideline checklist. Methods: Data were collected between January and April 2022. One hundred and thirty‐eight free text responses asking participants to identify stressors that influenced their self‐care effectiveness were analysed sequentially using deductive content analysis and thematic analysis. Results: Findings from deductive content analysis largely confirmed published work in Western literature on stressors complicating self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems. Conclusion: Chinese older adults with multiple chronic conditions identified a wide range of stressors that impacted their day‐to‐day self‐care. This study provided valuable insights into culturally related stressors in older adults with multiple chronic conditions. Findings deepened our knowledge of cultural influences on the success of self‐care in older adults with multiple chronic conditions, suggesting the potential for reaching populations across different cultures and regions. Implications for the profession and/or patient care: Stressors that might influence self‐care ability are important for nurses to assess in people with multiple chronic conditions. The design of self‐care interventions should take a culturally tailored intergenerational family‐centred approach to help mitigate the impact of stressors and ultimately improve patient outcomes. Impact: What problem did the study address?Stressors documented in older adults with MCCs have all been generated from research with Western populations. China is now home to the largest population of older people in the world. Understanding the influence of culturally relevant stressors on self‐care in Chinese older adults with MCCs is lacking.What were the main findings?Findings from deductive content analysis largely confirmed published work in Western literature on stressors that complicated self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors in older adults with MCCs in China: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems.Where and on whom will the research have an impact?The research will have an impact on guiding nurses' assessment of culturally relevant stressors' impact on self‐care for older adults with MCCs. In addition, findings could inform research and policy development to aim at mitigating the impact of culturally based stressors on self‐care. Reporting Method: This study adhered to the Standards for Reporting Qualitative Research (SRQR) guideline checklist. Patient or Public Contribution: During the member‐checking process, the validation of findings for accuracy was carried out by 10 participants, who also found resonance between these findings and their own experiences. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To map out the primary research studies relating to how virtual reality (VR) has been used to distract children and young people with long‐term conditions from pain or pruritus. Background: Pharmacologic treatment of chronic pain and pruritus may have side effects; hence, non‐invasive non‐pharmacological treatments are being sought. Design: The scoping review followed the methodology recommended by the Joanna Briggs Institute, PAGER framework and PRISMA‐ScR checklist. The protocol was registered with the Open Science Registration on 14 February 2022 https//doi.org/10.17605/OSF.IO/K2R93. Methods: Five databases (Medline, CINAHL, PsycINFO, Web of Science and Scopus) were searched. Data were extracted from primary research studies published between 2000 and 2022 involving children and adolescent populations (<21 years) with a long‐term condition that had an element of enduring pruritus and/or pain. Results: Of 464 abstracts screened, 35 full‐text papers were assessed with 5 studies meeting the eligibility criteria. Three main themes emerged from the included studies: (1) Improvements in pain and daily functioning; (2) positive perceptions of VR and (3) accessibility and feasibility of VR. No papers were found on the effect of VR on alleviating pruritus. Conclusion: VR is feasible, acceptable, and safe for children and adolescents with chronic pain in a range of long‐term conditions and offers promise as an adjunctive treatment for improving chronic pain and quality of life. No studies were identified that targeted pruritis or measured pruritis outcomes; thus, the effects of VR for pruritis are unknown. There is a need for rigorously designed, randomised controlled trials to test the clinical and cost‐effectiveness of VR interventions for chronic pain and pruritis in children and adolescents. The use of the PAGER (Patterns, Advances, Gaps, Evidence for Practice and Research Recommendations) framework for scoping reviews helped to structure analysis and findings and identify research gaps. Relevance to Clinical Practice: VR interventions offer promise in improving chronic pain related to long‐term conditions. [ABSTRACT FROM AUTHOR]

Background: Type 1 and 2 diabetes care, especially within primary health‐care settings, has traditionally involved doctor‐led clinics. However, with increasing chronic disease burden, there is scope for nurses to expand their role in assisting diabetes self‐management. Aims: This study aimed to determine the effectiveness of nurse‐led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes. Methods: Methodology from the Joanna Briggs Institute Method for Systematic Review Research and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed, including identifying publications, assessing study quality, summarizing evidence and interpreting findings. The search strategy involved using the Medical Subject Headings and keyword variations when searching MEDLINE (Ovid), Scopus, PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Inclusion criteria were samples with Type 1 or 2 diabetes, mean age of ≥18 years, English language studies and publication date of January 2011–December 2021. Results: Overall, 34 articles from 16 countries met inclusion criteria. Though not always clinically significant, results indicated that nurse‐led care had beneficial impacts on glycated haemoglobin values, with reductions from 0.03% to 2.0%. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. Conclusions: Findings support nurse‐led Type 1 and 2 diabetes care. Although further research is required, changes may necessitate increased recognition of nurse‐led care and funding. Nurse‐led care models should differ according to health‐care settings. Summary statement: What is already known about this topic? Diabetes is the world's fastest growing chronic condition and is widely recognized as a leading global challenge to the health and well‐being of individuals, families and societies.What this paper adds? Findings highlight the effectiveness of nurse‐led care in reducing glycated haemoglobin values in patients with Type 1 or 2 diabetes. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. The implications of this paper: There is scope for nurses to expand their role and assist diabetes self‐management. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to synthesize the available evidence on the effectiveness of nurse‐led multidisciplinary interventions in primary health care. Methods: The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM), from the establishment of the databases until the last updating search 1 April 2022. Two researchers screened the studies independently and extracted the data. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 12 studies were included in this review. It was found that nurse‐led multidisciplinary interventions significantly shortened patients' length of stay in hospital (standardized mean differences [SMD] = −1.28, 95%CI: −2.03 to −0.54; P<0.001) and decreased incidences of complications (RR = 0.24, 95%CI:0.10 to 0.54; P = 0.0006) compared to the control group, and lowered patients' anxiety levels (SMD = −1.21, 95%CI: −1.99 to −0.44; P<0.01) and depression levels (SMD = −1.85, 95%CI: −3.42 to −0.28; P<0.0001). Furthermore, the results of subgroup analysis indicated that nurse‐led multidisciplinary interventions had significant effects on patients' self‐management ability (SMD = 4.45, 95%CI:2.45 to 6.44; P<0.0001) and quality of life (SMD = 1.01, 95%CI: 0.63 to 1.40; P<0.0001) compared to the control group. Conclusions: Nurse‐led multidisciplinary interventions had strong effects in primary health care, contributing to shorten patients' length of stay in hospital, decrease incidences of complications and reduce the levels of anxiety and depression. Moreover, nurse‐led multidisciplinary interventions also improved patients' self‐management ability and quality of life. Summary statement: What is already known about this topic? Chronic diseases with long duration and slow recovery are one of the priorities for management in primary health care.In China and other countries around the world, primary health care is highly regarded for its efforts for the health of all.Several randomized controlled trials have explored the effectiveness of nurse‐led multidisciplinary interventions in primary health care, but the findings of these studies are contradictory. What this paper adds? The review demonstrates that nurse‐led multidisciplinary interventions could shorten patients' length of stay in hospital, decrease the incidence of complications and reduce the levels of anxiety and depression.Nurse‐led multidisciplinary interventions also improve patients' self‐management ability and quality of life.Nurse‐led multidisciplinary interventions are beneficial for promoting health and preventing disease in primary health care. The implications of this paper: Community primary health‐care personnel should be aware of the importance of nurse‐led multidisciplinary interventions in preventing disease and safeguarding health.For people with chronic diseases, community health‐care personnel should adopt multidisciplinary care methods to improve outcomes for patients.High‐quality studies are needed to verify the effects of interventions for patients. [ABSTRACT FROM AUTHOR]

Aims: To synthesise the composition and effectiveness of computer‐based patient decision aid (PDAs) in interventions for patients with chronic diseases. Design: A systematic review with meta‐analysis. Methods: Five databases were searched, and only randomised controlled trials (RCTs)were included. This review was conducted with the PRISMA guidelines. The JBI Appraisal Tools for randomised trials were used to assess the risk of bias. We used the random‐effects model to conduct meta‐analyses. Evidence from RCTs was synthesised using standardised mean differences or mean differences. The GRADE system was employed to assess the certainty of evidence and recommendations. This study was registered on PROSPERO (number: CRD42022369340). Data Sources: PubMed, Embase, Web of Science, CINAHL and Cochrane Library were searched for studies published before October 2022. Results: The review included 22 studies, and most computer‐based PDAs reported information on the disease, treatment options, pros and cons and risk comparison and value clarification. The use of computer‐based PDAs showed a significant effect on decision conflict and knowledge, but not on decision regret, satisfaction, self‐efficacy, anxiety and quality of life. The overall GRADE certainty of evidence was low. Conclusion: Although the quality of evidence was low, however, using computer‐based PDAs could reduce decision conflict and enhance knowledge when making medical decisions. More research is needed to support the contention above. Relevance to Clinical Practice: Computer‐based PDAs could assist health‐care providers and patients in the shared decision‐making process and improving the quality of decision‐making. Reporting Method: This study adhered to PRISMA guidelines. No Patient or Public Contribution: [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of a nurse support using a proactive mobile app to enhance parental self‐efficacy in symptom management for children with medical complexity. Design: A single‐blinded, randomized controlled trial with a two‐armed repeated measures design. Methods: Eligible parents and the children will be recruited from the special schools and non‐government offices. They will be randomly assigned either to the intervention or control groups. Subjects in the study group will receive nurse parental support using a symptom management mobile app for 3 months. The control group will receive the usual care that is available in the community. Data will be collected pre‐intervention (T1), immediately after the intervention (T2), and three‐month after intervention (T3). The primary outcome is parental self‐efficacy. The secondary outcomes include child's symptom burden and their health service utilization. Primary outcome will be compared across two groups in T2 and T3 using with control for the pre‐test value of parental self‐efficacy. Generalized estimating equation (GEE) will be used to address secondary objectives from T1 to T3 with appropriate link function. Discussion: As a result of the successful implementation of this nurse‐led symptom management, parental self‐efficacy will be enhanced. Both the symptoms reported by the children and their health service utilization will be reduced. Findings of this study will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and the children in local communities. Impact: The evidence produced in this study will enlarge the knowledge base that supports evidence‐based paediatric home nursing service with the use of health technology in symptom management. This evidence will also contribute to the development of other symptom management programs for other paediatric patient groups. Trial registration: NCT05765643 (ClinicalTrials.gov identifier). Patient or public contribution: Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application. Impact will be generated through the following benefits: Improve health service delivery: Home nursing service may not be sustainable in a long run in Hong Kong, as the health care system has been facing a serious nursing workforce shortage in recent years. Besides, these services are affected or even suspended during the community outbreak of infectious disease, like recent coronavirus disease pandemic. Nurse parental support in symptom management for the CMC using a proactive mobile health application will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and their CMC in local communities.Improve physical and psychological health of parents and their CMC: The success of program implementation will help to increase parental self‐efficacy in symptom management for their CMC, as a result of decrease of children's symptom burden.Improve knowledge base: The evidence produced in this study will (1) enlarge the knowledge base that supports evidence‐based paediatric community nursing service related to symptom management for the CMC. This evidence will contribute to the development of other symptom management programs for other paediatric patient groups. [ABSTRACT FROM AUTHOR]

Aim: To explore the health beliefs and health behaviours of older Vietnam‐born people living with chronic disease in Western Australia. Design: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care. Methods: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation. Results: This study included 12 participants. The health perspectives and practices of older Vietnam‐born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self‐blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese‐oriented and Westernized‐orientated practices. Individual factors were also identified as contributing to chronic disease self‐care among participants. Conclusion: This study emphasizes culture played a significant role in shaping the way that older Vietnam‐born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed. Implications: A better understanding of the health beliefs and practices of older Vietnam‐born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors. Patient and public contribution: This study encompassed the contribution of 12 older Vietnam‐born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants. [ABSTRACT FROM AUTHOR]

Aims: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self‐efficacy in cardiovascular self‐care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow‐up. Methods: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi‐structured interviews. A thematic analysis was applied using the data. Results: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. Conclusions: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease. Summary statement: What is already known about this topic? Primary care nursing is necessary for the improvement of cardiovascular risk factors.Chronic cardiovascular patients need training in self‐care.The organizational culture confers different forms of care to patients. What this paper adds? The vision of the socio‐cultural role of the family and community nurse is shown regarding cardiovascular prevention.Information is provided on the differentiating approach to chronic cardiovascular patients in primary care.Our study reflects the influence of routine care in nursing consultations, and what it entails to provide improved nursing care in cardiovascular patients. The implications of this paper: These findings can be used to understand the need to change the focus of nursing care in cardiovascular prevention.The implementation of a follow‐up protocol for the care of cardiovascular patients can improve patients' self‐care and reduce monotony in the nursing consultation.Further training and research is necessary regarding comprehensive chronic cardiovascular care within primary care services. [ABSTRACT FROM AUTHOR]

Introduction: Identifying determinants of emergency department (ED) use and hospitalization among patients with substance‐related disorders (SRDs) can improve health services to address unmet health needs. Aim: The present study aimed to identify the prevalence rates of ED use and hospitalization, and their associated determinants among patients with SRDs. Methods: Studies in English published from January 1, 1995, to December 1, 2022, were searched on PubMed, Scopus, Cochrane Library, and Web of Science to identify primary studies. Results: The pooled prevalence rates of ED use and hospitalization among patients with SRDs were 36% and 41%, respectively. Patients with SRDs who were the most at risk of being both ED users and hospitalized were those (i) having medical insurance, (ii) having other drug and alcohol use disorders, (iii) having mental health disorders, and (iv) having chronic physical illnesses. A lower level of education increased the risk of ED use only. Discussion: To decrease ED use and hospitalization, more comprehensive services may be offered to these vulnerable patients with diversified needs. Implications for Practice: Chronic care integrating outreach interventions could be more provided for patients with SRDs after discharge from acute care units or hospitals. [ABSTRACT FROM AUTHOR]

Aim: To synthesize and interpret existing qualitative research on the existential experiences of siblings of children with complex care needs. Design: Noblit and Hare's interpretive meta‐ethnography. Methods: The study has been registered in the international prospective register for systematic reviews (PROSPERO). Noblit and Hare's 7‐step procedure was followed and reciprocal translation was performed to analyse the data and develop a line of argument synthesis. Data Sources: A comprehensive systematic literature search of five databases, along with extensive manual searches, was completed in November 2022. The final sample comprised 18 studies published between 2010 and 2022. Results: A line of argument, expressed through an overarching metaphor, "balancing on life's ladder", illustrates the core findings of siblings' fluctuating experiences of existential well‐being, and encapsulates four third‐order themes: the emotional turmoil of siblings, interrupted family life, siblings strive to be themselves and siblings struggle to cope. Conclusion: Growing up with a sibling with complex care needs made children feel invisible, lonely and struggling to find the courage to cope. By adopting a lifeworld approach, nurses can become aware of healthy siblings' unmet needs. Future research is needed on how nurses can contribute to siblings' existential well‐being, in primary – and secondary health care settings. Implications: The study provides insight into siblings' existential experiences and factors improving their well‐being, enabling nurses to provide a more optimized lifeworld‐led clinical practice. Impact: Healthcare, nursing education and practice should be informed by the knowledge of existential issues. Nurses are well‐positioned to work alongside families to provide family‐centered care. Our findings have implications for health policies tailored to the needs of children with chronically ill siblings. Reporting Method: This review adheres to the Equator and improving reporting of meta‐ethnography (eMERGe) guidelines. Patient or Public Contribution: No patient or public contribution, because the data comprised previously published studies. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate whether chronic diseases are associated with higher COVID‐19 vaccine hesitancy and explore factors that influence COVID‐19 vaccine hesitancy in patients with chronic diseases. Background: Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID‐19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID‐19 infection, severe disease or death. Methods: From 6 to 9 August 2021, we performed an internet‐based cross‐sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID‐19 vaccine hesitancy were identified among patients with chronic diseases. Results: Both before and after propensity score matching, patients with chronic diseases had higher COVID‐19 vaccine hesitancy than the general population. In addition, self‐reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID‐19 vaccine hesitancy among patients with chronic diseases. Conclusions: Patients with chronic diseases were more hesitant about the COVID‐19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system. Relevance to Clinical Practice: Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice. Patient or Public Contribution: Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires. [ABSTRACT FROM AUTHOR]

Aims: To outline and examine evidence related to the meaning of 'psychosocial vulnerability' among caregivers of persons with chronic illnesses. Background: The number of informal caregivers continues to rise globally. Their risk of psychosocial vulnerability is frequently overlooked, but understanding their psychosocial vulnerability may offer insights into meeting their needs. Design Scoping review following the PRISMA 2020 extension guidelines. Data sources The databases CINAHL, Embase, Medline/Pubmed, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Lenus and ProQuest were systematically searched to identify original research. No date limit was set, and 23 studies were included. Review methods: A five‐step approach using the Arksey and O'Malley framework. Thematic analysis guided data analysis. Results: Carers' psychosocial vulnerability occurs when they experience barriers to resources while access and use of supports reduce risk. Antecedents of psychosocial vulnerability include a carer's age and sex, socioeconomic status and their health and wellbeing. Psychosocial vulnerability affects carers' relationships and causes personal losses. Conclusions: The concept of carers' psychosocial vulnerability is complex. Recognition of carers at risk for psychosocial vulnerability would help nurses direct relevant support and information to carers who need it most. Summary statement: What is already known about this topic? Carers play an increasingly important role in the delivery of holistic care in the community.Barriers and access to relevant support and homecare remain an issue for carers and patients worldwide.Caregivers frequently succumb to vulnerability as a result of their new identification with the role as well as the duty tied to the role. What this paper adds? Findings offer an understanding of factors which may contribute to carers' psychosocial vulnerability.An overview of the impact of caring for individuals with a chronic illness on carers' lives. The implications of this paper Recognition of those at risk for psychosocial vulnerability could enable health care professionals to provide the relevant support and information to carers who need it most.Further qualitative research is needed to increase understanding of carers' experience of caring for someone with a chronic illness.Carers must be seen as essential components of healthcare in order to ensure connection between policy and service delivery. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19. Background: At the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored. Methods: During February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors. Results: The fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression. Conclusion: With a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning. Summary statement: What is already known about this topic? Fear of progression is a common bio‐socio‐psychological consequence that widespread in cancer patients as well as chronic diseases.Very few studies focus on fear of progression in patients with major infectious disease, not to mention coronavirus disease (COVID‐19). What this paper adds? The present study surveys fear of progression in patients with mild or common type COVID‐19 and revealed a low‐to‐moderate level overall.Being unemployed, having no spouse diagnosed with COVID‐19, and a disease duration of 28 days or more are potential factors associated to patients' fear of the disease progression. The implications of this paper: The COVID‐19 outbreak has been declared as a public health emergency of international concern. Mental health problems such as fear of disease progression might need more attention beyond medical treatment.Future mental health nursing practice and research need to focus on those potential factors or patients with specific characteristics. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and restrictions imposed to eradicate it have affected healthy lifestyle‐related behaviours. Aim: The aim of this study was to determine the effect of COVID‐19 on lifestyle‐related behaviours. Methods: This cross‐sectional web‐based survey research was performed with a convenience sample of 1020 adults residing in Turkey. Data were collected with self‐report data collection tools on 8–28 April 2021: a sociodemographic characteristics form and the impact of COVID‐19 on lifestyle‐related behaviours questionnaire. Results: Eating behaviours, physical activity and sleep patterns of the participants were negatively affected during COVID‐19 pandemic (p < 0.001). More than half of the participants experienced weight gain during the pandemic. Also, stress levels and smoking increased (p < 0.01). The participants reported having changes in their lifestyles most frequently due to the fear of COVID‐19 infection, stress, decreased motivation, closure of the facilities for social and sports activities and increased food prices. Predictors of lifestyle‐related behaviours were found to be education (β =.189), income (β = −.101), residing in a village (β =.113) and the presence of a chronic disease (β =.075) (p < 0.001). Conclusions: During the pandemic, COVID‐19‐related restrictions should be applied whilst taking account of both social distancing measures and maintenance of healthy lifestyle‐related behaviours. Nurses should offer counselling for maintenance of healthy lifestyle‐related behaviours. Summary statement: What is already known about this topic? Studies performed at the beginning and during the course of COVID‐19 pandemic in different countries have shown that lifestyle‐related behaviours are negatively affected.Few studies have used a valid and reliable tool to determine the effect of COVID‐19 on lifestyle‐related behaviours.The effect of COVID‐19 on lifestyle‐related behaviours has not been examined from a nursing perspective. What this paper adds? In the present study, which was performed at a time when night curfews and weekend shutdowns were imposed in Turkey, lifestyles of the participants were found to be negatively affected.More than half of the participants gained weight and had increased stress and smoking and a decreased sleep quality.The negative effect on lifestyle‐related behaviours was more severe in participants with low education and income levels, living in a village and suffering from a chronic disease. The implications of this paper: Restrictions introduced during the pandemic should both take account of social distancing measures and allow healthy lifestyle‐related behaviours.Nurses playing a role in first line health care services should offer education and counselling for maintenance of healthy lifestyle‐related behaviours by utilizing information and communication technology (e.g., video calls). [ABSTRACT FROM AUTHOR]

Aim: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving. Background: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources. Design: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ). Methods: Semi‐structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2–18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience. Results: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem‐solving skills, enhancing their self‐efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. Conclusion: This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC. Relevance to clinical practice: Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength‐based approach to build maternal resilience. [ABSTRACT FROM AUTHOR]

Background: Caregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases. Data Sources: Embase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022. Methods: Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types. Results: Out of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high‐level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions. Conclusions: This umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies. Relevance to Clinical Practice: The findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies. Patient or Public Contribution: Patient or public contribution does not apply to this study. [ABSTRACT FROM AUTHOR]

Introduction: In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. Aim: We aim to synthesise the factors connected with IC. Methods: This scoping review followed the five‐stage framework of Arksey and O'Malley and was reported using PRISMA‐ScR guidelines. Results: In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. Conclusions: This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. Relevance to Clinical Practice: The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well‐being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. No Patient or Public Contribution: As this is a scoping review, no patient or public contributions are required. [ABSTRACT FROM AUTHOR]

Aim: To explore the lived experience of advanced preparation nurses (APNs) who are mothers (APN‐mothers) as they seek care in the Emergency Department for a child with a chronic disease. Design: Qualitative, Narrative Inquiry. Methods: Narrative Inquiry was used to examine critical self‐reflections of four (n = 4) APN‐mothers. Directed by a question guide, participants engaged in the Narrative Reflective Process through metaphoric and artistic means. Results: Participants identified salient challenges associated with their experiences. Narrative threads that emerged include feelings around being discovered, unfair expectations by healthcare providers, feelings of guilt and the tension from competing roles: APN and mother. Conclusion: APN‐mothers represent a unique population with enhanced knowledge, skills and judgement; however, they indicate that there is insufficient communication and interprofessional collaboration between parents and Emergency Department staff. Further research is needed to foster and improve therapeutic relationships between APN‐mothers and healthcare providers. Implications for the Profession and/or Patient Care: Findings can inform the development of family centred care guidelines for healthcare professional parents and their children. Impact: This study explores the experiences of an understudied population. This research will impact APN‐mothers, healthcare professionals in the Emergency Department as well as nursing students and researchers. Reporting Method: EQUATOR guidelines and SRQR reporting method used. Patient or Public Contribution: APN‐mothers, caregivers and support persons of children with chronic disease enacted investigator‐participant roles and were involved in each step of the study process. In addition, some patients (participants' children with chronic diseases) were included in data collected. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of partnership nursing among nurses when caring for children and young people with long‐term conditions, and their families. Background: Partnership nursing is promoted as a positive model of care among paediatric nurses, where shared roles and decision‐making, parental participation, mutual trust and respect, communication and negotiation are valued to create positive care experiences and enhance patient outcomes. Little is known about how nurses use partnership with both the patient and the parents in this triad to deliver partnership nursing. Design: A qualitative systematic review followed Joanna Briggs Institute meta‐aggregation approach and has been reported according to PRISMA guidelines. Methods: A comprehensive systematic search was conducted in seven electronic databases. Studies were assessed according to a pre‐determined inclusion criteria. Qualitative findings with illustrative participant quotes were extracted from included studies and grouped into categories to inform overall synthesised findings. Methodological quality assessment was conducted. Findings: A total of 5837 publications were screened, and 41 qualitative studies were included. Three overarching synthesised findings were identified: (1) Using education to promote feelings of safety and support, (2) Partnering to develop a strong therapeutic relationship and (3) Optimising communication underpinned by shared decision‐making principles to deliver individualised care. Conclusion: Nurses demonstrated successful partnership in their practice, but focused on developing dyadic nurse–parent and dyadic nurse–child partnerships. Future practice development that creates a three‐way triadic partnership may aid therapeutic relationships and shared decision‐making. Implications for clinical practice: Clinicians can reflect on how dyadic partnerships (focusing on the child or the parent) may exclude opportunities for coherent care. Further exploration in practice, policy and research as to how nurses determine child competency and child and parent level of engagement in triadic partnership may improve the potential of meaningful shared decision‐making. [ABSTRACT FROM AUTHOR]

Aims: This pilot study aimed to evaluate the effects of motor imagery training on lower limb motor function of stroke patients. Background: Motor imagery training has played an important role in rehabilitation outcomes of stroke patients. Methods: In this pilot randomized controlled trial 32 stroke patients were randomly divided into experimental and control groups from January to June 2017. Patients in both groups received conventional neuro‐rehabilitation five times a week in 3‐h segments for 6 weeks. Patients in the experimental group underwent an additional 20 min of motor imagery training. Measures were evaluated by motor function of the lower extremity, activities of daily living and balance ability. Results: The outcomes significantly improved by motor imagery training were the Fugl‐Meyer Assessment of the lower extremity, the Functional Independence Measure dealing with transfers and locomotion, and the Berg Balance Scale. Conclusion: Motor imagery training could be used as a complement to physical rehabilitation of stroke patients. Our findings may be helpful to develop nursing strategies aimed at improving functional ability of stroke patients and thus enhancing their quality of life. Summary statement: What is already known about this topic? Lower extremity dyskinesia is among the most common complications that significantly limit the patient's activities of daily living. Motor imagery training, a safe and cost‐efficient technique, may be used as a complement to physical rehabilitation of stroke patients.Evidence suggests that motor imagery training is effective in upper limb recovery after stroke.There is limited evidence of the effectiveness of motor imagery training on lower limb motor functions of patients with chronic stroke. What this paper adds? Motor imagery training can be incorporated into conventional therapy among individuals by rehabilitation specialist nurses with sufficient experience of motor imagery training, but substantial resources are needed.Six‐week motor imagery training resulted in a significant improvement in the motor performance of lower limbs in patients with stroke.Further study is needed to modify and optimize the present programme and should be focused on enabling more stroke patients to benefit from motor imagery training. The implications of this paper: The addition of motor imagery training to the conventional neuro‐rehabilitation can significantly promote the recovery of motor performance of lower limbs in stroke patients, thus reducing long‐term disability and associated socio‐economic burden.The findings of this pilot study may be helpful to develop nursing strategies aimed at improving functional ability and consequently the quality of life of stroke patients.Nurses can learn the motor imagery training as a technique for practising psychomotor nursing skills. [ABSTRACT FROM AUTHOR]

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

Aim: Establish linkages between components of the Self‐ and Family Management Framework and outcomes of the Nursing Outcomes Classification to evaluate the comprehensiveness of outcomes addressing self‐ and family management in the Nursing Outcomes Classification. Design: Descriptive study. Methods: Experts conducted a six‐step process to establish linkages: (1) preliminary mapping of all relevant nursing outcomes to the framework; (2) development of checklists for team members serving as 'identifiers' and 'reviewers'; (3) mapping all relevant nursing outcomes to the framework; (4) final agreement on mapped outcomes; (5) establishment of inter‐rater reliability; and (6) discussion of findings with authors of the Self‐ and Family Management Framework. Results: Three hundred and sixty‐three nursing outcomes were identified as related to the management of chronic disease across all components of the framework: outcomes related to patient self‐management (n = 336), family functioning (n = 16) and family caregivers (n = 11). Conclusion: The Nursing Outcomes Classification outcomes comprehensively address self‐management, and, less so, family functioning, and caregivers. Implications: Established linkages can be used by nurses to track and support patient and family management outcomes across the care continuum. Patient or public contribution: Linking standardized nursing outcomes to the Self‐ and Family Management Framework can assist in goal setting and measurement of nursing care during chronic disease management. This work can help describe to funders, policy makers and others invested in health care reform the specific contributions of nurses to self‐ and family management of chronic disease. Impact: This paper demonstrates the linkages between components of the Self‐ and Family Management Framework and Nursing Outcomes Classification outcomes. The results of this study offer the opportunity to quantify the impact of nursing care and enhance nursing practice for patients with chronic conditions as well as contribute to developing Nursing Outcomes Classification outcomes that consider self‐management processes. [ABSTRACT FROM AUTHOR]

Aim: Examined the evidence of low‐to‐moderate‐intensity physical activities to assess the effect in managing hypertension, diabetes mellitus and hyperlipidaemia conditions among community‐dwelling older adult. Background: Physical activity is recommended for the maintenance and improvement of health. However, high‐intensity physical activity may adversely impact exercise adherence by older adults. Design: This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions. The PRISMA statement was employed to guide the reporting of the systematic review and meta‐analyses. Data Sources: Seven electronic databases were searched to identify relevant articles that were published in English from 1 January 2000 to 31 December 2020. Review Method: This review included randomised controlled trials and cluster‐randomised controlled trials on interventions of physical activities with low‐to‐moderate intensities compared against usual care without physical activities. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias Tool. Meta‐analysis was performed using RevMan, with Cochran Q and I2 used for determining heterogeneity. The overall effect was reviewed with z scores. Results: Fifteen randomised controlled trials with 940 total participants were evaluated. Low‐to‐moderate‐intensity physical activity significantly improved systolic blood pressure [Z = 3.59, p =.0003], HbA1C [Z = 2.10, p =.04] and high‐density lipoprotein (HDL) levels [Z = 3.83, p =.0001], compared to usual care. A further subgroup analysis found no significant difference in systolic blood pressure level after three sessions a week as well as after three months. There were insufficient papers to evaluate for both HbA1C and HDL levels. Conclusion: Regular physical activity ranging from low‐to‐moderate intensity should be encouraged among older adults with chronic diseases. Relevance for clinical practice: This review suggested that low‐to‐moderate levels of physical activity could be encouraged among community‐dwelling older adults to improve their physical health. [ABSTRACT FROM AUTHOR]

Aim: To psychometrically assess the Spanish version of the Self‐Care of Chronic Illness Inventory (SC‐CII‐Sp) in community‐dwelling older adults with chronic multimorbidity. Design: A methodological study. Method: A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC‐CII‐Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC‐CII‐Sp and their scores on the Spanish Chronic Disease Self‐Efficacy scale (SCD‐SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC‐CII‐Sp's reliability was tested by computing the Cronbach's alpha. Results: The SC‐CII‐Sp showed good content and convergent validity. The CFA showed that the SC‐CII‐Sp has three sub‐scales. The 8‐item Self‐Care Maintenance sub‐scale has good internal consistency and is comprised of two dimensions: illness‐related and health‐promoting behaviour. The Self‐Care Monitoring sub‐scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6‐item Self‐Care Management sub‐scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. Conclusion: The Spanish version of SC‐CII is a valid and reliable instrument to be used in the assessment of self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Implications for the Profession: Nurses need valid and reliable tools to assess self‐care behaviours in Spanish‐speaking community‐dwelling older adults with chronic multimorbidity. This study provides a 19‐item tool that allows for the comprehensive evaluation of self‐care behaviours in healthy and ill states. Impact: Using the SC‐CII‐Sp in clinical or research settings could help nurses to examine the effects of different interventions on self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Patient or Public Contribution: None to be reported. [ABSTRACT FROM AUTHOR]

Aims: To identify the challenges and opportunities among primary health care nurses and general practitioners (GPs) in the care of older people with urinary incontinence (UI) and other chronic conditions in China. Background: UI is highly prevalent among community‐dwelling older people with chronic conditions but is underreported and poorly managed. Understanding the factors that affect primary health care professionals' practices in their care for this population is imperative to foster nurse‐led UI care services. Design: A qualitative descriptive study. Methods: Four focus groups were held with 24 primary health care nurses and GPs in Changsha, Hunan Province, China, between July and September 2021. A reflective thematic analysis was used to identify themes. Results: This study revealed misconceptions regarding older people living with UI and other chronic conditions in primary care health professional participants. Moreover, primary health care nurses had very limited autonomy in UI diagnosis and initiating care interventions for this patient population. By reflecting on practices, participants recognized various practical solutions to improve the detection and management of UI. Participants also identified barriers to accessing care services in older people with UI. They suggested changes in the health care system to achieve universal access to UI care services for older people. Conclusion: Nurse‐led UI care services in primary health care for community‐dwelling older people with chronic conditions are in high demand but are underdeveloped due to professional and health care system factors. Impact: Findings from this study provide new insights into challenges faced by primary health care professionals and illuminate practical solutions to address these challenges. Reporting Methods: Adherence to COREQ guidelines was maintained. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To synthesise and describe the combined evidence from systematic reviews of interventions using elements from the Transitional Care Model, on the content and timeframe of the interventions and the related improvement of outcomes for older patients with multiple chronic conditions. Background: The population of older patients with multiple chronic conditions is increasing worldwide and trajectories are often complicated by risk factors. The Transitional Care Model may contain elements to support transitions between hospital and home. Design: An umbrella review. Review Methods: A comprehensive search in five electronic databases was performed in April 2021 based on the search terms: 'Patients ≥60 years,' 'multi‐morbidity,' 'Transitional care model,' 'Transitional care,' and 'Systematic review.' PRISMA guidelines was used. Results: Five systematic reviews published from 2011 to 2020 comprising 62 intervention studies (59 randomised controlled trials and three quasi‐experimental trials) were included in the review. The synthesis predominantly revealed significant improvements in decreasing re‐admissions and financial costs and increasing patients' quality of life and satisfaction during discharge. Conclusion: The results of the review indicate that multiple elements from the Transitional Care Model have achieved significant improvements in older patients' transitions from hospital to home. Especially a combination of coordination, communication, collaboration and continuity of care in transitions, organised information and education for patients and pre‐arranged structured post‐discharge follow‐ups. Impact: The transition from hospital to home is a complex process for older patients with multiple chronic conditions. A specific focus on coordination, continuity, and patient education should be implemented in the discharge process. Nurses with specialised knowledge in transitional care are needed to ensure safe transitions. Patient and Public Contribution: The umbrella review is part of a larger research program which involved a patient expert advisory board, which participated in discussing the relevance of the elements within the umbrella review. [ABSTRACT FROM AUTHOR]

Aims: To determine the relationship between perception of COVID‐19, fear of COVID‐19 and self‐care management in individuals with chronic diseases during the pandemic process. Background: Individuals with chronic diseases are a sensitive group during the COVID‐19 pandemic process; it is thought that self‐care management may be adversely affected as a result of their more intense exposure to the psychological, physiological and economic effects of the pandemic. In the literature, there is no study examining the effect of perception of COVID‐19 and fear of COVID‐19 on self‐care management in individuals with chronic diseases. Design: Descriptive study. Methods: The study was conducted with 322 individuals who applied to the internal medicine outpatient clinics of a university's Health Practice and Research Center, met the inclusion criteria, agreed to participate in the study and had a chronic disease. Questionnaire form, Perception of COVID‐19 Scale (P‐COVID‐19), The Fear of COVID‐19 Scale (FCV‐19S) and Self‐Care Management Process in Chronic Illness Scale (SCMP‐G) were used to collect data. STROBE checklist was used to report the present study. Results: In the study, it can be stated that individuals with chronic diseases had a moderate to the high perception of contagiousness and dangerousness of COVID‐19, they had a moderate‐high level of fear of COVID‐19 and their self‐care care management was above moderate level. There was a significant positive correlation between P‐COVID‐19, FCV‐19S and SCMP‐G in the study. Conclusions: It was found that the perception of COVID‐19 contagiousness and the fear of COVID‐19 had a positive effect on the self‐care management of individuals with chronic diseases. Relevance to clinical practice: Determining the level of COVID‐19 perception and fear of COVID‐19 and their effects on the life of the individual, and evaluating self‐care management during the difficult pandemic process will increase the success in the holistic nursing care and management of chronic diseases. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross‐cultural perspective. Background: Persons with serious or life‐limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well‐being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. Design: A quantitative, cross‐sectional, observational cross‐cultural comparison was undertaken. Methods: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness‐related variables were also assessed using paper‐and‐pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. Results: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self‐reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. Conclusions: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. Relevance to clinical practice: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in‐depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs. [ABSTRACT FROM AUTHOR]

Aims: The aims of this work were to translate, culturally adapt and evaluate the reliability and validity of the Chinese version of the Self‐Management and Transition to Adulthood with Rx = Treatment Questionnaire. Background: Children and young people with chronic diseases are expected to start self‐managing their diseases and have a smooth and coordinated transition from paediatric‐ to adult‐oriented care. Design This study involved the cultural adaptation of a questionnaire into Chinese and examined its factor structure. Methods: This was a multicentre cross‐sectional study of children and young people/adolescents (8–18 years) who were diagnosed with chronic diseases in China from June 2016 to December 2018. Exploratory and confirmatory factor analyses were performed to analyse the questionnaire's validity. Results: Four major factors were identified in the Chinese version of the questionnaire, and it had a good fit to the target population. The internal reliability was good. All factors were positively and strongly correlated with the total score. The t test revealed that the Medication Management score was not significantly different between two age groups (8–11 and 12–18 years), but the scores of the other factors and overall scale were lower in the 8–11 years age group. Conclusion: The Chinese version of the questionnaire has good reliability and validity in the Chinese context. SUMMARY STATEMENT: What is already known about this topic? Over 90% of children and young people (CYP) with chronic diseases will survive into adulthood with their diseases, and they are expected to have an effective and coordinated health‐care transition.The Self‐Management and Transition to Adulthood with Rx = Treatment (STARx) Questionnaire is reported to be a useful tool for evaluating the transition readiness of CYP with chronic diseases. What this paper adds? This study is the first to apply the STARx Questionnaire to chronically ill CYP in the Chinese context, and it includes rheumatic diseases, renal disorders and diabetes.Four factors were identified—Medication Management, Health‐Care Engagement, Provider Communication and Disease Knowledge—and the questionnaire has good reliability and validity in the Chinese context.The Medication Management score was not statistically significantly different between two age groups (8–11 and 12–18 years), but the scores of the other factors and the overall scale were lower in the 8–11 years age group. The implications of this paper: The Chinese version of the STARx Questionnaire (STARx‐C) was shown to be a useful and reliable guide for nurses to identify the capacity of CYP with chronic diseases in terms of self‐management and, accordingly, to implement specific caring plans.Younger CYP should be more comprehensively supervised, whereas the older CYP need care providers to identify a suitable time for their transition. [ABSTRACT FROM AUTHOR]

Aims: To systematically identify and summarize the needs of chronically ill people concerning their sexual well‐being in peer‐reviewed published literature, to enable healthcare professionals to provide support in self‐management satisfying the needs. Design: A scoping review was performed according to the framework of (JBI Manual for Evidence Synthesis. JBI Global Wiki, 2020). Findings are reported in line with the PRISMA extension for scoping reviews. Review Methods: A literature search and thematic analysis were conducted. Data Sources: Full research was carried out in 2022 in the search engine BASE and the following databases: Scopus, MEDLINE, Science Citation Index Expanded, Social Sciences Citation Index and CINAHL. Peer‐reviewed articles published after 2011 were included. Results: Fifty articles could be found. Seven categories of needs could be identified. People with chronic diseases want their providers to initiate discussions about sexual concerns and treat them trustfully and respectfully. Most of the patients would like the issue of sexuality to be included in routine care. They perceive their medical specialists and psychologists as preferred providers to talk to about this issue. Nurses are seen as primary contact persons but in a smaller number of studies. Conclusion: Although the scoping review included different types of chronic diseases, the needs of chronically ill patients concerning their sexual well‐being are not very different. Healthcare professionals, especially nurses, who are often the first point of contact for people with chronic illnesses, should take the initiative for open discussions about sexual issues. That requires a new understanding of the role of nurses, training and further education. Implications for the Profession and/or Patient Care: Providing patient education and facilitating an open discussion about sexuality require further training in the new understanding of the role of the nurse and the concept of sexual well‐being. Impact: What problem did the study address? Chronic diseases have an impact on patients' sexuality. Patients want to be informed about sexual issues, but providers often do not address them. What were the main findings? Patients with a chronic condition expect providers to initiate discussions about sexual well‐being, regardless of the type of chronic disease. Where and on whom will the research have an impact? The research will impact healthcare professionals', especially nurses', future educational standards and ultimately patients. Reporting Method: PRISMA extension for scoping reviews. No patient or public contribution: Not required as it was a literary work (scoping review). [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to create a holistic understanding of the psychosocial processes of older persons with multiple chronic conditions' experience with unplanned readmission experiences within 30 days of discharge home and identify factors influencing these psychosocial processes. Design: Mixed methods systematic review. Data Sources: Six electronic databases (Ovid MEDLINE (R) All 1946‐present, Scopus, CINAHL, Embase, PsychINFO and Web of Science). Review Methods: Peer‐reviewed articles published between 2010 and 2021 and addressed study aims (n = 6116) were screened. Studies were categorised by method: qualitative and quantitative. Qualitative data synthesis used a meta‐synthesis approach and applied thematic analysis. Quantitative data synthesis used vote counting. Data (qualitative and quantitative) were integrated through aggregation and configuration. Results: Ten articles (n = 5 qualitative; n = 5 quantitative) were included. 'Safeguarding survival' described older persons' unplanned readmission experience. Older persons experienced three psychosocial processes: identifying missing pieces of care, reaching for lifelines and feeling unsafe. Factors influencing these psychosocial processes included chronic conditions and discharge diagnosis, increased assistance with functional needs, lack of discharge planning, lack of support, increased intensity of symptoms and previous hospital readmission experiences. Conclusions: Older persons felt more unsafe as their symptoms increased in intensity and unmanageability. Unplanned readmission was an action older persons required to safeguard their recovery and survival. Relevance to Clinical Practice: Nurses play a critical role in assessing and addressing factors that influence older persons' unplanned readmission. Identifying older persons' knowledge about chronic conditions, discharge planning, support (caregivers and community services), changes in functional needs, intensity of symptoms and past readmission experiences may prepare older persons to cope with their return home. Focusing on their health‐care needs across the continuum of care (community, home and hospital) will mitigate the risks for unplanned readmission within 30 days of discharge. Reporting Method: PRISMA guidelines. Patient or Public Contribution: No patient or public contribution due to design. [ABSTRACT FROM AUTHOR]

Aims and Objectives: We aimed to identify correlates of cannabinoid‐based products (CBP) use in patients with multiple sclerosis (MS) in France and Spain. Background: MS is responsible for a wide range of symptoms, including pain. Access to CBP differs according to local legislation. The French context is more restrictive than the Spanish one, and no data regarding cannabis use among MS patients has yet been published. Characterizing MS patients who use CBP constitutes a first step toward identifying persons most likely to benefit from them. Design: An online cross‐sectional survey was submitted to MS patients who were members of a social network for people living with chronic diseases and were living in France or Spain. Methods: Two study outcomes measured therapeutic CBP use and daily therapeutic CBP use. Seemingly unrelated bivariate probit regression models were used to test for associations between the outcomes and patients' characteristics while accounting for country‐related differences. STROBE guidelines were followed in reporting this study. Results: Among 641 study participants (70% from France), the prevalence of CBP use was similar in both countries (23.3% in France vs. 20.1% in Spain). MS‐related disability was associated with both outcomes, with a gradient observed between different degrees of disability. MS‐related pain level was associated with CBP use only. Conclusions: CBP use is common in MS patients from both countries. The more severe the MS, the more participants turned to CBP to alleviate their symptoms. Easier access to CBP should be ensured for MS patients in need of relief, especially from pain. Relevance to clinical practice: This study highlights the characteristics of MS patients using CBP. Such practices should be discussed by healthcare professional with MS patients. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to assess the perceived caregiver burden among parents of chronically ill children in Jordan. Background: Although there are few studies on the accurate prevalence of chronic diseases among Jordanian children, there are a few on the burden of caregiving, which is important because most children with chronic illness rely on their caregivers to perform their daily tasks. In Jordan, little is known about the caregiver burden associated with caring for children with chronic diseases. Design: A cross‐sectional design was reported in line with the STROBE guidelines. Methods: The Katz Index of Independence was used to determine the children's level of dependence, and the Burden Scale for Family Caregivers was used to measure the caregivers' level of burden. Results: Nearly, 49.3% of caregivers had a very severe burden, 31.2% of children had a severe functional impairment, 19.6% had a moderate impairment, and 49.3% had full functionality. Based on their children's dependency, caregivers' subjective burden varied greatly (p <.001). Fully functional children had a far lower disease burden than severely and moderately disabled children (p <.001). The caregiver burden score differed significantly across chronic disease categories (p <.001). Unemployed caregivers had a far higher subjective burden than working caregivers (p =.009), and single (divorced/widowed) caregivers had higher burdens than married caregivers. Conclusions: Various factors can increase caregiver burden. Therefore, healthcare providers must plan holistic and family‐centred interventions to reduce the caregiving burden. Relevance to Clinical Practice: There is a need to establish support programs to help reduce the level of burden among caregivers of children with chronic diseases. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide.Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. What the paper adds to existing knowledge?: The study examined rates and predictors of suicidality in Thai LGBT adults.Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past‐year suicidal ideation, while socio‐demographic and health‐related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. What are the implications for practice?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand.Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours.Standardized measures of sexual orientation and gender identity should be included in all patient intake forms.In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority‐specific stressors should be used.Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing. Introduction: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists. Aim: To examine rates and predictors of suicidality among Thai LGBT adults (N = 411). Method: Data collection was conducted via online and in‐person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health‐related factors, general and minority‐specific stressors and suicidality were completed. Results: Thirty‐nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12‐month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤.05, R2 = 0.327). Past‐year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p <.05, R2 = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R2 = 0.187). Discussion: General and minority‐specific stressors negatively impacted suicidality among LGBT participants. Implication for practice: Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Pre‐ and postmenopausal women (PPW) experience changes in physical, psychological and social health. South‐East Asia's female suicide rate is the highest compared with other countries, and the suicide rate of PPW in these countries continues to increase.The most influential factor in Asian women's suicidal ideation is family conflict; specifically, if PPW in South Korea cannot express their anger, it results in a culture‐bound syndrome called "Hwa‐Byung." However, there is a lack of research on Asian PPW. What the paper adds to existing knowledge?: This study found differences in individual‐ and community‐level factors affecting suicidal ideation between pre‐ and postmenopausal women.Individual factors that commonly affected suicidal ideation were experiencing violence, stress and depression. Individual factors that affected the suicidal ideation of premenopausal women more than postmenopausal women were religious beliefs, alcohol use and chronic disease.Community level factors affecting suicidal ideation were locational depression and locational counselling for stress in premenopausal women and locational counselling for depression in postmenopausal women. What are the implications for practice?: Mental health nurses could help prevent suicide by developing and applying community‐based programmes for PPW, considering the specific socio‐economic and cultural context and characteristics of Asian women.Mental health nurses could help PPW participate in programmes by preparing various interventions such as case management, personal counselling, physical activity, home‐based mental health services, cognitive behavioural therapy and digital interventions for self‐management.Mental health nurses need to prepare various methods such as online, offline, individual and group methods to work effectively in any social situation. Introduction: Pre‐ and postmenopausal women (PPW) experience physical and psychological changes with hormonal changes. Among Asian middle‐aged women, family and culture affect suicidal ideation, and the suicide rate among this population is increasing. There are few existing research on suicidal ideation among Asian PPW. Aim: We examined individual‐ and community‐level factors that predict suicidal ideation among PPW. Method: Large‐scale panel data from 5,154 South Korean PPW aged 35–64 years were used in a series of multilevel logistic regression analyses to examine factors associated with suicidal ideation at individual and community levels. Results: Among premenopausal women, religious beliefs, alcohol use, chronic disease, experience of violence, stress and depression were individual‐level factors. Locational depression and locational counselling for stress were community‐level factors. Among postmenopausal women, experience of violence, stress, depression and perceived health status were individual level factors, and locational counselling for depression was a community level factor. Discussion: Suicidal ideation among PPW is affected by both individual and community level factors. Nurses must comprehensively determine what risk factors affect suicidal ideation through various intervention methods—including online, offline, individual and group methods—while considering socio‐economic situations. Implications for Practice: Mental health nurses should provide targeted biopsychosocial interventions targeting psychosocial and physical problems and promoting the use of community resources to reduce PPW's suicidal ideation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self‐management of their chronic conditions, their recognition of deterioration and when to seek treatment/re‐attend hospital. Background: Chronic conditions have challenged older adults' self‐management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. Design: A qualitative exploratory design known as Interpretive Description was utilised. Methods: Purposeful sampling involved 27 community‐dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self‐management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. Results: Five themes emerged: (1) Post‐Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post‐Discharge Care. Conclusion: Older people sought a clear plan for self‐management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow‐up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. Relevance to clinical practice: To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self‐management of their chronic conditions. [ABSTRACT FROM AUTHOR]

Aim: To explore the process of recognition and response to clinical deterioration of children with medical complexity at home by their parents. Background: Children with medical complexity are characterised by known chronic conditions associated with frailty and functional limitations, dependence on healthcare services and high use of technology and resources. Their medical complexity often leads to the onset of complications. Targeted care ensures timely recognition and response to clinical deterioration at home, thus avoiding serious sequelae, inappropriate hospitalisations and improving quality of life. Evidence on parents' process of the recognition and response to clinical deterioration at home is limited. Design: Qualitative study using a Grounded Theory methodology. Method: Seven online focus groups were conducted with parents and healthcare providers experienced in their care. The interviews were transcribed verbatim and analysed through open, axial and selective coding, using a constant comparative iterative method. The COREQ guidelines guided the reporting of this work. Results: Four categories and one core category were identified: (1) Awareness of the unique and shared characteristics of children with medical complexity; (2) Parents' care maintenance and management; (3) Parents' care monitoring; (4) Parents' response to clinical deterioration and (5) Seeking the Shift of Agency, the core category as the foundation of the Process of Recognition and rEsponse of PAREnts to Deterioration (PRE‐PARE‐D) theory. Conclusion: The role of parents of children with medical complexity is evolving into active care leaders, by developing care management and care monitoring competences and negotiating care with healthcare providers. Relevance to clinical practice: The shift of agency from healthcare providers to parents requires education and counselling pathways to promote the development of parent's self‐efficacy, competencies and empowerment in the care management of their children. Home care delivery for children with medical complexity should aim at sustaining this partnership between healthcare providers and parents. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to construct a structural equation model guided by the ecological model to explore the factors influencing health behaviour among hypertensive stroke patients 6 months post‐stroke. Background: Health behaviour is important for recurrence prevention in hypertensive stroke patients. Moreover, previous studies have indicated that health behaviour at the end of the recovery period is of particular concern. The ecological model provides an integrated perspective for explaining the factors influencing health behaviour. Design: A cross‐sectional study guided by the STROBE. Methods: A total of 121 hypertensive stroke patients were included to assess stroke knowledge, health belief, depression, family function, chronic illness resource and health behaviour. A structural equation model was used to explore the health behaviour's factors and pathways. Results: In the final ecological model, sex, education level, depression and chronic illness resource directly affected health behaviour. Stroke knowledge directly affected health behaviour and indirectly affected health behaviour through health belief and chronic illness resource. Family function indirectly affected health behaviour through health belief, depression and chronic illness resource. Health belief affected health behaviour indirectly through depression and chronic illness resource. Conclusions: Hypertensive stroke patients' health behaviour is jointly and interactively influenced by stroke knowledge, health belief, depression, family function and chronic illness resource. In particular, chronic illness resource is an important mediator of health behaviour. Relevance to Clinical Practice: For clinical practitioners, health behaviour of men and patients with low educational levels should be specifically focused on. Additionally, it is necessary to provide stroke knowledge, establish health beliefs, control depression emotion and improve family function. Furthermore, chronic illness resources should be improved particularly due to its important mediating role. Patient or Public Contribution: Participants completed demographic and disease‐related questionnaires during hospitalisation and completed other questionnaires when returning to hospital at 6 months follow‐up. [ABSTRACT FROM AUTHOR]

Background: Long‐term care of patients with chronic illnesses is an important global public health issue, compromising the well‐being of family members and the family functioning. Previous studies have examined the interactive experiences and processes of various systems in the families coping with long‐term care stress; however, these studies have not been systematically reviewed and integrated. Aims: This review aimed to synthesise the existing qualitative evidence on the experiences and processes of family resilience operate in families providing long‐term care for patients with chronic illnesses and to provide suggestions for the development of interventions in future studies. Materials & Methods: We searched databases including PubMed, CINAHL, EMBASE, Web of Science, ProQuest and CNKI from their inception to March 2022. We used the JBI Critical Appraisal Tool for qualitative studies to evaluate the quality of the included studies was evaluated according to. We followed The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The results were integrated using the thematic and content analysis method. Results: Fourteen studies from eight countries covering 11 diseases reported on the experiences and coping processes of long‐term care families. Based on McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation (FAAR), five analytical themes were synthesised: stressors (risk factors), family belief system, internal family coping strategies, external support and resilient adaptation indicators; the relationships between themes and subthemes were illustrated. Discussion: This review synthesized qualitative evidence on the experiences and processes of family resilience operate in families providing long‐term care. The results of this study found that the cognition and belief of family members regarding dilemmas have a two‐way effect and act on the adaptation process of family members. In family adaptation, spirituality, hope, internal and external support are extremely important. In 14 studies, caregivers were from different countries with intercultural differences, but due to less reports on this content, it is difficult to compare the differences or impact that culture or ethnicity may have. Conclusions: Family resilience plays an important role in coping with stressors associated with the long‐term care of a loved one through family belief systems, internal support systems and external support systems. The development of family resilience‐based interventions for long‐term care families should consider the family as a whole and further construct a multidisciplinary, multilevel and multi‐type social support network to enhance family resilience. [ABSTRACT FROM AUTHOR]

Aims and objectives: To offer a review of the differing terminologies used by clinicians and researchers to describe the long‐term intensive care unit (ICU) patient and the underlying propositions that align with this terminology. Background: Ongoing medical and technological advances in emergency and intensive care have resulted in improved survival of critically ill patients in recent decades. In addition, these advancements have also resulted in improved survival of complex critically ill patients who progress to a trajectory of prolonged critical illness, having protracted stays in the ICU. There is great variability in terminology used to define the long‐term ICU patient. This lack of a common definition for long‐term ICU patients is problematic, increasing their vulnerability and risk of care not being centred about their unique needs. Design: In this discursive article, we explore the terminology used to define the long‐term ICU patient. An initial broad search of the literature across four electronic databases was conducted to identify common terminology used to define the long‐term ICU patient. From here, seven definitions were identified and chosen for inclusion in the review as they meet inclusion criteria and clearly described a group of patients who have an extended ICU stay. The seven selected terms are as follows: prolonged mechanical ventilation; failure to wean; insertion of tracheostomy; chronically critically ill; persistent critical illness; persistent inflammatory‐immunosuppressive and catabolic syndrome; and frailty. Following this a focused review of the literature with the selected terms was conducted to explore in greater detail the terminology. Discussion: The lack of clear definition for this patient group can potentiate their care needs being unmet. Acknowledgement of the need to clearly define this patient group is the first step to improve outcomes. Nursing is well positioned to recognise the different terminologies use to describe this group of patients and implement care to suit their unique clinical characteristics. Conclusion and Relevance to Clinical Practice: Recognition and standardisation of these terms are an important priority to pave the way to improve care pathways and outcomes for this group of patients and their family. [ABSTRACT FROM AUTHOR]

The article presents the discussion on multimorbidity or living with two or more chronic condition. Topics include Cardiovascular disease (CVD) being a leading cause of death globally and an exemplar condition where individuals live with multimorbidity; and CVD being projected to increase globally as the population ages and advances in medical care improve longevity.

Aims: A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background: Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design: A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods: Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results: Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions: The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population. [ABSTRACT FROM AUTHOR]