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Background: Involvement in research activities is complex in pediatric nursing and allied health professionals (AHPs). It is important to understand which individual factors are associated with it to inform policy makers in promoting research. Methods: A cross-sectional observational study was conducted to describe the level of participation in research activities over the last ten years of nurses and AHPs working in a tertiary pediatric hospital. A large sample of nurses and AHPs working in an Italian academic tertiary pediatric hospital completed an online self-report questionnaire between June and December 2018. Three multivariate logistic regression analyses were performed to predict participation in research projects, speaking at conferences, and writing scientific articles. Results: Overall, data from 921 health professionals were analyzed (response rate = 66%), of which about 21% (n = 196) reported participating in a research project, while 33% (n = 297) had attended a scientific conference as a speaker, and 11% (n = 94) had written at least one scientific paper. Having a Master or a Regional Advanced Course, working as an AHP or a ward manager, as well as regularly reading scientific journals and participation in an internal hospital research group or attendance in a specific course about research in the hospital, significantly predicted participation in research projects, speaking at conferences and writing scientific papers. It is important to foster research interest and competencies among health professionals to improve participation in research projects, speaking at conferences, and writing scientific papers. Conclusions: Overall, we found a good level of attendance at conferences as speakers (33%), a moderate level of participation in research (21%), and low levels for writing scientific papers (11%). Our study highlighted the need to support participation in research activities among nurses and AHPs. Policymakers should identify strategies to promote research among nurses and AHPs, such as protected rewarded time for research, specific education, strengthened collaboration with academics, and financial support. Moreover, hospital managers should promote the development of research culture among health professionals, to improve their research competencies and evidence-based practice. [ABSTRACT FROM AUTHOR]

Background: Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education. Methods: This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed. Results: We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary. Conclusions: The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education. [ABSTRACT FROM AUTHOR]

Introduction: Maternal glycemia is associated with pregnancy outcomes. Thus, supporting the self-management experiences and preferences of pregnant women with type 1 and type 2 diabetes is crucial to optimize glucose control and perinatal outcomes. Research design and methods: This paper describes the mixed methods integration of a sequential comparative case study. The objectives are threefold, as we integrated the quantitative and qualitative data within the overall mixed methods design: (1) to determine the predictors of glycemic control during pregnancy; (2) to understand the experience and diabetes self-management support needs during pregnancy among women with pre-existing diabetes; (3) to assess how self-management and support experiences helpe to explain glycemic control among women with pre-existing diabetes in pregnancy. The purpose of the mixing was to integrate the quantitative and qualitative data to develop rich descriptive cases of how diabetes self-management and support experiences and preferences in women with type 1 and type 2 diabetes during pregnancy help explain glucose control. A narrative approach was used to weave together the statistics and themes and the quantitative results were integrated visually alongside the qualitative themes to display the data integration. Results: The quantitative results found that women achieved "at target" glucose control (mean A1C of the cohort by the third visit: 6.36% [95% Confidence Interval 6.11%, 6.60%]). The qualitative findings revealed that feelings of fear resulted in an isolating and mentally exhausting pregnancy. The quantitative data also indicated that women reported high levels of self-efficacy that increased throughout pregnancy. Qualitative data revealed that women who had worked hard to optimize glycemia during pregnancy were confident in their self-management. However, they lacked support from their healthcare team, particularly around self-management of diabetes during labour and delivery. Conclusions: The achievement of optimal glycemia during pregnancy was motivated by fear of pregnancy complications and came at a cost to women's mental health. Mental health support, allowing women autonomy, and the provision of peer support may improve the experience of diabetes self-management during pregnancy. Future work should focus on developing, evaluating and implementing interventions that support these preferences. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is to present the research results on the perception of the professional self-image by Polish nurses and midwives as well as the psychometric adaptation of the Belimage scale. Methods: A cross-sectional survey was conducted from January to November 2018. The study group consisted of 670 clinical practice nurses and midwives. A diagnostic survey method was applied using the Belimage questionnaire after it obtained acceptable psychometric properties through an adaptation procedure. Results: In the group of respondents, the professional image of nurses and midwives is dominated by instrumental skills, documentation and organization of care, and communication skills. There is a statistically significant difference in the image of these two professions in terms of the ability to think and act creatively and critically, as well as innovation and evidence-based practice. The respondents' opinion regarding the perception of their image by themselves and society is statistically significant in each of the analyzed areas. In the professional image created by the public, nurses and midwives recognize that being a nurse/midwife is a vocation—277 (41.3%). However, in terms of their self-image, most nurses and midwives consider their work to be hard—442 (66%) and poorly paid—445 (66.4%). In the psychometric validation process, the Belimage questionnaire retained the original item structure, and the reliability of the subscales assessed with the Cronbach's alpha coefficient ranged from 0.845 to 0.730. Conclusions: The professional image of nurses and midwives varies depending on the profession and the perspective of the assessment in relation to themselves and society. The study showed a particularly unfavorable social image of nurses and midwives, which significantly influences the outlook of nurses and midwives themselves on this issue. [ABSTRACT FROM AUTHOR]

Background: The paper version of the training assessment was time-consuming and labor-consuming. It is an inevitable trend to change the appraisal method utilizing information technology. This study aimed to realize convenient and rapid management of the whole process of clinical nursing operation technology through information-based training and assessment platform. Methods: Combined with the operation mode of clinical nursing operation skills and set the basic functions of the information platform of clinical nursing operation training and assessment, the information-based training and evaluation platform for clinical nursing operation skills was established. The platform was officially operated in a tertiary level A general hospital in Shandong Province in 2018. Results: The information-based training and assessment platform is composed of Management Center (Computer Terminal) and a client terminal (APP terminal). The computer terminal contains 11 modules, and the APP terminal contains 8 modules. By December 2020, a total of 12,619 nurses had completed the training in nursing operation skills, and a total of 11,986 nurses had completed the examination. The examination results of nursing operation skills of the same nurses in 2018 were significantly higher than those in 2017(P < 0.05), and the error rate was significantly lower (P < 0.05). From 2016 to 2020, the scores of nasal feeding, CPR, and respiratory airbag of N1 level nurses significantly increased after using the information-based training and Assessment Platform (P < 0.05). Conclusion: Based on the information terminal training assessment can realize the management of the whole process of clinical nursing operation technology training and assessment, which is better than the traditional method, and is a very practical and convenient clinical training and assessment method. [ABSTRACT FROM AUTHOR]

Background: Clinical handover is a pivotal, high-risk communicative event because it involves the transfer of responsibility and accountability for patients and their care. Nurses' perceptions and their communication skills inevitably impact on their ability of clinical handover. Limited studies have explored nurses' handover practice in the Hong Kong context. This study aimed to identify factors associated with and specific impact paths between the quality, communication skills and nurses' perceptions on clinical handover. Methods: A questionnaire survey was conducted immediately after the nurses' training in effective handover communication. A convenience sample of 206 bilingual nursing staff from a local hospital in Hong Kong participated in this paper-and-pencil survey adopted from the Nurses Handover Perceptions Questionnaire survey. Results: The path analysis revealed that except the opportunity to ask questions and high perceptions of the ISBAR communication protocol, other factors were significantly correlated with improved quality of handover. In addition, nurses who had updated information were likely to ask more questions and obtain a better understanding of the patient care plan during handover. Conclusions: The quality of nursing handover depended on the degree of nurses' grasp of the patient care plan. The ISBAR communication protocol was considered helping nurses to improve their communication skills with other colleagues and indirectly enhance patient's safety. However, although ISBAR facilitated nurses to structure clearer handover communication, it was not the most important predictive factor for determining handover quality. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Introduction: Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is a common and potentially fatal post-surgery complication. Research has shown that 50% of VTE causes are intraoperative, with the risk of occurrence highest during and immediately post-surgery. Therefore, strategies for early assessment and prevention should be established. Objective: To identify optimal equipment selection, compression protocols, and strategies for complication prevention and management during intraoperative intermittent pneumatic compression (IPC), this study aims to synthesize the best available evidence. The objective is to inform accurate risk assessment and facilitate early mechanical prophylaxis against venous thrombosis. Methods: The Practical Application to Clinical Evidence model proposed by the Joanna Briggs Institute was utilized. Indicators were identified using the available best evidence from January 2023 to October 2023, and a baseline review was conducted. Negative factors were identified based on clinical evidence-based practice. The implementation rates of different indicators before (n = 372) and after (n = 405) evidence-based practice, the incidence rates of intraoperative IPC-related adverse events and VTE, and the risk of venous thrombosis before (n = 50) and after (n = 50) practice were identified and compared. Furthermore, medical staff's knowledge of best practices for intraoperative IPC was assessed through pre- and post-intervention surveys involving 109 operating room personnel. Results: All review indicators significantly improved (P < 0.01) after the evidence-based practice, and 9 reached 100%. Two intraoperative venous thrombosis events occurred before the evidence-based practice, with an incidence rate of 0.53%; no intraoperative venous thrombosis event occurred after the evidence-based practice, with no significant difference (X2 = 2.171, P = 0.141 > 0.05). However, there were significant differences in intraoperative venous blood hemodynamics before and after the practice (P < 0.05). Moreover, 9 IPC-related adverse events, including 4 cases of skin pressure, 3 cases of skin allergy, and 2 cases of lower limb circulation disorders, were reported before the evidence-based practice, with an incidence rate of 2.4%. Notably, no intraoperative IPC-associated adverse events occurred after the evidence-based practice(X2 = 9.913, P < 0.01). Meanwhile, the score of comprehension of the standard utilization of IPC for preventing venous thrombosis by medical staff in the operating room was 93.34 ± 3.64 after the evidence-based practice, which was higher than that (67.55 ± 5.45) before the evidence-based practice. Overall, the clinical practice was significantly improved the evidence-based practice. Conclusions: Applying intraoperative IPC utilization standards based on the best evidence in clinical practice effectively reduces the intraoperative IPC-associated adverse event rate and the risks of intraoperative venous thrombosis. It also improves the execution rates and compliance with mechanical prevention standards in the operating room by medical staff. Future research should prioritize the development and refinement of best clinical practices for intraoperative venous thrombosis prevention, with a particular emphasis on the integration of mechanical prophylaxis strategies. [ABSTRACT FROM AUTHOR]

Background: Given increases in China's aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, "Internet + Nursing Services" have received more attention. Thus, exploring the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and to test the validity and reliability of the scale. Methods: A preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale. Results: The final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ2/df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953. Conclusion: The scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in "Internet + Nursing Services". [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses. Method: In March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale. Results: After intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05). Conclusion: Balint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work. [ABSTRACT FROM AUTHOR]

Background: The Geriatrics Health Behavior Questionnaire (GHBQ) is essential for assessing health-related behaviors among older adults populations. This study focuses on the translation, cultural adaptation, and psychometric evaluation of the Arabic version of the GHBQ to ensure its relevance and accuracy for Arabic-speaking older adults individuals. Methods: This cross-sectional study was conducted at the Cairo University Educational Hospital's outpatient clinic. The GHBQ was translated and culturally adapted through a systematic process, including initial translation, back-translation, expert review, and pilot testing. The psychometric properties of the Arabic-translated GHBQ were evaluated using a sample of 200 older adults Arabic-speaking participants. Reliability was assessed using Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC). Validity was evaluated through Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results: The Arabic GHBQ demonstrated excellent reliability with Cronbach's alpha values ranging from 0.74 to 0.87 across subscales and ICC values confirming reproducibility (ICC = 0.82). The CVI indicated strong content validity (average CVI = 0.91). EFA revealed a five-factor structure, explaining 72% of the variance, with all factor loadings exceeding 0.60. CFA supported the questionnaire's structure with fit indices meeting recommended criteria: χ²/df = 2.05, NFI = 0.92, TLI = 0.94, GFI = 0.90, SRMR = 0.05, AIC = 140.35, and BIC = 160.22. Criterion validity was confirmed through significant correlations with established health behavior measures (r = 0.63, p < 0.001). Conclusions: The culturally adapted Arabic version of the GHBQ is a reliable and valid tool for assessing health behaviors in the older adults population in Egypt. This instrument can aid healthcare providers in identifying and addressing health behaviors, ultimately improving the well-being of this demographic. Future research should focus on expanding the sample and comparing the GHBQ with other similar tools used in Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Background: Given the increasing complexity of illnesses and rapid pace of technological advancements in professional training, it is vital to offer nurses ample opportunities to hone their clinical expertise and skills, particularly in ensuring the delivery of premier medical care. This study aimed to determine the factors and predictors influencing nurses' satisfaction with adopting mobile learning approaches in intensive care unit healthcare settings. Additionally, it sought to investigate the applicability of the technology acceptance model in explaining their inclinations and validating the measurement scales employed in the research. Methods: The study employed a cross-sectional survey research design, utilizing a technology acceptance questionnaire and a learning satisfaction questionnaire. The survey was conducted in six intensive care unit departments. A total of 212 participants completed the survey as the primary instrument. Rigorous assessments were conducted to establish the content validity and ensure instrument reliability. Results: The findings demonstrated that perceived usefulness was the most influential factor affecting nurses' intentions to embrace mobile learning approaches, with perceived ease of use emerging as the principal determinant of perceived usefulness. Conclusions: Incorporating mobile learning methodologies is paramount to increasing the calibration of professional nursing education programs. By effectively integrating digital information technology and tools, nursing educators can overcome teaching challenges, deliver innovative clinical nursing education content through mobile learning approaches, and foster optimal development in the field. [ABSTRACT FROM AUTHOR]

Background: As the global population continues to age, social realities such as advanced age, disability and living alone are coming to the fore, and the demand for medical care and health services for the elderly is increasing dramatically, especially in geriatrics. Given the important role geriatric nurses play in the diagnosis and treatment of diseases and rehabilitation of elderly patients, and due to the uniqueness and complexity of geriatric work, this requires geriatric nurses not only to have the competencies that are available in general nursing, but also to ensure that they have sufficient geriatric core competencies in order to effectively meet the needs of the patients and accelerate their recovery. Although previous studies have investigated the core competencies of nursing staff, there has been little research on geriatric nurses' core geriatric nursing competencies and their predictors. The aim of this study was to investigate the current status of the geriatric nursing competency inventory (GNCI) among geriatric nurses using latent profiling, to identify potential subgroups and their population characteristics, and to explore the factors that influence the potential subgroups. Methods: From January to March 2024, 1,313 geriatric nurses in Hefei City were selected by stratified cluster sampling method and surveyed with general information questionnaire, geriatric nursing competency inventory, and occupational coping self-efficacy scale for nurses(OCSE-N). Potential subgroups of GNCI differences among geriatric nurses were identified by latent profile analysis (LPA). Multiple logistic regression analyses were used to explore the factors influencing the GNCI of geriatric nurses with different latent profiles. Results: Geriatric nurses' OCSE-N was positively correlated with GNCI, and the GNCI score was 123.06(41.60), which indicated that geriatric nurses' GNCI was at an intermediate level. The OCSE-N score was 35.44(7.34), which was at a relatively high level. There was heterogeneity in the GNCI of geriatric nurses, which was classified into three subgroups i.e., Low-competency group, Medium-competency group, High-competency group. The results of multiple logistic regression analyses showed that OCSE-N, title, whether or not they attended geriatric nurse specialist training, and specialist nurse status were predictors of GNCI among geriatric nurses (P < 0.05). Conclusion: The GNCI categorical characteristics of geriatric nurses are obvious, and nursing managers should adopt targeted interventions according to the characteristics of nurses in different profiles to improve the overall quality of care. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the influence of green transformational leadership educational intervention on nurse managers' green behavior and creativity. Background: Organizational creativity is greatly influenced by leaders and their personality attributes. Additionally, innovative employee behavior is crucial for organizational performance and survival, which in turn promotes long-term organizational growth. Method: A quasi-experimental design was conducted by using pre-test, post-test, and follow-up for a group that included 116 nurse managers who completed the intervention. Data were collected through the green transformational leadership knowledge questionnaire, green transformational leadership scale, green behavior questionnaire, and green creativity scale. Results: Following the implementation of the Green Transformational Leadership educational intervention, there was an improvement in responses connected to the nurse manager's use of green behavior and creativity. Three months after the intervention ended, the improvement was still present. Conclusion: Nurse managers who had good knowledge about green transformational leadership showed increased green behavior and green creativity, which enhanced the organization's success. This study showed the significance of developing and improving the skills of managerial creativity for the nurse supervisor of a hospital through training in transformational leadership. Implications for nursing management: The concept of "green transformational leadership" refers to leadership behaviors and strategies aimed at promoting environmental sustainability and responsibility within an organization or a specific context. In the case we mentioned, it involves implementing educational interventions targeted at nurse managers to enhance their understanding and adoption of green practices, as well as fostering green behavior and creativity among them. [ABSTRACT FROM AUTHOR]

Background: Since 1999, reimbursements for nursing services for inpatients have been paid differentially according to the nurse staffing ratios in Korea. However, differentiated nursing fees are insufficient for nurse staffing; thus, steps have been taken to improve the policy. This study aimed to identify the impact of a policy that changed the method of calculating nurse staffing ratios from the nurse-to-bed ratio to the nurse-to-patient ratio on improving the nurse staffing ratio in medical institutions. Methods: Data were collected from 1,339 medical institutions that continuously provided medical services from 2017 to of 2021, and a prospective cohort was used for analysis. A generalized estimating equation for longitudinal ordered logistic regression was used to identify the impact of this policy change on the nurse staffing ratios in medical institutions. Results: During the cohort study, 59.8% of the first-applied group of medical institutions and 65.6% of the second-applied group of medical institutions improved their nurse staffing ratios. However, only 22.6% of the medical institutions to which the revised calculation method was not applied improved their nurse staffing ratios. A statistically significant difference was found in the improved nurse staffing ratio depending on whether and when the revised calculation method was applied (χ2 = 89.830, p <.001). The analysis of nurse staffing ratios of medical institutions from 2017 to 2021 showed that the likelihood of improving the nurse staffing ratio increased gradually after the revised calculation method was adopted. Also,the likelihood of the nurse staffing ratio improving in the first-applied group was 1.41 times higher (odds ratio = 1.41, 95% confidence interval = 1.04–1.92) than in the non-applied group. The odds ratio for the improvement of nurse staffing ratio in the second-applied group was 2.35 (95% confidence interval = 1.76–3.14). Conclusions: Financial incentives inherent in the new policy can be regarded as the driving force behind improvements in nurse staffing ratios. The revised calculation method should be extended to all medical institutions nationwide, and the law should be revised to secure the minimum number of nurses. [ABSTRACT FROM AUTHOR]

Background: Poor nurse-patient relationship poses an obstacle to care delivery, jeopardizing patient experience and patient care outcomes. Measuring nurse-patient relationship is challenging given its multi-dimensional nature and a lack of well-established scales. Purpose: This study aimed to develop a multi-dimensional scale measuring nurse-patient relationship in China. Methods: A preliminary scale was constructed based on the existing literature and Delphi consultations with 12 nursing experts. The face validity of the scale was tested through a survey of 45 clinical nurses. This was followed by a validation study on 620 clinical nurses. Cronbach's α, content validity and known-group validity of the scale were assessed. The study sample was further divided into two for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), respectively, to assess the construct validity of the scale. Results: The Nurse-Patient Relationship Scale (NPRS) containing 23 items was developed and validated, measuring five dimensions: nursing behavior, nurse understanding and respect for patient, patient misunderstanding and mistrust in nurse, communication with patient, and interaction with patient. The Cronbach's α of the NPRS ranged from 0.725 to 0.932, indicating high internal consistency. The CFA showed excellent fitness of data into the five-factor structure: χ2/df = 2.431, GFI = 0.933, TLI = 0.923, CFI = 0.939, IFI = 0.923, RMSEA = 0.070. Good content and construct validity are demonstrated through expert consensus and psychometric tests. Conclusion: The NPRS is a valid tool measuring nurse-patient relationship in China. [ABSTRACT FROM AUTHOR]

Background: Nurses work in close proximity to patients, and as such, they can have a direct impact on the control of infections; thus, it is important for nurses to be competent in infection control. However, the scales used to measure infection control performance in nurses are not suitable for measuring infection control competencies that reflect nurses' expertise, clinical environment, and work. Thus, this study aimed to develop a valid and reliable measure to assess infection control competency of clinical nurses. Methods: A concept analysis, using a hybrid model, was performed on the infection control competency of clinical nurses to confirm the components and develop 67 initial items. Ten experts evaluated the content validity of these items, and a Korean language expert and a Doctor of Nursing reviewed the questions to consolidate them into 59 items. Subsequently, 267 nurses working at a certified tertiary hospital in D City were surveyed to confirm the validity and reliability of the scale. Results: As a result of the study, the final scale comprising seven factors and 33 questions was derived, and the cumulative explanatory power of these factors was 60.8%. To verify convergent and discriminant validity, confirmatory factor analysis was conducted, and the average variance extraction index, composite reliability values, and confidence interval of the correlation coefficient between factors were confirmed. Convergent and discriminant validities were verified by comparison with standard values. The Cronbach's α for the entire scale in this study was 0.93. Consequently, the validity and reliability of the clinical nurses' infection control competency measurement scale were verified. Conclusions: The validity and reliability of the infection control competency measurement scale for clinical nurses (ICCS-CN) developed in this study was verified, and the scale can be effectively used to measure the infection control competency of clinical nurses. Measuring the infection control competency of clinical nurses will help reduce the harm caused by infection and ensure patient safety by decreasing infection rates in medical institutions. [ABSTRACT FROM AUTHOR]

Background: Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions. Methods: A retrospective observational study was carried out to examine the occurrence of the first surgical counting interruptions between 1st August 2023 and 30th September 2023. The data were collected using the "Surgical Counting Interruption Event Form", which was developed by the researchers specifically for this study. Results: A total of 66 circulating nurses (CNs) and scrub nurses (SNs) were observed across 1015 surgeries, with 4927.8 min of surgical count. The mean duration of the first surgical count was 4.85 min, with a range of 1.03 min to 9.51 min. In addition, 697 interruptions were identified, with full-term interruptions occurring an average of 8.7 times per hour. The most frequent source of interruption during the first surgical counts was instruments (N = 144, 20.7%). The first surgical counting interruptions mostly affected the CN (336 times; 48.2%), followed by the ORNs (including CNs and SNs) (243 times; 34.9%) and the SN (118 times; 16.9%). Most of the outcomes of interruptions were negative, and the majority of the nurses responded immediately to interruptions. Conclusions: The frequency of the first surgical counting interruption is high. Managers should develop interventions for interruptions based on different surgical specialties and different nursing roles. [ABSTRACT FROM AUTHOR]

Background: The level of nurses' job performance has always been of great concern, which not only represents the level of nursing service quality but is also closely related to patients' treatment and prognosis. The aim of this study was to analyze the relationship between perceived organizational justice and job performance and to explore the mediating role of organizational climate and job embeddedness among young Chinese nurses. Methods: A cross-sectional survey of 1136 young nurses was conducted between March and May 2023 using convenience sampling. Data were collected using the Job Performance Scale, Organizational Justice Assessment Scale, Nursing Organizational Climate Scale, and Job Embeddedness Scale, and the resulting data were analyzed using SPSS 25.0 and AMOS 26.0. Results: There was a significant positive correlation between job performance and perceived organizational justice (r = 0.477, p < 0.01), organizational climate (r = 0.500, p < 0.01), and job embeddedness (r = 0.476, p < 0.01). Organizational climate and job embeddedness acted as chain mediators between perceived organizational justice and job performance. The total effect of perceived organizational justice on job performance (β = 0.513) consisted of a direct effect (β = 0.311) as well as an indirect effect (β = 0.202) mediated through organizational climate and job embeddedness, with the mediating effect accounting for 39.38% of the total effect. Conclusions: Organizational climate and job embeddedness play a chain mediating role between perceived organizational justice and job performance, so hospital managers should pay attention to the level of perceived organizational justice among young nurses, and develop a series of targeted measures to improve their job performance using organizational climate and job embeddedness as entry points. [ABSTRACT FROM AUTHOR]

Background: Transition shock occurs at a vulnerable time in newly graduated registered nurses' careers and has a clear impact on both newly graduated registered nurses' productivity and patient recovery outcomes. Identifying classification features of transition shock and targeting interventions to support newly graduated registered nurses is imperative. The study aimed to explore potential transition shock subgroups of newly graduated registered nurses and further explore the impact of population characteristics and two indices of health on transition shock. Methods: A descriptive, cross-sectional design was conducted. An online questionnaire was sent via WeChat to newly graduated registered nurses who started work in 2021 at seven hospitals between August and November 2021, and 331 nurses filled out the questionnaire. Latent class analysis was used to identify the potential class of the transition shock of newly graduated registered nurses, and multinomial logistic regression analyses were used to determine the factors of potential classification. Results: The study identified four classes of transition shock in newly graduated registered nurses, namely, "high transition shock", "physical fatigue-lack of knowledge", "development adaptation" and "low transition shock-worry" groups. Newly graduated registered nurses who urinated less than 4 times per day (OR = 0.051, 95% CI = 0.005–0.502) were likely to be in the "high transition shock" group. Newly graduated registered nurses who did not delay urination (OR = 4.267, 95% CI = 1.162–11.236) were more likely to belong to the "low transition shock-worry" group. Newly graduated registered nurses without sleep disturbance were more likely to be in the "physical fatigue - lack of knowledge" (OR = 3.109, 95% CI = 1.283–7.532), "development adaptation" (OR = 8.183, 95% CI = 2.447–27.066), and "low transition shock-worry" (OR = 8.749, 95% CI = 1.619–47.288) groups than in the 'high transition shock' group. Conclusions: This study highlights potential patterns of transition shock among newly graduated registered nurses. Two indices of health, namely, delayed urination and sleep disturbance, can predict the subgroups of newly graduated registered nurses with transition shock. [ABSTRACT FROM AUTHOR]

Background: This study aimed to improve and implement the central sterile supply department (CSSD) training program through action research and to evaluate its effect. Materials and methods: The project was underpinned by action research. The problems that occurred in training were identified following scenario analysis, interviews, group discussions, and expert consultation to develop improvement measures. The training program characterized by CSSD was developed in the spiral circular process of "Plan-Act-Observe-Reflect". Results: After the two rounds of training, the CSSD nurses significantly improved their professional knowledge, skills, and satisfaction with training compared with those before improvement. The nurses' overall satisfaction with the training and their performance improved. Conclusions: The implementation of the training program designed based on action research can improve CSSD nurses' professional knowledge and skills and increase their enthusiasm for learning, laying the foundation for CSSD talent development. [ABSTRACT FROM AUTHOR]

Background: With the development of information technology, information has been an important resource in clinical medicine, particularly within the emergency department. Given its role in patient rescue, the emergency department demands a high level of information literacy from nurses to effectively collect, analyze, and apply information due to the urgency and complexity of emergency nursing work. Although prior studies have investigated the information literacy of nursing staff, little has been undertaken in examining the patterns of information literacy and their predictors among emergency department nurses. Aim: To clarify the subtypes of information literacy among nurses in the emergency department and explore the factors affecting profile membership. Methods: A cross-sectional study was conducted among a convenience sample of 2490 nurses in the emergency department from April to June 2023. The clinical nurses completed the online self-report questionnaires including the general demographic questionnaire, information literacy scale, self-efficacy scale and social support scale. Data analyses involved the latent profile analysis, variance analysis, Chi-square tests and multivariate logistic regression. Results: Four latent profiles were identified: 'Low information literacy (Class 1)', 'Moderate information knowledge (Class 2)', 'High information knowledge and support (Class 3)' and 'High information literacy (Class 4)', accounting for 20.14%, 42.11%, 23.36% and 14.39%, respectively. Each profile displayed unique characteristics representative of different information literacy patterns. Age, years of work, place of residence, hospital grade, title, professional knowledge, using databases, reading medical literature, participating in information literacy training, self-efficacy, and social support significantly predicted information literacy profile membership. Conclusions: Information literacy exhibits different classification features among emergency department nurses, and over half of the nurses surveyed were at the lower or middle level. Identifying sociodemographic and internal-external predictors of profile membership can aid in developing targeted interventions tailored to the needs of emergency department nurses. Nursing managers should actively pay attention to nurses with low information literacy and provide support to improve their information literacy level. Relevance to clinical practice: Insights from the current study of the latent profile analysis are beneficial to hospital managers in understanding the different types of emergency department nurses' information literacy. These insights serve as a reference for managers to enhance nurses' information literacy levels. [ABSTRACT FROM AUTHOR]

Background: Increasing compliance with isolation precautions is important in reducing hospital-acquired infections and their consequences. It is not possible to achieve and maintain nurse compliance through supervision, control, pressure, or training. Therefore, nurses must personally demand compliance with isolation precautions. This study aimed to determine the relationship between compliance with isolation precautions and the moral sensitivity levels of nurses who have just started working. Methods: This study employed a descriptive and cross-sectional research design. The study population consisted of 456 new nurses recruited during the pandemic. All of the new nurses who volunteered to participate in the study and completed the questionnaires completely were included in the study and 398 nurses constituted the sample of the study. Data were collected from 398 out of 456 novice nurses who agreed to participate in the study. The population coverage rate was 87.28%. Participants were selected using convenience sampling method. The data collection tools included an Introductory Information Form, The Isolation Compliance Precautions Scale (TIPCS), and the Moral Sensitivity Questionnaire (MSQ). Descriptive statistics, correlation analyses, and regression models were used to analyze data. Findings: The mean score of the MSQ was high (mean ± SD = 90.49 ± 25.94; median (P25-P75) = 84 (range, 74–97), and the score for TIPCS was high (mean ± SD = 79.29 ± 7.68; median (P25-P75) = 82 (range, 76–85)). No correlation was found between MSQ and TIPCS (p > 0.05). According to the regression analysis, although the MSQ did not correlate with TIPCS, compliance with isolation measures was found to increase as the conflict subscale of moral sensitivity increased (β= -0.36, CI= -0.55 to -0.16; p < 0.001). Choosing the profession willingly had a positive correlation with compliance with isolation measures (β = 5.3, CI = 2.4 to 8.3; p < 0.001). In addition, starting the profession at an early age had a positive correlation with compliance with isolation measures (β= -0.49, CI= -0.8 to -0.17; p = 0.002). Conclusion: The conflict sub-dimension of moral sensitivity is an important factor in nurses' compliance with isolation measures, and conducting necessary training and other studies to improve nurses' moral sensitivity may increase their compliance with isolation measures. [ABSTRACT FROM AUTHOR]

Background: Nursing performance is a key indicator of patients' care quality and safety. Most healthcare research tools are available in the English language; however, nurses around the world can employ these tools if rigorously adapted and cross-culturally validated. Aims and objectives: This study aims to provide a cross-cultural adaptation and validation of the six-dimension scale of nursing performance to be used among Arabic-speaking nurses. Design: The study employed a descriptive, correlational design with a cross-sectional approach. Methods: A five-step cross-cultural adaptation process was adopted. The scale was administered to 216 Jordanian nurses between January 2022 to April 2022. SPSS and AMOS were used for descriptive and correlation analyses and testing the six-dimension model through structural equation modeling (SEM). Results: The current study produced a valid, reliable, culturally adapted Arabic language version of the six-dimension scale of nursing performance. The internal consistency of the tool was supported by a Cronbach Alpha's value of 0.99. The model's goodness of fit indices were: CFI = 0.96, RMSEA = 0.048, and CMIN/df = 1.49. The exploratory factor analysis (EFA) of the scale identified three factors with eigenvalues greater than 1.00., explaining 75.22% of the variance. A subsequent EFA, specifying six factors, yielded 79.79% explained variance. All item factor loadings exceeded 0.30, confirming the scale's robust factor structure. Conclusions: This study proved that following a robust cross-cultural adaptation process results in a reliable and valid measure of nursing performance to be used among Arabic-speaking nurses. The study supports the dimensionality of nursing performance as evidenced by the SEM results. Therefore, the findings have the potential to considerably enhance studying nursing performance in healthcare fields in Arabic-speaking nurses. Relevance to clinical practice: The validation and cross-cultural adaptation of the Arabic version of the Six-Dimension Scale of Nursing Performance have direct implications for improving the quality of nursing services, enhancing patient safety, promoting cultural competence, and supporting the professional growth of Arabic-speaking nurses. [ABSTRACT FROM AUTHOR]

Virtual Reality simulation (VRS) is an innovative and emerging technology that has the potential to offer increased numbers of pre-registration students authentic learning experiences compared to traditional simulation- based education (SBE) with simulated participants. The aim was to evaluate learner outcomes of SBE compared to 4 fully immersive VRS scenarios, for vocational and higher education nursing students at a training and further education institute in Melbourne, Australia. A mixed methods quasi-experimental design study was conducted over two semesters from 2019 to 2020. Participants were 675 pre-registration nursing students. The intervention group (VRS n = 393) received 4 three-dimensional, immersive VRS modules. The control group (SBE n = 282) received 4 face-to-face large group immersive simulations. In the VRS group 95% of students actively participated, compared to SBE (on average 15%). Knowledge test scores were initially significantly greater (p < 0.01) for VRS versus SBE students, but not maintained post clinical placement. Intervention students found VRS to be realistic and prepared them for clinical practice. Some technical difficulties were identified with VRS. VRS was found to be more cost effective than SBE. VRS fostered critical thinking and provided an efficient and sustainable platform for learning about complex clinical situations. [ABSTRACT FROM AUTHOR]

Objective: To translate the Academic Goals Orientation Questionnaire (AGOQ) into Chinese and to determine the validity and reliability of the (AGOQ) in Chinese nursing students based on SEM and IRT multidimensional models. Methods: The participants were 654 nursing students with an age range of 17–26 years (mean age 21.61 ± 1.73 years). The psychometric properties of AGOQ were investigated based on a dual analytical perspective of structural equation modeling (SEM) and item response theory (IRT). Results: The Cronbach's α value of the questionnaire is 0.895. A four-factor model was obtained by exploratory factor analysis, which explained the variance of 71.892%. With confirmatory factor analysis, a new four-factors model was built and showed an acceptable goodness-of-fit, chi-square/degree of freedom (CMIN/DF) = 4.008, goodness of fit index (GFI) = 0.932, adjusted goodness of fit index (AGFI) = 0.905, comparative fit index (CFI) = 0.952, incremental fit index (IFI) = 0.952, Tucker Lewis index (TLI) = 0.941. In the analysis part of IRT, according to the comparison between Akek's information criterion (AIC) and Bayesian information criterion (BIC), we choose the Graded Response Model (GRM) for analysis. The results show that the difficulty value is monotonically increasing, and the discrimination of all items is greater than 0.19, which shows that 16 items can be retained. Conclusions: This study tested the psychometric characteristics of AGOQ of nursing students in China. The results confirmed that the Chinese version of AGOQ has good psychometric characteristics and can be used to measure the academic goal orientation of nursing students in China. [ABSTRACT FROM AUTHOR]

Background: To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction. Methods: We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction. Results: Responses were received from 930 cancer nurses. Most respondents (85%) described themselves as experienced nurses, and more than half had post-graduate qualifications. We identified individual, organizational, and systemic factors that contribute to job satisfaction and can impact in workforce shortages. The findings include strategies to address and prioritize workforce challenges. There were 89 different titles for advanced practice nursing roles. Managing high workload was a reported challenge by 88%. Intention to stay less than 10 years was reported by nearly 60%; this was significantly correlated with job satisfaction and age. Significantly higher scores for job satisfaction were associated with those who had career progression opportunities, career development opportunities, adequate peer support and a clearly defined scope of role. Conversely, job satisfaction scores decreased the more people agreed there was a lack of leadership and they had insufficient resources to provide quality care. Conclusion: Cancer nurses are critical to the delivery of cancer care however, the workforce faces multiple challenges. This study provides an understanding of the Australian cancer nursing workforce characteristics, their roles and activities, and highlights important considerations for retaining nurses in the profession. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease could have a profound effect on the life of patients and family caregivers. The caregivers' care burden increases as the disease progresses. Interventions reducing care burden should be investigated. Educational interventions could affect family caregivers' care burden among hemodialysis patients. However, most studies and interventions have focused on caregivers. Therefore, this study aims to compare the effect of teaching Health-promoting behaviors on the care burden of family caregivers of hemodialysis patients. Materials and methods: This trial was conducted using a pretest-posttest design and follow-up after one month. Hemodialysis patients and their family caregivers were selected using convenience sampling method. In total, 124 patient-caregiver pairs were divided into four groups of patient-centered education, caregiver-centered education, Patient and caregiver education and control by block randomization (15 blocks of 8 members and 1 block of 4 members) (n = 31 pairs per group). The intervention (teaching health-promoting behaviors) was performed in 8 sessions using the teach-back method, except for the control. The data were collected by patient and caregiver demographic forms and Novak and Guest care burden inventory as well as following the treatment regimen in three stages (before, immediately after and one month after the intervention). Demographic variables were compared among the four groups using ANOVA, Kruskal-Wallis and Chi-square test. The intragroup comparison of the main variables was made using the repeated measures ANOVA with modified LSD post hoc test. The intergroup comparison was made by one-way ANOVA with LSD post hoc test. Results: Out of 124 caregivers participating in the study, 68 (54.8%) were female. Also, out of 124 patients participating in the study, 86 (69.4%) were male. The mean age of the caregivers and patients was 39.2 ± 11.31 and 54.23 ± 14.20 years old, respectively. There was a statistically significant difference in the mean total care burden scores of the pre-test and post-test between the four groups (p < 0.001). The total care burden decreased in patient-centered, caregiver-centered and Patient and caregiver education groups. However, this reduction in the caregiver-centered and Patient and caregiver education groups was significantly higher than the patient-centered education group (p < 0.001). Conclusion: The results revealed teaching health-promoting behaviors reduced care burden. Moreover, caregiver-centered approach could reduce care burden more than patient-centered approach. Therefore, this could be used as a supportive method to improve the health of patients and caregivers. Trial registration number (TRN): IRCT20090522001930N4. Date of registration: 2021-11-12. [ABSTRACT FROM AUTHOR]

Background: Smart device overdependence adversely affects the overall development of preschool children. This study aimed to provide an emotion coaching group programme to mothers raising preschool children who are overly dependent on smart devices and to confirm the programme's effectiveness. Methods: This concurrent embedded mixed methods study used a non-equivalent control group pre-post design to verify the quantitative effect of the programme, and a descriptive research design to verify the qualitative effect. The study collected data from June 2019 to March 2021 from 51 (25 experimental, 26 control) mothers raising children aged 3–6 years in South Korea. The quantitative study examined the effects of an eight-session programme, conducted once a week for two hours, on mothers' emotional intelligence, parenting behaviour, and their children's attachment stability and smart device overdependence using a non-equivalent control group pre-post design. The analysis used a generalized estimate equation. For qualitative research, focus group interviews were used as a descriptive research design method, and content analysis was used for analysis. Results: Quantitatively, the results showed significant differences between the experimental and control groups in terms of changes in maternal emotional intelligence (χ2 = 14.99, p =.001), maternal positive parenting behaviour (χ2 = 9.32, p =.009), children's unstable attachment to their mothers (χ2 = 9.49, p =.009), and children's overdependence on smart devices (χ2 = 14.48, p =.001). Qualitatively, the study derived five themes for the experiences of mothers who participated in the programme: "hope for desirable parenting without emotional difficulties," "feelings touched by reflection," "warm but authoritative parenting," "children who became responsible by gaining psychological stability," and "changed view of my home." Conclusions: The emotion coaching group programme was effective in improving the emotional intelligence and parenting behaviour of mothers raising preschool children. The programme also improved preschool children's attachment stability to their mothers and overdependence on smart devices. The programme can be useful in community practice, and the present study can be used as evidence for education and research related to device overdependence. [ABSTRACT FROM AUTHOR]

Background: Aging leads to changes in the body system, such as sarcopenia. This can result in several health issues, particularly physical and mobility dysfunction. Asian people typically have little awareness of sarcopenia. Thus, this study incorporated nursing instruction into the mobile application design to allow users to easily learn about sarcopenia. Objective: This study evaluated a model for predicting high-risk populations for sarcopenia in home settings. We further developed a sarcopenia nursing guidance mobile application and assessed the effectiveness of this application in influencing sarcopenia-related knowledge and self-care awareness among participants. Methods: Using a one-group pretest–posttest design, data were collected from 120 participants at a teaching hospital in northern Taiwan. This study used an artificial intelligence algorithm to evaluate a model for predicting high-risk populations for sarcopenia. We developed and assessed the sarcopenia nursing guidance mobile application using a questionnaire based on the Mobile Application Rating Scale. Results: The application developed in this study enhanced participants' sarcopenia-related knowledge and awareness regarding self-care. After the three-month intervention, the knowledge and awareness was effectively increase, total score was from 4.15 ± 2.35 to 6.65 ± 0.85 and were significant for all questionnaire items (p values < 0.05). On average, 96.1% of the participants were satisfied with the mobile app. The artificial intelligence algorithm positively evaluated the home-use model for predicting high-risk sarcopenia groups. Conclusions: The mobile application of the sarcopenia nursing guidance for public use in home settings may help alleviate sarcopenia symptoms and reduce complications by enhancing individuals' self-care awareness and ability. Trial registration: NCT05363033, registered on 02/05/2022. [ABSTRACT FROM AUTHOR]

Background: This paper describes both the use of and needs for informal caregivers of people with dementia, based on a questionnaire survey organized within the National Dementia Programme in the Netherlands. The National Dementia Programme is a quality collaborative of the Dutch Alzheimer's Association, the Institute of Quality of Healthcare (CBO) and the Knowledge Centre on Ageing (Vilans), instigated by the Ministry of Health, Welfare and Sport, to improve integrated care for people with dementia and their informal caregivers. The support needs of informal caregivers are important to improve caregiver well-being and delaying institutionalization of the person with dementia. Methods: In the period April 2006 - January 2007, the National Dementia Programme questionnaire was completed by 984 informal caregivers. Descriptive statistics were used to analyze the use of and needs for additional professional support by informal caregivers. Chi-square tests were used to assess the relationships between characteristics of the caregivers (spouses, sons/daughters, sons/daughters in-law) and support needs on one hand and to assess the relationship between the living situation of the person with dementia (living at home or living in a nursing home or home for the elderly) and support needs on the other hand. Results: Almost all informal caregivers (92.6%) received some professional support. However, two thirds (67.4%) indicated they had one or more needs for additional professional support. Informal caregivers often need additional professional advice about what to do when their relative is frightened, angry of confused. Spouses reported different needs than sons or daughters (in-law): spouses relatively often need emotional support and sons or daughters (in-law) more often need information and coordination of dementia care. Conclusions: Most of the informal caregivers report that they need additional information and advice, e.g. about how to cope with behavioral problems of their relative, about the progression of the illness trajectory, emotional support and coordination of dementia care. Future support programmes, e.g. in the field of case management, should address the specific needs of informal caregivers. [ABSTRACT FROM AUTHOR]

Background: Restricting parturient women in healthcare facilities from choosing positions that provide the greatest comfort and benefit during labor is a global barrier. Several complex factors, including caregiver preference and medical intervention, shape the limitation. Therefore, a practical need exists to train midwives on the knowledge and skills to change this condition. Methods: The study used a parallel, single-blind, randomized controlled trial at a provincial maternity and child health hospital in Fujian, China, from June 1 to December 31, 2019. The midwives in a birth suite were selected and randomly enrolled in a one-month simulation-based hybrid training or face-to-face teaching in September 2019. The four-level Kirkpatrick's model, including reaction, learning, behavior, and results, was used to evaluate training effects before and after the program. Data were analyzed with SPSS 25.0 using Student's t-test, Spearman's correlation test, Mann–Whitney U test, Wilcoxon signed-rank test, and chi-square test analysis of variance. The significance level was set at p < 0.05. Results: Forty-two midwives were initially randomized to either the virtual simulation group or the face-to-face group. One midwife was excluded from the analysis due to intervention discontinuation, resulting in a final analysis of 41 midwives (n1 = 21, n2 = 20). Post-intervention, the virtual simulation group exhibited higher satisfaction and learning effects compared to the face-to-face group, while the rate of perineal incision in primiparas was lower (p<0.05). No significant changes or differences were observed in self-rated behavior between the two groups (p>0.05). The virtual simulation group demonstrated an increase in non-supine birth rate (p = 0.030) and a decrease in perineal incision rate among primiparas compared to pre-intervention (p = 0.035). Moreover, knowledge performance was associated with the duration of virtual simulation (r = 0.664, p = 0.001). Conclusions: Virtual simulation is a fascinating innovation that enables midwives to develop birthing positions without practicing on real pregnant women and is one solution to achieve work competency within a shortened training period. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of oral comprehensive nursing intervention on mechanically ventilated patients in ICU. Methods: Select 76 cases of mechanically ventilated patients in severe ICU admitted to our hospital from January 2022 to October 2022 as the research objects, and divide them into the control group and the observation group according to the way the patients receive oral care. 38 cases each. The patients in the control group received routine nursing intervention, and the patients in the observation group received comprehensive oral nursing intervention on the basis of the nursing of the control group. The clinical index data, oropharyngeal hygiene, pH value, blood gas analysis index levels, and the occurrence and death of ventilator-associated pneumonia were compared between the two groups of patients. Results: The hospitalization time of the two groups was compared (P > 0.05); the mechanical ventilation time and ICU stay time of the observation group were significantly lower than those of the control group (all, P < 0.05); the oral odor scores, The plaque index and soft scale index were significantly lower than those of the control group (all, P < 0.05); the pH value, PaO 2 value, and SpO 2 value of the observation group were significantly lower than those of the control group, and the PaCO 2 value was significantly higher than that of the control group. group (all, P < 0.05); the incidence of VAP in the control group was 55.26%, and the mortality rate was 15.79%, the incidence rate of VAP in the observation group was 21.05%, and the mortality rate was 2.63%, and the incidence rate and mortality rate of VAP in the observation group were significantly lower in the control group (all, P < 0.05). Conclusion: The application of nursing intervention can effectively promote the recovery of patients, improve the hygiene of patients' oropharynx, adjust the levels of pH and blood gas-related indicators in patients, and reduce VAP in patients. risk of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: Communication challenges are one of the main contributors for medication incidents in hospitals, but health professionals' perceptions about variety of the contributing communication factors and the factors' occurrence frequencies are studied little. This cross-sectional descriptive study aimed to (1) operationalize a literature-based framework into a scale for measuring health professionals' perceptions of communication factors, which contribute to medication incidents either directly or indirectly in hospitals, (2) to measure the construct validity and internal consistency of the scale and (3) to describe the primary results of the measured weekly perceived communication challenges. Methods: The structured online questionnaire with 82 communication related items was developed based on a framework in literature. A content validity index of expert panelists' answers was used for item reduction. Data was collected between November 1st, 2019, and January 31st, 2020, by convenience sampling. The study sample (n = 303) included multiple health professional groups in diverse specialties, unit types and organizational levels in two specialized university hospital districts in Finland. Exploratory factor analysis with Maximum Likelihood method and Oblique rotation produced a six factors scale consisting of 57 items and having acceptable construct validity and internal consistency. Results: The six communication factors contributing to medication incidents concerned (1) medication prescriptions, (2) guidelines and reporting, (3) patient and family, (4) guideline implementation,5) competencies and responsibilities, and 6) attitude and atmosphere. The most frequently perceived communication challenges belonged to the Medication prescription related factor. Detailed item frequencies suggested that the most usual weekly challenges were: (1) lack or unclarity of communication about medication prescriptions, (2) missing the prescriptions which were written outside of the regular physician-ward-rounds and (3) digital software restricting information transfer. Conclusions: The scale can be used for determining the most frequent detailed communication challenges. Confirmatory factor analysis of the scale is needed with a new sample for the scale validation. The weekly perceived communication challenges suggest that interventions are needed to standardize prescribing documentation and to strengthen communication about prescriptions given outside of regular ward-rounds. [ABSTRACT FROM AUTHOR]

Background/Objectives: Nurses in Lebanon are facing multiple crises and the severity of the situation calls for an empirical examination of their resilience status. Evidence indicates that resilience can buffer the negative effect of workplace stressors on nurses and is associated with favorable patient outcomes. The objective of this study was to test the psychometric properties of the Arabic Resilience Scale-14 that was utilized to measure resilience among Lebanese nurses, Methods: Data was collected from nurses working in health care centers using a cross-sectional survey design. We estimated the confirmatory factor analysis using the Diagonally Weighted least Squares. Fit indices for the confirmatory factor analysis model included Model chi-square, root-mean squared error of approximation and Standardized Root Mean Square Residual. Statistical significance was set at p < 0.05. Results: 1,488 nurses were included in the analysis. The squared multiple correlations values ranged from 0.60 to 0.97 thus supporting the construct validity of the originally hypothesized five factor model (self-reliance, purpose, equanimity, perseverance, and authenticity). Conclusions: The Arabic version of the Resilience Scale 14 tool is considered a valid tool for measuring resilience in any situation involving Arabic speaking nurses. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of needle stick injuries among nurses and the arising risks double the need to pay attention to improve their knowledge and change their behavior using effective educational models. The present study aimed to investigate the effect of educational intervention based on the health belief model on nurses' compliance with standard precautions in preventing needle stick injuries. Methods: This quasi-experimental study was conducted on 110 nurses working in medical training centers in Shiraz and Fasa in 2019. Subjects were selected using a simple sampling method and were randomly divided into two interventions (n = 55) and control (n = 55). The intervention included 7 sessions of 50–55 min. Before and 3 months after the intervention, the health belief model questionnaire was completed by both groups. The data were analyzed using SPSS software version 22 through chi-square, independent, and paired t-tests (P < 0.05). Results: Based on independent and paired t-tests, there was no significant difference between the control and intervention groups regarding the mean score of health belief model constructs before the intervention. However, there was a significant difference regarding the mentioned scores 3 months after the educational intervention. Based on the paired t-test, the mean score of awareness, perceived sensitivity, perceived severity, perceived benefits, self-efficacy, cues to action, and behavioral performance in the intervention group significantly increased after the educational intervention (P < 0.05). Also, there was a significant decrease in perceived barriers (P < 0.05). Conclusion: It is recommended to apply the proposed model as an effective and cost-effective method along with other methods in training programs for nurses and other health workers exposed to invasive procedures, contaminated blood, and secretions. [ABSTRACT FROM AUTHOR]

Background: Young breast cancer survivors with body image disturbance have poor quality of life. Self-compassion and different coping styles can influence their body image. The purpose of the study was to investigate the relationship between self-compassion, coping styles, and body image disturbance, and examined the mediation role of coping styles between self-compassion and body image disturbance among young breast cancer survivors in China. Methods: In the cross-sectional study, a total of 310 young women with breast cancer were assessed on self-compassion, coping styles, and body image disturbance by self-reported questionnaires in China. Spearman's correlation was used to test the links between variables and to verify the indirect effects between variables by constructing a structural equation model. Results: There were correlations between self-compassion, different coping styles, and body image disturbance. Confrontation, avoidance, and acceptance-resignation coping had significant mediation effects on the association between self-compassion and body image disturbance. The mediation effects of confrontation coping were greater than avoidance, and acceptance-resignation coping. Conclusions: In this study, different coping styles acted as mediators between self-compassion and body image disturbance, providing support for further understanding the mechanism between self-compassion and body image disturbance, and developing comprehensive interventions for body image disturbance. Oncology nurses should pay attention to the breast cancer survivors' self-compassion and coping styles and encourage them to adopt adaptive coping strategies, which can reduce body image disturbance. [ABSTRACT FROM AUTHOR]

Background: Mealtime difficulties related to cognitive functioning negatively impact a patient's life during the various stages of dementia, and they typically cause a burden and stress on family caregivers. Most people with dementia live at home alone or are cared for by informal caregivers, typically their spouses or other family members. However, no suitable screening tools for home-dwelling patients with dementia have been developed, nor have measurements focused on executive and self-eating functions. This study aimed to develop and evaluate the psychometric properties of the Dietary Function Assessment Scale (DFAS) for community-dwelling persons with dementia. Methods: A mixed-method design was used to develop the instrument. Methods included a comprehensive literature review to identify the item pool and an expert panel to assess the initial item pool. We performed convenience sampling of 190 home-dwelling people with dementia for psychometrical evaluation. The psychometric properties tests included item and factor analyses, criterion-related validity testing, internal consistency reliability testing, and defining the optimal cut-off values. The study was conducted from 2018 to 2019. Results: Items were generated based on an extensive literature review and pre-existing scales related to mealtime and executive functions in persons with dementia. The S-CVI/Ave of the DFAS was 0.89. A Principal Component factor analysis demonstrated seven items, with a two-factor structure accounting for 56.94% of the total variance. The two extracted factors were Self-eating ability and Dietary executive function. The confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate (r = -0.528, p < 0.01). The reliability of Cronbach's alpha internal consistency was 0.74, and McDonald's Omega coefficient was 0.80; the optimal cut-off value of 13 points with an AUC of 0.74 was established to determine poor dietary functioning in persons with dementia. Conclusion: The DFAS was simple, user-friendly, and a valid and reliable instrument to assess dietary functioning in community-dwelling persons with dementia. This short scale can be helpful for caretakers, who can use it to identify the dietary needs of home-dwelling persons with dementia and improve their care and eating experience. [ABSTRACT FROM AUTHOR]

Background: The most suitable and reliable inference engines for Clinical Decision Support Systems in nursing clinical practice have rarely been explored. Purpose: This study examined the effect of Clinical Diagnostic Validity-based and Bayesian Decision-based Knowledge-Based Clinical Decision Support Systems on the diagnostic accuracy of nursing students during psychiatric or mental health nursing practicums. Methods: A single-blinded, non-equivalent control group pretest–posttest design was adopted. The participants were 607 nursing students. In the quasi-experimental design, two intervention groups used either a Knowledge-Based Clinical Decision Support System with the Clinical Diagnostic Validity or a Knowledge-Based Clinical Decision Support System with the Bayesian Decision inference engine to complete their practicum tasks. Additionally, a control group used the psychiatric care planning system without guidance indicators to support their decision-making. SPSS, version 20.0 (IBM, Armonk, NY, USA) was used for data analysis. chi-square (χ2) test and one-way analysis of variance (ANOVA) used for categorical and continuous variables, respectively. Analysis of covariance was done to examine the PPV and sensitivity in the three groups. Results: Results for the positive predictive value and sensitivity variables indicated that decision-making competency was highest in the Clinical Diagnostic Validity group, followed by the Bayesian and control groups. The Clinical Diagnostic Validity and Bayesian Decision groups significantly outperformed the control group in terms of scores on a 3Q model questionnaire and the modified Technology Acceptance Model 3. In terms of perceived usefulness and behavioral intention, the Clinical Diagnostic Validity group had significantly higher 3Q model and modified Technology Acceptance Model 3 scores than the Bayesian Decision group, which had significantly higher scores than the control group. Conclusion: Knowledge-Based Clinical Decision Support Systems can be adopted to provide patient-oriented information and assist nursing student in the rapid management of patient information and formulation of patient-centered care plans. [ABSTRACT FROM AUTHOR]

Background: One way in which patients can participate in care is by taking part in medical documentation. Producing documentation together with patients has been found to decrease the amount of incorrect information, help patients to be involved, and promote shared decision-making. The aims of this study were to develop and implement a practice of producing documentation together with patients and to examine staff and patient experiences of this practice. Methods: A quality improvement study was conducted from 2019 to 2021 at a Day Surgery Unit in a Danish University Hospital. Before implementing a practice of documenting together with patients, nurses' perceptions of doing documentation together with patients were examined via a questionnaire survey. After an implementation period, a similar follow-up survey with staff was conducted, together with structured patient phone interviews. Results: A total of 24 nursing staff out of 28 (86%) filled in the questionnaire at baseline and 22 out of 26 (85%) at follow-up. A total of 61 out of 74 invited patients (82%) were interviewed. At baseline, the majority (71-96%) of participants agreed that documentation done together with the patient would contribute to increased patient safety, fewer errors, real-time documentation, patient involvement, visible patient perspective, correction of errors, more accessible information and less duplication of work. At follow-up, significant decreases in the staffs' positive perceptions of the benefits of documenting together with patients were found for all areas except for "real-time documentation" and "less duplication of work". Almost all patients found it okay that the nurses wrote up medical documentation during the interview, and more than 90% of patients found the staff responsive or very responsive and present during the reception interview. Conclusion: Before implementation of a practice of documenting together with patients, the majority of staff assessed such documentation as being beneficial, but a significant decrease in positive assessment was found at follow-up, with challenges such as feeling less connected with the patient and practical, IT-related issues being described. The patients found the staff to be present and responsive and felt that it was important to know what was being written in their medical record. [ABSTRACT FROM AUTHOR]

Background: Depressed patients commonly experience psychological pain. Research pointed to positive psychological interventions as an effective means of ameliorating psychological pain, although the exact effect is unclear. Based on the hope theory and solution-focused brief therapy (SFBT), this study combines hope theory with solution-focused brief therapy to develop a nurse-led psychological pain solution-focused (PPSF) intervention in depressed patients. Methods: This is an assessor-blinded randomized controlled trial following the SPIRIT guidance. A total of 84 depressed patients will be recruited from the inpatient wards of a psychiatric hospital and randomly assigned to the control and experimental groups. Patients in the control group will be treated as usual. In contrast, patients in the experimental group will receive 6 sessions of the PPSF intervention for two weeks on top of the routine care. Primary outcomes are psychological pain, hope, cognitive distortions. Secondary outcomes are depression and suicidal ideation. Data will be collected at 5-time points: baseline, 1 and 2 weeks (post-intervention), 1 month (follow up), and 6 months after baseline. Generalized equation evaluation will be used to assess the effectiveness of the PPSF intervention. Discussion: From a positive psychology perspective, there remains much room for developing psychological pain interventions in depressed patients. SFBT and hope theory are both based on positive psychology. With hope theory as the general framework and SFBT questions as the practical guide, the PPSF intervention program is designed that nursing staff can implement. If the intervention is effective, it will advance the development of psychological pain interventions for patients with depression. Trial registration: ChiCTR2100048223 [ABSTRACT FROM AUTHOR]

Background: The high levels of unmet needs in relation to provision of self-care information reported by women living with breast cancer suggests that pre-chemotherapy education is suboptimal. Chatbots are emerging as a promising platform to provide education to patients helping them self-manage their symptoms at home. However, evidence from empirical studies on the effect of chatbots education on women living with breast cancer self-care behaviors and symptoms management are scarce. Methods: This three-arm randomized controlled trial was performed in a chemotherapy day care center within an oncology center in Egypt. A total of 150 women living with breast cancer were randomly selected and randomized into three groups: the ChemoFreeBot group (n = 50), the nurse-led education group (n = 50), and the routine care group (n = 50). In the ChemoFreeBot group, women were given a link to interact with ChemoFreeBot and ask questions about their symptoms and self-care interventions by typing questions or keywords at any time. On the same day as their first day of chemotherapy, the nurse-led education group received face to face teaching sessions from the researcher (nurse) about side effects and self-care interventions. The routine care group received general knowledge during their chemotherapy session about self-care interventions. The self-care behaviors effectiveness and the frequency, severity and distress of chemotherapy side effects were measured at baseline and postintervention for the three groups. The ChemoFreeBot's usability was assessed. Results: The mixed design repeated measures ANOVA analyses revealed a statistically significant both group effect and interaction effect of group*time, indicating a significant difference between the three groups in terms of the physical symptoms frequency (F = 76.075, p <.001, F = 147, p <.001, respectively), severity (F = 96.440, p <.001, F = 220.462, p <.001), and distress (F = 77.171, p <.001, F = 189.680, p <.001); the psychological symptoms frequency (F = 63.198, p <.001, F = 137.908, p <.001), severity (F = 62.137, p <.001), (F = 136.740, p <.001), and distress (F = 43.003, p <.001, F = 168.057, p <.001), and the effectiveness of self-care behaviors (F = 20.134, p <.001, F = 24.252, p <.001, respectively). The Post hoc analysis with Bonferroni adjustment in showed that women in the ChemoFreeBot group experienced a statistically significant less frequent, less severe and less distressing physical and psychological symptoms and higher effective self-care behaviors than those in the nurse-led education and routine care groups (p >.001). Conclusion: ChemoFreeBot was a useful and cost-effective tool to improve increase self-care behavior and reduce chemotherapy side effects in women living with breast cancer through the provision of personalized education and the improvement of the accessibility to real-time and high-quality information compared to "one size fits all" approach used by nurses to provide the information. ChemoFreeBot can be an empowering tool to assist nurses to educate women with breast cancer and allow women to take an active role in managing their symptom. Trial registration: This study was retrospectively registered in the University hospital Medical Information Network (UMIN) Center, Clinical Trials Registry on 26/09/2022; Registration No:R000055389,Trial ID:UMIN000048955. [ABSTRACT FROM AUTHOR]

Background: Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human–machine interactions in nursing care, but few studies have examined interruptions and nurses' mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses' mental workload and performance in EHR tasks. Methods: A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1st to October 31st, 2021. An observer documented nurses' EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses' mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. Results: In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. Conclusions: Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses' mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic led to major changes in people's lives via protective strategies aimed at limiting the transmission of COVID-19, including social distancing, lockdowns, cancelled or limited leisure activities and tutorials and supervision for students taking place digital. All of these changes may have influenced students' health and quality of life. Aim: To describe and explore fear of COVID-19 and psychological distress, as well as general health and quality of life, among baccalaureate nursing students at 1 year into the COVID-19 pandemic. Method: We used a mixed method study design, including quantitative data from University of Agder, data that was a part of a national survey of baccalaureate nursing students nearly one year into the pandemic. All the nursing students at the university were invited to take part between 27 January and 28 February 2021. The quantitative survey included 396 (out of total 858) baccalaureate nursing students (response rate: 46%). The quantitative data were collected using well-validated measures of fear of COVID-19, psychological distress, general health and quality of life, and the data were analysed using the ANOVA-tests for continuous data and chi-square tests for categorical data. Qualitative data were gathered from focus group interviews from the same university two-three months later. Five focus group interviews were conducted with a total of 23 students (7 men, 16 women). The qualitative data were analysed using systematic text condensation. Results: The mean score (standard deviation [SD]) for fear of COVID-19 was 2.32 (0.71), for psychological distress was 1.53 (1.00), for general health was 3.51 (0.96) and for overall quality of life was 6.01 (2.06). In the qualitative data, we identified the overarching theme effect of COVID-19 on students' quality of life and the three main themes; importance of personal relations, physical health challenges and mental health challenges. Conclusion: The COVID-19 pandemic influenced negatively nursing students' quality of life and physical and mental health, and they often felt lonely. However, most of the participants also adapted strategies and resilience factors to cope with the situation. Via the pandemic situation, the students learned additional skills and mental mindsets that may be useful in their future professional lives. [ABSTRACT FROM AUTHOR]

Background: In a rapidly changing healthcare environment, Self-directed learning (SDL) ability is recognized as a crucial condition for nursing students and nurse to deal with severe challenges positively. Developing SDL ability is becoming more and more important among nursing students. SDL is related to nursing students enhancing their own knowledge, skills and maintaining lifelong learning. This study is aim at translating the Self-directed Learning Instrument (SDLI) into Chinese and verify its reliability and validity among nursing students. Methods: The study adopted a cross-sectional design and the multistage sampling design. The SDLI was translated into Chinese, and the reliability and validity of the scale were tested among 975 nursing students. Results: The Cronbach's α value of the Chinese version of SDLI was 0.916. The split-half reliability coefficient was 0.829, and the retest coefficient was 0.884. The content validity index of the scale was 0.95. Furthermore, the four-factors model was obtained by using exploratory factor analysis, explaining 55.418% variance, and the communalities of the items ranged from 0.401 to 0.664. With modified confirmatory factor analysis, the fit indices were chi-square/degree of freedom (CMIN/DF) = 2.285, the comparative fit index (CFI) = 0.947, and the tucker lewis index (TLI) was 0.938. And, the model fitting indexes were all in the acceptable range and confirmatory factor analysis indicated that the model fit the SDLI well. Conclusion: The Chinese version of SDLI has good validity and reliability among nursing students. It can be used to measure the SDL ability of nursing students in China. [ABSTRACT FROM AUTHOR]

Background: The outbreak of COVID-19 changed many studies' teaching mode in higher education profoundly, including nursing. This study evaluated the impact of distance education on the course performance of nursing students in a nursing fundamentals course during the epidemic of COVID-19. Methods: This is a comparative prospective and retrospective quasi-experimental study. Nursing students in a Sino-foreign cooperative program were allocated to either an intervention group (distance education, n = 48) or control group (face-to-face teaching, n = 36). A self-efficacy questionnaire, an academic engagement scale and grades of the final written examination were used to evaluate the students' self-efficacy, academic engagement and academic performance, respectively. The data in this study were analyzed by two independent sample t-tests and the Chi-square test. Students experiencing distance teaching had worse academic performance (p = 0.001) and lower levels of learning behavior self-efficacy (p<0.05). The total score of academic engagement (p = 0.04) for students experiencing distance teaching were significantly lower than the scores of those students in the control group. Conclusions: In the context of COVID-19, nursing students conducted using distance education had poor course performance. [ABSTRACT FROM AUTHOR]

Background: Animal models are increasingly used in Nursing science to study care approaches. Despite the scientific relevance and the ethical debate surrounding the use of experimental animals, there is a scarcity of scholarly literature exploring this topic in Nursing Schools. Aim: To evaluate perceptions and attitudes of nursing students enrolled in a Pharmacology course on the use of experimental animals and implementation of alternative methods, by comparing the experience for two academic years. An interdisciplinary collaboration has also been developed. Methods: A descriptive cross-sectional, quantitative study was developed. Undergraduate nursing students were enrolled in the Pharmacology subject at the University of Leon (Spain). The study was carried out in the Pharmacology facilities. Students followed a two-session practical class regarding experimental animals and alternative methods in the Pharmacology course (Degree in Nursing) in two different academic years (2019–20/2020–21). At the end of the activity, they answered a questionnaire to assess their opinions on the use of experimental animals and alternative methods in Pharmacology and the 3Rs principle. Results: A comparison of the students' perception with and without direct participation in the evaluation of promazine effects in mice was made. A total of 190 students participated in the teaching experience, providing high scores in all items (4–5 out of 5 points) regarding the teaching experience. Students became also aware of the advantages and disadvantages on the use of experimental animals, as well as the ethical considerations to bear in mind for their use and the need for alternative methods. Conclusions: In the students' opinion, the total replacement of animals by alternative techniques was very difficult, and they preferred to do the practice face-to-face. The alternative method designed was useful for the students to accept the employment of experimental animals in biomedical research and education, and know the legislation applied in the protection of animals. [ABSTRACT FROM AUTHOR]

Background: Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties. Methods: A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability. Results: The "float or PRN" and "manager" words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach's α = 0.68 ~ 0.93, McDonald's omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including "Response to Error", "Communication Openness", and "Reporting Patient Safety Events", when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0. Conclusion: The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed. [ABSTRACT FROM AUTHOR]

Background: Fatigue is a symptom characterized by an elevated prevalence in patients undergoing hemodialysis, which may cause extreme mental and muscular debilitation, significantly influencing social interaction, life quality and well-being. However, the significance of fatigue to patients undergoing hemodialysis has not been recognized yet, and prevention and management of fatigue in this population have not been thoroughly investigated. Additionally, previous studies mainly focused on muscular fatigue, while mental fatigue has been seldom discussed. This study aims to investigate the interaction between nurses and multidisciplinary of nonpharmacological integrated care interventions (NICIs) and assess the impact of fatigue on patients undergoing hemodialysis. Methods: The integrative nonpharmacological care interventions in this study included walking, motivational interviewing (MI) and health education regarding behavioral self-management. A single-center randomized controlled trial was conducted in the dialysis center of the nephrological department in a tertiary affiliated hospital of medical university from January to June 2019. A total of 118 patients were selected and randomly divided into the intervention group (IG) and the control group (CG). Four patients dropped out during the study, and 114 patients were enrolled for the eventual analysis. The 60 patients in the IG received routine nursing combined with integrated care interventions, while the 54 patients in the CG received routine nursing only. This study lasted for six months. Results: The experimental group exhibited significant reductions of overall fatigue (2.26 vs. 0.48), mental fatigue (1.41 vs. 0.54), muscular fatigue (2.13 vs. 0.75), and some biochemical indicators (e.g., serum urea) (P<0.05), compared with the CG. Conclusions: Nurses and multidisciplinary teams have been demonstrated to play a key role and interplay function in chronic disease management. Hence, the nurse-led multidisciplinary NICIs significantly alleviated total fatigue (muscular fatigue and mental fatigue) and improved other parameters. Trial registration: ChiCTR-IOR-16008621 (March 18, 2016) [ABSTRACT FROM AUTHOR]

Background: Report of medical error is one of the effective components in the quality of healthcare services. A significant part of medical errors can be prevented by acting appropriately. The theory of planned behavior offers a framework in which the nurse intention to perform the behavior of error reporting is investigated. This study was conducted to determine the factors related to the behavior of reporting clinical errors in nurses working in educational and medical centers in Rasht based on the theory of planned behavior in 2020. Methods: In this descriptive-analytical study, 326 nurses in all medical centers in Rasht were selected by the multi-stage random sampling method. Data collection tool was a valid and reliable questionnaire based on the theory of planned behavior. Data analysis was conducted using the SPSS software, analysis of variance, correlation, and linear regression. Results: 39% of nurses reported that they had reported a medical error, and the average number of error reports per nurse during the last 3 months was 1.42 errors. The predictive power of the theory of behavioral intention was 47%, and predictive constructs were attitude (B =.43), perceived behavioral control (B =.33), and subjective norm (B =.04) using linear regression. The predictive power of the theory for nurses' behavior was 3.1%. None of the demographic variables played a role in predicting the behavior of nurses' reporting clinical error, and no behavioral intention predicted the behavior of nurses' reporting clinical errors. Conclusion: The theory of planned behavior expresses the factors affecting the behavior intention of nurses' reporting clinical errors satisfactorily. However, it was an inappropriate theory in behavior prediction. It appears that factors, such as fear of consequences of error reporting, social pressures by colleagues and officials, and lack of knowledge and skills required to identify medical errors, are the barriers to conversion of intention to the behavior of reporting clinical errors. It is necessary to provide the ground to increase nurses' report of clinical errors by acting appropriately. [ABSTRACT FROM AUTHOR]