Search

This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher-participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study. Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour. [ABSTRACT FROM AUTHOR]

Kitson A, Conroy T, Wengstrom Y, Profetto-McGrath J, Robertson-Malt S. International Journal of Nursing Practice 2010; 16: 423–434 Defining the fundamentals of care A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems. [ABSTRACT FROM AUTHOR]

Aim: This study aims to adapt the "Nursing Practice Readiness Scale" to Turkish culture, and evaluate its psychometric properties. Background: New graduates' nursing practice readiness can impact their work adaptation and performance. Design: The research employed a methodological design. Methods: Data were collected between May and July 2022. The sample consisted of 436 newly graduated nurses. Content validity, construct validity and criterion validity were evaluated. Reliability was examined with adjusted item‐total correlation, Cronbach's a coefficient, composite‐reliability and split‐half reliability. Results: The Turkish version of Nursing Practice Readiness Scale was found to have good content and criterion validity. As a result of confirmatory factor analysis, the original five‐factor structure of the scale was also confirmed for the Turkish version. The scale's overall Cronbach's α coefficient was determined to be 0.96, with subscale coefficients ranging from 0.73 to 0.94. The composite reliability values of the subscales were found between 0.75 and 0.94. In split‐half reliability, the correlation coefficient between half was 0.952, with a Spearman–Brown Coefficient (Unequal Length) of 0.976. Conclusions: The Turkish version of Nursing Practice Readiness Scale is a valid and reliable measurement tool for evaluating the nursing practice readiness of newly graduated nurses. Summary statement: What is already known about this topic? The nursing practice readiness of newly graduated nurses may impact their work adaptation and performance.Work adaptation is an important predictor of intention to leave the profession and productivity. What this paper adds? This study adapted the Nursing Practice Readiness Scale to Turkish culture, and evaluated its psychometric properties.The Turkish version of Nursing Practice Readiness Scale was shown to be a valid and reliable tool that can be used to evaluate newly graduated nurses' nursing practice readiness. The implications of this paper Nurse educators will be able to assess the readiness of graduating students for nursing practice by using the scale.Nurse managers will be able to evaluate the readiness of new graduate nurses for nursing practice using the scale.Nurse managers and educators will be able to identify areas that need to be prioritized to increase the readiness of newly graduated nurses for nursing practice by using the scale. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationship between the psychological resilience and burnout of nurses caring for COVID‐19 patients and to determine the factors that affect their psychological resilience and burnout. Background: In pandemic diseases such as COVID‐19, nurses experience burnout due to long working hours, decreased quality of life and anxiety/fear about their own/families' health. Psychological resilience helps to control burnout in nurses and prevent the development of a global nurse shortage. Design: This was a descriptive, correlational study. Methods: The sample of this study included 201 nurses in a Training and Research Hospital. The study used the Brief Resilience Scale and the Burnout Measure Short Version. Data were collected between 4 May and 1 June 2020. Statistical analysis was made with Pearson/Spearman, independent sample t test, one‐way analysis of variance (ANOVA) test. Results: Nurses reported moderate burnout and psychological resilience, with a negative and highly significant correlation between psychological resilience and burnout levels. Conclusions: In order to increase the quality of patient care/treatment, nurse managers need to reduce nurses' burnout and increase their psychological resilience. Nurses are recommended to adopt a healthy lifestyle, organize training programmes and implement psychological resilience interventions to prevent sleep disorders. Giving nurses the tools to understand what they need to manage within their locus of control will allow them to find a new sense of resilience, preventing potential burnout. Summary statement: What is already known about this topic? Epidemics and pandemics cause many negative effects on the individual/society in terms of physical, psychological, social and economic aspects.During epidemic and pandemic, nurses experience burnout caused by the accumulation of professional stress.Nurses with high levels of psychological resilience experience less psychological distress such as anxiety, fear, burnout, sensory and psychosocial problems. What this paper adds? Nurses experienced moderate burnout and resilience during the early stages of the COVID‐19 pandemic.A negative correlation was found between nurses' burnout and psychological resilience.The burnout levels of nurses who were not college graduates, who were dissatisfied with their jobs and who intended to leave their jobs were found to be high. The implications of this paper: Nurses were vulnerable to burnout due to increased workloads in the COVID‐19 crisis, increased shifts and the fear of infecting themselves and their families.It is necessary to increase the psychological resilience of nurses in order to provide the highest level of care to patients with COVID‐19.Nurse manager should focus on reducing burnout in their nursing teams by supporting the postgraduate education of nurses and reducing their workload. [ABSTRACT FROM AUTHOR]

Aim: Expanding and sustaining student nurse placements outside of the acute sector is a universal challenge. This paper aims to evaluate the Care Home Education Facilitator Role introduced in one area of Wales, United Kingdom, and to report on the outcomes achieved from this novel role. Methods: Semi‐structured interviews were undertaken with key stakeholders including the Care Home Education Facilitator postholder leading the pilot, care home managers, higher education institutions' placement managers/coordinators, student nurses and national health service staff. Results: Five key areas were identified, which included timing of introducing the post and establishing a clear rationale and understanding of the intention of the role. The benefits, challenges and suggested improvements to the Care Home Education Facilitator initiative are provided. Conclusion: Introducing the role of the Care Home Education Facilitator to work closely with key stakeholders resulted in increased placements for student nurses, but investing time in developing relationships with these stakeholders was critical to the success of the role. Summary statement: What is already known about this topic? There is a universal shortage of clinical placements for nursing students, particularly within a care home setting.The number of studies exploring how we might grow the number of nurses needed in this setting is limited. What this paper adds? This study evaluated a novel initiative introduced in South Wales, United Kingdom, that focuses on the development of nursing placements in the care home setting.Engaging with stakeholders involved in the development and implementation of the Care Home Education Facilitator initiative, a roadmap was provided to illustrate the stepped approach required to support an active care home placement including key governance arrangements. The implications of this paper: For those involved in identifying and developing student placements, this study provides valuable insight to a role that can help increase student numbers in a care setting often overlooked.It identifies viable career options for nurses at the point of registration.The role assists with widening networks for the care homes across health and social care sectors. [ABSTRACT FROM AUTHOR]

Aims: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. Methods: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi‐structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. Results: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub‐themes. Conclusions: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management. Summary Statement: What is already known about this topic? Violence is most commonly reported as experienced by nurses in the emergency department.Violence affects nurses deeply and causes negative effects in daily life. What this paper adds: Nurses described the violence perpetrated by patients or by patients' relatives as a situation that causes negative feelings such as anger, worthlessness, and injustice.Nurses emphasized that violence affects their clinical environment and their daily lives. The implications of this paper: The multidimensional and destructive effects of violence on nurses have shown that it is important to make the necessary arrangements quickly to reduce violence in the emergency departmentThe study provides information about the experiences of nurses who have been exposed to violence by patients or their relatives in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Cultural competence is considered one of the criteria for high‐quality nursing care. Aim: This study aimed to analyse cultural competence in nursing. Methods: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi‐structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. Results: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient‐ and justice‐oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. Conclusion: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care. Summary statement: What is already known about this topic? There is a concern in nursing that the profession needs a unified definition of cultural competence.What this paper adds? This study showed that cultural competence in nursing is a continuous, developmental, complex, and extensive process that is patient‐ and justice‐orientated and emerges through learning and skills acquisition, including cultural knowledge, attitudes, and practices.The implications of this paper: The findings help identify and present the definition of cultural competence in nursing and be used in the training of nursing students and the continuous education of nurses. [ABSTRACT FROM AUTHOR]

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

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

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

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

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to examine the relationship between heart failure knowledge, self‐efficacy, social support, grit and self‐care behaviour in patients with heart failure and to identify factors associated with patients' self‐care behaviour. Background: Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines. Design: This descriptive cross‐sectional study was designed based on Bandura's Social Cognitive Theory. Methods: This study included 138 patients who were diagnosed with heart failure in an outpatient department of cardiology at a tertiary hospital in Korea. Data were collected between July and October 2020 using a structured questionnaire and electronic medical records. Data were analysed using the SPSS/WIN 27.0 program. Results: Grit had the strongest association with self‐care behaviour among patients with heart failure, followed by social support, self‐efficacy and heart failure knowledge. These variables accounted for approximately 52% of the variance in self‐care behaviour. Conclusions: Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. Based on the social cognitive theory, nursing intervention programmes that can simultaneously manage cognitive (knowledge and self‐efficacy), social and environmental (social support) and behavioural support (grit) factors should be developed and applied to nursing practices to promote self‐care. Summary statement: What is already known about this topic? Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines.Social cognitive theory is conceptualized as cognitive, social, environmental and behavioural in nature.Self‐care behaviour can be influenced by multi‐dimensional factors, including cognitive factors, such as knowledge and self‐efficacy, and social and environmental factors, such as social support. What this paper adds? Grit—a behavioural supporting element—was confirmed as a factor influencing the self‐care behaviour of patients with heart failure. The implications of this paper: Interventions for enhancing patients' grit should be developed; self‐efficacy, social support and heart failure knowledge for patients with heart failure should be considered in clinical nursing settings.Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the influence of Chinese culture and customs on the beliefs and health‐related behaviours of Chinese women with gestational diabetes mellitus (GDM). Methods: This descriptive qualitative study conducted semi‐structured interviews with 15 Chinese women between November 2022 and January 2023. The interview data were analysed using thematic analysis. Results: Three major themes are found: (1) beliefs in health, (2) beliefs in illness and GDM and (3) beliefs in health‐related behaviours. They worried about the negative effects of GDM on the infant and family, so they actively sought medical advice to maintain health. However, it is challenging for them to balance adhering to healthcare professionals' advice and avoiding practical difficulties in the impact of the Chinese sociocultural context. Conclusion: This study emphasizes the influence of Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM. Healthcare providers should recognize the influence of Chinese culture, customs and beliefs on women with GDM and their families, in order to provide individualized education to help them maintain health‐related behaviours. Summary statement: What is already known about this topic? The prevalence of gestational diabetes mellitus (GDM) is increasing in China and affects 14.8% of pregnant women.Some personal beliefs about illness and health can lead to inadequate self‐care behaviours and thus failure to achieve optimal self‐management and health goals.Factors of Chinese sociocultural content and Chinese traditional culture and customs may have different influences on Chinese married women's beliefs in health, illness and health‐related behaviours. What this paper adds? Influenced by Chinese culture and customs, Chinese women's perspectives on gestational diabetes are bidirectional. They fear the negative effects of the disease on infants' and families' health and actively seek help, while some try to balance following professional advice and practical difficulties, such as diet control and self‐glucose monitoring.The low‐risk self‐management awareness, lack of adequate healthcare knowledge, and self‐care practice in Chinese women with GDM are one of the factors that lead to practical difficulties in GDM management.Understanding the impact of traditional Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM, well‐trained healthcare professionals can disseminate personalized health education to individuals, families and communities to improve GDM management in these women. The implications of this paper: Health providers need to constantly update the GDM guidelines with Chinese cultural characteristics based on the cultural acceptance and customs of Chinese women with GDM in order to offer them individualized care and scientific advice.The findings of this study could act as a clinical resource for health professionals to investigate the impact of differences in culture and customs across countries or regions on individual beliefs and health‐related behaviours in different populations. [ABSTRACT FROM AUTHOR]

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

Background: Vaccination is a crucial protective intervention to prevent adult mortality and morbidity. Personal perceptions and resources have an important place in the vaccination decision. Aim: This study aimed to modify the Public Attitude Towards Vaccination–Health Belief Model scale for adult vaccines and evaluate its psychometric properties. Methods: Overall, 626 people participated in this methodological study. Content validity index, confirmatory factor analysis, internal consistency and item‐total score correlation were used for validity and reliability. The independent samples t test, logistic regression analysis and ROC analysis were used for criterion and concurrent validity. Results: In confirmatory factor analysis, values of fit indices were excellent or acceptable. The Cronbach alpha value was between 0.83 and 0.92. According to criterion validity, the susceptibility, severity, benefit, and health motivation scores of those with the vaccine were higher than those without, whereas their barrier score was lower. The barrier subscale was a risk factor, whereas the benefit score was a protective factor that increased the likelihood of vaccination. The concurrent validity of the scale was tested with the COVID‐19 vaccine. While the barrier subscale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is excellent, it is acceptable for the other subscales. Conclusion: Modified PAVS‐HBM is valid and reliable for adult vaccines. This scale was associated with vaccination behaviour and distinguished between vaccinated and unvaccinated individuals. Summary statement: What is already known about this topic? Vaccination rates are low in many countries due to issues of access, economy and infrastructure and in countries that provide vaccines.Low vaccination rates in adults are associated with mortality and morbidity.Vaccination management success is enhanced by orientation towards individual perceptions. What this paper adds? The modified Public Attitude Towards Vaccination Scale–Health Belief Model (PAVS‐HBM) was demonstrated as a reliable and valid scale.This scale explains the vaccination behaviour for different adult vaccines.This scale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is acceptable to excellent. The implications of this paper for practice: The scale can be used as a tool for researchers to evaluate the probability of individuals being vaccinated and to determine risk groups for vaccine refusal.It can be integrated with many models focused on behaviour change, and when used with a health model, the scale's explanation of individuals' vaccination behaviour can guide the structuring of nursing interventions for vaccination. [ABSTRACT FROM AUTHOR]

Aim: The study aimed at evaluating the effect of posture correction and stretching movements on lordosis and lumbar pain in pregnant women. Background: An increased lumbar lordosis during pregnancy is considered one of the most common causes of lumbar pain. Methods: This quasi‐experimental study was performed on 66 pregnant women referred to health centers in Tabriz, Iran, from November 2020 to June 2021. The participants were randomly assigned to the intervention and control groups. The intervention group received training of posture correction movements and stretching exercises during pregnancy from 16 to 18 to 35–37 weeks of pregnancy in six sessions for 45–60 min. The data were collected using a flexible ruler and a visual analog scale. Independent t‐tests, repeated measures ANOVA, and ANCOVA tests were used. Results: The mean (standard deviation: SD) of lumbar lordosis increased from 45.12 (2.07) to 54.97 (2.20) in the intervention group at 35–37 weeks and changed from 44.28 (2.03) to 55.54 (3.39) in the control group at 35–37 weeks (adjusted mean difference: −1.24, 95% confidence interval: −2.48 to −0.005, P = 0.04). The mean (SD) of lumbar pain at 28–30 weeks was 2.80 (1.72) in the intervention group and 3.74 (2.23) in the control group (P = 0.09). However, the mean (SD) of lumbar pain at 35–37 weeks in the intervention group 4.38 (2.45) was significantly lower than that in the control group 5.83 (2.96) (P = 0.04). Conclusion: This study provides evidence for the potential health benefits of training posture correction and stretching movements on controlling lumbar lordosis and reducing lumbar pain during pregnancy. Summary statement: What is already known about this topic? One of the most common causes of low back pain refers to the enhancement of lumbar lordosis.The standard corrective movements and stretching exercises approved during pregnancy increase muscular strength and reduce the severity of lordosis if they are done regularly. What this paper adds? This is the first study that investigates the impact of a childbirth preparation program including posture correction and stretching movements on lordosis and lumbar pain in pregnant women.The findings indicate that the posture correction movements and stretching exercises delivered in childbirth preparation classes are effective in controlling the enhancement of lumbar lordosis during pregnancy and reducing lumbar pain. The implications of this paper: Training of posture correction and stretching movements during pregnancy is recommended for all pregnant women with no contraindication to exercise during pregnancy and even for women with a history of caesarean section who may decline to participate in the preparation classes for physiological birth.Evidence‐based posture correction/exercise guidelines during pregnancy should be developed and embedded in prenatal care. [ABSTRACT FROM AUTHOR]

Background: Choosing Wisely is an international movement that stimulates conversations about unnecessary care. The campaign created five recommendations including a statement that less wound care is sometimes better. Aims: The study aims to evaluate nurses' and physicians' adherence to the Choosing Wisely recommendations for acute wound care in the Netherlands and the barriers and facilitators to improve this. Design: This is a mixed methods study using a survey and interviews. Methods: The survey was completed by 171 nurses and 71 physicians from November 2017 to February 2018. A total of 17 nurses and 6 physicians were interviewed. Results: Awareness of the five recommendations ranged from 62% to 89% for nurses and 46% to 85% for physicians. However, up to 15% of the nurses and 28% of physicians were aware but did not adhere to the recommendations. Barriers to adhering were a lack of knowledge, the work environment and perceptions of patients' preferences. Repeated attention, cost‐consciousness and an open culture facilitated the implementation. Conclusion: Although most nurses and physicians were aware of the recommendations, not all adhered to them. Increasing awareness is not enough for successful implementation. A tailored approach that removes the barriers is necessary, such as increasing knowledge about wounds and changing the work environment. Summary statement: What is already known on this topic? Less wound care is sometimes better: cleaning wounds with tap water only, not bathing wounds, using simple bandages and not using bandages on wounds healing by primary intention leads to better wound care for lower costs.It is unknown to what extent this is known and practiced by nurses and physicians and what barriers and facilitators they experience in practicing this. What this paper adds? Although the majority of nurses and physicians were aware of the Choosing Wisely recommendations for acute wounds, not all adhered to them.Awareness is not always sufficient for successful implementation, which requires a broader approach that targets the barriers. The implications of this paper Implementation of these recommendations can be improved by increasing knowledge about wounds and wound care, changing the work environment, and verifying the patient's presumed preferences regarding wound care. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later. Results: The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. Trial registration: ClinicalTrials.gov ID: NCT03944642. Summary statement: What is already known about this topic? Breastfeeding is the gold standard for infant and young child nutrition.However, national and global prevalence is lower than expected.Breastfeeding support has focused on a biomedical approach with a predominantly clinical approach to breastfeeding difficulties.What this paper adds? Establishes an intervention proposal from an integral approach centred on a woman, her child and her family.Considers the perspective of health professionals in relation to their strengths and difficulties in supporting mothers with breastfeeding.Estimates the effect of the intervention on the self‐efficacy of professionals and mothers.The implications of this paper: This intervention was feasible and accepted by participants and health professionals working in primary health care centres. Therefore, the exploratory trial can be subjected to a full trial following the protocol and recommendations from the findings at this stage.Although the effects measurements of the intervention effects are preliminary, they show promising results regarding breastfeeding (BF) maintenance rates, together with a recovery of exclusive breastfeeding at 4 months and a decrease in maternal postpartum depression risk. [ABSTRACT FROM AUTHOR]

Aims: To assess the effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease (COPD). Background: A few recent studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with COPD. More studies are needed to prove its benefits. Design: This study used a quasi‐experimental design. Methods: Seventy‐two admitted COPD patients were assigned to experimental group or control group through purposeful sampling. Data were collected from March 2016 to November 2017 in the Thoracic Intensive Care Unit of a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale and the Clinical COPD Questionnaire were measured before education and at the first, second and third months after discharge. Results: The Medical Research Council dyspnea scale and COPD Self‐Efficacy Scale results in the experimental group were significantly improved compared with the control group in the third month after discharge. The Clinical COPD Questionnaire score continued to improve in both groups in the third month after discharge, and there was no difference between the two groups. Conclusion: A short‐term unsupervised home‐based pulmonary rehabilitation with self‐ management program had significant benefits for patients with COPD. The long‐term effects need to be confirmed. Summary statement: What is already known about this topic? The literature emphasizes the importance of alternative supervision of home‐based pulmonary rehabilitation rather than center‐based pulmonary rehabilitation for patients who find this inconvenient to access.Few studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with chronic obstructive pulmonary disease (COPD). What this paper adds? This study demonstrates that a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program can improve dyspnea during physical activity, self‐care efficacy in certain activities and quality of life after discharge in patients with COPD. The implications of this paper: The findings of this study can be used as the basis for providing a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program for patients with COPD after discharge.We recommend that patients with COPD undergo unsupervised home‐based pulmonary rehabilitation with self‐management for 3 months after discharge, especially if regular hospital visits for this are not convenient.The effect of longer‐term unsupervised home‐based pulmonary rehabilitation can be further studied in the future. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). Method: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi‐structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. Results: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. Conclusions: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile. Summary statement: What is already known about this topic? There are gender differences in the prevalence of depression. What this paper adds? This study describes the experiences and emotions of women with depression and physical comorbidity within the context of psychoeducational group intervention. The implications of this paper: The study provides information about the experiences and emotions of women with depression. It will be important to include this qualitative information when planning effective interventions directed at patients with this profile. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors. Design: This was a descriptive, cross‐sectional, multicentre study. Methods: A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey. Results: The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05). Conclusion: This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential. Summary statement: What is already known about this topic? The problem of missed nursing care (MNC) affects healthcare institutions universally.MNC can serve as an indicator of patient safety, practice environment and quality of care.Intrapersonal, interpersonal, organizational and cultural factors may contribute to MNC.What this paper adds: This study found that nurses prioritize more structured and time‐sensitive care activities.This study showed the significant influence of staffing adequacy, patient volume and other variables on MNC.This study identified several significant predictors for each care activity, including the nature of the unit, weekly working hours, nurse‐to‐patient ratio, professional experience and intention to leave.The implications of this paper: To effectively reduce or eliminate MNC, the nature of each care activity should be examined separately.To develop more targeted, specific and comprehensive strategies, predictors of each care activity should be considered.A combination of observation and interview methods is recommended for a comprehensive evaluation of the effectiveness of the developed strategies. [ABSTRACT FROM AUTHOR]

Aim: This study's aim is to develop and psychometrically assess the Sickness Presenteeism Scale‐Nurse. Background: Evaluation of the effects of sickness presenteeism on nurses' performance and productivity is important for healthcare quality. Design: This was an instrument development and validation study. Methods: Scale items were created based on literature review and qualitative research. Data were collected from 619 nurses between October and December 2021. The factor structure of the scale was determined by explanatory and confirmatory factor analysis performed with different sample groups. Convergent and discriminant validity were investigated, and reliability was evaluated with Cronbach's α values, adjusted item‐total correlation, composite‐reliability and split‐half reliability. Results: Explanatory factor analysis showed that Sickness Presenteeism Scale‐Nurse consisted of four sub‐dimensions and 21 items and explained 57.9% of the total variance. This factor structure was confirmed by confirmatory factor analysis. The convergent and discriminant validity was confirmed. The total Cronbach's α value of the scale was calculated as 0.928, with Cronbach's α values of the sub‐dimensions calculated as 0.815–0.903; composite reliability values were calculated as 0.804–0.903. Conclusions: The Sickness Presenteeism Scale‐Nurse is a valid and reliable measurement instrument that can be used to evaluate the effect of nurses' sickness presenteeism behaviour on job performance. Summary statement: What is already known about this topic? Presenteeism can reduce work performance and productivity.Nursing is one of the occupations where presenteeism is commonly reported, but there is no scale to measure the effect of presenteeism on nurses' work performanceWhat this paper adds? In this study, the Sickness Presenteeism Scale‐Nurse, an instrument that can be used to evaluate the effects of sickness presenteeism on nurses' work performance, was developed.The Sickness Presenteeism Scale‐Nurse consists of four dimensions: general performance, patient safety, relationships within the team and emotion.This study provides evidence of the validity and reliability of the Sickness Presenteeism Scale‐Nurse.The implications of this paper: Effects of presenteeism on the performance and productivity of nurses can be evaluated by using Sickness Presenteeism Scale‐Nurse to provide information to guide policy makers in determining interventions to promote work performance and productivity. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID‐19) has adversely affected intensive care nurses; for instance, they have fought against an unknown disease, and their workload has increased. In addition, the COVID‐19 pandemic has led intensive care nurses to work in new settings and with new teams. Objective: The aim of this study was to explore and describe the caregiving experiences of nurses who were working in a new COVID‐19 intensive care unit in Turkey and providing care for patients infected with SARS‐CoV‐2. Method: In this descriptive qualitative study, semi‐structured interviews were held from 22 July to 31 August 2020 and were recorded and analysed based on thematic analysis. The researchers followed the COREQ checklist in reporting the study. Findings: From interviews held with 11 nurses, four main themes (uncertainty and challenges in the 'danger zone', emotional and psychosocial changes, professional effects of the pandemic and being ready for a future pandemic) were derived from 11 sub‐themes. Conclusions: The new setting and the ever‐changing team make caring for the COVID‐19 patient even more difficult. A good organization, an experienced permanent team, a known setting and good working conditions are essential to be prepared for possible pandemics in the future. Summary statement: What is already known about this topic? Pandemics are emergencies that can lead the health system to collapse.Patient care quality is associated with nurses' knowledge and experience.The COVID‐19 pandemic has led intensive care nurses to work in new settings and with new teams. What this paper adds? Nurses described challenges such as the fear, stress and stigma they experienced in the ICU during the first wave of the pandemic, which negatively affected patient care.The new setting and the ever‐changing team make caring for the COVID‐19 patient even more difficult. The implications of this paper: A good organization and an experienced permanent team should be established in order to ensure patient safety and high‐quality care in ICU settings for COVID‐19 patients.Working conditions of nurses should be improved without changing their setting during the pandemic. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the relationship between nurses' critical thinking skills and job performance and whether critical thinking and its subdomains predict job performance. Background: It is expected that nurses may use critical thinking skills to provide evidence‐based quality patient care in health care settings. However, there is limited evidence about whether critical thinking is related to job performance among nurses. Design: This was a descriptive, cross‐sectional survey study. Methods: The study included 368 nurses working in the inpatient wards of a university hospital in Turkey. The survey included a demographic information questionnaire, the Critical Thinking Scale in Clinical Practice for Nurses and the Nurses' Job Performance Scale. The collected data were analysed using descriptive statistics, comparisons, reliability and normality tests, correlation and regression analysis. Results: Participating nurses got average scores from the critical thinking and job performance scale and sub‐scales, and there was a positive, mid‐level and statistically significant correlation between the scale scores. According to the multiple linear regression analysis results, personal critical thinking, interpersonal and self‐management critical thinking and the total critical thinking scores positively affected the job performance scores of nurses. Conclusion: As critical thinking predicts nurses' job performance, managers of hospitals and nursing services should consider training programs or activities to increase nurses' essential thinking competencies, thus improving clinical nurses' performances. Summary statement: What is already known about this topic? Nurses' performance significantly impacts the delivery of healthcare services.Nurses are expected to analyse and make decisions by synthesizing their knowledge to produce better care.Critical thinking skills increase nurses' analysis and synthesis skills. What this paper adds? Nurses' job performance is associated with critical thinking.Personal, interpersonal and self‐management critical thinking are positively related to job performance. The implications of this paper: Nurses may increase their performance through critical thinking.Both managers of hospitals and nursing services may consider intervention to improve nurses' critical thinking abilities.Managers can organize programs or activities to increase nurses' critical thinking competencies to improve nursing performance. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a valid and reliable new intensive care unit nursing classification tool, including direct and indirect nursing activities, by measuring the nursing intensity provided to patients. Background: Prior tools primarily examine patients' medical records or disease severity/interactions, systematically failing to reflect comorbidity risk factors. Design: The Delphi technique was used to test the content validity of the Korean Patient Classification System on Nursing Intensity for Critical Care Nurses (KPCSNIC). Methods: Data were collected from four hospitals in two provinces from 26 December 2017 to 30 January 2018. To verify construct validity, staff nurses classified 365 patients, comparing differences by medical department and type of stay. To verify interrater reliability, data collectors and the head nurses of three intensive care units classified 87 patients. Results: The KPCSNIC had 8 categories, 44 nursing activities and 105 criteria. Reliability was high (r =.84). Construct validity was verified by revealing differences according to medical department and type of patient. Using total scores, four KPCSNIC groups were identified. Conclusion: The KPCSNIC developed in this study can support staffing for nursing intensity by providing more specific evaluation criteria. Moreover, it reflects nursing intensity, including direct and indirect nursing activities. Summary statement: What is already known about this topic? In order to secure the quality of nursing care, it is important to allocate an appropriate number of nurse staffing based on nursing demand and nursing time reflecting to the number and severity of patients, and shift of work.The patient acuity tools used in Korea are limited as they primarily examine patients' physiological characteristics based on medical records or quantify disease severity and interactions, systematically failing to reflect risk factors for comorbidities.The intensive care unit patient classification tool that is currently used underestimates clinical nursing intensity, as it does not realistically evaluate patient‐related disease factors and indirect nursing activities. What this paper adds? This study developed a new patient classification tool that reflects patients' clinical characteristics and classified them according to nursing intensity.In addition to direct nursing activities, indirect nursing activities that were invisible and difficult to measure can be scored using this tool. The implications of this paper: Since this tool enables quantitative measurement of nursing workload, data using this tool can be used as evidence for invoicing for nursing care fees, previously calculated as a percentage of inpatient fees per day.This study was conducted in a first‐grade hospital with a high level of nurse staffing. To secure the validity and reliability of the tool, additional research is needed, using the tool in a greater number and wider range of hospitals. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to evaluate the validity and reliability of the Turkish version of the Fear of COVID‐19 Scale (FCV‐19S). Methods: The study used a descriptive design and was conducted between April and May 2020. The participants were 213 nurses who were working in 12 hospitals in eight cities in Turkey. Content validity index, exploratory factor analysis and confirmatory factor analysis were used to evaluate validity. Cronbach's alpha, item‐scale correlation and test–retest reliability were used to evaluate reliability. Results: The CVI was 0.92 (0.81–1.00). A one‐factor solution was identified and the factor loading of items in scale varied from 0.377 to 0.909. The Cronbach's alpha value was 0.889 in the current study. Item‐scale correlations ranged between 0.570 and 0.815. Intraclass correlation coefficient ranged from 0.71 to 0.93. Conclusion: The Turkish version of the FCV‐19S for nurses was found to be valid and reliable measure of the fear of nurses towards COVID‐19. Summary statement: What is already known about this topic? With the high infection rate, relatively high mortality and limited treatment options, people worry about the COVID‐19 pandemic.Nurses, as a responsibility of their profession, have to be in contact with infected or possibly infected individuals in health care institutions.To protect the overall well‐being of nurses, it is essential to evaluate their physical, psychological and social status regularly, so it is necessary to evaluate the fear experienced by nurses due to COVID‐19. What this paper adds? The Turkish version of the Fear of COVID‐19 Scale for Nurses was found to be valid and reliable for assessing the nurse's fears towards COVID‐19. The implications of this paper: Inclusion of this instrument in nursing practices for Turkey may help to evaluate the fear experienced by nurses due to COVID‐19 and to take initiatives to alleviate this fear, for nurses to provide more effective care [ABSTRACT FROM AUTHOR]

Aims: This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. Methods: A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi‐structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. Results: Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context‐related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. Conclusion: Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. Summary statement: What is already known about this topic? Comprehensive understanding of context at various levels should generate greater knowledge about what affects advanced practice role development locally and globally.What this paper adds? Findings could help organizations to make sense of the full dimension of context and to predict or act on development of advanced practice nursing roles.The implications of this paper: Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to examine the efficacy of cryotherapy with frozen gloves for the prevention of the chemotherapy‐induced peripheral neuropathy of the hand. Background: Most breast cancer patients receive chemotherapy; consequently, patients frequently experience adverse effects of chemotherapy‐induced peripheral neuropathy. Methods: A quasi‐experimental and prospective self‐controlled study was conducted. Breast cancer patients wore frozen glove on the dominant hand for 90 min during their weekly treatment with paclitaxel (80 mg/m2). Treatment of the dominant hand, the intervention group, was continued for 12 weeks. The non‐dominant hand was considered the control group. Results: A total of 22 patients participated in this study, and only one patient did not reach the cumulative dose (960 mg/m2). Findings show that the incidences of sensory and motor symptoms of chemotherapy‐induced peripheral neuropathies at the following times (Time 1 to Time 4) were significantly lower in the intervention group than in the control group. However, although the incidences of motor symptoms were lower in the experimental group than in the control group, a significant difference was shown only at Time 4. Additionally, both groups of patients reported that their incidence of sensory symptoms were higher than those of motor symptoms. Conclusion: Cryotherapy with frozen gloves is useful in reducing both the sensory and motor symptoms of the chemotherapy‐induced peripheral neuropathy of the hands. Summary statement: What is already known about this topic? Most breast cancer patients receive chemotherapy; consequently, patients frequently experience adverse effects of the chemotherapy‐induced peripheral neuropathy.Previous studies have indicated that cryotherapy (frozen gloves or shocks) may effectively reduce chemotherapy‐induced peripheral neuropathy associated with the use of paclitaxel. However, there is limited evidence for the effective treatment of chemotherapy‐induced peripheral neuropathy. What this paper adds? Paclitaxel‐induced peripheral neuropathy is frequently observed in patients with breast cancer and cryotherapy may effectively reduce this.The study results show that cryotherapy with frozen gloves can effectively alleviate the sensory and motor symptoms of the hands in breast cancer patients during chemotherapy.Moreover, we also found that breast cancer patients reporting sensory symptoms had higher motor symptoms during treatment with paclitaxel. The implication of this paper: Cryotherapy is a simple, safe, and effective strategy to prevent chemotherapy‐induced peripheral neuropathy in patients with breast cancer who receive paclitaxel treatment.Moreover, a reduction in group effects may increase the willingness of patients to receive chemotherapy. [ABSTRACT FROM AUTHOR]

Aims: We aimed to develop and test the psychometric properties of a Medical Device‐related Pressure Injuries Knowledge and Practice Assessment Tool. Background: Assessment of nurses' knowledge and practices is critical in the prevention of Medical Device‐related Pressure Injuries. Design: This was an instrument development and testing study. Methods: The sample of the study consisted of nurses (n = 189). The study was conducted in three phases between January and February 2021. In the first phase, multiple‐choice items contained within Aetiology/Risk Factors, Prevention Interventions, and Staging domains were created. In the second phase, content validity and criterion validity were evaluated, and the tool was pre‐tested. The third phase examined item difficulty, discrimination index and distractor quality. The test–retest method was used for reliability. Results: The Content Validity Index was found to be 0.75, 0.86 and 0.96 for the domains of Aetiology/Risk Factors, Prevention and Staging, respectively. The item difficulty values of the items were between 0.18 and 0.96. A positive, strong and significant relationship was found between the results and a positive, moderate and significant relationship between the tools administered for the proof of scale validity. The Cronbach's alpha reliability coefficient was found to be 0.54. Conclusions: The tool is a suitable measurement instrument for use in nursing education, research and clinical settings. Summary statement: What is already known about this topic? Medical Device‐related Pressure Injuries (MDRPIs) are a common and preventable issue in healthcare settings.Nurses' knowledge and practices are important in the prevention and management of MDRPIs.It is crucial to measure nurses' knowledge levels and practices on MDRPIs by using valid and reliable measurement tools. What this paper adds? The study developed and psychometrically tested a Medical Device‐related Pressure Injuries Knowledge and Practice Assessment Tool.The Medical Device‐related Pressure Injuries Knowledge and Practice Assessment Tool (MDPI‐ASSET) was shown to be a valid and reliable tool that can be used to evaluate knowledge and practices. The implications of this paper: The tool developed in this study can be adapted to different languages.The tool can be used in nursing practice, education and research to identify knowledge and practice gaps and focus areas on optimizing strategies to improve care quality. [ABSTRACT FROM AUTHOR]

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

Aim: The aim of this study is to examine nursing students' experiences of alternative and nonstandard practicum methods used during the Coronavirus Disease 19 (COVID‐19) pandemic and the associations between these experiences and nursing students' anxiety with clinical decision‐making. Background: Nursing students experiencing alternative clinical practice methods during the COVID19 pandemic have expressed regrets about being unable to experience direct nursing care and doubts about their clinical decision‐making in actual clinical settings as a nurse in the future. Methods: Online surveys were distributed to 239 third‐year nursing students through a link in an email. Data were collected from December 2020 to January 2021. Results: Approximately 80% of participants in the Fall 2020 semester experienced an alternative clinical practice method. The extent of time spent experiencing alternative clinical practice methods and satisfaction with the clinical practicum were associated with anxiety about clinical decision‐making. Conclusions: Although the pandemic continues, nursing students' clinical practice is needed in a clinical setting as much as possible to reduce the anxiety about clinical decision‐making. During the pandemic, clinical nurse educators and clinical managers should work and communicate more closely to facilitate the students' clinical practice. Summary statement: What is already known about this topic? Nursing education has experienced challenges by effectively conducting nursing programmes while responding to the pandemic.In situations where the COVID‐19 pandemic was prolonged, many nursing clinical practicums were replaced with alternative and nonstandard methods.Empirical evidence of the relationship between alternative clinical practice methods and clinical decision‐making in nursing students is lacking. What this paper adds? Satisfaction with clinical practicums was associated with students' anxiety regarding clinical decision‐making during the COVID‐19 pandemic.The extent of time experiencing alternative clinical practice methods during the pandemic was positively associated with nursing students' anxiety with clinical decision‐making. The implications of this paper: Nurse educators should be aware of the extent to which nursing students' experiences of alternative clinical practice methods experience might be associated with anxiety about clinical decision‐making.Clinical nurse educators need to work in close cooperation with clinical managers to ensure that nursing students' clinical practice is as normal as possible during a pandemic to reduce their anxiety about clinical decision‐making. [ABSTRACT FROM AUTHOR]

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

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

Aim: This study aimed to explore and confirm the factor structure and item distribution of the Chinese version of Self‐care Ability Scale for the Elderly among older Chinese people. Methods: A cluster random sampling method was used to collect 2856 older people from five different cities of China from July 2018 to July 2019. A questionnaire comprised of socio‐demographic information and the Chinese version of the Self‐care Ability Scale for the Elderly was administered, and SPSS 21.0 and Mplus 7.4 were used for analyses. Results: Participants were aged 60 to 92 years, with a mean age of 71.52 (SD = 7.68) years. In the Exploratory Factor Analysis, the three‐factor structure and item distribution of the Chinese version of the Self‐care Ability Scale for the Elderly were verified to be better than other options. The factor loadings varied from 0.428 to 0.800, and the communality values ranged from 0.426 to 0.792. The modified model showed a good fit in the Confirmatory Factor Analysis. Conclusion: The Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and a good item distribution. It serves as a convenient and accurate assessment tool to assess the self‐care ability of older Chinese people. Summary statement: What is already known about this topic? Assessing self‐care ability plays a significant role in the care of older people.The Chinese version of the Self‐care Ability Scale for the Elderly is often used to assess the self‐care ability of older people in China but whilst it has good reliability and content validity, its factor structure and item distribution are not clearly explained in recent literature.Solid evidence on the factor analysis of the Chinese version of the Self‐care Ability Scale for the Elderly is needed to maintain a high standard of health care assessment for the older Chinese people. What this paper adds? We confirmed that the Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and item distribution.The Chinese version of the Self‐care Ability Scale for the Elderly can now be used as the study confirmed its validity and reliability. The implications of this paper: The instrument can be effective in older Chinese people to identify their self‐care support needs and thereby to enable provision of opportunities to implement appropriate nursing care.Health care professionals can use this instrument to assess the alterations in self‐care ability of older Chinese people after particular interventions. [ABSTRACT FROM AUTHOR]

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

Aim: To examine the relationships between self‐efficacy, uncertainty and anxiety among nursing graduates waiting for a mandatory nursing licensing test that was postponed due to the COVID‐19 pandemic. Methods: A total of 352 graduates of nursing education programs participated in this mixed‐methods study. The data were collected using an online questionnaire in June 2020. Results: The participants demonstrated high uncertainty and anxiety and low self‐efficacy towards the ability to succeed in the licensing exam. Graduates, who started working, reported lower uncertainty. Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of 24% of the variance of the anxiety. The qualitative analysis revealed three themes: (a) emotional distress, cognitive challenge and social implications, (b) consequences for significant others and (c) strengthening of professional values and norms. Conclusions: A significant crisis like a pandemic is accompanied by acute cognitive burden and stressful emotional experiences and creates an unconventional situation that requires unusual solutions. Granting a temporary permit for employment as a nurse following the postponement of a licensing test contributed to the ability of nursing graduates to cope with the situation. Policies to deal with similar situations in the future emergencies should be developed and implemented. Summary statement: What is already known about this topic? The COVID‐19 pandemic changed all the rules when the licensing examination was postponed at relatively short notice.The graduates found themselves without a work permit and also outside the education system.Many graduates reported economic challenges and feelings of uncertainty and fear of the future. What this paper adds? The participants demonstrated high levels of uncertainty and anxiety, with low self‐efficacy.Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of the anxietyQualitative analysis supported these findings through examples that paint the whole picture in vivid colours. The implications of this paper: The study emphasizes the importance of providing emotional support and information to the students in times of crisis, while communicating policy decisions.Granting a temporary permit for employment as a registered nurse following the postponement of the licensing test contributed to the ability of nursing graduates to contend with the situation.There is a need to formulate policies to deal with similar situations in the future. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and understand the barriers perceived by Italian nurses to adopting self‐monitoring for managing oral anticoagulation in real‐life settings. Background: Barriers to self‐monitoring implementation for managing oral anticoagulation have been poorly described. Design: The study had a qualitative descriptive and exploratory design with a hybrid approach. Methods: A literature review was conducted to identify a priori barriers (deductive approach), while a small and semi‐structured focus group discussion was performed to explore the contextual barriers experienced by Italian nurses (inductive approach). A classic content analysis technique was adopted. Data were collected in 2019. Findings Two main categories were identified. Organizational barriers referred to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring. Individual barriers encompassed professional characteristics (e.g. university background, professional knowledge, continuum education and accountability/responsibility) and patient characteristics (e.g. patient health literacy and knowledge, engagement/empowerment and educational programmes). Finally, unwarranted clinical variation in oral anticoagulation management arose as a barrier determined by organizational and individual elements. Conclusions: The results of this study pointed out an urgent public health issue in addressing barriers influencing self‐monitoring practice and in sustaining care models that might enhance the quality improvement of self‐monitoring for managing oral anticoagulation. Summary statement: What is already known about this topic? Anticoagulation therapy is one of the leading chronic treatments worldwide to prevent stroke in atrial fibrillation patients.Self‐monitoring is a valuable option to further improve the quality of anticoagulation surveillance and patient medication adherence compared to standard care models.Thus far, the barriers underpinning self‐monitoring implementation experienced by Italian nurses are mainly unexplored.What does this paper add? This study is the first Italian description regarding the main barriers perceived by Italian nurses to adopting SM in patients treated using oral anticoagulation therapy.Organizational barriers refer to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring.Individual barriers encompass professional characteristics and patient characteristics, and unwarranted clinical variation arose as a barrier determined by both organizational and individual barriers.The implications of this paper Description of the main barriers perceived by Italian nurses to adopt self‐monitoring of oral anticoagulation is required to prioritize policies and system‐level interventions.Health institutions, patient associations and scientific societies should develop policies that enhance the continuum of professional education of nurses regarding self‐monitoring for oral anticoagulation.Integrated care models where nurses have a leadership role in providing self‐monitoring practice are required to implement self‐monitoring widely. [ABSTRACT FROM AUTHOR]

Purpose: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. Methods: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. Results: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. Conclusion: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress. Summary statement: What is already known about this topic? Adolescence is an important developmental stage in which individuals experience rapid physical and cognitive changes; these developmental changes can be more stressful for adolescents with Moyamoya disease.Stressful situations increase the frequency and worsen the symptoms of transient cerebral ischaemic attacks, and these negative experiences lead to depression, anxiety, low self‐esteem, negative self‐concept formation and social maladjustment, which persist until adulthood. What this paper adds? The risk factors affecting the salutogenic sense of health in adolescents with Moyamoya disease were related to problems with interpersonal relationships and academic work.The families of adolescents with Moyamoya disease play a pivotal role in increasing their strength to resolve their state of tension.It is important for adolescents with Moyamoya disease to identify and understand the resources available to them and use them appropriately to manage the state of tension. The implications of this paper: This study is meaningful in that the factors affecting the salutogenic sense of health were identified by reflecting on the unique characteristics of the developmental stage of adolescents.The results of this study will guide clinical nurse and researchers in developing interventions to maintain and promote the health of adolescents with Moyamoya disease. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this project was to examine the role of cultural differences in shaping the management of diabetes among Ethiopian immigrants living in Israel. Methods: A qualitative, in‐depth study involved semistructured interviews with 16 Ethiopian immigrants with diabetes living in Israel. The interviews were audio‐recorded, transcribed and translated into Hebrew, if necessary. The authors each identified themes in the responses and then through discussion came to a consensus about the most significant ones and how to categorize them. Results: A main theme was revealed structuring the participants' perception of diabetes: an oscillation between a familiar narrative, associated with traditional life in Ethiopia, and a foreign one. Five additional subthemes were also identified as an oscillation about the causes of disease, between collectivism and individualism, between accessible food and a balanced diet, between relying on bodily sensations and prescribed treatment and between culturally oriented and translated knowledge. Conclusion: The participants understood that they could be adversely affected both by the changes in lifestyle following their move and by adhering to the traditional norms. They agreed that professional liaisons and peers who have successfully managed their diabetes could help provide a bridge between the narratives. Summary statement: What is already known about this topic? Diabetes is a worldwide epidemic where immigrant populations are more likely to suffer from it.Language and cultural barriers pose a challenge to immigrants when accessing healthcare.Among immigrants, diabetes‐related distress is often accompanied by distress due to the challenges of immigration and acculturation.What this paper adds? Among Ethiopian immigrants, there exists a division between two main narratives about their illness and the way it is treated: the familiar and the foreign.Ethiopian communities play an important role in the treatment of an individual's illness, for better or worse.Translation alone is not sufficient to make language accessible; it must be combined with a medically‐culturally tailored approach.The implications of this paper: An understanding of the oscillations between narratives that Ethiopian immigrants experience is important for promoting person‐centred care for this population.During individual and group training, nurses should include Ethiopian immigrants who have successfully managed their diabetes.Nurse managers should ensure that their clinic has professional liaisons not only for translation but also for the provision of culture‐based health care. [ABSTRACT FROM AUTHOR]

Aim: This quasi‐experimental study aimed to explore effects of walking exercise on disease activity, sleep quality, and quality of life among individuals with systemic lupus erythematosus. Methods: After recruiting people with systemic lupus erythematosus from a hospital in Taiwan between October 2020 and June 2021, participants were free to opt to receive one walking exercise programme plus standard care for 3 months or to membership of a control group receiving routine care. Primary outcomes included Systemic Lupus Erythematosus Disease Activity Score, the Pittsburgh Sleep Quality Scale, and a quality‐of‐life scale for patients with systemic lupus erythematosus, namely, LupusQoL. These scales were administered first, at baseline and later, within 1 week following completion of the intervention. Between‐group effects were compared using generalized estimating equations with adjustment for baseline variables. Results: The experimental and control groups each included 40 participants. Multivariate analysis indicated that adding the walking exercise programme into routine care elevated sleep quality and LupusQoL (the latter in the subscales of physical health, planning, and intimate relationships), except for disease activity. Conclusion: Findings of this study supported the addition of walking exercise as part of routine care for people with systemic lupus erythematosus and may be a reference in the provision of adequate care for these patients. Summary statements: What is already known about this topic? Systemic lupus erythematosus is a lifelong autoimmune disease that affects any organs throughout the body, thus insidiously causing negative impacts on the affected patients.Today, use of exercise programmes such as walking exercise has been studied as a remedy for many medical conditions, but its effectiveness in minimizing the symptoms of distress among people with systemic lupus erythematosus is unknown. What this study adds? Participants with systemic lupus erythematosus who opt to receive the walking exercise programme for 3 months in addition to routine care experience improved sleep quality and quality of life compared with those receiving routine care alone. The implications of this paper: In accordance with the belief that "an ounce of prevention is worth a pound of cure," early implementation of an exercise programme should be considered in addition to routine care for patients with systemic lupus erythematosus.Evidence from this research could provide empirically informed and robust data for healthcare policymakers and in turn might help to reduce the incidence of morbidity among patients with systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Background: Case management has been regarded as the front line of necessary change for fragmented healthcare system. Aim: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12‐month follow‐up. Methods: A quasi‐experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. Results: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. Conclusion: Nurse‐led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized. Summary statement: What is already known about this topic?: Current evidence of the effectiveness of case management is limited due to mixed results and single settings.Case management is rarely tested in single‐type cancer patients and in countries with underdeveloped primary care. What this paper adds?: Nurse‐led hospital‐based case management can effectively improve quality of life, anxiety, depression, symptom distress, treatment adherence and unplanned readmission rates.In countries with underdeveloped primary care, case management is a feasible way to provide continuous care to cancer patients and to improve healthcare utilization. The implications of this paper: Nurse case managers can serve as a pivot in multidisciplinary management of cancer patients to promote interdisciplinary cooperation and resource integration.A case management model is feasible and effective in colorectal cancer patients and in hospital‐dominated healthcare systems where primary care is underutilized.Future studies and nursing practice should develop an online case management platform and set up posts for full‐time case managers. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. Methods: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. Results: A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). Conclusions: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer. Summary Statement: What is already known about this topic? Nurses generally provide supportive care services and play imperative roles in supporting patients in cancer.Using a valid and reliable instrument to assess supportive care needs for patients with cancer is a critical step for the improvement of clinical practice and research. What this paper adds? Mixed methods were beneficial for developing the new self‐report and culturally appropriate instrument for Chinese patients with cancer.The Professional Nursing Support Scale (PNSS) is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the needs. The implications of this paper: The PNSS is expected to a reliable needs evaluation tool. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to determine thermal comfort among nurses working with personal protective equipment in COVID‐19 clinic. Methods: In this study, a descriptive design was carried out between June and September 2020. Sample of the study consisted of 246 nurses (77.6%) who worked in the COVID‐19 clinics with personal protective equipment. We used a questionnaire to determine thermal comfort of nurses; a follow‐up form to determine the factors affecting thermal comfort; and the ASHRAE Thermal Sensation Scale. Four measurements and follow‐ups were made three times. Results: More than half of nurses complained of ambient temperature and ventilation, one‐third complained of humidity and nearly half complained of poor air quality. The mean thermal comfort score of nurses working in COVID‐19 clinics was 1.19 (SD = 0.75). The thermal comfort of the nurses was negatively affected in all measurements except before wearing personal protective equipment. The highest scores were measured leaving the patient room and before removing personal protective equipment (M = 2.65, SD = 0.58). Conclusion: The thermal comfort, work performance and stress levels of the nurses were negatively affected by working with personal protective equipment. This study reveals the necessity of improving the working conditions of nurses, including working hours, environment and personal protective equipment. Summary statement: What is already known about this topic? Thermal comfort is one of the important factors affecting nurses' working performance.The working conditions of the nurses affected their thermal comfort.Due to the COVID‐19 pandemic, health‐care professionals had to work with personal protective equipment. What this paper adds? The thermal comfort of nurses working in patients' rooms with personal protective equipment was negatively affected in COVID‐19 clinics.The temperature and stress levels of the nurses increased, and their performance decreased when working in the patients' rooms with personal protective equipmentThe thermal comfort of nurses working in intensive care units was affected more negatively than nurses working in other services. The implications of this paper: The ventilation systems should be improved to provide thermal comfort for those working with personal protective equipment.Working time and breaks should be organized accordingly considering the negative effects of working with personal protective equipment on nurses. [ABSTRACT FROM AUTHOR]

Background: The Patient Health Engagement Scale was designed to assess the emotional and psychological attitudes of patients' engagement along their healthcare management journey. Aim: This study aimed to conduct psychometric testing of the Turkish version of the Patient Health Engagement Scale among patients with chronic diseases. Design: A cross‐sectional validation study was conducted and reported according to the STROBE checklist. Methods: There were 520 patients who completed the scale between March 2017 and February 2018. The content, construct and concurrent validity were evaluated. The reliability of the scale was measured using internal consistency and construct reliability. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. Results: The scale's validity was enabled by the translation and back translation method. The content validity index of the scale was 0.88. Construct validity determined one factor. The total variance was calculated at 85.29%. The factor loads ranged between 0.86 and 0.95. The results of the confirmatory factor analysis showed goodness‐of‐fit indices in the excellent range according to the literature. The reliability of the scale was calculated at 0.95. Conclusion: The scale was found to be a valid and reliable measurement tool to be used in identifying the engagement with health levels of patients with chronic diseases. Summary statement: What is already known about this topic? The Patient Health Engagement Scale describes the psychological readiness to be active in one's own health management.The Patient Health Engagement Scale measures patients' perceived susceptibility and severity of the disease and orientation toward health management. What this paper adds? The Turkish version of the Patient Health Engagement Scale was found to be a valid and reliable measurement tool. The implications of this paper: Engaging patients in their healthcare management may have an important role in improving treatments for patients with chronic diseases.The Patient Health Engagement Scale can be used to plan and evaluate the effectiveness of the interventions. [ABSTRACT FROM AUTHOR]

Aim: This study examined the feasibility of integrating actigraphy devices into orthopaedic surgical settings to assess the concurrent validity between objective actigraphy data and PROMIS measures. Additionally, the association between changes in actigraphy data and longitudinal changes in PROMIS measures was examined. Methods: Data were collected from 17 participants using actigraphy devices the week prior to and after orthopaedic surgery from 02/2019 to 03/2020. Participants completed PROMIS measures (Physical Function, Sleep Disturbance, Pain Interference) preoperatively and up to 6 months postoperatively. Nonparametric correlations (rs) assessed for concurrent validity. Linear mixed‐effects models examined the association between changes in actigraphy data and PROMIS measures. Results: Prolonged wake after sleep onset was associated with increased sleep disturbances (rs = 0.49; p = 0.045) and pain interference (rs = 0.51; p = 0.04). Changes in pain interference were correlated with increased awakenings (rs = 0.54; p = 0.03). Increased wake after sleep onset was associated with worsening sleep disturbance (β = 0.12; p = 0.01) and pain interference scores over the postoperative period (β = 0.12; p = 0.02). Conclusions: This study is among the first to examine changes in objective actigraphy data and longitudinal PROMIS measures following orthopaedic surgery and illustrates the feasibility of incorporating actigraphy into surgical settings to evaluate postoperative recovery. Summary statement: What is already known about this topic? Actigraphy activity and sleep monitoring, paired with robust patient‐reported outcomes, may provide a means by which providers can better understand the patient experience and barriers to recovery after surgery.Often postoperative recovery is only assessed using patient‐reported outcomes (e.g. PROMIS measures), despite consensus groups recommending pairing assessments with objective assessments to better estimate risks for poor postoperative outcomes.Previous studies integrating actigraphy and PROMIS measures together have predominately been limited to paediatric populations or over shorter postoperative periods.What this paper adds? Participants were found to return to preoperative levels of sleep, evident by concurrent changes in both actigraphy and patient outcomes, by 1 week postoperatively.PROMIS Sleep Disturbance and Pain Interference demonstrated concurrent validity with sleep data collected from wrist worn actigraphy devices prior to and after surgery.Prolonged wake after sleep onset was associated with increased PROMIS Sleep Disturbance and Pain Interference scores, while increasing awakenings during sleep were linked to increased PROMIS Pain Interference scores.The implications of this paper: This longitudinal study not only builds upon earlier cross‐sectional investigations with comparable sample sizes that examined the validity of PROMIS measures with actigraphy sleep related data but also uniquely examines how changes in the immediate postoperative period are associated with longitudinal postoperative outcomes.Pairing patient‐reported outcomes with objective actigraphy measures can help improve data collection for nurse scientists and improve nurses' postoperative assessments to help in estimating patient's risks for poor postoperative recovery. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to develop and initially assess the psychometric properties of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer (CSES‐OC). Methods: In total, 28 items in the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer were originally employed for a reliability and validity test based on expert suggestions and qualitative findings. The Cronbach's alpha coefficient and test–retest reliability were evaluated with the pilot sample, which included 30 caregivers. The main test, which included 107 caregivers during May 2016 to 2018, was used to execute the exploratory factor analysis (EFA) and concurrent validity. Results: The results of the main test showed a Cronbach's alpha coefficient of.95 for the revised 18‐item total scale after EFA. Four factors (acquiring resources, managing sudden and uncertain patient conditions, managing patient‐related nutritional issues and exploring and making decisions on patient care) were classified from EFA of the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer. The r coefficient was.59 (P <.01), which supported the concurrent validity between CSES‐OC and General Self‐Efficacy Scale. Conclusion: The study results show appropriate psychometric properties for the Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer that was constructed for evaluating caregiver caregiving self‐efficacy in caring for family members with oral cancer. Summary statement: What is already known about this topic? It is important to evaluate the caregivers' positive belief in their family members care abilities if they are to accomplish the tasks required of them when faced various difficulties at home.There is no instrument that measured perceived caregiving self‐efficacy in caregiver in caring for a sick family member with oral cancer. What this paper adds? Cronbach's alpha coefficient, test–retest reliability, exploratory factor analysis and concurrent validity supported the psychometric properties of Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer.This Caregiver Caregiving Self‐Efficacy Scale—Oral Cancer contains four dimensions: acquiring resources, managing sudden and uncertain patient conditions, managing patient‐related nutritional issues and exploring and making decisions on patient care. The implications of this paper: Caregiver Caregiving Self‐Efficacy Scale is appropriate to appraise the caregivers' competence beliefs relevant to caregiving at home. [ABSTRACT FROM AUTHOR]

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