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Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess mental health nurses' empathy towards consumers with dual diagnosis in Australian mental health settings. The research question was What is mental health nurses' empathy towards consumers with co‐existing mental health and drug and alcohol problems? Design and Methods: A cross‐sectional survey was carried out to understand mental health nurses' empathy. The convenience sample included 96 mental health nurses from various mental health settings with experience working with consumers with dual diagnosis. We assessed empathy using the Toronto Empathy Questionnaire. We utilised SPSS™ software to analyse both the descriptive data and multiple‐regression. Results: The mean empathy score was 47.71 (SD 8.28). The analysis of the association between demographic variables and individual subscales showed an association between the clinical setting and empathy (p =.031) and sympathetic physiological arousal (p =.049). The work sector was associated with sympathetic physiological arousal (p =.045) and conspecific altruism (p =.008). Emotional contagion (β =.98, p <.001), emotional comprehension (β = 1.02, p <.001), sympathetic physiological arousal (β = 1.01, p <.001) and conspecific altruism (β = 10.23, p <.001) predicted mental health nurses' empathy. Conclusions: This study found that most mental health nurses showed empathy towards consumers with dual diagnosis. Mental health nurses who are more empathetic towards their consumers experience emotional contagion. They understand emotions better, show sympathetic physiological responses and exhibit kind behaviour towards consumers. Implications for the Profession and Patient Care: Further research is required to understand how mental health nurses adapt to consumers' emotional states in different mental health settings. This information can help clinicians make better decisions about care quality for consumers with dual diagnosis. Impact: This study addressed mental health nurses' empathy towards consumers with dual diagnosis. Mental health nurses showed increased empathy towards consumers with dual diagnosis. The empathy levels vary based on age, clinical setting, work sector and work experience. Mental health nurses' empathy levels were predicted by emotional contagion, emotion comprehension, sympathetic physiological arousal and conspecific altruism. Empathy enhancement among mental health nurses, particularly towards consumers with dual diagnosis, is crucial and should be regarded as a top priority by healthcare leaders and educators. Reporting Method: Outlined by the Consensus‐Based Checklist for Reporting of Survey Studies (CROSS). Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: To report the development, testing and validation of an instrument to assess the stressors experienced by student nurses during their older adult clinical placements. Background: The world's population of older adults is accelerating rapidly, with associated increased healthcare demands and a growing need for skilled nursing staff. However, this sector fails to attract adequate numbers of nursing graduates which is leading to a significant gap between nursing supply and demand. Older adult care is considered to be less attractive than other specialties and accompanied by more sources of stress. Design: A quantitative design was used. Methods: Data were collected from a cohort of Irish student nurses (n = 242) completing older adult clinical placements as part of their undergraduate degree. Exploratory and confirmatory factor analysis examined the instrument's underlying latent structure. Discriminant validity was investigated using a confirmatory factor analysis model with covariates. STROBE guidelines for cross‐sectional studies informed reporting of this paper's research. Results: Factor analyses identified two factors relating to "Knowledge and Workload" and "Resources," which were assessed by nine and six items, respectively. Discriminant validity analyses found a significant relationship between age and the workload and knowledge factor, and between year of programme and the resources factor. The new instrument was labelled the Student Nurse Stressor‐15 (SNS‐15) Scale. Conclusions: The SNS‐15 contained some overlap with stressors from extant general student nurse stress instruments and a number of unique stressors encountered in older adult care. Future research directions are discussed. Relevance to clinical practice: The SNS‐15 may assist stakeholders in nurse education and practice with the development of undergraduate degree programmes and clinical placements, and ultimately, in improving patient care and student retention. [ABSTRACT FROM AUTHOR]

Aim: To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis. Design: Qualitative. Methods: Eighty‐one patients with breast cancer‐related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1‐, 3‐, 6‐, 9‐ and 12‐month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted. Results: Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post‐diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1‐, 3‐, 6‐, 9‐ and 12 months post‐diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns. Conclusion: Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns. Implications for the Profession and/or Patient Care: During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions. Impact: To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence‐based professional guidance on reproductive preservation techniques. Reporting Method: The study was reported using the consolidated criteria for reporting qualitative research guidelines. Patient or Public Contribution: Patients contributed to data collection through interviews. [ABSTRACT FROM AUTHOR]

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

Background: Medication self‐management (MSM) is defined as a person's ability to cope with medication treatment for a chronic condition, along with the associated physical and psychosocial effects that the medication causes in their daily lives. For many patients, it is important to be able to self‐manage their medication successfully, as they will often be expected to do after discharge. Aim: The aim of this study was to describe the willingness and attitudes of patients with schizophrenia spectrum or bipolar disorders regarding MSM during hospital admission. A secondary aim was to identify various factors associated with patient willingness to participate in MSM and to describe their assumptions concerning needs and necessary conditions, as well as their attitudes towards their medication. Methods: A multicentre, quantitative cross‐sectional observational design was used to study the willingness and attitudes of psychiatric patients regarding MSM during hospitalisation. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: In this study, 84 patients, of which 43 were patients with schizophrenia spectrum disorders and 41 were patients with bipolar disorders, participated. A majority of the patients (81%) were willing to participate in MSM during their hospitalisation. Analysis revealed patients are more willing to MSM if they are younger (r = −.417, p <.001) and a decreasing number of medicines (r = −.373, p =.003). Patients' willingness was positively associated with the extent of support by significant others during and after hospitalisation (Pearson's r =.298, p =.011). Patients were convinced that they would take their medication more correctly if MSM were to be allowed during hospitalisation (65%). Conclusion: Most of the patients were willing to self‐manage their medication during hospitalisation, however, under specific conditions such as being motivated to take their medication correctly and to understand the benefits of their medication. Relevance to Clinical Practice: From a policy point of view, our study provided useful insights into how patients look at MSM to enable the development of future strategies. Since patients are willing to self‐manage their medication during hospitalisation, this may facilitate its implementation. Patient contribution: Patients were recruited for this study. Participation was voluntary, and signed informed consent was obtained from all participants prior to the questionnaire. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study was conducted to examine the possible aetiology of nocturia in patients with long‐term COVID‐19. Background: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID‐19, 10–14 weeks after the illness. Design: A descriptive design. Methods: The study consisted of 70 patients who had experienced COVID‐19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. Results: When the nocturia effects of long‐term COVID‐19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p <.05). According to post‐hoc analysis, the mean age of patients with a dominant cardio‐metabolic factor was found to be significantly younger (p <.05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p <.05). Conclusions: It was found that the urinary tract aetiological factor was dominant in patients with long‐term COVID‐19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. Relevance to Clinical Practice: Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post‐COVID‐19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. Patient or Public Contribution: The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID‐19 infection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the relationship between burnout and post‐traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. Background: The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID‐19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. Design: An online cross‐sectional survey of targeted local 327 nurses who went to assist the COVID‐19 epidemic situation in Wuhan during the initial outbreak. Methods: This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. Results: Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. Conclusions: Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. Relevance to Clinical Practice: PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. Patient or Public Contribution: Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study. [ABSTRACT FROM AUTHOR]

This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing workforce. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Background Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. Design An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Methods A search was carried out using the EBSCOhost, Embase, MEDLINE, Psyc INFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). Results A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. Conclusions In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the prevalence of post‐traumatic stress symptoms, and to identify possible predictive factors in Norwegian intensive care unit survivors, 6 months after admission to the intensive care unit with COVID‐19. Background: The SARS CoV‐2 virus causing COVID‐19 has spread worldwide since it was declared a pandemic in March 2020. The most severely ill patients have been treated in the intensive care due to acute respiratory failure and also acute respiratory distress syndrome. It is well documented that these severe conditions can lead to complex and long‐lasting symptoms, such as psychological distress, and was, therefore, investigated for the specific COVID‐19 population. Design: Prospective observational study. Methods: Clinical data and patient reported outcome measures were collected by the Norwegian Intensive Care and Pandemic Registry and by the study group 6 months after admission to an intensive care unit. Results: Among 222 COVID‐19 patients admitted to Norwegian intensive care units between 10 March and 6 July 2020, 175 survived. The study sample consisted of 131 patients who responded to at least one patient reported outcome measure at 6 months following admission. The primary outcome was self‐reported post‐traumatic stress symptoms, using the Impact of Event Scale‐6 (n = 89). Of those, 22.5% reported post‐traumatic stress symptoms 6 months after admission. Female gender, younger age and having a high respiratory rate at admission were statistically significant predictive factors for reporting post‐traumatic stress symptoms. Conclusions: The result is in accordance with previously published research with comparable populations, suggesting that for many COVID‐19 survivors psychological distress is a part of the post‐acute sequelae. Results from the present study should be replicated in larger datasets. Relevance to Clinical Practice: This project provides important insight to post‐acute sequelae after COVID‐19 that patients may experience after critical illness. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID‐19. Background: Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID‐19 pandemic. Design: A cross‐sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID‐19 pandemic between 4 and 19 January 2021. Methods: The Maslach Burnout Inventory‐Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS‐CoV‐2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. Results: Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = −1.37; 95%CI ‐2.17 to −0.47) was related to lower EE. HCWs working in wards for patients with COVID‐19 reported lower EE (b = −1.39; 95%CI ‐2.45 to −0.32). HCWs who contracted COVID‐19 reported lower DP (b = −0.71, 95%CI ‐1.30 to −0.12). Conclusions: Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. Relevance to clinical practice: Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this paper is to describe how selected demographic characteristics 'explain' the observed variance in the distribution of maternal health literacy estimates in adolescents attending antenatal care in Uganda, as estimated by the 'Maternal health literacy scale'. Background By the age of 20 years, more than 60% of Ugandan females are mothers. In the Busoga region of Uganda, the percentage of pregnant adolescents and adolescent mothers is at its highest (above 30%). Design Validated questionnaire survey. Methods The Maternal health literacy scale was administered to 384 adolescents aged 15-19 years attending antenatal care in Jinja and Iganga districts of the Busoga region during the period of July 2013-December 2013. The Mann-Whitney U test in SPSS21 was used to determine if the two levels of dichotomised person factors, i.e. demographic characteristics, relate to 'significantly' different mean maternal health literacy estimates, not strictly following the normal distribution, as measured by the Maternal health literacy scale. Results The person factors, age, education level, pregnancy order and prepregnancy awareness about conception, explained approximately 12% of the observed variance in maternal health literacy estimates. Conclusions Prepregnancy awareness about conception was the single most contributory factor to the observed variance in estimated maternal health literacy levels. More research on women of childbearing age is warranted to explore the impact of further person factors on the maternal health literacy in pregnant adolescents. Relevance to clinical practice Using the person factors found to show 'significant' impact on maternal health literacy in pregnant adolescents, target-specific interventions aimed at improving maternal health literacy in pregnant adolescents can be formulated. By accounting for these factors in reproductive health policy designs, one might take preventive actions to curb the prevalence of adolescent pregnancies in both developing and developed countries. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the reported predictors of the practice of restricting a child for a clinical procedure in hospital. Background Previous work in this area is dominated by discussion papers and suggestions for addressing the issue of restriction. This is the first study to explore reported predictors of this practice with a view to implementing change based on research findings. Design A factorial survey was developed, which incorporated the use of vignettes with various scenarios. The factorial design enabled exploration of the interaction of multiple factors on the practice of restriction. Methods One hundred and sixty-six nurses caring for children were each sent 10 vignettes and asked to rate their likelihood to restrict a child based on the vignettes. A total of 105 nurses responded to the survey, representing a response rate of 63%. Hierarchical linear regression was used to identify reported predictors of restriction. Results Nurses were more likely to restrict a child if they had prior instruction on safe holding, if there was no play therapist available, if the nurse was a registered general nurse with no other registration qualification, if the child required cannulation or if the child was less than five years of age. Conclusion This study identified predictors of restriction from the perspective of practicing nurses; the evidence needs to be used in developing clinical guidelines and in multidisciplinary education. Relevance to clinical practice There is a need to move from any presumption of restriction towards more critical consideration of the individual requirements of the child. There is a need to increase the numbers of nurses receiving specialist training on the care of a child in hospital. The importance of a well-resourced play therapy service is supported, and there is a need for multidisciplinary work to explore alternatives to restriction. [ABSTRACT FROM AUTHOR]

Aim: To better understand occupational stress faced by nurse academics. Methods: A mixed‐methods systematic review, following the Joanna Briggs Institute [JBI], (Joanna Briggs Institute Reviewers' Manual: 2014 edition, 2014) process. Studies were assessed for quality and risk of bias by using standardised critical appraisal instruments from the Joanna Briggs Institute. In addition, processes and reporting were checked against the Equator guidelines. See Appendix S1. Results: The review revealed that nursing academics do experience occupational stress, including burnout. Occupational stress for academic nurses is associated with various factors including work–life balance, workload issues, resources and support, and adapting to change. However, much of the literature focuses on nurses during the initial transition from clinical to academic environment, with rather less focus on established mid‐to‐late career nurse academics. Discussion: Occupational stress and burnout are evident in the university academic workforce, adversely affecting the well‐being of academic nurses, and the long‐term sustainability of the academic nursing workforce. While there is considerable literature focusing on the novice academic nurse, particularly during the transition period, rather less is known about occupational stress among academic nurses across the career trajectory. Various strategies to deal with the negative consequences of occupational stress are identified, including (a) quality mentors for novice and younger nursing academics; (b) training in resilience building for novice academics; (c) supporting collegial relationships and reducing bullying; (d) assistance for professional development and research; (e) better support and resources to overcome increasing workloads; and (f) greater work‐related empowerment to enhance job satisfaction. Conclusion: There is a need for a broader whole‐of‐career research focus to more fully identify, explore and mitigate the occupational stressors that negatively affect the academic nurse workforce. Relevance to clinical practice: A strong and resilient academic nurse workforce is essential for the sustainability of the profession.Organisations should review their work practices and provide greater work‐related empowerment to reduce occupational stressors among nursing academics. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale. Design: Cross‐sectional study. Methods: Conducted in a 2600‐bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut‐off value were assessed using receiver operating curve (ROC). Results: The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut‐off value of 19 yielded the best predictive performance with a Yoden index of 0.710. Conclusion: PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut‐off value of 19 showing improved predictive accuracy. Patient or Public Contribution: Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work. [ABSTRACT FROM AUTHOR]

Aim: To describe positive and negative spiritual responses to providing COVID‐related nursing care among nurses working in hospitals. Background: The COVID pandemic has intensified and publicised the threats to nurse well‐being. Absent from the recommendations for promoting nurse well‐being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well‐being. Design: Cross‐sectional, descriptive observational, mixed methods study. Methods: Data were collected from 523 registered nurses employed in three Southern California hospitals during March–May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale–Short Form, Moral Injury Symptom Scale–Healthcare Professionals, Post‐traumatic Growth Inventory and demographic and work‐related items. STROBE guidelines for cross‐sectional observational studies were observed. Results: The mean for religious/spiritual struggles was 1.98 (range of 1–5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%–36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1–10); applying established criteria indicated it was troubling for at least 50%. The mean for post‐traumatic growth was 4 (on a scale of 0–6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. Conclusion: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. Relevance to Clinical Practice: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy—and allow spiritual transformation. [ABSTRACT FROM AUTHOR]

The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community. Integrative review of the literature. Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to examine the relationship between professional attitude and compassion among nurses. Material and Methods: The sample of the crossectional study recruited 202 nurses who accepted participation and working in a state hospital. Data were collected between 20 June 2019 and 2 August 2019 with a questionnaire form, Inventory of Professional Attitude at Occupation (IPA) and Compassion Scale. Data were collected via face‐to‐face method. Form and scales were completed by the participants. The study was reported according to the STROBE. Results: The mean IPA was 134.57 ± 15.43. The mean score of the Compassion Scale was 73.89 ± 11.54. The mean scores of the Compassion Scale's sub‐dimensions were 16.17 ± 3.22 for kindness, 8.62 ± 3.44 for indifference, 15.45 ± 3.17 for common humanity, 9.02 ± 3.46 for separation, 15.95 ± 3.00 for mindfulness, 8.67 ± 3.44 for disengagement. There were positive correlations between kindness (r =.356), common humanity (r =.214), mindfulness (r =.297) subscales and there were negative correlations between indifference (r = −.441), separation (r = −.411) and disengagement (r = −.415) subscales and the Inventory of IPA. There was a negative correlation between IPA and total Compassion Scale scores (r = −.140). IPA scores were significantly different according to sex, age, working duration, weekly working time, satisfied with colleague relationships. Compassion scores were significantly different for weekly working time, satisfaction with colleague relationships, suitability of the nursing profession and working in emergency and outpatient clinics (p <.05). Conclusion: As nurses' professional attitude scores increased, kindness, common humanity and mindfulness subscales scores increased, while indifference, separation and disengagement subscales scores of the compassion scale decreased. Relevance to clinical practice: Increasing the awareness about professional attitude and compassion in nursing should start with undergraduate education of nurses, and it is recommended to organise in‐service training to develop professional attitudes and compassion in occupational life and to research patient perspectives about compassion. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background: In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls. Design: Cross‐sectional survey study with a deductive approach. Methods: A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist. Results: Callers were most satisfied with affective support, followed by professional‐technical competence, health information and decisional control—in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller. Conclusions: Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls. Relevance to clinical practice: This study provides support for professionals at all levels in telenursing organisations to pay attention to interactional matters. The development of best practice for telenurses needs to consider all four components of interaction to enhance satisfaction with calls. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to determine the prevalence and predictive factors of sexual dysfunction and quality of sexual life in women with heart failure. Background: Symptoms of heart failure may cause a decrease in sexual performance, sexual satisfaction and sexual desire. Methods: This cross‐sectional study was conducted between December 2019 and June 22, 2020. The findings were reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (n = 356). Results: The majority of the participants had sexual dysfunction (84.8%), mainly a reduction in sexual desire. Participants had a mean SQOL‐F score of 75.49 ± 19.37. More than a quarter of the participants stated that they were afraid of dying during sex (29.2%). There were changes in sexual dysfunction based on the class of medications that participants used regularly. Almost all participants stated that they were never informed by nurses or other healthcare professionals about sex (98%). Menopausal women are seven times more likely to develop sexual dysfunction than non‐menopausal women (OR = 7.0, p <.001). Conclusion: Women with heart failure are more likely to develop sexual dysfunction. Many factors affect sexual dysfunction and sexual quality of life. Therefore, nurses should take sexual dysfunction into account when caring for women with heart failure. They should monitor them for risk factors and side effects, draw up and implement plans to respond to problems. Relevance to Clinical Practice: Sexual dysfunction is quite high in women with heart failure. Nurses should encourage these patients to talk about sexual problems and provide sexual health education and counselling regardless of the level of their sexual problems. Patient or Public Contribution: The patients evaluated the suitability of the questions at the pre‐application stage. We finalised the demographic questionnaires with their suggestions. The patients spent time filling out the questionnaires during the data collection phase and answered the questions sincerely. [ABSTRACT FROM AUTHOR]

Background: Postoperative delirium is one of the common complications after any major surgery such as gastrointestinal surgery. And it is related to increased mortality and morbidity and other serious surgical outcomes. Aims: This study aims to identify risk factors for postoperative delirium in patients undergoing gastrointestinal surgery. Materials and Methods: Relevant studies published before August 2021 were searched on Pubmed, Embase and Medline. The risk of bias of included studies was assessed by Newcastle–Ottawa Scale (NOS). A random‐effects model of DerSimonian‐Laird was used to synthesise the overall ORs or RRs for all risk factors. MOOSE checklist was used to review this manuscript. Results: A total of 21 studies including 6165 patients were finally included for quantitative analysis. The pooled incidence of postoperative delirium is 11% (95% CI: 9%‐15%). 16 risk factors were identified, in which age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative C‐reactive protein (CRP) levels, operation time, blood loss and perioperative blood transfusion were statistically significant while smoking, American Society of Anesthesiologists (ASA) score, performance status, diabetes and operation approach were insignificant. Discussion: This meta‐analysis may provide tips for nursing staff and surgeons to design and implement prevention programmes to reduce the incidence of postoperative delirium. Conclusion: Potential risk factors of delirium after gastrointestinal surgery are age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative CRP levels, operation time, blood loss and blood transfusion. [ABSTRACT FROM AUTHOR]

Aims and objectives: To test whether the revised Wilson and Cleary model could identify which factors contribute to health‐related quality of life in chronic kidney disease. Background: Chronic kidney disease affects a person's health‐related quality of life detrimentally although nursing practice informed by theory is only beginning to emerge. Design: A cross‐sectional study reported using the STROBE guidelines. Methods: About 886 participants with chronic kidney disease (varying grades) completed validated measures of symptoms (renal version of the Integrated Palliative care Outcome Scale), and general health perceptions and health‐related quality of life (European Quality of Life five‐dimension three‐level). Socio‐demographic and renal characteristics were also collected. Data were analysed using descriptive statistics and structural equation modelling. Results: Biological function (decreased kidney function and haemoglobin and greater number of comorbidities), directly contributed to increased symptom burden. Symptoms demonstrated strong negative relationships with both general health perceptions and health‐related quality of life. General health perceptions had a direct positive relationship with health‐related quality of life. As age increased, health‐related quality of life decreased. The only environmental characteristic of significance was the distance between home and hospital although it was not directly associated with health‐related quality of life. Overall, the model explained approximately half of the deterioration in health‐related quality of life. Conclusions: The model demonstrated how various factors influence alteration of health‐related quality of life in people with chronic kidney disease. Early identification of these factors could assist nurses to introduce effective management strategies into patient care plans proactively. Relevance to clinical practice: Comprehensive symptom assessment needs to occur not only in kidney failure but in earlier chronic kidney disease grades to enable timely interventions targeted at improving people's wellbeing. Patient or public contribution: Validated interviewer administered questionnaires were completed by participants with chronic kidney disease in this study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the use of physical restraints in aged care facilities(ACFs)and analyse its associated risk factors. Background: Physical restraints have been widely used in ACFs worldwide, but they can cause physical and mental harm to older people. It is important to regulate the use of physical restraint. Design: A cross‐sectional observational and correlational multicentre study. Methods: By convenience sampling method, we selected eight ACFs in four representative regions of Hunan province, China, for this study. The ACF‐related information was obtained by interviewing the managers and reviewing records. We conducted investigation and observation on the elderly in the ACFs to understand the use of physical restraints at three different times: 9:30–11:30, 16:00–18:00 and 19:30–21:30 on a working day. The STROBE checklist was followed for this cross‐sectional study. Results: This study found that the utilisation rate of physical restraints was 23.2%. The critical risk factors affecting the use of physical restrains include the following: (1) the ratio of nursing staff to the elderly residents; (2)whether there is a dementia care unit at the facility; (3) the number of elderly residents in each room; (4) the elderly residents' age, degree of education, marital status, care dependence and cognitive impairment; (5) whether the elderly has suffered from a stroke or senile dementia; (6) whether the elderly carries medical catheters. Conclusion: There is a lack of standardisation in the use of physical restraints in ACFs of central China. Chinese ACFs should develop guidelines and reduction measures to standardise the use of physical restraints, basing on the key factors affecting the use of physical restraints. Relevance to clinical practice: The use of physical restraints in ACFs is threatening the safety of the elderly residents. Understanding the implementation of physical restraint in ACFs can provide reference for reducing the use of physical restraint. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: This study aimed to understand the risk factors that contribute to medical device‐related (MDR) nasal mucosal membrane pressure injuries (MM PI) in ICU patients. Background: ICU patients require substantial tube‐based life support such as oxygen tubes, tracheal intubation and indwelling gastric tubes. As a result, there is an increased risk of PI occurrence; however, few studies have assessed the risk factors associated with nasal mucosal MDR‐MMPI in ICU patients. Design: A cross‐sectional study design was performed. Methods: From January 2019 to June 2020, data from 912 patients treated in the ICU of a tertiary first‐class a hospital in China were collected. The occurrence of PI of the nasal mucosa was obtained by nasopharyngoscope when replacing the nasal catheter fixation patch every day. The study methods were followed by the STROBE guidelines. Results: The incidence of nasal mucosal MDR‐MM PI was 10.9%. The degree of nasal mucosal MM PI was mainly grade 1 (62cases, 62.6%), and no grade 4 were observed. The columella (58 cases, 58.6%) was the most common site of nasal mucosal MM PI followed by the anterior septum (18 cases, 18.2%). A high patient APACHE‐Ⅱ score, the disturbance of consciousness, a history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and the use of vasoconstrictors were identified as significant influencing factors of nasal MM PI in ICU patients (p <.05). Conclusions: A high APACHE‐Ⅱ score, disturbance of consciousness, history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and use of vasoconstrictive drugs were risk factors for nasal mucosal MDR‐MM PI in ICU patients. This study informs on the risk factors of nasal mucosal MM PI that will allow medical support staff to carry out key interventional measures to prevent nasal mucosal MM PI. Relevance to clinical practice: This study illustrates the characteristics and risk factors of nasal mucosal pressure injury in intensive care units, potentially contributing to the prevention of the incidence of nasal mucosal MDR‐PI in ICU patients. [ABSTRACT FROM AUTHOR]

Aims and Objective: To investigate the incidence, characteristics and risk factors of delirium in the ICU. Background: Identifying the risk factors of delirium is important for early detection and to prevent adverse consequences. Design: An observational cohort study conducted according to STROBE Guidelines. Method: The study was conducted with patients who stayed in ICU ≥24 h and were older than 18 years. Patients were assessed twice daily using the RASS and CAM‐ICU until either discharge or death. Cumulative incidence was calculated. Demographic/clinical characteristics, length of stay and mortality were compared between patients with and without delirium. A logistic regression model was used to investigate risk factors. Results: The incidence of delirium was 31.8% and hypoactive type was the most frequent (41.5%). The median onset of delirium was 3 days (IQR = 2) with a mean duration of 5.27 ± 2.32 days. Patients with delirium were significantly older, had higher APACHE‐II, SOFA and CPOT scores, higher blood urea levels, higher requirements for mechanical ventilation, sedation and physical restraints, longer stays in the ICU and higher mortality than those without delirium. The logistic regression analysis results revealed that a CPOT score ≥3 points (OR = 4.70, 95% CI: 1.05–20.93; p =.042), physical restraint (OR = 10.40, 95% CI: 2.75–39.27; p =.001) and ICU stay ≥7 days (OR = 7.26, 95% CI: 1.60–32.84; p =.010) were independent risk factors of delirium. Conclusions: In this study, the incidence of delirium was high and associated with several factors. It is critical that delirium is considered by all members of the healthcare team, especially nurses, and that protocols are established for improvements. Relevance to the clinical practice: Based on the results of this study, delirium could be decreased by preventing the presence of pain, prudent use of physical restraints and shortening the ICU stay. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the prevalence and the associated factors of self‐perceived medical errors among Chinese emergency department nurses. Background: The emergency department is a place with a high incidence of medical errors. Studies about the occurrence and related influencing factors of medical errors among emergency nurses in China are very insufficient. Design: A nationwide cross‐sectional study. Methods: A nationwide cross‐sectional study was conducted from July 2018–August 2018. A total of 17,582 emergency department nurses from 31 provinces across China were eventually included in the analysis. Logistic regression is applied to examine the association of the independent variables with the perceived medical errors. The reporting of this study was compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Results: Of 17,582 participating nurses, 4445 (25.28%) reported self‐perceived medical errors in the past 3 months. Nurses who were serving as nurses‐in‐charge; who reported fair or bad physical health; who reported staff shortage; who were exposed to more verbal abuse at work; who experienced effort–reward imbalance; who reported more over‐commitment; or who had depressive symptoms were more likely to report medical errors. Older age and female gender were protective factors. Conclusions: In this study, a quarter of the emergency nurses reported that they had made medical errors in the past 3 months. Self‐perceived medical errors are associated with multiple domains of work‐related factors and personal distress. Feasible measures should be taken to reduce nurses' workload, improve their working environment, monitor and minimise the occurrence of medical errors among emergency department nurses. Relevance to clinical practice: Emergency nurses, who are the most frequently in contact with patients, play an important role in identifying risk factors and preventing medical errors. Identifying risk factors that may lead to medical errors in the medical environment from both internal and external aspects will help nursing practitioners, hospital administrators and policy makers to take timely preventive measures to reduce the occurrence of medical errors and reduce harm to patients. [ABSTRACT FROM AUTHOR]

Aim: To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge. Background: Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses. Design: A scoping review based on the steps proposed by the Joanna Briggs Institute. Methods: Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care‐ Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA‐ScR. Results: Twenty‐six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal—longer working career (42.3%) and older age (26.9%); (b) educational—higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace—working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%). Conclusions: Personal variables such as age and time of service are non‐modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice. Relevance to clinical practice: Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family‐focused care. [ABSTRACT FROM AUTHOR]

Objective: This cross‐sectional study aimed to describe cancer‐related fatigue (CRF) in colorectal cancer (CRC) patients who were surgically treated with curative intent, identify subgroups at risk of elevated fatigue levels and explore associations between CRF and treatment burden. Background: CRF is a prominent symptom among cancer patients. In patients treated for CRC, CRF is associated with adjuvant treatments, low quality of life and reduced ability to self‐manage. Methods: One hundred thirty‐four patients with CRC treated at a Norwegian university hospital between 2016–2018 were included. The Schwartz Cancer Fatigue Scale‐6 and the Patient Experience with Treatment and Self‐management questionnaires were applied for data collection. Statistical analyses included descriptive statistics and non‐parametric approaches to analyse correlations and identify differences between groups. The study adhered to STROBE Statement checklist for reporting of cross‐sectional studies. Results: Median fatigue level was 10.0 (range: 7.0–13.0). Physical fatigue was higher than perceptual fatigue, with medians of 6.0 (interquartile range [IQR]: 3.0–13.0) and 4.0 (IQR: 3.0–12.0), respectively. Higher fatigue levels were associated with age <60 years, advanced cancer and adjuvant treatments. Increased CRF was significantly associated with higher treatment burden on seven of the nine dimensions, adjusted for demographic and clinical variables. The association of fatigue and treatment burden was stronger in survivors <60 years, with advanced cancer, 6–12 months since surgery or who had more comorbid conditions. Conclusions: This study showed patients at risk of experiencing CRF following CRC treatment. It established proof of associations between CRF and treatment burden and identified subgroups of CRC patients where this association was stronger. Relevance to clinical practice: Screening of CRF in CRC patients can help clinicians provide individualized treatment and care to manage CRF. Clinicians should consider the association between CRF and treatment burden, especially in subgroups of CRF patients. [ABSTRACT FROM AUTHOR]

Background: Scar severity and scar viewing are known to affect body image. The literature is lacking on the relationship between body image and surgical scar assessment. The aims of this study were to compare patients from 3 different surgical departments in terms of body image and scar assessment at discharge, in comparison with nurses' scar assessment, and 3 months post‐surgery. In addition, the research examined age and gender in relation to the main variables. Methods: A longitudinal, comparative, correlational study was conducted using an instrument which included a health history, a nurses scar assessment tool and a patient scar assessment tool at hospital discharge, as well as a body image tool used both at discharge and at 3 months' post‐surgery. The 10‐item body image scale was comprised of affective items, behavioural items and cognitive items. The STROCSS 2019 checklist is used. Results: 75 patients were studied who were mostly male (68.0%) with a mean age of 59 and married (77.3%). The sample distribution of departments included 30.7% cardiothoracic, 29.3% neurosurgery and 40% urology. Cardiothoracic patients displayed a significant negative body image pre‐surgery compared to post‐surgery. Neurosurgical patients' scar assessments were significantly higher than nurses' assessments with no differences found in the other departments. Conclusions: The healthcare team needs to consider engaging patients in post‐surgery discussions concerning scarring and body image. The results of this study revealed that expectations in both clinician and patient participants need to be assessed and evaluated for congruency in order to offer a greater patient‐focused peri‐operative experience. [ABSTRACT FROM AUTHOR]

Background: Hypothermia is a common clinical issue during the perioperative period. The patients with perioperative inadvertent hypothermia are associated with higher risk of postoperative complications and higher hospitalisation costs. Aims: The aim of this study is to explore the prevalence of and predictors for hypothermia in patients entering postanaesthesia care unit. Design: Retrospective cohort study. Methods: A rigorous retrospective cohort study was conducted according to the STROBE reporting checklist. A total of 7216 patients were enrolled in this study. The perioperative variables potentially related to hypothermia were collected. Univariate analysis and multivariate logistic regression analysis were performed to investigate the contributing factors. Results: The overall prevalence of inadvertent hypothermia in postanaesthesia care unit was 21.3% (n = 1505). The multivariate logistic regression analysis showed that age >65 (OR = 1.561, 95% CI 1.371–1.778, p <.001), non‐supine position [lateral decubitus position (OR = 1.341, 95% CI 1.133–1.586, p =.001), lithotomy position (OR = 1.639, 95% CI 1.295–2.075, p <.001)], non‐superficial surgery (OR = 2.195, 95% CI 1.566–3.077, p <.001), non‐open surgery [laparoscopic surgery (OR = 1.205, 95% CI 1.020–1.423, p =.029), endoscopic surgery (OR = 1.430, 95%CI 1.084–1.887, p =.011)], the volume of intravenous infusion fluid >1000 ml (OR = 1.814, 95% CI 1.500–2.194, p <.001), blood transfusion (OR = 1.552, 95% CI 1.159–2.078, p =.003), operation performed in the summer or fall (OR = 1.874, 95%CI 1.656–2.122, p <.001) and use of dexmedetomidine (OR = 1.147, 95%CI 1.015–1.296, p =.028) were associated with increased risk of hypothermia. In contrast, our finding showed that body mass index ≥25 kg/m2 (OR = 0.556, 95%CI 0.491–0.630, p <.001), higher baseline body temperature (OR = 0.641, 95%CI 0.541–0.761, p <.001) and duration of fasting ≥18 h (OR = 0.487, 95%CI 0.345–0.689, p <.001) were associated with decreased risk of hypothermia. Compared with non‐hypothermic patients, patients with hypothermia were associated with prolonged length of hospital days (5 vs. 4 days, p <.001). Conclusion: For patients admitted to postanaesthesia care unit after elective procedures, old age, non‐supine position, non‐open surgery, non‐superficial surgery, large volume of intravenous infusion fluid, dexmedetomidine, blood transfusion and Summer or Fall operative season were associated with increased risk of hypothermia, whereas high body mass index, high baseline body temperature and long fasting duration were associated with decreased risk of hypothermia. Relevance to clinical practice: The outcomes of this study will raise the concerns of perioperative care team on hypothermia in surgical patients. Measures should be taken to improve perioperative hypothermia and clinical outcome. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To assess nursing and allied health students' demographics, knowledge and intentions to care for patients with an infectious disease, COVID‐19. Background: COVID‐19 has caused a public health crisis and worldwide panic. Little is known about students' knowledge levels and intentions to care for infected patients during pandemics. Design: A quantitative, cross‐sectional study. Method: A cross‐sectional study with a convenience sample (N = 480) of nursing and allied health students was analysed using the Mann–Whitney and Spearman's correlation tests. Results: At least 60% of the participants attained high scores for 16 of the 22 items on the knowledge scale. Knowledge was positively associated with attitude (rs =.19, p <.01) and perceived behavioural control (rs =.38, p <.01) and negatively associated with subjective norms (rs = −.11, p <.05). Senior students had higher scores (p =.024) in knowledge. Intention was negatively correlated with knowledge (rs = −.24, p <.01) and perceived behavioural control (rs = −.16, p <.01). Male students (p =.031) and younger students had higher scores in intention (p =.040). Males had higher scores in subjective norms (p <.001), and older and senior students had higher scores in perceived behavioural control (p <.001). Conclusions: Despite the current knowledge on COVID‐19 available through multimedia‐communication channels, students had negative perceived behavioural controls and intentions to care for COVID‐19 patients. Formal education and training are required to enhance students' intentions to care for patients with infectious diseases. Additionally, demographics and belief variables influence students' intentions to care, and further in‐depth analysis is required. Relevance to Clinical Practice This study suggests the importance of updating and contextualizing nursing and allied health curricula to meet global infectious disease guidelines and, ultimately, to support the healthcare system with efficient practitioners in future pandemics. [ABSTRACT FROM AUTHOR]

Aims and objectives To review the available evidence on aspirating when administering intramuscular injections and suggest recommendations for practice. Background The process of aspiration has been ingrained in the intramuscular injection procedure, and whilst many policies no longer recommend this practice, it often continues to be taught and practiced. The result is a variation in this procedure not always consistent with an evidence-based approach. Design A systematic literature review. Methods A systematic approach to searching the literature was undertaken using identified academic databases from inception to May 2014. Citation searching identified additional data sources. Six studies met the search criteria. Results The majority of health professionals do not aspirate for the recommended 5-10 seconds. Administering an injection faster without aspiration is less painful than injecting slowly and aspirating. The main influences on the decision of whether or not to aspirate are based on what health professionals are taught and fear of injecting into a blood vessel. Conclusions In the paediatric vaccination setting, the practice of aspirating during the administration of an intramuscular injection is unnecessary and there is no clinical reason to suggest that these principles may not be applied when using the deltoid, ventrogluteal and vastus lateralis sites in other settings. Owing to its proximity to the gluteal artery, aspiration when using the dorsogluteal site is recommended. Nurses must be supported in all settings, by clear guidance which rejects traditional practice and facilitates evidence-based practice. Relevance to clinical practice Educators need to ensure that their knowledge is up to date so that what they teach is based on evidence. This may be facilitated via regular educational updates. Further research and subsequent guidance are needed to support evidence-based practice in intramuscular injection techniques in all nursing settings. [ABSTRACT FROM AUTHOR]

Aims: The study compares the differences in self‐care knowledge, self‐efficacy, psychological distress and self‐management between patients with early‐ and end‐stage chronic kidney disease (CKD), and predicts the influential factors of self‐management. Design: A cross‐sectional study. Methods: A total of 185 subjects by using convenience sampling from one teaching hospital were collected. The research instruments included the Chronic Kidney Disease Self‐Care Instrument Knowledge, the Chronic Kidney Disease Self‐Efficacy Instrument, the Hospital Anxiety and Depression Scale, and the Chronic Kidney Disease Self‐Management Instrument. Descriptive statistics is used frequency, percentage, mean and standard deviation. Inferential statistics is used independent t‐test, one‐way ANOVA and multiple linear regression analysis. STROBE checklist was used as the guideline for this study. Results: Our results showed that a significant difference was found in the age (p = 0.005), systolic pressure (p =.006), self‐care knowledge (p =.011) and depression level (p =.003) between patients with early‐ and end‐stage CKD. Furthermore, patients with early‐stage CKD have less self‐care knowledge and lower depression levels compared with patients with end‐stage CKD. However, self‐efficacy is the most significant predictor of self‐management for patients with early‐ and end‐stage CKD. For patients with early‐stage CKD, self‐efficacy explained 69.1% of the variation in self‐management. Conclusion: According to our results, the management of depression in patients with CKD may improve their outcomes. Improving self‐care knowledge of patients with end‐stage CKD may improve their self‐management. Therefore, our findings suggest various interventions with different necessary and prioritised precision care at early‐ and late‐stage of CKD. Relevance to clinical practice: Nurses should strive to improve the self‐care knowledge of patients with early‐stage CKD to delay the progression of the disease to end‐stage. Screening for depression among patients with end‐stage CKD is relevant, and these patients should be referred to professional counsellors when necessary. [ABSTRACT FROM AUTHOR]

Aims and objectives: To find out the adherence to lifestyle modifications and its associated factors in hypertensive patients. Background: Low adherence to lifestyle modifications leads to poor therapeutic effectiveness, decreased quality of life, poor health outcomes and increased health care costs. Various factors play an important role in determining the adherence level varying among the different cultural, social and national contexts. Design: A cross‐sectional analytical research design was carried out. Methods: Information from 264 patients with hypertension was collected at the Outpatient Department of Manmohan Cardiothoracic, Vascular and Transplant Center, Kathmandu. A standard tool of WHO Steps Survey Questionnaire and Hypertension Fact Questionnaire was used for data collection. Chi‐square test and binary logistic regression were used for analysis using SPSS 16. Result: The overall adherence to lifestyle modifications was determined as 20.8% with the adherence rate being lowest up to 30.3% for adequate intake of fruits and vegetables. Likewise, 52.5% of patients had average knowledge of hypertension management. Age (p =.021), education (p =.001), occupation(p =.026), household income (p =.007) and family history(p =.011) had statistically significant association with the level of adherence. Younger age (AOR = 1.85 CI = 0.79–4.33) remained as the independent predictor of high adherence to lifestyle modifications. The study followed the STROBE checklist for reporting cross‐sectional study. Conclusion: This study identified that adherence to lifestyle modification is low in older patients. More effective lifestyle modification counselling and educational approaches focusing on the older age groups as well as considering educational level, occupation, family income and family history of hypertension are required to improve their level of adherence. Relevance to clinical practice: Nurses are frequently acquainted with the hypertensive patients in hospitals where they need to provide health teaching on lifestyle modifications. This study identifies the factors that need to be considered while counselling the hypertensive patients. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore what women aged below the national screening age in the UK know and think about cervical cancer and cervical screening. Background: The efficacy of cervical cancer screening is well established. However, cervical screening attendance in the United Kingdom has decreased, with especially low rates at the first screening opportunity at age 25. Research has not yet explored knowledge and beliefs underpinning young women's intention to screen before first screening invitation. Design: Qualitative exploratory study. Methods: Qualitative email interviews were undertaken with 16 participants, using questions derived from the Health Belief Model. Data were analysed using template analysis. The COREQ were followed. Results: Analysis generated three themes; (1) Learning about cervical cancer and cervical screening: sources of information and (missed) opportunities; (2) Young women know screening is important – but they don't always know why; (3) Screening intentions: a cost/benefit analysis of the available information. Conclusions: Young women had varied knowledge and beliefs about cervical cancer and screening which were underpinned by several sources of information available to them. Most women expressed an intention to attend screening when invited; however, some participants were unsure, with low screening‐based knowledge and low perceived susceptibility of cervical cancer identified as key barriers. Social media, familial interactions and interventions within education were highlighted as being suited to interventions aimed at increasing cervical cancer‐ and screening‐based knowledge in young women. Relevance to clinical practice: Findings suggest that women below screening age could be better informed about cervical cancer and screening. Tailored interventions addressing common concerns and misconceptions around screening may be acceptable to young women and could help to promote screening attendance at first invitation. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aims of the study were to (i) estimate the prevalence of frailty among older adults with type 2 diabetes, and (ii) investigate risk factors associated with frailty in the study group. Background: The high prevalence of frailty among older adults and its adverse health impacts including higher risks for physical disabilities and a higher mortality rate is quickly evolving to become an important public health issue. Design: A cross‐sectional design. Methods: Data were collected from the Clinical Diabetes Centre of our study group. Frailty was assessed using the Chinese version of the Tilburg frailty indicator. Other questionnaires included Activities of Daily Living, Mini‐Mental State Examination, Taiwan Geriatric Depression Scale and Instrumental Activities of Daily Living. Multivariable logistic regression was established to identify factors associated with frailty. The STrengthening the Reporting of OBservational studies in Epidemiology checklist was used preparing the manuscript. Results: A total of 248 subjects were recruited in this study, a total of 66 participants had frailty (26.6%). Our results showed that factors including age, number of chronic diseases, cerebrovascular accident, renal diseases, frequency of falling, frequency of hyperglycaemia, Activities of Daily Living, depression, Mini‐Mental State Examination, and Instrumental Activities of Daily Living ≧1 task disability were correlated with frailty in older adults with type 2 diabetes. After adjusting for confounding factors, multivariate logistic regression analyses showed a significant increase in the probability of frailty by 1.72‐times when comparing type 2 diabetes subjects with depression to those without depression. Conclusion: This study revealed that depression is a significant factor associated with the occurrence of frailty among older adults with type 2 diabetes. Relevance to clinical practice: Our results provided strong clinical evidence showing depression as an important factor associated with the risk of frailty in older individuals with type 2 diabetes. We recommend early detection via routine screenings for symptoms of depression during diabetes care to achieve early prevention or the delay of frailty and its implicated adverse health consequences. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to explore the self‐management of patients with early‐stage chronic kidney disease (CKD) and its influencing factors. Methods: A convenient sample of 226 patients with early‐stage CKD was recruited from 63 Public Health Centers in Indonesia, from June to September 2020. Demographic characteristics, health literacy, illness perception, self‐efficacy and self‐management were assessed using self‐reported questionnaires. Stepwise multiple linear regression analysis was performed to identify the factors influencing self‐management. This study adhered to the EQUATOR checklist, STROBE. Results: The mean estimated glomerular filtration rate was 63.45 ml/min/1.73 m2 (standard deviation [SD] = 15.34). The average scores for health literacy, illness perception, self‐efficacy and self‐management were 32.11 (SD = 4.46), 4.57 (SD = 1.46), 183.64 (SD = 38.23) and 76.92 (SD = 9.45), respectively. The influencing factors were education level, monthly income, family history of comorbidity, health literacy and self‐efficacy, which accounted for 45% of total self‐management score. Conclusions: Indonesian patients with early‐stage CKD showed low level of health literacy, but positive illness perception and self‐efficacy; these factors significantly affected CKD self‐management. Health literacy was found to influence all dimensions of self‐management: self‐integration, problem‐solving, seeking social support and adherence to the recommended regimen. Relevance to clinical practice: Adherence to the recommended regimen is the most challenging dimension of CKD self‐management. Health literacy was found to be a major determinant of self‐management. Improving health literacy and motivation of patients with early‐stage CKD may help sustain positive illness perception and self‐efficacy, and improve self‐management. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study explores embedded researcher's age, qualifications, research environment and experience in healthcare and academic organisations in Australia and makes comparisons across three core professional disciplines of nursing and midwifery, medicine and allied health. Background: The embedded researcher model, where a researcher is embedded as a core member of the clinical team, offers promise to support the implementation of research evidence into practice. Currently, there is a lack of clarity about how the model has been adopted across the three largest professional disciplines in Australian health care. Design: A cross‐sectional survey was designed and reported, using the STROBE Statement. Methods: A purposive sample of embedded researchers was invited to participate in an exploratory online survey. Embedded researchers worked, or had worked, for a minimum of 30% of their time, in a healthcare organisation doing research or building research capacity. Participant responses were extracted from the survey and imported into SPSS for analysis. Results: Perspectives of 100 Australian embedded researchers were compared across nursing and midwifery (36%, n = 37), allied health (35%, n = 36) and medicine (26%, n = 27). Professional differences are reported in respondents' qualifications and experience, employment conditions and their research cultures and environments. Comparatively, most nursing and midwifery embedded researchers were older, more clinically experienced than allied health respondents, who were more research qualified. Medical‐embedded researchers are typically older, more clinically experienced and focussed on producing personally relevant clinical research. Nursing and midwifery embedded researchers reported doing clinical research within their teams, as well as research capacity building, management and clinical practice roles. Conclusions: Embedded researchers describe different career trajectories across the three largest professional disciplines in Australian health care. Relevance to clinical practice: Embedded researchers from different professional disciplines enact their work differently. It appears that when they engage in research capacity building via a range of management and networking roles, embedded researchers contribute to their organisation's research culture and receive greater recognition for their achievements. [ABSTRACT FROM AUTHOR]

Aim and objective: The aim of the study was to investigate how the sleep improvement interventions developed for the wards were associated with patients' sleep. The objective was to promote patients' sleep. Background: The quality of sleep is vital for patients' health and recovery from illness. However, patients generally sleep poorly during hospitalisation. Sleep‐disturbing factors are connected to the hospital environment, patients' physical illness, emotional state and the activities of the staff. Many sleep‐disturbing factors can be influenced by appropriate nursing interventions. Design: A two‐group intervention study including the development of nursing interventions aimed at supporting patients' sleep. One group received a sleep promotion intervention and the other received standard care. Both groups evaluated their sleep in the morning. Methods: A survey of participants' sleep evaluations was collected with the five‐item Richards‐Campbell Sleep Questionnaire. The data were analysed statistically. The STROBE checklist was used to report the study. Results: From the participants' perspective, sleep was better in the intervention group, even though statistically significantly only among men. The pain intensity correlated with sleep quality. The number of patients in the room or whether participants had had an operation had no effect on their sleep evaluations. Conclusions: Interventions targeted at supporting and promoting the sleep quality of hospital inpatients may be effective. They should be developed in collaboration with patients and nurses. Several nursing interventions can be proposed to promote better sleep among patients; however, more research is needed to confirm the results. Sleep promotion should include both standardised protocols and individualised sleep support. Relevance to clinical practice: Investing in nursing interventions to promote patients' sleep is important. Patients' individual sleep‐related needs should be part of their care plan. Training programmes that support nurses' knowledge and skills of patients' sleep promotion should be part of nursing education in healthcare organisations. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to assess the impact of anxiety and depression on the quality of life (QOL) of haemodialysis patients. Background: The growing number of people undergoing haemodialysis therapy on a global scale is becoming a universal concern. Although haemodialysis treatment is known to affect one's psychological well‐being, the impact of depression and anxiety on one's QOL has not been well addressed. Design: A correlational cross‐sectional design. Methods: A convenience sample of 114 patients who had been undergoing haemodialysis therapy participated in this study. The research methods used complied with the STROBE checklist. Data were collected using the Kidney Disease and Quality of Life Survey‐36 and the Hospital Anxiety and Depression Scale. Descriptive and inferential statistics were used. The association between the KDQOL, anxiety and depression based on the characteristics of participants was investigated using an independent t test and one‐way analysis of variance. Results: The mean anxiety score of the participants was 7.7 ± 5.3, while the mean score for depression was 7.01 ± 4.2. Based on the cut‐off points, 50% of the participants had anxiety, 44.7% depression. There were negative correlations between anxiety and QOL (r = −0.599, p < 0.001) and between depression and QOL (r = −.599, p <.001). The burden of the disease and physical component scores were mostly affected by both anxiety and depression. Conclusions: Anxiety and depression are common symptoms among patients undergoing haemodialysis, and they have a negative impact on all domains of the QOL. Early detection and treatment of anxiety and depression may have a positive impact on disease outcomes. Relevance to clinical practice: The findings of the current study support the need to adopt effective strategies to improve screening for anxiety and depression. The detection of high physical symptom burden should draw attention to potential psychological issues. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to identify the incidence of postoperative delirium in PCC (patients with colorectal cancer) and the related factors of postoperative delirium by analysing the differences in the general, disease‐related and operation‐related characteristics. Background: Previous studies had some limitations in generalising the risk factors for postoperative delirium in PCC due to the lack of relevant factors, such as disease‐ and operation‐related characteristics. There is a need to investigate the factors of postoperative delirium by including cancer and surgical characteristics. Design: The current study is a cross‐sectional study to investigate the correlated factors of postoperative delirium in PCC. Methods: A total of 196 patients who underwent colorectal cancer surgery at the Keimyung University Dongsan Hospital in Korea participated in the study. Data collection was performed from 15 August 2018 to 10 July 2019. Patients' general, disease‐related and operation‐related characteristics were collected from questionnaires and electronic medical records. Data analysis was performed using descriptive statistics, t test, Chi‐square test and logistic regression using SPSS/WIN 22.0. The STROBE checklist has been used to report this study. Results: The results of this study showed that 26 (13.2%) PCC exhibited postoperative delirium and the risk factors for postoperative delirium were physical activity (OR = 2.94, p =.001), infection (OR = 2.17, p =.001) and nutritional status (OR = 1.10, p =.028). Conclusion: To reduce and prevent the occurrence of postoperative delirium in PCC, encouraging participation in physical activity before and after surgery are required, and regular monitoring of the infection symptoms and nutritional status. Relevance to clinical practice: Based on the results of this study, postoperative delirium in PCC could be decreased by encouraging physical activity immediately following operation, monitoring the signs and symptoms of infection using diverse objective laboratory findings and maintaining the nutritional status within the normal range. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To discover the current state of self‐management practices and levels of self‐efficacy among adults with cancer under treatment in Jeddah City, Saudi Arabia, and to identify their associated factors. Background: The prevalence of cancer and cancer treatment‐related problems is increasing in Saudi Arabia. However, effective cancer care programmes are not provided in this country. Design: Cross‐sectional correlational study. Methods: This study was conducted with a convenience sample of 130 adults with cancer under treatment from May 2020–August 2020 at the largest tertiary care hospital providing cancer care in the western region, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Self‐Care Inventory, Strategies Used by People to Promote Health, and sociodemographic and clinical surveys. Descriptive statistics and stepwise linear regression analysis were performed. Results: The total score for self‐management practices was 84.38 (SD = 13.66) and self‐efficacy, as a strong associated factor of self‐management, earned a total score of 104.24 (SD = 15.87). Stepwise regression analysis identified self‐efficacy, age and education level as important associated variables, explaining 57.6% of the total variance in self‐management practices. Significant effects of age, gender, marital status and duration of cancer on patients' self‐efficacy were also found. Conclusions: The levels of self‐management practices and self‐efficacy to manage cancer treatment‐related problems demonstrated by patients with cancer in this study were rated as a medium. Self‐efficacy, age and education level were the significant factors associated with self‐management practices of patients in Saudi Arabia. Age, gender, marital status and duration of cancer were identified as associated factors of self‐efficacy. Relevance to clinical practice: Enhancing patient's adherence to self‐management practices and increase patient's self‐efficacy through adopting educational intervention programmes, considering patient's sociodemographic and disease‐related characteristics, and continuous patient education must be taken into consideration in the cancer management plan. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community‐dwelling older adults according to self‐reported cataracts. Background: Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis. Design and Method: This is a cross‐sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed. Results: The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls. Conclusion: The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts. Relevance to clinical practice: The expanded understanding of the factors associated with falls among community‐dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events. [ABSTRACT FROM AUTHOR]

Aims: To describe the specific domains of diabetes distress and factors associated with these domains. Background: Diabetes distress is a common problem but not well recognised in adolescents by healthcare providers or adolescents themselves. There is insufficient evidence on how specific domains of diabetes distress exist in adolescents, making it challenging to select precise components to alleviate diabetes stress. Design: A quantitative, descriptive and cross‐sectional study. Methods: Data were collected on socio‐demographic and clinical characteristics, diabetes distress, perceived stress, self‐efficacy and diabetes self‐management using established questionnaires. Multivariate linear regression was conducted to examine the associations between specific factors and four domains in diabetes distress. STROBE checklist was used as the guideline for this study. Results: A total of 100 adolescents with type 1 diabetes aged 12 to 18 years participated in this study. Adolescents experienced the highest levels of distress in the regimen‐related distress [2.41 (SD =0.82)] and physician‐related distress [2.40 (SD =0.80)] domains. Older age, female gender, more diabetes problem‐solving and higher levels of perceived stress were associated with higher regimen‐related distress (β = 0.21 ~ 0.45, p < 0.05). Older age, female gender, a lower degree of endorsement of relevant diabetes‐related goals and higher levels of perceived stress were associated with higher physician‐related distress (β = −0.29 ~ 0.34, p < 0.05). Conclusions: Diabetes distress was reported more on regimen‐related and physician‐related domains among adolescents with type 1 diabetes in China, associating with older age, female, increased perceived stress and poor diabetes‐related problem‐solving. Relevance to clinical practice: Nurses need to screen the specific domains of diabetes distress among adolescents with type 1 diabetes, especially for the older adolescents and girls. This study highlighted the importance of incorporating diabetes‐related problem‐solving support and stress management strategies into diabetes management for adolescents with type 1 diabetes, which could help relieve diabetes distress. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationship between blood sampling techniques and haemolysis. Background: Haemolysis rates of blood samples have been thought to be influenced by the method of collection. There is a lack of research evidence available to clearly show the comparative risk of haemolysis across different blood sampling methods, including venepuncture and use of peripheral intravenous cannulas. Design: A prospective cohort study. Reporting followed the STROBE checklist. Methods: A trained observer was used to record blood sampling techniques over a 10‐week period between April and June 2019. These records were then linked to pathology haemolysis results. Multivariable logistic regression was used to model patient and blood draw characteristics affecting haemolysis. Results: Most of the blood samples were not haemolysed (n = 324, 87.1%). Multivariable analysis showed haemolysis was associated with increased tourniquet duration and if the level of tube was less than half full. Univariable analysis showed haemolysis was associated with increased age of the patient, the difficulty of cannulation/ venepuncture and increased number of attempts. No difference was found in the haemolysis rate related to the qualification of the blood collector. Conclusion: There was no significant difference in haemolysis rates associated with sampling blood from a PIVC compared with venepuncture. Research should be undertaken to determine whether education on the factors influencing haemolysis is useful in decreasing haemolysis rates. Relevance to clinical practice: There was no association with increased haemolysis rates when drawing blood via venepuncture compared with a peripheral intravenous cannula. Haemolysis of blood samples was associated with increased tourniquet duration, if level of the tube was less than half‐filled, increased age of the patient and difficulty of blood draw. Awareness of the risk of haemolysis associated with specific blood sampling methods may assist clinicians to improve care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the spiritual care needs and associated factors in patients with ostomy. Background: The significance of the spiritual care needs of the patients has been emphasised across countries and cultures in the literature. Design: A descriptive, cross‐sectional study. Methods: Outpatients with an ostomy (n = 127) were recruited from proctology, wound and stoma therapy unit and general surgery clinics between January and 28 March 2020. The data were collected using the Socio‐demographic Characteristics Form and Spiritual Care Needs Inventory (SCNI). SCNI has two components, namely 'meaning and hope' and 'caring and respect'. Descriptive statistics, correlation, Student's t test, ANOVA and multiple linear regression analyses were used to analyse the data. The STROBE checklist was used to report the study. Results: The mean scores of the spiritual care needs (65.31 ± 12.83), meaning and hope (37.35 ± 9.37), and caring and respect (27.96 ± 5.63) of the patients with ostomy were found to be moderate. The most significant factors affecting the meaning and hope component were the age, being female and decreases in the level of income. Scores of the patients who perceived the severity of the disease seriously and who practiced religious ritual regularly had more spiritual care needs for the component of caring and respect. Patients with ostomy needed interaction, respect for their privacy and dignity, to be shown concern and to be respected for their religious and cultural beliefs, which were the most salient needs. Conclusions: There is an unambiguous requirement for nurses to ensure spiritual care for patients with ostomy. Showing interest and spending time for the interaction with patients with ostomy, need‐based spiritual practices and life review are key elements of spiritual care. Relevance to clinical practice: Evaluating patients with ostomy spiritually requires information about how spiritual needs may arise and how to talk about spiritual needs. The result of the present study may help nurses to begin the process of maintaining spiritual care for patients with ostomy. [ABSTRACT FROM AUTHOR]

Aim and objectives: To assess the prevalence of anxiety, sleep disorders and self‐efficacy and their predicting factors among nurses facing COVID‐19. Background: The spread of COVID‐19 throughout the world determined a series of modifications of several National Health Service organisations, with a potential series of psychological consequences among nurses, who were particularly afflicted by this situation of changes and precariousness. Design: A cross‐sectional study was carried out from February–April 2020. Methods: A total of 1,005 nurses employed in different Italian hospital wards, during the COVID‐19 pandemic, were recruited. Analyses were based on descriptive statistics and multivariate logistic regression. The STROBE checklist for cross‐sectional studies was used in this study. Results: The prevalence of sleep disturbances, moderate anxiety and low self‐efficacy was 71.4%, 33.23% and 50.65%, respectively. We found a positive correlation between anxiety and sleep quality (0.408; p <.0001) and negative correlations between self‐efficacy and anxiety (−0.217; p <.0001) and sleep quality and self‐efficacy (−0.134; p <.0001). The factor independently associated with all variables was gender. Females were more prone to sleep disturbances, anxiety and low levels of self‐efficacy than males (p <.05). Conclusions: The prevalence of anxiety, sleep disorders and low self‐efficacy among Italian nurses during the COVID‐19 pandemic was high. Healthcare managers should recognise and consider these results to reduce the risk of the onset of major mental problems that could result in post‐traumatic stress disorder. Relevance to clinical practice: Nurses facing major incidents as COVID‐19 pandemic are among healthcare personnel exposed to a high risk to develop psychological disturbance that should be assessed and recognised, in order to find helpful coping strategies to inform support services and avoid to hesitate in post‐traumatic stress disorders. [ABSTRACT FROM AUTHOR]