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Aims and objectives: This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL. Background: Given the inherent vulnerabilities of the ageing process, the older people are an at‐risk group for both contagion of SARS‐CoV‐2 and the perpetuation of residual symptoms after infection, the so‐called long COVID or post‐COVID syndrome. Design: A cross‐sectional survey design using the STROBE checklist. Methods: Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL. Results: The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID‐19 survivors. Conclusions: Knowledge about the persistence of physical, emotional, and social symptoms of COVID‐19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society. Relevance to clinical practice: Given the novelty of long‐COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns. Patient or Public Contribution: No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This paper aims to examine the satisfaction and depressed mood experienced by nursing home workers during the COVID‐19 pandemic and associated variables. Specifically, to analyse the factors that may contribute to nursing home workers developing adaptive behaviours that promote satisfaction or, on the contrary, show characteristics associated with a negative mood. Background: Nursing homes have faced unprecedented pressures to provide appropriately skills to meet the demands of the coronavirus outbreak. Design: A cross‐sectional survey design using the STROBE checklist. Methods: Professionals working in nursing homes (n = 165) completed an online survey measuring sociodemographic and professional characteristics, burnout, resilience, experiential avoidance, satisfaction with life and depression. Data were collected online from April to July 2021, the time in which Spain was experiencing its fifth wave of COVID‐19. Two multiple linear regression models were performed to identify salient variables associated with depressive mood and satisfaction. Results: Resilience, personal accomplishment and satisfaction had a significant and negative relationship with depression and emotional exhaustion, depersonalisation and experiential avoidance had a positive relationship with depression. However, emotional exhaustion, depersonalisation and experiential avoidance had a negative and significant relationship with satisfaction and personal accomplishment, and resilience had a positive and significant relationship with satisfaction. In addition, it was found that accepting thoughts and emotions when they occur is beneficial for developing positive outcomes such as satisfaction. Conclusions: Experiential avoidance was an important predictor of the effects that the COVID‐19 pandemic can have on nursing home workers. Relevance to Clinical Practice: Interventions focusing on resources that represent personal strengths, such as acceptance, resilience and personal accomplishment, should be developed. No Patient or Public Contribution: The complex and unpredictable circumstances of COVID's strict confinement in the nursing home prohibited access to the centres for external personnel and family members. Contact with the professionals involved could not be made in person but exclusively through online systems. However, professionals related to the work environment have subsequently valued this research positively as it analyses 'How they felt during this complicated process'. [ABSTRACT FROM AUTHOR]

Aims and objectives: To detect the mediating effect of resilience on the relationship between perceived social support and burnout in Chinese palliative nurses. Background: Palliative nurses are a group that is vulnerable to burnout. Perceived social support may contribute to decreasing palliative nurses' burnout and facilitating their personal resilience, and resilience may be associated with lower levels of burnout. However, these relationships were unclear in the Chinese context. Design: A cross‐sectional design. Methods: The STROBE guideline was performed to report this study. A mixed sampling method including convenience sampling and stratified sampling was used to recruit participants, and a total of 319 palliative nurses completed the Nursing Burnout Scale, the Perceived Social Support Scale and the Connor–Davidson Resilience Scale from May 2021 to September 2021. Influencing factors were primarily identified using independent‐sample t tests and one‐way ANOVA. Bootstrap method was used to detect the mediating effect of resilience. Results: The level of burnout in palliative nurses (23.4 ± 7.68) was higher than that of general nurses in China. Education level, health condition and monthly income were influencing factors of burnout. Resilience was detected as a mediator in the relationships between perceived social support and dimensions of burnout. Conclusions: Chinese palliative nurses experience a relatively high level of burnout, which may be influenced by several sociodemographic variables. Resilience could mediate the effect of perceived social support on the dimensions of burnout. Problem‐oriented and palliative‐tailored strategies should be developed to further address burnout in Chinese palliative nurses. Relevance to clinical practice: Nurse managers and policy makers should support nurse ongoing education, adopt health‐promoting interventions and optimise salary systems. In addition, perceived social support resources and resilience training programmes are also warranted. Patient or public contribution: All participants were invited to complete the informed consent form and paper questionnaires. Human resource managers helped us collect some subjective data through the personnel management system. Nurse managers of palliative units conducted regular staff meetings to promote the data collection process. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Background. Globally, the environments in which nurses work influence the quality of nursing practice and health care. Design. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. Method. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. Results. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2-66-3-05. All subscales except work motivation (3-05, standard deviation: 0-44) scored less than 3-0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. Conclusion. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. Relevance to clinical practice. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. [ABSTRACT FROM AUTHOR]

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

Aim: This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated. Background: Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope. Design/Methods: A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross‐sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines. Results: Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24–35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope. Conclusions: The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope. Relevance to clinical practice: If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the duration of subsyndromal delirium (SSD) in intensive care unit (ICU) patients and the factors associated with SSD duration. Methods: This retrospective study included adult patients admitted to the ICU of Affiliated Hospital of Nantong University between December 2019 and June 2020. All patients with Richmond Agitation Sedation Scale scores of ≥−2 were evaluated every 8 h using the confusion assessment method of the intensive care unit (CAM‐ICU) until the patients with SSD were negative, progressed to delirium, fell into a coma, died, or were discharged from the ICU. Multivariable Cox regression analyses were performed to determine the factors associated with SSD duration. Results: Of the 388 patients, 53.6% had SSD, and 20.7% progressed from SSD to delirium. The duration of SSD ranged from 8 to 248 h, and the median duration was 48 h (interquartile range, 24–72). Age (hazard ratio [HR] = 0.985, 95% confidence interval [CI], 0.971–0.999, p = 0.035), surgery or not (HR = 0.514; 95% CI, 0.310–0.850; p = 0.010), duration of ventilation (HR = 1.003; 95% CI, 1.000–1.006; p = 0.044), duration of hypoxia (HR = 0.212; 95% CI, 0.103–0.438; p < 0.001), and adapted cognitive exam scores (HR = 1.057; 95% CI, 1.030–1.085; p < 0.001) were independently associated with the duration of SSD. Conclusions: The duration of SSD was associated with age, surgery, duration of ventilation, duration of hypoxia, and cognitive function. SSD has a high incidence among ICU patients, and many patients progress to delirium. Patient or Public Contribution: The study team met with public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation. Relevance to Clinical Practice: ICU staff should pay attention to SSD patients with older age, history of surgery, longer duration of ventilation, prolonged duration of hypoxia, and lower ACE scores. [ABSTRACT FROM AUTHOR]

Aims: It is extremely important to determine the relationship between COPD and self‐management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM. Design: A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Methods: This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self‐Efficacy and the Chronic Disease Self‐Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis. Results: Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect. Conclusions: Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM. Implications for the Profession and/or Patient Care: Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self‐management. Therefore, nurses should definitely consider symptom control in strengthening self‐management in the care of patients with COPD. Patient or Public Contribution: Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study. [ABSTRACT FROM AUTHOR]

Aims and Objective: To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. Background: Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. Design: Descriptive and correlational design. Methods: The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1–12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. Results: The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. Conclusions: Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. Relevance to Clinical Practice: The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education. [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]

Background: It is critical for nurses to provide healthcare services to healthy/sick individuals with a humanistic approach and with empathy. Aims: This research aimed to determine nurses' humanistic behaviour ability, empathy levels and related factors in clinical practice. Design: A descriptive cross‐sectional and exploratory study. Methods: Probability sampling method was used, and 337 nurses working in two public hospitals were included in the study. Data was collected using the Humanistic Practice Ability of Nursing Scale and the Empathy Level Determination Scale. Structural equation model analysis and descriptive statistics were used to evaluate the hypothesised model. This study adhered to the STROBE checklist for reporting. Results: Nurses' humanistic ability and empathy level in nursing practices were found to be above average. Both the ability to act humanely in nursing practices and their empathy levels were found to be significantly higher in nurses who were married and had children. A significant relationship was found between empathy levels and humanistic behaviours. Accordingly, nurses' empathy levels positively affected their humanistic care behaviours, and the model established between the two concepts was found to be statistically appropriate. Conclusions: Nurses' empathy levels positively affect their ability to act humanistically. The result of the model established between the two concepts also supports this. Care strategies should be developed that consider factors that will improve empathetic and humanistic behaviours in nurses and maximise individualised care practices. Implications for the Profession: Increasing the awareness of nurses about the factors affecting humanistic behaviours and empathic attitudes while caring for individuals in clinical practice, will contribute to improving the quality of nursing care. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Aim: To examine the effects of spousal support and parent–nurse partnership on caregiver burden of parents of children with chronic disease. Background: With the trend of increasing the global number of children with chronic diseases, the parental caregiver burden has become increasingly prevalent. Design: Cross‐sectional study. Methods: The study participants included 115 parents of children diagnosed with chronic disease at a general hospital in South Korea. The study duration was 4 June 2021–30 April 2022. Self‐reported measures included the parent–nurse partnership scale, the Korean version of the Parenting Alliance Inventory and the family caregiver burden scale. T‐tests, ANOVA, Pearson's correlation coefficients and hierarchical linear multiple regression were conducted using IBM SPSS version 26.0. This study followed STROBE guideline. Results: Parental caregiver burden was significantly negatively associated with spousal support and parent–nurse partnership. Factors significantly influencing caregiver burden were parental alcohol consumption; child's inherited metabolic disease, cardiovascular disease, disease relating to haematological tumours or kidney disease diagnosis; child's health perceived as poor by parents; child's dependency perceived as high by parents; hospitalization recency; and low spousal support. These factors accounted for 65% of caregiver burden. Conclusion: Parental caregiver burden was related to spousal support and parent–nurse partnership, but the primary factor affecting caregiver burden was spousal support. Relevance to clinical practice: The results highlighted the role of healthcare professionals in educating parents of children with chronic diseases to facilitate spousal support and have implications for nursing and community‐based interventions to reduce parental caregiver burden. Furthermore, they underlined that policymakers and other stakeholders should pay attention to the parental caregiver burden through government‐based, family‐centered strategies. Patient or public contribution: Parents of children with chronic disease were recruited to perform the self‐administered survey in the phase of data collection. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate whether the type of dressing used (occlusive vs. semi-occlusive) impacts on exit-site infection. Background The exit-site infections are a major predisposing factor for peritoneal dialysis-related peritonitis, the main cause of technique failure and an important cause of mortality. The care taken in exit-site dressing is considered an important procedure for the prevention of trauma and contamination of this area. Nevertheless, to our knowledge, no study has yet analysed the impact of different dressing types on early exit-site infection (up to two months after catheter insertion). Design A prospective observational study involving the BRAZPD II (Brazilian Peritoneal Dialysis Multicenter Study) cohort. Methods All incident patients with data available for dressing type applied following peritoneal dialysis catheter insertion were included in the study. A multilevel logistic regression model was used to compare the log-odds of exit-site infections between groups. Results A total of 2460 incident patients were included. Occlusive and semi-occlusive dressings were applied in 82·6% (n = 2031) and 17·4% (n = 427) of patients, respectively. Exit-site infection incidence was not affected by the type of dressing used, with a logit for occlusive dressing of 2·15 (95% CI 0·81-5·70). The combined outcome of exit-site infection and tunnel infection also showed no significance between the groups (logit 1·46, 95% CI 0·72-2·97). Conclusion Our results indicate that the type of exit-site dressing used during the healing phase following peritoneal dialysis catheter insertion has no impact on early exit-site infection rates. Relevance to clinical practice Provides evidence to support the similarity between occlusive and semi-occlusive dressing regarding infection rates in exit site of peritoneal dialysis catheter, therefore allowing the choice to be made accordingly to routine or availability. [ABSTRACT FROM AUTHOR]

Aims: To comprehensively examine the prevailing condition of care dependence among middle‐aged individuals who have experienced hemiplegia subsequent to a stroke and were currently undergoing post‐acute rehabilitation. Additionally, the study sought to analyse the determinants that impacted this phenomenon. Design: A single‐centre, cross‐sectional study design. Methods: During the period from January 2020 to October 2022, a cohort of 196 hemiplegic stroke patients, aged between 40 and 65, and within 6 months of their stroke onset, was selected from the cerebrovascular outpatient clinic at a tertiary hospital in Hangzhou. The demographic and disease‐related data, care dependence level, mental state, nutrition and depression status were collected. Furthermore, all collected data were analysed by descriptive and correlative statistical methods. Results: The care dependence level was 51.04 ± 9.42, with an incidence of care dependence of 78.1%. Multivariate regression analysis showed that age, history of falls, physical dysfunction, chronic comorbidities, depression, nutritional status and cognitive dysfunction were influencing factors for care dependence in the participants after a stroke. Conclusion: The incidence of care dependence among hemiplegic patients aged from 40 to 65 years old in the early stage after a stroke was high. Nursing staff should focus on these patients with a history of falling, physical dysfunction, comorbidity, depression status, nutritional status and cognitive dysfunction in clinical practice. Relevance to Clinical Practice: The incidence of care dependence in middle‐aged hemiplegic patients following a stroke is significantly increased. Some risk factors should be assessed, monitored, and controlled by nursing staff as early as possible in order to reduce the dependence levels in post‐acute rehabilitation period and improve the quality of life of hemiplegia patients. Reporting Method: Our study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist: cross‐sectional studies (see Table S1). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify factors associated with health behaviours among stroke survivors, through a multi‐centre study. Design: A sequential mixed methods design. Methods: In the quantitative research phase, a total of 350 participants were recruited through multi‐stage sampling from December 2022 to June 2023. General information questionnaires, The Stroke Prevention Knowledge Questionnaire (SPKQ), Short Form Health Belief Model Scale (SF‐HBMS), Health Promoting Lifestyle Profile (HPLPII), and the WHOQOL‐BREF (World Health Organization Quality of Life Questionnaire, Brief Version) were distributed across five tertiary hospitals in Henan province, China. For the qualitative research component, semi‐structured interviews were conducted to explore the barriers and facilitators of health behaviour. This study adheres to the GRAMMS guidelines. Results: A total of 315 participants (90.0%) completed the survey. Identified barriers to health behaviour included residing in rural areas, higher scores on the Charlson Comorbidity Index (CCI) and mRS, as well as lower scores on SPKQ, SF‐HBMS and WHOQOL‐BREF. Twenty‐four individuals participated in qualitative interviews. Twenty‐eight themes were identified and categorised by frequency, covering areas such as knowledge, skills, intentions, social influences, social/professional role and identity, environmental context and resources, beliefs about capabilities, beliefs about consequences and behavioural regulation. Both quantitative and qualitative data suggested that health behaviour among stroke survivors is at a moderate level, and the identified barrier factors can be mapped into the COM‐B model (Capability, Opportunity, Motivation and Behaviour). Conclusion: The study indicates that key barriers to health behaviour among stroke survivors align with the COM‐B model. These identified factors should be carefully considered in the planning of future systematic interventions aimed at improving health behaviours among stroke survivors. Patient or Public Contribution: Patients were invited to completed questionnaires in the study and semi‐structured interviews. The investigators provided explanation of this study' content, purpose and addressed issues during the data collection. [ABSTRACT FROM AUTHOR]

Aims: To examine how perceived balance problems are associated with self‐reported falls in the past month after controlling for known correlates of falls among older adults. Background: Approximately 30% of adults age 65 and older fall each year. Most accidental falls are preventable, and older adults' engagement in fall prevention is imperative. Limited research suggest that older adults do not use the term 'fall risk' to describe their risk for falls. Instead, they commonly use the term 'balance problems'. Yet, commonly used fall risk assessment tools in both primary and acute care do not assess older adults' perceived balance. Design and Method: The Health Belief Model and the concept of perceived susceptibility served as the theoretical framework. A retrospective, cross‐sectional secondary analysis using data from the National Health and Aging Trends Study from year 2015 was conducted. The outcome variable was self‐reported falls in the last month. Results: A subsample of independently living participants (N = 7499) was selected, and 10.3% of the sample reported a fall. Multiple logistic regression analysis revealed that the odds of reporting a fall in the past month was 3.4 times (p <.001) greater for participants who self‐reported having a balance problem compared to those who did not. In contrast, fear of falling and perceived memory problems were not uniquely associated with falls. Using a mobility device, reporting pain, poor self‐rated health status, depression and anxiety scores were also associated with falling. Conclusion and Implications: Older adults' perceived balance problem is strongly associated with their fall risk. Perceived balance may be important to discuss with older adults to increase identification of fall risk. Older adults' perceived balance should be included in nursing fall risk assessments and fall prevention interventions. A focus on balance may increase older adults' engagement in fall prevention. [ABSTRACT FROM AUTHOR]

Background: Post‐operative diarrhoea is a common adverse event after pancreatic surgery. While the risk factors for this condition have been identified, the increasing trend of administering chemotherapy before surgery might change these factors. This study aimed to identify the risk factors of post‐operative diarrhoea in patients with pancreatic ductal adenocarcinoma (PDAC) who underwent neoadjuvant chemotherapy. Design: A retrospective cohort study. Methods: Patients who underwent neoadjuvant chemotherapy and pancreatectomy because of PDAC between 2021 and 2023 were included. The preoperative characteristics of, operative details of and post‐operative outcomes in patients with and without post‐operative diarrhoea were collected and compared. The independent risk factors of post‐operative diarrhoea were identified using logistic regression analysis. STROBE checklist was used. Results: Post‐operative diarrhoea occurred in 65 out of 145 (44.8%) patients during hospitalization. Elevated white blood cell count, advanced tumour stage, and late abdominal drain removal were independent risk factors for post‐operative diarrhoea (p <.001, p =.006 and p =.009, respectively). Conclusions: Some perioperative factors influence post‐operative diarrhoea in patients who undergo neoadjuvant chemotherapy. More attention should be paid to patients at a higher risk of post‐operative diarrhoea, with an emphasis on high‐quality management for these patients. [ABSTRACT FROM AUTHOR]

Aims: To identify latent profiles of competence and perceptions of spiritual care among clinical nurses and explore the possible influencing factors. Background: Understanding nurses' level of spiritual care competence and their perceptions and acceptance of such care is important, which could help devise nurse training programmes to address such competence in clinical nurses. However, research addressing interindividual variability in competence and perceptions among Chinese nurses is lacking. Design: Multicentre cross‐sectional study. Methods: Nurses working in departments with critically ill patients from 12 community, 5 secondary and 10 tertiary hospitals in Shanghai completed a demographic information questionnaire and the Chinese versions of the Spiritual Care Competence Scale, Spiritual Care‐Giving Scale and Spiritual Perspectives Scale. The data were analysed using IBM SPSS v26.0 and Mplus version 8.3. Latent profile analysis identified subgroups with different levels of spiritual care competence. Results: In total, 1277 Chinese nurses were recruited. Four profiles of competence and perceptions of spiritual care were revealed: Low ability (23.8%), High ability (6.4%), High acceptance (34.9%) and Moderate (34.9%). The level of job position, spiritual care‐related education, hospital grade and nurses' perceptions and perspectives of spiritual care predicted the probability of profile memberships in their competence. Conclusions: There was heterogeneity in the characteristics of spiritual care competence. Nursing managers can implement individualised interventions, including relevant training, according to the influencing factors of different competence profiles to improve the level of such competence among nurses. Relevance to Clinical Practice: The results provide a new and expanded view of improving nurses' spiritual care competence. Interprofessional collaboration with clinicians, administrators, educators and spiritual leaders can contribute to the development of related education and training. Reporting Method: EQUATOR guidelines, STROBE checklist: cross‐sectional studies. Patient or Public Contribution: All participants were clinical nurses. Participants were informed they could withdraw from the study at any time. [ABSTRACT FROM AUTHOR]

Aim: To explore relationship coping strategies and sexual dysfunction, and the predictive factors of sexual dysfunction in adults receiving haemodialysis and peritoneal dialysis. Background: Sexual dysfunction is a common problem in adults receiving haemodialysis and peritoneal dialysis. This problem may be related to psychological and physiological conditions. However, the association between psychological conditions such as coping strategies and sexual dysfunction is not clearly understood. Design: This study is a cross‐sectional study. Methods: The data were collected from November 2021 to July 2022 using the General Information Form, Arizona Sexual Experiences Scale: Female and Male Versions, and the Ways of Coping Inventory. Correlation and multiple regression analyses were conducted to investigate the relationship between coping strategies and sexual dysfunction. Reporting Method: STROBE checklist. Results: A total of 110 adults, 67 on haemodialysis and 43 on peritoneal dialysis, who met the eligibility criteria were included in this study. The optimistic, helpless and submissive approach sub‐dimensions of coping strategies had positive correlation with sexual dysfunction in adults receiving haemodialysis. Among the sub‐dimensions of the ways of coping inventory, helpless approach was positive predictor and seeking social support was negative predictor of sexual dysfunction in adults receiving haemodialysis. The coping strategies were not predictors of sexual dysfunction for adults receiving peritoneal dialysis. Conclusions: This study showed that helpless coping strategy increases sexual dysfunction, and seeking social support decreases sexual dysfunction in haemodialysis. Implications for the profession and/or patient care: According to this study, social support is effective coping strategy for reducing sexual dysfunction. Education and support for effective coping strategies should be provided to dialysis patients by healthcare professionals at the start of dialysis treatment. Effective coping strategies should be integrated into routine care standards and nursing or hospital policies. Patient or Public Contribution: Adults receiving haemodialysis and peritoneal dialysis were involved in this study. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper will focus on the key concepts behind record linkage and describe how probability matching of Scottish health records can be used for national health research. Background. Record linkage can bring together two or more records relating to the same individual. This allows information from multiple sources to be joined together to produce richer data sets for research purposes and has wide applicability in public health and epidemiological research. The probability matching techniques underpinning record linkage bring together records on a patient basis using key identifying information on each record. Scotland has a strong track record for performing linkage for research purposes owing to routinely collected and well-maintained national administrative health data sets, the emergence of the Scottish record linkage system and organisations like the Information Services Division of NHS National Services Scotland who centrally hold permanently linked patient-based databases. Design. A record linkage retrospective population cohort study is described within this paper. Methods. The paper will describe current linkage methodology before discussing typical applications in the setting of Information Services Division and focusing on a particular linkage study investigating rates and risk factors for gastroschisis. Results. Conclusions from the gastroschisis study are typical of the types of important findings drawn from analysing linked health data. Conclusions. Scotland's good track record for linking records for health research is evidenced by the high volume of research projects, publications and findings resulting from probability matching of national health data. Relevance to clinical practice. Record linkage allows information relating to the same person held across different data sources to be brought together. Probabilistic record linkage can overcome data quality issues, producing accurate matches. This allows linked, analysable, patient-based databases, capable of answering complex research questions, to be produced from several data sources with wide applications in the field of health research. [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]

Aims and Objectives: The study aimed to identify factors associated with participation in Phase II cardiac rehabilitation and to assess patient perceptions towards the usage of technologies in cardiac rehabilitation. Background: Despite efforts to promote utilisation of cardiac rehabilitation (CR), participation among patients remains unsatisfactory. Little is known of patient decision to participate Phase II CR in a multi‐ethnic country. Design: A cross‐sectional study design. Methods: A consecutive sampling of 240 patients with coronary heart disease completed Coronary Artery Disease Education Questionnaire (CADE‐Q) II, Hospital Anxiety and Depression Scale (HADS), Multidimensional Scale of Perceived Social Support (MSPSS) and Cardiac Rehabilitation Barriers Scale (CRBS). Results: Seventy per cent of patients (mean age 60.5 [SD = 10.6] years, 80.8% male) participated in phase II cardiac rehabilitation. Self‐driving to cardiac rehabilitation centres, higher barriers in perceived need/health care and logistical factors were significantly associated with decreased odds of participation. Patients with more barriers from comorbidities/functional status, higher perceived social support from friends, and anxiety were more likely to participate. Chinese and Indians were less likely to participate when compared with Malays. More than 80% of patients used both home and mobile broadband internet, and 72.9% of them would accept the usage of technologies, especially educational videos, instant messenger, and video calls to partially replace the face‐to‐face, centre‐based cardiac rehabilitation approach. Conclusion: Several barriers were associated with non‐participation in phase II cardiac rehabilitation. With the high perceived acceptance of technology usage in cardiac rehabilitation, home‐based and hybrid cardiac rehabilitation may represent potential solutions to improve participation. Relevance to clinical practice: By addressing the barriers to cardiac rehabilitation, patients are more likely to be ready to adopt health behaviour changes and adhere to the cardiac rehabilitation programme. The high perceived acceptance of using technologies in cardiac rehabilitation may provide insights into new delivery models that can improve and overcome barriers to participation. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to describe the knowledge, attitudes and practices (KAP) of nurses in implementing advance directives (ADs) for older patients and analyze the influencing factors before the establishment of the first advance directives act in China. Design: Multicenter cross‐sectional survey. The standards for reporting the STROBE checklist are used. Methods: This cross‐sectional study developed a self‐designed structured questionnaire to assess nurses' knowledge, attitudes and practices about ADs. Nurses were recruited by stratified random sampling through the Nursing Departments of 12 hospitals in southwest China and were asked to fill out the questionnaire face to face about knowledge, attitudes and practices. Data were analyzed following descriptive statistics, rank‐sum test and multiple linear regression. Results: This study included 950 nurses. The study found that nurses were extremely supportive of ADs. Unmarried nurses had better knowledge of ADs than married ones. Nevertheless, there was a discrepancy between the participants' knowledge, attitude and practice. The participants' practice was lower (4.3%) compared with their attitude (81.9%) and knowledge (42.2%). Knowledge on, attitudes towards and standardized procedures for ADs in the workplace affected nursing practice. Conclusions: The study recommends that courses on ADs and appropriate support from medical institutions should be provided to nurses to increase their knowledge and confidence in implementing ADs. Healthcare professionals should be sufficiently equipped to implement ADs and handle their execution appropriately to provide adequate end‐of‐life care corresponding to patients' wishes. Relevance to Clinical Practice: The study results inform rich insights as it discusses the numerous interrelating factors influencing these three fundamental aspects that affect the success of any AD policy by surveying the knowledge, attitudes and practices of clinical nurses. Furthermore, our results hint at distinct areas of improvement in the nursing practice to facilitate the wider implementation and acceptance of ADs in China. Patient or Public Contribution: This study involved no patient. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the predictors and outcomes of patient safety culture (PSC) among oncology nurses working in public Saudi hospitals according to participant characteristics and evaluate the relationship between PSC domains. Background: PSC is crucial in healthcare systems, particularly in oncology and chemotherapy units, and its assessment can enhance the standard service provided and cancer care quality. There is currently limited research on the status, predictors and outcomes of PSC in cancer care settings in developing countries, including Saudi Arabia. Design: A cross‐sectional correlational study. Methods: A convenience sample of 101 oncology nurses working in two large Saudi tertiary care hospitals participated in this study. The Hospital Survey on Patient Safety Culture validated instrument and demographic and work surveys were completed by the participants. The study methods were compliant with the STROBE checklist. Descriptive statistics and multiple linear regressions were used to analyse the data. Results: The areas of PSC strength were related to organizational learning–constant improvement, feedback and communication about errors, and transitions and handoffs. Manager/supervisor actions and expectations, hospital management support, communication openness, experience in the current unit and oncology unit/area were the predictors of PSC. In terms of PSC outcomes, the oncology nurses reported either no or one to two adverse events and a substantially good patient safety rating. Conclusion: The level of PSC was lower than expected. Communication openness, experience in the current unit and oncology unit/area were the strongest predictors of PSC. Investing in oncology nursing practice that addresses these concerns and prioritizes patient safety is critical in Saudi cancer care settings to increase patient safety. Relevance to clinical practice: The findings contribute to a better understanding of the predictors and outcomes of PSC, which should be considered when establishing effective nursing interventions or strategies for PSC in cancer care settings. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study explores UK nurses' experiences of working in a respiratory clinical area during the COVID‐19 pandemic over winter 2020. Background: During the first wave of the pandemic, nurses working in respiratory clinical areas experienced significant levels of anxiety and depression. As the pandemic has progressed, levels of fatigue in nurses have not been assessed. Methods: A cross‐sectional e‐survey was distributed via professional respiratory societies and social media. The survey included Generalised Anxiety Disorder Assessment (GAD7), Patient Health Questionnaire (PHQ9, depression), a resilience scale (RS‐14) and Chalder mental and physical fatigue tools. The STROBE checklist was followed as guidance to write the manuscript. Results: Despite reporting anxiety and depression, few nurses reported having time off work with stress, most were maintaining training and felt prepared for COVID challenges in their current role. Nurses reported concerns over safety and patient feedback was both positive and negative. A quarter of respondents reported wanting to leave nursing. Nurses experiencing greater physical fatigue reported higher levels of anxiety and depression. Conclusions: Nurses working in respiratory clinical areas were closely involved in caring for COVID‐19 patients. Nurses continued to experience similar levels of anxiety and depression to those found in the first wave and reported symptoms of fatigue (physical and mental). A significant proportion of respondents reported considering leaving nursing. Retention of nurses is vital to ensure the safe functioning of already overstretched health services. Nurses would benefit from regular mental health check‐ups to ensure they are fit to practice and receive the support they need to work effectively. Relevance to clinical practice: A high proportion of nurses working in respiratory clinical areas have been identified as experiencing fatigue in addition to continued levels of anxiety, depression over winter 2020. Interventions need to be implemented to help provide mental health support and improve workplace conditions to minimise PTSD and burnout. [ABSTRACT FROM AUTHOR]

Aims: To investigate the health‐related quality of life (HRQoL), symptoms, psychological and cognitive state and pulmonary and physical function of nonhospitalised COVID‐19 patients at long‐term, and to identify factors to predict a poor HRQoL in this follow‐up. Background: Studies have focused on persistent symptoms of hospitalised COVID‐19 patients in the medium term. Thus, long‐term studies of nonhospitalised patients are urgently required. Design: A longitudinal cohort study. Methods: In 102 nonhospitalised COVID‐19 patients, we collected symptoms at 3 months (baseline) and at 6–7 months (follow‐up) from diagnosis (dyspnoea, fatigue/muscle weakness and chest/joint pain), HRQoL, psychological state, cognitive function, pulmonary and physical function. This study adhered to the STROBE statement. Results: HRQoL was impaired in almost 60% of the sample and remained impaired 6–7 months. At 3 months, more than 60% had impaired physical function (fatigue/muscle weakness and reduced leg and inspiratory muscle strength). About 40%–56% of the sample showed an altered psychological state (post‐traumatic stress disorder (PTSD), anxiety/depression), cognitive function impairment and dyspnoea. At 6–7‐months, only a slight improvement in dyspnoea and physical and cognitive function was observed, with a very high proportion of the sample (29%–55%) remained impaired. Impaired HRQoL at 6–7 months was predicted with 82.4% accuracy (86.7% sensitivity and 83.3% specificity) by the presence at 3 months of muscle fatigue/muscle weakness (OR = 5.7 (1.8–18.1)), PTSD (OR = 6.0 (1.7–20.7)) and impaired HRQoL (OR = 11.7 (3.7–36.8)). Conclusion: A high proportion of nonhospitalised patients with COVID‐19 experience an impaired HRQoL, cognitive and psychological function at long‐term. HRQoL, PTSD and dyspnoea at 3 months can identify the majority of patients with COVID‐19 who will have impaired quality of life at long‐term. Relevance to clinical practice: Treatments aimed at improving psychological state and reducing the fatigue/muscle weakness of post‐COVID‐19 patients could be necessary to prevent the patients' HRQoL from being impaired at 6–7 months after their reported recovery. [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]

Aims: To examine the relationship among eHealth literacy, empowerment and self‐management and the mediating effects of empowerment in diabetic kidney disease (DKD) patients in the eHealthcare context. Background: Self‐management is an essential aspect of healthcare in delaying disease progression for DKD. In the eHealthcare era, health services providing self‐management are transforming. The ability and confidence of patients to use eHealth services is a critical issue that impacts the effectiveness of self‐management, but little is known about the role of eHealth literacy and empowerment in self‐management. Design: A cross‐sectional study guided by the STROBE. Methods: Overall, 127 Taiwanese patients were enrolled using convenience sampling. Data collection used structured questionnaires and chart reviews. Multiple regression was used to infer self‐management predictors, and SPSS PROCESS macro and bootstrapping verified the mediating effects. Results: Empowerment and eHealth literacy both showed significant positive correlations with self‐management. Empowerment was the main predictor of self‐management and had a complete mediating effect between eHealth literacy and self‐management. Conclusion: Increasing patients' eHealth literacy can improve empowerment and prevent health inequality issues. Healthcare providers should consider improving patients' eHealth literacy to enhance their self‐management. Relevance to Clinical Practice: Healthcare service systems need to create user‐friendly eHealthcare environments, and healthcare professionals can provide multifaceted instructions that fit patients' eHealth literacy levels to enhance their motivation and confidence in disease care, thus cultivating positive self‐management behaviours. Impact: The popularity of eHealthcare services aimed at promoting self‐management behaviours is increasing. However, the level of eHealth literacy is an essential factor that affects the effectiveness of self‐management in the healthcare environment. In addition, empowerment is a major critical influence factor of self‐management and a completely mediating variable between self‐management and eHealth literacy. Consequently, healthcare providers should consider promoting patients' eHealth literacy to empower people using eHealthcare services for implementing self‐management. Reporting Method: The Strengthening the Reporting of Observational Studies in cross‐sectional studies (STROBE) checklist was used to ensure comprehensive reporting. Patient or Public Contribution: Patients were diagnosed with DKD in the study hospital. Physicians and case managers transferred patients to research assistants who screened them for the inclusion criteria and invited them to participate in this study if they met the requirements. After participants signed informed consent, the research nurse encouraged participants to respond to the research questionnaire face to face. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To learn about the attitudes of nurses working in the Andalusian Public Health System regarding euthanasia and its legalisation. Background: Euthanasia often finds itself in the crosshairs of ethical and political debate on an international scale. Currently, the Spanish Organic Law 3/2021 of 24 March, 2021, recognises euthanasia as a fundamental right in Spain. It is of particular interest to know about the views, attitudes and stances that Andalusian nurses have of euthanasia as they are key players within the framework of euthanasia and administration of life‐ending drugs. They play a central role in guiding patients through the euthanasia application process. Design: Observational descriptive study. Methods: A study of Andalusian Public Health System nurses was carried out using non‐probability convenience sampling. 518 nurses with an average age of 44.75 years answered in a questionnaire that was distributed on an online platform. Socio‐demographic and occupational variables were assessed, together with the Death Anxiety Scale and the Euthanasia Attitude Scale. A bivariate analysis and a multivariate linear regression model were performed. The STROBE checklist was used. Results: The mean score obtained on the Euthanasia Attitude Scale was 75.95 (SD = 16.53). The mean score obtained on the Death Anxiety Scale was 7.56 (SD = 3.05). The variables age and work experience were negatively correlated with the total scores of the Euthanasia Attitude Scale and the categories 'Ethical considerations', 'Practical considerations' and 'Treasuring life'. On the other hand, there was a significant positive correlation between age and work experience and 'Spiritual beliefs' category. Conclusions: The current situation shows a worrying paradox. There is a stark difference between positive professional attitudes towards euthanasia and the desire to participate in its application. Relevance to Clinical Practice: It is vital that educational and healthcare institutions make the necessary efforts to ensure that nurses develop sound moral judgement, displaying the moral conscience and ethical commitment required of this established profession. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To investigate the impact of socio‐demographic factors and job stressors on the emotional intelligence of psychiatric nurses. Background: Emotional intelligence plays a crucial role in enabling nurses to effectively manage their own emotions, comprehend the emotions of others and assist individuals in dealing with diverse stressors. Nevertheless, a comprehensive conceptualization of the relationship between job stressors and emotional intelligence remains lacking. Design: This study employs a multi‐centre cross‐sectional design. Methods: A multi‐centre cross‐sectional survey involving 1083 registered nurses from 11 psychiatric hospitals across four provinces in China was conducted. Non‐probability sampling was utilised. The survey encompassed assessments of nurse job stressors, emotional intelligence using a scale and socio‐demographic characteristics using a questionnaire. A multiple linear regression model was applied to identify significant variables associated with emotional intelligence based on demographic attributes and various nurse job stressors. The study adhered to the STROBE checklist. Results: The findings revealed a noteworthy negative correlation between nurse job stressors and emotional intelligence. Socio‐demographic factors and job stressors of certain nurses were able to predict emotional intelligence and its dimensions among psychiatric nurses, with percentages of 44.50%, 40.10%, 36.40%, 36.60% and 34.60%. Conclusion: Providing emotional intelligence training for psychiatric nurses could enhance their capacity to cope effectively with workplace stress, particularly among younger nurses who engage in limited physical activities. Relevance to Clinical Practice: The analysis of the relationship between emotional intelligence and nurse job stressors could facilitate early detection and intervention by managers based on pertinent factors. This, in turn, could elevate the emotional intelligence level of psychiatric nurses. No Patient or Public Contribution: This study did not recruit participants, so details of participants were not be involved. [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]

Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to determine the relationship between the demand for telenursing and the chronic illness resources available to patients with type 2 diabetes mellitus (T2DM), as well as the factors that affect this requirement. Design: Cross‐sectional. Methods: This study included 586 participants with T2DM. A telenursing needs questionnaire developed by the research team was used to assess the telenursing needs of patients with T2DM, and the Chinese version of the Chronic Illness Resources Survey was used to assess the participants' community chronic disease resources. A one‐way ANOVA and multiple regression analysis were used to determine the factors influencing the demand for telenursing and to estimate the relationship between chronic illness resources and the need for telenursing. The STROBE checklist was followed. Results: The patients' telenursing needs, ranked from high to low, are as follows: individualized skills and safety; basic disease care; psychological and spiritual needs; respect and social support; and high‐level health management. The chronic disease resource score was 3.47 ±.02, which suggested that patients with T2DM have relatively rich disease resources. Multiple regression analyses showed that resources for chronic diseases, the course of diabetes and complications, family income and other chronic diseases accounted for 79.6% of the variance in T2DM patients' telenursing needs. Conclusions: The telenursing needs of patients with T2DM are prominent, and primarily focus on basic nursing needs for the disease. To some extent, chronic disease resources affect the telenursing needs of patients with T2DM. Relevance to Clinical Practice: It is crucial to pay attention to research on telenursing for T2DM patients from the patients' perspective. Enhancing resources for chronic diseases may help meet the telenursing needs of T2DM patients. Patient or Public Contribution: Parents and diabetes management specialists participated in designing the telenursing needs questionnaire. [ABSTRACT FROM AUTHOR]

Aims: To gain insights into the barriers towards the prevention and/or reduction of involuntary treatment in long‐term geriatric care. Design: Mixed methods. Background: Measures to which a person resists and/or does not provide consent for are defined as involuntary treatment. The use of involuntary treatment violates the autonomy of (older) persons and causes more harm than benefit. Moreover, it contradicts the values of person‐centred care. Nevertheless, its use among people living with dementia (PLWD) is still common practice. Methods: We conducted a cross‐sectional, mixed methods study, including an online survey for professional caregivers and a semistructured focus group interview with professional caregivers. Results: A total of 218 participants completed the questionnaire. The percentage of participants who perceived barriers in one of the 22 survey items ranged from 15% to 42%. Lack of time, the experienced need to use involuntary treatment, uncertainty about responsibilities of stakeholders and a lack of knowledge on methods to prevent and/or reduce the use of involuntary treatment were most seen as barriers. Nursing staff perceived a lack of time hindering them in the prevention or reduction of involuntary treatment more often than other professional caregivers. Working in home care and having no former experience with involuntary treatment usage increased perceived barriers. Participants of the focus group interview confirmed these findings and added that professional caregivers in general lack awareness on the concept of involuntary treatment. Conclusions: One out of four professional caregivers experiences barriers hindering prevention and/or reduction of involuntary treatment. More research is needed to gain a better understanding of how professional caregivers can be supported to remove barriers and, consequently, prevent and/or reduce the use of involuntary treatment. Relevance to Clinical Practice: Professional caregivers experience many barriers towards the prevention and reduction of involuntary treatment. Future initiatives should aim to remove the perceived barriers. [ABSTRACT FROM AUTHOR]

Aims: To determine the risk of pressure injury development in the intensive care unit based on changes in patient conditions. Design: This retrospective study was based on secondary data analysis. Methods: Patient data from electronic health records were retrospectively obtained and we included 438 and 1752 patients with and without pressure injury, respectively, among those admitted to the medical and surgical intensive care units (ICUs) from January 2017–February 2020. Changes in patient conditions were analysed based on the first and last objective data values from the day of ICU admission to the day before the onset of pressure injury and categorised as follows: improved, maintained normal, exacerbated and unchanged. Logistic regression was performed to identify the significant predictors of pressure injury development based on 11 variables. Results: The 11 selected variables were age, body mass index, activity, acute physiology and chronic health evaluation II score, nursing severity level, pulse and albumin, haematocrit, C‐reactive protein, total bilirubin and blood urea nitrogen levels. The risk for a pressure injury was high with exacerbation of or persistently abnormal levels of nursing severity, albumin, haematocrit, C‐reactive protein, blood urea nitrogen and pulse >100 beat/min. Conclusion: Periodic monitoring of haematological variables is important for preventing pressure injury in the intensive care unit. Reporting Method: The study followed STROBE guidelines. Patient or Public Contribution: This study contributes to the utilisation of patient data from electronic health records. Relevance to Clinical Practice: In addition to other pressure injury risk assessment tools, ICU nurses can help prevent pressure injuries by assessing patients' blood test results, thereby promoting patient safety and enhancing the efficacy of nursing practice. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To identify symptom clusters and examine their association with health‐related quality of life. Background: Multiple myeloma patients undergoing chemotherapy suffer from disease symptoms and adverse effects during the course of the disease. However, single symptom management has little effect, and symptom management for these patients remains challenging. Symptom clusters open a new perspective and provide important clues for symptom management. Design: A cross‐sectional study. Method: Participants were invited to complete the Chinese version of the Memorial Symptom Assessment Scale and Quality of Life Questionnaire‐core 30. Appropriate indicators were used for descriptive statistics. Principal component analysis was used to identify symptom clusters. Associations between symptom clusters and quality of life were examined with Pearson correlation coefficients, Pearson correlation matrix and multiple linear regression. This study was reported following the STROBE checklist. Results: A total of 177 participants were recruited from seven hospitals in this study. We identified self‐image disorder, psychological, gastrointestinal, neurological, somatic and pain symptom clusters in multiple myeloma patients with chemotherapy. Approximately 97.65% of patients suffer from multiple symptom clusters. The pain, psychological and gastrointestinal symptom clusters have negatively influence on health‐related quality of life. The strongest association was found with the pain symptom cluster. Conclusion: Most of multiple myeloma patients suffer from multiple symptom clusters. When improving the multiple myeloma patients' health‐related quality of life, the clinical staff should prioritise relieving the pain symptom cluster. Relevance to Clinical Practice: When multiple myeloma patients undergoing chemotherapy suffer from multiple symptom clusters, nurses should prioritise relieving the pain symptom cluster to improve their health‐related quality of life. When drawing up and providing interventions, nurses should focus on the correlation among symptoms rather than single symptom. By relieving one symptom in a given cluster, other symptoms within the same symptom cluster may also be relieved. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this study was to establish pressure ulcer prevalence and prevention in the long-term care setting. Background. There is no information on pressure ulcers prevalence in care of the older person in Ireland; therefore, a prevalence study was undertaken to investigate key aspects related to current practices in pressure ulcer prevention. Design. A cross-sectional survey design was employed. Method. Ethical approval was received. Participants included 1100 older individuals residing in 12 long-term care settings. Data were collected using the Braden scale, the European Pressure Ulcer Advisory Panel minimum data set and pressure ulcer grading system. Results. All participants were Irish and white, 70% were women, and 75% were aged 80 years or older. Prevalence was 9%, with 28% of pressure ulcers grade 1, 33% grade 2, 15% grade 3 and 24% grade 4, mainly located on the sacrum (58%) and the heel (25%). Seventy-seven per cent scored Braden low risk or not at risk; however, 53% were completely immobile/very limited mobility and 58% were chair/bedfast. There was a significant association between activity and mobility and pressure ulcer development ( χ2 = 45·50, p < 0·001 and χ2 = 46·91, p = 0·0001, respectively). Fifty per cent had a pressure redistribution device in bed, and 48% had one in use on the chair; however, 9% had a repositioning regime planned for when in bed and 5% planned for when seated in the chair. Conclusions. This paper reports on the first ever pressure ulcer prevalence survey conducted in long-term care in Ireland, and results provide significant insights into decision-making and use of resources in the prevention of pressure ulcers. Relevance to clinical practice. Pressure ulcers are common, costly and impact negatively on individuals. Current practices in prevention show several areas for improvement, namely, risk assessment, care planning and documentation. [ABSTRACT FROM AUTHOR]

The primary objective of the study was to determine which professional, situational and patient characteristics predict nurses' judgements of patient acuity and likelihood of referral for further review. A secondary aim was to test the feasibility of the factorial survey method in an acute area. There is increasing recognition that indicators of deterioration in acutely unwell adults are being missed and referrals delayed. The reasons for this are unclear and require exploration. Assessing nurses' clinical decision-making or judgements in a 'real-world' situation is problematic. The study used a factorial survey design where participants completed randomly generated paper-based vignettes on one occasion. The dependent variables were assessment of patient acuity and likelihood of referral. Independent variables consisted of a number of patient characteristics, i.e. heart rate, blood pressure, nurse characteristics, i.e. clinical experience, and situational characteristics i.e. staffing. Participants were registered nurses working in acute areas excluding intensive care and theatre. Ninety-nine participants responded resulting in 1940 completed vignettes. An early warning score was the single most significant predictor of referral behaviour accounting for 9·6% of the variance. When this was not included in the vignette, nurses used physiological characteristics e.g. respiratory rate, urine output, neurological status. These explained 12% of the variance in the model predicting assessment of patient acuity and 9·4% or the variance predicting likelihood of referral. When given a series of vignettes, nurses appear to use appropriate physiological parameters to make decisions about patient acuity and need for referral. Our results support the use of early warning scoring systems. Education and professional development should focus more on developing and maximising clinical experience and expertise rather than knowledge acquisition alone. A factorial survey method is feasible to explore decision-making in this area. This study has several implications for practice. The emergence of an early warning scoring system as a significant individual predictor supports the use of such systems. However, the small amount of explained variance suggests that there are other influences on nurses' assessment of patient acuity and referral decisions that were not measured by the factorial survey approach. Educational provision might focus not just on knowledge acquisition but include educational delivery methods that incorporate or mimic real-ward settings. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the association between perceived nurse–patient interaction and quality‐of‐life among nursing home residents, adjusted for loneliness, anxiety and depression. Background: Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality‐of‐life. Anxiety, depression and loneliness are found detrimental to NH residents' quality‐of‐life. The nurse–patient relationship is important for patient's well‐being, both in terms of illness and symptom management. Design: Cross‐sectional design. Methods: Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long‐term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement. Results: Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse–patient interaction was statistically significant to quality‐of‐life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality‐of‐life. Nurse–patient interaction and loneliness explained together 25% of the variation in quality‐of‐life. Conclusion: This study suggests that loneliness is frequent as well as more detrimental to quality‐of‐life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse–patient interaction represents an essential health‐promoting resource for Quality‐of‐life in this population. Relevance to clinical practice: Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse–patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse–patient interaction as a health‐promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted [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]

Aims and Objectives: To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. Background: OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. Design: A cross‐sectional design following the STROBE guideline. Methods: A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health‐related quality of life. OHL was measured using the validated Chinese version of the short‐form Health Literacy of Dentistry (HeLD‐14) scale. Descriptive statistics, the Mann–Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. Results: The median HeLD‐14 score (p25–p75) was 50.0 (44.0–54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self‐reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. Conclusions: The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. Relevance to clinical practice: The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. Patient or public contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to measure the impact of a complex quality improvement intervention on the incidence of SSI in patients undergoing elective colorectal surgery. Background: Surgical site infections are a major postoperative complication for patients undergoing colorectal surgery. Prevention of SSIs necessitates a complex intervention requiring many elements to be in place to ensure the successful implementation of prevention measures. Design: This study was a non‐equivalent pre‐test post‐test design where consecutive patients undergoing colorectal surgery were surveyed for surgical site infections for 30 days postoperatively and is reported using the SQUIRE 2.0. Methods: A baseline cohort of patients was retrospectively reviewed in a single centre to ascertain the surgical site infection incidence rate in the first 6 months of 2018 (T0) and prospectively at two 6‐month time periods in 2019 (T1, T2) following the introduction of a complex intervention. There were 311 patients included across three time periods. Results: There was a notable decrease in surgical site infection incidence rates from baseline over the course of the study. Univariate analysis identified Body Mass Index, a wound contamination classification of dirty or contaminated, duration of surgery >75th percentile and a National Healthcare Safety Network risk index score of 3 as factors that significantly increase the probability of developing a surgical site infection. Multivariate analysis identified duration of surgery and body mass index increased the probability of an SSI. The results of the logistical regression model found that there was a significant reduction in the probability of an SSI between T0 and T2. Conclusions: The implementation of a complex intervention led to a reduction in the incidence of surgical site infections and improved implementation of evidence‐based practices as part of a care bundle in relation to the prevention of surgical site infections in patients undergoing elective colorectal surgery. Relevance to Clinical Practice: A multicomponent multidisciplinary complex intervention as part of a quality improvement project can successfully reduce the incidence rates of surgical site infections in patients who require elective colorectal surgery. Normalisation Process Theory provides guidance and support in implementing complex interventions for the prevention of surgical site infection. Patient or Public Contribution: Patients provided post‐discharge information on their wound healing as part of the surveillance component of the intervention. Five patients reviewed and provided feedback on a patient information booklet which was developed from this quality improvement intervention. A multidisciplinary steering group guided all stages of the project. [ABSTRACT FROM AUTHOR]

Aims: To assess the incidence density of local complications of peripheral venous catheters in patients aged 70 years and older, to identify risk factors for local complications of peripheral venous catheters, to describe microbiological epidemiology and to assess the impact of complications on patient outcomes. Design: Prospective, observational, single‐centre study. Methods: Patients 70 years and older admitted to the geriatric department of a teaching hospital in France between December 2019 and May 2020 were considered for inclusion if they had a peripheral venous catheter during their stay. Nurses checked the catheter insertion site three times a day for local complications; physicians ensured the follow‐up of complications. The STROBE checklist was used in this prospective observational study. Results: A total of 322 patients were included, with 849 peripheral venous catheters; the median age was 88 years and 182 (56.5%) were women. The incidence density of local complications was 50.5/1000 peripheral venous catheter‐days. Risk factors for local complications on multivariate analysis were dressing replacement (OR 1.18), furosemide (OR 1.11) and vancomycin (OR 1.60) infusion, urinary continence (OR 1.09) and hematoma at the catheter insertion site (OR 1.15). Thirteen cellulitis and three abscesses were diagnosed. Occurrence of a local complication was associated with a 3‐day increased duration of hospital stay (17 vs. 14 days). Conclusion: Risk factors for peripheral venous catheter local complications include urinary continence, furosemide or vancomycin infusion, hematoma at the peripheral venous catheter insertion site or dressing replacement. Implication for the Patient Care: Closer clinical monitoring may help reduce the occurrence of local peripheral venous catheters complication in patients 70 years and older. Relevance to Clinical Practice: Patients at greater risk of peripheral venous catheter local complications deserve closer clinical monitoring or improved preventive measures, which may be beneficial to reduce the length of hospital stay. No Patient or Public Contribution: The study was designed to describe risk factors for local complications of peripheral venous catheters in order to reinforce surveillance in this specific population by nurses and medical staffs. Patients had their peripheral venous catheter insertion site checked thrice a day by the nurse in charge as part of usual care. They, as service users, caregivers or members of the public, were not solicited for data collection, analysis, interpretation or preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Background: Falls are common adverse events in acute care hospitals, and about 25–50% of fallers suffer injuries. In acute care, fall rates range from 0.4–9 falls per 1000 patient days, varying among unit types, patient characteristics, and diseases. Several risk factors have been identified, including recent falls, age, reduced mobility, cognitive ability and polypharmacy. Several countries have become an aging society in which an increasing number of older patients need acute care. Therefore, the prevention of falls has become one of the most important aspects of patient safety. Aim and Design: This retrospective study aimed to explore adults' inpatient falls in a Finnish university hospital with several specialties. The objectives were to draw an overall picture of fall rates in Finnish acute care, and to model risk factors for falls including secondary diagnoses. Methods: The study was conducted in a large university hospital in Finland. The data consisted of patients' electronic health records from 2014–2016 and included a total of 114,951 adult patients. Univariable and multivariable binary logistic regression model analysis was used to identify risk factors for falls and multiple imputation was used to missing data. The study reporting followed the STROBE guidelines. Results: A total of 841 falls were recorded, totalling 1.5 falls per 1000 patient days, and the rate of falls with injury was 0.4 per 1000 patient days. The regression model included the following risk factors: increasing old age, prolonged hospital stays, specialty of neurology, mode of arrival (emergency care and hospital transfer), no operation during hospital stays and secondary diagnoses such as dementia, pneumonia and alcohol abuse. Conclusions: In acute care, falls occur most in patients with neurological diagnoses and least in surgical patients. Risk factors for falls include increasing age, emergency arrival, hospital transfer and prolonged hospital stay. Relevance to Clinical Practice: Educational interventions to improve healthcare professionals' competence and preventive interventions to avoid inpatient falls need to be prioritized in medical specialties with high fall rates. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship of the implementation of a nurse‐led high‐flow nasal cannula oxygen protocol on the clinical outcomes of infants with bronchiolitis in a regional paediatric unit. Background: Bronchiolitis is a common lower respiratory illness and is the leading cause for hospitalisation of infants globally. Standard care involves the provision of supportive measures. Historically, supplemental oxygen was provided by low‐flow nasal cannula. High‐flow nasal cannula oxygen has been increasingly adopted despite limited evidence of its efficacy. Methods: This study employed non‐equivalent, post‐implementation only design to explore clinical outcomes of infants with bronchiolitis admitted for high‐flow nasal cannula oxygen therapy. The study compared infants in the 24 months before and after the initiation of a high‐flow nasal cannula protocol. The primary clinical outcome was length of stay, secondary outcomes included time on high flow, weaning time, escalation of care and time outside of physiological parameters. Implementation strategy evaluation was measured by compliance with applying the protocol, reported as episodes of variance, and duration of variance. The StaRI checklist was selected as the most appropriate reporting guideline. Results: A total of 80 patients were admitted with bronchiolitis and received high‐flow nasal cannula oxygen therapy during a 48‐month period; 37 patients were prior, and 43 after, the introduction of a nurse‐led high‐flow nasal cannula protocol. Length of stay was significantly reduced in the post‐implementation group compared to the historical control group (83.8 vs. 61.3 h). Time on high flow and weaning time was decreased in the post‐implementation group compared to the control group (33.5 vs. 26.7 h and 26 vs.12.25 h, respectively); however, these did not reach statistical significance. There was varied application of the HFNC protocol. Conclusions: The implementation of a nurse‐led high‐flow nasal cannula protocol was associated with a reduced length of stay. Relevance to Clinical Practice: This study demonstrated that infants with bronchiolitis that were treated with a nurse‐led high‐flow nasal cannula (HFNC) therapy protocol had positive effects on clinical outcomes including a shorter length of stay than compared with those with physician‐directed care in a regional paediatric unit. A weight‐based (2 L/kg) HFNC therapy was safely administered to infants with bronchiolitis in a regional hospital paediatric ward with no paediatric intensive care unit (PICU). [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effects of effort‐reward imbalance (ERI) on emergency nurses' turnover intention and the role of depressive symptoms between ERI and turnover intention. Background: Turnover intention is crucial for clinical practice due to its relationship with turnover behaviour and destructive effect on stability of nursing staff. The ERI is a mainstream model to explain job stress, which seems to be one of the key variables, but the direct evidence is not adequate. In addition, there have been only a few studies looking into the complexity of the relationship between ERI and turnover intention, and more research is needed. Methods: This is a cross‐sectional study conducted from July to August 2018, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. We employed a standardised questionnaire to collect sociodemographic information and target turnover intention. Hierarchical multiple logistic regression and mediation analyses were performed for the data analyses. Results: This study included responses from 17,582 emergency nurses in China. On turnover intention, ERI exerted both direct effect and indirect mediating effect. The results also indicate that depressive symptoms partially mediated the effect of ERI on turnover intention, and that 27.4% of this effect can be explained by mediating effects. Conclusions: To improve the turnover intention, it is necessary to consider reducing ERI and depressive symptoms of emergency nurses as powerful measures not to be ignored. Relevance to Clinical Practice: This study provides important insights regarding how nursing administrators should better reduce the workload of caregivers and improve depressive symptoms to avoid turnover intention. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the levels of second COVID‐19 booster dose/new COVID‐19 vaccine hesitancy among nurses and explore the potential predictors of vaccine hesitancy. Background: COVID‐19 full vaccination seems to be highly effective against highly contagious variants of SARS‐CoV‐2. Healthcare workers are at high‐risk group since they have experienced high levels of COVID‐19‐associated morbidity and mortality. Design: An on‐line cross‐sectional study was carried out in Greece in May 2022, using a self‐administered questionnaire. Methods: The study population included nurses in healthcare services who were fully vaccinated against COVID‐19 at the time of study. We considered socio‐demographic characteristics, COVID‐19‐related variables, and attitudes toward COVID‐19 vaccination and pandemic as potential predictors of vaccine hesitancy. We applied the STROBE checklist in our study. Results: Among 795 nurses, 30.9% were hesitant toward a second booster dose or a new COVID‐19 vaccine. Independent predictors of hesitancy included lower educational level, absence of a chronic condition, good/very good self‐perceived physical health, lack of flu vaccination during 2021, front‐line nurses that provided healthcare to COVID‐19 patients, nurses that had not been diagnosed with COVID‐19 and nurses that had at least one relative/friend that has died from COVID‐19. Moreover, increased compliance with hygiene measures, increased fear of a second booster dose/new COVID‐19 vaccine and decreased trust in COVID‐19 vaccination were associated with increased hesitancy. Conclusions: Our study shows that a significant percentage of nurses are hesitant toward a second booster dose/new COVID‐19 vaccine. This initial hesitancy could be a barrier to efforts to control the COVID‐19 pandemic. Relevance to clinical practice: Nurses' role during the COVID‐19 pandemic is essential since they are the front‐line healthcare workers empowering the public with their passion and empathy. There is a need to communicate COVID‐19 vaccine science in a way that is accessible to nurses in order to decrease COVID‐19 vaccine hesitancy. Patient or public contribution: No patient or public contribution. [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]

Purpose: This cross‐sectional, descriptive, correlational study aimed to measure burnout, quality of life (QOL) and perceptions of patient‐related adverse events among paediatric nurses amid the COVID‐19 pandemic and assess the relationships between these scores and participants' demographic and work‐related characteristics. Background: The mental health of most nurses may severely suffer due to the significant adversities that they struggle with while they care for their patients amid the COVID‐19 pandemic. Mental distress negatively affects nurses' relationships and work performance, which may adversely influence the quality of care and patient safety. Methods: A convenient sample of 225 Jordanian paediatric nurses completed a test batter comprising the Copenhagen Burnout Inventory, the Brief Version of the World Health Organisation's Quality of Life questionnaire and the nurse‐perceived patient adverse events' questionnaire. This study was prepared and is reported according to the STROBE checklist. Results: Paediatric nurses reported high levels of burnout, low QOL and high occurrence of hospital‐acquired infections. Participants' age and hospital/unit capacity were significantly associated with burnout and QOL. Conclusion: Personal traits, perceived salary insufficiency and hospital/unit capacity represent factors that aggravate burnout, lower quality of life and worsen perceived patient safety among paediatric nurses. Relevance to clinical practice: Policymakers should promote nurses' mental integrity and patient safety by addressing issues of workload and financial sufficiency and by provide interventions aimed to increase nurses' resilience. Patient or public contribution: Patients or public were not involved in setting the research question, the outcome measures, the design or implementation of the study. However, paediatric nurses responded to the research questionnaires. [ABSTRACT FROM AUTHOR]