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Aims and Objectives: To explore organisation‐wide experiences of person‐centred care and risk assessment practices using existing healthcare organisation documentation. Background: There is increasing emphasis on multidimensional risk assessments during hospital admission. However, little is known about how nurses use multidimensional assessment documentation in clinical practice to address preventable harms and optimise person‐centred care. Design: A qualitative descriptive study reported according to COREQ. Methods: Metropolitan tertiary hospital and rehabilitation hospital servicing a population of 550,000. A sample of 111 participants (12 patients, 4 family members/carers, 94 nurses and 1 allied health professional) from a range of wards/clinical locations. Semi‐structured interviews and focus groups were conducted at two time points. The audio recording was transcribed, and an inductive thematic analysis was used to provide insight from multiple perspectives. Results: Three main themes emerged: (1) 'What works well in practice' included: efficiency in the structure of the documentation; the Introduction, Situation, Background Assessment, Recommendation (ISBAR) framework and prompting for clinical decision‐making were valued by nurses; and direct patient care is always prioritised. (2) 'What does not work well in practice': obtaining the patient's signature on daily care plans; multidisciplinary (MDT) involvement; duplication of paperwork and person‐centred goals are not well‐captured in care plan documentation. (3) 'Experience of care'; satisfaction of person‐centred care; communication in the MDT was important, but sometimes insufficient; patients had variable involvement in their daily care plan; and inadequate integration of care between MDT team which negatively impacted patients. Conclusions: Efficient and streamlined documentation systems should herald feedback from nurses to address their clinical workflow needs and can support, and capture, their decision‐making that enables partnership with patients to improve the individualisation of care provision. Relevance to clinical practice: The integration of effective MDT involvement in clinical documentation was problematic and resulted in unmet supportive care from the patient's perspective. [ABSTRACT FROM AUTHOR]

Aim and objectives. This education-focused paper presents a discussion of possible data sources used in patient safety issues specific to fall reduction in hospital inpatient care settings. Background. Although hospitals and clinicians in the USA have been implored to improve care and reduce events that harm patients (falls), studies to date have failed to clearly address the facility system-level factors for falls. Making meaningful approaches to modify risk factors is clearly overdue. Design. Discursive paper. Method. Possible data sources for answering patient fall-related research questions in hospital settings are categorised as: (1) archived hospital data, (2) surveys of patients/families/clinicians, (3) interviews and focus groups of patients/families/clinicians, (4) publicly available data sets and (5) published legal cases. The complexities of research in fall prevention are illustrated using the conceptual models. Examples were included to illustrate the use of these data sources. Discussion. Data-related issues include: (1) unit of analysis, (2) computer data processing capabilities, (3) merging data sets from different sources and (4) data abstraction, aggregation and data analytic techniques. Conclusions. The trend to use multiple data sources to answer research questions is gradually emerging. To demonstrate effective fall prevention efforts across hospitals, publicly available data sets can be reliable sources for analyses to inform policymakers about meaningful fall prevention programmes that result in positive outcomes. Relevance to clinical practice. Challenges to develop and evaluate any interventions to eliminate risk factors for falls often relate to selecting feasible interventions and whether staff members accept the interventions and adhere to adopting the intervention. Using multiple data sources with time factors to cross-validate the sufficiency of nurses' knowledge with their practice patterns may be more productive. This need further supports the importance of this paper about possible data sources used in the research on patient safety specific to fall reduction for adults in hospital inpatient care settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: To review and synthesise research studies on surgical and medical inpatients' perceptions on unmet nursing care needs. Background: Missed nursing care is a growing phenomenon that has been shown to adversely affect care outcomes—mainly in adult medical and surgical care settings. However, to date the aggregated and synthesised evidence of missed care comes from research that measures perceptions on missed care in surgical and medical settings from nurses, but not from the patients. Design: Scoping review. Methods: In September 2018, three databases were searched: MEDLINE/PubMed, CINAHL and SCOPUS and papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Inclusion criteria were as follows: primary studies; published in peer‐reviewed journals; in English or Italian; and regarding routine care provided to adult inpatients. Quality appraisal and a thematic analysis were conducted. Results: Of the 1541 abstracts initially identified, 44 papers were included. Five themes emerged: "communication," "self‐management, autonomy and education," "personal sphere," "essential physical care" and "emotional and psychological care." The majority of the unmet needs were related to the "personal sphere" and "emotional and psychological care." These unmet needs were not identified in previous literature on nurses' perspectives of missed care. Also, physical care deficits like oral hygiene were identified. Conclusion: It is important to take into account patients' perspectives. The themes focusing on patients' personal sphere, and emotional and psychological care, underline how patients need nurses to pay more attention to their cultural background, consider the person as a whole and for nursing care to be holistic and respectful of patients' dignity. Relevance to Clinical Practice: This study intends to raise awareness amongst nurses and policymakers about the importance of addressing missed nursing care and unmet patients' needs in adult medical or surgical inpatient settings to ensure high‐quality care and patient satisfaction. [ABSTRACT FROM AUTHOR]

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

Aim: To explore the experiences of women who have had ovarian hyperstimulation syndrome, and healthcare professionals who care for them. Background: Ovarian hyperstimulation syndrome is a side effect of fertility treatment. Little research exists internationally that explores the experiences of women who have had this condition, or the healthcare professionals who manage it. Design: Qualitative study using semi‐structured interviews. Methods: Eighteen interviews with women who had experienced ovarian hyperstimulation syndrome (n = 10) and healthcare professionals (n = 8) in six UK fertility centres. Framework analysis was used. This paper is reported following COREQ guidelines. Results: Women described a range of symptoms and severity, sometimes experiencing worrying physical health problems such as abdominal swelling and shortness of breath. The combination of the symptoms, and their management, on delaying future fertility treatment could cause emotional distress. Healthcare professionals at different centres described variation in practice, which generally involved 'active monitoring' until symptoms became severe, when women would be hospitalised. Women expressed feeling 'left in limbo' while waiting for symptoms to improve or worsen, and described a lack of control during this waiting period. Healthcare professionals felt they provided adequate information about ovarian hyperstimulation syndrome and its management. This, however, did not align with women's perceptions that information, including potential delays to their fertility treatment, was missing. There was similar mismatch between women's and healthcare professionals' views of decision‐making about fertility treatment following ovarian hyperstimulation syndrome, including women's concerns about having to make rushed, unplanned decisions about their fertility treatment when they did not feel adequately informed to do so. Conclusion: Ovarian hyperstimulation syndrome and its management can have a significant physical and emotional impact on women, and influence their fertility treatment. Improvements could be made to the information women receive about this condition, its management and its implications for wider fertility treatment. Implications for the profession and/or patient care: Nurses have the skills and knowledge to support women through the physical and emotional stresses of fertility treatment. Therefore, they are well placed to provide specialist information and support for OHSS and ensure women are fully informed about all aspects of the condition, including how its management might delay fertility treatment. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the effectiveness of specialist nurse interventions in the care of women with breast cancer. Background: Nurses perform a crucial role in physical and psychosocial support of women with breast cancer. However, only few reviews have explored and discussed the roles and interventions carried out by specialised nurses in breast cancer care. Design: Systematic review based on PRISMA guidelines. Methods: A comprehensive literature search was conducted in PubMed, CINAHL, Scopus, Web of Science, Science Direct, Cochrane Library, IndMed and Shodhganga databases for articles published in English language from 1980 to 2018. Only RCTs were included. Quality assessment, data extraction and analysis were completed on all included studies. Results: Sixteen papers were assessed for methodological quality. Due to methodological heterogeneity of the papers, a meta‐analysis was not performed. The reviewers categorised the main outcomes under different domains like physical problems, psychological problems, patient satisfaction, patient needs, quality of life and cost data. Discussion: This review provides evidence on specialist nurses' role in breast cancer care. The methodological aspects of studies in this review vary in different aspects. More studies with rigorous scientific methods are needed to provide robust evidence on effectiveness of specialist nurses' role. Conclusion: Even though specialist nursing interventions can contribute to health outcomes of women with breast cancer, there is limited number of studies reported from developing countries. This warrants the need for specialist nurse interventions in breast cancer care from developing countries. Relevance to clinical practice: Offering a specialist nurse service helps the patients to meet their informational and educational needs, supportive care and coordination of care. Specialist breast nurse services can be integrated into hospital setting to improve patient care and treatment adherence. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study intended to contribute to the improvement of nursing care for both children and their parents and aimed to identify the best and worst experiences of school‐aged children during hospitalisation. Background: Child hospitalisation has traditionally been studied from the parent's perspective, but studies in which the child is the subject are scarce and mainly focus on to the hospitalisation experiences. Design: A cross‐sectional, observational and descriptive exploratory design was used, and STROBE reporting guidelines were followed. Methods: A paper survey was applied by the primary researcher within a 3 months period to 252 children. It presented two open‐ended statements: 'In my opinion the best thing about the hospital is ...' and 'In my opinion the worst thing about the hospital is...'. The study was submitted and approved by the national data protection commission and also by the ethics committees of each of the six institutions where the study was undertaken. Informed consent was also obtained from children and parents. Results: Answers were analysed through content analysis. Five categories were identified for each of the open‐ended statements. Children identified 'people', 'physical environment', 'activities', 'outcomes' and 'food' as best experiences. The worst experiences included: 'feelings', 'activities', 'food', 'environment' and 'outcomes'. Conclusions: The results allowed the identification of the children's most valued aspects of hospitalisation. Relevance to Clinical Practice: The results should be considered by healthcare professionals in order to make the hospitalisation experience more positive from the perspective of the school‐aged children. [ABSTRACT FROM AUTHOR]

Aims and objectives This systematic review provides an overview of the literature published on Releasing Time to Care: The Productive Ward between 2005 and June 2011. Background Releasing Time to Care: The Productive Ward programme was developed by the NHS Institute for Innovation and Improvement and launched in England in 2007. The programme comprises thirteen modules that aim to increase time for direct patient care, improve the patient and staff experience and make changes to the ward environment to improve efficiency. Design A systematic literature review. Methods The terms ' Releasing Time to Care' and ' Productive Ward' were applied to key healthcare databases; CINAHL, Medline, Science Direct, Pro Quest, Health Business Elite, British Nursing Index, Embase, Health Management Information Consortium and PsychInfo. All papers were read and subject to a quality assessment. Results The literature search identified 95 unique sources. A lack of research on The Productive Ward programme meant it was necessary to include non-empirical literature. In total, 18 articles met the inclusion criteria. Seven key themes were identified: the patient and staff experience, direct care time, patient safety, financial impact, embedding and sustainability, executive support and leadership, and common barriers and determinants of success. It also highlighted areas that require further exploration such as long-term sustainability of the programme and consistent data measurement between organisations. Conclusion The review tentatively reports how The Productive Ward programme has been used to transform nursing practice for the benefit of patients and frontline staff, and how it resulted in cost savings. The literature review identified a potential positive results bias in the current literature whereby favourable outcomes were reported. Relevance to clinical practice This paper summarises the types of evidence and current literature on The Productive Ward providing a reference for frontline staff implementing the programme. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine missed care within two patient safety public inquiries using a socio‐ecological model. Background: Missed care is a care which has been omitted or rendered incomplete. Possible outcomes of missed care have been identified including poor patient outcomes such as higher mortality rates, reduced care quality and lower patient satisfaction, job dissatisfaction, staff burnout and higher attrition rates. Design: A qualitative design, specifically document analysis, was used to review two serious case reviews. Methods: Between August–December 2018, two public patient safety inquiries were examined using a document analysis method. Both inquiries are based in acute hospital care settings of nursing (UK) and midwifery (Ireland). The Standards for Reporting Qualitative Research checklist provided a framework to report the study methods, context, findings, analysis and interpretation. Results: Findings highlighted instances of missed care related to practice which contributed to poor patient outcomes. Missed care was located within contingency factors, such as unintended negative patient health and safety outcomes in multiple system levels which resulted in care deficits. Conclusions: A socio‐ecological model enabled consideration of how multi‐system deficits combine to impact nursing and midwifery care delivery. To tackle current and future practice challenges, broader contextual issues that influence front‐line cases should be identified and addressed before they create conditions which result in substandard care. Relevance to clinical practice: This paper adds to the scholarship on missed care by incorporating a greater contextual lens. Findings suggest that some factors contributing to missed care events may be systemic in origin. Practice, policy, research and education should foster nurses' and midwives' review of the totality of influencing factors impacting missed care and care deficits. Consequently, early warning signs and proactive responses at a system level should be inherent in all settings that nurses' and midwives' practice. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to determine the relationship between perceptions of nursing presence and intensive care experiences in adult intensive care unit patients'. Background: Intensive care units (ICUs) are settings where patients have many negative emotions and experiences, which affect both treatment and post‐discharge outcomes. The holistic presence of nurses may help patients turn their negative emotions and experiences into positive ones. Design: A descriptive‐correlational design was used and reported according to the STROBE checklist. Methods: The sample consisted of 182 participants. Data were collected using a personal information form, the Glasgow Coma Scale (GCS), the Intensive Care Experience Scale (ICES), and the Presence of Nursing Scale (PONS). Results: A strong positive correlation existed between total ICES and PONS scores (r = 0.889, p < 0.001). There was a strong positive correlation between PONS total score and ICES subscales (awareness of surroundings (r = 0.751, p < 0.001), frightening experiences (r = 0.770, p < 0.001), recall of experience (r = 0.774, p < 0.001), and satisfaction with care (r = 0.746, p < 0.001)). Males (β = −0.139, p < 0.05), and patients who were university and higher education graduate (β = 0.137, p < 0.05) had higher positive ICU experiences. It was also found length of ICU stay was correlated with ICU experiences and nursing presence. Conclusions: The more positively the patients perceive nurses, the better ICU experiences they have. Gender and education level were found determinants of adult ICU patients' experiences. ICU length of stay predicted what kind of experience patients have and how much they feel the presence of nurses. Relevance to Clinical Practice: Nurses should make their presence felt completely and holistically by using their communication skills for patients have more positive intensive care experiences. Nurses should consider variables which affects patients' ICU experiences and nursing presence. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the quantitative and qualitative literature on the impact of nurse‐led postdischarge telephone follow‐up (TFU) call interventions on patient outcomes. Background: Adverse patient outcomes such as postdischarge problems, premature contact with health systems, inability to self‐manage conditions and hospital readmissions all have an impact on the health and well‐being, and satisfaction of patients as well as a financial impact on healthcare systems. Design: A mixed‐study systematic review. Review methods: A systematic search of CINAHL, Ebsco, PubMed, Quest and Cinch‐Health databases was undertaken using the key terms "nurs*," "nurse‐led," "nurse initiated," "discharge," "hospital," "telephone," "follow‐up" and "telephone follow‐up" to identify relevant original peer‐reviewed studies published between 2010–2016. Ten articles were selected for inclusion. The selected papers were critically appraised. A sequential explanatory approach with a convergent synthesis was used to report findings following PRISMA guidelines. Results: The findings demonstrate that nurse‐led TFU interventions have the potential to improve patient outcomes. The studies suggest patient satisfaction with TFU is one of the strongest positive outcomes from the interventions. However, the results do not support improvement in patient readmission or mortality. Conclusions: Of the 10 studies reviewed, only two were methodologically strong limiting the conclusions that can be drawn from the current research on this topic. Telephone follow‐up interventions improve patient satisfaction and have the potential to meet patient information and communication needs, improve self‐management and follow‐up appointment attendance and reduce postdischarge problems. Further research is required to explore patients' perceptions of the most useful content of TFU calls, the efficacy of TFU calls and nurses' perceptions and experiences of conducting TFU interventions. Relevance to clinical practice: When conducted by a nurse, these interventions have the potential to enhance postdischarge care to patients and meet care needs. Patients perceive TFU as acceptable and are satisfied with this form of postdischarge care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate patients' satisfaction with care, 2 years after the introduction of person‐centred handover (PCH) in an oncological inpatient setting, and to describe patients' perceptions of individualised care. Background: To obtain higher levels of patient satisfaction, bedside nursing handovers have been evaluated with positive results. One such model is PCH, which blends aspects of person‐centred care with the bedside report and provides the opportunity for nursing staff and patients to perform the handover together. Design: A survey‐based design was used with one data collection period. Patient satisfaction scores were compared with baseline data from a previous study that has been conducted in the same wards. Method: Patient satisfaction was measured with the EORTC IN‐PATSAT32 questionnaire, and individualised care was assessed with the Individualized Care Scale. A total of 120 adult patients with cancer were invited to participate from August 2017–March 2018. Of these, 90 chose to participate. The STROBE checklist for cross‐sectional studies was used when preparing the paper. Results: Compared to the previous study, statistically significant improvements in patient satisfaction were observed in the subscales "Exchange of information between caregivers" and "Nurses' information provision" postimplementation of PCH. Regarding patients' perceptions of individualised care, the highest scores were in the ICS‐A subscale "Clinical situation" and ICS‐B "Decisional control," while "Personal life situation" scored the lowest overall. Conclusions: Person‐centred handover seems to have sustainable positive effects on important outcomes regarding patient satisfaction. A novel finding is the positive impact on nurses' information provision, indicating that PCH can facilitate effective information exchange between patients and nurses. Relevance to clinical practice: Person‐centred handover seems to improve patients' satisfaction with nurses' provision and exchange of information. Nurses and managers should carefully consider the implementation process of PCH and evaluate its long‐term effects. PCH can be recommended in the oncology inpatient setting. [ABSTRACT FROM AUTHOR]

Aims and objectives To test eight person-centred key performance indicators and the feasibility of an appropriate measurement framework as an approach to evidencing the patient experience. Background The value of measuring the quality of patient care is undisputed in the international literature, however, the type of measures that can be used to generate data that is meaningful for practice continues to be debated. This paper offers a different perspective to the 'measurement' of the nursing and midwifery contribution to the patient experience. Design Fourth generation evaluation was the methodological approach used to evaluate the implementation of the key performance indicators and measurement framework across three participating organisations involving nine practice settings. Methods Data were collected by repeated use of claims, concerns and issues with staff working across nine participating sites ( n = 18) and the senior executives from the three partner organisations ( n = 12). Data were collected during the facilitated sessions with stakeholders and analysed in conjunction with the data generated from the measurement framework. Results The data reveal the inherent value placed on the evidence generated from the implementation of the key performance indicators as reflected in the following themes: measuring what matters; evidencing the patient experience; engaging staff; a focus for improving practice; and articulating and demonstrating the positive contribution of nursing and midwifery. Conclusions The implementation of the key performance indicators and the measurement framework has been effective in generating evidence that demonstrates the patient experience. The nature of the data generated not only privileges the patient voice but also offers feedback to nurses and midwives that can inform the development of person-centred cultures. Relevance to clinical practice The use of these indicators will produce evidence of patient experience that can be used by nurse and midwives to celebrate and further inform person-centred practice. [ABSTRACT FROM AUTHOR]

Aim: The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors. Background: Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke. Design: A scoping review. Methods: Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. Data Sources: A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net‐work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023. Results: Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full‐text screening. Full‐text screening yielded 49 articles that met inclusion criteria. Conclusion: This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home. Implications for the Profession and/or Patient Care: This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them. Reporting Method: PRISMA checklist for scoping reviews. Patient and Public Contribution: No patient or public contribution was part of this study. [ABSTRACT FROM AUTHOR]

Aims: To define nurse‐led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes. Background: Nurse‐led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse‐led clinic implementation and their impact on patient health care. Design: Scoping review using narrative synthesis. Methods: PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse‐led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA‐ScR) checklist. Results: Among the 36 identified studies, key principles of what constitutes nurse‐led clinics were articulated providing a robust definition. Nurse‐led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse‐led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations. Conclusion: The review highlights several fundamental elements are central to nurse‐led clinic success and are highly recommended when developing interventional nurse‐led strategies. Nurse‐led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse‐led care and the clinics in which they operate is provided. Relevance to Clinical Practice: The comprehensive definition, clear mediators of success and the health impact of nurse‐led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

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

Aims and objectives. This paper describes further testing of the instrument Patient Evaluation of Emotional Care during Hospitalisation. Background. In 2005, a questionnaire was developed that could be completed by patients to evaluate the quality of emotional care received during their time in hospital. This questionnaire was tested at an acute care private hospital in Perth, Western Australia, with encouraging estimates of reliability and validity. The purpose of this study was to further test this questionnaire in a larger sample of inpatients at a public hospital in the same state. Design. Psychometric evaluation. Method. A hospital-wide survey of 13 wards of a public hospital was conducted. Two hundred and fifty-one patients completed the questionnaire. Results. Psychometric testing of the Patient Evaluation of Emotional Care during Hospitalisation demonstrated acceptable internal consistency reliability. Confirmatory factor analysis substantiated the four sub-scales as follows: Level of Security, Level of Knowing, Level of Personal Value and Level of Connection. The Level of Connection sub-scale was assessed for the first time in this study. This sub-scale had the lowest mean score of all the sub-scales across the hospital as well as in each of the wards surveyed. Qualitative data substantiated, from the patients' perspective, a lack of connection with hospital staff. Conclusions. Further psychometric testing of the Patient Evaluation of Emotional Care during Hospitalisation instrument has confirmed its psychometric properties and usefulness as an instrument to measure emotional care during hospitalisation. Relevance to clinical practice. The Patient Evaluation of Emotional Care during Hospitalisation is a reliable and valid tool with which the emotional care of patients in hospital can be measured and the effectiveness of interventions assessed. [ABSTRACT FROM AUTHOR]

The aim was to review available literature on research and service evaluation evidence of nurse-led case management services targeting older people with multiple chronic conditions in their own homes. This was anticipated to highlight important issues for nursing practice, healthcare policy, service provision and health service research. Enhanced roles for nurses have developed in response to demands for increased efficiency in the provision of healthcare especially in the area of chronic disease management. It is apparent that the evidence to support nurses providing a case management approach for patients with multimorbid chronic conditions in their home environment is ambiguous. A systematic review of the literature. The review was carried out across multiple sources including search and alert engines, electronic databases, relevant journal websites and grey literature. The inclusion criteria applied concentrated on articles in the English language, case management intervention involving nurses providing care in the patients' own home and older people (aged over 65 years) with multiple chronic illnesses. Of a total of 568 papers identified, eight were of relevance and included in the review. The qualitative data derived from this systematic review suggests that access to case management services had a positive impact on the patient, the carer and the healthcare staff particularly the General Practitioner. In contrast the more robust quantitative data does not demonstrate a significant impact on emergency admissions, bed days, nor costs. Further research is needed to understand how case management can most effectively improve service effectiveness for patients and their carers and reduce cost of care. A new emphasis on comparative effectiveness research is required which has the potential to reshape the whole system of healthcare provision for patients with complex needs. [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: The purpose of this study was to assess the safety, feasibility and effectiveness of a nurse‐led glaucoma assessment clinic service. Background: Glaucoma is a group of serious, irreversible optic neuropathies that progressively damage the optic nerve resulting in blindness. Over 64.3 million people globally are affected by glaucoma with numbers projected to increase to 111.8 million by 2040. Glaucoma is a major public health concern that requires the development of innovative models of care to meet current and future health care demands. Methods/Design: A mixed method design was used to evaluate the assessment of non‐complex glaucoma patients attending a new nurse‐led clinic. Under an ophthalmologist's supervision, the glaucoma nurse completed 100 hof clinical training and assessment to ensure they were competent in completing and interpreting the required glaucoma assessment protocols. Interrater reliability between the glaucoma nurse and ophthalmology doctor was undertaken. Glaucoma patient waitlist appointment data were also compared before and after the introduction of the nurse‐led clinics. This study adhered to the SQUIRE checklist for the reporting of excellence with quality improvement projects. Patient Contribution: Patients contributed to the evaluation of this new nurse‐led service by providing follow‐up feedback on their experience. Results: Agreement between clinicians for appropriate follow‐up appointment times was high with 93% (n = 315) agreement achieved. Furthermore in 297 (87.5%) cases, both clinicians agreed on the patient being referred to the doctor for follow‐up review. Glaucoma consultations were shown to increase from 3,115 appointments in 2019/20 to 3,504 appointments in 2020/21 after the introduction of the nurse‐led clinic. The nurse‐led clinics accounted for 14.5% (n = 512) of clinic appointments. Conclusions: The introduction of the nurse‐led glaucoma assessment clinic service allowed patients to be reviewed safely, efficiently and satisfactorily. This new service subsequently allowed for more complex glaucoma patients to be seen by the ophthalmologists. Relevance to clinical practice: Findings revealed that suitably trained glaucoma nurses are able to clinically assess and safely monitor stable non‐complex glaucoma patients. Highlights the need for appropriate investment in clinical training and supervision to ensure that glaucoma assessment nurses are adequately prepared to undertake this new practice role. [ABSTRACT FROM AUTHOR]

Aim and Objectives: This study aimed to identify the associations between longitudinal trajectories of self‐care behaviours and unplanned hospital readmissions in patients with heart failure. Background: Adherence to self‐care behaviours is crucial to prevent hospital readmissions; however, self‐care behaviours remain unsatisfactory among patients with heart failure. Studies of long‐term trajectories of self‐care behaviours and their influence on hospital readmissions are limited in this population. Design: A prospective, longitudinal observational study. Methods: Among 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1‐year follow‐up data to determine the association between 1‐year trajectories of self‐care behaviours and hospital readmissions using Kaplan–Meier analysis and multivariable Cox regression, adjusted for confounding variables. Results: Self‐care behaviour trajectories of heart failure patients were classified as 'high‐stable' (58.4%) or 'low‐sustained' (41.6%). The cumulative rate of readmissions for the low‐sustained class was higher than that of the high‐stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self‐care behaviours trajectories. The low‐sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high‐stable class. Conclusions: Longitudinal self‐care behaviours pattern trajectories of heart failure patients were stratified as high‐stable and low‐sustained. Routine follow‐up assessment of patients' self‐care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions. Relevance to clinical practice: Identification of trajectory patterns of self‐care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self‐care behavioural patterns in heart failure patients. Reporting Method: The study has been reported in accordance with the STROBE checklist (Appendix S1). Patient or Public Contribution: Patients have completed a self‐reported questionnaire after providing informed consent. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To analyse research‐based evidence about patients' right to know from their own perspective to promote ethically high‐quality nursing and to identify future research areas. Background: Patients' right to know is a fundamental right. Although of topical research interest, the current state of scientific evidence on patients' right to know has not been reviewed. Design: A scoping review according to the methodological framework by Arksey & O'Malley and the Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews. Methods: In June 2022, a literature search was conducted in the Ovid Medline, CINAHL and Cochrane Library databases. The inclusion criteria were peer‐reviewed, empirical studies on the right to know with samples comprising adult patients. Data were analysed with inductive content analysis, and methodological quality was assessed with Mixed Methods Appraisal Tool. Results: Out of 2658 identified reports, 12 were selected for analysis. Based on the results, the research on patients' right to know can be classified into two main content categories: (1) expectations of the right and (2) realisation of the right. In the quality assessment, most of the reports did not meet all the quality criteria, the most common deficits being related to instrumentation and risk of bias. Conclusions: Research‐based evidence on patients' right to know provided a general insight into expectations and realisation of the right to know and not to know. The results indicate a need for continued efforts for novel approaches with high‐quality methodological choices in future studies. Relevance to Clinical Practice: Nurses make constantly ethical decisions: The findings of this study can be useful for their decision‐making and understanding of the patient's perspective on knowledge issues, and therefore, support ethically high‐quality patient education. Patient or Public Contribution: No direct patient or public contribution to the review. [ABSTRACT FROM AUTHOR]

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

Background: Healthcare provision remains challenging leading to a focus on health service redesign including the development of nurse‐led clinics. While there is a belief that nurse‐led services positively impact on healthcare delivery, it is necessary to inform development through examination of the evidence. Methods: A search was conducted of Cumulative Index of Nursing and Allied Health Literature, MEDLINE, EMBASE, Scopus and the Cochrane Library for systematic reviews evaluating the effectiveness of nurse‐led clinics when compared with usual care published between 2015 and 2020. Outcomes of interest were clinical outcomes, patient satisfaction and patient access to health care. Study quality was appraised using the AMSTAR 2 tool (A MeaSurement tool to Assess Systematic Reviews). A narrative analysis was conducted. Results: From 681 identified studies, nine were included, with reporting quality rated from very low to high quality. Patient clinical outcomes were reported as equal to or better than usual care across all studies included. There was evidence of high levels of patient satisfaction with nurse‐led clinics across the included systematic reviews. While access to health care was the least reported variable, there were reports that access to health care increased or patient reliance on other healthcare providers reduced due to nurse‐led clinics. Conclusions: Despite the heterogeneous nature of the systematic reviews, along with some quality issues in reporting, there was evidence that nurse‐led services provided comparable or superior care to usual care with high levels of patient satisfaction. There was a lack of reporting on the impact of nurse‐led clinics on patient access to health care; further research is required on this area. Health service managers should consider nurse‐led clinics an effective innovation in health service provision. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate socioeconomic, behavioural and healthcare delivery factors that are associated with health outcomes of cancer patients during the COVID‐19 pandemic, especially among underserved cancer patients. Background: Cancer patients are at a higher risk of adverse physical and mental health outcomes during the pandemic than those without cancer. Design: Cross‐sectional online survey. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines in this study. Methods: The sample comprised 322 individuals diagnosed with incident cancer between January 2019 and January 2020. Demographically, 64% were female, 49% had a college degree, 12% were African American, and 88% were White (77% of the Whites were from metropolitan and 23% from nonmetropolitan areas). Descriptive analysis and multivariable regression analyses of global health status, depression and irritability were performed. Results: After adjusting for demographic variables and comorbidity, the feelings of loneliness, crowded living space, lower confidence in taking preventive measures and less satisfaction with telehealth visits were significantly associated with poorer global health, depression and irritability. Daily exercise was associated with better global health, and difficulty in getting medicine was associated with depression and irritability. Moreover, African Americans who felt lonely reported more depression and irritability and those who had less confidence in taking preventive measures reported more irritability than Whites. Respondents having low income and feeling lonely reported more depression than others. Conclusions: In this study, socioeconomic factors (e.g. loneliness or crowded living conditions) were as important to health outcomes during the pandemic as behavioural (e.g. prevention and exercises) and quality‐of‐care factors (e.g. telehealth, access to medicine). Disparity was more pronounced in the mental health of African Americans and those with low incomes. Relevance to clinical practice: Healthcare providers should promote social support and physical activity for improving health and reducing mental health disparities among cancer patients. [ABSTRACT FROM AUTHOR]

Aim: To design and implement a plan to improve oncohaematological patients' sleep. Background: The hospital environment can compromise inpatients' sleep, negatively impacting on health outcomes and patient satisfaction. Design and Method: The improvement plan was designed in collaboration with 18 professionals, 3 patients and 3 accompanying relatives. The study designed followed the SQUIRE 2.0 guidelines. Outcome variables were self‐reported patient satisfaction regarding sleep, measured using a 30‐item, ad hoc questionnaire and a 10‐point visual analogue scale, completed by 318 oncohaematological inpatients (pre‐intervention n = 120, post‐intervention, n = 198) in a comprehensive cancer centre in Spain from 2017 to 2019. Results: Overall, 61.5% (n = 190) of the inpatients reported sleep alterations, and 92.6% reported interruptions in their nightly sleep. Half slept less than 6 h/night, but 58.0% said they felt rested upon waking, despite the interruptions. These outcomes were similar before and after the intervention. The improvement plan identified four domains for work (professionals, care procedures, instruments/environment and patients/relatives), 10 areas for improvement and 35 actions for implementation. However, overall sleep worsened significantly, from 6.73 to 6.06 on the 10‐point scale. The intervention significantly improved variables related to professionals' behaviour, including noise during the shift change, conversations at the control desk and the use of corridor lights. Sleep disturbances were mainly caused by pain/discomfort and infuser alarms, and collectively they decreased significantly after the intervention (p =.008). However, overall sleep worsened significantly, from 6.73 to 6.06 on the 10‐point scale. Conclusions: Pain, clinical devices and noise made by professionals are the main causes of sleep disturbances. Involving professionals in decision‐making to improve patients' sleep have a positive impact on noise levels. Relevance to clinical practice: This study proposes new strategies for improving sleep by increasing staff awareness and changing attitudes towards patients' sleep. Nurses should be involved in addressing sleep disturbances during hospitalization. [ABSTRACT FROM AUTHOR]

Aim and objective: To summarize the evidence on the effects of different techniques during the second stage of labour on reducing perineal laceration depending on available systematic reviews to provide optimal evidence for decision‐making. Background: Preventing perineal laceration has been considered an important part of improving women's health. Various techniques have been used to prevent perineal laceration during the second stage of labour. However, systematic reviews evaluating the effects of different techniques on reducing perineal laceration show inconsistent results. Design: Overview of systematic reviews. Methods: Five English and four Chinese databases were systematically searched for relevant systematic reviews and meta‐analyses published between 1 January 2016 and 31 August 2021. The quality of the included reviews was assessed by the AMSTAR 2 tool. A narrative synthesis was conducted to report the results of moderate‐to‐high quality systematic reviews. The overview was reported according to the PRISMA statement. Results: Eighteen reviews were included, of which four reviews had moderate‐to‐high methodological quality. Perineal massage and warm compresses significantly decreased the incidence of third‐ or fourth‐degree perineal laceration (moderate‐quality evidence). Hands‐off technique had no impact on perineal laceration (low‐to‐moderate quality evidence). Ritgen's manoeuvre could reduce the incidence of first‐degree perineal laceration but increase the incidence of second‐degree perineal laceration (very low‐quality evidence). Spontaneous pushing (low‐quality evidence) and delayed pushing (moderate‐quality evidence) had no impact on the incidence of third‐ or fourth‐degree perineal laceration. Upright positions did not increase the risk of third‐ or fourth‐degree perineal laceration (very low‐ to low‐quality evidence) but increased the risk of second‐degree perineal laceration for women without epidural analgesia (low‐quality evidence). Conclusions: Perineal massage and warm compresses could be the better choice for preventing perineal laceration in the second stage of labour. Relevance to clinical practice: Midwives and obstetricians could use perineal massage and warm compresses to prevent perineal laceration and should consider women's preferences and experience with perineal techniques. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to assess the impact of 24/7 trauma nurse practitioner service model on the emergency department patient flow. Background: Seamless transition of trauma patients through the emergency department to inpatient hospital care is crucial for coordination of care, clinical safety and positive health outcomes. A level 1 trauma centre located in Southern West Virginia, USA expanded their trauma nurse practitioner service covering the emergency department 24/7. Design: Retrospective cohort study conducted in accordance with the Strengthening the Reporting of Observational studies in Epidemiology guidelines. Methods: Patients admitted to the trauma centre between March 2019 and February 2020 were divided into two groups: trauma patients managed by trauma nurse practitioners versus the hospitalist service. The hospital service group was chosen as the comparator group because any admission prior to night coverage by the trauma nurse practitioners were managed by the hospitalist service. Results: The emergency department length of stay was significantly lower in trauma nurse practitioners' patients by an average of 300 min (772.25 ± 831.91 vs. 471.44 ± 336.65, p = <.001). Similarly, time to place emergency department discharge order was shorter by 49 min (277.76 ± 159.69 vs. 228.27 ± 116.04, p =.001) for this group. Moreover, trauma nurse practitioners on an average placed one less consultation (1.06 ± 0.23 vs. 1.46 ± 0.74, p <.001). Conclusion: The patient care provided by trauma nurse practitioners aided in the reduction of strain felt by their emergency department. They were able to help facilitate patient flow thus lessening the pressure of boarding in an overcrowded emergency department. The study institution hopes to sustain the current service model and continue to review outcomes and processes managed by trauma nurse practitioners to ensure consistency and quality. Relevance to Clinical Practice: Similar trauma centres should evaluate the structure of their trauma service that includes the role of trauma nurse practitioner service and work towards allowing them to manage patient care from the emergency department 24/7. [ABSTRACT FROM AUTHOR]

Aim and objectives: To examine the implementation (reach, dose, fidelity, adaptations, satisfaction), mechanisms of impact (attitude, subjective norm, perceived behavioural control and intention) and context of the PRITAH intervention. Background: Involuntary treatment, defined as care provided against one's will, is highly prevalent in home care. The PRITAH intervention comprises policy, workshops, coaching and alternative measures for professional caregivers to prevent and reduce involuntary treatment in home care. Design: Quasi‐experimental study. Methods: Eight home care teams from two care organisations participated in this study. Guided by the Theory of Planned Behavior, the mechanisms of impact were evaluated with questionnaires. Implementation and context were assessed using attendance lists, evaluation questionnaires, focus groups and logbooks. The study adhered to the TREND checklist. Results: 124 of 133 eligible professional caregivers participated (93%). All four components were delivered with minor deviations from protocol. Participants' subjective norms and perceived behavioural control changed over time in favour of the intervention group. No effects were seen for attitude and intention. Barriers included an unclear policy and lack of communication between stakeholders. The multidisciplinary approach and possibility to discuss involuntary treatment with the specialised nurse were described as facilitators. Conclusions: Prevention and reduction of involuntary treatment at home is feasible in home care practice and contributes to changing professional caregivers' subjective norms and perceived behavioural control, prerequisites for behavioural change in order to prevent and reduce involuntary treatment. A follow‐up study on the effectiveness of PRITAH on actual use, prevention and reduction of involuntary treatment in home care is needed. Future studies should emphasise the role of family caregivers and GPs and actively involve them in the prevention and reduction of involuntary treatment. Relevance to clinical practice: Involuntary treatment is commonly used in dementia home care and professional and family caregivers need to be supported in prevention and reduction of involuntary treatment in people with dementia. [ABSTRACT FROM AUTHOR]

Aim and objectives: To determine the effect of structured Virtual Patient Visits (sVPVs) on the anxiety, satisfaction, hospital anxiety and depression levels of intensive care unit (ICU) COVID‐19 patients and their relatives. Background: There is no evidence regarding the direct effect of virtual patient visits in the ICU. Design: The STROBE statement guided this study. This investigator‐initiated, prospective and single‐centre study included COVID‐19 patients and their relatives in an adult ICU between July and December 2020. We implemented daily sVPVs between all patients and their relatives. The study's primary outcome was the daily anxiety levels of patients and relatives immediately before and after sVPVs. The secondary outcomes were as follows: 1) hospital anxiety (HADS‐A) and depression (HADS‐D) levels during admission to and after discharge from the ICU and 2) satisfaction levels regarding the ICU and sVPVs of patients' relatives. Results: A total number of 301 daily sVPVs were conducted between 50 patients and their relatives. There was a significant difference between daily anxiety levels before and after sVPVs in both patients (2.97 vs. 1.49) and their relatives (5.70 vs. 3.53; p >.05). Whereas the anxiety levels of patients with basic face or high flow nasal cannula and non‐invasive mechanical ventilation decreased statistically significantly more than those with IMV after a sVPV (p <.001), there was not a significant difference in decreased anxiety levels of patients' relatives according to the type of respiratory support provided to the patient (p >.05). HADS‐A levels of relatives decreased statistically significantly after discharge/death. There was no statistically significant difference in HADS‐A and HADS‐D levels after discharge/death between the relatives of patients who died or did not die (p >.05). Furthermore, the overall ICU satisfaction rates were statistically significantly lower in relatives of patients who died than those who did not die (p <.05). Conclusion: Regardless of whether the patients were intubated, sVPVs reduced the anxiety levels of all patients and relatives. The sVPV programme offered emotional support to patients and family members, with high levels of satisfaction, as well as provided regular informative updates and the opportunity for daily visits or final goodbyes. Relevance for clinical practice: The sVPV programme is essential for all ICUs during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of mobilization protocol on mobilization start time, maintenance of mobilization and patient care outcomes in patients who underwent major abdominal open surgery. Background: Early mobilization in the first 24 hours postoperatively is recommended. Early mobilization is one of the evidence‐based, effective nursing interventions that improve patient care outcomes. Design: A quasi‐experimental non‐randomised design was used in the study. Methods: In the study, the groups were followed sequentially and the data of the control group (n = 21) were collected before the intervention group (n = 21). The patients in the control group were mobilised postoperatively by the nurses according to the decision of the nurse and physician in the intensive care unit (ICU) on the day of the operation. There was no standard protocol for mobilization in the ICU. Mobilization training was given to the patients in the intervention group by the researcher nurse the evening before the operation, and a mobilization protocol was applied on the 0th postoperative day. Data on patient care outcomes were collected until the day when the patient was discharged from the hospital. The TREND checklist was followed. Results: According to the postoperative comparison of the patients in the intervention group to those in the control group, patients in the intervention group started mobilization earlier after admission in intensive care unit (6.22 ± 1.95 hours versus 12.21 ± 3.76 hours), had higher postoperative 0th‐day total mobilization time (128 minutes versus 34 minutes), had a shorter passage of flatus time and length of intensive care unit and hospital stay and had higher sleep quality and satisfaction scores. Conclusions: The structured mobilization protocol is effective in the management of early mobilization and improvement of patient care outcomes. Relevance to clinical practice: mobilization protocols ensure that the mobilization process is maintained effectively. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study investigated the effects of multimedia‐based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography. Background: Cerebral angiography is the gold standard for diagnosing cerebrovascular conditions; however, patients might experience related anxiety and discomfort. For such patients, reductions in anxiety related to informational interventions have been inconsistent, and the effects on patient discomfort and satisfaction with nurses were not confirmed. Design: This quasi‐experimental study with a non‐equivalent, control group, non‐synchronised design was conducted using the TREND checklist. Methods: Fifty‐five patients who underwent cerebral angiography at a neurosurgery ward were enrolled in this study. Twenty‐seven patients in the experimental group were provided multimedia‐based information on cerebral angiography, including actual on‐site photographs and videos, an explanation of the benefits of cerebral angiography and introduction to medical staff. Twenty‐eight in the control group were provided a printed explanation. The collected data were analysed using the χ²‐test, Fisher's exact test, independent t test, paired t test or ANCOVA. Results: In the experimental group, anxiety was significantly decreased post‐intervention, and there was a significant difference in state anxiety between the experimental and control groups. Discomfort and satisfaction with care also showed significant differences between these two groups. Conclusion: This study confirmed that multimedia‐based information decreases patient anxiety and discomfort while increasing satisfaction with care among those undergoing cerebral angiography compared with a printed explanation only. Relevance to clinical practice: The anxiety and discomfort of patients undergoing cerebral angiography should be considered a major nursing problem. This study evaluated the effects of multimedia‐based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography and showed it to be an effective nursing intervention. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: To report patient and family intensive care experiences using the Measuring the Intensive Care Experience (MICE) tool across two intensive care units (ICU). Background: The patient and family experience of care is an important indicator for quality improvement of ICUs, yet few studies evaluate both patient and family experiences in relation to overall care quality as well as specifically measuring quality of medical care, nursing care and organisational care as well as overall experience of the quality of intensive care. Design: A cross‐sectional survey. Methods: A 23 item survey was administered to ICU patients and their family members across two ICUs, a regional 189‐bed hospital and a metropolitan 227‐bed hospital in Queensland, Australia. The response rate was 272 of 394 ICU patients (36.4%). STROBE guidelines were used in reporting this study. Results: Findings indicate a highly positive overall experience of ICU care among patients and families. However, patients reported areas of unmet needs following their stay in ICU broadly related to (1) symptom management, education and information support, and (2) improving the incorporation of patient and family care ICU‐related shared decision‐making. Conclusions: Supportive interventions are needed that target improve symptom management and inform and education ICU patients. Relevance to clinical practice: The MICE survey facilitated the identification of a range of areas requiring quality improvement. Improving the integration of patients and families into shared decision‐making and support is a key aspect for quality improvement. [ABSTRACT FROM AUTHOR]

Aims and objectives: To obtain feedback regarding the comprehension and acceptability of an information leaflet on breast cancer screening among women. Background: Women usually receive a leaflet inviting them to participate in breast cancer screening programmes for early detection of breast cancer. These leaflets include relevant information about mammograms to aid with decision‐making. It is important to know how the target population perceives these leaflets, as this may influence the attitude towards breast cancer screening. Design: A mixed‐methods study (concurrent triangulation design). Methods: Participants were 41 women aged between 40–60 years in the north of Spain. The leaflet included information about breast cancer, mammograms, benefits/risks of screening, and the breast cancer mortality and survival rates in relation to screening. Three written methods were used to assess the leaflet: a readability assessment (Flesch Index) and two comprehension assessments (Cloze and multiple‐choice questions). In addition, 26 semi‐structured interviews were conducted to explore the women's opinions regarding comprehension, acceptability and the contribution of the leaflet as a decision aid. The COREQ checklist was used to guarantee the quality and rigour of the qualitative study. Results: Overall, women found the leaflet fairly easy to read and most understood the content. Some women found the information on mortality alarming, difficult to understand and a cause for rejection. The leaflet was viewed as a decision aid, although further information was requested on mammograms, the need for complementary tests and the risks and symptoms of breast cancer. Conclusion: The leaflet was accepted by women and, overall, easy to understand. The participation of the target population enabled the content and format of the leaflet to be adjusted to their needs. Relevance for clinical practice: Nurses can contribute towards improving the breast cancer screening leaflets, considering women's perceptions surrounding screening. [ABSTRACT FROM AUTHOR]

Aim: To review and synthesise the literature examining the patients' experience of faecal microbiota transplantation. Background: Faecal microbiota transplantation is a common treatment for many conditions, including Clostridium Difficile infections. Patients' experience of treatments is an important influence on clinical decision‐making and treatment adherence. Design: The PRISMA guidelines guided this systematic review. The review was registered with PROSPERO [CRD42020140446]. Method: A search of Cumulative Index of Nursing and Allied Health Literature, Medline and Embase was conducted for studies published in English and French up to June 2020. Risk of bias was examined using Critical Appraisal Skills Program tools, and quality appraisal was performed independently by three reviewers. Primary outcome of interest was the patient experience of faecal microbiota transplantation. Data were synthesised using a narrative approach. Results: The search identified 3316 citations, and 12 studies were included. Methodological quality of studies was moderate to low quality. Few studies have accurately explored the patients' experience of faecal microbiota transplantation: most focus on clinical outcomes or hypothetical scenarios regarding the patients' perspectives of faecal microbiota transplantation. Only one study was identified where the sole focus was the patients' experience of faecal microbiota transplantation. Patient's experience of faecal microbiota transplantation was diverse and complex with physiological and psychological components dependent on the patient's medical condition, the administration method and the efficacy. Conclusion: Patients did not find faecal microbiota transplantation unappealing; however, patients equally reported the procedural experience was unpleasant. Limited results and low quality evidence suggest that further evaluation of the patient experience of faecal microbiota transplantation would be beneficial. Relevance to clinical practice: Identifying the patients' experience of faecal microbiota transplantation may inform recommendations regarding alternate treatment therapies and enable opportunities to provide quality care for patients that require faecal microbiota transplantation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate the effectiveness of a psycho‐educational intervention for shoulder and breast day surgery patients in decreasing pain intensity and pain interference with function and strengthening adherence with the analgesic regimen; and further to identify factors that influence average pain intensity and pain interference with function. Background: Pain is one of the most prevalent symptoms after day surgery. However, pain management is left to the patients and family, and interventions to help patients are needed. Design: Randomised clinical trial with an intervention (n = 101) and a usual care group (n = 119) using multiple measurements during 6 months postoperatively. The CONSORT checklist is used. Methods: Patients in the intervention group received a booklet about pain and pain management and coaching by research nurses on postoperative days 2, 3 and 7. Differences between groups were identified using the chi‐squared analysis and t tests. Changes with time were identified using a linear mixed model with repeated measures. Results: After controlling for covariates, group differences at any time in average pain intensity and pain interference with function were not statistically significant. Changes over time within any one group in average pain intensity and pain interference with function were statistically significant and decreased with time. Higher levels of average pain intensity and pain interference over time were associated with shoulder surgery, female, younger, pain expectation, preoperative pain and poorer adherence. Conclusions: No group differences related to the intervention were revealed, and preoperative teaching together with a pain management booklet and coaching may help to strengthen the intervention's effects. Further research on interventions directed towards pain management is needed. Relevance to clinical practice: Day surgery patients' postoperative pain and pain management is not satisfactorily handled. To encourage and educate patients to use the prescribed analgesics in the immediate postoperative days may be necessary to enhance pain management. Clinical trial registration: ClinicalTrials.gov (NCT01595035). [ABSTRACT FROM AUTHOR]

Aims and objectives: To review the literature on patients' experiences of surgery cancellation to gain knowledge of nursing care needs and identify gaps in evidence. Background: Surgery cancellations are an ongoing challenge in healthcare systems with negative impacts on healthcare costs, hospital staff and patients. Most research addresses the reasons for cancellation and implementation of preventive interventions, but limited knowledge exists about patients' experiences of cancellation. Design: The scoping review was undertaken using the methodology recommended by the Joanna Briggs Institute for Scoping Reviews and the Reporting Cheklist for Scoping Reviews (PRISMA‐ScR). Methods: A systematic search was conducted by two independent researchers in Cochrane Library, CINAHL, PubMed and PsycINFO. A forward and backward citation search was performed in Scopus, and references in relevant studies were explored. The tool Covidence was applied to select, compare and discuss relevant articles. The Mixed Methods Appraisal Tool was used for critical appraisal. Results: Surgery cancellation is emotionally harmful with negative effects on patients. Four themes were identified: 'Initial reactions to cancellation', 'Reactions during a new waiting period at home and during readmission to hospital', 'Information about cancellation' and 'The experience of new practical arrangements'. Patients whose surgery was cancelled experienced initial feelings such as anger, rejection and anxiety and physical/psychosomatic symptoms in the extended waiting period. Patients prefered early sufficient information about cancellation from the surgeon. The practical arrangements were stressfull for the patients. Conclusion: Nursing care and identification of vulnerable patients are essential to prevent negative effects in the extended waiting period. Provision of timely, sufficient and professional information about cancellation from the surgeon is important. Further research assessing consequences of cancellation is needed. Relevance to clinical practice: Patients would benefit if hospitals find systems to minimise cancellation, and healthcare professionals could systematically develop professional supportive interventions tailored to patients' individual needs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The study purpose was to investigate if compassion fatigue, burnout, compassion satisfaction and personal characteristics are associated with alarm fatigue and predict alarm fatigue in critical care nurses. Background: The phenomena of alarm fatigue, compassion fatigue and burnout place nurses, patients and the healthcare environment in potentially harmful situations and represent the opposite of the foundation of caring and compassion satisfaction in nursing. It has been noted that healthcare organisations should address alarm fatigue as mandated by the Joint Commission based on the higher number of alarms sounding in the critical care environment and based on factors influencing nurses to respond to the alarm. Design: This was a correlational and predictive quantitative study. Methods: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for research reporting of observational studies was followed in this study. Nurses working in the step‐down and intensive care units from three hospitals in a selected healthcare network in Pennsylvania were recruited using convenience sampling (n = 52). Observation, the ProQOL and demographic surveys were used to collect data on alarm fatigue, compassion fatigue, burnout, compassion satisfaction and personal characteristics of critical care nurses. Methods of data analyses included descriptive statistics, chi‐square, Spearman's ρ and binary logistic regression. Results: The study results revealed that the participating critical care nurses showed alarm fatigue, were at risk for compassion fatigue and were near risk for burnout. Conclusions: This study illuminated the significant relationships among alarm fatigue and the characteristics of gender, nursing unit, nurse‐to‐patient ratio and age in critical care nurses. Relevance to clinical practice: The study results can help critical care nurses take the initiative to not only help themselves prevent or overcome alarm fatigue, compassion fatigue and burnout, but also help their coworkers in this area. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the effects of flexible sacrum positions on mode of delivery, duration of the second stage of labour, perineal trauma, postpartum haemorrhage, maternal pain, abnormal foetal heart rate patterns and Apgar scores based on published literature. Background: Maternal positions served as a nonmedical intervention may facilitate optimal maternal and neonatal outcomes during labour. Flexible sacrum positions are conducive to expanding pelvic outlet. Whether flexible sacrum positions have positive effects on maternal and neonatal well‐being is a controversial issue under heated discussion. Design: We performed a systematic review and meta‐analysis based on PRISMA guidelines. Methods: Randomised controlled trials (RCTs) comparing any flexible sacrum position with non‐flexible sacrum position in the second stage of labour were included. PubMed, EMBASE, Cochrane Library, CINAHL, CNKI (China National Knowledge Infrastructure), SinoMed and Wanfang databases were searched from inception to 11 March 2019 for published RCTs. Risk of bias was assessed by the Cochrane criteria, and random‐effects meta‐analyses were conducted by RevMan 5.3. Results: Sixteen studies (3,397 women) published in English were included. Flexible sacrum positions in the second stage of labour could reduce the incidence of operative delivery, instrumental vaginal delivery, caesarean section, episiotomy, severe perineal trauma, severe pain and shorten the duration of active pushing phase in the second stage of labour. However, flexible sacrum positions may increase the incidence of mild perineal trauma. There was no significant difference in the duration of the second stage of labour, maternal satisfaction and other outcomes. Conclusions: Flexible sacrum positions are superior in promoting maternal well‐being during childbirth. However, several results require careful interpretation. More rigorous original studies are needed to further explore their effects. Relevance to clinical practice: The results support the use of flexible sacrum positions. Flexible sacrum positions are recommended to apply flexibly or tailor to individual woman's labour progress. [ABSTRACT FROM AUTHOR]

Aims and objective: To investigate the effects on the quality of care of the Patient Report Informing Self‐Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care. Background: Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self‐management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients. Design: A multicentre randomised controlled trial with a post‐test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108). Methods: In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self‐management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients' satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann–Whitney U test for ordinal data. Results: Participants in the intervention group were more satisfied with the QPP domains "personal attention," regarding both "perceived reality" (p =.021) and "subjective importance" (p =.012). The PRISMS form revealed "shortness of breath" as the most commonly experienced problem and the issue most desired to discuss. Conclusion: The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication. Relevance to clinical practice: The PRISMS form can be a useful tool in improving person‐centred care when delivering self‐management support. Register Id: 192691 at http://www.researchweb.org/is/en/sverige/project/192691. [ABSTRACT FROM AUTHOR]

Aim and objective: To explore how working‐age adults experience patient participation in hospital haemodialysis. Background: End‐stage kidney disease is a progressive, chronic condition imposing patients with high treatment burdens and low health‐related quality of life. Patients face multiple medical decisions related to living with kidney failure. Given their frequent interaction with health services, patient participation may be of special value. Design: Qualitative design with a narrative approach. Methods: In 2018, eleven patients aged 35–64 years undergoing hospital haemodialysis participated in individual interviews. All interviews were analysed using a narrative approach. Reporting followed the Consolidated criteria for Reporting Qualitative Research guidelines. Findings: The patients' narratives of participation comprised three themes following their healthcare trajectory: Informed, but not involved in treatment choices; Duality of care and control; and Frail trust reflecting collaborative deficiencies. The patients received good information about dialysis, but were not involved in choice of treatment modality. Professional work, as well as the nature of treatment, contributed to restricted patient autonomy. Patients' trust suffered from collaborative deficiency generating delays in their treatment trajectories, and patients extended their responsibility into the coordination of transitions as a way of coping with these issues. Conclusions: The study identified challenges related to patient involvement and interdisciplinary collaboration. Involving patients through dialogue and acknowledging their experiences, preferences and lifestyles may strengthen the mutual patient–professional understanding of treatment. Despite increased focus on seamless trajectories, patients face obstacles regarding interdisciplinary collaboration and coordination of health services. Relevance to clinical practice: The findings indicate a want of individually customised care for people requiring dialysis. Patients need to be involved in the choice of treatment modality as well as decisions related to the current treatment. Information must include potential consequences of the different treatment modalities. Health services need to strengthen collaboration in order to secure treatment continuity and patient involvement. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare nurse and patient satisfaction with intentional rounding in a rural Australian hospital setting and examine which aspects of care predict satisfaction. Background: Intentional rounding is a systematic process used by healthcare professionals to anticipate and address the fundamental needs of hospitalised patients. Despite a wealth of literature about nurse and patient satisfaction with intentional rounding, no studies have compared nurse and patient satisfaction, and little is known about intentional rounding in a rural setting. Design: A cross‐sectional study was undertaken with nursing staff and patients at a rural hospital and reported in accordance with STROBE guidelines. Methods: Nurses (n = 63) and patients (n = 66) were invited to complete the Patient Satisfaction Survey between April and June 2018. Nurse and patient responses were compared and predictors of nurse and patient satisfaction with intentional rounding care were determined using generalised estimating equation models. Results: Both nurses and patients positively rated satisfaction with all aspects of nursing care provided and received through intentional rounding. Nurses' satisfaction with care provided to patients through intentional rounding was predicted by interest in patients' feelings about their care. Patient satisfaction with the care they received whilst hospitalised was predicted by the ability to see a nurse when they needed to, the provision of pain relief when needed, feeling comfortable and safe, and the perception that nurses were interested in their feelings about their care. Conclusion: Intentional rounding is a means for nurses to regularly attend to patients' emotional and physical needs, which is central to patients feeling safe and cared for whilst hospitalised. Relevance to clinical practice: Intentional rounding practices ensure that patients feel genuinely cared for by nursing staff whilst hospitalised and can improve nurse and patient interactions, satisfaction and outcomes. [ABSTRACT FROM AUTHOR]

Aims and Objective: To evaluate the effect of acupressure on intramuscular injection pain, satisfaction and vital signs. Background: Pain at the injection site may lead to discomfort and may affect patients' compliance to treatment. Design: This was a prospective, single‐blind, crossover study. The study complied with the guidelines of Consolidated Standards of Reporting Trials (CONSORT) Checklist. Methods: Seventy‐two healthy volunteer university students received an intramuscular injection of 2 ml sterile saline (%0.9 NaCl) to the ventrogluteal site with and without acupressure on separate days in a random order following a standard procedure by the same investigator. Pain and satisfaction were assessed immediately after the injection with the visual analog scale (VAS) by a researcher blinded to the study. Results: A total of 134 injections were analysed. The result of the study reveals that acupressure alleviates the severity of pain and increases the patient satisfaction. Conclusions: The findings of this research support that use of acupressure, which is easy and cost‐effective, could reduce injection pain when performed on a specific point. Relevance to Clinical Practice: Safe and accurate administration of medications is one of the crucial responsibilities of nurses. Acupressure is a nonpharmacologic approach, which can be effective in decreasing the injection pain and increasing patient satisfaction. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to determine the effect of methods of distraction to relieve pain associated with the peripheral intravenous catheter (PIC) insertion procedure, thus improving patient satisfaction. Specifically, we examined such effect by playing 3D videos with virtual reality goggles and showing pictures to the patient containing distractive optical illusions. Background: In the literature, although the efficacy of various pharmacological methods for reducing pain associated with the insertion of PIC has been evaluated in adults, studies on nonpharmacological methods are limited. Methods: The research was conducted with a randomised controlled single‐blind experimental study. The sample consisted of 120 patients. While nothing is applied to the control group, cards containing distractive optical illusion pictures and playing 3D videos with VR goggles during PIC insertion is applied for distraction groups. The data collection form consisted of items that measured the sociodemographic characteristics of the patients and a visual analog scale. The CONSORT checklist was followed in reporting this study. This study is registered with ClinicalTrials.gov. No. NCT03945929. Results: The mean pain level was 4.72 ± 3.15 in the control group and 3.41 ± 2.81 in the distraction groups and the difference was found to be statistically significant (p =.02). When the mean satisfaction level between the groups was compared, it was found to be 5.12 ± 3.41 in the control group and 8.07 ± 2.67 in the groups undergoing distraction methods. The difference between them was statistically significant (p =.01). Conclusions: This study found that the use of cards containing distractive optical illusion pictures and playing 3D videos with VR goggles during PIC insertion in adult patients were both effective. Relevance to clinical practice: These distraction methods may be used to reduce pain due to PIC insertion in nonurgent and less urgent adult patients in the emergency department. [ABSTRACT FROM AUTHOR]

Aim and Objectives: To investigate factors related to self‐management and predictors of self‐management in older adult patients with type 2 diabetic nephropathy. Background: Diabetic patients suffer many comorbidities during their lifetime, and the process of self‐management is complex. Self‐management and an integrated care experience are extremely important for older adults with diabetic nephropathy. Design: A cross‐sectional correlation design was adopted. Methods: A total of 123 older patients were enrolled in the study from June 2016 to November 2017. Data collection involved a demographic questionnaire, the Patients' Experience of Integrated Care Questionnaire and the Partners in Health Scale to measure the integrated care experience and self‐management. Data analysis included descriptive statistics, independent t tests, Pearson product‐moment correlation and multiple linear regression. The methods are consistent with the STROBE criteria (Data S1). Results: The results showed that the majority of the sample was female (56.9%). The average age was 77 years old. Stepwise regression analysis showed that re‐admission during the past year (p <.001), physical function (p <.001) and integrated care experience (p <.001) are predictors of self‐management in older adult patients with type 2 diabetic nephropathy and explained 42.8% of the variation in self‐management behaviour. Conclusion: The results can be used to enhance the awareness of clinicians of the importance of an integrated care experience and self‐management among older patients with type 2 diabetic nephropathy. Clinicians also should pay attention to physical function and the integrated care experience to promote self‐management. Relevance to Clinical Practice: Studies on the integrated care experience and self‐management of diabetic neuropathy in older adults are limited in Taiwan. The results of this study provide valuable information to support the importance of integrated care among this specific population. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore how satisfied patients are with the process of treatment and care and to identify the experiences that patients perceive during elective primary fast‐track total hip and knee arthroplasty journey. Background: Greater satisfaction with care has predicted better quality of recovery, and patient experience has been positively associated with patient safety and clinical effectiveness. However, a little is still known about how patients experience their treatment and care. Design: A qualitative interview study. Methods: The study was conducted among 20 patients in a single joint replacement centre during 2018. Patient satisfaction was measured using a numerical rating scale. Patients' experiences were identified through qualitative semi‐structured interviews which were analysed using an inductive content analysis method. The COREQ checklist was used (Supporting Information). Results: The mean numerical rating scale score for overall satisfaction was 9.0 (SD 1.1) on a scale from 0–10. The patients' experiences were grouped under eight main categories that were derived from the qualitative data in the analysis: (a) patient selection, (b) meeting the Health Care Guarantee, (c) patient flow, (d) postdischarge care, (e) patient counselling, (f) transparency of the journey, (g) communication and (h) feedback. Conclusions: The findings suggest that patients are highly satisfied after an elective primary fast‐track total hip and knee arthroplasty. However, closer analysis of the patients' experiences reveals challenges and suggestions on how they could be solved, often involving digital technologies. Relevance to clinical practice: As the number of total joint arthroplasties grows, patients and their families need to take ever greater responsibility, for their own care from advance preparation to rehabilitation. The findings of the study can be used to organise work, improving patient‐clinical communication, fostering engagement and improving patient centredness. In addition, the results pinpoint the issues on how the patient experience could be improved. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the perspectives of patients and health professionals on facilitators and barriers to care in a diabetes clinic in urban South Africa. Background: Although much attention has been given to the science behind diabetes management, a qualitative approach to exploring experiences, facilitators and barriers to care may have considerable value in understanding and improving diabetes care. Design: We conducted a qualitative study in the context of a 3‐year collaboration at a diabetes clinic. The present study formed part of the preparatory phase to the larger project. Methods: Linguistically and culturally matched research assistants collected data over a period of 18 months. Methods included interviews, focus groups, ethnographic observations and informal discussions with 38 patients and health professionals. Data from each participant group were transcribed, translated and analysed using reflexive thematic analysis principles and thereafter triangulated. The Standards for Reporting Qualitative Research checklist was followed. Results: Initial findings suggest that factors can be classified into three overarching themes: relationships, health systems and the interplay between disease and the lifeworld. System resource pressures, the nuances of team interactions and a complex healthcare site may adversely affect care, even at sites where there are elements of good practice. Conclusions: The collective psychosocial experience of patients appears to conflict with the biomedical approach to diabetes management. The all‐consuming nature of the disease, together with contextual and systemic factors, plays a significant role in influencing experiences of care. Relevance to clinical practice: While systemic and contextual influences on experiences of diabetes care may be difficult to modify, our study suggests a need to focus on ways of enhancing relationships within the clinic and seeking to understand the lifeworld of the patient. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the experiences and wishes of lesbian and bisexual women concerning health care in Finland. Background: Sexual orientation is a personal aspect of identity and also an important aspect of holistic health care. Lesbian and bisexual women have unmet health needs. The way that healthcare personnel encounter lesbian and bisexual women affects whether they disclose their sexual orientation. Design: Qualitative inductive survey. Methods: The research data for this study were collected in spring 2018 using an electronic survey (n = 22). The data were analysed using inductive content analysis. The research report has been checked using COREQ checklist, see Appendix S1. Results: The research data were divided into two main domains: experiences and wishes. Women described health care as being heteronormative. They had both good and bad experiences, and their own poor experiences and those of others had a negative impact on their utilisation of healthcare services. Women had apprehensions about encountering stereotyping in health care and did not always disclose their orientation, even though recognising it would be integral to the provision of holistic health care. Lesbian and bisexual women wished that health care would refrain from heteronormativity, acknowledge issues that were important to them and engage with them without any prejudgement. They also wished healthcare environments would be improved to reflect an open acceptance of sexual minorities and also co‐operate with sexual minority organisations. Conclusions: Women had conflicting experiences. Heteronormativity was seen as an obstacle for holistic health care. Women hoped health care would collaborate with the third sector. Relevance to clinical practice: Sexual diversity should be acknowledged and better communicated to patients. Women hoped personnel would have the understanding to treat them in the same professional way as any other patients, but with expertise specific to their needs, for example in sexual health guidance. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore adult general surgical patients' perceptions of, and satisfaction with, discharge education provided by healthcare providers. Background: Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self‐manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience. Design: A constructivist‐interpretivist paradigm using qualitative interviews. Methods: Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study. Results: Four themes were uncovered: (a) The quality of discharge information influences patients' postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients' preferences with the delivery of discharge education. Conclusion: Inadequate discharge education leads to patients' inability to self‐manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations. Relevance to clinical practice: Understanding patients' view may inform the design of patient‐centred discharge education interventions for patients to self‐manage their recovery postdischarge. [ABSTRACT FROM AUTHOR]