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Aims and Objectives: This study aimed at determining the perception of fatigue among patients with a history of the coronavirus disease (COVID‐19). Background: Fatigue is a long‐lasting distressing symptom. It is a multidimensional symptom consisting of several factors, including physiological, psychological, social and environmental. It is vital to examine and understand the perception of fatigue among post‐COVID‐19 participants. Design: A descriptive phenomenological design. Methods: The study sample consisted of 14 post‐COVID‐19 participants that were recruited using criterion sampling. The fatigue levels of the participants were determined using the Chalder Fatigue Scale (CFS), and those with a fatigue score above 12 were interviewed. All the interviews were conducted with a smartphone due to the COVID‐19. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used. Results: The age of the participants varied from 24 to 67 years, with the majority of the participants being female (n = 8). The COVID‐19 duration ranged from one to 11 months, and the CFS scores varied between 14 and 33. Four themes emerged following the qualitative data analysis: a new symptom beyond fatigue, fatigue increases dependency in daily life, fatigue impedes sociability and a way to hold on to life's regular rhythms. Conclusions: This study concluded that fatigue in post‐COVID‐19 participants is a new experience that is difficult to define and manage and overwhelmingly affects the physical and social aspects of life. Participants look for new ways to live with fatigue and turn to traditional methods and psychosocial strategies. Relevance to clinical practice: This study revealed the miscellaneous aspects of fatigue in post‐COVID‐19 participants. Nurses should evaluate fatigue with a holistic approach that includes its physical, social, emotional and spiritual aspects. Nurses can play an active role in the management of fatigue, which is a very common symptom in the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: This scoping review aims to describe published work on the symptoms and management of long COVID conditions. Background: Symptoms and management of COVID‐19 have focused on the acute stage. However, long‐term consequences have also been observed. Methods: A scoping review was performed based on the framework suggested by Arksey and O'Malley. We conducted a literature search to retrieve articles published from May 2020 to March 2021 in CINHAL, Cochrane library, Embase, PubMed and Web of science, including backward and forward citation tracking from the included articles. Among the 1880 articles retrieved, 34 articles met our criteria for review: 21 were related to symptom presentation and 13 to the management of long COVID. Results: Long COVID symptoms were described in 21 articles. Following COVID‐19 treatment, hospitalised patients most frequently reported dyspnoea, followed by anosmia/ageusia, fatigue and cough, while non‐hospitalised patients commonly reported cough, followed by fever and myalgia/arthralgia. Thirteen studies described management for long COVID: Focused on a multidisciplinary approach in seven articles, pulmonary rehabilitation in three articles, fatigue management in two articles and psychological therapy in one study. Conclusion: People experience varied COVID‐19 symptoms after treatment. However, guidelines on evidence‐based, multidisciplinary management for long COVID conditions are limited in the literature. The COVID‐19 pandemic may extend due to virus mutations; therefore, it is crucial to develop and disseminate evidence‐based, multidisciplinary management guidelines. Relevance to clinical practice: A rehabilitation care plan and community healthcare plans are necessary for COVID‐19 patients before discharge. Remote programmes could facilitate the monitoring and screening of people with long COVID. [ABSTRACT FROM AUTHOR]

Purpose: A model was hypothesised by integrating two theoretical models: the compassion satisfaction‐compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work‐related variables during the COVID‐19 pandemic. Background: Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety. Methods: A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work‐related variables. Compassion satisfaction ‐ compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist. Results: The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work‐related variables (co‐workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life. Conclusion: The Compassion satisfaction ‐ compassion fatigue ‐Empowerment integrated model allows for assessing the different paths in the relationship between work‐related variables and burnout. Relevance to clinical practice: These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID‐19 pandemic. These strategies should focus on enhancing co‐workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence. [ABSTRACT FROM AUTHOR]

Aim: To explore patients' and healthcare professionals' (HCPs) experiences of oral care during hospitalisation to identify needs and challenges. Background: Daily oral care is important to patients' health and well‐being, to prevent diseases in the oral cavity, systemic infections and increased morbidity, which subsequently can lead to prolonged hospitalisation and, at worst, increased mortality. Despite this knowledge, oral care is a neglected part of nursing practice. Studies do not clearly identify barriers regarding oral care, as the existing knowledge is inadequate. Design: A qualitative study exploring participants' experiences to gain new in‐depth knowledge of oral care among hospitalised patients. Methods: A phenomenological‐hermeneutic approach was applied. Participant observations were conducted on five hospital wards, combined with individual semi‐structured interviews with 16 patients and 15 HCP. Data analysis was based on Ricoeur's theory of narrative and interpretation. Results: Four themes describing the challenges regarding oral care emerged: Oral care as a gut feeling; oral care fades into the background; even self‐reliant patients need help with oral care; and the mouth reflects the life lived. Conclusions: The identified challenges show there is a need for improvement in the health professional approach to oral care in nursing practice. Focus on increasing HCPs' knowledge, skills and competences can increase their nursing agency and support patients' self‐care capacity. Impact: Investigation of oral care during hospitalisation revealed four main challenges concerning both patients' and HCPs' lack of knowledge and awareness of oral care. Thus, patients and HCPs should be included in developing solutions to improve oral care in nursing practice. Reporting methods: The COREQ criteria for reporting qualitative research were adhered to. Patient contribution: A patient representative was involved in the discussion of the proposal, conduct and results of the study. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the impact of nurse‐led follow‐up care supporting self‐management of people who have had or have cancer. Background: Cancer care is evolving towards enabling people to self‐manage the impact of cancer, treatment and overall care on their quality of life (QoL), self‐efficacy and distress. Design: A systematic review following Joanna Briggs Institution (JBI) guidance and reported in accordance with the PRISMA statement was undertaken. Methods: Four databases were searched, OVID Medline, CINAHL, PsychINFO and Embase. Quantitative randomised control trials with people who have or have had cancer accessing nurse‐led care or nurse‐led intervention, undertaken within secondary care were included. Narrative synthesis was undertaken due to heterogeneity of measures used and time points of assessment. Results: Seven papers were included in the final review, all meeting moderate to high‐quality appraisal. Only one study found an impact of nurse‐led care on all three factors under investigation, with a further two studies finding an effect on distress. The remaining studies did not find an impact of the intervention. Conclusion: Clinical Nurse Specialists are well placed to provide follow‐up care for people with cancer, but in relation to QoL, self‐efficacy and distress, there is limited evidence of effectiveness of nurse‐led interventions. Public or patient contribution: This systematic review did not have any public or patient contribution. Relevance to clinical practice: Cancer care is moving to a chronic care, self‐management model. Clinical nurse specialists are well placed to innovate interventions that assist people with cancer to self‐manage. [ABSTRACT FROM AUTHOR]

Aim: To explore how the Cognitive Continuum Theory has been used in qualitative nursing research and to what extent it has been integrated in the research process using the Qualitative Network for Theory Use and Methodology (QUANTUM). Background: Theory, research and nursing are intrinsically linked, as are decision‐making and nursing practice. With increasing pressure on nurses to improve patient outcomes, systematic knowledge regarding decision‐making is critical and urgent. Design: A meta‐aggregative systematic review. Methods: Databases: CINAHL, Medline, PsycINFO, Embase and PubMed were searched from inception until May 2022 for peer‐reviewed research published in English. Seven studies were included and assessed for methodological quality using the Joanna Briggs Institute checklist for qualitative research. A meta‐aggregative synthesis was conducted using Joanna Briggs methodology. The QUANTUM typology was used to evaluate the visibility of the Cognitive Continuum Theory in the research process. Results: The review identified five synthesised findings, namely: 1. the decision‐making capacity of the individual nurse, 2. nurses' level of experience, 3. availability of decision support tools, 4. the availability of resources and 5. access to senior staff and peers. Only two of seven studies rigorously applied the theory. The included studies were mainly descriptive‐exploratory in nature. Conclusion: The transferability of the Cognitive Continuum Theory was demonstrated; however, evolution or critique was absent. A gap in the provision of a patient‐centric approach to decision‐making was identified. Education, support and research is needed to assist decision‐making. A new Person‐Centred Nursing Model of the Cognitive Continuum Theory has been proposed to guide future research in clinical decision‐making. Relevance to Clinical Practice: Nurses make numerous decisions every day that directly impact patient care, therefore development and testing of new theories, modification and revision of older theories to reflect advances in knowledge and technology in contemporary health care are essential. [ABSTRACT FROM AUTHOR]

Aim: Mental distress, non‐specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut‐off points for identifying highly distressed patients are lacking, entailing a gap in CPP management. Design: This instrumental cross‐sectional study identified a statistically derived cut‐off score for the Depression Anxiety Stress Scale‐8 (DASS‐8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years). Methods: Receiver operator characteristic curve, decision trees and K‐means clustering techniques were used to examine the predictive capacity of the DASS‐8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist. Results: Cut‐off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut‐off score for predicting key outcomes. Women with DASS‐8 scores below 15.5 had higher analgesic intake. Conclusion: CPP women with a DASS‐8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co‐morbidities. Implications for patient care: At a cut‐off point of 13.0, the DASS‐8 may be a practical instrument for recommending a thorough clinician‐based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted. [ABSTRACT FROM AUTHOR]

Aim: To investigate the mental well‐being of early career nurses working in the United Kingdom during the COVID‐19 pandemic, with a particular emphasis on symptoms related to post‐traumatic stress disorder. Design: A longitudinal survey study. Methods: Data were acquired at three timepoints during the COVID‐19 pandemic (between May 2020 and March 2021) to determine whether symptoms of post‐traumatic stress disorder persisted over time. Quantitative measures of well‐being were supplemented with survey data on the nurses' experiences of working during the pandemic. Results: Twenty‐seven per cent of participants suffered from persistent symptoms of post‐traumatic stress while working as nurses during the pandemic. The nurses' baseline resilience, as well as their perception of the quality of their work environment, were significant negative predictors of symptoms of post‐traumatic stress. Participants identified a range of strategies that would have helped them during the crisis, including visible, consistent and empathetic leadership, adequate training and a supportive work environment. Conclusion: The context of the pandemic has highlighted the vulnerability of the psychological well‐being of early career nurses in the workforce. Immediate implementation of some of the more simple interventions suggested in this paper would provide early career nurses with rapid support. More complex support mechanisms should be given immediate consideration, with a view to implementation in the longer term. Implications for the Profession: This study contributes new knowledge about the psychological well‐being of early career nurses working during the pandemic and suggests support mechanisms that will be crucial for the retention of these nurses in the profession. A measurement of resilience may be useful for determining the appropriate level of support to provide to early career nurses. Impact: Early career nurses are vulnerable to attrition from the profession. This could be exacerbated if the psychological well‐being of these nurses is not being supported.Around 25% of early career nurses suffered from persistent symptoms of post‐traumatic stress disorder while working as nurses during the height of the pandemic, which is a novel finding compared to other longitudinal studies.Understanding the psychological well‐being of early career nurses working during a crisis period (such as a pandemic) equips nurse managers with appropriate strategies to improve nurses' emotional health and to enhance their retention within the workforce.The current findings may be of interest to clinical practitioners who have responsibility for the retention of nursing staff. No patient or public contribution. One of the authors is a statistician. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to generate empirical evidence, drawing from clinical records, with the goal of elevating the level of evidence supporting the nursing diagnosis (ND) of 'chronic pain'. Background: Chronic pain is a prevalent condition that affects all age groups. Patients often feel disbelieved about their pain perception, leading to adverse psychological effects, difficulty accessing healthcare and poor rehabilitation outcomes. Design: Retrospective descriptive study. Standards for Reporting Diagnostic Accuracy Studies guidelines were followed in this study. Methods: Data were extracted from Electronic Health Records (EHR) of patients admitted to the University Hospital of Perugia, Italy, between March 2016 and December 2022. The study sample comprised individuals without a specific medical diagnosis or high‐risk population. Out of 1,048,565 EHR, 43,341 clinical‐nursing diaries with the keyword 'pain' were identified, from which 283 clinical‐nursing notes were selected based on a keyword‐based retrieval technique and diagnostic definition for further analysis. Results: Our study findings support the diagnostic descriptors of the 'chronic pain' ND in clinical‐nursing diaries. We observed the presence of 9 out of 11 defining characteristics, 7 out of 10 related factors, 4 out of 8 at‐risk populations and 11 out of 17 associated conditions. Conclusions: The study validated diagnostic criteria for chronic pain and proposed 'haematological pathology' as a new associated condition. The findings were presented to the Diagnosis Development Committee of NANDA‐International for further review. However, limitations of the study prompted the need for further analysis using natural language processing and artificial neural network techniques. As a result, a new research direction using artificial intelligence (AI) tools was initiated. Relevance to Clinical Practice: The study validates diagnostic descriptors for chronic pain and proposes future directions in semantic analysis and AI tools, aiming to enhance clinical practice and decision‐making in nursing care. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID‐19 pandemic. Design: An observational and longitudinal study. Methods: Using the Patient Health Questionnaire‐9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021. Results: 13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID‐19 and use of psychotropic drugs Conclusions: There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases. Implications for the profession and/or patient care: With the advent of the COVID‐19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long‐term effects of this scenario is still a challenge. Impact: What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID‐19 pandemic. What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID‐19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload. Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams. Reporting method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study. Patient or public contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery. Objective: To investigate the global prevalence of overweight and obesity among nurses. Design: Systematic review with meta‐analysis. Setting: 29 different countries across the WHO‐classified geographical region. Participants: Nurses. Methods: Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle‐Ottawa Scale (NOS). Inter‐rater agreement was measured using Cohen's Kappa. Meta‐analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I2 statistic. Results: Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%–33.5%; p <.01) and 16.3% (n = 76, 95% CI: 13.7%–19.3%, p <.01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South‐East Asia (n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators. Conclusions: This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health. Patient or Public Contribution: Not applicable as this is a systematic review. Registration: PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display%5frecord.php?RecordID=403785. High prevalence of overweight and obesity among nurses worldwide. [ABSTRACT FROM AUTHOR]

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

Aim: To examine the multidimensional properties of caregiver burden among family caregivers of patients with advanced cancer in a palliative context. Design: A sequential, explanatory, mixed‐method study was performed. Methods: Family caregivers of patients diagnosed with advanced cancer were recruited from a palliative care department of a third‐level hospital in Sichuan Province, China. The Caregiver Burden Inventory, Social Support Rating Scale and Connor–Davidson Resilience Scale were used to collect quantitative data, and a total of 150 caregivers were recruited from January 2022 to September 2022. Qualitative data were collected through semi‐structured interviews, and a total of 22 caregivers were interviewed from October 2022 to November 2022. Survey data were analysed using descriptive statistics, and the factors of caregiver burden were identified using the Mann–Whitney U test, Kruskal–Wallis H test and Spearman correlations. Interpretative phenomenological analysis was performed to analyse the interview data to initially explore the multidimensions of caregiver burden. The following‐a‐thread method and convergence coding matrix were used for triangulation to examine the multidimensional properties of caregiver burden. Results: The participants experienced a moderate level of caregiver burden (32.97 ± 13.09). Through triangulation, six meta‐themes and nine meta‐subthemes were identified as multidimensional properties of caregiver burden, including physical (too many caring tasks and poor health condition), emotional (strong negative emotions resulting from patients' suffering and insufficient and ineffective family communication), social (less social interaction and social role conflict) and economic burdens, factors that aggravate burden (prevention and control of COVID‐19 and spousal relationship with patients) and factors that mitigate burden (social support). Conclusion: Multiple dimensions of caregiver burden were experienced by family caregivers of patients with advanced cancer in the palliative context. Family‐centred palliative care must be further developed. Implications for the profession: It is important to develop family‐centred palliative care. Therefore, the focus must be on developing a rational understanding of palliative care in public and a culture‐oriented death education in palliative units. Impact: This study adopted a mixed‐method approach to comprehensively understand the phenomenon of and factors in caregiver burden in the Chinese palliative oncology context.Our findings suggest that family caregivers in palliative oncology experience a moderate level of caregiver burden, with dimensions including physical, emotional, social and economic burdens, among which emotional burden is the most prominent.The findings of this study provide policy makers and nurse practitioners with targets to be addressed in family‐centred care in Chinese palliative units. Reporting Method: The results of this study are reported based on the guidelines of the Mixed‐Methods Article Reporting Standards. Patient or Public Contribution: Eligible caregivers were invited to participate in the study and semi‐structured interviews. Nurse managers of the palliative unit helped us access the patient‐management system. [ABSTRACT FROM AUTHOR]

Aim: To explore and gain a broader understanding of residents' viewpoints and experiences of spiritual care when living in a nursing home. Design: A qualitative hermeneutical interview study inspired by Gadamer's philosophical hermeneutics. Methods: Thirty‐eight individual interviews of 14 male and 24 female residents; of these, 24 had a dementia diagnosis. The setting was one large Norwegian nursing home providing long‐term care. FACIT‐Sp‐12 was used as a guide for the interview, in addition to two open‐ended questions about thriving and spiritual care. Findings: The older residents' voices portray a broad and diverse understanding of spiritual care, and four themes emerged: (1) Spiritual at‐homeness, (2) Spiritual awareness, (3) Philosophy of life and (4) Interconnectedness. Conclusion: Accepting one's life situation in a nursing home can foster a feeling of belonging, leading to feeling more at‐home. Spiritual well‐being, including finding purpose, spiritual awareness and beliefs, was found to be interconnected with spiritual at‐homeness in the nursing home. Implications for the Profession and/or Patient Care: This study provides insights into older nursing home residents' viewpoints on spiritual care, including persons living with dementia. Impact: The study addressed the limited evidence regarding how older residents themselves experience and express spiritual care. Listening to older nursing home residents' voices provides a unique contribution to the research field. As several individuals with dementia contributed to the findings, this study mirrors the current population of residents in nursing homes. The findings may inform healthcare provision and policymakers and impact upon spiritual care in the field of older people nursing and dementia care services. Reporting Method: The COREQ guideline. Patient or Public Contribution: Participation through interviews of nursing home residents. [ABSTRACT FROM AUTHOR]

Aim: To investigate the self‐reported levels of social support from friends and family and from nurses as mediators of the relationship between self‐rated physical and psychological condition in hospitalised patients. Design: Cross‐sectional study of adult inpatients at a large tertiary‐care hospital in the northeast United States. Methods: Multiple mediation analysis of survey data. Results: In surveys received from 324 inpatients, one fourth of the variation in patients' self‐rated psychological condition was explained by self‐rated physical condition. Social support from family and friends mediated a significant proportion (11.0%) of the relationship between self‐rated physical and psychological condition, however social support from nurses did not. Conclusion: Social support from family and friends can positively influence the psychological health of inpatients, but nurses are not an adequate replacement for the social support provided by family and friends. Implications for Nursing: Although nurses cannot replace the social support provided by family and friends, the assessment of social isolation and care planning of interventions to support patients is a fundamental nursing role. Technology to connect patients with friends and family should be used to mitigate isolation for hospitalised patients unable to receive in‐person visits from loved ones. Impact: The influence of social support from family and friends and nurses was addressed. The study found social support from family and friends, but not nurses, to influence the relationship between physical and psychological ratings. This finding has implications for the role of nurses in the hospital setting. Reporting Method: Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed. [ABSTRACT FROM AUTHOR]

Aim: To describe parents' experiences with interprofessional collaboration (IPC) in neonatal pain management. Background: Neonatal care should be based on IPC, and non‐pharmacological pain‐relieving methods are recommended to be used primarily that enables parental participation. However, there is a lack of knowledge about pain management on IPC from the parent's viewpoint. Design: A descriptive qualitative study. Method: The research involved a purposive sample of parents (n = 16) whose infant had been treated at a neonatal intensive care unit in Finland. Interviews were conducted with participants from all over Finland who were recruited through the national association for premature infants. Parents discussed their experiences during semi‐structured interviews which were guided by the subareas of IPC, partnership, cooperation and coordination. The data were analysed using deductive‐inductive content analysis. The reporting of results followed COREQ guidelines. Results: Based on the parent's experiences the partnership involved themes of understanding the neonatal pain management context, being able to influence the pain management, and feeling valued. Cooperation included themes of identifying different roles and equality. Coordination was described through the sharing of knowledge, skills and expertise, as well as feeling supported by professionals. Conclusion: Parental involvement on IPC should be developed through interventions that involve training around pain assessment and non‐pharmacological pain‐relief methods. Relevance for clinical practice: Professionals involved in neonatal care should act in a goal‐oriented and unified manner to promote a culture of care that allows for active parental participation. No patient or public contribution: The research has been carried out in accordance with good scientific practice. Only the research team has been involved in the design, conduct, analysis and drafting of the manuscript. [ABSTRACT FROM AUTHOR]

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

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

Background: As frontline healthcare workers, there is a growing expectation that nurses should be able to respond to disclosures of family violence. However, the profession and hospital systems have been slow to respond with clear skills, knowledge and confidence deficits identified in existing research. There is limited research which has robustly evaluated the effectiveness of in‐depth, multifaceted training on readiness to respond among nurses. Aim: To longitudinally evaluate the effectiveness of an in‐depth family violence training intervention on confidence, knowledge and clinical skills of nurses working in a large tertiary adult hospital. Design: Single‐centre, longitudinal intervention study. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) cross‐sectional guidelines were used. Methods: One hundred and ten nursing clinicians participated in this study to complete a comprehensive evidence‐based model of healthcare workers response for assisting patients experiencing family violence. A mixed methods survey was used to assess change in knowledge, confidence and clinical skills among participants. Outcome assessment was electronically undertaken at baseline, 6–9 months and 12–15 months following intervention. Results: Statistically significant improvement was seen in self‐reported knowledge, confidence and frequency of screening for family violence. Relative to baseline estimates, these improvements were identified 6–9 months and 12–15 months following intervention; albeit with consideration to the visually observed trend of skill reversion at follow‐up. Quantitative findings were paralleled by qualitatively identified improvements in the recognition of the intersectional nature of violence, need for patient collaboration in screening and depth in considerations around how family violence is screened for. Conclusions: Findings provide tentative support for the utility of a multidimensional training approach to improving nurses' readiness to respond to disclosures of family violence. Relevance to clinical practice: This study provides preliminary support for multidimensional, evidence‐based training to effectively improve nurses' confidence, knowledge and clinical skills required for responding to family violence. Reporting Method: The study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (SQUIRE) Statement: guidelines for reporting observational studies (see Table S1). Patient Contribution: Patients were involved in the initial design of the survey tool. This involvement came through the Allied Health Consumer panel and included input on the design and question wording of the survey items. [ABSTRACT FROM AUTHOR]

Aim: To test the feasibility of a study protocol that compared the efficacy of neutral‐ and negative‐pressure needleless connectors (NCs). Design: A single‐centre, parallel‐group, pilot randomised control trial. Methods: Our study compared neutral‐(intervention) and negative‐pressure (control) NCs among adult patients in an Australian hospital. The primary feasibility outcome was measured against predetermined criteria (e.g. eligibility, attrition). The primary efficacy outcome was all‐cause peripheral intravenous catheter failure, analysed as time‐to‐event data. Results: In total, 201 (100 control; 101 intervention) participants were enrolled between March 2020 and September 2020. All feasibility criteria were met except eligibility, which was lower (78%) than the 90% criterion. All‐cause peripheral intravenous catheter failure was significantly higher in the intervention group (39%) compared to control (19%). Conclusion: With minor modifications to participant screening for eligibility, this randomised control trial is feasible for a large multicentre randomised control trial. The neutral NC was associated with an increased risk of peripheral intravenous catheter failure. Implications for the Profession and/or Patient Care: There are several NC designs available, often identified by their mechanism of pressure (positive, negative and neutral). However, NCs can contribute to peripheral intravenous catheter failure. This is the first randomised controlled trial to compare neutral and negative NC designs. Negative pressure NCs had lower PIVC failure compared to neutral NCs, however the results might not be generalisable to other brands or treatment settings. Further high‐quality research is needed to explore NC design. Reporting Method: Study methods and results reported in adherence to the CONSORT Statement. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective: This study examined levels of self‐reported dignity and explored factors expected to influence dignity experienced by older adults during acute hospitalisation in Ghana. Background: Dignified care has been recognised as inseparable from quality nursing care and maintaining patients' dignity has been highlighted in professional codes of conduct for nurses. However, there is a lack of research on self‐reported dignity and the factors that influence the dignity of older adults during acute hospitalisation in Africa. Setting: A large teaching hospital in the northern region of Ghana. Participants: Hospitalised older adults. Methods: A cross‐sectional survey was used to gather data from a convenience sample of 270 older inpatients, using the Hospitalized Older Adults' Dignity Scale. Data were analysed using descriptive statistics and stepwise ordinal logistic regression to investigate stratified dignity outcomes. The study was reported following the STROBE checklist. Results: More than half of the older adults surveyed reported low to moderate levels of dignity. Demographic characteristics such as age, marital status, religious status, occupation, level of education and type of hospital ward did not show any significant associations with dignity levels. However, there was a significant association found between dignity levels and sex and the number of hospitalisations. Conclusion: Most older adults in a Ghanian hospital experienced loss of dignity during their acute hospitalisation. Male older adults reported higher dignity levels during acute hospitalisation than their female counterparts. Further, older adults who were admitted to hospital for the second time reported less dignity compared to those admitted three or more times. Relevance to clinical practice: The results emphasise the importance of healthcare professionals having the necessary knowledge and skills to provide gender‐sensitive care, which ultimately promotes the dignity of all patients. Additionally, the results underscore the urgency of implementing measures that guarantee patients' dignity during all hospital admissions. Patient or public contribution: Survey questionnaires were completed by hospitalised older adults at the study setting. [ABSTRACT FROM AUTHOR]

Background: Pain in the postoperative period of amputation surgeries, when not managed correctly, can have consequences for the patient. Purposes and Objectives: The aim of this study was to map the scientific evidence on pain management in patients in the postoperative period of amputation surgeries. Design: Scoping review with elaboration based on the recommendations of the Joanna Briggs Institute, supported by The PAGER framework and guided by the PRISMA‐ScR Checklist. Methods: The survey was conducted in August 2022 in 10 data sources. The 3300 publications found were analysed by two independent reviewers, after applying inclusion and exclusion criteria, 16 studies were selected. Results: Publications occurred between the years 1997 and 2022 and mainly dealt with the management of residual pain and phantom limb through pharmacological measures with pain assessment made by numerical scales. Conclusions: The literature pointed out strategic uses of analgesics and highlighted technologies for neurostimulation through catheters. The need for new studies with non‐pharmacological measures and with designs that can prove their effectiveness is reinforced. Relevance to Clinical Practice: The knowledge of these strategies by health professionals allows adequate pain management and patient follow‐up for a less traumatic recovery. Patient or Public Contribution: To patient or public involvement in this scoping review. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to determine how much time nurses spend on direct and indirect patient care in acute and subacute hospital settings. Background: Quantifying direct and indirect nursing care provided during inpatient stay is vital to optimise the quality of care and manage resources. Design: Time and motion cross‐sectional observational study and reported the study according to the STROBE guideline. Methods: Nurses working in an acute or subacute medical wards of a single health service participated. Nurses were observed twice for 2 h on the same day with an observer break in between sessions. Real‐time task‐related data were digitally recorded using the Work Observation Method By Activity Timing (WOMBAT) tool by a single research assistant. Frequency and time spent on pre‐determined tasks were recorded and included direct care, indirect care, documentation, medication‐related tasks, communication (professional) and other tasks. Task interruptions and multitasking were also recorded. Results: Twenty‐one nurses (acute n = 12, subacute n = 9) were observed during shifts between 7 AM and 9 PM in May–July 2021. A total of 7240 tasks were recorded. Nurses spent a third of their time on direct patient care (27% direct care and 3% medication administration). A total of 556 task interruptions occurred, mostly during documentation, and medication‐related tasks. A further 1385 tasks were performed in parallel with other tasks, that is multitasking. Conclusions: Time spent on tasks was similar regardless of the setting and was consistent with previous research. We found differences in the distribution of tasks throughout the day between settings, which could have implications for workforce planning and needs to be investigated further. Interruptions occurred during documentation, direct care and medication‐related tasks. Local‐level strategies should be in place and regularly revised to reduce interruptions and prevent errors. Relevance to clinical practice The association between interruption and increased risk of error is well‐established and should be an ongoing area of attention including observations and education provided in local settings. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To evaluate the effectiveness of home‐based cardiac telerehabilitation in patients with heart failure. Design: This systematic review and meta‐analysis of randomised controlled trials were designed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Methods: Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias within the included studies. A fixed‐ or random‐effects meta‐analysis model was used to determine the mean difference, based on the results of the heterogeneity test. Data sources: A librarian‐designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI and Wanfang databases was conducted to identify studies in English or Chinese on randomised controlled trials up to 15 August 2022. Results: A total of 2291 studies were screened. The meta‐analysis included data from 16 studies representing 4557 participants. The results indicated that home‐based cardiac telerehabilitation could improve heart rate, VO2 peak, 6‐minute walk distance, quality of life and reduce readmission rates. No significant differences were observed in the left ventricular ejection fraction percentages between the home‐based cardiac telerehabilitation and usual care groups. Compared with centre‐based cardiac rehabilitation, home‐based cardiac telerehabilitation showed no significant improvement in outcome indicators. Conclusion: Patients with heart failure benefit from home‐based cardiac telerehabilitation intervention. With the rapid development of information and communication technology, home‐based cardiac telerehabilitation has great potential and may be used as an adjunct or substitute for centre‐based cardiac rehabilitation. Impact: This systematic review and meta‐analysis found that patients with heart failure would benefit from home‐based cardiac telerehabilitation intervention in terms of cardiac function, functional capacity, quality‐of‐life management and readmission rate. Future clinical interventions should consider home‐based cardiac telerehabilitation as an alternative to conventional cardiac rehabilitation in patients with heart failure to improve their quality of life. No Patient or Public Contribution: Our paper is a systematic review and meta‐analysis, and such details do not apply to our work. [ABSTRACT FROM AUTHOR]

Aims: To describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision‐making phase of treatment‐seeking. Background: Previous attempts to reduce the treatment‐seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID‐19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential. Design: Meta‐synthesis. Data sources: We searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022. Methods: We screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies. Results: Twenty‐one studies were included, identifying four themes and nine sub‐themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self‐sacrifice. Conclusion: Deciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID‐19 pandemic. Implications for the profession and/or patient care: Details of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated. Impact: Results would help healthcare professionals to implement individualised management of decision‐making of treatment‐seeking among AMI patients, and improve medical records of patients' prehospital experiences. Reporting Method: The Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings. Patient or Public Contribution: Two AMI patients contributed to the data synthesis by giving simple feedback about the final themes. [ABSTRACT FROM AUTHOR]

Aims/objectives: Through interviews with clinical service providers, we explored stigma's impact on HIV service provision for African Americans during COVID‐19. Background: African Americans experience disproportionate rates of HIV and COVID‐19. We explored COVID‐19's impact on HIV services for African American adults in a Southern city. Design: The study was qualitative and observational. Methods: Key informant interviews were conducted (n = 11) across two healthcare centres and two community‐based organisations and thematically analysed using phenomenological approaches by two coders. Interviews explored pre‐ and post‐COVID‐19 service provision and parallels between COVID‐19 and HIV, particularly as related to stigma. The COREQ checklist was utilised to ensure research quality. Results: According to the providers interviewed, all providers offered HIV prevention/treatment, but PrEP and preventive services diminished greatly early in the COVID‐19 pandemic. Successful transition to telehealth depended on existing telehealth use. Challenges exacerbated by COVID‐19 included food/housing insecurity and physical distancing constraints. Clients' COVID‐19 informational needs shifted from concerns to vaccine requests over time. Interviewees stated HIV and COVID‐19 both carry 'risk taking'; however, HIV risk was more physically intimate than COVID‐19. Notably, some providers used stigmatising language referring to clients with HIV/COVID and omitted person‐centred language. Conclusions: Findings suggest need to address challenges in telehealth to improve client experiences now and for future pandemics. More research is needed to examine intersectional stigmatisation of COVID‐19 and HIV for African Americans to design person‐centred counselling interventions. Relevance to Clinical Practice: Results demonstrate need for provider training to reframe stigma discussions using client centeredness, educating African Americans on HIV and COVID‐19 prevention, and coordination with local organisations to address multiple care needs. Patient/Public Contribution: This research highlights needs of clients based on the views of healthcare providers caring for predominantly African American communities in a Southern city. However, no patients, service users, caregivers or members of the public were directly involved in this study. [ABSTRACT FROM AUTHOR]

Aim: To synthesise qualitative research on pulmonary sequelae of COVID‐19 and identify patient needs and experiences to develop nursing care strategies. Background: Qualitative research on long COVID by subtype has not yet occurred. As pulmonary sequelae constitute a serious long COVID subtype, exploring patient experience and needs can generate knowledge to guide nursing practice. Design: Systematised review methodology utilised on a purposive sample of published articles and reported using the PRISMA guidelines and checklists. Searched MEDLINE, Cumulative Index to Nursing and Allied Health, and Google Scholar, for English or French articles published from February 2020 to June 2022; qualitative research with adults recovering from COVID‐19 with evidence of pulmonary sequelae. Methods: Established principles for data extraction followed related to data reduction, data presentation, data comparison, and conclusion formulation and verification. Analysis was informed by Thorne's Interpretive Description and extended with Meleis' transitions theory, Mishel's uncertainty in illness theory and Moore et al.'s holistic theory of unpleasant symptoms. The quality of included studies was assessed Joanna Briggs Institute critical appraisal tool for qualitative research. Results: Four articles with six pooled participants provided data to yield three main themes: (1) a novel health‐illness transition, (2) lung injury and pulmonary fibrosis as antecedent to illness uncertainty, (3) and pulmonary symptoms that are compounded by fatigue and weakness. Conclusion: Pulmonary sequelae of COVID‐19 confers a unique health‐illness transition, uncertainties and symptoms that can be addressed by theory informed nursing practice. Relevance to Clinical Practice: Advocacy, optimising the nurse–patient relationship, offering up‐to‐date information and addressing uncertainty may help patients cope with pulmonary sequelae, a complex subtype of long COVID with important considerations for clinical nursing care. Despite a lack of evidence‐informed clinical pathways, nurses can support patients to understand novel treatments, support discharge planning and acknowledge the synergistic nature of pulmonary symptoms and fatigue to support health‐illness transitions. No Patient or Public Contribution: This article involved analysis of previously published works. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum. Background: Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent. Design: This study was cross‐sectional and partly prospective. Methods: The sample consisted of mother–infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3‐month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi‐square tests and regression analyses were conducted. The STROBE checklist was followed. Results: Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain. Conclusion: Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group. Implications for Practice: Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care. Patient or Public Contribution: The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors. Trial Registration: The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242–31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850 [ABSTRACT FROM AUTHOR]

Aim: To explore perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. Design: A nested qualitative study within a multi‐centre, quasi‐experimental pilot study comparing usual care weight management to a dietitian‐led weight‐loss diet. Methods: Semi‐structured individual interviews were conducted with adults with end‐stage osteoarthritis and a body mass index ≥30 kg/m2 waitlisted for primary total knee or hip arthroplasty. Participants with diverse sociodemographic characteristics and varied success with weight management in the pilot study were purposively sampled. Interviews were analysed using inductive thematic analysis, underpinned by constructivist–interpretivist epistemology. The Patient Activation Measure and Health Literacy Questionnaire were used for context when interpreting the findings. Results: Twenty‐five participant interviews were conducted with a sociodemographically varied sample (aged 44–80 years, 9 born in Australia, 6 in paid employment and 11 lost ≥5% of their baseline weight). Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment‐related beliefs influenced participants' perspectives towards weight loss. Adaptability, the ability to overcome barriers to weight loss, comprised three subthemes; readiness to act, degree of independence and problem‐solving skills. Approaches towards navigating healthcare influenced uptake and adherence to weight management recommendations. Importantly, these themes were dependent on social and environmental circumstances, which influenced the type of barriers experienced and resources available to the individual. Conclusion: Differences in a person's beliefs, their ability to adapt and navigate healthcare and sociocultural context appear to explain successful weight management among people with end‐stage arthritis. Implications for the profession and/or patient care: Clinicians should allow for individualisation cognisant of the identified themes when providing advice and treatment to promote adherence to weight management interventions. Impact: This study explored perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment‐related beliefs influenced participants' perspectives towards weight loss. Understanding and assessing the contribution of each factor may guide weight management from clinicians treating patients with obesity and osteoarthritis. Reporting Method: The data are reported using the COREQ guidelines. Patient or Public Contribution: Patients contributed to the data collected. [ABSTRACT FROM AUTHOR]

Background: Older people in the nursing home environment are much less mobile and capable of taking care of themselves as they age, and most of them face the plight of loneliness, which seriously affects the quality of life of older people in their later years. Aims: A systematic review and synthesis of older people's experiences of loneliness in nursing homes. Design: Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. Methods: A search of PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database and the Wipu Database for qualitative studies of older people's experiences of loneliness in nursing homes was conducted with a search time frame of March 2023. Evaluation of the quality of the literature using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden's method of thematic and content analysis. Results: A total of 13 papers were included, and 36 research findings were distilled and integrated into three themes: causes of loneliness; feelings of loneliness; coping with loneliness; and seven sub‐themes: aging and loss; environmental transformation; loneliness is a pain; loneliness is a choice; participation; strengthening social ties; and diverting attention. Conclusions: Older people in nursing homes face varying degrees of loneliness, which is a subjective feeling influenced by the interplay between personal awareness and the external environment, so future care interventions should be developed in a comprehensive manner, taking into account the characteristics of the older people themselves and their external environment. No Patient or Public Contribution: This study is a meta‐synthesis and does not require relevant contributions from patients or the public. [ABSTRACT FROM AUTHOR]

Background: Burnout is a significant occupational problem among oncology nurses, affecting their physical and mental health and the quality of medical care. Besides, there is a gradually increasing trend that we should pay more attention to. Objectives: To investigate the prevalence, influencing factors and interventions of oncology nurses' burnout among different continents. Design: Systematic review and meta‐analysis. Data Sources: English literature in PubMed, EMBASE, MEDLINE/EBSCOhost, CINAHL Complete and Web and of Science were searched before 1 March 2022. Results: Twenty studies included 5904 oncology nurses in this review. Meta‐analysis was performed in 19 of the studies. First, the pooled mean scores estimate for emotional exhaustion (EE) was 22.13 (95% CI: 19.69–24.58), depersonalization (DP) was 6.89 (95% CI: 5.67–8.10) and personal accomplishment (PA) was 32.86 (95% CI: 29.34–36.37). A high level of burnout was defined as a high level of EE (score ≥ 27), a high level of DP (score ≥ 10), and a low level of PA (score ≤ 33). Of these, 36.40% of nurses reported high EE, 28.26% reported high DP and 28.68% reported low levels of PA. Furthermore, there are differences in the prevalence, influencing factors and intervention measures of burnout among oncology nurses in different regions. The highest pooled mean scores for EE and DP were found in Asia. And the highest pooled mean scores for PA were found in the Americas. The factors that influence burnout among Asian oncology nurses are mostly personal‐related factors such as empathy and personality traits, while the factors that influence burnout among European oncology nurses are work‐related factors. This review included three intervention studies from Europe and the Americas, with fewer intervention studies on burnout in oncology nurses in Asia. Conclusion: Oncology nurses in Asia had the highest pooled mean scores for EE and DP, and the highest mean scores for the PA pool in the Americas. There are regional differences in the prevalence and factors influencing burnout among oncology nurses, but there are few interventions for it. Therefore, future interventions should be developed to address the differences that exist in different regions. Relevance To Clinical Practice: Burnout among oncology nurses in different regions is a concern, and this review may provide a reference for managers to target interventions to alleviate burnout among oncology nurses. [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]

Aim and Objective: The aim of this cross‐sectional study was to determine the point prevalence and associated risk factors of medical device‐related pressure injuries (MDRPI) in intensive care patients in Turkey. Background: MDRPI remain a clinical problem that has garnered the attention of healthcare professionals. Design: This study used a cross‐sectional design and was conducted over a single day in all intensive care units. Method: Data were collected through face‐to‐face interviews, observation, skin examination and detailed diagnosis of MDRPI development and influencing factors. Presence of pressure injuries on the skin in the areas where the patient's medical device was placed was defined. The study was reported according to the STROBE declaration. Results: MDRPI developed in 65 out of 200 patients included in the study (32.5%). The most frequent locations were on the face (71%). The MDRPIs were commonly associated with nasogastric tube (29.2%), endotracheal tube (18.5%) and CPAP mask (15.4%). A significant proportion of these injuries were mucosal (53.8%, n = 35). The majority of the skin pressure injuries were classified as Stage II (18.5%, n = 12). The risk increased 14 times in patients who were hospitalised for 9–16 days and 13 times in those who received mechanical ventilator support. Conclusion: The study findings suggest that MDRPI developed in approximately one of three patients hospitalised in the intensive care unit, and the length of hospital stay and mechanical ventilator support were important determining risk factors. The high prevalence of MDRPI may indicate inadequate nursing care quality. Therefore, it is recommended that nurses be aware of risk factors and evaluate the suitability and safety of medical devices. Patient or Public Contribution: No patient or public contribution was involved in this study. [ABSTRACT FROM AUTHOR]

Aims: This study examined whether nurse work engagement mediated the associations of job resources (collegial support and autonomy) and a personal resource (empathy) with individualized care delivery, in both hospital and long‐term care settings. We also explored potential setting‐specific differences in how strongly the resources were associated with work engagement and individualized care delivery among nurses. Design: We conducted a cross‐sectional study in three hospitals and two long‐term care facilities. Methods: In total, 454 nurses completed a web‐based survey including validated measures on resources (collegial support, autonomy, empathy), work engagement and individualized care delivery. Data were analysed using mediation and moderated mediation analyses. Results: In both settings, all resources were indirectly associated with individualized care delivery via work engagement. Empathy was also directly associated with individualized care delivery, and a stronger association was found in the long‐term care setting than in the hospital setting. Conclusion: The present study showed work engagement to mediate the associations of job resources and empathy with individualized care delivery in both hospital and long‐term care settings. Individualized care delivery was furthermore directly facilitated by high levels of empathy, especially among nurses working in long‐term care settings. Implications for the profession and/or patient care: Patients may benefit from better individualized care delivery by empathic nurses who are more work‐engaged in the face of sufficient job resources in their practice environment. Impact: Nurses are better able to deliver individualized care when provided with sufficient job resources (collegial support and autonomy) that support their being work‐engaged professionals. Furthermore, empathic nurses also reported being able to better support patient individuality. These findings can be translated to policies of hospitals and long‐term care facilities, to optimize job resources and enhance empathy and thus facilitate the support of patient individuality by nurses. Reporting method: This study adhered to the STROBE guidelines. Patient or public contribution: Nurses were involved in the design and data collection of the study. [ABSTRACT FROM AUTHOR]

Aim: To explore discharge planning with a range of key stakeholders in subacute care, including consumers. Design: Qualitative descriptive study. Methods: Patients (n = 16), families (n = 16), clinicians (n = 17) and managers (n = 12) participated in semi‐structured interviews or focus groups. Following transcription, data were analysed thematically. Results: The overarching facilitator of effective discharge planning was collaborative communication, leading to shared expectations by all stakeholders. Collaborative communication was underpinned by four key themes: patient‐ and family‐centred decision‐making, early goal setting, strong inter‐ and intra‐disciplinary teamwork, and robust patient/family education. Conclusion: Effective planning for discharge from subacute care is enabled by shared expectations and collaborative communication between key stakeholders. Implications for the profession and/or patient care: Effective discharge planning processes are underpinned by effective inter‐ and intra‐disciplinary teamwork. Healthcare networks should foster environments that promote effective communication between and within multidisciplinary team members as well as with patients and their families. Applying these principles to discharge planning may assist in reducing length of stays and rates of preventable readmissions post‐discharge. Impact: This study addressed a lack of knowledge about effective discharge planning in Australian subacute care. It found that collaborative communication between stakeholders was an overarching facilitator of effective discharge planning. This finding impacts subacute service design and professional education. Reporting method: COREQ guidelines were followed in reporting this study. Patient or public contribution: No patient or public contribution in the design, data analysis or preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aims: This study examined the perceptions of the SHARE plus intervention and its effects on communication, collaboration, and involvement in day‐to‐day diabetes management in older adults with Type 1 diabetes (T1D) and their care partners. Background: The SHARE plus intervention includes continuous glucose monitoring with a data sharing app that allows care partners to view glucose data on a smartphone and receive alerts. People with T1D and their care partners are educated about communication strategies, problem‐solving strategies, and action planning when using glucose data sharing. Design: Qualitative descriptive design. Methods: Older adults with T1D wore a continuous glucose monitor for 3 months (n = 10). Care partners (n = 10) used a data‐sharing app. The SHARE plus intervention consisted of one 90‐min education session. Semi‐structured interviews were conducted across 10 dyads (person with diabetes and care partner) following the 12‐week study. A qualitative description and a constant comparison approach were used to examine similarities and differences in experiences. Interviews were transcribed, coded, and analysed for common themes. The manuscript adheres to COREQ EQUATOR checklist. Results: The SHARE plus intervention increased diabetes knowledge across the dyads, improving confidence and helping partners understand how to navigate symptoms and behaviours and when to intervene. Dyads worked together to optimise diabetes management through improved communication, collaboration, and management of disagreements. Although the majority of persons with diabetes and their care partners reported no conflictual communication, disagreements about diabetes management remained in some dyads. The SHARE plus intervention impacted care partners in various ways from a psychological perspective. While live‐in‐care partners felt peace of mind, care partners living away from persons with diabetes had some increased worry and concern. Conclusion: The SHARE plus intervention results can help guide future development of diabetes dyadic care and education interventions using diabetes technology. Relevance to Clinical Practice: The SHARE plus intervention is a brief, practical intervention that can help diabetes clinicians improve communication and collaboration among spouses living with older adults with T1D who use continuous glucose monitoring with data sharing. Patient Contribution: A person with diabetes was part of the research team and assisted with design of the intervention and subsequent interviews and analysis. [ABSTRACT FROM AUTHOR]

Aims: To investigate patients' psychological reactions to postponement of elective cardiac surgery, and whether postponement was associated with increased complications post‐operative and while waiting. Design: A single‐centre observational prospective cohort study. Methods: All adult patients referred for elective cardiac surgery during the study period were considered for inclusion. Psychological data were collected using a survey distributed to patients prior to surgery and at 6 months post‐operative. Clinical data were obtained from patient records. Results: A total of 83 postponed and 132 non‐postponed patients were included. Postponed patients displayed more avoidance behaviour, but only immediately before surgery. Postponed patients maintained their satisfaction with perceived social support, whereas non‐postponed patients became more dissatisfied over time. Waiting 0–14 days was associated with increased symptoms of depression before surgery compared to non‐postponed patients or those waiting more than 14 days. Surgical complications were the same in both groups. No patients experienced aggravation of their disease leading to urgent or emergent surgery while waiting for surgery. Hospital‐related reasons were the most common cause for postponement of surgery. Conclusion: Postponement of selected patients is not associated with increased risk of psychological distress or complications related to the patient's disease. Reporting Method: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Implications for Patient Care: Pre‐ and post‐psychological interventions may be relevant to consider in relation to elective cardiac surgery as it has been shown to positively affect outcome. Organisational/hospital‐related reasons are still very common causes for postponement of elective surgeries, and hospital administrations should focus upon eliminating/decreasing this. Public Contribution: Questionnaires filled by patients were used to understand an association between postponement of cardiac surgery and psychological distress. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to capture and explore family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown. Background: The unprecedented lockdown episodes due to COVID‐19 have brought significant changes in the hospital visiting policies and caregiving practices. As part of the precautionary measures for hospital visits, the bedside companion was restricted to one caregiver for patients with cancer in Shanghai hospitals. Design: This study adopted a descriptive phenomenological approach. Methods: Data were collected among 20 family caregivers recruited from the Oncology department of a tertiary hospital in Shanghai in May 2022, using purposive sampling method and followed by unstructured, open‐ended interviews. Colaizzi's seven‐step data analysis method was used to analyse the data to reveal the emergent themes and subthemes of the phenomenon. Results: Four themes were generated on family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown, including (1) Feeling scared for the patient; (2) Living a life feeling trapped under COVID‐19 surveillance; (3) Feeling neglected and unseen; (4) Growing resilience and appreciation. Conclusions: The lockdown exacerbated the burden of family caregivers when they cared for the hospitalised patients with cancer during the lockdown period. However, positive reframing of the lived experience facilitated their coping with the challenging situation. Relevance to Clinical Practice: Findings from this study highlighted the potential proactive roles the healthcare providers could play in improving family caregivers' health and supporting them during and beyond the COVID‐19 pandemic. Reporting Method: The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist. Patient or Public Contribution: Family caregivers of patients with cancer were involved in data collection and member‐checking of the transcripts and interpretations of their experiences. [ABSTRACT FROM AUTHOR]

Aim(s): To explore vital sign assessment (both complete and incomplete sets of vital signs), and escalation of care per policy and nursing interventions in response to clinical deterioration. Design: This cohort study is a secondary analysis of data from the Prioritising Responses of Nurses To deteriorating patient Observations cluster randomised controlled trial of a facilitation intervention on nurses' vital sign measurement and escalation of care for deteriorating patients. Methods: The study was conducted in 36 wards at four metropolitan hospitals in Victoria, Australia. Medical records of all included patients from the study wards during three randomly selected 24‐h periods within the same week were audited at three time points: pre‐intervention (June 2016), and at 6 (December 2016) and 12 months (June 1017) post‐intervention. Descriptive statistics were used to summarise the study data, and relationships between variables were examined using chi‐square test. Results: A total of 10,383 audits were conducted. At least one vital sign measurement was documented every 8 h in 91.6% of audits, and a complete set of vital signs was documented every 8 h in 83.1% of audits. There were pre‐Medical Emergency Team, Medical Emergency Team or Cardiac Arrest Team triggers in 25.8% of audits. When triggers were present, a rapid response system call occurred in 26.8% of audits. There were 1350 documented nursing interventions in audits with pre‐Medical Emergency Team (n = 2403) or Medical Emergency Team triggers (n = 273). One or more nursing interventions were documented in 29.5% of audits with pre‐Medical Emergency Team triggers and 63.7% of audits with Medical Emergency Team triggers. Conclusion: When rapid response system triggers were documented, there were gaps in escalation of care per policy; however, nurses undertook a range of interventions within their scope of practice in response to clinical deterioration. Relevance to Clinical Practice: Medical and surgical ward nurses in acute care wards frequently engage in vital sign assessment. Interventions by medical and nurgical nurses may occur prior to, or in parallel with calling the rapid response system. Nursing interventions are a key but under‐recognised element of the organisational response to deteriorating patients. Implications for the profession and/or patient care: Nurses engage in a range of nursing interventions to manage deteriorating patients, (aside from rapid response system activation) that are not well understood, nor well described in the literature to date. Impact: This study addresses the gap in the literature regarding nurses' management of deteriorating patients within their scope of practice (aside from RRS activation) in real world settings.When rapid response system triggers were documented, there were gaps in escalation of care per policy; however, nurses undertook a range of interventions within their scope of practice in response to clinical deterioration.The results of this research are relevant to nurses working on medical and surgical wards. Reporting Method: The trial was reported according to the Consolidated Standards of Reporting Trials extension for Cluster Trials recommendations, and this paper is reported according to the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To propose educational strategies to prevent delirium in older adults. Design: Integrative review. Methods: This review followed the methodology of Whittemore and Knafl (J Adv Nurs 52(5):546–553, 2005. 10.1111/j.1365‐2648.2005.03621.x). Data Sources: A literature search was performed of the PubMed, CINAHL, Embase, Cochrane Library CENTRAL, and Scopus databases on 8 July 2022. Results: Three themes of educational interventions were identified: capacity building, resource provision and enhancement of relationships, collectively termed Fa‐CARE. Educational interventions improved family caregivers' knowledge about delirium, their anxiety; depression; self‐efficacy; and attitudes. Among older adults, these interventions improved the duration, severity and incidence of delirium; functional abilities; and length of hospital stay. Conclusion: Providing education to family caregivers benefits both those caregivers and the older adults. When planning educational intervention, diverse and innovative approaches need to be considered. Implications for the profession and/or patient care: This study can guide family education regarding the care of older adults with delirium. Impact: Educational interventions positively impacted both family caregivers and older adults with delirium.Educational interventions provide family caregivers with resources, improve their capacity for delirium management, and enhance their relationships with older adults.This study suggests future directions in education for family caregivers of older adults with delirium. Reporting method: This review adhered to the EQUATOR guidelines by using the PRISMA 2020 checklist. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim(s): To systematically locate, evaluate and synthesize evidence regarding effectiveness of interprofessional tracheostomy teams in increasing speaking valve use and decreasing time to speech and decannulation, adverse events, lengths of stay (intensive care unit (ICU) and hospital) and mortality. In addition, to evaluate facilitators and barriers to implementing an interprofessional tracheostomy team in hospital settings. Design: Systematic review using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) and Johns Hopkins Nursing Evidence‐Based Practice Model's guidance. Methods: Our clinical question: Do interprofessional tracheostomy teams increase speaking valve use and decrease time to speech and decannulation, adverse events, lengths of stay and mortality? Primary studies involving adult patients with a tracheostomy were included. Eligible studies were systematically reviewed by two reviewers and verified by another two reviewers. Data Sources: MEDLINE, CINAHL and EMBASE. Results: Fourteen studies met eligibility criteria; primarily pre‐post intervention cohort studies. Percent increase in speaking valve use ranged 14%–275%; percent reduction in median days to speech ranged 33%–73% and median days to decannulation ranged 26%–32%; percent reduction in rate of adverse events ranged 32%–88%; percent reduction in median hospital length of stay days ranged 18–40 days; no significant change in overall ICU length of stay and mortality rates. Facilitators include team education, coverage, rounds, standardization, communication, lead personnel and automation, patient tracking; barrier is financial. Conclusion: Patients with tracheostomy who received care from a dedicated interprofessional team showed improvements in several clinical outcomes. Implications for Patient Care: Additional high‐quality evidence from rigorous, well‐controlled and adequately powered studies are necessary, as are implementation strategies to promote broader adoption of interprofessional tracheostomy team strategies. Interprofessional tracheostomy teams are associated with improved safety and quality of care. Impact: Evidence from review provides rationale for broader implementation of interprofessional tracheostomy teams. Reporting Method: PRISMA and Synthesis Without Meta‐analysis (SWiM). Patient/Public Contribution: None. [ABSTRACT FROM AUTHOR]

Problem: Nurses are fundamental in presenting information to their patients to ensure understanding of information, and health directions enabling improved health outcomes. Limited research exists exploring how nurses assess patient's health literacy in Australia. Aim: To explore Australian nurses' perceptions of patients' health literacy and how nurses assess health literacy to provide patient education. Design: A qualitative study underpinned by phenomenology. Methods: Registered Nurses (N = 19) across five Queensland hospitals participated in semi‐structured interviews which explored nurses' assessment of patient's health literacy level and their practices of delivering education. The transcripts were analysed using an inductive process with interpretative analysis. Results: Four themes were identified: how we assess patient health literacy; challenges with health literacy assessment; consumer focused assessment; and building assessment strategies. Participants relied on cues from the patient to identify when information has not been understood. Participants felt that online training programs in the workplace would assist in education for assessment techniques; identification of patients with low health literacy; and how to best communicate with patients that have low health literacy. Conclusion: Formal health literacy assessments should be introduced to hospitals in Australia, but training is required to enable the nurse, the confidence and ability for health literacy assessment. Tailored education based on health literacy assessment would enhance the patient's understanding and improve discharge planning, which may reduce health service costs and readmissions. Reporting method: The Consolidated criteria for reporting qualitative research (COREQ) guidelines for qualitative research were followed. Patient or public contribution: Registered Nurses (N = 19) participated in qualitative interviews, providing data for analysis. Relevance to clinical practice: This study shows that nurses are already conducting informal assessments, simply by using observation and looking for cues. More education for nurses about health literacy and how to tailor their discussions with patients will improve communication. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: To conduct an in‐depth exploration of oral hydration care provided to people living with dementia in acute hospital wards, using a person‐centred care framework. Background: Oral hydration care is an important, yet rarely explored aspect of fundamental care for people with dementia admitted to acute hospitals. Using person‐centred care as a conceptual framework we investigated how oral hydration care is delivered for people living with dementia in acute hospital wards. Design: A qualitative, multiple‐case study. The cases were three acute wards in one hospital. Methods: Direct observation of care for 13 people with dementia (132 h), semistructured interviews with ward staff (n = 28), ward leaders (n = 4), organisational leaders (n = 5), people with dementia (n = 6), their relatives (n = 5), documentary analysis of clinical inpatient records (n = 26) and relevant hospital policies. Data were analysed using framework analysis. Results: Four themes were identified: (1) The acute hospital: oral hydration is obscured and not prioritised (2) Overshadowing of oral hydration at ward level (3) Siloed nature of hydration roles (4) Strategies for, and barriers to, delivering person‐centred oral hydration care. Conclusions: This study combines the concept of person‐centred care and oral hydration care for people living with dementia admitted to acute hospital wards, demonstrating that person‐centred hydration care was complex and not prioritised. Relevance to Clinical Practice: Nurses should consider means of improving prioritisation and cohesive delivery of person‐centred hydration care in acute hospital wards. [ABSTRACT FROM AUTHOR]

Aim: To identify and classify the transitional and aftercare needs of persons hospitalised with and recovering from COVID‐19. Background: Several studies exist that describe the patient needs at the acute phase of COVID‐19. The transitional and aftercare needs that emerge during recovery, however, remain vague. Methods: A scoping review was conducted and reported according to the PRISMA extension guidelines for scoping reviews (PRISMA‐ScR). Primary studies were identified from database search. Narrative synthesis was undertaken, with the Omaha System as a framework. Results: Forty studies were included. Persons recovering from the infection may have several needs in all domains of the Omaha System. Although the severity and persistence of the needs may be unrelated to the severity of the initial infection, they may vary based on factors such as age and pre‐morbid factors. Conclusion: Recovering from COVID‐19 is associated with varied biopsychosocial‐environmental needs which can adversely affect the quality‐of‐life experience. The review findings represent an inventory of needs that can guide the development of multi‐disciplinary post‐acute or aftercare programmes. Relevance to Clinical Practice: Recovering from COVID‐19 can be a protracted process requiring ongoing professional support after discharge. Policies are required to support the development and implementation of post‐acute programmes of care. Comprehensive transitional and aftercare rehabilitative programmes are needed to support the recovery process. [ABSTRACT FROM AUTHOR]

Aims: To assess the association of postoperative delirium developed in the post‐anaesthetic care unit (PACU) with older patients' ability to perform activities of daily living (ADL) during the first five postoperative days. Background: Previous studies have focused on the association between postoperative delirium and long‐term function decline, however the association between postoperative delirium and the ability to perform ADL, particularly in the immediate postoperative period, needs further investigation. Design: A prospective cohort study. Methods: A total of 271 older patients who underwent elective or emergency surgery at a tertiary care hospital in Victoria, Australia, participated in the study. Data were collected between July 2021 and December 2021. Delirium was assessed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM‐5). The Katz Index of Independence in Activities of Daily Living (KATZ ADL) scale was used to measure ADL. ADL was assessed preoperatively and daily during the first five postoperative days. The STROBE checklist was used to report this study. Results: Results showed that 44 (16.2%) patients developed new episode of delirium. Postoperative delirium was independently associated with decline in ADL (RR = 2.83, 95% CI = 2.71–2.97; p < 0.001). Conclusions: Postoperative delirium was associated with a decline in ADL among older people during the first five postoperative days. Screening for delirium in the PACU is essential to identify delirium during the early stages of postoperative period and implement a timely comprehensive plan. Relevance to clinical practice: Delirium assessment of older patients in the PACU, and for at least the first five postoperative days, is strongly recommended. We also recommend engagement of patients in a focused physical and cognitive daily activity plan, particularly for older patients undergoing major surgery. Patient or public contribution: Patients and nurses helped in data collection at a tertiary care hospital. [ABSTRACT FROM AUTHOR]

Aims: To explore the implementation of a dementia care pathway in an acute care setting. Background: Dementia care in acute settings is often constrained by contextual factors. We developed an evidence‐based care pathway with intervention bundles, and implemented it on two trauma units, with the aim to empower staff and improve quality care. Design: Process evaluation using quantitative and qualitative methods. Methods: Pre‐implementation, unit staff completed a survey (n = 72) assessing family and dementia care skills and level of evidence‐based dementia care. Post‐implementation, champions (n = 7) completed the same survey, with additional questions on acceptability, appropriateness and feasibility, and participated in a focus group interview. Data were analysed using descriptive statistics and content analysis guided by the Consolidated Framework for Implementation Research (CFIR). Reporting Guideline: Standards for Reporting Qualitative Research Checklist. Results: Pre‐implementation, staff's perceived skills in family and dementia care were moderate overall, with high skills in 'building relationships' and 'sustaining personhood'. Evidence‐based interventions were delivered seldom to frequent, with 'individualized care' scoring lowest and 'assessing cognition' scoring highest. Implementation of the care pathway/intervention bundles was overshadowed by the pandemic, and failed due to major organisational‐ and process‐related barriers. Acceptability scored highest and feasibility lowest, with concerns relating to complexity and compatibility of pathways/bundles when introduced into clinical routines. Conclusions: Our study implies that organisational and process factors are the most influential determinants to the implementation of dementia care in acute settings. Future implementation efforts should draw on the evolving evidence within implementation science and dementia care research to ensure effective integration and improvement process. Relevance to Clinical Practice: Our study provides important learning around improving care for persons with dementia and their families in hospitals. Patient or Public Contribution: A family caregiver was involved in the development of the education and training programme. [ABSTRACT FROM AUTHOR]

Aims and objective: To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID‐19 pandemic (May–June 2020). Background: As other healthcare professionals, nursing students who worked during the first COVID‐19 wave suffered from dysfunctional mental health symptoms. Design: Sequential, mixed‐method, multicentre study. Methods: The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi‐structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting. Results: The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned. Conclusion: The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members. Relevance to Clinical Practice: In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience. [ABSTRACT FROM AUTHOR]

Aims: To examine the association between nursing unit safety culture, quality of care, missed care and nurse staffing levels, and inpatient falls using two data sources: incidence of falls and nurses' perceptions of fall frequency in their units. The study explores the association between the two sources of patient falls and identifies if nurses' perceptions of patient fall frequency reflect the actual patient falls recorded in the incident management system. Background: Inpatient falls are associated with severe complications that result in extended hospitalisation and increased financial consequences for patients and healthcare services. Design: A multi‐source cross‐sectional study guided by the STROBE guidelines. Methods: A purposive sample of 33 nursing units (619 nurses) from five hospitals completed an online survey from August to November 2021. The survey measured safety culture, quality of care, missed care, nurse staffing levels and nurses' perceptions of patient fall frequency. In addition, secondary data on falls from participating units between 2018 and 2021 were also collected. Generalised linear models were fitted to examine the association between study variables. Results: Nursing units with strong safety climate and working conditions and lower missed care were associated with lower rates of falls using both data sources. Nurses' perceptions of the frequency of falls in their units were reflective of the actual incidence rate of falls, but the association was not statistically significant. Conclusion: Nursing units with a strong safety climate and better collaborations between nurses and other professionals, including physicians and pharmacists, were associated with lower incidents of patient falls. Relevance to Clinical Practice: This study provided evidence for healthcare services and hospital managers to minimise patient falls. Patient or Public Contribution: Patients who had experienced a fall, which was reported in the incident management system, from the included units in the five hospitals were part of this study. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore what constitutes brilliant aged care. Background: Although many aged care services do not offer the care that older people and carers need and want, some perform better. Rather than focus on problems with aged care, this study examined brilliant aged care—practices that exceeded expectation. Design: The methodology for this study was informed by grounded theory, underpinned by constructionism to socially construct meaning. Methods: This study invited nominations for a Brilliant Award via a survey, and interviews with the nominees via web conference. After receiving survey responses from 10 nominators, interviews were conducted with 12 nominees. Data were analysed using reflexive thematic analysis and documented according to COREQ guidelines to optimise rigour and transparency. Results: According to participants, brilliant aged care involved being relationally attuned to older people, a deep understanding of the older person, recognition of aged care as more than a job, innovative practices and permission to reprioritise. Conclusions: This study suggests that, in aged care, brilliance happens. It emphasises the importance of meaningful connections and relationships in aged care, where thoughtful acts acknowledge an older person's value and humanity as well as creativity and innovation. Relevance to Clinical Practice: For those who manage and deliver aged care, the findings suggest that small practice changes can make a positive difference to older people. Brilliant aged care can involve acts of empathy; enthusiasm for aged care; innovative practices, even those that are small scale; and reprioritising workplace tasks to spend time with older people. For policymakers, this study highlights the need to recognise and raise the profile of the pockets of brilliance within the aged care sector. This might be achieved via awards and other initiatives that serve to celebrate and learn from brilliance in its myriad forms. Patient or Public Contribution: The nominees, who included carers, were invited to participate in workshops with other carers and older people to co‐design a model of brilliant aged care, during which workshop participants discussed and critiqued the findings constructed from the data. [ABSTRACT FROM AUTHOR]