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Purpose: The aim of this paper was to present the results of the first study in which nursing research literature production was studied in the relation to country and health determinants. Design: Bibliometric analysis was used. Methods: The corpus of nursing publications was harvested from the Scopus indexing and abstracting database. Using research articles' metadata (funding acknowledgments, publication years, and author affiliations), we analyzed global trends in the nursing research literature production of funded and nonfunded publications. Next, we performed a regression analysis and correlation analysis relating nursing research productivity to health and country determinants. Findings: The search resulted in 118,870 papers, among which 22.0% were funded (24.7% for G8 countries). Nursing literature production is exhibiting a positive trend. The United States is by far the most productive country in terms of funded and nonfunded literature production, although it is ranked only ninth in per capita production, for which Sweden is the most productive country regarding funded papers. The study also revealed that gross domestic product, human development factor, and gross national income were related to nursing research literature productivity. Conclusions: The positive trend in nursing research literature production (both funded and nonfunded) reveals a growth in nursing research funding. Regionally centered research literature production shows that the more developed and "rich" countries produce the majority of publications. A positive correlation is evident between country determinants and research literature production, as is a positive correlation between per capita literature research production and well‐being and health determinants. Clinical Relevance: Substantial growth in terms of nursing research literature production and research funding has been identified. While a limited amount of research in this area exists, this study revealed some interesting relations between nursing literature production and country and health determinants, which might motivate nursing researchers to pursue more intensive research and funders to support further growth of nursing research funding. [ABSTRACT FROM AUTHOR]

Purpose: The confidence in a study will be reduced due to the incorrect representation of statistical results. However, it is unknown to what extent p values are incorrectly represented in published nursing journals. The study aims to evaluate the articles in 30 nursing journals in terms of the error in reporting of p values (p =.000). Design and Methods: This was a bibliometric analysis. All papers published in 10 leading nursing journals (between 2015 and 2019), the 10 bottom nursing journals (2019), and 10 selected key nursing journals (2019) indexed in the Science Citation Index Journal Citation Reports were reviewed to detect errors in reporting of p values (p =.000). Results: A total of 3,788 papers were reviewed. Notably, it was found that 93.3% (28/30) of the nursing journals contained incorrect representation of p values (p =.000). The reporting rate of these journals ranges from 0% to 57.1%, with an overall rate of 12.8% (486/3,788). In addition, the rate of incorrect representation of p values (p =.000) showed no statistically significant difference between different publication years (Χ2 = 4.976, p =.290). However, the rate of reporting was different between study types, journals, and regions (p =.007, p =.020, and p <.001, respectively). Conclusions: The incorrect representation of p values is common in nursing journals. Clinical Relevance: We recommend that both publishers and researchers be responsible for preventing statistical errors in manuscripts. Furthermore, various kinds of statistical training methods should be adopted to ensure that nurses and journal reviewers have enough statistical literacy. [ABSTRACT FROM AUTHOR]

Background: Preschool‐age children in hospitals are at a high risk of unexpected incidents. Safety incidents in hospitals can cause serious damage to the children. Objective: To determine the effectiveness of the mobile‐type mHealth Safe Kids Hospital (SKH) application (app) for the prevention of hospitalized child safety incidents. Design: This study used a three‐group, randomized controlled trial pre‐post design. Setting(s): This study was conducted in the pediatric ward of three general hospitals in Korea. Participants: A total of 124 eligible hospitalized children and their caregivers were enrolled in the study from June to December 2018. Of these, 116 finally participated in the study, and 8 were excluded because they were discharged before the intervention. Methods: Hospitalized preschool‐age children and their caregivers were randomly allocated into three groups: experimental group I (n = 39), experimental group II (n = 39), and the control group (n = 38). Experimental group I received the SKH app intervention, the experimental group II received a paper‐based intervention, whereas the control group received the usual intervention. Participants' outcomes of awareness, knowledge, and behavior related to hospital safety, were assessed at two time points: baseline and 24 h after the intervention. Results: Hospital safety awareness had a higher increase after intervention in experimental groups I and II than in the control group. Among the four subdomains of hospital safety awareness, there was a significant increase in the scores of experimental group I on three subdomains after the intervention: falls (F = 8.19, p < 0.001), burns (F = 6.73, p = 0.002), and medical devices (F = 6.81, p = 0.002). In hospital safety knowledge and safety behavior, experimental group I had the highest average score after the intervention compared with experimental group II and the control group; however, there was no statistically significant difference in the average score of the three groups. Conclusions: Using the SKH app is easy to attract the interest of preschool‐age children and is also easy for nurses to use in clinical trials; thus, it is considered to be a useful educational intervention to prevent safety incidents in clinical fields in future. Clinical Relevance: It is thought to contribute to the prevention of preschool‐age children's safety incidents in pediatric wards. [ABSTRACT FROM AUTHOR]

Purpose To examine the effect of auricular acupressure therapy on primary dysmenorrhea among female high school students in South Korea. Design A randomized controlled trial was employed. Methods The study sample consisted of 91 female high school students, with 45 participants in the experimental group and 46 in the control group in two regions of South Korea. The average age of the participants was 16.7 years, and the average age of menarche was 12.2 years. Auricular acupressure therapy including an auricular acupressure needle on skin paper tape was applied on an ear for 3 days during periods of extreme primary dysmenorrhea. The acupoint names were Jagung, Sinmun, Gyogam, and Naebunbi. For the placebo control group, only the skin paper tape without an auricular acupressure needle was applied on the same acupoints. Measures used were the Menstrual Distress Questionnaire to assess primary dysmenorrhea, and the visual analog scale to assess abdominal and back pain of participants. Findings There were significant differences on abdominal pain ( t = 24.594, p < .001), back pain ( t = 22.661, p < .001), and primary dysmenorrhea ( t = 32.187, p < .001) between the two groups. Auricular acupressure therapy decreased abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. Conclusions Auricular acupressure therapy was an effective intervention for alleviating abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. For feasibility of the auricular acupressure therapy in practice, it is needed to train and learn the exact positions of acupoints in ear. Clinical Relevance Health providers should consider providing auricular acupressure therapy as an alternative method for reducing abdominal and back pain, and primary dysmenorrhea in female high school students in South Korea. [ABSTRACT FROM AUTHOR]

Purpose: Despite the importance of research in the discipline of nursing, current trends in nursing research have rarely been discussed across countries. The purpose of this article was to identify current trends in nursing research across five countries, including the United States, South Korea, Taiwan, Japan, and Hong Kong, in order to provide directions for future global nursing research. Organizing Construct: A discussion article. Methods: To identify the current trends, seven leaders from the five countries had discussions through a series of workshops and conference presentations. After the most recent conference, all the leaders reflected for a month on their presentations and compiled the exemplars and cases from their experience and the existing literature in individual countries into a table. The tables and supporting references were collected at the completion of the reflection period. Then, the PowerPoint (Microsoft Corporation, Redmond, WA, USA) slideshows of the conference presentations by the leaders and the collected tables were analyzed using a content analysis. Findings: Six themes reflecting the current trends in nursing research were extracted: (a) demographic alterations; (b) increasing diversities and globalization; (c) technology innovation; (d) individualized or personal care and population health initiatives; (e) health policies and regulations; and (f) nursing workforce changes. Conclusions: Future directions for nursing research across the countries were proposed: (a) cost‐effectiveness research; (b) implementation science; (c) data science; (d) training of the future generation of nurse researchers; (e) population health; and (f) team science. Clinical Relevance: This topic could be applied to any clinical settings. [ABSTRACT FROM AUTHOR]

Purpose To examine the perception of registered nurses and nursing assistants regarding the use of physical restraints with residents of nursing homes located in four of the regions of Spain; and to evaluate the relationship of these perceptions to the staff respondents' level of training. Design Cross-sectional multicenter and correlational study. The research was conducted in 2013 in 19 Spanish nursing homes with 2,940 residential beds. A total of 785 nurses (170 registered nurses and 615 nursing assistants) participated in the study. Methods The Perception of Restraint Use Questionnaire (PRUQ), consisting of 17 of the most cited reasons for using these devices, was used, as was a questionnaire capturing the sociodemographic characteristics and educational or experience level of staff respondents. Findings Nurses reported the most important uses for restraints as prevention of falls and avoidance of medical device interference. As indicated by an average PRUQ score of 3.47, staff respondents supported restraint use, especially nursing assistants (3.59) as compared to registered nurses (3.00). With regard to training: 83.7% had participated in little, if any, training and only 29.2% had read three or more documents related to restraint use; 66.6% believed that their training was inadequate. No correlation was found between the results of the PRUQ and the respondents´ sociodemographic characteristics or participation in training activities. No differences were found among nurses by region. Conclusions In contrast to papers published in other countries, nurses in this study still consider it necessary to apply restraints in everyday practice. The education of nursing staff regarding restraint and knowledge of alternatives is needed; they should at least be aware of international standards of care regarding physical restraint use. Clinical Relevance Most of the staff perceived their training related to the use of these devices as insufficient. Nursing assistants considered the use of restraints more important than did the registered nurses. [ABSTRACT FROM AUTHOR]

Purpose: The research aimed to examine the effect of a lifestyle intervention program using mobile application versus booklet for adults with metabolic syndrome in Hong Kong. The outcomes comprised body weight (primary outcome), exercise amount, improvement of cardiometabolic risk factors, cardiovascular endurance, perceived stress scale, and exercise self‐efficacy. Design A three‐arm randomized controlled trial namely App group, Booklet group, and control group was adopted. Methods: Two hundred sixty‐four adults with metabolic syndrome were recruited from community centers from 2019 to December 2021. Inclusion criteria are those adults with metabolic syndrome, able to use a smart phone. All participants received a 30‐min health talk. App group additionally received a mobile application, while Booklet group received a booklet, and the control group received a placebo booklet. Data were collected at baseline, Weeks 4, 12, and 24. SPSS and generalized estimating equations (GEE) model were employed for data analysis. Findings Attrition rates were minimal, ranged from 2.65% to 6.44%. Both app and booklet group showed significant improvement in outcomes (exercise amount, waist circumference) when compared to control group. However, statistically significant and superior results were observed in app group, including body weight, exercise amount, waist circumference, body mass index, and systolic blood pressure when compared to booklet group. Conclusion: The lifestyle intervention supported with app was found to be superior to the booklet support for reducing body weight and maintaining exercise. Clinical Relevance: The lifestyle intervention program using mobile application support could be used widely for adults with metabolic syndrome in the community. Suggest nurses may incorporate this program in their health promotion strategies focusing on a healthy lifestyle to reduce the risk of progression to metabolic syndrome. [ABSTRACT FROM AUTHOR]

Purpose: Since its origin in the United States in 2005, Quality and Safety Education for Nurses (QSEN) has guided nurses' preparation for alleviating preventable harm and improving quality safe care. QSEN's value is illustrated through specific inclusion in the competency‐based 2021 American Association for Colleges of Nursing (AACN) Essentials. The purpose of this bibliometric analysis is to explore publication patterns of the extant QSEN literature to assess QSEN's spread and global penetration and to map the available knowledge and data regarding quality and safety education for nurses. Design Bibliometric analysis. Method: Two QSEN investigators and two health science librarians completed database searches to identify articles with keywords QSEN or Quality and safety education for nursing. Inclusion criteria were (1) QSEN‐specific and (2) published in a peer‐reviewed journal. Using PRISMA screening, the final sample included 221 articles between 2007 and 2021. Results: Average annual QSEN publications was 14.5 articles; the highest was 26 publications in 2017. Article types were 84 research, 77 descriptive/reviews, 28 quality improvement projects or case studies, 20 statements, and 12 editorials. Focus analysis revealed 165 education articles, 35 clinical practice, 17 professional development, and 4 leadership/administration. Fourteen journals published three or more; eight were education journals. Nine topic clusters indicated areas of publication focus, including clinical teaching, simulations, performance, context, and criteria of analysis, factors of efficacy, innovation and advanced practice, patient care and outcomes, academic concepts, and research frameworks. Conclusions: Results reveal far less QSEN penetration for guiding professional practice, research measuring outcomes and impact, and global collaboration to examine cultural implications for diversity and inclusion. Results present future recommendations to assure all nurses worldwide have access to competency development to alleviate preventable healthcare harm. Clinical Relevance: Originating in the United States (US), the QSEN project provided the seminal framework for transforming education and practice through defining the six quality and safety competencies (patient‐centered care, teamwork and collaboration, evidence‐based practice, quality improvement, safety, and informatics) essential to alleviate preventable healthcare harm. Results reveal opportunities to advance QSEN penetration in developing professional practice, guiding research measuring outcomes and impact, and extending global collaboration to examine cultural implications for diversity and inclusion. [ABSTRACT FROM AUTHOR]

Background: Healthcare systems are becoming increasingly complex. Systems thinking can help us to understand this complexity and how to apply that understanding to design and evaluate interventions that improve health outcomes. With the current emphasis on developing advanced nursing practice, it is timely to examine systemic processes that characterize ANP systems and their interactions with wider healthcare systems, and how these processes enable and constrain the role. Objective: To make explicit the systemic processes that characterize the Advanced Nurse Practitioner (ANP) system and how they enable and constrain the role. Design: An interpretive descriptive study. Setting: The study was conducted in a large Hospital Group, consisting of eleven acute hospitals, within the Irish Healthcare System. Participants: Twenty nine participants, including ANPs, nurses, nurse managers, medics and allied health professionals, participated in the study. Methods: Data were collected through seven in‐depth interviews and four focus groups. Data were analyzed using the Organic Systems Framework (OSF), where attention was on language indicative of the processes of individuation, integration, differentiation and homogenization. Results: Participants emphasize how ANP systems exert power by individuating and differentiating; however, restrictive regulations and medical control constrain this power. Integration and homogenization are expressed as ANPs encourage and engage in collaborative practice towards common purposes. When hierarchical structures and professional self‐interest dominate, however, these processes are submerged, resulting in unbalanced systems. Conclusion: ANP systems realize their power through increased autonomy by individuating and differentiating. Hierarchical structures positioning ANPs in subservient roles should be challenged. Processes of integration and homogenization are expressed in collaborative practices. We recommend that ANPs realize and articulate the value and diversity that they bring to health systems to strengthen their contribution to them. Clinical Relevance: Lack of awareness of the systemic processes that enable and constrain the ANP role affects the role's potential contribution to the healthcare system. Systems thinking and employing the OSF as an analysis framework can help us to understand these processes and their implications, and how to apply that understanding to design and evaluate interventions that improve health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Recognizing the specific factors in relapse disorders related to each substance can help improve treatment methods and adopt more effective preventive strategies. This study aimed to compare the situational factors associated with relapse in opiate‐related disorders with stimulant‐related disorders (SRDs) of those referred to substance misuse treatment centers. Design: This study was a cross‐section type. Methods: The study participants were 150 clients with SRDs and 150 with opiate‐related disorders. Samples were selected using two stages random sampling method. Data were collected through a demographic questionnaire and the Inventory of Drug‐Taking Situations (IDTS). Results: The mean score of IDTS in the two groups was significantly different (X̄1 = 45.93 ± 11.12 vs. X̄2 = 48.34 ± 15.07; t = 3.32, p < 0.01). The mean scores of 'unpleasant emotions,' 'physical discomfort,' 'conflict with others,' and 'social pressure to use and urge/temptations' subscales were significantly higher in the stimulant group than in the opiate group (p < 0.05). However, the mean of the testing' personal control' subscale was higher in the opiate group than in the stimulant group (p < 0.05). Conclusion: This study reveals that despite some similarities, relapse‐related situational factors in opiates and stimulants differ. Some situational factors, such as social pressure and coping with unpleasant emotions, play a more critical role in relapse to both stimulant and opiate groups. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is increasing among Andalusian adolescents, causing health, social and financial problems. School nurses visit schools and provide health promotion to adolescents in Andalusia. In order to better tailor health promotion programs, it is important to understand the sociodemographic and motivational factors related to cannabis use in Andalusian adolescents. Design/Methods: In this cross‐sectional study, 369 students (aged 15–18 years) from secondary schools in Andalusia were involved. An anonymous questionnaire based on the I‐Change Model was self‐administered during school hours. Cannabis users were compared with non‐cannabis users regarding sociodemographic and motivational factors. Contingency tables, mean comparison tests, and logistic regression analyses were conducted. Results: The prevalence of cannabis use in the last year was 21.6%. Non‐cannabis users had a few positive beliefs toward cannabis use (e.g. the ability to relax or medical benefits), as well as users. Users recognized some disadvantages of cannabis use but played down their importance and mentioned more advantages. Moreover, social influence, especially from peers, plays a critical role in cannabis use. Specific social situations and moods seemed to be special risk factors for cannabis use, such as being at a celebration or feeling good. Results of regression analysis showed that cannabis use is mainly associated with age, low family function, low family affluence, high pocket money, perceiving few disadvantages of cannabis use, much social modeling of cannabis use, social norm and pressure favoring cannabis, low self‐efficacy to resist using cannabis and positive intentions to use cannabis. Conclusions: Based on our results, prevention programmes lead by nurses can be tailored to the factors important to prevent cannabis use, focusing on outlining the disadvantages of cannabis use, alternatives for using cannabis when feeling good, increasing salience of healthy social influences and reinforcing self‐efficacy to resist temptations to use cannabis are recommended. Clinical Relevance: Nurses need to know the sociodemographic factors and motivations associated with the use of cannabis in adolescents in order to establish effective preventive interventions at school. [ABSTRACT FROM AUTHOR]

Introduction: Although many studies have investigated the relationship between patient outcomes and the level of nurse staffing, little is known about the association between increased night‐shift nurse staffing and patient outcomes. In the Japanese universal health insurance system, a new scheme of additional financial incentives for acute care hospitals was launched in 2012 to increase the number of nurses during the night shift in general wards. The objective of this study was to investigate whether an additional financial incentive to increase night‐shift nurse staffing in general wards was associated with better patient outcomes. Design: Adoption of the above‐mentioned scheme of additional financial incentives was used as a natural experiment, and the difference‐in‐differences method was conducted to evaluate the effect of the scheme. The study was performed using a nationwide inpatient database and hospital information in Japan. Methods: To conduct a difference‐in‐differences analysis, first, hospitals with and without increased night‐shift nurse staffing were matched using propensity score matching. A patient‐level difference‐in‐differences analysis was then conducted. The intervention group comprised the hospitals that adopted the new scheme of additional financial incentives. The outcome measures were in‐hospital mortality, failure to rescue, and length of hospital stay. Results: Subjects were 403,971 adult patients who underwent planned major surgeries in Japanese acute care hospitals from April 2012 to March 2018. The adjusted difference‐in‐differences estimates were not significant for in‐hospital mortality (odds ratio: 0.83; 95% confidence interval: 0.68 to 1.01; p = 0.07) or failure to rescue (odds ratio: 0.92; 95% confidence interval: 0.73 to 1.14; p = 0.44). The adjusted difference‐in‐differences estimate for length of hospital stay was significant (percent change: −3.2%; 95% confidence interval: −6.1 to −0.3%; p = 0.029), indicating that the adoption of the scheme was associated with a decreased length of hospital stay. Conclusions: Increased night‐shift nurse staffing was not associated with a decrease in in‐hospital mortality or failure to rescue, but it was associated with a reduction in the length of hospital stay. It may be necessary to consider changes in policy content to make the policy more effective. The findings of this study are potentially useful for medical policymakers considering nurse staffing to decrease the length of stay, which may decrease costs. Clinical relevance: This study showed that increased night‐shift nurse staffing was not associated with a decrease in in‐hospital mortality or failure to rescue, but it was associated with a reduction in the length of hospital stay. The examination of the effectiveness of increasing nurse staffing during a specific shift in acute care hospitals is potentially useful for health policymakers worldwide in their considerations of future nurse staffing policies. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review and meta‐analysis aimed to synthesize the outcomes of theory‐based nursing interventions for coronary heart disease management. Design and Methods: Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta‐analyses statement guidelines was followed for this meta‐analysis. Randomized controlled trials on patients with coronary heart disease, using a theory‐based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p‐values, and fixed or random‐effect models (PROSPERO registration number X). Findings A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta‐analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta‐analysis found theory‐based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life. Conclusions: The evidence from this meta‐analysis reveals that theory‐based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well‐designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory‐based nursing interventions on patient outcomes in the CHD population. Clinical relevance: Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta‐analysis provides insights into the implementation of theory‐based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory‐based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes. [ABSTRACT FROM AUTHOR]

Background: Post‐stroke cognitive impairment (PSCI) imposes a huge burden on patients and society as a whole; however, unequivocally effective treatments for PSCI are still lacking. Therefore, the exploration of effective and safe non‐pharmacological treatment modalities for PSCI is a key imperative. Moxibustion has been widely used for cognitive rehabilitation; however, there is a paucity of systematic reviews of the available evidence. Therefore, we conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs) that investigated the effectiveness of moxibustion for treatment of PSCI to provide evidence base for the treatment of PSCI with moxibustion. Objective: To evaluate the efficacy of moxibustion in improving cognitive function and activities of daily living (ADLs) in patients with PSCI. Design: Systematic review and meta‐analysis of RCTs. Participants: Patients with a clinical diagnosis of PSCI. Review Methods: Relevant studies published in English or Chinese were retrieved from ten databases until December 2021. RCTs that assessed the efficacy of moxibustion on cognitive functioning and ADL in patients with PSCI were included. Two reviewers independently identified the trials and extracted the data. Risk‐of‐bias was assessed using the Cochrane Risk of Bias Tool. Cochrane's Review Manager (RevMan 5.4) software was used for the meta‐analysis. Results: Eighteen RCTs (1290 participants) qualified the inclusion criteria and were included. Compared with the control group, the addition of moxibustion significantly improved the cognitive function, evaluated using the Montreal Cognitive Assessment (MoCA) [pooled mean difference (MD): 2.27, 95% CI: 1.98, 2.55, I2 = 22%]. The pooled MD of Mini‐Mental State Examination (MMSE) score was 1.85 (95% CI: 1.56, 2.15, I2 = 26%), and the pooled odds ratios (OR) total effective rate was 4.74 (95% CI: 2.55, 8.80, I2 = 0%) (p < 0.05 for all). Moxibustion also significantly improved ADL, assessed using Modified Barthel Index (MBI) (pooled MD = 4.10, 95% CI: 2.10 to 6.10, I2 = 0%) and Barthel Index (pooled MD: 8.63, 95% CI: 7.47, 9.79, I2 = 5%) (p < 0.05 for all). Conclusions: Compared with control group, the addition of moxibustion significantly improved the cognition and ADL of patients with PSCI. Clinical Relevance: Nurses can incorporate moxibustion into the rehabilitation nursing of PSCI. [ABSTRACT FROM AUTHOR]

Introduction: Internationally, the adoption of technology into residential aged care settings has been slow and fraught with multiple challenges for residents, staff and service providers. The aim of this study was to evaluate the acceptability, efficiency, and quality of health information system implementation into aged care. Methods: Three‐stage, mixed‐methods participatory action research, concurrent with the natural experiment of a co‐designed health information system implementation into a 169‐bed aged care home in Australia. Data were collected pre‐, during, and post implementation between 2019 and 2021. Qualitative data included focus groups, interviews, and observations. Quantitative data included work observations, pedometers, record audits, incident reports and staff and resident surveys. There were 162 participants composed of 65 aged care residents, 90 staff, and 7 managers/consultants. Results: Improved work efficiency included reduced staff time searching for information (6%); reduced nurse time on documentation (20.4% to 6.4%), and 25% less steps. Documentation improvement included resident assessments (68% to 96%); resident‐focused goals (56% to 88%) and evaluations (31% to 88%). The staff reported being better equipped to manage the 'delicacies of dignity'. Conclusion: Implementation of a health information system into a residential aged care facility was associated with improved resident‐focused care and staff efficiency. Clinical relevance: Technology can support nurses and care staff to spend more time with residents in residential aged care homes, improve the quality of resident care, and assist meeting regulatory reporting requirements. Flexible and tailored co‐design strategies can enhance both effectiveness and success of technology implementation into residential aged care. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic had an unprecedented effect on those living and working in care‐homes for older people, as residents were particularly vulnerable to contracting the SARS‐CoV‐2 virus, associated with high morbidity and mortality. Often undervalued, care‐home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID‐19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. Objective: To explore RNs' experiences of working in older people's care‐homes during the COVID‐19 pandemic. Design: Qualitative interview study. Setting: Care‐homes for older people in England and Scotland, UK. Methods: Recruitment via direct contact with care‐homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of care‐home, and location. Data collected through one‐to‐one online interviews using topic guide developed collaboratively with care‐home nurses, focusing on how COVID‐19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. Results: Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March–June 2021; majority aged 46–55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID‐19. RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt that relatives and regulatory bodies were not always appreciative. RNs developed enhanced clinical skills, increasing their professional standing, but reported having to compromise care, leading to moral distress. Broadly, participants reported a sense of solidarity across care‐home staff and working together to cope with the crisis. Conclusion: Care‐home nurses felt unprepared for managing the COVID‐19 pandemic, many experienced moral distress. Supporting care‐home nurses to recover from the pandemic is essential to maintain a healthy, stable workforce and needs to be specific to care‐home RNs, recognizing their unique pandemic experiences. Support for RNs will likely benefit other care‐home workers either directly through wider roll‐out, or indirectly through improved wellbeing of nurse leaders. Clinical relevance: The COVID‐19 pandemic, an international public health emergency, created many challenges for Registered Nurses (RNs) working in long‐term care facilities for older people, as residents were particularly vulnerable to the impact of the SARS‐CoV‐2 virus. Care‐home RNs faced challenges distinct from their hospital‐based nursing peers and non‐nursing social care colleagues due to their isolation, leadership roles, professional legal obligations, and ethical responsibilities, leading to psychological distress on the one hand, but also a newly found confidence in their existing and newly developed skills, and increased recognition by the wider health community of their specialisms. [ABSTRACT FROM AUTHOR]

Purpose: We examined the association between social distancing and trouble sleeping during the COVID‐19 outbreak in adults 65+, and underlying potential mechanisms. Methods: We used data from the extensive Survey of Health, Aging, and Retirement in Europe (SHARE). Logistic regression analysis tested the direct and indirect associations between social distancing and trouble sleeping during the pandemic, the mediation effect of depression, and the moderating‐mediation effects of perceived economic status and employment status. Findings Social distancing was associated with a higher probability of sleeping problems, partially mediated by depression and moderated by employment status and perceived economic status. Depression had a greater effect on trouble sleeping among those unemployed and those who perceived their economic status as difficult or partially difficult. Conclusion: COVID‐19 policy of lockdowns and physical distancing has negative consequences on sleeping and the development of depressive symptoms among older adults. Clinical and policy relevance: Clinicians should be aware of sleep problems in older adults during the pandemic and after, and try to reduce depressive symptoms. Policymakers should determine future policies and regulations that encourage employment among older adults and improve their economic resilience during pandemics. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth's potential to improve access to specialty health care, increase favorable patient outcomes, and save money demands attention. Unfortunately, patients often fail to embrace telehealth. The COVID‐19 pandemic fueled greater telehealth usage globally. Little is known about patient perceptions of telehealth in the context of a pandemic. Therefore, we sought to understand patient perceptions of telehealth during the COVID‐19 pandemic and explore relevant policy implications. Design: Researchers used a cross‐sectional, non‐experimental design to survey 366 patients across two telehealth programs at a Mississippi academic health sciences center between November 1, 2021 and November 15, 2021. Methods: As part of a larger, psychometric study on patient acceptance of telehealth, participants rated the item, "The COVID‐19 pandemic has made me more open to using telehealth" on a 5‐point Likert scale (1 = strongly disagree; 5 = strongly agree). Means of the different groups were analyzed using independent t‐test and one‐way ANOVA with Bonferroni post‐hoc multiple comparisons. Results: Of the total participants, 73% (n = 366) either agreed or strongly agreed that the COVID‐19 pandemic had made them more open to using telehealth. Significant differences existed by age (p = 0.016), race/ethnicity (p = 0.015), and sex (p < 0.001), however, groups did not differ by age during post‐hoc analysis. A significant difference in the mean responses was observed between black participants (M = 4.29) and white participants (M = 3.91; p = 0.011). In addition, female participants (M = 4.11) rated the item higher than male participants (M = 3.65). Conclusion: As access to telehealth increased due to the COVID‐19 pandemic, patients' perceptions to telehealth seem to have shifted in the positive direction as well. Findings may be used to support expansion of telehealth and advocacy for patients in a variety of settings. Clinical Relevance: Study findings indicate that participants of telehealth are more open to using telehealth due to the COVID‐19 pandemic. Implementing telehealth should be a priority to increase access to care for those who have limited access to specialty care, and policymakers should advocate to decrease barriers to telehealth within their institutions. [ABSTRACT FROM AUTHOR]

Purpose: A stroke survivor who is discharged to home care faces many challenges during the transition from the hospital to home, including managing their care at home and engaging in rehabilitation and recovery. Case management was developed to ease the transition from hospital to home and help people with stroke cope with their care management challenges. However, the effects of case management intervention remain inconclusive. Case management was designed to direct care and may represent a novel method for reducing the burden of care. This study was designed to evaluate the effects of case management interventions on mental health outcomes, activities of daily living capacity, physical function, and social function among stroke survivors. Design Systematic review and meta‐analysis. Methods: This study included studies examining the impacts of case management interventions for stroke survivors that were published in English and identified by searching eight databases, from database inception to February 20, 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to pool effect sizes using a random‐effects model (in Stata 16.0). The revised Cochrane risk‐of‐bias tool for randomized trials (RoB‐2) was used to assess the methodological quality of each study. Findings The inclusion criteria were satisfied by eight studies (including a total of 1119 stroke survivors). Case management had positive effects on mental health (SMD: 0.26; 95% CI: 0.07 to 0.45, p = 0.001) and activities of daily living (SMD: 0.68; 95% CI: 00.37 to 0.99, p < 0.001). However, no significant effects were observed for either physical function or social function. Conclusion: Case management appears to enhance the mental health and activities of daily living among stroke survivors. Clinical Relevance: Case management interventions hold promise as efficient, cost‐effective, and accessible strategies to positively influence care for stroke survivors. This intervention strategy could be applied to the hospital‐to‐home transition to guide care among this population. [ABSTRACT FROM AUTHOR]

Introduction: Post‐burn scarring is often cosmetically unappealing and create discomfort. This makes it crucial to understand the experience of individuals living with scars which can offer insights into their recovery. This review sought to develop an in‐depth understanding of living with post‐burn scars. Design: A systematic review and meta‐ethnography approach were employed. We utilized an interpretive approach to inductively generate codes. These codes were examined iteratively using a constant comparison strategy following which they were re‐interpreted to formulate themes which formed the basis of undertaking a narrative synthesis. Results: Twenty‐five studies were retained. The analytical process yielded two themes: emergence of a new identity and living with the redefined self. The experience of living with scars is entwined with the initial trauma as the scars served as a permanent reminder of the injury. Emergence of a new identity involved a process of meaning making, mourning the loss of the old self, confronting the new self, reconciling the remains of the old self with the new, rebuilding a new identity, and navigating through functional restrictions. These processes were particularly challenging for persons involved in self‐immolation. Positive coping and changing one's perspective emerged as strategies to facilitate living with the redefined self. Conclusion: Living with scars is a challenging process which is more difficult for persons whose injuries are due to self‐immolation (act of burning oneself). The findings highlight a latent yet ongoing process towards subjective recovery. Clinicians need to be aware of the processes and incorporate these into rehabilitation programmes. Clinical relevance: Burn survivors need ongoing professional support to adjust to and live with the scars. Victims of self‐immolation should be considered for early psychosocial support. [ABSTRACT FROM AUTHOR]

Purpose: To explore the relationships between job satisfaction, community satisfaction, practice environment, burnout, and intention to leave of nurses working in Australian small rural hospitals. Design A national cross‐sectional survey of 383 nurses from Australian rural public hospitals of less than 99 beds during 2018. Methods: Job satisfaction was measured on a four‐point Likert scale. Factors associated with community satisfaction, practice environment, burnout and intention to leave were analyzed using multiple linear regression to explore the predictors of job satisfaction. Findings Overall job satisfaction was positive, with most nurses moderately (n = 146, 38.1%) or very satisfied (n = 107, 27.9%) with their current job. Emotional exhaustion, nurse manager ability, leadership and support of nurses were the most significant predictors of job satisfaction. Conclusion: This study provides new insight into the factors impacting the job satisfaction of nurses working in rural hospitals. The knowledge gained is important to inform strategies to retain nurses in rural areas and, in turn, ensure rural communities have access to quality health care. Clinical relevance: The impact of nurses' job satisfaction on burnout, patient safety, and intention to leave is well recognized; however, there is limited understanding of job satisfaction in a rural hospital context. This study provides an understanding of the factors that impact job satisfaction of nurses working in small rural hospitals and highlights the importance of improving the practice environment to reduce the high attrition rates of this workforce. [ABSTRACT FROM AUTHOR]

Purpose: The use of technology‐assisted interventions in dementia care contributes to increased communication, reduced burden on the caregivers, improved health outcomes, and improved expense management. Technology‐assisted interventions can be provided remotely to monitor, improve, and enable home care, benefiting the health of both patients and caregivers. Despite increasing use, the effectiveness of technology‐assisted interventions for dementia care remains uncertain, with studies reporting inconclusive findings subject to interpretation. Therefore, the current study investigated the available evidence to explore the efficacy of technology‐assisted interventions for people with dementia. Design Systematic review and meta‐analysis. Methods: The study was preregistered with the PROSPERO international prospective register of systematic reviews using a Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA)‐guided protocol. The primary search was conducted in eight databases from database inception to January 29, 2022. Using a random‐effects model, the standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized to obtain pooled effect sizes (using Stata 16.0). The updated Cochrane Risk of Bias 2 tool (RoB‐2) was used to evaluate the methodological quality of the studies. Findings A pooled analysis of 12 trials, including 584 people with dementia, showed more improvement associated with technology‐assisted interventions compared with standard care, including in the domains of cognitive function (SMD = 0.39; 95% CI: 0.14 to 0.64; p < 0.001) and depression (SMD = −0.75; 95% CI: −1.33 to −0.17; p = 0.01). However, no significant effects were observed for activities of daily living (ADL) or quality of life. Conclusion: Technology‐assisted interventions appear to improve cognitive function and reduce depression in people with dementia compared with standard care. Clinical relevance: This study may be used to demonstrate that interventions incorporating many modalities or technologies can be used to enhance dementia care, which may improve favorable outcomes when using technology‐assisted interventions to remotely initiate appropriate activities for people with dementia. Because technology allows for simultaneous communication and access to shared multimedia, it removes environmental constraints and allows treatment to be administered remotely. [ABSTRACT FROM AUTHOR]

Objective: This meta‐analysis was conducted to examine the association between breastfeeding and undernutrition among children under 5 years of age in developing countries. Study design: Systematic review and meta‐analysis. Methods: A comprehensive literature search was conducted of datasets from Embase, CINHAL, PubMed, Cochrane Library, and Indonesian databases to include eligible studies. Comprehensive Meta‐Analysis 3.0 statistical software was used to perform data entry and data analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted from each study or were calculated based on the reported number of cases and controls in each study. Random‐effects models or fixed‐effects models were used to demonstrate overall risk estimates. A moderator analysis was conducted to examine possible moderators explaining the heterogeneity across studies. Findings In total, 33 studies were included which examined the association of breastfeeding with undernutrition. A random‐effects model showed that breastfeeding had inverse correlations with overall undernutrition (OR = 0.82, 95% CI = 0.68, 0.99) and the stunting type of undernutrition (OR = 0.73, 95% CI = 0.55, 0.95). A moderator analysis showed that studies which included exclusive breastfeeding and unclear birth weights had low risks of overall undernutrition (p < 0.05). Moreover, studies which included exclusive breastfeeding and adopted a case–control study design exhibited a low risk of the stunting type of undernutrition (p < 0.05). Conclusions: Providing breastfeeding or exclusive breastfeeding can benefit children under 5 years of age in developing countries reduce overall undernutrition and the stunting type of undernutrition. Clinical relevance: Healthcare professionals should develop and implement suitable strategies to increase awareness regarding the importance of breastfeeding and enhance breastfeeding and exclusive breastfeeding adherence. [ABSTRACT FROM AUTHOR]

Introduction: An occupational stress was reported as an inhibitor of optimal performance among nurses. Emotional intelligence (EI) has emerged as a successful behavioral buffer against occupational stress and as a facilitator for better performance. This study aimed to investigate the potential relationship between nurses' EI and their work performance; and to examine the mediating role of occupational stress. Design: A predictive correlational design was adopted. Method: Self‐reported questionnaires were administered to 391 full‐time bedside nurses recruited from one of the big hospitals in Saudi Arabia, between April and June 2021. Data were coded and analyzed using IBM SPSS version 25.0. Simple and multiple linear regression analyses were used to test the hypotheses. The significance level for all tests was set at p ≤ 0.05. Bonferroni correction method was used to control the family‐wise error rate. Results: The findings revealed an affirmative association between nurses' EI and work performance (β = 0.69, p < 0.001; r2 = 0.483). Additionally, an inverse association was established between nurses' EI and their perception of occupational stress (β = −0.54, p < 0.001; r2 = 0.286), and between nurses' perception of occupational stress and work performance (β = −0.52; p < 0.001; r2 = 0.226). Additionally, our results showed that occupational stress played a mediating role in the relationship between nurses' EI and work performance. Conclusion: This study presented a novel framework that includes two factors affecting work performance among nurses in Saudi Arabia. Our results suggest that EI is vital for effective work performance among nurses. Additionally, EI was found to be a useful coping strategy against occupational stress. Clinical Relevance: EI has been described as a valuable asset for better performance and effective group cohesiveness among nurses. Optimal nurses᾽ performance leads to meeting patients᾽ needs and organizational goals. [ABSTRACT FROM AUTHOR]

Purpose: Work–family conflict (WFC) is an important issue in nursing administration and management that is associated with reduced work effectiveness and patient safety issues. To date, very few studies have attempted to explain the mechanisms underlying these relationships. The aim of this study was to determine the influence of work–family conflict (WFC) on patient safety outcomes and job engagement via the intermediary role of transformational leadership (TL). Design: Cross‐sectional study. Methods: Seven hundred fifty‐four nurses from 10 acute care hospitals in the Philippines were included in this cross‐sectional study. Findings: A higher perception of WFC was associated with increased adverse events, reduced quality of care and decreased job engagement. WFC was indirectly associated with quality of care, adverse events and job engagement through the intermediary of TL. Conclusions: The results of this study underscore the important role of nurse managers' TL in sustaining work–family balance and, in turn, improving patient safety outcomes and enhancing job engagement among nurses. Clinical relevance: Institutional measures to foster patient safety outcomes and sustain the nursing workforce should involve enhancing nurse managers' leadership behaviors through theory‐driven interventions, periodic leadership assessment, and implementation of leadership development activities. WFC may be addressed by creating empowering work conditions, providing adequate coaching and mentorship to nurses, and implementing work–family friendly policies in the workplace. [ABSTRACT FROM AUTHOR]

Purpose: While nurse editors carry great responsibility for the scientific literature in the nursing profession, little has been published about this unique role. The purpose of this study was to examine contemporary nurse editors' roles and practices. Design: In early 2019, a sample of 129 nurse editors participated in a cross‐sectional study using survey methods. Methods: The online survey was based on an instrument used in a prior study and included 43 primarily multiple‐choice questions. Findings were analyzed using descriptive statistics. Findings: Beyond the expected roles of journal management, editorial decision making, leadership for the profession, and specific journal focus, some aspects of the nurse editor role have remained unchanged. The role continues to be learned mostly on the job and nurse editors still find satisfaction in helping other nurses publish and disseminate their work. Nurse editors are older and better educated. They also are receiving more manuscripts submitted to their journals and perceive this role as hard work but worth it. This is also the first study to report on the role of other levels of editors. Conclusion: This study provides a description of the current roles and practices of nurse editors. Nurse editors can bring more attention to the role and encourage more nurses to consider this role as an attainable and a satisfying one. Clinical relevance: Being a nurse editor is a leadership role and one that many nurses may not consider as a career goal. Nurse editors can increase the visibility of this role and engage, encourage, and support nurses who are interested in this role. [ABSTRACT FROM AUTHOR]

Background: Post‐traumatic growth induced from cancer diagnosis and treatment could benefit the prognosis of cancer survivors, but intervention based on self‐disclosure in group is limited. Objective: Aimed to examine the effectiveness of a supportive‐expressive group intervention on post‐traumatic growth. The impact of the intervention on anxiety and depression were also explored. Design: This randomized clinical trial enrolled patients from June 2017 to September 2018 with a one‐month follow‐up. Data collectors were blinded to patient grouping. Setting: A single center study in Chengdu, China. Participants: One hundred sixty‐eight participants who met the eligibility criteria were randomly assigned to the intervention group (n = 84) or control group (n = 84); 46 were excluded and 122 patients finished the one‐month follow‐up. Methods: Participants in the intervention group received nurse‐led support intervention focusing on topics such as "Being a Patient", "Interpersonal Relationships", "Journey for Recovery", and "Planning the Future" while participants in the control group received health education, rehabilitation training etc. according to the nursing routine of breast cancer patients. The intervention was designed in accordance with the diagnosis and treatment process as well as patient needs. Participants in both groups were evaluated three times (T1‐baseline before the intervention, T2‐end of the intervention, and T3‐1 month follow up). Post‐traumatic growth, anxiety and depression were evaluated. Results: Participants in the intervention group reported higher level of post‐traumatic growth (p < 0.01 or 0.05) and reduced anxiety and depression (p < 0.01 or 0.05 and p < 0.01 or 0.05). The multilevel model indicated that the intervention significantly promoted post‐traumatic growth (βT3 = 7.87, p < 0.05) and dimensions of relating to others (βT3 = 4.26, p < 0.001), personal strength (βT3 = 4.27, p < 0.01), appreciation of life (βT3 = 8.69, p < 0.001), and new possibilities (βT3 = 1.91, p < 0.05), anxiety (βT3 = −3.63, p < 0.001), and depression (βT3 = −2.27, p < 0.001), but had no effect on the dimension of spiritual change. In addition, the multi‐level model showed that patients with younger ages (β = −0.05~−0.52, p < 0.05–0.001), with high school and above education levels (β = 1.53~9.29, p < 0.01) and accompanied by husbands(β = −1.48~−8.51, p < 0.05) had more effective intervention and patients with religious belief had a better spiritual change level (β = 1.86, p < 0.001). Conclusions: These findings provide evidence for the potential effectiveness of the nurse‐led intervention on positive benefits of post‐traumatic growth and relieved anxiety and depression for Chinese breast cancer survivors and will inform the design and development of a large randomized controlled trial. Clinical relevance: The supportive‐expression group intervention can be applied independently by nurses. The four themes of self‐disclosure can help patients grow after trauma, and this method can be used as a psychological support technique for breast cancer patients during hospitalization. [ABSTRACT FROM AUTHOR]

Purpose: More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery. Design: A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively). Methods: Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale‐Pain (VAS‐P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t‐test and chi‐squared test were used for descriptive statistics, and paired t‐test and linear mixed model were used to examine the effect of acupressure in alleviating pain. Findings: After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001). Conclusions: This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases. Clinical relevance: Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study were to review the types of nurse‐led nonpharmacological pain interventions (NPI) offered to cancer patients and/or family caregivers, and to determine a comprehensive and robust estimate of the effect size of nurse‐led NPI for cancer patients on various pain‐related outcomes. Design: Systematic review and meta‐analysis. Studies assessing nurse‐led NPIs targeting cancer patients and published between January 2008 and December 2020 were identified by searching multiple literature databases, including MEDLINE®, EMBASE, Google Scholar, Cochrane Library, ProQuest Medical Library, and CINAHL®. Methods: This review was conducted in accordance with the Preferred Reporting Item for Systematic Reviews and Meta‐analyses guidelines. The selected randomized clinical trials were independently assessed for methodological quality. The effect sizes (ESs) of treatment were presented as standardized mean differences (Hedges' g) and 95% confidence intervals (CIs). Findings: A meta‐analysis was performed to analyze data from 22 randomized clinical trials. Three types of nurse‐led NPI were offered, mainly to cancer patients but also to some caregivers: music, physical, and psycho‐educational interventions. The dose and duration of nonpharmacological interventions varied widely. The study participants ranged in age from 44.1 to 67.3 years. Meta‐analysis indicated that, although these interventions had small effects in long‐term (g = 0.24, 95% CI: 0.06–0.43, p = 0.011) to medium effects in short‐term (g = 0.43, 95% CI: 0.32–0.53, p < 0.001), they significantly reduced patients' pain, increased their knowledge of pain management, reduced barriers to pain management and pain coping, and improved other physical and emotional symptoms. The significance of the ES differed according to the type of intervention, with psycho‐educational and physical NPIs having a significant but medium short‐term ES, whereas music NPI had a significant but large short‐term ES. Only psycho‐educational NPIs had significant long‐term effects. Conclusion: The combined ES showed that these nurse‐led NPIs were significantly effective in both the short and long‐term. Types of intervention as a potential moderator were associated with short‐term and long‐term effects of nonpharmacological interventions on patient outcomes. Clinical relevance: Research‐tested interventions should be provided to help patients cope effectively with pain. [ABSTRACT FROM AUTHOR]

Objectives: To systematically evaluate the effectiveness of psychological intervention durations and different psychological interventions on treating depression in primary caregivers of Alzheimer's disease (AD) patients. Methods: A computerized search of PubMed, Cochrane Library, Embase, Ebsco, Web of Science, CNKI, CSBD, and CSTJ databases on randomized controlled trials (RCTs) of psychological interventions for depressed primary caregivers of AD patients was performed. Depression scores were derived from the Self‐rated Depression Scale (SDS) and the Centre for Epidemiological Studies Depression Scale (CES‐D). The results were analyzed using Revman 5.3 utilizing Trial Sequential Analysis (TSA) software for data analysis. Results: Eight RCTs involving 857 depressed primary caregivers of AD patients were included in the study. Of the four psychological interventions studied, only three (i.e., cognitive‐behavioral psychological, integrated psychological, and psychological interview intervention) were shown to significantly reduce depression levels in primary caregivers of AD patients after 2‐months, 10‐weeks, and 6‐months of treatment (p ≤ 0.05). It is uncertain that a supportive psychological intervention or a 3‐months psychological intervention reduced the level of depression. Sequential and sensitivity analyses confirmed the reliability of the outcome measures. Conclusion: Cognitive‐behavioral psychological, integrated psychological, and psychological interview interventions were able to significantly reduce depression levels in primary caregivers of AD patients. These findings reveal that psychological interventions may be a promising means for depressed primary caregivers of patients with AD. Clinical relevance: For the primary caregivers of AD patients, effective interventions can help reduce psycho‐depressive symptoms and improve the quality of life for the caregivers and the patients. Medical staff may want to use this information to help to provide a more effective guide for primary caregivers in an effort to reduce possible levels of depression. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the effects of massage therapy using 5% lavender oil on the severity of restless legs syndrome (RLS) and the quality of life (QoL) of patients on hemodialysis (HD). Design and methods: This is a randomized placebo‐controlled study with a pretest–posttest design. This study was conducted from January 30, 2019, to May 6, 2019, at HD centers in Turkey, and it includes 58 participants—31 study patients and 27 controls. Data were collected using patient identification form, RLS severity rating scale, Kidney Disease Quality of Life Scale (KDQOLTM‐36) and patient follow‐up charts. As per the massage therapy protocol, the patients in the study and control groups received massage therapy with lavender oil and baby oil, respectively. Findings: RLS severity significantly decreased in all follow‐up weeks in the study group and in the first, second, and third follow‐up weeks in the control group. There were significant differences between the groups in terms of KDQOLTM‐36 subscales and total scores at the initial and final follow‐ups. Conclusion: In HD patients, massage with lavender oil lessened the severity of RLS and improved the QoL. Accordingly, this therapy can be recommended to HD patients. Clinical relevance: Massage therapy during HD sessions is easy, inexpensive, and patient‐friendly with no side effects. It is known to reduce symptoms and enable the patients to easily perform daily activities of living. Massage therapy with lavender oil is effective and can be easily applied to patients with RLS by nurses. Trial registration: This study was registered under the Clinical Trials protocol registration system (NCT04630470) upon completion. [ABSTRACT FROM AUTHOR]

Background: Heart failure has a great cost on the health care system. The readmission and mortality rates and their predictors are greatly affected by political and sociocultural unrests. Aims: To determine the readmission and mortality rates and their predictors in heart failure population in times of political and sociocultural unrests. Design: A cross‐sectional follow‐up with patients recruited for the Lebanese Heart Failure Snapshot was conducted over the month of June in 2019. Methods: Phone calls were conducted at 30–90 days, 6–12 months following hospital discharge for patient previously admitted to one of the study hospitals for heart failure exacerbation. Follow‐up data was conducted from July 2019 till May 2020. Findings: The mean age of the 120 participants was 71 years with a mean ejection fraction of 41%. The 30–90 days, 6–12 months readmission rates were 20%, 56%, 75%, and 78%, respectively. Readmission predictors were non‐sinus rhythm and low diastolic blood pressure at admission. Mortality rates at 30–90 days, 6–12 months were 7%, 11%, 17%, and 28%, respectively. Low diastolic blood pressure and longer length of hospital stay were associated with mortality. Conclusion: The rapid changes in the country make it difficult to formulate an intervention plan. This was seen in the increased rates of readmission and the decreased rates of mortality. Rigorous research should be conducted at every phase of the sociocultural changes in developing countries that were hit by the COVID‐19 pandemic and had their economy largely affected. Impact: The occurrences of the countries can greatly influence the outcomes of patients with heart failure. This is true in developing countries that were affected by the COVID‐19 pandemic socially, economically, and politically. Research should be done regularly to establish the effect of these changes on patients with heart failure. Nevertheless, nursing roles are the common denominator that should be adapted to all the changes and provided despite all challenges to assure improved outcomes. Such practices include discharge education tailored to the subjective needs of the patients and continuous, uninterrupted follow‐up despite of all the occurrences. These practices are likely to decrease adverse outcomes in patients with heart failure. [ABSTRACT FROM AUTHOR]

Introduction: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. Objectives: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. Methods: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25‐item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi‐square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. Results: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical‐surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). Conclusions: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence‐based tobacco cessation programs at the organizational‐level, including post‐discharge active quitting smoking support. Clinical relevance: Three‐quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the application of infrared thermal imaging and adopt deep learning to detect air leakage for determining the fitness of respirators during fit‐checks. Background: The outbreak of Covid‐19 virus constitutes a public health crisis with substantial resultant morbidities and mortalities; has exerted profound impacts. Methods: This was a prospective observational study, employing a non‐probability sampling method on a convenience sample to recruit the participants and followed the Strengthening the Reporting of Observational Studies in Epidemiology statement guidelines. Results: The use of infrared thermal imaging identified air leakage points as a disruption to the facial thermal pattern distribution at (a) front of face; (b) right lateral of the face; (c) left lateral of the face; (d) top of the facemask with the head facing down; and (e) bottom of the facemask with the head facing up. Results also indicated that artificial intelligence tools and the proliferation of deep learning have the potential to detect the location of air leakage locations. Conclusion: The use of infrared thermal imaging provides evidence of the feasibility and applicability of infrared thermal imaging techniques in detecting air leakage for individuals wearing respirators. Clinical relevance: The use of infrared thermal technology can serve a potential role in complement fit‐checking of respiratory protective devices and offers promising practical utility in determining the fitness of respirators for nurses at the frontline to protect against the air‐borne viruses. [ABSTRACT FROM AUTHOR]

Purpose: To determine the research output of Caribbean nurses and midwives. Methods: We searched the Scopus database to identify publications by Caribbean nurses and midwives during the period 2000–2020. Publications were included in the analysis if they had at least one author who was either a nurse or midwife and affiliated with a Caribbean geographic location. All publication types and languages were included in the analysis. Organization analysis and collaboration networks were created using the VOS Viewer application. Findings: The number of Scopus publications by Caribbean nurses and midwives progressively grew from 22 in 2000 to 584 in 2020. Cuba recorded the highest number of nursing research publications (319) followed by Jamaica (92), and Puerto Rico (59). Most publishing institutions were universities. The University of the West Indies (Jamaica) ranked highest with 15.2% of publications, followed by Universidad de Ciencias Médicas de La Habana with 14.4% of publications, Universidad de Puerto Rico ranked third with 9.8% of publications. The majority of publications (83.6%) were peer reviewed research articles, while review articles accounted for 9.8% of publications. Six out of the ten journals that published most research done by Caribbean nurse researchers were Cuban journals which published a total of n = 250 (75.8%) articles. All six journals had no impact factor and had low cite scores. Conclusions: Our analysis of bibliometric indicators suggest that recent and steady growth in nursing and midwifery research in the Caribbean has had low visibility. Equipping nurses and midwives with the necessary knowledge and skills to lead, teach, and conduct high quality research through doctorate level education is an imperative for increasing research productivity among Caribbean nurses and midwives. Clinical relevance: Nursing and midwifery research is critical for evidence‐based nursing and midwifery practice. High quality and context specific research evidence will enable Caribbean nurses and midwives to provide quality and culturally sensitive nursing and midwifery care and contribute to evidence informed policy decisions. [ABSTRACT FROM AUTHOR]

Purpose: To test the effects of a Vitality Acupunch exercise program on the functional fitness and the ability to perform the activities of daily living (ADL) among older adults with probable sarcopenia in residential facilities. Design: This was a cluster‐randomized controlled trial. A total of 12 long‐term care facilities randomly assigned to the intervention and control groups with 1:1 allocation ratio. Among them, 114 older adults with probable sarcopenia participated at baseline and were allocated to either the intervention or control group according to the facility where they resided in. Of these, 103 older adults completed the study. Methods: The intervention group (n = 52) underwent the Vitality Acupunch exercise program three times a week, each lasting 40 min, for 6 months while the control group (n = 51) performed its routine daily activities. Findings: The functional fitness and ADL of the intervention group significantly improved at each time point (all p < 0.001), while the control group showed a significant decreasing trend. Except the lower limb muscular endurance, the functional fitness and ADL of the intervention group significantly improved compared to the control group at T1, and the improvements were still significant at T2. Conclusions: Functional fitness and the ability to perform ADL in older adults with probable sarcopenia were significantly improved after receiving the Vitality Acupunch exercises. Clinical relevance: An exercise that integrates the meridian theory and exercise concepts effectively improves functional fitness in probable sarcopenic older adults. Clinical trial registration: Clinicaltrials.gov (NCT04504786). The trial was first posted on August 7, 2020. This part of the data was collected from August 2020 to March 2021. [ABSTRACT FROM AUTHOR]

Background: Because much worldwide cancer incidence and mortality is related to modifiable risk factors, many global health organizations provide evidence‐based recommendations on healthy weight, diet, and physical activity levels for cancer prevention. Even though adherence to such guidelines is reported to reduce cancer incidence and mortality, this adherence is often suboptimal. Identifying factors related to adherence to the guidelines can suggest interventions to improve health promoting lifestyle behaviors for cancer prevention. Objectives: Examine a comprehensive set of potentially predictive factors in meeting American Cancer Society's guidelines for healthy weight, fruits and vegetables intake, and physical activity. Methods: Data used in the analysis were from adults aged 18 years and older without a history of a cancer diagnosis who participated in the Health Information National Trends Survey in 2019 (n = 3407). Multivariate logistic regression analyses were used to determine the significant predictors for meeting each of the healthy weight, fruits and vegetables intake, and physical activity guidelines. Results: Overall adherence to each guideline was low: 39.0% met the physical activity guideline, 30.4% met the healthy weight guideline, and 17.6% met the fruits and vegetables intake guideline. Meeting the healthy body weight guideline was greater in current smokers, females, those who had at least some college education, those who did not have a chronic health condition, and those who had very good self‐rated health. Meeting the fruits and vegetables intake guideline was greater in females, those who had very good self‐rated health, and those who talked to friends or family members regarding their health. Meeting the physical activity guideline was greater in males, those who had household incomes of at least $50,000, those who did not have a chronic health condition, and those who had very good self‐rated health. Conclusions: The current analyses identified a unique set of predictors for meeting each guideline among US adults who reported never having been diagnosed with cancer. Based on these findings, interventions related to each guideline should be especially targeted to individuals having characteristics that were less likely to meet them. Clinical relevance: Findings from the current study can assist health care providers who counsel about cancer prevention in the clinical setting. [ABSTRACT FROM AUTHOR]

Purpose: From its beginnings in China in December of 2019, the novel coronavirus COVID‐19 spread and quickly became the center of nursing care and conversation across the globe (WHO, 2020). This meta‐ethnographic study was conducted in order to provide the profession of nursing interpretative explanations of a common experience during the care of patients with COVID‐19. Design and method: A literature review focused on the experience of the nurse during the COVID‐19 pandemic revealed a total of 13 qualitative studies conducted in China, Spain, Turkey, Iran, Brazil, and the United States. A meta‐ethnographic review of these qualitative works, using the method of Noblit and Hare, was then conducted which revealed the experience of the nurse across the globe during the COVID‐19 pandemic. Findings: The review revealed strong similarities between the experiences of the nurse across the 13 studies. Given this reciprocal relationship, translations were constructed and synthesized until four new themes emerged outlining the global experience of the nurse during the COVID‐19 pandemic. Conclusions: Despite the differences between the structures of healthcare and government of the six countries represented in this meta‐ethnography, the experience of the nurse emerged into a narrative shared by those represented in this study. As the profession of nursing continues to work through ongoing waves of COVID‐19, these results will help guide the resources and training provided to nurses on the frontline of care. Clinical relevance: Despite great personal risk, nurses across the globe stepped up to the challenge of upholding and improving the health of the world's people during the COVID‐19 pandemic. As health policy, education, and system leaders, we must listen to the common experience revealed in this meta‐synthesis and respond by providing the resources needed to improve nursing practice and care. [ABSTRACT FROM AUTHOR]

Purpose: Urinary incontinence is a syndrome common in older adults, but it is not clear whether urinary incontinence is associated with the risk for mortality in elderly nursing home residents. Methods: We conducted a systematic review and meta‐analysis in PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. The Newcastle‐Ottawa Scale (NOS) was used to assess the quality of the included studies. The meta‐analysis was summarized using a random‐effects or fixed‐effects model, and the heterogeneity among studies was examined using the I2 statistic. Findings: Six cohort studies with 1,656 participants were included in the final analysis. The NOS score for each study was greater than 6. Urinary incontinence was significantly associated with a higher risk for mortality in nursing homes, with a hazard ratio (HR) of 1.20 (95% confidence interval [CI] 1.12–1.28, I2 = 41.6%). The significant association of urinary incontinence with increased mortality risk was observed in subgroup analysis according to region, status of dementia, and follow‐up period, with a pooled HR of 2.02 (95% CI 1.32–3.11, I2 = 0%) for Asian countries, 1.18 (95% CI 1.11–1.26, I2 = 41.6%) for Western countries, 1.17 (95% CI 1.09–1.26, I2 = 0%) for patients with dementia, 1.35 (95% CI 1.13–1.60, I2 = 58.9%) for patients without dementia, 1.16 (95% CI 1.07–1.25, I2 = 43.2%) for studies with a follow‐up period of 1 year, and 1.30 (95% CI 1.15–1.48, I2 = 24.5%) for studies with a follow‐up period of more than 1 year. Conclusions: Urinary incontinence is associated with an increased risk for death among residents of care facilities. Therefore, it was necessary to screen the elderly dwelling in nursing homes who were experiencing or at risk for urinary incontinence with useful tools (e.g., overactive bladder symptom score, bladder control self‐assessment questionnaire, three incontinence questions). In addition, early interventions strategies, such as weight loss, stopping smoking, pelvic floor muscle training, and medical and surgical treatments would contribute to decreasing the risk for urinary incontinence and preventing adverse outcomes in nursing home residents. Clinical Relevance: In our study, we found that the elderly with urinary incontinence who resided in nursing homes had a higher risk for mortality than those without urinary incontinence. Therefore, urinary incontinence in the elderly residing in nursing homes is of particular concern. Early detection and intervention are important for the elderly with urinary incontinence, and caregivers should be made aware of this importance. [ABSTRACT FROM AUTHOR]

Purpose: This study identified facilitators and barriers pertaining to the use of multiple mobile health (mHealth) devices (Fitbit Alta® fitness tracker, iHealth® glucometer, BodyTrace® scale) that support self‐management behaviors in individuals with type 2 diabetes mellitus (T2DM). Design: This qualitative descriptive study presents study participants' perceptions of using multiple mobile devices to support T2DM self‐management. Additionally, this study assessed whether participants found visualizations, generated from each participant's health data as obtained from the three separate devices, useful and easy to interpret. Methods: Semistructured interviews were completed with a convenience sample of participants (n = 20) from a larger randomized control trial on T2DM self‐management. Interview questions focused on participants' use of three devices to support T2DM self‐management. A study team member created data visualizations of each interview participant's health data using RStudio. Results: We identified two themes from descriptions of study participants: feasibility and usability. We identified one theme about visualizations created from data obtained from the mobile devices. Despite some challenges, individuals with T2DM found it feasible to use multiple mobile devices to facilitate engagement in T2DM self‐management behaviors. Discussion: As mHealth devices become increasingly popular for diabetes self‐management and are integrated into care delivery, we must address issues associated with the use of multiple mHealth devices and the use of aggregate data to support T2DM self‐management. Clinical Relevance: Real‐time patient‐generated health data that are easily accessible and readily available can assist T2DM self‐management and catalyze conversations, leading to better self‐management. Our findings lay an important groundwork for understanding how individuals with T2DM can use multiple mHealth devices simultaneously to support self‐management. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to test the hypothesis model showing the relationship between nurses' individual and working characteristics, nursing work environment, subjective career success, job satisfaction, intent to leave, and professional commitment. Design and Methods: A cross‐sectional and correlational design was utilized for the study. The study sample consisted of 604 nurses working in four hospitals in Istanbul, Turkey. Data were collected using the Nurse Information Form, Subjective Career Success Inventory, Practice Work Environment Scale of the Nursing Work Index, Job Satisfaction Global Item, Intent to Leave Subscale, and Professional Commitment Scale. Data were analyzed using descriptive and correlation analysis, and the hypothesis model was tested using structural equation modeling. Findings: The hypothesis model that was established to test the antecedents and outcomes of subjective career success in nurses was acceptable and had a good fit. Having a master's degree, work schedule with rotating shifts (negative), good individual income, participation in hospital affairs, staffing and resource adequacy, and nurse–physician relations were significantly associated with the subjective career success of nurses. Subjective career success had a positive effect on job satisfaction and professional commitment and a negative significant effect on intent to leave in nurses. Conclusions: This study revealed that human capital, objective career success, and some characteristics of the nursing work environment were significantly associated with nurses' subjective career success, and that increased subjective career success produced positive professional and organizational outcomes. Clinical Relevance: The results of this study, which revealed the antecedents and outcomes of nurses' career success, should be taken into consideration by managers who wish to retain a qualified nursing workforce. [ABSTRACT FROM AUTHOR]

Purpose: To explore how big data can be used to identify the contribution or influence of six specific workload variables: patient count, medication count, task count call lights, patient sepsis score, and hours worked on the occurrence of a near miss (NM) by individual nurses. Design: A correlational and cross‐section research design was used to collect over 82,000 useable data points of historical workload data from the three unique systems on a medical‐surgical unit in a midsized hospital in the southeast United States over a 60‐day period. Data were collected prior to the start of the Covid‐19 pandemic in the United States. Methods: Combined data were analyzed using JMP Pro version 12. Mean responses from two groups were compared using a t‐test and those from more than two groups using analysis of variance. Logistic regression was used to determine the significance of impact each workload variable had on individual nurses' ability to administer medications successfully as measured by occurrence of NMs. Findings: The mean outcome of each of the six workload factors measured differed significantly (p <.0001) among nurses. The mean outcome for all workload factors except the hours worked was found to be significantly higher (p <.0001) for those who committed an NM compared to those who did not. At least one workload variable was observed to be significantly associated (p <.05) with the occurrence or nonoccurrence of NMs in 82.6% of the nurses in the study. Conclusions: For the majority of the nurses in our study, the occurrence of an NM was significantly impacted by at least one workload variable. Because the specific variables that impact performance are different for each individual nurse, decreasing only one variable, such as patient load, will not adequately address the risk for NMs. Other variables not studied here, such as education and experience, might be associated with the occurrence of NMs. Clinical Relevance: In the majority of nurses, different workload variables increase their risk for an NM, suggesting that interventions addressing medication errors should be implemented based on the individual's risk profile. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to test a modified version of the Technology Acceptance Model, which describes users' technology adoption, to examine the relations between patient portal use and potential influencing factors in adult patients who have used patient portals. The modified model posits that patient portal use can be explained by attitude and self‐efficacy for using patient portals, perceived usefulness and ease of use, data privacy and security concerns, eHealth literacy, education level, and age. Design: A cross‐sectional anonymous online survey was conducted for adult patients who had used their patient portals in the past 12 months. Methods: Participants were recruited from 20 settings selected in a large integrated health care system. Data from 743 patients were subject to structural equation modeling for model testing. Findings: Sixty‐eight percent were White and female, with a mean age of 53.1 years (SD = 15.34). Forty‐seven percent used patient portals about monthly or more frequently. Scores for perceived usefulness and ease of use of patient portals were relatively high (as measured using the modified Perceived Health Web Site Usability Questionnaire; each item mean, 6.0–6.2; range, 1–7). The final model adequately fit the data (comparative fit index =.983, standardized root mean square residual =.064, root mean square error of approximation =.059). Patient portal self‐efficacy and data privacy and security concerns had a direct impact on patient portal use. Perceived usefulness and ease of use, eHealth literacy, education level, and age indirectly influenced patient portal use. Conclusions: This study contributes to expanding a theoretical understanding of adult patients' patient portal use in a real health care environment. Future studies need to include more diverse populations in various settings. Clinical Relevance: Knowledge gained from this study can be used by technology experts to make patient portals more user friendly and by administrators to implement patient portals more effectively. [ABSTRACT FROM AUTHOR]

Purpose: RobotReviewer is a machine learning system for semi‐automated assistance in risk of bias assessment. The tools's performance in randomized controlled trials (RCTs) in the field of nursing remains unknown. We aimed therefore to evaluate the agreement in risk of bias assessment between RobotReviewer and human reviewers. Design: Evaluation study using a retrospective diagnostic design. Methods: We used RobotReviewer as the index test and human reviewers' risk of bias assessment reported in Cochrane reviews as the reference test. A convenience sample of electronically available English‐language full texts of RCTs included in Cochrane reviews with nurs* in the title were eligible for inclusion. In this context, we assessed random sequence generation, allocation concealment, and blinding (personnel or participants and assessors) corresponding to Cochrane risk of bias version 2011. Two independent research teams performed and double‐checked data extraction and analysis. We calculated sensitivity, specificity, receiver operating characteristic (ROC) curve, the area under the ROC curve, predictive values, observed percentage of agreement, and Cohen's kappa (including confidence intervals, if applicable). Findings: The selection process yielded 190 RCTs published between 1958 and 2016 in 23 Cochrane reviews published between 2000 and 2018. Missing assessments of risk of bias domains in Cochrane reviews or RobotReviewer yielded varying sample sizes per risk of bias domain. Sensitivity ranged from 0.44 to 0.88 and specificity from 0.48 to 0.95. Positive predictive value was highest for allocation concealment (0.79) and lowest for blinding assessors (0.25). Cohen's kappa was moderate for randomization (0.52), allocation concealment (0.60), and for blinding of personnel/patients (0.43). Blinding of outcome assessors had only slight agreement (0.04). Conclusions: This is the first evaluation of risk of bias assessment by RobotReviewer in RCTs included in nursing‐related Cochrane reviews. It yielded a moderate degree of agreement with human reviewers for randomization and allocation concealment, and an adequate sensitivity for detecting low risk of selection bias. Clinical Relevance: Based on our results, using the RobotReviewer for risk of bias assessment in RCTs can be supportive in some risk of bias domains. However, human reviewers should supervise the semi‐automated assessment process. [ABSTRACT FROM AUTHOR]

Purpose: To examine how robot‐enabled focus on professional task engagement and robot‐reduced nonprofessional task engagement are related to nurses' professional turnover intention. Design: We adopted a two‐wave study design. Methods: We collected the first wave of data in a large hospital in Taiwan during October and November 2019 and the second wave between December 2019 and February 2020. We used the data collected from 331 nurses who participated in both waves. Findings: We found that robot‐enabled focus on professional task engagement is positively related to nurses' overall job satisfaction and perceived health improvement. Robot‐reduced nonprofessional task engagement is positively related to nurses' perceived health improvement. Both overall job satisfaction and perceived health improvement are negatively related to nurses' professional turnover intention. Conclusions: Robots' ability to focus nurses' efforts in professional tasks may help improve nurses' health and overall job satisfaction, and by extension reduce their turnover intention. Clinical Relevance: Nurse managers could suggest hospitals introduce robots, particularly those that can share nurses' nonprofessional workload. This, meanwhile, could focus nurses' efforts on professional task engagement. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the role of individual (work engagement, personal initiative), group (transformational, transactional, passive‐avoidant leadership) and organisational factors (support for innovation climate) in fostering the two components of nurses' innovative behaviours, idea generation and idea implementation. Design and Method: A cross‐sectional study was conducted in an Italian public hospital, in two departments that had been created by merging other departments. A self‐report questionnaire was completed by 118 nurses. Hierarchical regression analysis was used to test the hypotheses. Findings: Respondents reported a high frequency of idea generation followed by idea implementation. Personal initiative and passive‐avoidant leadership were significantly and positively related to nurses' idea generation and idea implementation. Support for innovation was positively related to idea implementation. Transactional and transformational leadership did not show any relationships with the two innovative work behaviours. Conclusions: This study shows that nurses' innovative work behaviour is a complex and multi determined behaviour, influenced by individual, group, and organisational factors. It also shows that low levels of passive‐avoidant leadership may contribute to innovation. Clinical Relevance: Healthcare policies and strategies are needed to support a leadership style that allows space for autonomy, and that, together with support for innovation and personal initiative, facilitates nurses' idea generation and idea implementation. [ABSTRACT FROM AUTHOR]

Purpose: A deluge of fake news and misinformation about the coronavirus disease 2019 (COVID‐19) on the Internet poses challenges for the public in their search for reliable and relevant health information for taking protective measures, especially among people with chronic diseases (PWCD). This study aimed to (a) understand the satisfaction level of the online information related to COVID‐19 in people with and without chronic diseases; (b) explore information‐searching behavior and digital health literacy in PWCD; and (3) identify the possible predictors of information satisfaction among PWCD. Methods: This was a multicity, cross‐sectional study using an online survey with a convenience sample of people who (a) were 15 years of age or older and (b) had access to the Internet in mainland China, Hong Kong, and Macau. Findings: Four thousand four hundred and seventy‐two subjects completed the survey, of whom less than 50% felt satisfied with the online information. About 20% of respondents (n = 882) were diagnosed with at least one chronic disease and reported a lower level of information satisfaction (p =.003) than the people without chronic diseases. The majority of the PWCD obtained their online health information from social media. Higher digital health literacy (adjusted odds ratio [OR] = 5.07), higher frequency of searches regarding symptoms of COVID‐19 (adjusted OR = 2.07), higher perceived importance of quickly learning from the information searched (adjusted OR = 1.63), and lower frequency of searches on the topic of dealing with psychological stress (adjusted OR = 0.54) were found to be predictors of information satisfaction among PWCD. Conclusions: The majority of PWCD sought online information related to COVID‐19 from social media, and their level of information satisfaction was significantly lower than among people without chronic diseases. Digital health literacy is a strong and significant predictor of information satisfaction. Clinical Relevance: To support PWCD, we not only have to provide them with clear and accurate information, but also promote their digital health literacy so that they may seek, understand, and appraise health information from the Internet to make appropriate health‐related judgments and decisions. [ABSTRACT FROM AUTHOR]

Purpose: To assess Taiwanese nurses' attitudes toward and knowledge about sexual minorities, and their awareness and behavior of providing care to sexual minority patients. Design: A cross‐sectional descriptive design was employed. Methods: A total of 323 Taiwanese nurses 20 years of age or older completed an online questionnaire between September and November 2019. It included five sections: demographics, the Attitudes Toward Lesbians and Gay Men Scale, Knowledge About Homosexuality Questionnaire, Gay Affirmative Practice Scale, and nurses' needs for promoting culturally competent care. Results: Taiwanese nurses held positive attitudes, and demonstrated high levels of awareness and behaviors of providing care to sexual minority patients. However, they had limited knowledge regarding homosexuality. More so, nurses who were older, self‐identified as heterosexuals, were married, had more than 10 years' work experience, and were Buddhists had poor knowledge about homosexuality. Nurses reported that for providing culturally competent care they required knowledge about sexual minorities' physical and mental health issues; the populations' social and welfare resources; communication skills training; privacy; and safe space. Conclusions: Information on homosexuality and health issues among sexual minority populations, communication skills training, privacy, and safe space should be provided to Taiwanese nurses to improve their abilities to provide culturally competent care and to reduce health inequalities among sexual minorities. Clinical Relevance: This study's results could be used as evidence for designing and providing training programs for nurses regarding culturally competent care, and thus promote quality nursing care and decrease difficulties of accessing healthcare services among sexual minority patients. [ABSTRACT FROM AUTHOR]

Purpose: To determine if there are long‐term effects of a self‐management intervention guided by self‐regulation theory for adults with knee osteoarthritis at 6 and 12 months after completing the intervention. Design: This long‐term follow‐up study used a longitudinal quasi‐experimental design with repeated measures. Methods: A convenience sample of 127 patients with knee osteoarthritis who were 45 to 64 years of age were recruited from outpatient clinics in Taiwan. The Self‐Management Needs of Knee Osteoarthritis Scale was used to assess self‐management needs at enrollment (baseline). To evaluate the long‐term effects, participants were reassessed at 6 and 12 months after the intervention using the following questionnaires: The Knee Injury and Osteoarthritis Outcome Score, Healthcare Outcomes, and the Short‐Form Health Survey. Generalized estimating equations compared assessments at baseline with scores at 6 and 12 months following completion of the intervention. Multiple regression was used to examine significant factors associated with the assessments. Findings: Participants had moderate levels of self‐management needs. When assessments at 6 months were compared with baseline, scores for knee symptoms and physical function and quality of life showed significant improvements; significant reductions were seen in body mass index, unplanned medical consultations, and pain medication doses. Assessments at 12 months compared with baseline measures indicated these improvements were maintained. These improvements were significant from baseline measures at both 6 months and 12 months after adjustments were made for time and other significant variables. Conclusions: Twelve months after completion of the intervention, the significant improvements seen at 6 months were maintained. Our findings demonstrate that the self‐management intervention had significant long‐term effects on knee symptoms and physical function, body mass index and pain medication doses, and overall quality of life for patients with moderate self‐management needs of knee osteoarthritis. Clinical Relevance: Clinical care of knee osteoarthritis that includes a self‐regulation theory–based self‐management intervention could provide long‐term benefits to patients. [ABSTRACT FROM AUTHOR]

Purpose: To examine the activities, concerns, and expectations of critical care nurses and professional critical care nursing organizations worldwide. Design: A descriptive survey methodology was used. This study is the fifth worldwide quadrennial review of its type to monitor variations in critical care nursing needs and provide robust evidence to inform policy related to critical care nursing practice. Methods: The fifth World Federation of Critical Care Nurses international survey of critical care nursing organizations was emailed to potential participants from countries with critical care nursing organizations or known critical care nurse leaders. Data were collected online. Responses were entered into SPSS version 23 software (IBM Corp., Armonk, NY, USA) and analyzed by geographical region and national wealth group. Findings: Eighty‐two national representative respondents participated in the survey, of whom two thirds (n = 56, 68%) had an established critical care nursing organization in their country. The five most important issues identified were working conditions, teamwork, staffing levels, the need for formal practice guidelines and competencies, and wages. The top five critical care nursing organization services that were considered to be of most importance were professional representation, as well as provision of workshops and education forums, national conferences, practice standards and guidelines, and local conferences. The most important contributions expected from the World Federation of Critical Care Nurses were standards for clinical practice and professional practice, international conferences, professional representation, and study and education grants. Conclusions: The results highlight priority areas for critical care nursing and reinforce the need to address factors that can inform critical care nursing policy and practice. Results of this survey should be incorporated into strategic action plans at the national and international levels. Clinical Relevance: Nursing leaders, policymakers, and other interested stakeholders should consider these findings when planning critical care workforce requirements. Interested parties should work collaboratively to inform recommendations for further policy and action. [ABSTRACT FROM AUTHOR]