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Aim: This study aimed to evaluate the effects of uncoated paper on skin moisture, pressure injury risk and pressure injury incidence in neurological intensive care unit patients. Methods: A randomized controlled design was used. The experimental group (n = 68) received usual care (repositioning every 2 h and use of an air mattress) and application of uncoated paper on the sacral area for 5 days, whereas the control group (n = 67) received only usual care. A repeated measures analysis of variance was used to determine changes in the skin moisture and risk of pressure injury between the groups. A chi‐squared test was used to determine the change in the incidence of pressure injuries for sacral area. Data were collected from 20 October 2017 to 6 March 2018. Results: There were statistically significant differences in the skin moisture and risk of pressure injuries between the experimental and control groups. However, a significant difference was not observed in the incidence of pressure injuries between the groups. Conclusion: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients. SUMMARY STATEMENT: What is already known about this topic? The neurological intensive care unit patients with motor deficits, loss or deterioration of sensory function and decreased consciousness have high risk of pressure injuries.Although various guidelines consider excessive skin moisture as an important cause of pressure injuries, few targeted interventions exist to manage excessive skin moisture. What this paper adds? The uncoated paper application was effective in reducing skin moisture in neurologic intensive care unit patients.In addition, application of uncoated paper application has an effect on risk of pressure injury in neurologic intensive care unit patients. The implications of this paper: The use of uncoated paper may be a valid nursing intervention for the prevention of pressure injuries in neurological intensive care unit patients.Nurses should recognize that pressure injuries are potentially preventable adverse events and use various preventive interventions including skin moisture management. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the documentation of pro re nata (PRN) medication for anxiety and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. Background: The ability to accurately document patients’ symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, Nursing process and critical thinking, Saddle River, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552) and considerable information missing (e.g., Marinis et al., 2010, J Clin Nurs, 19, 1544–1552). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker et al., 2008, J Clin Nurs, 17, 1122–1131). Design: The project was a mixed‐method, two‐phase study that collected data from two sites. Methods: In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Results: Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. Conclusions: We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Relevance to clinical practice: Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be made through training, using structured report templates and by switching to electronic databases. [ABSTRACT FROM AUTHOR]

Current advances in technology have enabled the development of a computer-based questionnaire that provides advantages over the paper-based mode of administration, such as automatic data entry, storage and calculations. However, before implementing a computer-based questionnaire, its equivalence with the original paper-based questionnaire must first be demonstrated. The purpose of this study was to evaluate the measurement equivalence of the computerized Diabetes- Specific Quality-of- Life questionnaire ( cD- QOL) with its original paper-based counterpart. A two-period crossover design was used in this study. The measurement equivalence was evaluated using quadratic weighted kappa coefficients, intraclass correlations and Cronbach's alpha comparisons. The cD- QOL was equivalent to its original paper-based counterpart. Participants preferred the cD- QOL over the paper-based questionnaire and reported that it was easy to use. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of non‐communicable disease risk factors among the nursing staff and educate them on prevention. Background: Nursing staff is integral to the Indian community healthcare systems. Recent studies report a high prevalence of non‐communicable diseases in Indian nursing staff. Therefore, data on the prevalence of non‐communicable disease risk factors among nursing staff are crucial for education on prevention. Design: A cross‐sectional digital survey‐based study. Method: We invited 4435 nursing staff to attend our online survey. We used a customized questionnaire for data collection, including a digitized version of the Community‐Based Assessment Checklist form. A score of >4 was considered high risk and warranted screening. Result: Among 682 nursing staff who attended, 70% had never undergone screening for non‐communicable diseases. The prevalence of non‐communicable disease risk factors was significantly higher in male nursing staff. In addition, logistic regression analysis showed that age, tobacco and alcohol use, increased waist circumference, physical inactivity and family history of non‐communicable diseases were significant risk factors among nursing staff. Conclusion: The study findings suggest that the nursing staff have suboptimal self‐health concerns on non‐communicable diseases. This situation warrants continued medical education, awareness campaigns on adopting a healthy lifestyle and health promotion. Summary statement: What is already known about this topic? The prevalence of non‐communicable diseases (NCDs) among Indian nursing staff is a growing concern, underscoring the need for comprehensive research and targeted interventions.Despite the significant health risks faced by this demographic, there is a notable lack of data on NCD risk factors specific to Indian nursing professionals. What this paper adds? This paper adds information on the prevalence of NCD risk factors chiefly among nursing staff in the Delhi National Capital Region.Male nursing staff have particularly high NCD risk factors. The implications of this paper: Findings may help develop routine screening programmes for nursing staff, continued nursing education and good, safe nursing practice. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the feasibility of implementing a psychological first aid intervention for psychological distress, resilience capacity, quality and meaning of life among survivors affected by earthquake adversity in Northern Syria. Methods: A quasi‐experimental, pre‐posttest, two‐group research design was utilized. A convenience sample of 95 survivors (46 in the study group and 49 in the control group) was recruited for the psychological First Aid intervention at a 1:1 ratio. The psychological first aid intervention was delivered in 10 sessions, twice weekly, followed by 3‐month follow‐up. Results: A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared with the control group. Conclusion: Our work verified the suitability of implementing psychological first aid following the catastrophic temblors which struck Northern Syria. Given that the psychological first aid intervention is grounded in psychological safety, cognitive reframing, mobilization of social support and installation of hope, the feasibility of its path following public health emergency, traumatic events or even a personal crisis can be favourable. Summary statement: What is already known about this topic? On 6 February 2023, a massive earthquake devastated large portions of war‐torn northwest Syria and southern Turkey, leaving millions in these regions battling to reconstruct their lives.In northwest Syria, strong aftershocks left more than 4500 people dead, injured hundreds more and demolished at least 10 000 structures.Disasters such as earthquakes can have a significant impact on the mental health and well‐being of those affected. Survivors may experience high levels of psychological distress and other negative mental health recovery outcomes.There is a need for psychologically supportive interventions such as the psychological first aid intervention to help survivors cope with the aftermath of such disasters.What this paper adds? A statistically significant improvement in the mean scores of resilience capacity, quality and meaning of life among survivors, along with a significant reduction in psychological distress, was registered among the study group compared to the control group.Our work verified the suitability of implementing the psychological first aid intervention following the catastrophic temblors which struck Northern Syria.The implications of this paper: Being ready for disasters is critical; health care professionals, including nurses, are one of the most frequently requested actors in disaster interventions.Nurses are an indispensable part in ascertaining the psychological repercussions of disasters on survivors, families and communities.Due to their training and professional experience, nurses can take the lead in reducing health‐threatening risks. [ABSTRACT FROM AUTHOR]

Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effectiveness of the bladder stimulation technique (BST) to collect urine samples from newborns and its effects on physiological parameters and comfort of the newborn. Design: This was a randomized controlled trial conducted in a NICU. A total of 64 newborns were divided into 2 groups: 32 newborns in the experimental group and 32 newborns in the control group. Methods: Newborns in the experimental group (EG) were subjected to the BST, and in the control group (CG), urine collection was via sterile urine bags, which is routine practice. Procedural success was defined as the collection of urine samples within 3 min of beginning the stimulation technique in the experimental group and of placing the sterile urine bag in the control group. Results: The success rate of the procedure in 3 min was 62.5% in the EG and 28% in the CG (P = 0.006, absolute difference: 35%, 95% confidence interval 27% to 42%, NNT: 3). According to the comparison of the overall mean COMFORTneo scale and pain and distress subscale scores at the 1‐ and 3‐min marks, there was a significant difference between the EG and CG (p < 0.05). The mean scores in the EG were higher than those in the CG. The mean oxygen‐saturation was significantly lower in the EG than in the CG (p < 0.05), and the increase in heart rate was significantly higher in the EG (p = 0.018). Conclusions: BST is a more successful method within 3 min for collecting urine samples from newborns compared to sterile urine bags. However, the newborns' comfort levels minimally decreased at 3 min, and they had moderate pain and distress, while the BST was being implemented. This increase in physiologic parameters was statistically significant but not clinically significant. Summary statement: What is already known about this topic? Urinary tract infection is a commonly diagnosed bacterial infection in young infants with fever. However, the symptoms of this infection are non‐specific, so urine samples are needed to accurately diagnose and exclude it.There are multiple methods available for collecting urine samples, each with its own advantages and disadvantages.The bladder stimulation technique is a noninvasive and efficient method for collecting urine samples. However, few studies have examined the pain and distress effects of this technique, and these studies have reported varying results. What this paper adds? This study found that bladder stimulation techniques were more effective than sterile urine bags in collecting urine samples within 3 min from newborns.The bladder stimulation technique led to decreased saturation and comfort levels, increased heart rate, and increased pain and distress in the newborns during urine sampling; these increases in physiologic parameters were statistically significant but not clinically significant. The implications of this paper: The bladder stimulation technique is an effective noninvasive method for quickly collecting urine samples.Considering the pain and distress‐increasing properties of the technique, it may be recommended before invasive interventions (bladder catheterization and suprapubic aspiration) when urine sample collection with urine bags is not possible; it can be used in cases where urgent urine collection is required. [ABSTRACT FROM AUTHOR]

Aim: The research was conducted to measure the effect of health literacy‐grounded web‐based education program on health literacy, nutrition and exercise behaviours in adolescents. Background: The increasing prevalence of obesity in adolescents is explained by a sedentary lifestyle and unhealthy diet. Health literacy is essential for adolescents to maintain their healthy behaviours. Methods: The research was conducted as a parallel group randomized controlled trial. The study was completed by 114 adolescents (experimental = 42, control = 72). The Personal Information Form, the Health Literacy Scale for School‐Age Children and the Nutrition and Exercise Subscales were used to collect data. A web‐based education program was implemented. Two‐way mixed design ANOVA with Bonferroni test was used to examine the group, time and group * time interaction of the measurements. Results: There was no statistically significant difference between the experimental and control groups regarding health literacy level, nutrition and exercise behaviours pre‐test mean scores (p > 0.05). In the post‐test, the mean scores of health literacy and nutrition behaviours in the experimental group were higher than the control group (p < 0.001). However, there was no significant difference in exercise behaviours (p > 0.05). The power and effect size in mean scores changes for health literacy (99.8%, η2 = 0.039) and nutrition (99.8%, η2 = 0.039) were moderate. Conclusion: The study concluded that health literacy‐grounded web‐based education program increased the health literacy levels of adolescents and improved their nutritional behaviours; however, there was no sufficient change in exercise behaviours. Summary statement: What is already known about the topic? The health literacy level of adolescents is inadequate or limited.Obesity and sedentary lifestyle are more common problems among adolescents.Interventions such as wellness coaching and health education were used to improve nutrition or exercise behaviours. What this paper adds? Health literacy‐grounded web‐based education program helps to increase the health literacy levels of adolescents.Health literacy‐grounded web‐based education program was found effective in improving nutrition behaviours. The implications of this paper: Nurses could implement web‐based education programs to prevent the negative consequences of unhealthy behaviours of adolescents.Nurses could provide opportunities to access health‐related information via web‐based interventions.Nurses could collaborate with school administrators to integrate nutrition and exercise behaviours into comprehensive and coordinated school‐based programs. [ABSTRACT FROM AUTHOR]

Introduction: Obtaining vascular access is crucial in critically ill patients. The EZ‐IO® device is easy to use and has a high insertion success rate. Therefore, the use of intraosseous vascular access (IOVA) has gradually increased. Aim: We aim to determine how IOVA was integrated into management of vascular access during out‐of‐hospital cardiac arrest (OHCA) resuscitation. Methods: Analysing the data from the OHCA French registry for events occurring between 1 January 2013 and 15 March 2021, we studied: demography, circumstances of occurrence and management including vascular access, delays and evolution. The primary outcome was the rate of IOVA implantation. Results: Among the 7156 OHCA included in the registry, we analysed the 3964 (55%) who received cardiopulmonary resuscitation. The vascular access was peripheral in 3122 (79%) cases, intraosseous in 775 (20%) cases and central in 12 (<1%) cases. The use of IOVA has increased linearly (R2 = 0.61) during the 33 successive trimesters studied representing 7% of all vascular access in 2013 and 33% in 2021 (p = 0.001). It was significantly more frequent in traumatic cardiac arrest: 12% versus 5%; p < 0.0001. The first epinephrine bolus occurred significantly later in the IOVA group, at 6 (4–10) versus 5 (3–8) min; p < 0.0001. Survival rate in the IOVA group was significantly lower, at 1% versus 7%; p < 0.0001. Conclusion: The insertion rate of IOVA significantly increased over the studied period, to reach 30% of all vascular access in the management OHCA patients. The place of the intraosseous route in the strategy of venous access during the management of prehospital cardiac arrest has yet to be determined. Summary statement: What is already known about this topic? How the intraosseous vascular access was integrated into the vascular approach during the medical resuscitation of out‐of‐hospital cardiac arrest remains unknown What this paper adds? The use of intraosseous access strongly increased (more than 400%) between 2013 and 2021, exceeding 30% of all vascular access in OHCA in 2021.The outcome of OHCA patients treated with intraosseous access was less favourable. The implications of this paper: The use of intraosseous venous access increased despite the lack of evidence supporting this practice.More studies are required to precisely determine the place of the intraosseous route and its impact on the prognosis of cardiac arrest. [ABSTRACT FROM AUTHOR]

Aims: This study was conducted to examine the effect of monthly telephone message reminders after training on women's beliefs and practice behaviours regarding breast self‐examination. Methods: This randomized controlled study was conducted with 83 women aged 20–69 years living in Turkey between September 2021 and July 2022. Women were randomly assigned (1:1) to the intervention (n = 41) or control group (n = 42), both groups received online breast self‐examination training, and the intervention group received monthly reminders on their mobile phones for 3 months. Participants completed the Champion's Health Belief Model Scale and breast self‐examination practice evaluation form at baseline and 3 months after intervention. Results: After the intervention, the mean scores of the benefits and self‐efficacy subscales of Champion's Health Belief Model Scales were significantly higher in the intervention group compared to the control group, and the mean score of barriers was lower. The rate of performing breast self‐exam regularly and at the appropriate time was higher in the intervention group. The rate of forgetting to perform breast self‐examination was higher in control group. Conclusion: A monthly reminder message may be recommended to increase women's belief in breast self‐examination and increase regular practice. Summary statement: What is already known about this topic? Breast cancer is common, it is a type of cancer that progresses slowly and can be treated with early diagnosis and regular application of breast self‐examination is one of the effective non‐invasive screening methods for early diagnosis of breast cancer among women.Studies have found that forgetfulness and neglect, lack of awareness about BSE techniques and lack of knowledge are important obstacles to breast self‐examination. What this paper adds? Breast self‐examination training and then a monthly phone message reminder approach was used in women.It has been observed that the monthly telephone reminder message is an intervention that increases the belief in breast self‐examination in women, along with an increase in the rate of regular and timely examination practice and a decrease in the rate of forgetting to do so. The implications of this paper: The importance of regular phone message reminders about breast self‐examination should be included in the in‐service training given to all health professionals, especially midwives and nurses working in the delivery of primary health care services.A central message system could be developed to remind women of breast self‐examination at the national level. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the validity and reliability of the Turkish version of the Clinical Interpersonal Reactivity Index, an instrument to assess nurses' empathy. Background: A practical empathic approach is valuable for planning nursing interventions suitable for the patient's conditions and needs and increasing patient satisfaction. Design: This is a methodological study. Methods: The study was carried out at Muğla Sıtkı Koçman University Training and Research Hospital, recruiting a total of 358 nurses between January and February 2023. Exploratory and confirmatory factor analyses were used to determine and validate the factor structure of the Clinical Interpersonal Reactivity Index. Results: The exploratory factor analysis extracted three factors. According to the confirmatory factor analysis, all goodness of fit measures were within acceptable limits. Cronbach's α values were 0.89 for the total scale with 17 items and between 0.73 and 0.81 for the factors. In test–retest analyses, all intra‐class correlation coefficients were higher than 0.7, and the correlations between the first and second applications of the scale were between 0.61 and 0.73. Conclusion: The Turkish version of the Clinical Interpersonal Reactivity Index can be applied as a valid and reliable measurement tool to evaluate empathy in Turkish nurses. Summary statement: What is already known about this topic? In order for nurses to provide adequate care and help to their patients, their empathy skills should be developed at the desired level, and they should have an empathetic disposition.Numerous empathy scales have been developed to measure empathy, a crucial element in interpersonal relationships, but since these scales have an excessive number of items and explanatory texts, their evaluation takes a long time. The Clinical Interpersonal Reactivity Index, which was originally developed in English, has been designed so that nurses can quickly assess their empathic abilities and perspectives reflecting their respective helping actions. What does this paper add? The factor structure determined as a result of'the confirmatory factor analysis of the Clinical Interpersonal Reactivity Index has three factors, and the factor structure in the original scale has two factors.The Clinical Interpersonal Reactivity Index has 17 items in the present study and 27 in the original scale.The Clinical Interpersonal Reactivity Index is a reliable and valid scale for the Turkish culture. The implications of this paper: The Turkish version of the Clinical Interpersonal Reactivity Index can be used as a self‐assessment tool to evaluate empathic dispositions and practices among Turkish nurses.Nurse educators can also use the Clinical Interpersonal Reactivity Index to evaluate empathy education programmes. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to introduce the Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) into China and test its applicability in Chinese infertile population. Background: Infertility‐related stress not only influences patients' psychological well‐being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. Design: The design used in this study is a cross‐sectional survey. Methods: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI‐FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman–Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. Results: The revised Chinese version of COMPI‐FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI‐FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman–Brown coefficient was 0.836, explaining excellent reliability. Conclusion: The revised Chinese version of COMPI‐FPSS shows good reliability and validity, and it can be used to evaluate the infertility‐related stress of infertile patients in China. Summary statement: What is already known about this topic? With the number of infertile people on the rise globally, infertility‐related stress needs attention.Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) with its brief and accessible entries is extensively applied abroad.China currently lacks such a tool. What this paper adds? This study translated the COMPI‐FPSS into Chinese and the Chinese version of COMPI‐FPSS contains 11 items and 2 dimensions, including personal stress domain and social stress domain, which has good reliability and validity. The implications of this paper: The Chinese version of COMPI‐FPSS could provide a short and reliable tool for clinical practice and research, which will reduce the burden on researchers and patients. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to evaluate the effect of the Roy adaptation model‐based strengthening program (RAMBSP) applied to nursing students on social media addiction, healthy lifestyle behaviours and self‐esteem. Methods: One hundred five nursing students studying at a nursing faculty of a university were included in this prospective, two‐armed (1:1), randomized controlled study. The study group (n:54) had 12 weeks of RAMBSP online group sessions. No intervention was made to the control group (n:51). The social media addiction level, which was the primary outcome of the study, was evaluated with the Bergen Social Media Addiction Scale (BSMAS) and healthy lifestyle behaviours and self‐esteem, which were secondary outcomes, were evaluated with the Healthy Lifestyle Behaviours Scale II (HLBS‐II) and the Rosenberg Self‐Esteem Inventory (REI). Students filled out BSMAS, HLBS‐II, and REI online via Google Forms before and after RAMBSP. Findings: At the end of the programme, there was no significant difference between the groups in terms of BSMAS scores of the students in the study group (p > 0.05); however, the difference was significant in terms of HLBS‐II and REI scores (p < 0.05). It was determined that the empowerment programme increased students' awareness of social media addiction. Conclusion: It is recommended to implement programmes that will increase students' awareness of social media addiction and its effects and to conduct new research that will cover large and different sample groups. Trial registration: It was registered at ClinicalTrials.gov in March 2021 (NCT04820517). Summary statement: What is already known about this topic? With the development of technology, social media addiction is widely seen in nursing students, who are a fragile group.Biopsychosocial approaches should be presented together in practices aimed at reducing or controlling the use of social media.It is not known whether an empowerment programme based on the nursing model (Roy adaptation model) to reduce social media addiction in nursing students is effective. What this paper adds? This programme constitutes an example of how to combine Roy adaptation model, one of the nursing models related to reducing social media addiction and providing controlled social media use, with the empowerment programme.The strengthening programme based on Roy adaptation model helped student nurses to acquire and maintain healthy lifestyle behaviours by increasing their awareness of social media addiction and improving their self‐esteem. The implications of this paper Roy adaptation model‐based psychoeducation should be conducted to enable nursing students to gain awareness of social media addiction and its consequences.Roy adaptation model‐based activities should be planned and implemented to intervene in students with social media addiction and to lead them to healthy social media use.Course contents should be added to the nursing curriculum to encourage the use of social media in a way that is effective, safe and contributes to personal development. [ABSTRACT FROM AUTHOR]

Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine‐related information and have a primary role in building confidence regarding vaccines. Aim: The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID‐19) and their attitudes towards the COVID‐19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated. Methods: A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling. Results: Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID‐19. Age and fear were also positively associated with anxiety related to COVID‐19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine. Conclusion: Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination. Summary statement: What is already known about this topic? The COVID‐19 pandemic significantly affected the psychological health of nurses.Nurses have a fundamental function in the general acceptance of vaccines. What this paper adds? Relationships were found between COVID‐19‐related fear, anxiety and attitudes towards the COVID‐19 vaccine.Anxiety and a positive attitude towards the vaccine were found to be predictors of fear related to COVID‐19.Fear related to COVID‐19 and being vaccinated against COVID‐19 were predictors of attitudes towards vaccination. The implications of this paper: Nursing managers could organize programmes to improve the coping skills of nurses in responding to situations that cause psychological burden.Nursing managers could support nurses through education to develop positive attitudes towards vaccines. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexually transmitted diseases (STDs) remains high worldwide in today's society, especially among young people. Youth education on STDs could help to reduce the prevalence of the condition in society and prevent new cases. Aim: The aim of this study is to assess the effectiveness of peer‐based short‐form educational videos on youths' knowledge of STDs. Methods: This quasi‐experimental study was conducted in Turkey. The sample consisted of 121 students divided into experimental and control groups. Pre‐ and post‐test control group quasi‐experimental research design was employed in this study during the spring semester of the academic year 2021–2022. Peer‐based short‐form educational videos created by nursing students were used as an intervention. The survey form and Sexually Transmitted Disease Knowledge Questionnaire were used to collect data. Results: Participants with parental responsibilities and had previous STD experience had higher knowledge score than the other subgroups. There was a significant main effect of peer‐based short‐form educational video on participants overall knowledge score of STDs. Additionally, the effect of intervention continued at 12‐week follow‐up measurement. Conclusion: Peer‐based short‐form educational videos increase young people's knowledge of STD, and the impact of the intervention continued at 12‐week follow up. Summary statement: What is already known about this topic? Sexually transmitted diseases continue to be prevalent in society, particularly among young people.Sexually transmitted diseases can lead to serious health conditions and have a significant impact on sexual and reproductive health.The effectiveness of internet‐based education and lectures on sexually transmitted diseases has already been investigated.Little research has been addressed to determine the impact of educational materials, which are short videos on knowledge of sexually transmitted diseases created by utilizing nursing students' peer assessment. What this paper adds? Peer‐based short‐form educational videos increase young people's sexually transmitted disease knowledge.People with parental responsibilities and a previous sexually transmitted infections responded to interventions more favourably.The effects of peer‐based short‐form educational videos persisted 3 months afterwards. The implications for this paper: This cost‐free method has a potential to be widely used as a public health intervention to educate young people on sexually transmitted diseases.The peer‐based short‐form educational videos can be combined with other interventions to increase young people's knowledge of sexually transmitted diseases. [ABSTRACT FROM AUTHOR]

Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

Background: High cognitive load in nurses is a common problem in the intensive care unit (ICU). However, it remains unclear what different types of cognitive load the ICU nurses have experienced during the implementation of delirium interventions. Aim: To describe the characteristics and explore the effect of implementing a delirium intervention on the cognitive load of nurses working in the ICU. Methods: A cluster‐randomized controlled clinical trial was conducted. Six ICUs were randomized in a 1:1 ratio, and eligible nurses from these units provided either a delirium bundle intervention in addition to usual care (27 nurses) or usual care alone. An instrument was used to measure different types of cognitive load (MDT‐CL), assessing intrinsic, extraneous and germane cognitive load. The repeated measures analysis of variance was used to detect between‐group differences. Results: Among these nurses, significant between‐group differences were identified in terms of their overall (P < 0.001), intrinsic (P < 0.001) and extraneous (P < 0.001) cognitive load. There was no significant change observed in the germane cognitive load (P = 0.489) in the delirium intervention group. Conclusion: It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses, in order that tailored strategies can be applied to reduce cognitive load in ICU nurses. Summary statement: What is already known about the topic? ABCDEF bundle interventions are effective to reduce ICU delirium incidence and improve clinical outcomes.Nursing care in the intensive care units is characterized by elevated demand on workloads and increased cognitive load.Cognitive load has been identified to include three different types: intrinsic cognitive load, extraneous cognitive load and germane cognitive load. What this paper adds? The application of a delirium intervention in ICU nurses can increase the intrinsic, extraneous and overall cognitive load but had no effect on the germane cognitive load in ICU nurses.It is important to understand how the implementation of a delirium intervention affects different types of cognitive load in nurses so that tailored strategies can be applied to reduce cognitive load in ICU nurses. The implications of this paper: Evaluating different types of cognitive load in ICU nurse is helpful to support appropriate allocation of nursing resources and improvement of patient safety.This study highlights the necessity of improving efforts focusing on reduction of the intrinsic and extraneous cognitive load related to nursing care for delirium in ICUs. [ABSTRACT FROM AUTHOR]

Aim: This study compared the effects of web‐based and face‐to‐face education given to office workers on health beliefs and physical activity levels towards obesity. Methods: The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846. Results: A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05). Conclusion: It was determined that web‐based and face‐to‐face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level. Summary statement: What is already known about this topic? Beliefs about obesity and physical activity are changed by face‐to‐face education methods.Along with the changing and developing technology, web‐based education has gained importance as well as face‐to‐face education.Studies on the effect of web‐based education compared with face‐to‐face education are limited. What this paper adds? This study determined that face‐to‐face education and web‐based education had an effect on beliefs about effecting change in obesity and the duration of physical activity.Web‐based education can be as effective as face‐to‐face education for this. The implications of this paper: Individuals' beliefs about reducing obesity can change with face‐to‐face education and also with web‐based education, which can be accessed more easily in desired time periods.Web‐based education can be used to improve obesity in cases where face‐to‐face education cannot be applied. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the association between medication literacy and blood pressure control among hypertensive patients. Background: Blood pressure control is a challenge for global health systems. Medication literacy is essential for medication self‐management in hypertensive patients and a basis for managers to develop comprehensive intervention strategies for hypertension medication use. Design: A cross‐sectional observational study was conducted. Methods: A total of 378 hypertensive patients was selected by convenience sampling from two tertiary hospitals and four community health service centres from December 2021 to January 2022 in Changsha, China. Associations between medication literacy and blood pressure control were identified with chi‐square, independent samples t‐tests and logistic regression analyses. Results: The average medication literacy score of the hypertensive patients investigated was low. Over a third of patients had uncontrolled blood pressure. Logistic regression analysis showed that medication literacy was an influencing factor for blood pressure control rate in hypertensive patients. Conclusions: Medication literacy and blood pressure control among hypertensive patients was poor. Medication literacy was a facilitator of blood pressure control so improving medication literacy may be of value to improve blood pressure control in hypertensive patients. Summary statement: What is already known about this topic? Medication literacy is essential for medication self‐management in hypertensive patientsThe association between medication literacy and blood pressure control in hypertensive patients is unclear. What this paper adds? Medication literacy and blood pressure control rates among hypertensive patients were poor and in need of urgent improvement.Medication literacy was a facilitator of blood pressure control in hypertensive patients. The implications of this paper: Clinical nurses may enhance hypertension management by improving medication literacy.Findings provide a base for implementing medication literacy intervention strategies and promoting blood pressure management. [ABSTRACT FROM AUTHOR]

Background: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. Design: This study was designed as an instrument development study. Methods: This study aimed to develop a scale to measure the attitudes of parents with children aged 0–5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item‐level test–retest analyses for reliability. Results: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28‐item two factors = 62.47%). Conclusion: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health‐care services based on the results of the measurement. Summary statement: What is already known about this topic? Vaccination plays an important role in health practice.Parents' attitudes towards vaccination affect their children's vaccination status.Increasing vaccination rates in children will contribute to the reduction of infectious diseases and mortality. What this paper adds? A new valid and reliable measurement tool for determining vaccine hesitancy has been developed.The validity and reliability of the scale of attitudes towards vaccination among parents of children aged 0–5 years were tested.The tool could be used to determine the attitudes of parents of children aged 0–5 years towards vaccination. The implications of this paper The scale may help in determining factors affecting parents' attitudes on vaccination.The scale can generate data to guide nursing practices to increase vaccination rates.The scale can be used to influence nursing practices to increase vaccination rates and promote vaccine awareness, trust and acceptance. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the effects of a web‐based birth preparation programme based on the Health Belief Model and supported by motivational interviews on fear of childbirth, self‐efficacy and the labour process in primigravida women. Methods: The study was conducted in a single‐blind, randomized controlled design with 73 pregnant women. The Birth Health Belief Scale, the Wijma Delivery Expectation/Experience Questionnaire A‐B, the Childbirth Self‐efficacy Scale and the Labour Process Assessment forms were used to collect data. Five sessions of motivational interviews were held with the pregnant women in the experimental group, while those in the control group were administered placebo education. Results: Fear of birth was lower, and the birth self‐efficacy total score was higher in the experimental group. None of the groups indicated significant differences in terms of their mode of delivery. Conclusion: Health Belief Model‐based web‐based birth preparation programme and motivational interviews were found to reduce the fear of birth, increase self‐efficacy and positively affect the birth process in primigravida women. Summary statement: What is already known about this topic? Caesarean delivery is an important health problem that is common all over the world.Fear of childbirth and low self‐efficacy are two important reasons for the increase in the frequency of caesarean section rates.Nurses can make important contributions to the prevention of optional caesarean birth by providing women with health education.What this paper adds? The web‐based birth preparation programme based on the Health Belief Model and motivational interview decreased fear of birth and improved attitudes and behaviours towards vaginal delivery by increasing health beliefs and birth self‐efficacy.The implications of this paper: This study brings a new perspective, indicating that a birth preparation programme based on the Health Belief Model and supported by motivational interviews with primigravida women is an effective method of preventing elective caesarean delivery.It is recommended that nurses use web‐based training tools and conduct cognitive behavioural strategies in antenatal classes. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to present national data for children and adolescents requiring hospitalization in Thailand. Background: Feeding and eating disorders can cause life‐threatening and negative health impacts. In Asia, the prevalence is rising. Data from children and adolescents in Thailand are limited. Design: This study is a retrospective study of the national database. Methods: Data from the National Health Security Office database on Universal Health Insurance Coverage (2015–2019) of 0–17‐year‐olds were analysed by diagnosis (anorexia nervosa, bulimia nervosa, vomiting associated with psychological disturbances, other eating disorders and unspecified eating disorders). Descriptive statistics, chi‐square test and multinomial logistic regression were used. Results: There were 163 patients, averaging 9.4 ± 5.2 years old, requiring 205 admissions. Most diagnoses showed stable trends, except for a slight decrease in anorexia and unspecified eating disorders. Most admissions were due to unspecified eating disorders and psychogenic vomiting, followed by anorexia nervosa. The overall prevalence was 3.86 per 100 000 admissions. Anorexia had the highest hospital costs and re‐admission rates. Anorexia nervosa was most prevalent in early adolescence and females, while bulimia nervosa was most prominent in middle adolescence and had a male predominance. Conclusion: Early recognition in clinical practice could increase early detection and improve outcomes. Summary statement: What is already known about this topic? Eating disorders are serious mental health conditions that involve unhealthy eating habits and cause fatal medical complications.Most studies have been reported from Western or developed countries; recently, more data are emerging from the East, particularly in developing countries including the Southeast Asia.Underdiagnoses and underdetection can cause delayed treatment and prognosis. What this paper adds? Some types of eating disorders such as anorexia nervosa and bulimia nervosa have specific characteristics. ○Anorexia nervosa was mostly prominent among early adolescents but was also found in younger children. Patients with anorexia nervosa required a longer length of stay, had the highest re‐admission rate and had the highest treatment cost per admission.○Bulimia nervosa was more prominent during middle adolescence. Contrasting to previous literature, we found that Thai males were diagnosed with bulimia nervosa 2.5 times higher than females.○Psychogenic vomiting was prominent in children of both sexes. The implications of this paper: We present the prevalence of national data on feeding and eating disorders among children and adolescents, but we believe that there are more patients with eating disorders outside the health care system, who remain underdetected and underdiagnosed.For early detection, minimizing admissions and complications, clinicians, nurses and health care providers who are at the front line are encouraged to recognize eating disorders, particularly in this era where body image is a concern for adolescents.This study portrays feeding and eating disorders among children and adolescents in Thailand, and the trends may represent counties that have similar socioeconomic backgrounds and health care systems. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Aims: Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Design: Prospective observational study. Methods: This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. Results: The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. Conclusion: In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. Relevance to Clinical Practice: In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. Reporting Method: This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patient or Public Contribution: Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aims: The present study aimed to explore the effects of a guided self‐help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses. Background: Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face‐to‐face delivery of mindfulness interventions may be inconvenient for individuals. Guided self‐help interventions may be more accessible. Methods: This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8‐week guided self‐help mindfulness intervention, while the individuals in the control group received a psycho‐educational brochure. The Five Facet Mindfulness Questionnaire, the Connor‐Davidson Resilience Scale and the Maslach Burnout Inventory‐Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively. Results: After an 8‐week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group. Conclusions: The guided self‐help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses. Summary statement: What is already known about the topic? Mindfulness‐based interventions can improve psychological resilience and reduce job burnout of nurses.A growing body of studies has begun incorporating self‐help strategies with mindfulness‐based interventions.There are few studies exploring the use of the guided self‐help mindfulness interventions for Chinese psychiatric nurses and the associated effects on psychological resilience and job burnout. What this paper adds? The guided self‐help mindfulness intervention reduced job burnout and improved psychological resilience compared with psycho‐education intervention. Implications of this research Self‐guided mindfulness interventions can be used to improve psychological resilience and reduce job burnout among psychiatric nurses.In the future, the impact of self‐help mindfulness interventions on the mental health of nurses in other specialties can be trialled. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence and clustering of NANDA‐International nursing diagnoses in patients assisted by pre‐hospital emergency teams. Design: Retrospective descriptive study of electronic record review. Methods: Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two‐step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020. Results: Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six‐cluster solution (n = 26.788) was found. Five clusters had a single high‐prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co‐occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051). Conclusion: Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre‐hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases. Implications for the profession and/or patient care: Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre‐hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre‐hospital clinical setting. Impact: What problem did the study address? There are different models of pre‐hospital emergency care services.The use of standardized nursing languages in the pre‐hospital setting is not homogeneous.Studies on NANDA‐I nursing diagnoses in the pre‐hospital context are scarce, and those available are conducted on small samples. What were the main findings? This paper reports the study with the largest sample among the few published on NANDA‐I nursing diagnoses in the pre‐hospital care setting.Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance.Patients attended by pre‐hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers. Where and on whom will the research have an impact? Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre‐hospital setting, increasing the evidence of individualized and standardized care plans for pre‐hospital care. Reporting method: STROBE checklist has been used as a reporting method. No Patient or Public Contribution: Only patients' records were reviewed without further involvement. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify and synthesize available research reporting parental mental health outcomes related to contact with a stillborn baby. Background: Stillbirth is devastating events for parents. The effects of contact with the stillborn baby on parental mental health are uncertain. Methods: This was a systematic review and meta‐analysis carried out by searching six international electronic databases including PubMed, EMBASE, Cochrane, Web of Science, PsycINFO and CNKI databases from inception to 15 January 2023. Review Manager software was used for data analysis. Results: Ten studies were included (n = 3974). Contact with a stillborn baby increased the risks of anxiety, depression and post‐traumatic stress disorder in the short term and increased the risks of anxiety and post‐traumatic stress disorder in the long term. Parents who had contact with a stillborn baby were more satisfied with their decision. Subgroup analysis showed that seeing a stillborn baby had no significant effect on anxiety or depression, but holding a stillborn baby increased the risks of anxiety. Conclusions: Caregivers should respect the parents' decision on whether to have contact with the stillborn baby and provide parents with continuous information, emotional and behavioural support after they have contact with stillborn babies. Summary statement: What is already known about this topic? Stillbirth is a tragic event for parents and the extended families and can trigger intense grief and devastating psychosocial symptoms.Although some studies have been conducted to investigate the effect of contact with the stillborn baby on parental mental health, there is no consensus on the effectiveness of contact with the stillborn baby. What this paper adds? Contact with stillborn baby, particularly holding a stillborn baby, may increase the risk of harm to parental mental health.Parents were more satisfied with their decision to have contact with a stillborn baby rather than no contact with their stillborn baby. The implications of this paper: This study may provide evidence for managers and caregivers about the development of guidelines for contact with a stillborn baby and promote parental mental health. [ABSTRACT FROM AUTHOR]

Background: There are many controversies over the necessity of monitoring gastric residual volume in the nursing care of enteral nutrition. We aimed to conduct an updated meta‐analysis to evaluate the effects of monitoring or not monitoring gastric residual volume on patients' outcomes and complications. Methods: We searched the Cochrane Library database to 15 April 2021 for randomized controlled trials (RCTs) on the effects of gastric residual volume and no gastric residual volume monitoring. Review Manager software was used for data analysis. Results: A total of seven RCTs involving 1240 enteral nutrition patients were included. Gastric residual volume monitoring was associated with reduced incidence of vomiting (OR2.33, 95% CI:1.68–3.24), whereas no gastric residual volume monitoring was associated with reduced incidence of unnecessary interruptions of enteral nutrition (OR0.38,95% CI:0.26–0.55). There were no significant differences on the incidence of abdominal distention (OR1.87, 95% CI:0.82–4.28), diarrhoea (OR1.03,95% CI:0.74–1.43), VAP (OR0.83, 95%CI:0.37–1.89), duration of mechanical ventilation (MD −0.06,95% CI:−1.22–1.10), length of ICU stay (MD −1.33, 95% CI:−3.58–0.91) and mortality (OR0.90,95% CI:0.61–1.34). Conclusions: Not monitoring gastric residual volume is associated with reduced unnecessary interruptions of enteral nutrition related to inadequate feeding and increased risk of vomiting. Summary statement: What is already known about this topic? Enteral nutrition is vital to the prognosis of critically ill patients.Monitoring the gastric residual volume has been used for the safety of enteral nutrition.The role of gastric residual volume monitoring in critically ill patients remains unclear. What this paper adds? Monitoring gastric residual volume is associated with reduced incidence of vomiting.Not monitoring gastric residual volumes may reduce unnecessary interruptions of enteral nutrition.There are no significant differences on the incidence of abdominal distention, diarrhoea, VAP, duration of mechanical ventilation, length of ICU stay and mortality between patients with or without gastric residual volume monitoring. The implications of this paper: Omission of gastric residual volume monitoring may result in more complete delivery of prescribed enteral nutrition and hence of better nutritional support / status for these patients.The role of gastric residual volume monitoring on enteral safety and nutritional intake of ICU patient needs further investigation. [ABSTRACT FROM AUTHOR]

Aim: To assess if experimental warming interventions are superior to routine warming interventions in preventing perioperative hypothermia. Background: Perioperative hypothermia is a critical issue for the complications of surgery. There are various kinds of perioperative warming interventions, including experimental and routine warming interventions. Methods: We performed a systematic literature review and meta‐analysis for the randomized clinical trials of experimental warming interventions vs. routine warming interventions in the perioperative period. Findings: A total of 15 studies were included with 983 participants allocated to experimental warming interventions and 939 controls with routine warming interventions, who were receiving a variety of surgeries. The focused outcome was the intraoperative and postoperative body temperature. All included studies were randomized clinical trials. Among the participants receiving operations, the meta‐analysis showed that routine warming intervention groups experienced lower intraoperative and postoperative body temperatures compared to the experimental warming groups. The meta‐analysis results included positive mean differences, significant tests for overall effect and significant heterogeneity in the random‐effects model. Conclusions: In spite of significant heterogeneity, experimental warming interventions are likely to demonstrate superior warming effects when compared to routine warming interventions, as shown by the current meta‐analysis results of randomized clinical trials. Summary statement: What is already known about this topic? Perioperative hypothermia is a significant factor for prognosis within and after surgery.The difference between experimental and routine nursing interventions for maintaining intraoperative and postoperative body temperature was unknown. What this paper adds? The meta‐analysis showed that routine warming intervention groups experienced significantly lower intraoperative and postoperative body temperatures when compared to experimental warming groups. The implications of this paper: Experimental warming interventions might be associated with superior warming effects.The heterogeneity of surgery type and experimental warming methods might limit the interpretation of findings. [ABSTRACT FROM AUTHOR]

Aim(s): To assess the effectiveness of sub‐epidermal moisture (SEM) assessment technology in the detection of early‐stage pressure damage in a critical care unit (CCU) and dark skin tone patients and its impact on hospital‐acquired pressure injury (HAPI) incidence. Design: Quality improvement study employing Kurt Lewin's change model emphasizing planning, implementation, evaluation and sustainable change. Methods: The study evaluated 140 adult patients admitted to the CCU over a 24‐week period, from July to December 2022. Retrospective analysis of standard PI care pathways was performed in 90 patients admitted during a 12‐week pre‐implementation period. Fifty patients were admitted through the subsequent 12‐week implementation period. SEM assessments were performed daily at the sacrum and heels and interventions were applied based on SEM assessments; SEM delta ≥0.6 indicating localized oedema or persistent focal oedema. Statistical analyses were performed on anonymized data. Results: Pre‐implementation HAPI incidence was 8.9% (N = 8/90). All eight patients were African American with varying skin tones. A 100% reduction in HAPI incidence was achieved in the implementation period which included 35 African American patients. The relative risk of HAPI incidence was 1.6 times higher in the pre‐implementation group. Conclusion: Implementing SEM assessment technology enabled equitable PI care for all population types and resulted in a 100% reduction of PIs in our CCU. Objective SEM assessments detected early‐stage PIs, regardless of skin tone and enabled providing interventions to specific anatomies developing tissue damage as opposed to universal preventive interventions. Implications: PI care pathways relying on visual and tactile skin assessments are inherently biased in providing equitable care for dark skin tone patients. Implementing SEM assessments empowers healthcare practitioners in driving objective clinical interventions, eliminates bias and enables positive PI health outcomes. Impact: Implementing SEM assessment technology had three main effects: it detected early tissue damage regardless of skin tone (detection effect), enabled anatomy‐specific interventions (treatment effect) and prevented PIs across all population types (prevention effect). The authors have adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines. Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community? Addressing health inequities in pressure injury prevention; Demonstrated effectiveness across patient populations; Resource optimization and enhanced patient safety. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects of COVID‐19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. Design: A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Methods: Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non‐parametric chi‐square test were used for analysis. STROBE checklist was used for the preparation of this paper. Results: A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre‐pandemic values, HbA1c levels improved in T3, but HDL levels worsened. Conclusions: COVID‐19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Impact: Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium‐term. [ABSTRACT FROM AUTHOR]

Aim: Smoking is harmful to human health. However, the relationship between smoking and blood pressure (BP) has not been consistent. This study aimed to analyse nurses' smoking behaviours and their relationship with BP. Methods: This cross‐sectional study recruited 128 009 nurses in 11 cities in China. They were surveyed with questionnaires including BP measurements. The main contents of the questionnaire included smoking status and other factors that might be associated with hypertension. Multiple linear regression analyses and binary logistic regression analyses were used to analyse the data. Results: The results showed there was a significant difference in the smoking rate among nurses with different characteristics (P < 0.05). For both male and female nurses, smoking was associated with increased diastolic BP and mean arterial pressure, but only with increased systolic BP of male nurses. The prevalence of hypertension among male and female nurses was not related to smoking. Conclusion: Despite a relatively low overall smoking rate, rates among some groups are high. Different cities, hospitals, and departments can combine local data and conditions to formulate targeted tobacco control measures to improve nurses' physical and mental health. Summary statement: What is already known about this topic?: The number of tobacco‐related diseases has been steadily increasing worldwide over the past few decades.A decrease in the smoking rate of medical staff can lead to a decrease in the smoking rate of the general population.The association between smoking and blood pressure remains controversial, and further clarification is required. What this paper adds?: There was a significant difference between the smoking rates of nurses with different characteristics.The smoking rates were relatively high for nurses in emergency departments and operating rooms and those with >10 night shifts per month within the last 6 months.Among nurses, smoking is related to increase in diastolic blood pressure and mean arterial pressure in both men and women but only to increased systolic blood pressure in men; however, there was no association with hypertension risk. The implications of this paper: This study can support nursing managers to take targeted interventions to target smoking populations to reduce their smoking rates.For nurses who smoke due to high pressure, it is suggested that the working hours and cycles should be adjusted appropriately, the proportion of nurses should be increased, and the work intensity should be reduced to alleviate the work pressure.Nurses with high blood pressure should especially be dissuaded from smoking. [ABSTRACT FROM AUTHOR]

Background: Falls lead to numerous negative health outcomes and jeopardize the physical function and quality of life in older adults. Cognitive impairment and physical frailty were found to be associated with the risk of falls, but there was no systematic review that estimated the association between cognitive frailty and the risk of falls. Methods: A systematic literature search of the cross‐sectional, cohort, and case–control studies in Cochrane library, Scopus, CINAHL, EMBASE and PsycINFO was conducted on 3 September 2021. Study quality was assessed by using the Joanna Briggs Institute critical appraisal tool. A random effects meta‐analysis was performed to estimate the odds ratio of the incidence of falls in older adults with cognitive frailty. Results: Seven studies were included. The overall quality of the included studies was acceptable. The meta‐analysis of cohort studies showed older adults aged 60 and above with cognitive frailty had a pooled odds ratio of 1.45 (95% confidence interval 1.30, 1.61) for at least one fall compared with those without cognitive frailty. The meta‐analysis of cross‐sectional studies showed that the odds of older adults with cognitive frailty experiencing at least one fall was 1.64 times (95% confidence interval 1.51, 1.79) higher than those without cognitive frailty. Conclusion: The association between cognitive frailty and the risk of falls is statistically significant. Timely detection of cognitive frailty is essential especially in the community nursing level for preventing falls. Summary statement: What is already known about this topic? Cognitive impairment and physical frailty are inextricably associated, and phenotype of cognitive frailty contains components that may leading to falls. What this paper adds? The association between cognitive frailty and the risk of falls among older adults is statistically significant. Timely detection of cognitive frailty in older adults is essential for fall prevention. The implications of this paper: Nurses especially in the community level should assess the cognitive function and physical frailty of older adults periodically, and special attention should be paid to older adults with cognitive frailty for fall prevention.Interventions such as physical and cognitive activities are suggested to improve older adults' cognitive frailty so that their risk of falls can be reduced.Further interdisciplinary research is needed to explore the methods of fall prevention among people with cognitive frailty. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to examine the efficacy of cryotherapy with frozen gloves for the prevention of the chemotherapy‐induced peripheral neuropathy of the hand. Background: Most breast cancer patients receive chemotherapy; consequently, patients frequently experience adverse effects of chemotherapy‐induced peripheral neuropathy. Methods: A quasi‐experimental and prospective self‐controlled study was conducted. Breast cancer patients wore frozen glove on the dominant hand for 90 min during their weekly treatment with paclitaxel (80 mg/m2). Treatment of the dominant hand, the intervention group, was continued for 12 weeks. The non‐dominant hand was considered the control group. Results: A total of 22 patients participated in this study, and only one patient did not reach the cumulative dose (960 mg/m2). Findings show that the incidences of sensory and motor symptoms of chemotherapy‐induced peripheral neuropathies at the following times (Time 1 to Time 4) were significantly lower in the intervention group than in the control group. However, although the incidences of motor symptoms were lower in the experimental group than in the control group, a significant difference was shown only at Time 4. Additionally, both groups of patients reported that their incidence of sensory symptoms were higher than those of motor symptoms. Conclusion: Cryotherapy with frozen gloves is useful in reducing both the sensory and motor symptoms of the chemotherapy‐induced peripheral neuropathy of the hands. Summary statement: What is already known about this topic? Most breast cancer patients receive chemotherapy; consequently, patients frequently experience adverse effects of the chemotherapy‐induced peripheral neuropathy.Previous studies have indicated that cryotherapy (frozen gloves or shocks) may effectively reduce chemotherapy‐induced peripheral neuropathy associated with the use of paclitaxel. However, there is limited evidence for the effective treatment of chemotherapy‐induced peripheral neuropathy. What this paper adds? Paclitaxel‐induced peripheral neuropathy is frequently observed in patients with breast cancer and cryotherapy may effectively reduce this.The study results show that cryotherapy with frozen gloves can effectively alleviate the sensory and motor symptoms of the hands in breast cancer patients during chemotherapy.Moreover, we also found that breast cancer patients reporting sensory symptoms had higher motor symptoms during treatment with paclitaxel. The implication of this paper: Cryotherapy is a simple, safe, and effective strategy to prevent chemotherapy‐induced peripheral neuropathy in patients with breast cancer who receive paclitaxel treatment.Moreover, a reduction in group effects may increase the willingness of patients to receive chemotherapy. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effectiveness of prenatal breast‐feeding education provided to pregnant women who experience fear of breast‐feeding in the COVID‐19 pandemic period. Methods: A prospective randomized controlled trial study was conducted with 128 pregnant women (64 in the experimental group and 64 in the control group) between November 2021 and February 2022. The data were collected via the Numeric Pain Rating Scale, the Breastfeeding Motivation Scale and the Iowa Infant Feeding Attitude Scale to assess fear, motivation and attitudes regarding breast‐feeding. The pregnant women in the experimental group were provided with and education programme on 'safe breastfeeding in the COVID‐19 pandemic'. The breast‐feeding education included in standard care was given to the control group after pre‐test data collection was completed. Results: The significant differences in the mean Numeric Pain Rating Scale, Breastfeeding Motivation Scale and Iowa Infant Feeding Attitude Scale scores of the groups were in favour of the experimental group (P < 0.05). It was determined that in the first postnatal month, in the experimental group, the numbers of women who believed that their breast‐feeding was not affected by COVID‐19 and the numbers of infants solely breastmilk‐fed were higher compared to the control group (P < 0.05). Conclusion: Prenatal breast‐feeding education about safe breast‐feeding in the COVID‐19 pandemic period can reduce fears of breast‐feeding and increase motivation and approving attitudes regarding breast‐feeding. Summary statement: What is already known about this topic? The COVID‐19 pandemic dramatically reduced access for new mothers to their immediate family, health‐care providers and support systems, which are social support providers.The COVID‐19 pandemic also caused mothers to experience intense fear, anxiety and uncertainty about whether to continue breast‐feeding.Although published guidelines emphasize that the advantages of breast‐feeding outweigh the risk of transmission, fears of transmission of COVID‐19 have caused mothers to avoid breast‐feeding. What this paper adds? During the COVID‐19 pandemic period, the breast‐feeding motivation of expectant mothers who received midwife support for breast‐feeding increased, and their fear of breast‐feeding decreased. The implications of this paper: To ensure well‐being in postpartum mothers, a special breast‐feeding education plan should be developed for the conditions during the pregnancy and postpartum periods.In the COVID‐19 pandemic period, breast‐feeding education can be beneficial for this vulnerable group. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of an online multidisciplinary weight loss management programme. Methods: Between July 2016 and July 2017 this randomized controlled trial recruited patients in Nanjing, China who were living with type 2 diabetes mellitus and who were obese or overweight and randomized them to online versus conventional groups. All participants were managed by a multidisciplinary team. The experimental group was managed using the Why Wait WeChat Platform for Weight Reduction Management. Results: There were 55 and 52 participants in the online and conventional groups, respectively. The decreases in fasting blood glucose (−4.26 vs. −2.99 mmol/L), 2‐h postprandial blood glucose (−4.48 vs. −2.68 mmol/L) and glycated haemoglobin (−22.11 vs. −6.21 mmol/mol) were more pronounced in the online compared to conventional group (all P < 0.05). After the intervention, self‐management ability parameters, including diet control, foot care and total score, were improved in the online group compared with the conventional group, as well as all indexes of quality of life (all P < 0.05). Conclusion: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus. Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. Summary statement: What is already known about this topic?: Multidisciplinary approaches have been introduced into weight loss management models for patients with type 2 diabetes mellitus and obese or overweight in outpatient clinics of third‐level hospitals, but their effects have not been clearly described. What this paper adds?: The online multidisciplinary weight loss management programme improved blood glucose in obese or overweight patients living with type 2 diabetes mellitus.Self‐management ability parameters (including diet control, foot care and total score) and quality of life were improved in the online group compared with the conventional group. The implications of this paper: This is the first trial of an online programme in the management of type 2 diabetes mellitus in China.Trial findings might have international applicability in the management of type 2 diabetes mellitus and could lead to improvement of prognosis. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [ABSTRACT FROM AUTHOR]

Aim: This quasi‐experimental study aimed to explore effects of walking exercise on disease activity, sleep quality, and quality of life among individuals with systemic lupus erythematosus. Methods: After recruiting people with systemic lupus erythematosus from a hospital in Taiwan between October 2020 and June 2021, participants were free to opt to receive one walking exercise programme plus standard care for 3 months or to membership of a control group receiving routine care. Primary outcomes included Systemic Lupus Erythematosus Disease Activity Score, the Pittsburgh Sleep Quality Scale, and a quality‐of‐life scale for patients with systemic lupus erythematosus, namely, LupusQoL. These scales were administered first, at baseline and later, within 1 week following completion of the intervention. Between‐group effects were compared using generalized estimating equations with adjustment for baseline variables. Results: The experimental and control groups each included 40 participants. Multivariate analysis indicated that adding the walking exercise programme into routine care elevated sleep quality and LupusQoL (the latter in the subscales of physical health, planning, and intimate relationships), except for disease activity. Conclusion: Findings of this study supported the addition of walking exercise as part of routine care for people with systemic lupus erythematosus and may be a reference in the provision of adequate care for these patients. Summary statements: What is already known about this topic? Systemic lupus erythematosus is a lifelong autoimmune disease that affects any organs throughout the body, thus insidiously causing negative impacts on the affected patients.Today, use of exercise programmes such as walking exercise has been studied as a remedy for many medical conditions, but its effectiveness in minimizing the symptoms of distress among people with systemic lupus erythematosus is unknown. What this study adds? Participants with systemic lupus erythematosus who opt to receive the walking exercise programme for 3 months in addition to routine care experience improved sleep quality and quality of life compared with those receiving routine care alone. The implications of this paper: In accordance with the belief that "an ounce of prevention is worth a pound of cure," early implementation of an exercise programme should be considered in addition to routine care for patients with systemic lupus erythematosus.Evidence from this research could provide empirically informed and robust data for healthcare policymakers and in turn might help to reduce the incidence of morbidity among patients with systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Aims: To explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables. Design: Further analysis of a multicentre cross‐sectional and survey‐based study. Methods: A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed. Results: The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours. Conclusions: The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours. Impact: This study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors. Reporting Method: This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. What Does This Paper Contribute to the Wider Global Clinical Community?: This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours. Study Registration: This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084). Implications for the Profession and/or Patient Care: For breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours. [ABSTRACT FROM AUTHOR]

Aims: To perform temporal validation of a risk prediction model for breast cancer‐related lymphoedema in the European population. Design: Temporal validation of a previously developed prediction model using a new retrospective cohort of women who had undergone axillary lymph node dissection between June 2018 and June 2020. Methods: We reviewed clinical records to identify women who did and did not develop lymphoedema within 2 years of surgery and to gather data regarding the variables included in the prediction model. The model was calibrated by calculating Spearman's correlation between observed and expected cases. Its accuracy in discriminating between patients who did versus did not develop lymphoedema was assessed by calculating the area under the receiver operating characteristic curve (AUC). Results: The validation cohort comprised 154 women, 41 of whom developed lymphoedema within 2 years of surgery. The value of Spearman's coefficient indicated a strong correlation between observed and expected cases. Sensitivity of the model was higher than in the derivation cohort, as was the value of the AUC. Conclusion: The model shows a good capacity to discriminate women at risk of lymphoedema and may therefore help in developing improved care pathways for individual patients. Implications for the Profession and/or Patient Care: Identifying risk factors for lymphoedema secondary to breast cancer treatment is vital given its impact on women's physical and emotional well‐being. Impact: What problem did the study address? Risk of BCRL. What were the main findings? The prediction model has a good capacity to discriminate women at risk of lymphoedema. Where and on whom will the research have an impact? In clinical practice with women at risk of BCRL. Reporting Method: STROBE checklist. What Does this Paper Contribute to the Wider Global Clinical Community?: It presents a validated risk prediction model for BCRL. No Patient or Public Contribution: There was no patient or public contribution in the conduct of this study. [ABSTRACT FROM AUTHOR]

Background: The Patient Health Engagement Scale was designed to assess the emotional and psychological attitudes of patients' engagement along their healthcare management journey. Aim: This study aimed to conduct psychometric testing of the Turkish version of the Patient Health Engagement Scale among patients with chronic diseases. Design: A cross‐sectional validation study was conducted and reported according to the STROBE checklist. Methods: There were 520 patients who completed the scale between March 2017 and February 2018. The content, construct and concurrent validity were evaluated. The reliability of the scale was measured using internal consistency and construct reliability. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. Results: The scale's validity was enabled by the translation and back translation method. The content validity index of the scale was 0.88. Construct validity determined one factor. The total variance was calculated at 85.29%. The factor loads ranged between 0.86 and 0.95. The results of the confirmatory factor analysis showed goodness‐of‐fit indices in the excellent range according to the literature. The reliability of the scale was calculated at 0.95. Conclusion: The scale was found to be a valid and reliable measurement tool to be used in identifying the engagement with health levels of patients with chronic diseases. Summary statement: What is already known about this topic? The Patient Health Engagement Scale describes the psychological readiness to be active in one's own health management.The Patient Health Engagement Scale measures patients' perceived susceptibility and severity of the disease and orientation toward health management. What this paper adds? The Turkish version of the Patient Health Engagement Scale was found to be a valid and reliable measurement tool. The implications of this paper: Engaging patients in their healthcare management may have an important role in improving treatments for patients with chronic diseases.The Patient Health Engagement Scale can be used to plan and evaluate the effectiveness of the interventions. [ABSTRACT FROM AUTHOR]