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Background: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. Aim: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). Research Design and Setting: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. Results: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital‐acquired pressure ulcers. Conclusions: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital‐acquired ulcers at hospital discharge. Relevance to Clinical Practice: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. No Patient or Public Contribution: No direct patient contact was made during the data collection. [ABSTRACT FROM AUTHOR]

Aims: To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents. Design: A cross-sectional study design. Methods: In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage= 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis. Results: All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females. Conclusion: Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours. Impact: Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking. [ABSTRACT FROM AUTHOR]

Background: Improving triage accuracy for accurate patient identification and appropriate resource allocation is essential. Little is known about the trend of triage accuracy, and factors associated with mistriage vary from study to study. Aim: To identify incidence and risk factors of mistriage, such as overtriage and undertriage. Design: This is a cross-sectional study. Methods: The data came from the National Emergency Department Information System database in 2016–2020. All patients 15 years and older visiting emergency departments in Korea were assessed for eligibility, and 20,641,411 emergency patients' data were used. Multivariable logistic regressions were conducted to confirm the associated factors with overtriage and undertriage compared to expected triage. Demographic characteristics, disease-related signs and triage-related factors were independent variables. Results: Expected triage decreased from 96.8% in 2016 to 95.7% in 2020. Overtriage (0.5%–0.7%) and undertriage (2.4%–3.3%) increased. The occupation that performed triage the most (over 85%) was nurses. Associated factors with overtriage were demographic characteristics (40–64 age group, female), disease-related signs (known disease, direct visit) and triage-related factors (regional emergency medical centre). Risk factors to undertriage were disease-related signs (systolic/diastolic blood pressure and pulse rates within normal range). Conclusions: While the acuity degree remained within the recommended range, the accuracy of triage decreased, and there was a gradual increase in mistriaged cases. Nurses have performed most of the triage and played a key role in expected triage. Associated factors with overtriage were demographic characteristics, disease-related signs and triage-related factors and risk factors to undertriage were disease-related signs. Patient or public contribution: No patient or public contribution. Implications for the profession: Nurses should be aware of what factors are associated with mistriage and why the factors cause mistriage to improve the triage accuracy because they are responsible for the majority of the triage assessments. [ABSTRACT FROM AUTHOR]

Background: Medication self‐management (MSM) is defined as a person's ability to cope with medication treatment for a chronic condition, along with the associated physical and psychosocial effects that the medication causes in their daily lives. For many patients, it is important to be able to self‐manage their medication successfully, as they will often be expected to do after discharge. Aim: The aim of this study was to describe the willingness and attitudes of patients with schizophrenia spectrum or bipolar disorders regarding MSM during hospital admission. A secondary aim was to identify various factors associated with patient willingness to participate in MSM and to describe their assumptions concerning needs and necessary conditions, as well as their attitudes towards their medication. Methods: A multicentre, quantitative cross‐sectional observational design was used to study the willingness and attitudes of psychiatric patients regarding MSM during hospitalisation. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: In this study, 84 patients, of which 43 were patients with schizophrenia spectrum disorders and 41 were patients with bipolar disorders, participated. A majority of the patients (81%) were willing to participate in MSM during their hospitalisation. Analysis revealed patients are more willing to MSM if they are younger (r = −.417, p <.001) and a decreasing number of medicines (r = −.373, p =.003). Patients' willingness was positively associated with the extent of support by significant others during and after hospitalisation (Pearson's r =.298, p =.011). Patients were convinced that they would take their medication more correctly if MSM were to be allowed during hospitalisation (65%). Conclusion: Most of the patients were willing to self‐manage their medication during hospitalisation, however, under specific conditions such as being motivated to take their medication correctly and to understand the benefits of their medication. Relevance to Clinical Practice: From a policy point of view, our study provided useful insights into how patients look at MSM to enable the development of future strategies. Since patients are willing to self‐manage their medication during hospitalisation, this may facilitate its implementation. Patient contribution: Patients were recruited for this study. Participation was voluntary, and signed informed consent was obtained from all participants prior to the questionnaire. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study was conducted to examine the possible aetiology of nocturia in patients with long‐term COVID‐19. Background: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID‐19, 10–14 weeks after the illness. Design: A descriptive design. Methods: The study consisted of 70 patients who had experienced COVID‐19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. Results: When the nocturia effects of long‐term COVID‐19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p <.05). According to post‐hoc analysis, the mean age of patients with a dominant cardio‐metabolic factor was found to be significantly younger (p <.05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p <.05). Conclusions: It was found that the urinary tract aetiological factor was dominant in patients with long‐term COVID‐19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. Relevance to Clinical Practice: Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post‐COVID‐19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. Patient or Public Contribution: The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID‐19 infection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the relationship between burnout and post‐traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. Background: The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID‐19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. Design: An online cross‐sectional survey of targeted local 327 nurses who went to assist the COVID‐19 epidemic situation in Wuhan during the initial outbreak. Methods: This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. Results: Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. Conclusions: Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. Relevance to Clinical Practice: PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. Patient or Public Contribution: Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Background Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. Design An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Methods A search was carried out using the EBSCOhost, Embase, MEDLINE, Psyc INFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). Results A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. Conclusions In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Stigma related to mental illnesses is a great burden on societies globally. Factors associated with nurses' attitudes towards people with mental illness in health-care settings are discrepant., Stigmatized attitudes among staff members towards patients with mental illness have widely been studied in various specialized health care contexts, but less often in primary health-care settings., What this paper adds to the existing knowledge? Nurses' attitudes towards people with mental illness in general were positive in primary care health settings. Younger nurses expressed feeling afraid of mentally ill patients., They not only lacked a feeling of safety around these patients but were also often of the opinion that people with mental illness should be segregated from the general population., What are the implications for practice? Systematic and continuous mental health on-the-job training for primary care nurses is recommended to strengthen the positive attitudes of young nurses towards patients., Young nurses especially should be prevented from developing stigmatized attitudes towards patients with mental problems and to ensure a skilled workforce for the future in this demanding area of health care., Abstract Introduction Despite the development of mental health services in many countries, nurses working in different health care specialties may still have concerns and negative attitudes towards people with mental illness. Aim To describe nurses' attitudes towards people with mental illness and examine factors associated with their attitudes in primary care health centres. Method The data were collected from nursing staff ( N = 264, response rate 84%) in 15 primary care health centres in two Finnish cities (spring 2014) with a self-report questionnaire (Attribution Questionnaire-27, Corrigan 2003) and analysed by descriptive statistics and multiway covariance analysis. Results Nurses' attitudes towards people with mental illness were generally positive. The nurses mostly reported willingness to help and feelings of concern and sympathy towards these patients. However, younger nurses or those without additional mental health training expressed a fear of patients. Discussion Special attention should be paid to nursing education and on-the-job training to prevent young nurses from developing stigmatized attitudes towards patients. Implications for practice Higher confidence in nursing staff could ensure a skilled work force in areas of mental health in the future, prevent young nurses from developing a fear of patients at work and support positive attitudes towards patients with mental problems. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The TAS-20 is the most widely used self-reported questionnaire to assess the level of alexithymia in students and community and clinical samples., What this paper adds to existing knowledge? The TAS-20-C exhibited high levels of reliability and validity, indicating that it is appropriate for the assessment of alexithymia in Chinese adolescents., What are the implications for practice? Screening adolescents who are at risk of alexithymia through the TAS-20 could help to perform necessary and effective precautions to decrease the adverse effects of alexithymia, such as the risks of developing depressive mood and behavioral problems., Abstract Purpose The aim of this study was to examine the psychometric properties of the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20-C) in a sample of Chinese adolescents. Method Adolescents ( n = 1260) recruited from three schools in mainland China completed the TAS-20-C, the somatization subscale of the Symptom Checklist 90 (SCL-90) and Center for Epidemiological Studies Depression Scale (CES-D). Five different factorial models of the TAS-20 were tested using confirmatory factor analysis (CFA). Cronbach's α, mean inter-item correlations and predictive validity were also evaluated. Results Among those five different factorial models, the four-factor structure model was suitable and invariant across gender and age in this sample. The TAS-20-C demonstrated adequate internal reliability. Gender and age accounted for insignificant amounts of variability in total TAS-20-C and factor scores. TAS-20-C total and subscale scores were correlated significantly with SCL-90 somatization subscale and CES-D. Girls scored higher than boys on difficulty identifying feelings (DIF) and pragmatic thinking (PR) subscales. DIF and lack of subjective significance or importance of emotions (IMs) subscale scores were higher among younger than among middle and older adolescents. Implications for Practice Validating the TAS-20 in adolescents is quite important to use it in evaluating adolescents' alexithymia, and screen those at risk of alexithymia. [ABSTRACT FROM AUTHOR]

This paper is the report of a study to determine the effect on pain of internally rotating the foot, pointing the toes down and/or using the Z-track technique during intramuscular injection and to investigate differences in pain perception related to gender and body mass index. A randomized controlled trial was carried out from September to November 2010 on 75 patients receiving diclofenac sodium intramuscularly at a university hospital in Zonguldak, Turkey. The primary outcome measure collected was pain intensity, measured on a visual analogue scale. Each subject received three injections by the same investigator using three different techniques. The three techniques were randomly allocated, and the subjects were blinded to the injection technique being used. After each injection, another investigator, who had no prior knowledge of which injection technique was used, immediately assessed pain intensity using the visual analogue scale. Research findings demonstrated that the Z-track and internally rotated foot techniques significantly reduced pain intensity during intramuscular injection. Statistically significant differences in pain intensity were observed between the three injection techniques. The results supported the hypothesis that the internally rotated foot and Z-track techniques significantly reduce pain intensity. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Outreach services are often successful in engaging and housing street homeless individuals., People experiencing homelessness have greatly increased rates of mental illness and substance abuse., What this paper adds to existing knowledge? Given the relative lack of research involving street homeless individuals, this ret-rospective chart review examined factors associated with successful housing by a multidisciplinary street outreach team, including the use of hospitalization as an intervention within a housing first framework., The majority of clients were successfully housed by the end of outreach team involvement., An admission to hospital was strongly associated with successful housing for those with a psychotic disorder., What are the implications for practice? Multidisciplinary outreach teams, specifically those with psychiatric and nursing support, successfully work with and house people experiencing street homeless-ness and psychosis., Mental health nurses embedded in the community are an essential link between inpatient and outpatient care for highly vulnerable street homeless individuals., Abstract Introduction Housing-first strategies have helped establish housing as a human right. However, endemic homelessness persists. Multidisciplinary outreach teams that include nursing, social and psychiatric services allow for integrative strategies to engage and support clients on their housing trajectory. The following retrospective review focused on the identification of demographic, clinical, and service characteristics that predicted the obtainment of housing, and explored the role of psychiatric hospitalization as an intervention, not an outcome measure, in contrast to previous studies. These have rarely focused on street homelessness. Method A retrospective chart review of 85 homeless, primarily rough-sleeping, clients was conducted to determine housing outcomes and the factors associated with obtaining housing through care provided by a psychiatric street outreach team in Toronto, Canada. Demographics, homelessness duration, diagnosis, hospitalization and housing status were tracked during team involvement. Results Overall, 46% (36/79) were housed during the study term. Securing housing at the end of treatment/data collection was significantly enhanced by hospitalization (OR = 9.04, 95% CI [2.43, 33.59]). It was significantly diminished by psychosis (OR = 0.22, 95% CI [0.05, 0.95]) and prior homelessness >36 months (OR = 0.10, 95% CI [0.02, 0.50]). Twenty-three of 31 (74%) hospitalized clients with psychosis were subsequently housed, compared to 4 of 30 (13%) not hospitalized (Fisher's exact, P < .001). Discussion Multidisciplinary street outreach teams successfully house long-standing homeless clients (>12 months without a permanent address) with serious mental illness and/or substance abuse. Hospitalization can be utilized as a complimentary intervention, particularly for those with psychosis, in the continuum of housing first initiatives, and can contribute to securing housing for those with persistent psychotic disorders. Implications for nursing practice Community mental health nurses are uniquely positioned to translate care between hospital and community settings, ensuring timely assessment, intervention and treatment of clients who are historically difficult to engage. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Many studies indicate that working with people with a personality disorder is a real challenge, which is especially known by professionals, and it also displays different attitudes that can affect their professional stance. There is no specific study examining those difficulties, emotional reactions and attitudes of mental health professionals towards people with a PD in Turkey., What this paper adds to existing knowledge? We examined emotional reactions, difficulties and attitudes of mental health professionals towards people with a PD and also the interaction between these variables. We found a strong relationship between MHWs' feelings of boredom/discontent, guilt/pity and a tendency to display positive behaviours/an inability of establishing boundaries against people with a PD. Besides, a higher level of education resulted in reduced experience of difficulties while working with patients with a diagnosis of 'PD' among nurses., What are the implications for practice? Mental health professionals and especially nurses who spend most of their time working with people with PD in the inpatient services need to be well educated and be experienced in coping with patients' relational problems and emotional fluctuations, and also be aware of their own emotional reactions., Abstract Introduction Working with people with a personality disorder ( PD) can arouse strong feelings, and cause difficulties as well as different attitudes among mental health workers ( MHWs). While attitudes towards people with PD and the difficulties experienced by MHWs have been previously investigated, the reciprocal relationship between the two has not been thoroughly investigated. Aim/Question This study aims to investigate (1) affective reactions of MHWs to people with personality disorders, (2) the difficulties that MHWs experience while working with these patients, (3) their attitudes towards these patients, and (4) the interaction between these variables. Method The data for this study were collected through a Personal Information Questionnaire, the Difficulty of Working with Personality Disorders Scale and the Attitudes towards Patients with Personality Disorders Scale from 332 MHWs from several mental health clinics in Turkey, all of whom were experienced in working with people with PD. Results The results indicate that the participants described 'difficulty in forming a relationship, understanding the client, and estab lishing cooperation' among the primary reasons of difficulties. This study also shows that there is a strong relationship between MHWs' feelings of boredom/discontent, guilt/pity and a tendency to display positive behaviours/an inability of establishing borders against people with PD. Discussion The findings of this study imply that the level of education, expertise, psychotherapy treatment and clinical supervision of MHWs all affect perceived difficulties and attitudes towards people with PD. It is also noted that among nurses, a higher level of education results in reduced experience of difficulties while working with patients with PD. Implication for practice The results foreground the need for specific skills to be developed in MHWs through theoretical training, case-focused supervision and receiving personal psychotherapy for MHWs. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this paper is to describe how selected demographic characteristics 'explain' the observed variance in the distribution of maternal health literacy estimates in adolescents attending antenatal care in Uganda, as estimated by the 'Maternal health literacy scale'. Background By the age of 20 years, more than 60% of Ugandan females are mothers. In the Busoga region of Uganda, the percentage of pregnant adolescents and adolescent mothers is at its highest (above 30%). Design Validated questionnaire survey. Methods The Maternal health literacy scale was administered to 384 adolescents aged 15-19 years attending antenatal care in Jinja and Iganga districts of the Busoga region during the period of July 2013-December 2013. The Mann-Whitney U test in SPSS21 was used to determine if the two levels of dichotomised person factors, i.e. demographic characteristics, relate to 'significantly' different mean maternal health literacy estimates, not strictly following the normal distribution, as measured by the Maternal health literacy scale. Results The person factors, age, education level, pregnancy order and prepregnancy awareness about conception, explained approximately 12% of the observed variance in maternal health literacy estimates. Conclusions Prepregnancy awareness about conception was the single most contributory factor to the observed variance in estimated maternal health literacy levels. More research on women of childbearing age is warranted to explore the impact of further person factors on the maternal health literacy in pregnant adolescents. Relevance to clinical practice Using the person factors found to show 'significant' impact on maternal health literacy in pregnant adolescents, target-specific interventions aimed at improving maternal health literacy in pregnant adolescents can be formulated. By accounting for these factors in reproductive health policy designs, one might take preventive actions to curb the prevalence of adolescent pregnancies in both developing and developed countries. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify the reported predictors of the practice of restricting a child for a clinical procedure in hospital. Background Previous work in this area is dominated by discussion papers and suggestions for addressing the issue of restriction. This is the first study to explore reported predictors of this practice with a view to implementing change based on research findings. Design A factorial survey was developed, which incorporated the use of vignettes with various scenarios. The factorial design enabled exploration of the interaction of multiple factors on the practice of restriction. Methods One hundred and sixty-six nurses caring for children were each sent 10 vignettes and asked to rate their likelihood to restrict a child based on the vignettes. A total of 105 nurses responded to the survey, representing a response rate of 63%. Hierarchical linear regression was used to identify reported predictors of restriction. Results Nurses were more likely to restrict a child if they had prior instruction on safe holding, if there was no play therapist available, if the nurse was a registered general nurse with no other registration qualification, if the child required cannulation or if the child was less than five years of age. Conclusion This study identified predictors of restriction from the perspective of practicing nurses; the evidence needs to be used in developing clinical guidelines and in multidisciplinary education. Relevance to clinical practice There is a need to move from any presumption of restriction towards more critical consideration of the individual requirements of the child. There is a need to increase the numbers of nurses receiving specialist training on the care of a child in hospital. The importance of a well-resourced play therapy service is supported, and there is a need for multidisciplinary work to explore alternatives to restriction. [ABSTRACT FROM AUTHOR]

Background: Self‐efficacy and family social support are significantly associated with hypertension self‐care behaviours. However, little is known about their mechanism in Saudi Arabia. This cross‐sectional study aimed to examine the relationships among family social support, self‐efficacy, and self‐care behaviours among men with hypertension in Saudi Arabia. Methods: Data were collected from May to August of 2018. The Hypertension Self‐Care Profile and the Perceived Social Support from Friends and Family scales were used to measure the study variables. Multiple linear regression was used to analyse the relationships between the variables, and the Baron and Kenny test was used to assess if self‐efficacy mediated the relationship between family social support and hypertension self‐care behaviours. Results: Respondents (N = 158) from the Jizan and Al‐Sharqia regions of Saudi Arabia completed the survey. Family social support and self‐efficacy were significantly associated with hypertension self‐care behaviours. In regression, self‐efficacy was the only variable significantly associated with hypertension self‐care behaviours. Self‐efficacy fully mediated the relationship between family social support and hypertension self‐care behaviours. Conclusions: Interventions to enhance hypertension self‐care behaviours among Saudi men could focus on increasing individual's self‐confidence to perform specific healthy behaviours. Family support can also contribute to the performance of hypertension self‐care behaviours. SUMMARY STATEMENT: What is already known about this topic? Hypertension is a public health concern in Saudi Arabia, and its control is highly associated with effective self‐care behaviours.Family social support is an important factor that contributes to improved blood pressure control and enhanced patients' quality of life.Self‐efficacy is necessary to promote healthy self‐care behaviours. What this paper adds? There is a need to support family members' engagement in hypertension treatment plan.The study provides evidence that self‐efficacy fully mediates the relationship between family social support and hypertension self‐care behaviours among men in Saudi Arabia. The implications of this paper: Nurses providing care for patients with hypertension should teach the family how to care for their loved ones to prevent unexpected complications.The results of this study can be used for further encouragement to self‐efficacy interventions for patients with hypertension.Based on our analysis of the literature, it is clear that further research is needed on improving self‐efficacy and family social support in hypertension care. [ABSTRACT FROM AUTHOR]

Background: Despite a growing body of literature investigating the impact of patients' age and sex differences on pain, there is little research on how patients' characteristics and behaviours affect nurses' pain management decisions. Aim: This study examined surgical nurses' views and experiences toward pain management in relation to the patients' characteristics and behaviours in a Jordanian university hospital. Methods: Focus group discussions (n = 4) were used with a convenience sample of 27 female Registered Nurses. Results: The study revealed differences in postoperative pain management related to patients' characteristics. Male patients were seen as more tolerant of postoperative pain than female patients and thus required less nursing attention. As a consequence, nurses might assess female surgical patients inaccurately or judgementally. Nurses label female patients as "demanding" or "over‐sensitive" without intending to be judgemental. Nurses also reported that patients accompanied by relatives received quicker nursing responses and closer monitoring than unaccompanied patients. Conclusions: If patients' pain following surgery is to be treated effectively, health care policymakers and educators should work together to eliminate and prevent potential biases that might lead to disparities in pain management. SUMMARY STATEMENT: What is already known about this topic? Postsurgical pain is still the most common complaint verbalized by patients and remains a largely unrecognized clinical problem.Registered Nurses in the postoperative setting play a vital role in the planning, implementation, and evaluation of pain management interventions.Experimental evidence has revealed some contradictions in whether pain perceptions among patients are related to age and gender; thus, there is a need to explore the views of those in pain management decisions. What this paper adds? This is the first qualitative study to examine the views of surgical nurses towards their pain management decisions that considers patient characteristics.Male patients were deemed more tolerant of post‐operative pain than the female patients and thus requiring less nursing attention.The study revealed that nurses might carry inaccurate perceptions towards female surgical patients, which could be seen in the form of judgemental labelling of these patients. The implications of this paper: The study emphasizes the need to employ a multidisciplinary strategy to enhance the status of surgical patient status and consideration of their circumstances including gender, age, sociocultural, and policy factors that might influence nurses' decisions and practice in pain management.Family caregivers need education about pain management and acknowledgement from surgical nurses about their role in pain management. [ABSTRACT FROM AUTHOR]

Aim: To better understand occupational stress faced by nurse academics. Methods: A mixed‐methods systematic review, following the Joanna Briggs Institute [JBI], (Joanna Briggs Institute Reviewers' Manual: 2014 edition, 2014) process. Studies were assessed for quality and risk of bias by using standardised critical appraisal instruments from the Joanna Briggs Institute. In addition, processes and reporting were checked against the Equator guidelines. See Appendix S1. Results: The review revealed that nursing academics do experience occupational stress, including burnout. Occupational stress for academic nurses is associated with various factors including work–life balance, workload issues, resources and support, and adapting to change. However, much of the literature focuses on nurses during the initial transition from clinical to academic environment, with rather less focus on established mid‐to‐late career nurse academics. Discussion: Occupational stress and burnout are evident in the university academic workforce, adversely affecting the well‐being of academic nurses, and the long‐term sustainability of the academic nursing workforce. While there is considerable literature focusing on the novice academic nurse, particularly during the transition period, rather less is known about occupational stress among academic nurses across the career trajectory. Various strategies to deal with the negative consequences of occupational stress are identified, including (a) quality mentors for novice and younger nursing academics; (b) training in resilience building for novice academics; (c) supporting collegial relationships and reducing bullying; (d) assistance for professional development and research; (e) better support and resources to overcome increasing workloads; and (f) greater work‐related empowerment to enhance job satisfaction. Conclusion: There is a need for a broader whole‐of‐career research focus to more fully identify, explore and mitigate the occupational stressors that negatively affect the academic nurse workforce. Relevance to clinical practice: A strong and resilient academic nurse workforce is essential for the sustainability of the profession.Organisations should review their work practices and provide greater work‐related empowerment to reduce occupational stressors among nursing academics. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the prevalence of post‐traumatic stress symptoms, and to identify possible predictive factors in Norwegian intensive care unit survivors, 6 months after admission to the intensive care unit with COVID‐19. Background: The SARS CoV‐2 virus causing COVID‐19 has spread worldwide since it was declared a pandemic in March 2020. The most severely ill patients have been treated in the intensive care due to acute respiratory failure and also acute respiratory distress syndrome. It is well documented that these severe conditions can lead to complex and long‐lasting symptoms, such as psychological distress, and was, therefore, investigated for the specific COVID‐19 population. Design: Prospective observational study. Methods: Clinical data and patient reported outcome measures were collected by the Norwegian Intensive Care and Pandemic Registry and by the study group 6 months after admission to an intensive care unit. Results: Among 222 COVID‐19 patients admitted to Norwegian intensive care units between 10 March and 6 July 2020, 175 survived. The study sample consisted of 131 patients who responded to at least one patient reported outcome measure at 6 months following admission. The primary outcome was self‐reported post‐traumatic stress symptoms, using the Impact of Event Scale‐6 (n = 89). Of those, 22.5% reported post‐traumatic stress symptoms 6 months after admission. Female gender, younger age and having a high respiratory rate at admission were statistically significant predictive factors for reporting post‐traumatic stress symptoms. Conclusions: The result is in accordance with previously published research with comparable populations, suggesting that for many COVID‐19 survivors psychological distress is a part of the post‐acute sequelae. Results from the present study should be replicated in larger datasets. Relevance to Clinical Practice: This project provides important insight to post‐acute sequelae after COVID‐19 that patients may experience after critical illness. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID‐19. Background: Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID‐19 pandemic. Design: A cross‐sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID‐19 pandemic between 4 and 19 January 2021. Methods: The Maslach Burnout Inventory‐Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS‐CoV‐2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. Results: Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = −1.37; 95%CI ‐2.17 to −0.47) was related to lower EE. HCWs working in wards for patients with COVID‐19 reported lower EE (b = −1.39; 95%CI ‐2.45 to −0.32). HCWs who contracted COVID‐19 reported lower DP (b = −0.71, 95%CI ‐1.30 to −0.12). Conclusions: Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. Relevance to clinical practice: Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff. [ABSTRACT FROM AUTHOR]

This paper is a report of a study to examine the influence of demographic, learning involvement and learning performance variables on metacognition of undergraduate nursing students in a blended learning environment. A cross-sectional, correlational survey design was adopted. Ninety-nine students invited to participate in the study were enrolled in a professional nursing ethics course at a public nursing college. The blended learning intervention is basically an assimilation of classroom learning and online learning. Simple linear regression showed significant associations between frequency of online dialogues, the Case Analysis Attitude Scale scores, the Case Analysis Self Evaluation Scale scores, the Blended Learning Satisfaction Scale scores, and Metacognition Scale scores. Multiple linear regression indicated that frequency of online dialogues, the Case Analysis Self Evaluation Scale and the Blended Learning Satisfaction Scale were significant independent predictors of metacognition. Overall, the model accounted for almost half of the variance in metacognition. The blended learning module developed in this study proved successful in the end as a catalyst for the exercising of metacognitive abilities by the sample of nursing students. Learners are able to develop metacognitive ability in comprehension, argumentation, reasoning and various forms of higher order thinking through the blended learning process. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research was to investigate the effect of urinary incontinence on body image, self‐esteem, and quality of life. Methods: The study was conducted with 218 women with urinary incontinence. The study data were collected using the Socio‐Demographic Characteristics Questionnaire, Body Cathexis Scale, Rosenberg Self‐Esteem Scale, and Incontinence Quality of Life Questionnaire. Results: There was a weak, statistically significant, positive relationship found between the Body Cathexis Scale total average scores and the Rosenberg Self‐Esteem Scale total average scores of the women and a weak, statistically significant, negative relationship with the Incontinence Quality of Life Questionnaire total average scores. In addition, a weak, statistically significant, negative relationship was found between the Rosenberg Self‐Esteem Scale total score averages and Incontinence Quality of Life Questionnaire total score averages. Significant effects were seen for body image score with pad usage; for self‐esteem in relation to number of deliveries, duration, and frequency of urinary incontinence; and for incontinence quality of life and duration and frequency of urinary incontinence and pad usage. Conclusions: It was concluded that most of the women with urinary incontinence had negative body image and that more than half of them had moderate or low self‐esteem and a moderate quality of life. SUMMARY STATEMENT: What is already known about this topic? More than 200 million people in the world have incontinence problems, and the majority are women.Urinary incontinence causes negative psychosocial effects such as continuous leakage of urine and fear of smelling bad, feeling unclean, decreased self‐esteem, deterioration of body image, stigmatization, embarrassment, and decreased sexual desire.There are very few studies in the literature that determine the relationship between body image and self‐esteem in women with urinary incontinence. What this paper adds? Negative effects were demonstrated for urinary incontinence in relation to women's body image, self‐esteem, and quality of life. The implications of this paper: Urinary incontinence does not directly threaten women's lives but can become a problem that physically and psychologically affects the family and social life of a woman significantly; therefore, women with incontinence should be carefully considered and evaluated from a holistic viewpoint.Nurses should assess the emotions, thoughts, and perceptions of body image, self‐esteem, and quality of life of women with urinary incontinence, and as the awareness about urinary incontinence and its treatment increases, the population of patients receiving help will increase, thus increasing the success rate in urinary incontinence management. [ABSTRACT FROM AUTHOR]

Background: The majority of breast cancer patients will experience some level of emotional distress, with some patients having long‐term psychological maladjustment. Personal and social resources play a role in recovery yet the interplay between these factors warrants further examination. This study aimed to investigate the interaction of psychosocial factors impacting women in their breast cancer trajectory, at 2 years or less following diagnosis (stages I‐III). Design A longitudinal cohort study approach was used in this study. Methods: The sample consisted of n = 49 participants. Data were collected between June 2013 and October 2013 and followed for 12 months across the trajectory of the disease. Results: The mean age was 56.6 years (SD 11.6 years). Most participants had stage I or stage II breast cancer. Time (over three time points—4 weeks, 6 months, and 12 months) after diagnosis was significantly associated with the body image (P = .003) and age (P = .004). Conclusion: Older women with breast cancer reported less concern regarding body image than their younger peers. These findings suggest that posttreatment younger women may require access to psychological support posttreatment. SUMMARY STATEMENT: What is already known about this topic? The majority of breast cancer patients experience some level of emotional distress, with some patients having long‐term psychological maladjustment.Personal resources (ie, self‐image, optimism, and perceived control) and social resources (ie, social support) play a central role in recovery.The interplay between the personal and social resources is not well known particularly in the first 2 years postdiagnosis What this paper adds? Older women with breast cancer reported less concern regarding body image than their younger peers.Older women also experienced more positive future perspectives when compared with younger women.Younger women appeared less adaptive psychologically. The implications of this paper: There are known psychological impacts for women who have breast cancer, and nurses are well placed within their scope of practice to undertake routine mental state examination of these patients.Younger women who have breast cancer in particular may require additional psychological supports during the first 2 years postdiagnosis. [ABSTRACT FROM AUTHOR]

Aim: This study examines the amount of sleep and daytime sleepiness, and how these change in a follow‐up cohort study of school‐aged children. Methods: A total of 1351 schoolchildren (aged 10) and their parents were invited to participate in the study and were studied again at ages 12 and 15 years. A survey put forth by the Health Behaviour of Schoolchildren research network was used. Results: The amount of sleep during weekdays dropped significantly from age 10 to 15. At weekends, the amount of sleep increased significantly. During weekdays, the proportion of children reporting having slept enough dropped from 71% at age 10 to 19% at age 15. Frequent daytime sleepiness occurred in 13% of children at age 10 and increased to 24% at the age of 15. Conclusions: It is essential to promote adequate amount of sleep and prevent daytime sleepiness in children growing from age 10 to 15 years. Nurses and other health care professionals should systematically assess and promote healthy sleeping habits while caring for children between these ages. SUMMARY STATEMENT: What is already known about this topic? Sufficient sleep is essential for the healthy development of school‐aged childrenThe amount of sleep drops between ages 10 and 15 years What this paper adds? Daytime sleepiness increases significantly between ages 10 and 15 years, and girls reported more frequent daytime sleepiness compared with boys.The amount of sleep drops more in girls compared with boys between the ages 10 and 15 yearsParents reported their children to sleep more compared with the children themselves The implications of this paper: Daytime sleepiness and amount of sleep should be systematically assessed by nurses and other health care professionals.Gender and age specific differences should be considered when promoting healthy sleep.Future research should focus on developing effective, youth‐driven interventions to promote healthy sleep and prevent daytime sleepiness. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study designed to examine the association between modernization and future care preferences among adult children caregivers of older Arab parents in Israel and to identify factors that may mediate the association. Method. Cross-sectional data were collected in 2006-2007 by a structured interview from 250 randomly sampled Arab-Israeli adult children caregivers (response rate = 94%). Respondents' preference for formal and/or informal future care for themselves was regressed on selected predictor variables. Results. The vast majority of family caregivers would 'prefer' to be cared for by family members (76.4%). Urbanization level was a negative correlate of preference for future family care and a positive correlate of preference for future formal care. However, these associations were mediated by the extent of filial piety and caregiving burden. Filial piety was a positive predictor of preference for future family care (OR = 3.6, P < 0.01), and a negative predictor of preference for formal care (OR = 0.09, P < 0.01). Caregiving burden was a positive predictor of preferences for future formal care (OR = 5.15, P < 0.01). Conclusion. Modernization has an impact on future care preferences in traditional cultures. In order to maintain informal family care, community nurses should examine ways to lessen the burden of care among family caregivers. They should also develop culturally sensitive services that will meet the evolving expectations and preferences that are held by the next generations of family caregivers. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study investigating nurse burnout and its association with occupational stressors in Shanghai, China. Background. Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. Measuring burnout among nurses and its association with occupational stressors are important in providing appropriate intervention to reduce stress and burnout. Method. In total, 527 nurses from 41 hospitals in Shanghai returned self-reported questionnaires in June 2008. Their burden of burnout was measured by the Chinese version of 'Maslach Burnout Inventory', and their stress by the Chinese version of 'job content questionnaire' and 'effort-reward imbalance questionnaire'. Results. Most nurses (74.76%) had a Demand/Control ratio higher than 1 and 27.13% had an Effort/Reward ratio higher than 1. The nurses showed a high level of emotional exhaustion, moderate level of depersonalization, and low level of reduced personal accomplishment. Linear regression analyses showed higher burden of stress and burnout among nurses at younger age, or on shift duty or from higher grade hospitals. Both the job content questionnaire and effort-reward imbalance questionnaire models had good predictive powers of the nurses' burnout, especially the effort-reward imbalance questionnaire model is more powerful than the other in predicting two Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization. Conclusion. Nurses in Shanghai were suffering from high levels of burnout, which was strongly associated with work-related stress. Interventions in reducing occupational stress are needed to reduce the burden of burnout in Chinese nurses. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses. Background. The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions. Methods. This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007-2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory. Results. Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses. Conclusion. Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions. [ABSTRACT FROM AUTHOR]

The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community. Integrative review of the literature. Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study conducted to gain a better insight into the current nutritional care practices in Belgian hospital wards for older people, and to study the association between these practices and the prevalence of malnutrition. Background. In 1999, the Council of Europe assessed nutritional care practices and support in 12 European countries and showed them to be sparse and inconsistent. At the time of research, no studies had described the association between nutritional care practices and malnutrition prevalence in Belgium. Methods. In 2007, a cross-sectional survey was carried out in a representative sample of Belgian hospital wards for older people. In total, 2094 patients from 140 wards for older people were included. Results. The overall prevalence rate of malnutrition in wards for older people was 31.9%. Nutritional care practices such as nutritional screening and assessment, use of a standardized screening instrument and a nutritional protocol were suboptimal. Multilevel analysis revealed that ward characteristics explained for 9.1% whether a patient was malnourished or not. None of the registered nutritional care practices could explain a patient's individual risk. Conclusion. Malnutrition is a frequently occurring problem on hospital wards for older people. Increased consciousness among healthcare professionals and hospital policy makers of the importance of nutritional care will contribute to further improvement in care quality. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study measuring attitudes of primary care nurses towards caring for people with hepatitis C. Background. Hepatitis C is a major public health problem. Attitudes to caring for people with hepatitis C vary and can have an impact on nursing care practices. International literature has identified discriminating practices amongst healthcare professionals including nurses. There is limited research examining primary care nurses' attitudes to caring for people with hepatitis C. Methods. A cross-sectional postal census survey of 981 nurses working in one health board region in the Republic of Ireland was conducted during the period March 2006 to June 2006. Results. A response rate of 57.1% (n = 560) was achieved. Exploratory factor analysis of an attitude scale identified three latent variables: 'infection control behaviour', 'caring' and 'fear'. Attitudes were generally positive towards caring for persons with hepatitis C; however, 51.7% of respondents would use additional infection control precautions if caring for someone with known hepatitis C. Younger nurses and those educated to degree level and above held significantly more positive attitudes to caring. Nurses agreed that they have a central role in managing and treating people with hepatitis C; however, many agreed that they lack the knowledge and skills to care for persons with hepatitis C. Conclusions. Negative attitudes can result in discriminatory experiences for persons with hepatitis C or at risk. Nurses require ongoing education on hepatitis C to improve knowledge, to limit concerns and ensure adherence to infection control guidelines. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an exploration of relationships between demographic and clinical variables and the symptoms of breathlessness, depression, anxiety, fatigue, sleeping difficulties and pain for patients with chronic obstructive pulmonary disease. Background. Research into chronic obstructive pulmonary disease has focused on single symptoms and we lack knowledge about possible associations between several symptoms. Methods. A total of 154 patients with chronic obstructive pulmonary disease participated in a cross-sectional study from June 2006 to December 2007 (response rate 40%). All underwent pulmonary lung function tests and completed questionnaires including demographic variables, the Brief Pain Inventory, Hospital Anxiety and Depression Scale, Lee Fatigue Scale, General Sleep Disturbance Scale and the Respiratory Quality of Life Questionnaire. Bivariate correlation and multiple regression analyses were performed. Results. Breathlessness was statistically significantly positively associated with the other symptoms, after controlling for demographic and clinical variables. Younger age was statistically significantly related to more breathlessness, anxiety and sleeping difficulties and lower levels of education was statistically significantly related to more breathlessness, depression and anxiety. In relation to clinical variables, smoking was statistically significantly related to more depression, whereas more co-morbidity was statistically significantly related to more breathlessness and pain. Poorer lung function was statistically significantly related to more breathlessness. However, higher lung function was related to more sleeping difficulties. Conclusion. Breathlessness is associated with symptoms such as depression, anxiety, fatigue, sleeping difficulties and pain, suggesting the need for an expanded focus on symptoms in chronic obstructive pulmonary disease guidelines, health care and research. [ABSTRACT FROM AUTHOR]

white c. & gallagher p. (2010) Effect of patient coping preferences on quality of life following renal transplantation. Journal of Advanced Nursing 66(11), 2550-2559. Aim. This paper is a report of a study investigating the relationships between quality of life, patient coping preferences, and desire to be actively involved in care following renal transplantation. Background. While the general consensus is that quality of life is improved greatly by kidney transplantation, it is apparent that it is not uniformly a positive experience in this regard. There is a need to identify individual difference factors that influence quality of life following renal transplantation. Method. A correlational study was conducted in the national referral centre for renal transplantation in the Republic of Ireland in 2006 with a sample of 172 transplant recipients. Data were collected using a questionnaire composed of standardized instruments to measure the key concepts. Results. Participants perceived that they had good quality of life, and used more problem-solving than avoidance coping strategies. Avoidance coping strategies were associated with statistically significantly lower quality of life following transplantation. Being younger, attaining a higher education level, being in employment and being married were associated with higher quality of life following transplantation. Conclusion. Assessment of coping strategies among the transplant population should be further explored in clinical practice, and steps employed to promote the use of positive coping strategies in order to maximize quality of life after transplant. [ABSTRACT FROM AUTHOR]

iliopoulou k.k. & while a.e. (2010) Professional autonomy and job satisfaction: survey of critical care nurses in mainland Greece. Journal of Advanced Nursing 66(11), 2520-2531. Aim. This paper is a report of a study conducted to describe Greek critical care nurses' views on professional autonomy and its relationship with job satisfaction and other work-related variables. Background. Professional autonomy is generally considered a highly desirable nursing attribute and a major factor in nurse job satisfaction. In the critical care environment, a high level of accountability, responsibility and autonomy are required to optimize outcomes of critically unstable patients. Method. A questionnaire survey was conducted with a convenience sample of Greek critical care nurses ( n = 431; response rate 70%) in 2007. Data were collected on professional autonomy, job satisfaction, role conflict and role ambiguity. Results. Overall, nurses reported acting moderately autonomously. Younger nurses reported statistically significant lower levels of autonomy. Higher levels of autonomy were reported by female nurses. Multiple logistic regression revealed that appointment level, type of critical care unit and registration with a professional organization were independently associated with autonomy. A positive moderate association was found between reported autonomy, job satisfaction, role conflict and role ambiguity, but there was no relationship between job satisfaction and reported role conflict and role ambiguity. Conclusion. Further education, role enhancement and support are required for nurses working in critical care in Greece if they are to achieve the maximum potential of their professional role. Failure to address the perceptions of professional autonomy may have an impact on staff retention, because of job dissatisfaction. [ABSTRACT FROM AUTHOR]

ulrich c.m., taylor c., soeken k., o'donnell p., farrar a., danis m. & grady c. (2010) Everyday ethics: ethical issues and stress in nursing practice. Journal of Advanced Nursing 66(11), 2510-2519. Aim. This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. Results. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. [ABSTRACT FROM AUTHOR]

gambino k.m. (2010) Motivation for entry, occupational commitment and intent to remain: a survey regarding Registered Nurse retention. Journal of Advanced Nursing 66(11), 2532-2541. Aim. This paper is a report of a study of the relationships between Registered Nurses' motivation for entering the profession, occupational commitment and intent to remain with an employer until retirement. Background. Identifying and supporting nurses who are strongly committed to their profession may be the single most influential intervention in combating the nursing shortage. An understanding of the characteristics these individuals possess could lead to a decline in the high attrition rates plaguing the profession. Method. Using a survey design, Registered Nurses enrolled at the school of nursing and/or employed at the associated university medical centre of a large, not-for-profit state university were polled in 2008. Logistic regression analysis was used to determine how the variables of motivation for entry and occupational commitment could indicate intent to remain. Results. The strongest indicators of intent to remain were normative commitment and age, with a 70% average rate of correctly estimating retention. Exp(B) values for normative commitment (1·09) and age (1·07) indicated that for each one-point increase on the normative commitment scale or one-point increase in age, the odds of remaining with an employer until retirement increased by 1·1%. Conclusion. Transformational changes in healthcare environments and nursing schools must be made to encourage loyalty and obligation, the hallmarks of normative commitment. Retention strategies should accommodate mature nurses as well as promote normative commitment in younger nurses. [ABSTRACT FROM AUTHOR]

shin s.m., kim m.j., kim e.s., lee h.w., park c.g. & kim h.k. (2010) Medical Aid service overuse assessed by case managers in Korea. Journal of Advanced Nursing 66(10), 2257–2265. Aim. This paper is a report of a study conducted to describe characteristics of overusers of the Medical Aid service, assess appropriateness of overusers’ medical service use, and determine contributing factors to medical aid overuse in Korea. Background. Medical Aid use in Korea has increased in recent years, but no systematic studies reported the characteristics of overusers and appropriateness of their medical service use. Method. In a cross-sectional study, case managers conducted interviews, evaluated participants’ insurance claim data, and determined overusers by the case managers’ determination of the appropriateness of their medical service use and their expenditures during the year of 2006. Descriptive statistics, chi-square analysis, analysis of variance, and multiple logistic regression were used for data analysis. Result. Most heavy users were elderly, female, less educated, and had stress, lower perceived health status and multiple clinic visits. Twenty-five per cent of inpatients and 63·9% of outpatients were classified as overusers. The average total cost per capita of an overuser was 43·3% higher than that of an optimal user. Age, education, stress, arthritis, multiple clinic visits and frequent clinic visit recommendations by providers were statistically significant contributing factors to the overuse. Conclusion. Preventive measures are needed to decrease the overuse of Medical Aid in Korea; such measures should focus on characteristics contributing to overuse, including the provider-induced demand for more clinic visits. Case managers could play an important role as gatekeepers, managers, and educators for optimal use of Medical Aid in Korea and elsewhere in the world that faces similar problems. [ABSTRACT FROM AUTHOR]

palhares l.c., gallani m.-c.b.j., gemignani t., matos-souza j.r., ubaid-girioli s., moreno h. jr, franchini k.g., nadruz w. jr & rodrigues r.c.m. (2010) Quality of life, dyspnea and ventricular function in patients with hypertension. Journal of Advanced Nursing 66(10), 2287–2296. Aim. This paper is a report of an investigation of the relationship between health-related quality of life and left ventricular function among patients with hypertension who did not fulfil the criteria for heart failure. Background. Heart failure is a common consequence of hypertension, with Doppler echocardiography being the gold-standard tool to evaluate left ventricular function, mainly hypertension-induced left ventricular damage. Echocardiographic data indicating poorer ventricular function have been related to lower levels of health-related quality of life in patients with systolic and/or diastolic heart failure. However, data are still lacking regarding the correlation between health-related quality of life and left ventricular function and structure in patients with hypertension who do not fulfil the criteria for heart failure. Method. Between September 2005 and February 2007, 98 patients with hypertension without systolic or diastolic heart failure were evaluated. Health-related quality of life was assessed using the Medical Outcomes Study Short Form-36. Left ventricular function was evaluated through Tissue Doppler echocardiography. Results. Statistically significant but weak correlations (varying from r = −0·22 to 0·35) were observed between some of the Short Form-36 domains and echo data. To consider the potential effect of dyspnoea in this relationship, patients were split according to the presence or absence of the symptom. In the subgroup without dyspnoea, similar patterns of correlation were observed (varying from r = 0·26 to 0·32). In the subgroup with dyspnoea, however, more and stronger correlations were observed between echo data and health-related quality of life domains, varying from r = −0·40 to 0·50. Conclusion. Nurses should be aware of the relevance of evaluating the functional echocardiographic data of patients who not fulfil heart failure criteria, but who experience dyspnoea in order to implement appropriate action plans. [ABSTRACT FROM AUTHOR]

Accessible summary • This paper describes the role of the psychiatric nurse working in a high secure psychiatric facility in Ireland. • Since this study in 2006, this role has transformed moving from a custodial to a recovery model of care. • The United Kingdom Central Council framework for this study provided a useful method to establish a baseline for this role and as part of strategy to develop nursing practice. The Central Mental Hospital is one of the oldest high secure mental health services in Europe dating back to 1845 but has been one of the last to introduce (forensic) psychiatric nurses. This paper describes the role of psychiatric nurses working in this high secure psychiatric facility in Ireland. The United Kingdom Central Council competency framework was considered to be a prudent starting point for beginning to understand this role in an Irish context. The study received a response rate of 74% and found that the Irish Forensic Mental Health Nurse experiences many of the same challenges as their international colleagues. A high proportion of nursing practice is focused on assessment, communication and creating a therapeutic environment based very much in keeping with the mainstream role in mental health nursing. Skills in specialist assessments and addressing offending behaviour were considered important but deficient at that time. The importance of recovery and human rights were considered paramount but challenged by the need for risk management and security. [ABSTRACT FROM AUTHOR]

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

Aim: To describe a Delphi study regarding practice variation in needs assessment by Dutch home care nurses, to define practice variation in home care nursing and explore which factors may have a role in this needs assessment. Design: A Delphi study was conducted with the participation of home care representatives. Method: A Delphi questionnaire was developed, preceded by literature research and an expert meeting. The Delphi study took place between December 2020 and February 2021. The goal was to achieve a consensus level of at least 70%. Results: After three rounds, 32 experts reached a consensus about definitions regarding variation in needs assessment, warranted and unwarranted variation. In total, 59 factors were determined related to (1) the client and health, (2) the clients' context, (3) nurses and (4) the nurses' context. Thirty‐four factors scored warranted of influence and 18 (of 34) were client related. Most of the factors that scored unwarranted influencing needs assessment (17 of 26) were related to the home care nurses' context. Conclusion: Having a consensus about the definition of practice variation in needs assessment and possible influencing factors support the professionals to discuss and improve the unity and quality of their decision‐making process in home care. This may contribute to more righteous care for clients in need of home care. Impact: Since 2015, home care nurses in the Netherlands are responsible for determining the amount, type and duration of care for clients in need of home care. This so‐called needs assessment legitimizes the payment by health insurers. Signals of practice variation in needs assessment are heard in home care field. Although practice variation may be justified, it can lead to over or underuse of care, which may affect clients' outcomes. If we can identify influencing factors and find patterns that contribute to practice variation, we might gain a better understanding of the process and improve home care. Patient or public contribution: In this study, there was no patient or public involvement. Client representatives were included in this research as experts in the home care field, and they participated in three rounds of the Delphi study. They contributed by sharing their expert opinion on the definitions presented and the factors possibly influencing needs assessment. [ABSTRACT FROM AUTHOR]

Aim: To describe positive and negative spiritual responses to providing COVID‐related nursing care among nurses working in hospitals. Background: The COVID pandemic has intensified and publicised the threats to nurse well‐being. Absent from the recommendations for promoting nurse well‐being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well‐being. Design: Cross‐sectional, descriptive observational, mixed methods study. Methods: Data were collected from 523 registered nurses employed in three Southern California hospitals during March–May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale–Short Form, Moral Injury Symptom Scale–Healthcare Professionals, Post‐traumatic Growth Inventory and demographic and work‐related items. STROBE guidelines for cross‐sectional observational studies were observed. Results: The mean for religious/spiritual struggles was 1.98 (range of 1–5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%–36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1–10); applying established criteria indicated it was troubling for at least 50%. The mean for post‐traumatic growth was 4 (on a scale of 0–6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. Conclusion: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. Relevance to Clinical Practice: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy—and allow spiritual transformation. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to examine the relationship between professional attitude and compassion among nurses. Material and Methods: The sample of the crossectional study recruited 202 nurses who accepted participation and working in a state hospital. Data were collected between 20 June 2019 and 2 August 2019 with a questionnaire form, Inventory of Professional Attitude at Occupation (IPA) and Compassion Scale. Data were collected via face‐to‐face method. Form and scales were completed by the participants. The study was reported according to the STROBE. Results: The mean IPA was 134.57 ± 15.43. The mean score of the Compassion Scale was 73.89 ± 11.54. The mean scores of the Compassion Scale's sub‐dimensions were 16.17 ± 3.22 for kindness, 8.62 ± 3.44 for indifference, 15.45 ± 3.17 for common humanity, 9.02 ± 3.46 for separation, 15.95 ± 3.00 for mindfulness, 8.67 ± 3.44 for disengagement. There were positive correlations between kindness (r =.356), common humanity (r =.214), mindfulness (r =.297) subscales and there were negative correlations between indifference (r = −.441), separation (r = −.411) and disengagement (r = −.415) subscales and the Inventory of IPA. There was a negative correlation between IPA and total Compassion Scale scores (r = −.140). IPA scores were significantly different according to sex, age, working duration, weekly working time, satisfied with colleague relationships. Compassion scores were significantly different for weekly working time, satisfaction with colleague relationships, suitability of the nursing profession and working in emergency and outpatient clinics (p <.05). Conclusion: As nurses' professional attitude scores increased, kindness, common humanity and mindfulness subscales scores increased, while indifference, separation and disengagement subscales scores of the compassion scale decreased. Relevance to clinical practice: Increasing the awareness about professional attitude and compassion in nursing should start with undergraduate education of nurses, and it is recommended to organise in‐service training to develop professional attitudes and compassion in occupational life and to research patient perspectives about compassion. [ABSTRACT FROM AUTHOR]

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

Aims and Objectives: This study aimed to determine the prevalence and predictive factors of sexual dysfunction and quality of sexual life in women with heart failure. Background: Symptoms of heart failure may cause a decrease in sexual performance, sexual satisfaction and sexual desire. Methods: This cross‐sectional study was conducted between December 2019 and June 22, 2020. The findings were reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (n = 356). Results: The majority of the participants had sexual dysfunction (84.8%), mainly a reduction in sexual desire. Participants had a mean SQOL‐F score of 75.49 ± 19.37. More than a quarter of the participants stated that they were afraid of dying during sex (29.2%). There were changes in sexual dysfunction based on the class of medications that participants used regularly. Almost all participants stated that they were never informed by nurses or other healthcare professionals about sex (98%). Menopausal women are seven times more likely to develop sexual dysfunction than non‐menopausal women (OR = 7.0, p <.001). Conclusion: Women with heart failure are more likely to develop sexual dysfunction. Many factors affect sexual dysfunction and sexual quality of life. Therefore, nurses should take sexual dysfunction into account when caring for women with heart failure. They should monitor them for risk factors and side effects, draw up and implement plans to respond to problems. Relevance to Clinical Practice: Sexual dysfunction is quite high in women with heart failure. Nurses should encourage these patients to talk about sexual problems and provide sexual health education and counselling regardless of the level of their sexual problems. Patient or Public Contribution: The patients evaluated the suitability of the questions at the pre‐application stage. We finalised the demographic questionnaires with their suggestions. The patients spent time filling out the questionnaires during the data collection phase and answered the questions sincerely. [ABSTRACT FROM AUTHOR]

Background: Postoperative delirium is one of the common complications after any major surgery such as gastrointestinal surgery. And it is related to increased mortality and morbidity and other serious surgical outcomes. Aims: This study aims to identify risk factors for postoperative delirium in patients undergoing gastrointestinal surgery. Materials and Methods: Relevant studies published before August 2021 were searched on Pubmed, Embase and Medline. The risk of bias of included studies was assessed by Newcastle–Ottawa Scale (NOS). A random‐effects model of DerSimonian‐Laird was used to synthesise the overall ORs or RRs for all risk factors. MOOSE checklist was used to review this manuscript. Results: A total of 21 studies including 6165 patients were finally included for quantitative analysis. The pooled incidence of postoperative delirium is 11% (95% CI: 9%‐15%). 16 risk factors were identified, in which age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative C‐reactive protein (CRP) levels, operation time, blood loss and perioperative blood transfusion were statistically significant while smoking, American Society of Anesthesiologists (ASA) score, performance status, diabetes and operation approach were insignificant. Discussion: This meta‐analysis may provide tips for nursing staff and surgeons to design and implement prevention programmes to reduce the incidence of postoperative delirium. Conclusion: Potential risk factors of delirium after gastrointestinal surgery are age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative CRP levels, operation time, blood loss and blood transfusion. [ABSTRACT FROM AUTHOR]

Aims and objectives: To test whether the revised Wilson and Cleary model could identify which factors contribute to health‐related quality of life in chronic kidney disease. Background: Chronic kidney disease affects a person's health‐related quality of life detrimentally although nursing practice informed by theory is only beginning to emerge. Design: A cross‐sectional study reported using the STROBE guidelines. Methods: About 886 participants with chronic kidney disease (varying grades) completed validated measures of symptoms (renal version of the Integrated Palliative care Outcome Scale), and general health perceptions and health‐related quality of life (European Quality of Life five‐dimension three‐level). Socio‐demographic and renal characteristics were also collected. Data were analysed using descriptive statistics and structural equation modelling. Results: Biological function (decreased kidney function and haemoglobin and greater number of comorbidities), directly contributed to increased symptom burden. Symptoms demonstrated strong negative relationships with both general health perceptions and health‐related quality of life. General health perceptions had a direct positive relationship with health‐related quality of life. As age increased, health‐related quality of life decreased. The only environmental characteristic of significance was the distance between home and hospital although it was not directly associated with health‐related quality of life. Overall, the model explained approximately half of the deterioration in health‐related quality of life. Conclusions: The model demonstrated how various factors influence alteration of health‐related quality of life in people with chronic kidney disease. Early identification of these factors could assist nurses to introduce effective management strategies into patient care plans proactively. Relevance to clinical practice: Comprehensive symptom assessment needs to occur not only in kidney failure but in earlier chronic kidney disease grades to enable timely interventions targeted at improving people's wellbeing. Patient or public contribution: Validated interviewer administered questionnaires were completed by participants with chronic kidney disease in this study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the use of physical restraints in aged care facilities(ACFs)and analyse its associated risk factors. Background: Physical restraints have been widely used in ACFs worldwide, but they can cause physical and mental harm to older people. It is important to regulate the use of physical restraint. Design: A cross‐sectional observational and correlational multicentre study. Methods: By convenience sampling method, we selected eight ACFs in four representative regions of Hunan province, China, for this study. The ACF‐related information was obtained by interviewing the managers and reviewing records. We conducted investigation and observation on the elderly in the ACFs to understand the use of physical restraints at three different times: 9:30–11:30, 16:00–18:00 and 19:30–21:30 on a working day. The STROBE checklist was followed for this cross‐sectional study. Results: This study found that the utilisation rate of physical restraints was 23.2%. The critical risk factors affecting the use of physical restrains include the following: (1) the ratio of nursing staff to the elderly residents; (2)whether there is a dementia care unit at the facility; (3) the number of elderly residents in each room; (4) the elderly residents' age, degree of education, marital status, care dependence and cognitive impairment; (5) whether the elderly has suffered from a stroke or senile dementia; (6) whether the elderly carries medical catheters. Conclusion: There is a lack of standardisation in the use of physical restraints in ACFs of central China. Chinese ACFs should develop guidelines and reduction measures to standardise the use of physical restraints, basing on the key factors affecting the use of physical restraints. Relevance to clinical practice: The use of physical restraints in ACFs is threatening the safety of the elderly residents. Understanding the implementation of physical restraint in ACFs can provide reference for reducing the use of physical restraint. [ABSTRACT FROM AUTHOR]

Aims: To determine factors associated with poor sleep quality among patients with pre‐dialysis chronic kidney disease. Design: This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statements and checklist. Data Sources: Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. Review Methods: Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle–Ottawa Scale by two doctorial prepared nursing scientists. Results: A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal‐related and cognitive arousal behaviours were associated with poor sleep quality. Conclusion: Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre‐dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. Impact Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self‐management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease. [ABSTRACT FROM AUTHOR]

Aim: To examine the mediating effect of sleep quality on the relationship between lower urinary tract symptoms and health‐related quality of life in women with type‐II diabetes. Design: A cross‐sectional study. Methods: A study questionnaire comprising three valid instruments was used to obtain data about lower urinary tract symptoms, sleep quality and physical and mental component summary health‐related quality of life between July 2017 and December 2018 (n = 343). Pearson's correlation coefficients were estimated initially to examine the relationships between the three variables. Multiple regression models were tested using a regression‐based approach Hayes PROCESS macro for SPSS to examine the significance of proposed mediation effects. Results: Most participants experienced at least one urinary symptom (n = 268, 78.1%). The total number of types of lower urinary tract symptoms experienced by participants was significantly inversely correlated with physical and mental component summary health‐related quality of life, and sleep quality. Participants' sleep quality was significantly correlated with physical and mental component summary health‐related quality of life. The relationships of lower urinary tract symptoms with physical and mental component summary health‐related quality of life were, respectively, fully and partially mediated by sleep quality. Conclusion: Sleep quality played a mediating role on the relationship between lower urinary tract symptoms and health‐related quality of life. Our findings could lead to improvements of diabetes care in nursing and healthcare practices. Impact Understanding the role of sleep quality in the adverse effects of lower urinary tract symptoms on health‐related quality of life contributes to the development and delivery of appropriate strategies to promote optimal health‐related quality of life. We recommended including assessments of lower urinary tract symptoms, sleep and health‐related quality of life in routine diabetes management. Nurses and healthcare professionals should concurrently reduce lower urinary tract symptoms and improve sleep to achieve this population's optimal health‐related quality of life. Patients or public contribution: We recruited a sample of older women with type‐II diabetes at the endocrinology and metabolism outpatient departments of two hospitals. Study participants provided responses on the study questionnaires. The two hospitals provided needed supports (e.g., height/weight scales, suitable places for interview) during the data collection process. [ABSTRACT FROM AUTHOR]