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Aim: To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices. Background: Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring. Design and Methods: This integrative literature review covers papers published between 2000 and 2022. Four databases—PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)—were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA‐S checklists were used. An Integrative review methodology guided the process. Findings: In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient–nurse relationship. Conclusion: The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing. Implications for the profession and patient care: By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts. Patient or public contribution: No patient or public contribution was made due to the study design. [ABSTRACT FROM AUTHOR]

Aims: To identify the barriers and facilitators to healthcare for people without documentation status. Design: We conducted a systematic integrative literature review following the Whittemore and Knafl methodology. Methods: Literature search was conducted to identify studies addressing barriers or facilitators to healthcare for people without documentation status in the United States between 2012 and 2022. Studies were critiqued for quality, with results analysed thematically using the social‐ecological model. Data Sources: Searches were conducted in PubMed, PAIS, Web of Science, CINAHL and Psych Info in October 2022. Results: The review incorporated 30 studies (19 qualitative and 11 quantitative). People without documentation status encountered numerous healthcare barriers such as intrapersonal (lack of financial resources and health insurance, fear), interpersonal (language and cultural discrepancies, discrimination), community (bureaucratic requirements, anti‐immigrant rhetoric) and policy‐related barriers. Conversely, linguistically and culturally competent care, empathetic and representative staff, health navigators, safety‐net clinics and supportive federal policies emerged as key facilitators. Conclusion: These findings illuminate the complex healthcare disparities experienced by people without documentation status and underscore facilitators enhancing care accessibility. Future research is needed to explore interventions to increase access to care for this population. Impact: This paper provides a comprehensive examination of the complex barriers and facilitators to healthcare for people without documentation status in the United States. The findings support the value of universal healthcare access, a priority of the World Health Organization, and can inform healthcare policies and practices worldwide. Reporting Method: The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework. Patient or Public Contribution: No patient or public contribution was needed. Trial and Protocol Registration: The study protocol was registered with the PROSPERO database (registration number: CRD42022366289). [ABSTRACT FROM AUTHOR]

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

Aim: To identify fathers' perceptions and experiences of caring for their children with congenital heart disease. Design A qualitative systematic review. Data sources PubMed, Clinical Key, the Joanna Briggs Institute Evidence‐based practice database, CINAHL Complete, Embase and PsycINFO were searched for all journal articles published before May 2020. Review methods: After applying the selection criteria, five studies were identified reporting on fathers with children between 1 month and 12 years. The quality of the articles was evaluated. Results: Six main themes regarding fathers' perceptions and experiences of caring for their children with congenital heart disease were identified: (1) lack of disease knowledge, (2) responsibility to the family and emotional suppression, (3) gratitude for the sustained life of their children, (4) acceptance of being different from others, (5) regrouping and planning for the future and (6) the struggles of father–child relationships. Conclusion: In caring for their children with congenital heart disease, fathers are akin to a suffering warrior, full of hardship. With a self‐imposed sense of responsibility and suppressed emotions, fathers may feel lonely and hurt, but they must fight for their families and children. Summary statement: What is already known about this topic? Congenital heart disease is one of the most common chronic illnesses in childhood.Parents of children with congenital heart disease face cardiac‐related medical problems, decision‐making and economic circumstances throughout their healthcare experience including impact on their physiological and psychological health.Previous studies have focused on the roles of mothers of children with congenital heart disease. What this paper adds: This systematic review identifies six themes regarding fathers' perceptions and experiences of caring for their children with congenital heart disease: (1) lack of disease knowledge, (2) responsibility to the family and emotional suppression, (3) gratitude for the sustained life of their children, (4) acceptance of being different from others, (5) regrouping and planning for the future and (6) the struggles of father–child relationships.In caring for their children with congenital heart disease, fathers are akin to a suffering warrior, full of hardship.With a self‐imposed sense of responsibility and suppressed emotions, fathers may feel lonely and hurt, but they must fight for their families and children. The implications of this paper: The findings about fathers' perceptions and experiences of caring for their children with congenital heart disease can be beneficial in improving nursing practice.Health care professionals need to actively involve and support fathers in caring for their children with congenital heart disease. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact of cultural beliefs of dementia as witchcraft in sub‐Saharan Africa. Background: The population of sub‐Saharan Africa is ageing, which increases the number of those at risk of dementia. Mental health and physical diseases that affect behaviour have often been associated with witchcraft. Accusations of witchcraft leave individuals vulnerable and at risk. Method: A systematic review, which followed the Preferred Reporting for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines and completed a PRISMA checklist. CINAHL, PsycINFO, Web of Knowledge, PubMed and Science Direct databases were searched for relevant studies published from their inception to 31 May 2019 by applying appropriate Medical Subject Headings. Data analysis adhered to Thomas and Harding's thematic synthesis. Results: The review identified limited literature on this topic, with only five papers meeting the inclusion and exclusion criteria. Studies explored health provision, and knowledge and beliefs of dementia in Tanzania and South Africa. Three themes emerged as follows: (a) poor knowledge of dementia, including the belief of dementia as witchcraft; (b) challenges of supporting a family member with dementia in the community; and (c) health‐seeking behaviours of and for people with dementia. Conclusion: There remains a need for dementia awareness and education across sub‐Saharan Africa communities, including faith and traditional healers, and healthcare professionals to support pluralistic healthcare provision. Nurses are the best‐placed healthcare professionals to support these initiatives and the development and implementation of low‐resource nonpharmacological interventions to support people with dementia and their families living in the community. Relevance to clinical practice: Nurses working in sub‐Saharan Africa and those caring for patients from sub‐Saharan Africa can only provide person‐centred care and support for a person with dementia and their family if they understand their cultural beliefs, one of which may include witchcraft. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self‐efficacy outcomes in patients with diabetes. Methods: A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis. Results: Ten articles containing 1,452 people with diabetes were selected. The results of meta‐analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self‐efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short‐term effects on improving knowledge, but there was no significant long‐term effect. Conclusion: Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice. SUMMARY STATEMENT: What is already known about this topic? Some patient decision aids have been reported to support patients with diabetes' information processing and decision making.The application of patient decision aids can narrow the knowledge gap between patients and doctors so as to facilitate patient activation. What this paper adds? This article extends the evidence on the beneficial effects of patient decision aids on reducing decisional conflict, improving self‐efficacy and knowledge level among patients with type 2 diabetes mellitus.The review recommends patient decision aids as a supplementary method to promote the quality and effectiveness of decision making for patients with diabetes. The implications of this paper Clinicians could incorporate patient decision aids as part of their clinical consultation, being fully considerate of the patient's preferences. [ABSTRACT FROM AUTHOR]

Aim: To explore the international literature related to women's knowledge and experience of perimenopause and menopause and to inform future directions for research and individualised healthcare delivery. Background: Menopause is a normal physiological process experienced by most women. Despite this, care and support is fragmented and the implication on women's long‐term health is not sufficiently understood. Design: An integrative review of primary research on women's knowledge and experience of perimenopause and menopause. Method: CINAHL, Medline, Wiley Online Library, SCOPUS, PubMed and Google Scholar were searched from 2011 to 2021.Quantitative and qualitative studies written in English exploring women's knowledge and experience of menopause were included. The search strategy for the review complied with PRISMA guidelines. The mixed methods appraisal tool was used to assess quality. Thematic analysis was employed to present a narrative synthesis of the data. Results: A total of 17 studies, comprising 10 quantitative, and seven qualitative studies met the inclusion criteria. The four themes regarding women's knowledge and experience of perimenopause and menopause identified in the literature were as follows: (1) Symptoms associated with perimenopause and menopause; (2) Strategies to manage symptoms; (3) Support and information (4) Attitudes, education and health literacy. Conclusion: This integrative review of the international literature highlights that women's knowledge of perimenopause and menopause varies significantly globally and within countries. The experience of perimenopause and menopause for women is heterogenous and influenced by deeply embedded sociocultural patterns. Relevance for Clinical Practice This integrative review has shown that individualised support for women during perimenopause and menopause is critical to ensure the diverse needs of women are suitably addressed. No Patient or Public Contribution: As this was a review of the literature, no patients, service users, caregivers or members of the public were involved in this review. [ABSTRACT FROM AUTHOR]

kelo m., martikainen m. & eriksson e. (2011) Self-care of school-age children with diabetes: an integrative review. Journal of Advanced Nursing 67(9), 2096-2108. Abstract Aim. This paper is a report of an integrative review of findings from empirical studies on self-care in school-age children with type 1 diabetes. The purpose is to generate insight into opportunities to develop empowering patient education. Background. Managing diabetes is demanding and requires parental involvement in care. Good self-care forms the basis for diabetes management and self-care patterns are established at school age, but how and to what extent school-age children increase their self-care capabilities is unclear. Data sources. A search for studies from 1998 to 2010 focusing on self-care in school-age children with diabetes was conducted through electronic databases. Review methods. Using integrative methods, quantitative and qualitative papers surveyed were analysed separately, but the themes that arose were combined at the end of the analysis. Findings. Self-care is formed in a learning process involving the objectives of normality, being able to cope and independence. The content of self-care is a combination of knowledge and skills. Children have the technical skill, but they need their parents to participate in the care and share responsibility for it. The factors related to self-care comprised the characteristics of the child; the nature of the illness and care; and support from the parents, school environment, peers and healthcare team. Conclusion. A balance between diabetes care requirements and a child's maturity should be found. Nurses must adopt an empowering manner of education and recognize and assess a child's readiness to learn diabetes care and bear responsibility for it. Nurses must also help parents and other adults to gradually shift the responsibility to the children. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing studies that focused on improving hospitalized patient safety through patient and family engagement interventions to identify priorities and gaps. Design: A scoping review. Methods: Eight databases and citations of important reviews were searched on 30 September 2022. Two researchers independently screened the records. Then, two researchers extracted the data and cross‐checked. The results were synthesized narratively, and a comparison was performed for studies from China and those from other countries. Results: Ninety‐eight studies were included. The results indicated that patient and family engagement interventions were applied to decrease the incidence of patient safety incidents, and to improve the healthcare providers' and patients' knowledge, attitude or practice of patient safety. Most studies only engaged patients and families at the direct care level, and the engagement strategies at the organization and health system levels were insufficient. For stakeholders, many studies failed to consider patients' perspectives in intervention design and report taking staff training as a supportive strategy. Healthcare providers, especially nurses, were the main implementers of current interventions. Certain differences were observed between studies from China and those from other countries in the above aspects. Conclusions: International interest in engaging patient and family for patient safety is growing. Future studies should enhance the patient and family engagement as a partner in various patient safety at the direct care level, and further explore the engagement at the organization and health system levels. Relevance to Clinical Practice: Nurses, as the main formal caregivers for patients, should promote patient and family engagement in patient safety, especially at direct care level. Nurse should also incorporate the perspectives of patients in the design and implementation of interventions. Reporting Method: PRISMA‐ScR Checklist. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe and synthesise current knowledge on the maintenance and preservation of vessels in patients who need the placement of a vascular access device. Introduction: To administer drugs, blood or intravenous fluids, nurses or doctors insert a peripheral vascular access device on the arm using the traditional approach. This approach implies that devices are blindly inserted until flow is satisfactory and all possible sites have been exhausted. A proactive approach would ensure at the outset that the best device is used for each patient, eliminating repeated attempts at cannulation. Design: An integrative review was conducted using data recorded until July 2017. Searches were conducted in PubMed, Cochrane Library, CINAHL and Scopus. Review method: A modified version of Cooper's five‐stage method and the PRISMA guidelines were used to perform the integrative review. Results: Nine papers were included in this review. The patients were active participants in a proactive approach to vessel health and preservation. The involvement of each healthcare professional in vessel health and preservation improves outcomes and expands the use of a proactive approach to vascular device management. Because nurses are directly involved in the use of such devices and support patients during the decision‐making process, they should take the lead in the use of the proactive approach. Conclusion: Despite the many documented advantages of the proactive approach to preserving vessels in many settings and healthcare systems, it has not been widely tested. Future research is needed to guarantee high‐quality vessel health and preservation care, thus contributing to the development and dissemination of the proactive approach. Relevance to clinical practice: The proactive approach preserves vessels for future needs, improves the delivery of the treatment plan and reduces length of stay, costs, risk of infection, complications and pain perceived by patients. This approach also ensures better use of nurses' time and vascular access device material. [ABSTRACT FROM AUTHOR]

Aims and objectives This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives. Background Ambiguities remain about how patients participate in routine measures designed to promote patient safety. Design Systematic review using integrative methods. Methods Electronic databases were searched using keywords describing patient involvement, nursing input and patient safety initiatives to retrieve empirical research published between 2007 and 2013. Findings were synthesized using the theoretical domains of Vincent's framework for analysing risk and safety in clinical practice: 'patient', 'healthcare provider', 'task', 'work environment', 'organisation & management'. Results We identified 17 empirical research papers: four qualitative, one mixed-method and 12 quantitative designs. All 17 papers indicated that patients can participate in safety initiatives. Conclusions Improving patient participation in patient safety necessitates considering the patient as a person, the nurse as healthcare provider, the task of participation and the clinical environment. Patients' knowledge, health conditions, beliefs and experiences influence their decisions to engage in patient safety initiatives. An important component of the management of long-term conditions is to ensure that patients have sufficient knowledge to participate. Healthcare providers may need further professional development in patient education and patient care management to promote patient involvement in patient safety, and ensure that patients understand that they are 'allowed' to inform nurses of adverse events or errors. A healthcare system characterised by patient-centredness and mutual acknowledgement will support patient participation in safety practices. Further research is required to improve international knowledge of patient participation in patient safety in different disciplines, contexts and cultures. Relevance to clinical practice Patients have a significant role to play in enhancing their own safety while receiving hospital care. This review offers a framework for clinicians to develop comprehensive practical guidelines to support patient involvement in patient safety. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand the factors influencing parental attitudes towards antibiotic prescribing. Background: Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR) and is a significant global threat to patient safety. In primary care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents play a vital role in decision‐making regarding accessing healthcare services and requesting treatment for their children. Design: A systematic review was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) statement (Moher et al., Systematic Reviews, 4, 2015, p. 1). Methods: The CINAHL, MEDLINE, PsycINFO, The Cochrane Library, BRITISH NURSING INDEX, EMBASE and PUBMED databases were searched for primary research published between 2006–2016. All types of primary research were searched and screened against inclusion criteria. The Critical Appraisal Skills Programme tool was used to appraise identified publications. Quantitative data were summarised descriptively, and qualitative data were thematically analysed. Results: A total of 515 publications were initially screened, and 55 full‐text articles were eligibility assessed. Twenty papers met inclusion criteria. Four main themes were identified: the quality of relationships with healthcare providers, dealing with conflicting messages, rationalising antibiotic use and parental practices informed by past experience. Conclusions: Parents wanted reassurance and advice regarding children's illnesses, had poor antibiotic knowledge and were influenced by personal past experiences. More accessible education, including simple information leaflets, is required. Further research on the influence of culture, ethnicity and socio‐economic factors would be beneficial. Relevance to clinical practice: Healthcare professionals must provide adequate time for reassurance and explanations of decision‐making. Easy‐to‐read information regarding appropriate antibiotic usage should be easily accessible for parents. [ABSTRACT FROM AUTHOR]

Background: There is mounting evidence for the health benefits of aromatic scents for the older people with dementia. However, existing research has focused on indoor aromatherapy using essential oils. It is necessary to explore the health benefits of smellscapes in the outdoor environment for older people with dementia. Aims and Objectives: This scoping review aims to examine existing evidence for smellscape as a healing factor in institutional garden for older people with dementia, try to bridge the knowledge gaps between outdoor sensory garden scents and aromatherapy to develop green care techniques that incorporate outdoor activities. Methods: Seven databases (Scopus, PubMed, PsycINFO, CINAHL, MEDLINE, Embase and Web of Science) were searched with English language articles published between 1990 and 2022. The PRISMA‐ScR Checklist was used. Results: Out of 1013 articles, 11 meet the inclusion criteria. The comprehensive health outcomes include five aspects: mental health; physical health; reduced agitation behaviour; improved cognitive function; and well‐being. These aspects are part of the rehabilitation model comprising the person (older people with dementia), environment (garden smellscapes) and outdoor activities (active or passive interventions or a combination). Conclusions: The smellscape, as a healing factor in the garden, not only benefits from evidence on indoor aromatherapy but also creates a sensory environment for older people with dementia by compensating for functional impairment, activity support and environmental creation, thereby promoting enhanced health and well‐being. Relevance to Clinical Practice: The research on the healing effects of smellscapes presented in this review offers a novel environmental intervention technique for transferring evidence on essential oils to outdoor sensory gardens. This green care technique is suggested to assist in the creation of healing environments and interventions for people with dementia who cannot be cured. No Patient or Public Contribution: This scoping review did not directly involve patient or public contributions to the manuscript. [ABSTRACT FROM AUTHOR]

Background: There is growing interest in Mental health literacy (MHL) worldwide, given its important role in overcoming barriers to service use and reducing mental health disparities. However, little is known about MHL among Arabs. Aim: We conducted a scoping review to examine MHL levels and correlates among Arabs in both Arab and non‐Arab countries, based on Jorm's MHL framework. Methods: We conducted a scoping review based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, using six electronic databases: PubMed, PsycINFO, CINAHL, Soc Index, Web of Science, and Scopus. Data were summarized and synthesized. Results: Nine studies examining MHL among Arabs met our inclusion criteria. Seven of them used a quantitative cross‐sectional design. Four studies were conducted in Arab, and five were in non‐Arab countries. Five studies were conducted among university students. The studies included indicate moderate to high levels of MHL. Higher MHL was associated with female gender, personal experience of mental health illness, and with help‐seeking behaviours. Conclusions: Our review shows a significant lack of empirical studies on Arabs' MHL. These findings should be considered as a call for action for public health researchers, mental health workers, and policymakers to prioritize research in this field. [ABSTRACT FROM AUTHOR]

Aims: To identify the components and characteristics of health literacy interventions for people with disabilities and to explore the outcomes in terms of health literacy competencies. Design: A mixed‐method systematic literature review. Review Methods: The search results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis. The quality appraisal was guided by the Mixed Methods Appraisal Tool. The contents of each intervention were mapped to the health literacy intervention model and the outcomes were annotated using the integrated model of health literacy. Data Sources: The literature search was conducted using several electronic databases, including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO in December 2022. Results: Ten studies were selected for this systematic literature review. Seven studies were quantitative, two were qualitative and one was a mixed‐methods study. The four components of the health literacy interventions included empowering individuals with low‐health literacy (n = 10), strengthening individuals' social support system (n = 3), improving communication with health professionals (n = 1) and reducing barriers to access health systems (n = 3). No intervention addressed improving health professionals' health literacy competencies. Health literacy competencies identified as outcomes in the studies included access (n = 1), understand (n = 7), appraise (n = 1) and apply (n = 9) the health information. Conclusions: The significant findings of this systematic literature review provide baseline data and evidence for developing health literacy interventions for people with disabilities. However, this review demonstrates that only a handful of intervention studies have addressed the low‐health literacy of people with disabilities. Further and more rigorous interventions addressing health literacy for people with diverse disabilities are warranted. Impact: This review provides insights into how health literacy interventions can be tailored to the type of disability. Further, efforts should be expanded to comprehensively promote all the four core competencies of health literacy to reduce health disparities for individuals living with disabilities. No Patient or Public Contribution: Systematic literature review. [ABSTRACT FROM AUTHOR]

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

Aims: To systematically examine and review relevant qualitative studies exploring the current lifestyle among individuals at high risk of colorectal cancer (CRC), and their awareness of the role of a healthy lifestyle in CRC prevention. Background: The increasing incidence and mortality of CRC have presented a serious threat against the health and life of people. As the major population affected by CRC, the lifestyle of individuals at a high risk of CRC is attracting increasing attention. Design: A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used. Data Sources: Literature was retrieved from PubMed, Web of Science, the Cochrane Library, Embase, CINAHL and PsycINFO from the inception to December 2021. Review Methods: Two reviewers independently screened the titles and abstracts and identified the eligible studies. Critical appraisals of each included study were performed. Thematic analysis was used to guide the data synthesis. Results: The data from nine articles were analysed. Three interpretive themes were extracted that formed an overarching synthesis of the experience with healthy lifestyles among high‐risk individuals of CRC. The findings suggested that these individuals with limited awareness of CRC and personal risks lacked sufficient knowledge about the relationship between lifestyle and CRC, and their attitudes and practices towards the role of a healthy lifestyle in CRC prevention were also diversified. Conclusion: Professionals can potentially provide personalised guidance for healthy lifestyles based on knowledge of prevention, the actual background and social support of individuals at high risk of CRC. Impact: Considering that knowledge gaps and health beliefs among these individuals are the premise blocking their adoption of a healthy lifestyle, the findings of this review may make contributions to the design and content of public health policy and prevention programs. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the social determinant factors and access to health care for women with lived experience of domestic and family violence. Design: Qualitative synthesis. Data Sources: A search of CINHAL, Embase, Medline and PubMed, was conducted between December 2021 and March 2022. Review Methods: Primary qualitative studies published in English from 2000 to 2021 were included. Findings were thematically analysed using the Levesque et al. (2013) access to healthcare framework. Study design was assessed using the Critical Appraisal Skills Programme for qualitative research. Results: Twenty‐eight studies were included. Findings related to the Levesque domains of approachability, appropriateness and availability of health services. Social determinants included perceived stigma and fear of discrimination leading to a lack of trust in healthcare professionals and fear of disclosure, which prohibits disclosure. Women reported their limited awareness of available support services, an absence of health professional screening and insufficient response when they disclosed presence of domestic and family violence, which collectively reduced their healthcare access. Conclusion: Findings advance our understanding of how social determinant factors influence women's ability to access health care. The determinants related to discrimination and stigma, which prohibited the establishment of trust, were the most influential factors on access to care. Impact Women experiencing domestic and family violence are hesitant to disclose, and violence continues in secret. Social determinant factors of stigma and trust prohibit women's disclosure and therefore their access to health care. Findings hold implications for nurses' consciousness of these social determinant factors. Raising nurses' awareness to curiously question the presence of domestic and family violence may build trust that leads to disclosure and improves access to health care. No Patient or Public Contribution: The authors intend to present the findings to people with lived experience in the next phase of this programme of research. [ABSTRACT FROM AUTHOR]

Aim and objective: To explore what is known about knowledge, attitudes and beliefs that influence hand hygiene practices in in low‐ and middle‐income Caribbean and Latin American countries. Background: With the emergence of infectious diseases such as the recent COVID‐19 pandemic, handwashing is key to preventing communicable diseases as they disproportionately affect populations in low‐income countries. While hand hygiene is known to be the single most effective method for avoiding the transmission of infection, little is known about the beliefs and practices of individuals in these regions. Methods: Following PRISMA 2020 Checklist, an integrative review of studies published from 2008–2020 was conducted (Preferred Reporting Items for Systematic Reviews and Meta‐analyses). Whittemore and Knafl's method was used to review the literature. Six databases were searched, and the Johns Hopkins Evidence Based Rating Scale was used for study appraisal. Results: The review yielded 18 studies conducted across Latin America. Poor handwashing practices are influenced by various factors including inadequate education and training, cultural beliefs, lack of resources and substandard government regulations. Communicable diseases and other diarrheal illnesses were highly prevalent, especially after a major disease outbreak. Conclusion: Future post‐disaster campaigns aimed at improving hand hygiene and handwashing practices should focus on beliefs and attitudes to affect behaviour change since there was a higher disease susceptibility during those times. Barriers to proper hand hygiene include false attitudes such as, washing hands only after touching bodily fluids/patient contact or not washing hands at all after open defecation. Relevance to clinical practice: Researchers working with populations in Latin America and the Caribbean should partner with local community health workers to improve compliance to recommended hand hygiene practices. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the atrial fibrillation (AF)‐specific information needs of patients with AF. Background: Patients' understanding of AF is pertinent to optimising treatment and outcomes, thus highlighting the need for effective patient education. The information required to deliver effective AF‐specific patient education is less examined. Methods: Guided by Arksey and O'Malley's framework, a scoping review was conducted for studies reporting the AF‐specific information needs of patients with AF. Systematic searches were conducted across six databases (Medline, PubMed, CINAHL, Scopus, PsycINFO and ProQuest). All analyses were narrated in prose and outlined in tables. The PRISMA‐ScR checklist was used to report this review. Results: The systematic search yielded 3816 articles, of which 22 were included. Three major themes emerged from the thematic analysis. Each theme was supported by three subthemes. First, in 'Understanding AF', patients reported the need for 'Easy‐to‐understand information', information on the 'Screening and diagnosis' of AF and 'Trajectory of disease and its associated risks'. Second, in 'Treating AF', patients required information on the 'Role of anticoagulation', 'Existing or novel therapeutic options' and 'Monitoring effectiveness of treatment'. Lastly, in 'Living with AF', patients needed education in 'Symptom management', 'Secondary prevention of risks' and 'Recognition of emergency situations'. Conclusions: This review has identified the key AF‐specific information needs of patients with AF. Being cognisant of the information needs of patients with AF, healthcare providers may become more effective in developing person‐centred patient education interventions. Relevance to clinical practice: Delivering relevant patient education is an important cornerstone for atrial fibrillation care. Nurses by convention play a professional role in patient education. It may be facilitative for nurses to refer to the review findings when developing and implementing patient education interventions. Being in the midst of an ongoing pandemic, patient education strategies may require the use of telecommunication technologies. [ABSTRACT FROM AUTHOR]

Aim and Objectives: The aim of the study was to synthesise the effect of educational interventions on the level of epilepsy knowledge in children with epilepsy and parents. Background: Educational interventions are commonly used to provide knowledge about epilepsy management. One of the most important responsibilities of nurses is to inform children with epilepsy and parents in a skilful way. Design: Systematic review and meta‐analysis based on PRISMA 2020. Methods: We searched CINAHL, Cochrane Library, Science Direct, Web of Science, Ovid, PubMed, Scopus, Springer Link, ProQuest, TR Index ending March 2021. The review followed the PRISMA guidelines. This meta‐analysis was analysed in Comprehensive Meta‐Analysis version 3 software. The risk of bias of included studies was assessed with the Cochrane handbook. The results were the level of epilepsy knowledge of children and parents. Results: Ten studies meeting the inclusion criteria were included in this meta‐analysis, including four randomised studies and six non‐randomised studies. Educational interventions had large effect on improving the level of epilepsy knowledge in children with epilepsy (p <.001, Hedge's g = 1.19) and parents (p <.001, Hedge's g = 1.41). As a result of the subgroup analyses, significant differences were found only in the type of educational intervention. It was found that traditional education is more effective than technology‐based education in improving the level of epilepsy knowledge in parents (p =.005, Hedge's g = 1.77). Conclusion: Educational interventions have high and beneficial effect on the level of epilepsy knowledge in the children with epilepsy and parents; can be used as effective interventions in the epilepsy management. However, due to low number of randomised controlled studies, further high‐quality randomised controlled studies are needed about this topic. Relevance to clinical practice: The findings will contribute to the use of educational interventions in the epilepsy management for health professionals, especially nurses. Thus these interventions will contribute to improving epilepsy management of children with epilepsy and parents. [ABSTRACT FROM AUTHOR]

Aims: To examine the patient‐related factors that have been linked to glycaemic control in people living with type 2 diabetes mellitus in Middle Eastern countries. Design: A systematic review and meta‐analysis. Data Sources: A computerized search was conducted using the databases MEDLINE (via PubMed and Ovid), EMBASE, Scopus and CINAHL to identify peer‐reviewed articles published in English between 1 January 2010 and 21 May 2020. On 28 June 2021, the search was updated with the same keywords and databases; however, no further relevant studies were identified. Review Methods: Extracted data were analysed using Review Manager 5.4. Results: The final sample consisted of 54 articles with a total of 41,079 participants. Pooled data showed an increased risk of inadequate glycaemic control in smokers [OR = 1.26, 95% confidence interval (CI): 1.05, 1.52; p =.010], obese patients (OR = 1.30, 95% CI: 1.10, 1.54; p =.002), patients with elevated waist to hip ratio (OR = 1.62, 95% CI: 1.16, 2.26; p =.004) and longer disease duration (OR = 2.01, 95% CI: 1.64, 2.48; p <.001). A lower risk of inadequate control was associated with physical activity (OR = 0.40, 95% CI: 0.24, 0.67; p <.001) and self‐management (OR = 0.49, 95% CI: 0.29, 0.82; p =.006). Conclusion: These findings highlight the opportunity to address factors to improve glycaemic control. Further longitudinal studies are required to better understand these variations, to assess all predictors of glycaemic control in participants with type 2 diabetes, and to provide a strong basis for future measures to optimize glycaemic control. [ABSTRACT FROM AUTHOR]

Aim: To synthesize what is known about elder abuse and relationship factors associated with abuse between caregivers and older people with memory disorders at home. Background: Concerns about abuse in the caring relationship between older people with memory disorders and family caregivers have increased. Abuse is associated with negative outcomes on older people's health, quality of life, and zest for life. Abuse in the caring relationship manifests in financial exploitation, neglect, mistreatment, and physical issues. Design: Systematic review. Data sources: Databases including Scopus, PubMed/Medline, SveMed+, Cinalh, SonINDEX, and ProQuest were searched using keywords about abuse in the caring relationship between older people with memory disorders and family caregivers at home. Articles published between 2005-2019 were retrieved and underwent data analysis and knowledge synthesis. Review methods: The review was presented under the categories of the dyadic approach of elder abuse in connection with the role of caregiver (risk) and care recipient (vulnerability) by Fulmer et al. (2005). Results: The search process led to 12 quantitative studies, including an intervention, a prospective, nine surveys, and a cross-sectional structural interview. Findings were synthesized and presented under 'personal', 'physical and psychological', and 'social' domains indicating the bilateral roles of caregiver and care recipient leading to abuse. Conclusion: This review depicted factors influencing abuse in the caring relationship between older people with memory disorders and their family caregivers at home. They included family caregivers' psychological issues, knowledge of memory disorders and modifications, previous caring relationship, social support, number of care recipients, and care recipients' functional level. Impact: • This review identifies what influences elder abuse by family caregivers using the dyadic approach and explains how abuse can be prevented through suggested strategies. • The review findings are relevant to multidisciplinary healthcare providers and can guide the provision of support, screening and assessment, educational programs, and legislative initiatives. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and objectives: To explore how parents and nurses experience partnership in neonatal intensive care units and to identify existing barriers and facilitators to a successful partnership. Background: Family‐centred care is recommended as a frame of reference for treatment and care in neonatal intensive care units. A key element in family‐centred care is partnership. Such partnerships are characterised by complex interpersonal relationships and interactions between nurses and parents/families. Partnerships therefore appear to present a significant challenge. Design: A qualitative review and meta‐synthesis. Methods: Comprehensive searching in ten databases: CINAHL, PubMed (MEDLINE), EMBASE, PsycINFO, Scopus and SweMed+, OpenGrey, MedNar, Google Scholar and ProQuest Dissertations & Thesis Global. A total of 1,644 studies (after removal of duplicates) were critically assessed, and 21 studies fulfilled the inclusion criteria. A meta‐aggregation was used to synthesise the findings from the studies and was methodically quality assessed with QUARI/SUMARI and PRISMA. Findings: Through a meta‐aggregative approach, two synthesised findings were developed: (a) co‐creation of mutual knowledge and (b) developing competencies and negotiating roles. The first synthesis embraced the categories: being respected and listened to, trust and sharing knowledge, and the second synthesis embraced the categories: space to learn with guidance, encouraging and enabling, being in control. In constructing the categories, findings were identified as characteristics, barriers and facilitators to application. Conclusion: A successful relationship between parents and nurses can be achieved through co‐creation of mutual knowledge and development of competencies and negotiation of roles. Neonatal intensive care unit nurses are in a position where they exercise power, but they can change the culture if they are aware of what seems to facilitate or create a barrier to a partnership with parents. Relevance to clinical practice: This new evidence may inform a change in policies and guidelines which could be integrated into nurses' clinical practice in neonatal intensive care units. [ABSTRACT FROM AUTHOR]

Objectives: To perform a systematic review search and critically review the empirical evidence concerning the factors affecting glycaemic control in patients with type 1 or 2 diabetes mellitus. Background: Previous primary studies have investigated the factors associated with glycaemic control among patients with type 1 or 2 diabetes, but attempts to amalgamate these evidences have been methodologically limited. Hence, a robust review of the evidence is essential to explore factors that can be addressed to promote good glycaemic control in patients with diabetes. Design: Mixed‐method systematic review using the Preferred Reporting Items for Systematic review and Meta‐Analysis 2009 flow diagram, integrating evidence from qualitative and quantitative studies (see Supporting Information File S1). Methods: A systematic review of the literature published between 2006–2017 was conducted in seven electronic databases (CINAHL, MEDLINE, Scopus, EMBASE, PsycINFO, PubMed and ScienceDirect) using the search terms "diabetes mellitus," "glycemic control," "self‐concept," "knowledge," "self‐efficacy," "empowerment," "race," "ethnicity," "duration," "medication," "obesity" and "comorbidity." Results: A total of 1,582 articles were initially retrieved, and 24 of these articles were included in this systematic literature review. The overall empirical evidence suggested that higher socio‐economic status, greater dietary knowledge, and higher self‐efficacy and empowerment improve glycaemic control among patients with diabetes mellitus. Conclusions: This review presented the factors associated with glycaemic control that may pose significant socio‐economic problems to most nations worldwide and impede development nationally, regionally and even globally. Greater emphasis needs to be placed on implementing lifestyle changes on a societal level to stem the tide of the epidemic. Relevance to Clinical Practice: There is a need to implement self‐management initiatives, that incorporate dietary knowledge, to empower patients with diabetes in their own care. Future public health policy must be geared towards increasing the capability of dealing with the rising incidence of diabetes and implementing primary prevention. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the health literacy of the baby boomer generation and what this means for nursing care. Background: Nurses are encouraged to tailor information and education to the individual's level of understanding or health literacy but there may be generational differences in health literacy due to historical, social, and economic contexts. The baby boomer generation, people born between 1946 and 1966, are projected to be high users of health services as they age, therefore nurses’ understanding of their health literacy characteristics is important. Design: Integrative literature review. Methods: Database and manual searching for articles occurred in July 2017. Four articles met the criteria. Data were extracted and tabulated, and methodological‐quality was assessed. Results: Three categories of relevance emerged from the analysis of study findings: social demographics may predict health literacy, navigation of the health care system is challenging with low health literacy, and mechanisms to translate information into action remain unclear. Conclusions: Although there is limited evidence to guide practice in regard to health literacy for the baby boomer generation, the emergence of the internet may confound nursing assessment of literacy: people from the baby boomer generation may appear to have higher literacy than they actually possess. Relevance to clinical practice: Sociodemographic information may be used for initial screening for health literacy. Creative questions are recommended to overcome possible stigma associated with individual awareness of low literacy. The mechanisms for translating information into action require further investigation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine what is known about hypertension among adults living in Haiti. Background: Hypertension is the leading cause of morbidity, the identified cause of heart failure in 45% of patients and is associated with more than 70% of cardiovascular disease‐related hospital admissions in Haiti. Design: An integrative review of the literature. Methods: Searching four databases from 2007 to 2018, Whittemore and Knafl's method was used to review the literature. Three nurse researchers independently reviewed and appraised each publication applying the Johns Hopkins Evidence‐based Practice Appraisal tool. Results: Eight publications were identified and appraised for level and quality of evidence. The synthesis of the literature yielded common themes of (i) high prevalence of hypertension among adults living in rural areas, (ii) public health challenges, (iii) lack of knowledge and awareness of hypertension and (iv) barriers to effective treatment. Conclusion: Hypertension is a highly prevalent disease in Haiti that is understudied and warrants attention. To better serve this vulnerable population, culturally tailored prevention strategies and disease management programmes are recommended. Relevance to clinical practice: There is a lack of quality evidence to guide nurses in the management of hypertension for this vulnerable population. Identification of barriers to effective treatment among this underserved population will assist nurses and other healthcare professionals in identifying best possible practices for patient care in clinical settings across Haiti. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe, interpret and synthesise the current research findings on the impact of the Early Warning Score and Rapid Response Systems on nurses’ competence in identifying and managing deteriorating patients in general hospital wards. Background: As patient safety initiatives designed to ensure the early identification and management of deteriorating patients, the Early Warning Score and Rapid Response Systems have broad appeal. However, it is still unclear how these systems impact nurses’ competence when these systems are used in general hospital wards. Methods: CINAHL, PubMed, Cochrane, EMBASE and Ovid MEDLINE databases were systematically searched for relevant articles. Articles were appraised, a thematic analysis was conducted, and similar and divergent perspectives on emergent themes and subthemes were extracted by a team of researchers. Results: Thirty‐six studies met the inclusion criteria. The analysis of findings showed how the Early Warning Score and Rapid Response Systems impacted three competence areas: (i) Nurses’ competence in assessing and caring for patients related to the subthemes: (a) sensing clinical deterioration and (b) the development of skills and knowledge. (ii). Nurses’ competence in referring patients, related to the subthemes: (a) deciding whether to summon help and (b) the language and communication lines in the referral process. (ii) Nurses’ coping and mastery experiences. Conclusion: The impact of the Early Warning Score and Rapid Response Systems on nurses’ competence in identifying and managing deteriorating patients is beneficial but also somewhat contradictory. Relevance to clinical practice: A greater understanding of nurses’ development of competence when using the Early Warning Score and Rapid Response Systems will facilitate the design of implementation strategies and the use of these systems to improve practice. [ABSTRACT FROM AUTHOR]

Background Type 2 diabetes is highly prevalent in patients with acute coronary syndrome and impacts negatively on health outcomes and self-management. Both conditions share similar risk factors. However, there is insufficient evidence on the effectiveness of combined interventions to promote self-management behaviour for people with diabetes and cardiac problems. Identifying critical features of successful interventions will inform future integrated self-management programmes for patients with both conditions. Objectives To assess the evidence on the effectiveness of existing interventions to promote self-management behaviour for patients presenting with acute coronary syndrome and type 2 diabetes in secondary care settings and postdischarge. Design We searched MEDLINE, PubMed, CINAHL Plus, PsycInfo, Cochrane Library and AMED for randomised controlled trials published between January 2005-December 2014. The search was performed using the following search terms of 'acute coronary syndrome', 'type 2 diabetes' and 'self-management intervention' and their substitutes combined. Results Of 4275 articles that were retrieved, only four trials met all the inclusion criteria (population, intervention, comparison and outcome) and were analysed. Overall, the results show that providing combined interventions for patients with both conditions including educational sessions supported by multimedia or telecommunication technologies was partially successful in promoting self-management behaviours. Implementation of these combined interventions during patient's hospitalisation and postdischarge was feasible. Intervention group subjects reported a significant improvement in self-efficacy, level of knowledge, glycated haemoglobin, blood pressure and fasting glucose test. However, there are many threats have been noticed around internal validity of included studies that could compromise the conclusions drawn. Conclusion With limited research in this area, there was no final evidence to support effectiveness of combined interventions to promote self-management behaviour for patients with type 2 diabetes and acute coronary syndrome. Sufficiently powered, good quality, well-conducted and reported randomised controlled trials are required. [ABSTRACT FROM AUTHOR]

Aim To assess the quality of evidence and determine the effect of patient-related and economic outcomes of self-management support interventions in chronically ill patients with a low socio-economic status. Background Integrated evidence on self-management support interventions in chronically ill people with low socio-economic status is lacking. Design Systematic literature review. Data sources Cochrane database of trials, PubMed, CINAHL, Web of Science, Psyc INFO and Joanna Briggs Institute Library were searched (2000-2013). Randomized controlled trials addressing self-management support interventions for patients with cardiovascular disease, stroke, cancer, diabetes and/or chronic respiratory disease were included. Review methods Data extraction and quality assessment were performed by independent researchers using a data extraction form. Results Studies ( n = 27) focused mainly on diabetes. Fourteen studies cited an underlying theoretical basis. Most frequently used self-management support components were lifestyle advice, information provision and symptom management. Problem-solving and goal-setting strategies were frequently integrated. Eleven studies adapted interventions to the needs of patients with a low socio-economic status. No differences were found for interventions developed based on health behaviour theoretical models. Conclusion Limited evidence was found for self-management support interventions in chronically ill patients with low socio-economic status. Essential characteristics and component(s) of effective self-management support interventions for these patients could not be detected. Rigorous reporting on development and underlying theories in the intervention is recommended. [ABSTRACT FROM AUTHOR]