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Aim: The aim of this qualitative meta‐synthesis was to discover the factors impacting on missed nursing care of nurses through systematic thinking. Background: Although nurses are responsible for high‐quality care, missed nursing care is common, endangering patient safety. Understanding of the causes related to missed nursing care could help nursing managers improve the quality of nursing care. Design: A qualitative meta‐synthesis guided by the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA). Methods: As a method designed to contribute to knowledge development, meta‐synthesis allows for integration of qualitative study findings using thematic synthesis. Six databases were searched up to October 2021; nine studies met the inclusion and quality assessment criteria and meta‐synthesis were conducted. Results: Three themes related to the causes why nurses missed nursing care were found. The themes included intrinsic resources (professional and ethical values, ambiguous nurse role, prioritization, education system, and knowledge), system structure (staff and resources shortage, heavy workload but limited time, and organizational management failure), and social environment (communication, working relationship and skill mix, and inappropriate ward layout). Conclusion: The phenomenon of missed nursing care is a global tissue, with variations in its elements but also notable similarities. Meta‐synthesis provides evidence of intrinsic and extrinsic factors that contribute to missed nursing care. Relevance to Clinical Practice: Recognizing and understanding the causes of missed nursing care is essential for nursing managers to ensure patient safety and the provision of high‐quality care. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the preliminary effect of an integrated novel intervention comprising visualised sleep report feedback using information and communication technology and periodic health guidance on improving sleep indicators among community‐dwelling older people. Methods: The intervention was implemented among 29 older people in Sakai City, Japan, in a 3 months pilot trial. Non‐worn actigraph devices were placed under participants' bedding to continuously measure their sleep state, and they received monthly sleep reports in writing. Sleep efficiency, total sleep time, sleep latency, and the number of times away from bed were recorded. A trained nurse expertly interpreted participants' sleep data and provided telephone health guidance. The first month's data were used as the baseline (T1), the second month provided data for the first intervention (T2), and the third month provided data for the second intervention (T3). Friedman tests and Wilcoxon signed‐rank tests were used to examine differences in sleep outcomes between different time points. Results: Participants' mean age was 78.97 ± 5.15 years, and 51.72% (15/29) were female. Comparison of T2 and T1 showed the intervention decreased participants' sleep latency at T2 (P = 0.038). Compared with T1, the intervention significantly decreased sleep latency (P = 0.004), increased total sleep time (P < 0.001), and improved sleep efficiency (P < 0.001) at T3. When T3 was compared with T2, only total sleep time was significantly increased (P < 0.001). There were no significant differences in the number of times away from bed across the three time points (P > 0.05). Conclusions: This visualised sleep report feedback and periodic health guidance intervention for community‐dwelling older people showed promising, albeit small preliminary effects on sleep. A fully powered randomised controlled trial is required to verify the significance of this effect. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Family caregivers of dementia patients face significant challenges, including managing their own emotional responses. Understanding factors influencing expressed emotion (EE) is crucial for effective support interventions. The aim of this study was to explore and describe changes in EE among family caregivers of dementia and its associated factors at different time points over 3 months.A 3‐month observational study was conducted in Japan. We collected demographically detailed data on family caregivers currently providing care, including care burden, relationship closeness, and depression. We assessed EE using the validated Family Attitude Scale (FAS). After adjustment for multiple confounding factors, multivariate linear regression analysis was performed to assess factors affecting EE at various time points. Linear regression analysis with generalised estimating equations was used to assess associations between 3‐month time‐varying EE and burden, intimacy, and depression.Fifty‐six family caregivers completed the study. Changes in FAS scores did not show statistical differences over 3 months. It is worth noting that the degree of relationship closeness and care burden are important influencing factors of EE in both cross‐sectional analysis and longitudinal analysis.Early identification of risk factors can aid in developing interventions aimed at preventing high levels of EE in the dementia family, thereby mitigating their detrimental effects. Tailored interventions are essential to enhance caregiver well‐being and cultivate positive caregiver–patient relationships. [ABSTRACT FROM AUTHOR]