The 50 most-cited articles in Journal of Advanced Nursing, 2022

AIM: To identify how patient journey mapping is being undertaken and reported. DESIGN: A scoping review of the literature was undertaken using JBI guidance. DATA SOURCES: Databases were searched in July 2021 (16th-21st), including Ovid's Medline, Embase, Emcare and PsycINFO; Scopus; Web of Science Core Collection, the Directory of Open Access Journals; Informit and; ProQuest Dissertations and Theses Global. REVIEW METHODS: Eligible articles included peer-reviewed literature documenting journey mapping methodologies and studies conducted in healthcare services. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. A table was used to extract data and synthesize results. RESULTS: Eighty-one articles were included. An acceleration of patient journey mapping research was observed, with 76.5% (n = 62) of articles published since 2015. Diverse mapping approaches were identified. Reporting of studies was inconsistent and largely non-adherent with relevant, established reporting guidelines. CONCLUSION: Patient journey mapping is a…

AIM: To evaluate the characteristics and methodology consistency in nursing research with descriptive phenomenological design. DESIGN: Scoping review methodology. DATA SOURCES: Three electronic databases (CINAHL, Embase, PubMed) were systematically searched for qualitative studies with a descriptive phenomenological design published in nursing journals between January 2021 and December 2021. REVIEW METHODS: Quality appraisal of each study was conducted using the Critical Appraisal Skills Programme checklist. Data were extracted and presented narratively based on research objective, design justification and consistency, theoretical framework, sampling method and sample size, data collection method, data analysis approach and presentation of findings. RESULTS: One hundred and three studies were included in the review. Overall, the characteristics of the studies are mostly consistent with Husserl's phenomenology approach in terms of research objectives, the use of other theoretical frameworks, sampling and data collection methods. However, the findings revealed several inconsistencies…

AIMS: This review aims to explore the prevalence and incidence rates of mental health conditions in healthcare workers during and after a pandemic outbreak and which factors influence rates. BACKGROUND: Pandemics place considerable burden on care services, impacting on workers' health and their ability to deliver services. We systematically reviewed the prevalence and incidence of mental health conditions in care workers during pandemics. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Searches of MEDLINE, Embase, Cochrane Library and PsychINFO for cohort, cross-sectional and case-control studies were undertaken on the 31 March 2020 (from inception to 31 March 2020). REVIEW METHODS: Only prevalence or incidence rates for mental health conditions from validated tools were included. Study selection, data extraction and quality assessment were carried out by two reviewers. Meta-analyses and subgroup analyses were produced for pandemic period (pre- and post), age, country income, country, clinical setting for major depression disorder (MDD), anxiety disorder and…

AIM: To investigate the association of unfinished nursing care on nurse outcomes. DESIGN: Systematic review in line with National Institute for Health and Care Excellence guideline. DATA SOURCES: CINAHL, the Cochrane Library, Embase, Medline, ProQuest and Scopus databases were searched up until April 2020. REVIEW METHODS: Two independent reviewers conducted each stage of the review process: screening eligibility, quality appraisal using Mixed Methods Appraisal Tool; and data extraction. Narrative synthesis compared measurements and outcomes. RESULTS: Nine hospital studies were included, and all but one were cross-sectional multicentre studies with a variety of sampling sizes (136-4169 nurses). Studies had low internal validity implying a high risk of bias. There was also a high potential for bias due to non-response. Only one study explicitly sought to examine nurse outcomes as a primary dependent variable, as most included nurse outcomes as mediating variables. Of the available data, unfinished nursing care was associated with: reduced job satisfaction (5/7 studies); burnout (1/3);…

AIM: To critically synthesize the literature that describes men's help-seeking and engagement with general practice. DESIGN: Integrative literature review. DATA SOURCES: CINAHL plus, Medline and APA PsycInfo were searched for papers published between 1999 and March 2021. REVIEW METHODS: After screening titles and abstracts, full-text papers were screened against inclusion / exclusion criteria. All included papers were assessed for methodological quality. Findings were extracted, critically examined and synthesized into themes. RESULTS: Twenty studies met the inclusion criteria. Thematic analysis revealed four themes related to; (1) structural barriers, (2) internal barriers, (3) men's understanding of the role of general practice, and (4) self-care and help-seeking. The findings indicate that men can find general practice unwelcoming and unaccommodating. Men can also experience psychological barriers that impact engagement and help-seeking. Men predominantly view general practice as a source of acute health care and do not appreciate the role of general practice in preventive health…

AIM: To report an analysis of the concept of post-separation abuse and its impact on the health of children and adult survivors. DESIGN: Concept analysis. DATA SOURCES: A literature search was conducted via PubMed, Cochrane and Embase and identified articles published from 1987 to 2021. METHODS: Walker and Avant's (2019) eight stage methodology was used for this concept analysis, including identifying the concept, determining the purpose of analysis, identifying uses of the concept, defining attributes, identifying a model case and contrary case, antecedents and consequences and defining empirical referents. RESULTS: Post-separation abuse can be defined as the ongoing, willful pattern of intimidation of a former intimate partner including legal abuse, economic abuse, threats and endangerment to children, isolation and discrediting and harassment and stalking. An analysis of literature identified essential attributes including fear and intimidation; domination, power and control; intrusion and entrapment; omnipresence; and manipulation of systems. Antecedents to post-separation abuse…

AIMS: Black, Asian and minority ethnic women are at higher risk of dying during pregnancy, childbirth and postnatally and of experiencing premature birth, stillbirth or neonatal death compared with their White counterparts. Discrimination against women from ethnic minorities is known to negatively impact women's ability to speak up, be heard and their experiences of care. This evidence synthesis analysed Black, Asian and minority ethnic women's experiences of UK maternity services in light of these outcomes. DESIGN: We conducted a systematic review and qualitative evidence synthesis using the method of Thomas and Harden. DATA SOURCES: A comprehensive search in AMED, Cinahl, Embase, Medline, PubMed and PsycINFO, alongside research reports from UK maternity charities, was undertaken from 2000 until May 2021. Eligible studies included qualitative research about antenatal, intrapartum and postnatal care, with ethnic minority women in maternity settings of the UK NHS. REVIEW METHODS: Study quality was graded using the Critical Appraisal Skills Programme tool. RESULTS: Twenty-four studies…

AIMS: To explore how consultation exercises were described in a convenience sample of recent scoping reviews. DESIGN: Critical literature review. DATA SOURCES: We searched PsycINFO, Embase, CINAHL and PubMed in July 2020. Our inclusion criterion was a peer-reviewed journal article reporting a scoping review in Danish, English, Norwegian or Swedish. REVIEW METHODS: We identified a convenience sample of articles (n = 66) reporting a consultation exercise as part of a scoping review. The descriptions of the consultation were charted, summarized and critically discussed. RESULTS: The current analysis showed no widely accepted consensus on how to approach and report a consultation exercise in the sample of scoping reviews. The reports of stakeholder consultation processes were often brief and general, and often there were no reports of the effects of the stakeholder consultation processes. Further, there was no discussion of the principal theoretical problems mixing stakeholder voices and review findings. CONCLUSION: The finding that conventional research ethics and research methods…

AIMS: To evaluate the effectiveness of virtual reality (VR) intervention in the management of pain, anxiety and fear in paediatric patients undergoing needle-related procedures. DESIGN: A systematic review and meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: A librarian-designed search of the Cochrane Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI, and Wanfang databases was conducted to identify research articles in English or Chinese on RCTs up to February 28, 2022. REVIEW METHODS: Two researchers independently screened eligible articles. The Cochrane Handbook for Systematic Reviews was used to assess the risk of bias in the included studies. A fixed- or random-effects meta-analysis model was used to determine the pooled mean difference based on the results of the heterogeneity test. RESULTS: A total of 2269 articles were initially screened. The meta-analysis included data from 27 studies representing 2224 participants. Compared with the non-VR group, the VR intervention group significantly reduced pain, anxiety, and fear in paediatric patients who…

AIM: To explore communication research in nursing by investigating the theoretical approaches, methods, content and perspectives in research on real-time registered nurse (RN)-patient communication. DESIGN: An integrative review of real-time communication between RNs and patients. DATA SOURCES: Empirical research papers were searched in PubMed, CINAHL Plus and Medline. The results from the database searches were supplemented with results from manual searches in reference lists. REVIEW METHODS: A total of 1369 articles published between January 1996 and December 2021 were screened, which resulted in the inclusion of 52 articles. RESULTS: The integration of various theories, such as nursing or communication theories, is weak in most of the included studies. RN-patient communication appears to influence relationship building. Even when nurses strive to meet patients' needs, they often focus primarily on nursing routines and physical care. The topic of the communication varies depending on the situation and different communication styles are used. When a patient-centred approach is…

AIMS: To examine the effects of nursing deans/directors' transformational leadership behaviours on academic workplace culture, faculty burnout and job satisfaction. BACKGROUND: Transformational leadership is an imperative antecedent to organizational change, and employee well-being and performance. However, little has been espoused regarding the theoretical and empirical mechanisms by which transformational leaders improve the academic workplace culture and faculty retention. DESIGN: A cross-sectional survey design was implemented. METHODS: Nursing faculty employed in Canadian academic settings were invited to complete an anonymous online survey in May-July 2021. A total of 645 useable surveys were included in the analyses. Descriptive statistics and reliability estimates were performed. The moderated mediation model was tested using structural equation modelling in the Analysis of Moment software v24.0. Bootstrap method was used to estimate total, direct and indirect effects. RESULT: The proposed study model was supported. Transformational leadership had both a strong direct effect…

AIM: To evaluate the effectiveness of psychological interventions in reducing fear of cancer recurrence in breast cancer survivors. DESIGN: A systematic review and meta-analysis. DATA SOURCES: PubMed, Embase, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, PsycINFO, Web of Science and ClinicalTrials.gov were searched for relevant studies published from 1 January 1976 to 28 November 2020. METHODS: Eligible randomized controlled trials on psychological interventions for reducing fear of cancer recurrence in breast cancer survivors were included in meta-analysis. Review Manager 5.4 was used to conduct the meta-analysis, and the fear of cancer recurrence score was calculated by using standardized mean differences and 95% confidence intervals. Risk of bias was assessed with the Cochrane risk-of-bias tool. Quality of evidence, sensitivity analyses, and subgroup analyses were also conducted. RESULTS: This systematic review included 16 randomized controlled trials. We found psychological interventions significantly reduced fear of cancer recurrence. Subgroup analyses…

AIMS: To evaluate the relationships between workload, nursing teamwork and nurse fatigue and the moderating effect of nursing teamwork on the relationship between workload and fatigue. DESIGN: This cross-sectional online survey study used data from 810 United States hospital nurses collected between March and April 2021. METHODS: Workload, nursing teamwork and fatigue were measured using the Quantitative Workload Inventory, the Nursing Teamwork Survey, and the Occupational Fatigue Exhaustion Recovery scale. Hierarchical multiple linear regression models were used. RESULTS: All the nursing teamwork subscales (i.e. trust, team orientation, backup, shared mental model, team leadership) were significantly negatively related to acute and chronic fatigue. Nursing teamwork components of team orientation, shared mental model and team leadership moderated the relationship between workload and chronic fatigue. The relationships between workload and chronic fatigue were stronger when these components of nursing teamwork were high. No moderating effects were found with acute fatigue.…

AIMS: To propose a decision tree for identifying appropriate integration procedures and joint displays for achieving integration in mixed methods studies. DESIGN: A methodological discussion. DATA SOURCES: Methodological literature including mixed methods textbooks, methodological reviews and studies published in the last 10 years (2012-2022). IMPLICATIONS FOR NURSING: Mixed methods are instrumental to study complex nursing care processes and health-human phenomena. Nurse researchers can use this decision tree to choose the most appropriate integration procedures to overcome the integration challenge when designing and conducting mixed methods nursing studies. CONCLUSION: Integration procedures and joint displays are the most widely used methods for tackling the integration challenge in mixed methods research (MMR). The multifaceted and contingent nature of these methods are beneficial for their tailored and adapted use at the data collection, analysis, interpretation and reporting levels. The use of the most pertinent integration procedures and joint displays is critical for…

AIMS: To increase the quality and safety of patient care, many hospitals have mandated that nursing clinical handover occur at the patient's bedside. This study aims to improve the patient-centredness of nursing handover by addressing the communication challenges of bedside handover and the organizational and cultural practices that shape handover. DESIGN: Qualitative linguistic ethnographic design combining discourse analysis of actual handover interactions and interviews and focus groups before and after a tailored intervention. METHODS: Pre-intervention we conducted interviews with nursing, medical and allied health staff (n = 14) and focus groups with nurses and students (n = 13) in one hospital's Rehabilitation ward. We recorded handovers (n = 16) and multidisciplinary team huddles (n = 3). An intervention of communication training and recommendations for organizational and cultural change was delivered to staff and championed by ward management. After the intervention we interviewed nurses and recorded and analyzed handovers. Data were collected from February to August 2020.…

AIM: To explore the effects of disability, depressive, anxiety and stress symptoms on patients' and their partners' quality of life (QoL) using the actor-partner interdependence model (APIM). DESIGN: A cross-sectional study using actor-partner interdependence model. METHODS: We recruited 183 dyads of stroke survivors and their family caregivers in Indonesia. The World Health Organization Disability Assessment (WHODAS 2.0), Depression, Anxiety and Stress (DASS-42) and Rand Short Form Health Survey (SF-36) were used to measure disability, depressive, anxiety and stress symptoms and QoL of stroke survivors and family caregivers. The actor-partner interdependence model was tested using multilevel modelling. The actor-partner interdependence mediation model (APIMeM) was applied to estimate the direct and indirect effect. RESULTS: Disability had actor effects on stroke survivor's overall QoL and partner effect on family caregiver's overall QoL. More severe disability of stroke survivors was associated with a lower overall QoL of their own and that of family caregiver's overall QoL.…

AIM: To describe the experience of stigma among transgender and gender-diverse (TGD) people accessing care. DESIGN: A qualitative meta-synthesis. DATA SOURCES: CINAHL, Medline, PubMed and PsycINFO were used to retrieve English-language, peer-reviewed qualitative studies from September 2016 to September 2021. REVIEW METHODS: The methods for this qualitative meta-synthesis included four steps. Step 1: Form the clinical question and purpose of synthesis to define and refine search terms. Step 2: Evaluate the literature using PRISMA. Step 3: Appraise the literature using Lett's Critical Review Form. Step 4: Conduct a reciprocal translation to synthesize the results. RESULTS: Of the 12 articles that met the inclusion criteria, 3 were from nursing journals. The articles included were studies conducted in U.S.A., Brazil, Canada, Colombia, Mozambique, Sweden, Uganda and United Kingdom, and most recruited transfeminine-identifying participants. Three main themes emerged: stigma experienced within the individual, interpersonal and structural socio-ecological levels among TGD people accessing…

AIM: To explore how nurses' use of electronic health records impacts on the quality of nurse-patient interactions and communication. DESIGN: An integrative review. DATA SOURCES: MEDLINE®, CINAHL®, PscyINFO, PubMed, BNI and Cochrane Library databases were searched for papers published between January 2005 and April 2022. REVIEW METHODS: Following a comprehensive search, the studies were appraised using a tool appropriate to the study design. Data were extracted from the studies that met the inclusion criteria relating to sample characteristics, methods and the strength of evidence. Included empirical studies had to examine interactions or communication between a nurse and patient while electronic health records were being used in any healthcare setting. Findings were synthesized using a thematic approach. RESULTS: One thousand nine hundred and twenty articles were initially identified but only eight met the inclusion criteria of this review. Thematic analysis revealed four key themes, indicating that EHR: impedes on face-to-face communication, promotes task-orientated and formulaic…

AIM: Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work. BACKGROUND: Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross-level impact of organizational and individual characteristics. METHODS: A cross-sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro. RESULTS: Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment. CONCLUSION:…

AIMS: To map the nursing skills required for different types of disasters. DESIGN: This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute. DATA SOURCES: A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review. REVIEW METHODS: The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized. RESULTS: We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three…

To evaluate the impact of general practice nurse-led interventions for blood pressure control and cardiovascular disease risk factor reduction in patients with hypertension. Systematic review and meta-analysis of randomized control trials. CINAHL, Medline and Scopus databases were searched to identify peer-reviewed studies published between 2000 and 2021. A systematic review of randomized control trials was conducted using a structured search strategy. The Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to appraise study quality. Meta-analysis and narrative synthesis were performed to determine the effectiveness of the included interventions. Eleven trials comprising of 4454 participants were included in the review. Meta-analysis showed significant reductions in both systolic and diastolic blood pressure in trials with 6 months or less follow-up. Improvements were also demonstrated in reducing blood lipids, physical activity, general lifestyle measures and medication adherence. Evidence for dietary improvements and reduction in alcohol and smoking…

AIMS: To identify factors that motivate or inhibit nurses' speaking up for patient safety. DESIGN: A descriptive qualitative study. METHODS: We conducted semi-structured interviews with 15 nurses from four Korean hospitals between December 2020 and January 2021. Data were analysed using inductive content analysis. RESULTS: We identified safety culture, supportive unit managers and role models, positive reactions from or familiarity with others, high-risk situations and personal characteristics and beliefs as motivators of nurses' speaking up. Hierarchies and power differentials, seniority and unit tenure, concerns about relationships, and heavy workloads inhibited nurses' speaking up. CONCLUSION: Individual, organizational and cultural characteristics influence nurses' decisions on whether or not to voice their concerns, suggestions or ideas. Certain characteristics of Korean culture, such as strong hierarchies and the valuing of good relationships, play an important role in nurses' speaking up behaviours. Our findings can be used to inform educational interventions and management…

AIMS: To synthesize the empirical and theoretical literature on change fatigue in nursing, including how change fatigue affects nurses, the nursing profession and strategies to prevent and overcome it. BACKGROUND: Change fatigue refers to the overwhelming feelings of stress, exhaustion and burnout associated with rapid and continuous change across healthcare organizations. Change fatigue can affect nurses' wellbeing, yet there is a distinct lack of literature which synthesizes the relationship between cumulative organizational change and nurses' wellbeing. DESIGN: Integrative review following Toronto and Remington and Whittemore and Knafl methodology. DATA SOURCES: Searches were conducted in CINAHL, Embase, Medline, APA PsycInfo, Scopus, Business Source Complete and ProQuest Dissertations & Theses Global in January 2022. REVIEW METHODS: A comprehensive search was conducted to identify literature on change fatigue in nursing. Included literature were critically appraised for methodological quality. Data from each article were abstracted and thematically analysed. RESULTS: Twenty-six…

AIMS: To systematically review the literature on relationships between communication issues and missed nursing care. DESIGN: Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. DATA SOURCES: EMBASE, Web of Science, CINAHL, PubMed and Cochrane databases were comprehensively searched from inception to December 2021. REVIEW METHODS: Screening, data extraction and initial quality assessment were conducted independently by two reviewers. The JBI quality assessment tool was used for study appraisal and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Discrepancies were settled by consulting a third researcher. RESULTS: A total of 18 articles were included. Missed nursing care was common and the status of communication was not optimistic in clinical. Nurses' sociodemographic characteristics and work environment both influenced missed nursing care and communication. Intrateam communication included three parts: doctors-nurses…

AIM: To identify the evidence on factors that impact delegation practices by Registered Nurses to Assistants in Nursing in acute care hospitals. DESIGN: An integrative review. DATA SOURCES: Database searches were conducted between July 2011 and July 2021. REVIEW METHODS: We used the 12-step approach by Kable and colleagues to document the search strategy. The (Whittemore & Knafl. 2005. Journal of Advanced Nursing, 52(5), 546-553) integrative review framework method was adopted and the methodological quality of the studies was assessed using Joanna Briggs critical appraisal instruments. RESULTS: Nine studies were included. Delegation between the Registered Nurse and the Assistant in Nursing is a complex but critical leadership skill which is impacted by the Registered Nurse's understanding of the Assistant in Nursing's role, scope of practice and job description. Newly qualified nurses lacked the necessary leadership skills to delegate. Further education on delegation is required in pre-registration studies and during nurses' careers to ensure Registered Nurses are equipped with the…

AIM: To explore how nurses perceived having a calling to nursing. DESIGN: A mixed-method study. METHODS: Survey data collected in autumn 2020 and semi-structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t-tests and the interview data with qualitative thematic analysis. RESULTS: Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay. CONCLUSION:…

AIMS: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. DESIGN: The study used a cross-sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. METHODS: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018-2019. The work environment was measured using the Nurse Practitioner-Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner-Administration Relations, Nurse Practitioner-Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed-effect proportional-odds cumulative logit models to assess the association between work environment…

AIMS/QUESTIONS: To explore the barriers and facilitators to nurses accessing clinical supervision; explore the barriers and facilitators to organizations implementing clinical supervision and capture what skills nurses require to facilitate clinical supervision. DESIGN: Scoping review of peer-reviewed research and grey literature. DATA SOURCES: CINAHL, Medline, PsychINFO and Scopus were searched for relevant papers published between 1990 and 2020. Google, Google Scholar, OpenGrey & EThOS were used to search for grey literature. REVIEW METHODS: PRISMA-ScR guidelines were used during the literature review process. Eighty-seven papers were included, and data were extracted from each paper using a standardized form. Data synthesis was undertaken using Seidel's analytical framework. RESULTS: Five themes were identified: Definitions and Models, (Mis) Trust and the Language of Supervision, Alternative Parallel Forums and Support Mechanisms, Time and Cost and Skills required. CONCLUSION: Since its inception in the 1990s, clinical supervision has long been regarded as a supportive platform…

AIMS: To synthesize quantitative evidence on levels of dignity during acute hospital admission and identify barriers and facilitators to patients' dignity or dignified care from the perspective of hospitalized patients. The secondary aim was to examine the relationship between dignity and demographic, clinical and psychological characteristics of patients. DESIGN: A systematic review based on the protocol of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline for reporting systematic reviews. DATA SOURCES: Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, AgeLine) were searched in February 2021, followed by backward-forward searching using Web of Science and Scopus databases. REVIEW METHODS: Potentially eligible articles were scrutinized by two reviewers. Articles that met the eligibility criteria were appraised for quality using the Critical Appraisal Tool for Cross-Sectional Studies. Two reviewers extracted data for the review and resolved differences by consensus. RESULTS: Out of 3052 potentially eligible studies, 25 met the inclusion…

AIMS: To explore Registered Nurses' approaches to pressure injury prevention, including how they perceive their roles, how they prioritize pressure injury prevention and factors influencing prevention in the Chinese context. DESIGN: A qualitative descriptive study. METHODS: Audio-recorded, face-to-face, semi-structured individual interviews were conducted with Registered Nurses in a large tertiary hospital in China from August to December 2020. Using the System Engineering Initiative for Patient Safety Model, the interview guide was developed to describe the work system, processes and outcomes (three domains) associated with nurses' pressure injury prevention practices. Deductive and inductive content analyses were used. FINDINGS: Twenty-seven nurses participated in the interviews. Four themes related to two domains of the model emerged: Work system: (i) Nurses lead and coordinate pressure injury prevention; Work processes: (ii) Individualized pressure injury prevention is founded on comprehensive patient assessment; (iii) Collaborating ensures patients receive appropriate pressure…

AIM: To synthesize research evidence on perceptions and help-seeking behaviours in community-dwelling older people with urinary incontinence based on the Capability-Opportunity-Motivation-Behaviours model. BACKGROUND: Urinary incontinence is highly prevalent in community-dwelling older people, yet only a small proportion seek help from health professionals. Untreated urinary incontinence has a detrimental impact on older people's quality of life and distresses their caregivers. DESIGN: Systematic integrative review. DATA SOURCES: Ten databases were searched systematically between 9 November 2020 and 17 December 2020 including Medline (PubMed), CINAHL, Ageline, Web of Science, Scopus, ProQuest, Psyclnfo, CNKI, Wanfang and Vip. REVIEW METHODS: Quality appraisal was applied to assess the quality of selected articles. Data relevant to the review aim were extracted from included articles for analysis. Convergent qualitative synthesis was used to synthesize findings. RESULTS: Twenty articles were included and two main themes with six sub-themes were identified. Theme one described three…

AIM: To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings. DESIGN: Umbrella review. DATA SOURCES: An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature. METHODS: Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews. RESULTS: Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty-six sub-branches and seven main-branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support". CONCLUSIONS: Evidence demonstrates that newly graduated registered…

AIMS: Diagnostic Reasoning (DR) is an essential competency requiring mastery for safe, independent Nurse Practitioner (NP) practice, but little is known about DR content included in NP education programs. The aims of this study were to identify whether and how the concept of DR is addressed in NP education. DESIGN: We conducted a scoping review on DR-related content and teaching innovations in U.S. primary care NP education programs, with implications for NP education programs worldwide. Concepts and principles with global applicability include: conducting focused and hypothesis-directed histories and exams, generating the problem statement, formulating the differential diagnosis, appropriate and relevant diagnostic testing, determining the working diagnosis and developing evidence-based, patient-centred management plans. DATA SOURCES: N = 1115 articles retrieved from Medline, Embase, PsycINFO, and CINAHL for the period 2005-2021. Forty-one scholarly articles met inclusion/exclusion criteria. REVIEW METHODS: Data were extracted, synthesized and grouped by theoretical frameworks,…

The objective of this study was to assess burdens placed on and consequences of the COVID-19 pandemic on nursing home staff. DESIGN: We conducted a qualitative descriptive interview study. METHODS: We interviewed 18 nurses, nursing aides and care aides from five different nursing homes by using a semi-structured interview guideline between June and September 2020. Data were analysed with a qualitative content analysis method by combining an inductive and deductive coding frame. RESULTS: Results show that the qualitative work load and work organization were major concerns. Regarding the qualitative work load, participants stated that they were required to perform additional tasks to care for residents, because the pandemic interventions placed the residents under stress and dealing with relatives presented significant challenges. Nursing home staff reported that psychological consequences such as uncertainty, fear and stress represented major effects of the COVID-19 situation. CONCLUSION: We could show that qualitative workloads were assessed and perceived differently. Most nursing…

AIMS: To identify types of nurse-led interventions for multimorbidity and which outcomes are positively affected by them. DESIGN: Mixed-methods systematic review following the Joanna Briggs Institute (JBI) methods for convergent-integrated reviews. PROSPERO ID: CRD42020197956. DATA SOURCES: Cochrane CENTRAL, CINAHL, Embase and MEDLINE were searched in October 2020. Grey literature sources included OpenGrey, the Journal of Multimorbidity and Comorbidity and reference mining. REVIEW METHODS: English-language reports of nurse-led interventions for people with multimorbidity were included based on author consensus. Two reviewers performed independent quality appraisal using JBI tools. Data were extracted and synthesized using a pre-existing taxonomy of interventions and core outcome set. RESULTS: Twenty studies were included, with a median summary quality score of 77.5%. Interventions were mostly case-management or transitional care interventions, with nurses in advanced practice, support to self-manage conditions, and an emphasis on continuity of care featuring frequently.…

AIM: To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students. DESIGN: This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students. METHODS: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed. RESULTS: The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout. CONCLUSION: The mechanism by which…

AIMS: To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. REVIEW METHODS: Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence.…

AIMS: This discursive paper draws on three key leadership theories with the aim of outlining how styles of leadership impact the provision of fundamentals of care. DESIGN: Discussion paper. DATA SOURCES: key leadership theories, leadership and fundamentals of care literature. IMPLICATIONS FOR NURSING: The conceptualization of fundamentals of care is viewed through the lens of nursing leadership, and collective, compassionate and transformational leadership theory. The cognitive dissonance that nursing leaders encounter when trying to reconcile organizational, patient and nurses' needs is considered, and the pressure to deliver high-quality fundamentals of care presents a challenge to nurse leaders. CONCLUSION: Leaders must align nursing and patient outcome data to drive forward and prioritize fundamental care. Focusing on key elements of relational leadership styles will ensure a workforce fit to provide fundamental care, which in the current climate must be an organizational and global nursing priority. IMPACT: This discussion attempts to draw together overlapping leadership…

AIMS: To enhance conceptual clarity and interdisciplinary understanding of structural violence, and to illuminate its implications for contemporary social justice and health equity research, by: (1) synthesizing scholarly literature pertaining to structural violence and health; (2) defining its key attributes, antecedents, consequences and characteristics; (3) contextually situating this phenomenon over time and across disciplines. DESIGN: A comprehensive review of scholarly health literature pertaining to 'structural violence' or its surrogate term 'structural determinants of health' was guided by a Research and Education Librarian. DATA SOURCES: In November 2019 and again in April 2021, CINAHL, Embase, Global Health, Medline, PsycINFO, PubMed and Scopus electronic databases were searched for peer-reviewed articles that described structural violence in the context of health. Of the 238 unique records identified, 32 articles were selected for inclusion and comprise the review sample. REVIEW METHODS: Using Beth Rodgers' evolutionary concept analysis method, articles were…

AIMS: The aim of this study was to explore the impact of the pandemic on the emotional and mental well-being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. DESIGN: Longitudinal, qualitative semi-structured interview study. METHODS: Remote semi-structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow-up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. RESULTS: In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and…

AIM: One of the greatest challenges in responding to the COVID-19 pandemic is preventing staff exposure and infection by ensuring consistent and effective use of personal protective equipment (PPE). This study explored health care workers' experience of prolonged PPE use in clinical practice settings and their concerns regarding PPE supply, effectiveness and training needs. DESIGN: A descriptive cross-sectional design was adopted in this study. METHODS: Health care workers (N = 592) from an acute care hospital completed an online survey from July to September 2020 assessing: (i) usage frequencies, side effects and interference with patient care; and (ii) perceptions of access to PPE, likelihood of exposure to infection and adequacy of PPE training. RESULTS: PPE-related side effects were reported by 319 (53.8%) participants, the majority being nurses (88.4%) and those working in high-risk areas such as the emergency department (39.5%), respiratory wards (acute 22.3% and non-acute 23.8%) and COVID-19 isolation ward (13.8%). The average time wearing PPE per shift was 6.8 h (SD 0.39).…

AIMS: A discussion of the challenges of recruiting participants from harder-to-reach populations for quantitative survey studies and potential avenues for tailored strategies to address these challenges. DESIGN: Discussion paper. DATA SOURCES: The search was conducted on August 2, 2021, in the CINAHL and PubMed databases, and in Google scholar. The initial search identified 5880 articles, and the final analysis included 44 articles that met the inclusion criteria. Articles were retained if they addressed methodological challenges or strategies for recruitment and concerned research with harder-to-reach populations. IMPLICATIONS FOR NURSING: This article draws on the literature regarding the challenges of recruiting research participants from harder-to-reach populations and known strategies for overcoming them. These strategies include, for example, establishing a trusting relationship between the researcher and the participant community and gaining in-depth knowledge of the target population. These challenges and strategies for recruiting participants from these populations are…

AIMS: To estimate the prevalence of computer vision syndrome (CVS) in healthcare workers and its relationship to video display terminal (VDT) exposure, sociodemographic, optical correction and work characteristics, and to analyse whether there are differences among occupational groups. DESIGN: Cross-sectional study. METHODS: . Logistic regression was used to identify the factors associated with CVS. All the results were stratified by occupational group. RESULTS: The prevalence of CVS was 56.75% with nurses being the most affected occupational group (61.75%). It was associated significantly with female sex (aOR = 2.57; 95% CI 1.36-4.88) and morning shifts plus on-call (aOR = 2.33; 95% CI 1.11-4.88) in the physicians and surgeons group. Among the nurses, it was associated with female sex (aOR = 2.35; 95% CI 1.03-5.37), seniority between 10 and 20 years (aOR = 2.17; 95% CI 1.03-4.59), VDT exposure at work of 2-4 h/day (aOR = 6.14; 95% CI 1.08-35.02), VDT exposure at work >4 h/day (aOR = 7.14; 95% CI 1.29-39.62) and self-perception that using the software application was not easy (aOR =…

AIM: To evaluate the effectiveness of cardiovascular risk communication strategies to improve understanding and promote risk factor modification. DESIGN: Systematic review with narrative synthesis. DATA SOURCES: A comprehensive database search for quantitative and qualitative studies was conducted in five databases, Cumulative Index to Nursing and Allied health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), EMBASE, Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science. The searches were conducted between 1980 and July 2019. REVIEW METHODS: The systematic review was conducted in accordance with Cochrane review methods. Data were extracted and a narrative synthesis of quantitative and qualitative results was undertaken. RESULTS: The abstracts of 16,613 articles were assessed and 210 underwent in-depth review, with 31 fulfilling the inclusion criteria. We observed significant heterogeneity across study designs and outcomes. Nine communication strategies were identified including numerical formats, graphical formats, qualitative…

AIMS: Identify and synthesize evidence of nurses' competency in electrocardiogram interpretation in acute care settings. DESIGN: Systematic mixed studies review. DATA SOURCES: Cumulative Index to Nursing and Allied Health Literature, Medline, Scopus and Cochrane were searched in April 2021. REVIEW METHODS: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. A data-based convergent synthesis design using qualitative content analysis was adopted. Quality appraisal was undertaken using validated tools appropriate to study designs of the included papers. RESULTS: Forty-three papers were included in this review. Skills and attitudes were not commonly assessed, as most studies referred to 'competency' in the context of nurses' knowledge in electrocardiogram interpretation. Nurses' knowledge levels in this important nursing role varied notably, which could be partly due to a range of assessment tools being used. Several factors were found to influence nurses' competency in electrocardiogram interpretation across the included…

AIM: To describe hospital nurse leaders' experiences with digital technologies. DESIGN: A qualitative descriptive study. METHODS: Semi-structured focus group interviews in one university-affiliated hospital in Finland. Data were collected from October to November 2021 and analysed using content analysis an e-leadership framework. RESULTS: A total of 20 frontline nurse leaders and middle-managers participated. Leaders had different kinds of experiences that concerned their traits, cognition, affect and behaviour with digital technologies. Leaders experienced that they needed to be open-minded towards digitalization, which sometimes eased their work by making it more efficient. Occasionally, they also got frustrated with digitalization, which caused them stress. Leading digital technologies required collaboration with several different stakeholders, and leaders were especially responsible for ensuring nurses' digital competence. Also, leaders own digital capability was highlighted, although some leaders experienced that their digital capability was low. CONCLUSION: The e-leadership…

Abstract Aims To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting. Design Quantitative study. Methods We conducted a secondary data analysis of a cross‐sectional, representative survey with German nurses (BIBB/BAuA‐Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ 2 ‐tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses. Results Forty‐four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work‐related psychosocial risk factor being independent of the care setting. Emotional demands were a…

AIMS: To identify, evaluate and summarize evidence of patient and clinician experiences of being involved in video or telephone consultations as a replacement for in-person consultations. DESIGN: Narrative synthesis. DATA SOURCES: Medline; EMBASE; EMCARE; CINAHL and BNI. Searching took place from January 2021 to April 2021. Papers included were published between 2013 and 2020. REVIEW METHODS: Papers were appraised by two independent reviewers for methodological quality. Data extraction was conducted according to the standardized tool from Joanna Briggs Institute. RESULTS: Seven qualitative studies were included, from five countries and from the perspective of patients, relatives, administrators, nurses, physiotherapists and physicians. We developed two main themes: Pragmatic Concerns and Therapeutic Concerns. Each theme contained two categories: Pragmatic Concerns: (a) the convenience of non-face to face consultations; (b) using technology and equipment in a consultation; Therapeutic Concerns (c) building therapeutic relationships; and (d) embracing benefits and addressing…

AIMS: (1) To examine registered nurses' knowledge and confidence in recognizing and managing to patients with sepsis and (2) identify nurse and workplace factors that influence their knowledge on sepsis. DESIGN: A multi-site, cross-sectional survey. METHODS: An online survey was developed and content validated. Data was collected from registered nurses working in the inpatient wards and emergency departments of three hospitals of a single healthcare cluster in Singapore during August 2021. Statistical analyses of closed-ended responses and content analysis of open-ended responses were undertaken. RESULTS: A total of 709 nurses completed the survey. Nurses possessed moderate levels of knowledge about sepsis (mean score = 10.56/15; SD = 2.01) and confidence in recognizing and responding to patients with sepsis (mean score = 18.46/25; SD = 2.79). However, only 369 (52.0%) could correctly define sepsis. Nurses' job grade, nursing education level and clinical work area were significant predictors of nurses' sepsis knowledge. Specifically, nurses with higher job grade, higher nursing…

AIMS: To clarify second victim symptoms subgroups, explore the factors affecting profile membership and determine how desired support strategies differ between the subgroups. DESIGN: A cross-sectional study using an online survey. METHODS: A total of 378 Korean staff nurses directly involved in patient safety incidents were recruited between December 2019 and February 2020. Data analyses consisted of latent profile analysis, multinomial logistic regression and analysis of variance. RESULTS: Three latent profiles were identified: 'mild symptoms', 'moderate symptoms' and 'severe symptoms'. Lower organizational support and higher non-work-related support were more likely to belong to the severe symptoms' profile. Incidents that caused temporary harm to the patient were more strongly associated with an increased likelihood of belonging to the moderate and severe symptoms profiles than no-harm events. Participants with severe symptoms agreed more with the usefulness of the support strategies than other participants; the usefulness of the psychological support strategies was rated…