The 50 most-cited articles in Journal of Advanced Nursing, 2023

Healthcare systems are responsible for 4%-5% of the emissions of greenhouse gases worldwide. The Greenhouse Gas Protocol divides carbon emissions into three scopes: scope 1 or direct emissions secondary to energy use; scope 2 or indirect emissions secondary to purchased electricity; and scope 3 for the rest of indirect emissions. AIM: To describe the environmental impact of health services. DESIGN: A systematic review was conducted in the Medline, Web of Science, CINAHL, and Cochrane databases. Studies that focused their analysis on a functional healthcare unit and which included. This review was conducted from August to October 2022. RESULTS: The initial electronic search yielded a total of 4368 records. After the screening process according to the inclusion criteria, 13 studies were included in this review. The reviewed studies found that between 15% and 50% of the total emissions corresponded to scopes 1 and 2 emissions, whereas scope 3 emissions ranged between 50% and 75% of the total emissions. Disposables, equipment (medical and non-medical) and pharmaceuticals represented the…

AIM: To systematically provide an overview of the qualitative evidence available on the motivations for nurses to leave the nursing profession. DESIGN: A qualitative systematic review using the meta-aggregation design of the Joanna Briggs Institute. DATA SOURCES: Qualitative studies in English, dating from 2010 until January 2023, were obtained from CINAHL, PsycINFO and PubMed. REVIEW METHODS: Studies were selected using predetermined inclusion and exclusion criteria. Quality assessment was done using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The assessment of confidence in the review findings was done according to the ConQual approach. RESULTS: Nine papers that investigated nurses' motivations to leave the profession were included. We developed four synthesized findings from 11 synthesized categories and 31 categories to reflect nurses' motivations to leave the profession, including (1) challenging work environment, (2) emotional distress, (3) disappointment about nursing reality, and (4) culture of hierarchy and discrimination. CONCLUSION:…

AIM: To report the results of a mapping exercise by the European Federation of Nurses on current advanced practice nursing frameworks and developments across Europe. DESIGN: Online, cross-sectional, questionnaire study. METHODS: An online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. The questionnaire solicited input on 60 items concerning key features of advanced practice nursing, intending to map existing developments and better understand the current state of advanced practice nursing in Europe. Data analysis used descriptive statistics, including counts and percentages, tabulation; open-text responses were handled with thematic synthesis techniques. RESULTS: The definition, sense-making and operationalization of advanced practice nursing vary across Europe. Important variations were noted in the definition and requirements of advanced practice nursing, resulting in different views on the competencies and scope of practice associated with this role. Importantly, the level of education and training required to qualify and…

AIMS: To review and synthesize available evidence exploring the impact of pandemics on direct healthcare providers' workloads in the acute care setting. DESIGN: Scoping review. DATA SOURCES: A review of English research articles published up to August 2022 that examined the impact of pandemics on healthcare providers' workloads was undertaken. Studies were identified by searching four electronic databases: Medline (EBSCO), CINAHL (EBSCO), Web of Science and PsychInfo (EBSCO). Fifty-five studies met the inclusion criteria. REVIEW METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Scoping Review checklist. RESULTS: Healthcare workers experience an increase in workload pressures during a pandemic. This included patients requiring more care, undertaking non-normal work activities, increase in work content including changes to documentation, increase in demand and skills required, an increase in overtime and hours of work per week and higher patient-to-nurse ratios. The review also highlighted changes to the work environment and worsened…

AIMS: This study offers an empirical exploration of self-assessed digital competencies of students, most of whom studied in nursing courses, using a discipline-based self-assessment survey tool. A range of digital competencies were explored: information and communication technology proficiency and productivity, information literacy, digital creation, digital research, digital communication, digital learning and development, digital innovation, digital identity management and digital well-being. DESIGN: A cross-sectional empirical study. METHODS: Quantitative data were collected from November to December 2021 via a questionnaire survey administered to students. Quantitative results were reported through descriptive statistical analysis. Mann-Whitney (U-test) and Kruskal-Wallis non-parametric statistical tests were used to identify statistically significant differences based on age demographics and pre- or post-registration course. Thematic analysis was utilized for survey open-ended questions data. RESULTS: Students reported low competencies in the following digital literacy…

BACKGROUND: Quantifying qualitative data as part of mixed-methods research (MMR) can add to the study results' analysis. Comparable results may reinforce the conclusions, while differences hold an opportunity for an in-depth discussion. To date, there is little guidance for researchers seeking to quantify their qualitative data. OBJECTIVES: Describing conversion of qualitative data to quantitative values, comparison with matched questionnaire results, discussing the benefits of this process and the matched MMR design. METHODS: We describe in detail how qualitative data from 46 interviews were converted into quantitative values (i.e., quantitative-qualitative values, QQVs) using MMR design, enabling a comparison of results from interviews and questionnaires obtained from the same participants. This process was embedded in a larger MMR study on family-caregivers caring for people-with-end-stage-dementia conducted between the years 2020-2021. RESULTS: A QQV was generated for three main themes and compared to the questionnaires' scores regarding the same topics. There were no…

BACKGROUND: With healthcare undergoing rapid digitalization, the effective integration of new technologies is crucial for nursing professionals, who form the largest group in the healthcare workforce. However, barriers within the nursing profession may impede digitalization efforts, leading to under utilization of available technologies and missed opportunities for enhancing healthcare quality and population health. AIMS: This article aims to investigate the adoption and use of digital technologies by nurses, considering how key demographics, such as gender, age, and voluntariness of technology use, interact to influence their acceptance and utilization of these technologies. METHODS: Employing the Unified Theory of Acceptance and Use of Technology (UTAUT) as a framework, we conducted a discursive exploration, supplemented by a literature review from diverse academic sources. Keywords related to UTAUT, digitalization, nursing practice and technology adoption were searched on PubMed, CINAHL and Google Scholar. Additionally, UK government and professional regulator reports were…

AIMS: Synthesize a review of reviews of the family's role in supporting adherence to diabetes self-care management practices (DSMP) for adults with type 2 diabetes (DM2). DESIGN: An umbrella review. DATA SOURCES: Scopus, Web of Science including MEDLINE, CINAHL via EBSCO, PubMed and Science Direct were searched for systematic reviews from their year of establishment until June 2021. REVIEW METHODS: The review followed the Joanna Briggs Institute (JBI) guidelines for umbrella reviews. The JBI data extraction form for systematic reviews and research syntheses was used for data extraction. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Systematic reviews and Research Syntheses. RESULTS: Nineteen reviews met the inclusion criteria. The key findings were summarized using a narrative and thematic analysis methods. Four main themes were identified: family interactions and diabetes self-management, family support as informal social support, factors affecting families' roles, and tailoring culturally sensitive family-based interventions. CONCLUSION: There…

AIMS: Fear of cancer recurrence (FCR) is a multifaceted concept influenced by individual characteristics, social support, psychological factors. This study aims to identify distinct FCR profiles among breast cancer patients and explore the associated variables with these patterns. DESIGN: A cross-sectional study was conducted from April 2022 to March 2023. METHODS: A convenience sample of 339 patients completed a questionnaire that assessed general and disease-related data, including the Fear of Progression Questionnaire-Short Form, Social Support Rating Scale, Medical Coping Modes Questionnaire. Statistical analysis involved latent profile analysis (LPA) and multinomial logistic regression. RESULTS: Three latent patterns of FCR were found: the low fear (28.9%), the moderate fear (51.3%), and the high fear (18.0%). The study identified the social support, family monthly income, employment status, utilization of confrontation coping mode and avoidance coping mode, as factors that impacted the FCR. CONCLUSIONS: Social support, family monthly income, employment status, and medical…

AIMS: To discuss how Husserl's descriptive phenomenology, as a philosophy and approach, has been used and reported in researching the experiences of others, using the topic of foreign-trained nurses. DESIGN: Discussion paper. DATA SOURCES: A systematic search of MEDLINE (PubMed), CINAHL, SCOPUS, British Nursing Database and PsycInfo was carried out in December 2021. The inclusion criteria were peer-reviewed phenomenological research articles, grounded by Husserl's philosophy, conducted among foreign-trained nurses and published in English from 2000 to 2021. FINDINGS: Two main themes were the outcome of critically reviewing relevant selected literature, 'referring to the original philosophy is not enough' and 'phenomenological findings need to be phenomenological'. These findings confirm some arguments about nurse researchers' discrepant use of phenomenology in their studies, including the proper application of phenomenological notions on the ground. IMPLICATION FOR NURSING: Nurse researchers need to clearly distinguish between phenomenology and other qualitative research approaches…

AIM: To identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally. DESIGN: Integrative review. METHODS: The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal Tool. A deductive content analysis based on Elo and Kyngäs' methodology was employed. DATA SOURCES: CINAHL, MEDLINE, EMBASE, Web of Science, British Education Index, GreenFILE and Scopus were searched up to the 8th November 2022. RESULTS: Thirty-two studies were included in the review. Two studies included nursing educators in their samples, the rest focused solely on students. Findings suggest that whilst some students were aware of sustainability issues and felt that nurses have a responsibility to mitigate climate change, others showed limited awareness and believed that nurses have more important priorities. A global interest was seen among students for increased curricular content related to sustainability and climate change. Waste management…

AIMS: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self-efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. DESIGN: A cross-sectional study. METHODS: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self-efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. RESULTS: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and…

AIM: To refine the Rushton Moral Resilience Scale (RMRS) by creating a more concise scale, improving the reliability, particularly of the personal integrity subscale and providing further evidence of validity. BACKGROUND: Healthcare workers are exposed to moral adversity in practice. When unable to preserve/restore their integrity, moral suffering ensues. Moral resilience is a resource that may mitigate negative consequences. To better understand mechanisms for doing so, a valid and reliable measurement tool is necessary. DESIGN: Cross-sectional survey. METHODS: Participants (N = 1297) had completed ≥1 items on the RMRS as part of the baseline survey of a larger longitudinal study. Item analysis, confirmatory factor analyses, reliability analyses (Cronbach's alpha), and correlations were used to establish reliability and validity of the revised RMRS. RESULTS: Item and confirmatory factor analysis were used to refine the RMRS from 21 to 16 items. The four-factor structure (responses to moral adversity, personal integrity, relational integrity and moral efficacy) demonstrated adequate…

AIM: To investigate barriers to healthcare professionals recognizing and managing delirium in hospitalized older people. DESIGN: A mixed-methods systematic review. PROSPERO ID: CRD42020187932. DATA SOURCES: MEDLINE, EMBASE, PsycINFO and CINAHL were searched (2007 to February 2023). REVIEW METHODS: Included studies focused on healthcare professionals' recognition and management of delirium for patients aged 65 years and over in a hospital ward or emergency department. Enhancing rigour, screening of results was conducted independently by two researchers. Qualitative and quantitative data were tabulated separately and grouped. Data were compared to identify similarities and differences. All studies were quality appraised. RESULTS: 43 studies were included; 24 quantitative, 16 qualitative and three mixed-methods. Data synthesis highlighted synergy between qualitative and quantitative findings. Barriers were reflected in six themes: (1) healthcare professionals' knowledge and understanding; (2) communication; (3) workforce development; (4) interprofessional working; (5) confounders; and…

AIMS: Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. DESIGN: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach. METHODS: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audio-recorded and then inductively coded and developed into themes. RESULTS: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3)…

AIM: To examine the influence of hospital culture and authentic leadership on the effects of quality improvement practices on patient satisfaction. BACKGROUND: Nurses in formal leadership roles shape and are shaped by organizational culture to achieve high performance standards to influence quality of care. DESIGN: Using structural equation modelling, we tested a model on quality improvement practices across three participant groups that differed based on authentic leadership and hospital culture. METHODS: We used survey data from a cross-sectional study conducted in 2015 measuring nurse. Managers' perceptions of authentic leadership, implementation of quality improvement, and organizational culture in Canadian hospitals. RESULTS: 226 nurse managers participated. Our model estimations fit for the high-relational group and mixed group. Our model explained 50.7% and 39.5% variance in our outcome variable of patient satisfaction for the high-relational group and mixed group, respectively. Our model failed to fit the low-relational group. CONCLUSION: Authentic leadership and…

AIMS: To evaluate and synthesize psychometric properties of the MOS-SSS and to identify quality versions of MOS-SSS for use in future research and practice. DESIGN: A psychometric systematic review. DATA SOURCES: Articles about the translation, adaptation, or validation of the MOS-SSS in Medline, PubMed, CINAHL, and Web of Science and their reference lists published before 11 November 2022. REVIEW METHODS: The review followed the Consensus Standards for the Selection of Health Measurement Instruments guidelines. RESULTS: The review included 35 articles. Eleven versions of MOS-SSS (3, 4, 5, 6, 8, 12, 13, 16, 18, 19, and 22 items) have been validated in various populations and 13 languages. Of 14 studies developing a translated version of MOS-SSS, four studies performed both an experts' evaluation of content validity and a face validity test; two studies reported translation evaluation in the form of a content validity index. Of 35 studies, six performed both exploratory factor analysis and confirmatory factor analysis for structural validity; hypotheses and measurements for construct…

AIMS: To evaluate the effects of couple-based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months). DESIGN: A systematic review and meta-analysis. DATA SOURCES: Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022. REVIEW METHODS: The quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment. RESULTS: Nineteen RCTs were included. For patients' overall effects, couple-based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well-being; body image) and social…

AIMS: To synthesize the published studies on medication adherence trajectories among patients with chronic diseases and identify the influencing factors. DESIGN: Systematic review. DATA SOURCES: Medline (Ovid), Embase (Ovid) and Web of Science core collection were searched from database inception to 1 July 2022. REVIEW METHODS: Potentially eligible articles were independently screened by three reviewers using set inclusion and exclusion criteria. The Joanna Briggs Institute critical appraisal checklist for cohort studies was used to appraise the quality of the included articles. Three reviewers independently evaluated the quality, extracted data and resolved differences by consensus. Results were presented using descriptive synthesis, and the prevalence of recategorised medication adherence trajectories was calculated from the published data. RESULTS: Fifty studies were included. Medication adherence trajectories among patients with chronic diseases were synthesized into six categories: adherence, non-adherence, decreasing adherence, increasing adherence, fluctuating adherence and…

AIM: To critically examine nurses' experiences of speaking up during COVID-19 and the consequences of doing so. DESIGN: Longitudinal qualitative study. METHODS: Participants were purposively sampled to represent differing geographical locations, specialities, settings and redeployment experiences. They were interviewed (remotely) between July 2020 and April 2022 using a semi-structured interview topic guide. RESULTS: Three key themes were identified inductively from our analysis including: (1) Under threat: The ability to speak up or not; (2) Risk tolerance and avoidance: Consequences of speaking up; and (3) Deafness and hostility: Responses to speaking up. Nurses reported that their attempts to speak up typically focused on PPE, patient safety and redeployment. Findings indicate that when NHS Trusts and community services initiated their pandemic response policies, nurses' opportunities to speak up were frequently thwarted. CONCLUSION: Accounts presented in this article include nurses' feeling a sense of futility or of suffering in silence in relation to speaking up. Nurses also…

AIMS: The aims of the study were to describe the processes used to introduce advanced practice nursing roles and factors that facilitated or hindered role implementation, examine the time advanced practice nurses (APNs) spend in role activities and how these activities relate to domains of advanced practice nursing and examine how implementation processes influenced APN integration within healthcare teams. DESIGN: A multiple case study was conducted. METHODS: Five cases were included, representing the four population areas approved for advanced practice nursing in France. Data were collected from January to March 2021 using observation, interview and document analysis methods. Data were examined using thematic analysis. RESULTS: Participants included APNs (n = 5), nurses/allied health providers (n = 5), physicians (n = 5), managers (n = 4) and decision-makers (n = 4). Stakeholder engagement and leadership provided by decision-makers, managers, physicians and APNs facilitated role implementation. Poor stakeholder role understanding, uncertain role funding, and the COVID-19 pandemic…

AIM: To identify the barriers associated with inadequate antenatal attendance by disadvantaged women in Australia and to further explore how these barriers are experienced by this population group. DESIGN: A qualitative descriptive study utilizing semi-structured interviews and thematic analysis. METHODS: Interviews were conducted with 11 pregnant women who self-identified as experiencing disadvantage, purposively sampled from a local government area of Victoria, Australia, characterized by socio-economic disadvantage. Data were collected from February to July 2019. RESULTS: Study participants reported a range of barriers to receiving timely and adequate antenatal care (ANC). For several women, a combination of personal (e.g., emotions, knowledge), health service provision (e.g., limited access to continuity of care provider and continuity of information, inflexible scheduling, difficulty travelling, staff attitudes), and broader social-contextual factors (e.g., financial situation, language, cultural norms) were ultimately insurmountable. Whereas some barriers were experienced as…

INTRODUCTION: The global nursing workforce is predominantly female, with a large proportion working in the 45-55 age group. Menopause is a transition for all women, and; therefore needs recognition as it can impact work performance and consequently staff turnover. BACKGROUND: Women will go through the menopause, but not all women are affected. The menopause transition presents a range of signs and symptoms both physical and psychological which can impact the quality of life and individuals' work/life balance. The nursing workforce is predominantly women that will work through the menopause transition. OBJECTIVES: The study explored perspectives on digital health interventions as strategies to support menopausal women and to understand the requirements for designing health interventions for support in the workplace. DESIGN: A qualitative explorative design. SETTINGS: Nurses working in a range of clinical settings in England, Finland, Denmark, New Zealand, Australia and USA. METHODS: Nurses (n = 48) participated in focus groups from six different countries from February 2020-June 2022…

AIMS: To explore the experiences and consequences of bariatric surgery stigma from the perspective of bariatric surgery patients and to identify knowledge gaps in the literature. DESIGN: A scoping review. DATA SOURCES: Studies published between December 2002 and January 2022 were identified from the following databases: PubMed, Web of Science, PsycINFO and MEDLINE. REVIEW METHODS: We screened 3092 records and included 28 studies. Findings were grouped thematically using the health stigma discrimination framework. RESULTS: Patients experienced several types of stigmas, including perceived, experienced, anticipated and internalized stigma, related to undergoing bariatric surgery. Patients were confronted with negative comments and judgement from others when they disclosed their decision to have surgery or when they revealed that they had undergone surgery. These experiences led to conflicts in the decision-making process, such as delaying the choice for surgery, seeking surgery abroad or opting out. Patients who internalized stigma often reported feelings of shame and embarrassment…

BACKGROUND: Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate. PURPOSE: The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate. DESIGN: A quasi-experimental study using a one-group pretest-posttest design consistent with TREND guidelines. METHODS: The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis. RESULTS: Following the intervention, safety climate and…

AIMS: The aim of this study was to explore factors that influence family caregiver readiness to adopt health smart home technology for their care-dependent older adult family member. Health smart homes are designed to remotely monitor the health and wellness of community-dwelling older adults supporting independent living for as long as possible. Accordingly, if the health smart home is deployed into the home of a care-depended older adult, it can potentially support family caregivers by facilitating workforce participation and give piece of mind to the family caregiver who may not live close to the older adult. However, wider adoption of health smart home technologies into the homes of community-older adults is low, and little is known about the factors that influence the readiness of family caregivers to adopt smart home technologies for their care-dependent older adults. DESIGN: A qualitative Descriptive study design was utilized. METHODS: Qualitative data were collected between 2019 and 2020 via semi-structured interviews. Thematic analysis of interviews was completed, and data…

AIMS: To (a) explore the experiences of early career registered nurses in rural hospitals in Australia and (b) identify strategies they believe would help increase job satisfaction and retention. DESIGN: Qualitative descriptive design. METHODS: Thirteen registered nurses located in outer regional, remote or very remote (herein 'rural') Australian hospitals participated in semi-structured interviews. Participants had graduated from a Bachelor of Nursing program in 2018-2020. Data were analyzed using thematic analysis and an essentialist, bottom-up approach. RESULTS: Seven themes related to the experiences of rural early career nursing: (1) appreciate diverse scope of practice; (2) rewarding sense of community and opportunity to give back; (3) staff support determines the quality of experience; (4) feeling underprepared and the need for ongoing education; (5) diverse views on the optimal length of rotation and level of input into choice of clinical area; (6) difficulty maintaining work/life balance due to work hours and rostering; and (7) lack of staff and resources. Strategies to…

AIM: A critical discussion of the intersections between racism and colonialism as social determinants of health and explore how these discriminatory ideologies shape nursing inquiry. DESIGN: Discussion paper. DATA SOURCES: A review of pertinent discourse on racism and colonialism in nursing from 2000 to 2022. IMPLICATIONS FOR NURSING: The failure to address health inequity plaguing racialized and marginalized populations locally and globally affects all groups, as illustrated in the COVID-19 pandemic. Racism and colonialism are inextricably linked, creating potent forces that influence nursing scholarship and adversely affect the health of a culturally and racially diverse society. Power differentials exist within and between countries creating structural challenges that lead to inequitable distribution of resources and othering. Nursing cannot be abstracted from the sociopolitical context in which it exists. There have been calls to address the social drivers that influence the health of the communities. More still needs to be done to support an antiracist agenda and decolonize…

AIM: To evaluate the impact of a virtual reality (VR) intervention on adult patients' preoperative anxiety, heart rate, respiration rate and blood pressure. 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 studies in English or Chinese on RCTs from their inception to 31 May 2022. Detailed search strategies and the checklist are provieded in Supplementary files S1 and S2. REVIEW METHODS: Two researchers independently screened eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions 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: This study included 11 articles with a total of 892 participants. VR distraction comprised five studies, and VR exposure consisted of six studies. The results…

AIMS: To explore and describe registered nurses' perceptions and experiences of work well-being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay. DESIGN: Qualitative descriptive study. METHODS: Thirty-nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30-60 min. The semi-structured interview transcripts were transcribed verbatim and analysed inductively and thematically. RESULTS: Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID-19, uncertainty of role, workload and rostering, and finally, not feeling supported,…

AIM: To examine the concept of preparedness over time in research with informal caregivers of older adults. DESIGN: Concept analysis. METHODS: Rodgers' evolutionary method of concept analysis was used to guide this theoretical paper due to the dynamic nature of preparedness, which is influenced by both context and time. Using Rodgers' inductive approach, concept elements were derived from a content analysis of included studies. In the final step, to generate hypotheses and implications regarding the concept, the conceptual structure of preparedness of informal caregivers of older adults was connected to a theoretical problem in the nursing discipline using the Caregiving Stress Process Framework. DATA SOURCES: Four databases (EBSCO CINAHL, Ovid MEDLINE, Ovid PsycINFO and Scopus) were searched in November 2022 and updated in September 2023. No date limits were set for searching, as the intent was to analyse possible variations of the concept over time. RESULTS: The attributes of preparedness include self-confidence, having knowledge, skills and abilities to perform daily tasks,…

BACKGROUND: The commitment of nurses to their profession and workplace is closely linked to the delivery of high-quality patient care. Existing literature highlights the positive impact of commitment on care quality and patient outcomes. Conversely, a lack of commitment can lead to nurse burnout and disengagement. However, it remains unclear whether and how cultural beliefs and practices influence newly graduated nurses' commitment to the nursing profession and their workplace. AIM: To explore the cultural beliefs and practices influencing newly graduated nurses' commitment to the profession and commitment to their workplace during their first year of employment. DESIGN: A focused ethnographic study. METHODS: Data consisted of field notes from 94 h of participant observations and 10 semi-structured interviews with newly graduated nurses working in acute care settings in Denmark. Data were analysed using ethnographic content analysis. Data were collected between March and June 2022. RESULTS: The findings reveal a major theme, termed 'A State of Transience among Newly Graduated…

AIM: To explore if and how nurses' perceived organizational support affects their ability to handle and resolve ethical value conflicts. DESIGN: A mixed methods design with a longitudinal questionnaire survey and focus group interviews. METHODS: A questionnaire survey in six hospitals in two Swedish regions provided data from 711 nurses responding twice (November-January 2019/2020 and November-January 2020/2021). A cross-lagged path model tested the mutual prospective influence between the organizational climate of perceived organizational support, frequency of ethical value conflicts, and resulting moral distress. Four focus group interviews were conducted with 21 strategically selected nurses (April-October 2021). Qualitative data collection and analysis were inspired by Grounded Theory. RESULTS: A climate of perceived organizational support was empowering, contributing to role security. It prospectively decreased the frequency of ethical value conflicts but not the moral distress when conflicts did occur. CONCLUSION: It is important to facilitate the development of perceived…

AIM: The purpose of this study was to explore the relationship between nurses' well-being and their ethical leadership, and the mediating role of workplace mindfulness in this relationship. DESIGN: This was a quantitative cross-sectional study. METHODS: This cross-sectional study was conducted in three tertiary hospitals in central China from May 2022 to July 2022, and the Nurses' Workplace Mindfulness, Ethical Leadership and Well-Being Scale were distributed and collected via the Internet. A total of 1579 nurses volunteered to participate in this study. SPSS 26.0 statistical software was used to analyse the data by Z-test and Spearman's rank correlation; the internal mechanism of workplace mindfulness and ethical leadership on nurses' well-being was completed by AMOS 23.0 statistical software. RESULTS: The scores of nurses' well-being, workplace mindfulness and ethical leadership were 93.00 (81.00, 108.00), 96.00 (80.00, 112.00) and 73.00 (67.00, 81.00) respectively. The professional title, age and department atmosphere affect their well-being. Spearman's analysis showed that…

AIM: Despite the documented benefits of the World Health Organisation Patient Safety Checklist compliance rates with implementation continue to cause risk to patient safety. This qualitative systematic review aimed to explore the reported factors that impact compliance and implementation processes related to surgical safety checklists in perioperative settings. DESIGN: A qualitative systematic review. METHODS: A systematic review using the Joanna Briggs Institute (JBI) approach to synthesize qualitative studies was conducted and reported according to PRISMA guidelines. Electronic databases were expansively searched using keywords and subject headings. Articles were assessed using a pre-selected eligibility criterion. Data extraction and quality appraisal was undertaken for all included studies and a meta-aggregation performed. DATA SOURCES: The CINAHL, Medline and Scopus databases were searched in August 2022 and the search was repeated in June 2023. RESULTS: 34 studies were included. Following the synthesis of the findings there were multiple interrelating barriers to checklist…

AIMS: This study aimed to measure sleep quality and its possible association with fear of progression (FOP) in patients with chronic heart failure (HF). DESIGN: A cross-sectional study. METHODS: A total of 254 patients with chronic HF were recruited from two tertiary hospitals in China. The sociodemographic and clinical data of participants were collected using a general information questionnaire. The Pittsburgh Sleep Quality Index and Fear of Progression Questionnaire-Short Form were used to evaluate sleep quality over 1 month and FOP. Pearson correlation and hierarchical regression were conducted to analyse the relationship between sleep quality and FOP. RESULTS: Of all participants, 85.8% had poor sleep quality, with a mean score of 12.3 ± 4.2 (possible score could be 0 to 21). The severity of FOP was positively correlated with poor sleep quality. HF hospitalization in the past year, numbers of HF drugs, monthly income and total score of FOP were strong predictors of decreased sleep quality, accounting for 24.2% of the variance in the sleep quality of these patients. CONCLUSIONS:…

AIMS: Our study aims to investigate the effect of work-life balance programmes on Chinese nurses' psychological well-being, directly and indirectly, via learning goal orientation. Our research also aims to investigate the moderating role of servant leadership, a holistic leadership style that prioritizes serving employees, in the association between work-life balance programmes and psychological well-being. DESIGN: A questionnaire-based, time-lagged study (1-week interval). METHODS: From September 2022 to October 2022, we collected a total of 211 matched and valid responses from nurses working for hospitals in Jiangsu Province, China. Data regarding work-life balance programmes, servant leadership, learning goal orientation and psychological well-being were gathered using a survey administered in two waves, 1 week apart. We utilized the PROCESS Model 5 to test the moderated mediation model. RESULTS: Work-life balance programmes significantly improved nurses' psychological well-being. Moreover, learning goal orientation mediated the relationship between work-life balance programmes…

AIM: To report an analysis of the concept of community empowerment. DESIGN: Concept analysis. DATA SOURCES: Literature published in the CINAHL, PubMed, Scopus and Medline electronic databases from 2016 to 2022 were systematically searched from 30 July to 1 October 2022. METHOD: The amended guideline from Walker and Avant's approach (2011) to concept analysis was performed in nine stages: choosing a concept, determining the purpose of analysis, identifying definitions of the concept, defining attributes, identifying a model case, identifying antecedents, identifying consequences, defining empirical referents and applying the concept to nursing practice. RESULTS: Community empowerment is a fundamental idea in health promotion that may assist communities in defining priorities, making choices, developing strategies and executing them to improve health and minimize inequalities in health. Community empowerment is an effective tool that advanced practice nurses (APNs) may employ to eliminate health inequities and promote community health. CONCLUSION: This concept analysis is one step…

AIM: The aim of this systematic review is to describe and evaluate the effectiveness of transition interventions to safeguard patient safety and satisfaction during patients' transition from hospital to home health care. DESIGN: Systematic review. DATA SOURCES: MEDLINE, Ovid Nursing Database, PsycINFO, EMBASE, CINAHL, Clinical Trials and SveMed+ was systematic searched in January 2019 and September 2020 to identify peer-reviewed papers. No language, geographical or publication date restrictions. REVIEW METHODS: Cochrane Handbook for Systematic Reviews of Interventions was used. Data analysis focused on aggregated data and a descriptive synthesis. Risk of bias was rated using Cochrane risk-of-bias tool. RESULTS: In total, 10,524 references were identified in the literature search, twenty-six articles were included. The interventions were divided into three main groups: (i). systematic patient education pre-discharge; (ii). establishment of contact with the local healthcare services pre-discharge and (iii). follow-up initiated by nurses from the hospital at home post-discharge. The…

AIM: To explore the factors that affect the experiences of autistic patients in the hospital setting. DESIGN: A scoping review. DATA SOURCES: A systematic literature search using the databases CINAHL, Medline and Google Scholar was undertaken in September 2021 and updated in January 2023. This review is based on the methodological framework of Arksey and O'Malley (International Journal of Social Research Methodology, 8(1):19-32, 2005), which was further refined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. RESULTS: Autistic patients, as well as their families and healthcare staff, face several barriers that can impact their healthcare experiences within hospital settings. Of 211 articles screened, 30 were eligible and included. Through our review, we identified two main themes. The first theme, 'challenges to hospital experiences', includes four sub-themes: (1) communication, (2) a mismatch between the needs for autistic patients and the hospital environment, (3) challenges related to parents' experiences and (4) challenges…

AIMS: This scoping review aims to identify existing theories associated with digital nursing practice to add a lens on the future use of digital technologies by nurses. DESIGN: A review of theories related to digital technology in nursing practice was conducted following the framework described by Arksey and O'Malley. All published literature until 12th May 2022 was included. DATA SOURCES: Seven databases were utilized including Medline, Scopus, CINAHL, ACM Digital Library, IEEE Xplore, BNI and Web of Science. A Google Scholar search was also performed. REVIEW METHODS: The search terms included (nurs* AND [digital OR technol* OR e-health or ehealth or digital health or telemedicine or telehealth] AND theory). RESULTS: The database searches yielded 282 citations. After screening, nine articles were included in the review. These described eight distinct nursing theories. CONCLUSION: The focuses of the theories included the role of technology in society and nursing. How technology should be developed to support nursing practice, health consumers' use of nursing informatics, the use of…

AIMS: To describe nurse managers' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them. DESIGN: A qualitative study using interviews. METHODS: A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis. RESULTS: The study identified three main categories: (1) Management of second victim support, which contained three sub-categories related to the nurse manager's role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub-categories developing practices and developing an open and non-blaming patient safety culture. CONCLUSION: Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional…

Abstract Aim This study aimed to investigate the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions. Design This cross‐sectional study was conducted using an online survey of 168 nurses working in public and university hospitals. Methods Data were collected between April and November 2022 with the Toxic Leadership Scale, Organizational Trust Scale and Turnover Intention Scale. Descriptive statistics, correlations, and regression analyses were used to analyse these data. Results It was determined that almost half of the nurses (46.4%) were exposed to negative behaviours from their managers within the last year. Nurses' perception of toxic leadership, organizational trust level and turnover intention were moderate. It was found that nurses' perceptions of toxic leadership had a negative effect on organizational trust level ( R 2 = .691; β = −0.832; p < .05) and a positive significant effect on turnover intention ( R 2 = .267; β = 0.521; p < .05). Conclusions This study revealed that toxic leadership behaviours in…

AIMS: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. DESIGN: Cross-sectional survey conducted January to April 2020. METHODS: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. RESULTS: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with…

AIMS: To understand the experience of loss in Australian women with endometriosis. DESIGN: A total of 532 participants completed an online survey containing three open-ended questions relating to pelvic pain and activity loss due to endometriosis. Participants were Australian women aged between 18 and 50 years (M = 30.8, SD = 7.1) with a self-reported diagnosis of endometriosis. An inductive, qualitative approach, with template analysis was used to identify and organize themes. A pragmatic feminist perspective was used to interpret the findings. RESULTS: Three main themes were identified: the loss of liberty: 'I'm trapped in the house'; the loss of bodily autonomy: 'I can barely move/breathe/talk' and loss of connection: 'It stops me from being social'. Pain emerged as the greatest concern for participants, preventing them from the physical functioning required to participate in many of life's activities. CONCLUSIONS: The losses women with endometriosis experience are wide-reaching, restricting control and choice across multiple life domains. Losses were often unacknowledged by…

AIMS: To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). DESIGN: A cross-sectional study. METHODS: A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness. RESULTS: Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with…

AIMS: To evaluate the features of depressive and anxiety symptoms and illness perception and their associations in patients with acute coronary syndrome (ACS). DESIGN: Secondary analysis of data from a cross-sectional study and baseline data from a randomized controlled trial. METHODS: From June to July 2019 and June to September 2020, patients with ACS in four public hospitals in China completed measurements of depressive and anxiety symptoms, illness perception, and sociodemographic and clinical characteristics. Data were analysed using univariate and multiple logistic regression analyses. RESULTS: This study included 510 participants (mean age, 61.0 ± 9.9 years; 67.8% male). The prevalence of depressive and anxiety symptoms was 66.3% and 56.5%, respectively. Total score of illness perception was 43.5 ± 9.1 and mean scores of each dimension ranged from 5.5 to 7.6, suggesting relatively negative illness perceptions. The top two perceived causes of illness were negative emotions or stress (27.3%) and dietary habits (25.5%) and 24.7% of participants were unaware of causes regarding…

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…

AIMS: To examine (1) the association between healthcare workers' workplace ostracism and job satisfaction, stress and perceived health, and (2) whether this relationship is mediated by loneliness and self-esteem. DESIGN: A cross-sectional study. METHODS: Healthcare (N = 569) managers and employees (nurses, practical nurses, doctors and social workers) in Finland responded to a semi-structured survey in January 2021 and evaluated their experiences of workplace ostracism, job satisfaction, stress, perceived health, loneliness and self-esteem during the last year. To examine the association of these variables, linear regression and mediator model tests were performed. RESULTS: Workplace ostracism had a clear direct association with job satisfaction, stress and perceived health. Loneliness fully mediated the relationship between workplace ostracism, stress and perceived health, and partly mediated the association between workplace ostracism and job satisfaction. Self-esteem partly mediated the association between workplace ostracism, stress, job satisfaction and perceived health.…

AIMS: To explore the current situation, influencing factors and pathways of safety behaviour of nurses in tumour specialized hospitals, in order to provide a theoretical basis for managers to manage and train nurses, improve their safety behaviour level and ensure medical safety. DESIGN: An anonymous cross-sectional survey. METHOD: A total of 2147 nurses from Grade A cancer hospitals in 15 provinces of China were selected by a convenient sampling method. Questionnaires were collected through the Questionnaire Star platform. Nurses' safety behaviour was measured using the nurse Safety Behaviour Scale, Self-efficacy by the General Self-efficacy Scale, and nurses' occupational burnout was measured by the occupational Burnout Scale, and work engagement through the the Work Engagement Scale. Structural equation modelling was used to test the relationship among nurses' safety behaviour, general self-efficacy, occupational burnout and work engagement. SPSS25.0 software was used to test the relationship among the safety behaviour of nurses, general self-efficacy, occupational burnout and…