Impact of Nurse-Patient Relationship on Quality of Care and Patient Autonomy in Decision-Making

Nursing privilege: A concept analysis

AIM

The study aimed to provide a comprehensive concept analysis of nursing privileges by elucidating its meaning and implications within the healthcare context.

DESIGN

A concept analysis paper.

METHODS

A comprehensive literature review was conducted from nursing and healthcare databases, professional nursing organizations, and regulatory bodies. Documents reviewed include research studies, policy documents and professional guidelines. The study employed Walker and Avant's eight-step method of concept analysis. This involved identifying the uses of the concept, its underlying attributes and referents, and constructing model, borderline, related and contrary cases. The antecedents, consequences and empirical referents of nursing privileges were also determined.

RESULTS

The analysis uncovered vital attributes defining nursing privileges, encompassing professional authority, autonomy, access to resources, information, influence, decision-making power, respect and recognition. Additionally, antecedents and consequences of nursing privilege were identified, spanning development and resource access, as well as professional satisfaction and enhanced patient care.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Nurses' views of patient- and family-centered care and its practices in peri-operative contexts in hospitals in Northern Ghana

BACKGROUND

The purpose of the study was to explore the views of nurses on the concept of patient- and family-centered care (PFCC) and its practices in a peri-operative context in Northern Ghanaian hospitals.

METHODS

The study, using a qualitative explorative, descriptive, and contextual research design was conducted at six selected hospitals located in the Northern part of Ghana. Purposive sampling was used to recruit participants for individual and focus group interviews. Data were generated between March and May 2022. Data saturation was reached with 27 participants comprising 15 individuals and 12 members from two focus group interviews. All interviews were digitally recorded and transcribed verbatim and the data analyzed using thematic analysis.

RESULTS

Two themes emerged from the study, namely nurses' understanding of the concept of PFCC and how they see the benefits of PFCC in a peri-operative context. Subthemes of the nurses' understanding of PFCC included their perceptions of PFCC, the need for collaboration, supporting the patient's family for better post-operative and effective communication, and PFCC practices in the peri-operative context. Subthemes for benefits of PFCC in the peri-operative context included nurse-related benefits, patient- and family-related benefits, and healthcare system-related benefits.

CONCLUSIONS

The study revealed that the concept of PFCC is unfamiliar to the Ghanaian peri-operative context despite the positive perceptions exhibited by the nurses in terms of their understanding of PFCC and its related benefits to nurses, patients, and families as well as the healthcare system.

Dual-loaded liposomal carriers to combat chemotherapeutic resistance in breast cancer

INTRODUCTION

The resistance to chemotherapy is a significant hurdle in breast cancer treatment, prompting the exploration of innovative strategies. This review discusses the potential of dual-loaded liposomal carriers to combat chemoresistance and improve outcomes for breast cancer patients.

AREAS COVERED

This review discusses breast cancer chemotherapy resistance and dual-loaded liposomal carriers. Drug efflux pumps, DNA repair pathways, and signaling alterations are discussed as chemoresistance mechanisms. Liposomes can encapsulate several medicines and cargo kinds, according to the review. It examines how these carriers improve medication delivery, cancer cell targeting, and tumor microenvironment regulation. Also examined are dual-loaded liposomal carrier improvement challenges and techniques.

EXPERT OPINION

The use of dual-loaded liposomal carriers represents a promising and innovative strategy in the battle against chemotherapy resistance in breast cancer. This article has explored the various mechanisms of chemoresistance in breast cancer, emphasizing the potential of dual-loaded liposomal carriers to overcome these challenges. These carriers offer versatility, enabling the encapsulation and precise targeting of multiple drugs with different modes of action, a crucial advantage when dealing with the complexity of breast cancer treatment.

Association of burnout and harassment among cardiology trainees: Pakistan's perspective

OBJECTIVE

This study explores the relationship between sexual harassment and burnout among cardiology trainees, shedding light on the prevalence and impact of these experiences in medical practice.

METHODS

A cross-sectional online survey was conducted among 518 respondents, with 420 responding to the Sexual Experience Questionnaire (SEQ). The survey measured harassment experiences and their impact on burnout, especially among female physicians. Correlations were analyzed to understand the association between these variables.

RESULTS

Out of 1,375 invitees, we received 671 (48.8 %) responses. The study population was divided into two main groups: males (359) and females (312). The study identified a high prevalence of sexual harassment experiences among female physicians, with incidents occurring primarily during training. Moderate to large correlations were observed between SEQ subscales related to colleagues and patients and their families. While sexual harassment was not significantly related to burnout, this study suggests the need for interventions to create a safer medical workplace. Approximately 22 % of male participants (n = 359) reported career-related inappropriate sexual incidents, with 28 % of male physicians experiencing weekly burnout. Among female participants (n = 312), around 37 % reported inappropriate incidents, while 42 % of female physicians felt weekly burnout.

CONCLUSION

Sexual harassment in medicine is a pervasive issue with potential implications for physician well-being. Initiatives aimed at changing the organizational response and fostering a more equitable environment are warranted to address this critical concern.

Emergency room nurses' caring ability and its relationship with patient safety outcomes: A cross-sectional study

INTRODUCTION

Nurse caring ability plays a crucial role in providing quality care and ensuring patient safety. However, further research is warranted to understand the specific impact of caring ability on patient safety in the emergency department.

AIM

This study has two-fold purposes: (a) to examine the association between nurses' demographic characteristics and their perceptions of their caring ability, and (b) to explore the relationship between nurses' caring ability and nursing care quality, as well as its impact on adverse patient events and missed care.

METHODS

This cross-sectional study included a convenience sample of emergency room nurses working in select hospitals in the Philippines. Descriptive statistics and regression analyses were performed to analyze the data.

RESULTS

A total of 164 out of the 200 emergency nurses invited responded to the survey. The mean score for the caring ability inventory was 67.89 out of 80. Nurses' demographic characteristics, including job status (working part-time) and hospital size (working in small and medium-sized hospitals), were associated with higher levels of caring ability. Higher levels of nurses' caring ability were associated with better nursing care quality (β = 0.259, p <.001), a reduction in adverse events (β = -0.169, p <.05), and a decrease in instances of missed care (β = -0.158, p <.01).

CONCLUSION

This study emphasizes the significance of nurses' characteristics in influencing nurse caring abilities. Additionally, the results underscore the importance of nurse caring ability in the emergency department and its association with nursing care quality and patient safety outcomes. Organizational strategies directed toward promoting and enhancing nurse caring ability in the emergency department can have positive implications for nursing practice, including improved nursing care quality, reduced adverse events, and decreased instances of missed care.

Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: a cross-sectional study

BACKGROUND

One of the global issues facing the nursing profession is work-related stress because it interferes with care quality and organisational competency. These kinds of stressful situations can cause damage to the mental ability of the affected individual resulting in low job productivity. In a Nigerian healthcare setting, patient safety is under-researched.

AIM

This study aimed to assess the influence of work-related stress on patient safety culture among nurses in a tertiary hospital.

MATERIALS AND METHODS

The study adopted a descriptive cross-sectional survey. The Population of the study was nurses who are currently serving as employees at Federal Medical Center Birnin-Kebbi. Proportional and systematic sampling methods were used in the selection of the sample of the study. The tools used for this study were adapted Hospital Survey on Patient Safety (HSOPS) and Nurses' Occupational Stressor Scale. Ethical approval was obtained from the research ethical committee of the hospital.

RESULTS

The moderate stress experience was having the highest percentage (45.0%). The highest percentage of the nurses (69.9%) practised a moderate safety culture. There were weak or very weak significant negative correlations (P < 0.01) between patient safety culture practices and occupational stress across all the subscales of the nurses' occupational stressors scale except in the occupational hazards subscale in which there was extremely weak and non-significant negative correlation. Work-family conflict was a significant predictor of patient safety culture, t (208) = -2.341, P < 0.05. Difficulty in taking leave was a significant predictor of patient safety culture, t (208) = -2.190, P < 0.05.

CONCLUSION

There was a significant negative correlation between stress and safety practice which implies that as stress increased safety practice decreased. These study findings can be used to develop ongoing strategies and targeted interventions in addressing work-related stress.

Are the European reference networks for rare diseases ready to embrace machine learning? A mixed-methods study

BACKGROUND

The delay in diagnosis for rare disease (RD) patients is often longer than for patients with common diseases. Machine learning (ML) technologies have the potential to speed up and increase the precision of diagnosis in this population group. We aim to explore the expectations and experiences of the members of the European Reference Networks (ERNs) for RDs with those technologies and their potential for application.

METHODS

We used a mixed-methods approach with an online survey followed by a focus group discussion. Our study targeted primarily medical professionals but also other individuals affiliated with any of the 24 ERNs.

RESULTS

The online survey yielded 423 responses from ERN members. Participants reported a limited degree of knowledge of and experience with ML technologies. They considered improved diagnostic accuracy the most important potential benefit, closely followed by the synthesis of clinical information, and indicated the lack of training in these new technologies, which hinders adoption and implementation in routine care. Most respondents supported the option that ML should be an optional but recommended part of the diagnostic process for RDs. Most ERN members saw the use of ML limited to specialised units only in the next 5 years, where those technologies should be funded by public sources. Focus group discussions concluded that the potential of ML technologies is substantial and confirmed that the technologies will have an important impact on healthcare and RDs in particular. As ML technologies are not the core competency of health care professionals, participants deemed a close collaboration with developers necessary to ensure that results are valid and reliable. However, based on our results, we call for more research to understand other stakeholders' opinions and expectations, including the views of patient organisations.

CONCLUSIONS

We found enthusiasm to implement and apply ML technologies, especially diagnostic tools in the field of RDs, despite the perceived lack of experience. Early dialogue and collaboration between health care professionals, developers, industry, policymakers, and patient associations seem to be crucial to building trust, improving performance, and ultimately increasing the willingness to accept diagnostics based on ML technologies.

The effectiveness of Balint group work on the quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses: a randomized controlled trial

Background

Balint group training has gained popularity in medical practices as an intervention designed to enhance the quality of life, well-being, and communication skills of healthcare practitioners. Psychiatric nurses, in particular, encounter distinct challenges and stressors inherent in their profession, necessitating the development and implementation of effective interventions to assist them in coping with the difficulties they experience. In this vein, the current study aimed to investigate the effectiveness of Balint group training on quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses.

Methods

Thirty psychiatric nurses from Razi Hospital in Tehran were recruited via the purposeful sampling method in 2022 and were randomly assigned to either the Balint group, consisting of eight weekly one-hour training sessions, or a control group. Participants completed the Walton Quality of Work Life Questionnaire, Connor-Davidson Resilience Scale, and Communication Skills Scale before and after the intervention. The data were analyzed using the Analysis of Covariance (ANCOVA).

Results

The study found no significant differences between the Balint group and the control group in terms of quality of work life, resilience, and nurse-patient communication skills.

Conclusion

Findings suggest that Balint group training was not an effective intervention for improving the well-being and communication skills of psychiatric nurses. However, the study highlights the need for further investigation into the potential factors that may explain the lack of significant gains and offers insights for future research in this area.

Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group study

BACKGROUND

The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination.

METHODS

This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis.

RESULTS

Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship.

CONCLUSION

According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students' awareness of the perspective of the relationship with patients with mental health disorder and its relevance.

A Comprehensive Review of Current Trends in the Diagnosis and Treatment of Ovarian Germ Cell Tumors

Ovarian germ cell tumors constitute a rare and intricate spectrum of neoplasms characterized by diverse histological subtypes. This comprehensive review elucidates the classification, diagnosis, treatment, prognosis, and unique challenges associated with these tumors. The classification is rooted in histological attributes, with principal subtypes encompassing dysgerminoma, immature teratoma, yolk sac tumor (endodermal sinus tumor), choriocarcinoma, and mixed germ cell tumors. Each subtype bears distinct characteristics and clinical implications, necessitating precise diagnosis and tailored therapeutic strategies. Diagnosis hinges upon recognizing the broad clinical presentation, employing imaging techniques (such as ultrasound and MRI), evaluating tumor markers (alpha-fetoprotein and beta-human chorionic gonadotropin), and conducting histopathological examinations where necessary. Staging, primarily utilizing the International Federation of Gynecology and Obstetrics (FIGO) system, is pivotal in determining the extent of disease, guiding treatment choices, and facilitating prognostic assessment. Treatment modalities encompass surgery, chemotherapy (including standard regimens and emerging therapies), radiation therapy, targeted therapies, and immunotherapy. Prognosis is influenced by histological subtype, tumor stage, patient age, surgical success, response to chemotherapy, and tumor markers, while predictive biomarkers are continually emerging. Despite advances in treatment, ovarian germ cell tumors pose distinct challenges, including late diagnosis, treatment-related side effects, and the enigma of chemoresistance. An integral aspect of comprehensive care is supportive strategies to manage symptoms and offer psychological and emotional support. This review accentuates the vital role of early diagnosis and multidisciplinary care in optimizing outcomes. Future research directions and evolving clinical practices are explored in these intricate and distinctive malignancies, highlighting the dynamic landscape of ovarian germ cell tumors.

The Effects of Patient-Centered Communication on Patient Engagement, Health-Related Quality of Life, Service Quality Perception and Patient Satisfaction in Patients with Cancer: A Cross-Sectional Study in Türkiye

INTRODUCTION

Patient-centered communication is a type of communication that takes place between the provider and the patient.

OBJECTIVES

It is aimed to reveal the effects of patient-centered communication on patient engagement, health-related quality of life, perception of service quality and patient satisfaction.

METHOD

The study was conducted by applying multiple regression analysis to the data obtained from 312 patients with cancer treated in a training and research hospital affiliated to the Ministry of Health in Diyarbakır, Türkiye.

RESULTS

More than half of the patients were female and had stage 4 cancer. Different types of cancer were detected (breast cancer, cancer of the digestive organs, lymphatic and hematopoietic cancer, cancer of the genital organs, cancer of the respiratory organs, etc.). It can be stated that the average values obtained by patients from patient-centered communication and its sub-dimensions are high. There are positive, moderate and low and significant relationships between the overall patient-centered communication and patient engagement, patient satisfaction, service quality perception and quality of life. It was statistically revealed that patient-centered communication positively affected patient engagement, health-related quality of life, service quality perception, and patient satisfaction.

CONCLUSION

Patient-centered communication positively affects various short and medium-term health outcomes and this study offers suggestions for improving patient-provider communication.

Factors Associated With the Nursing Care Experience of Patients Admitted to Riyadh Region Hospitals

Introduction

In the contemporary healthcare landscape, the paradigm of patient experience and patient-centered care has emerged as a crucial point for healthcare reform, emphasizing the patient's active role in shaping healthcare systems.

Objective

This study aimed to investigate the patient experience level of nursing care and examine associated factors among hospitalized patients in Riyadh, Saudi Arabia.

Methods

Cross-sectional secondary analysis of patient experience data included more than 8,000 patients discharged from Ministry of Health hospitals in Riyadh during 2022G. The national survey examined patient perceptions of multiple aspects of nursing care. Although most patients gave high overall scores, lower scores were observed for nurse introductions and prompt responses to call buttons. There are opportunities to improve communication and response through interventions targeting nurse staffing, training, and incentives. A checklist called Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to report the study.

Results

71.2% Of patients rated their nursing care experience as "very good." No differences were seen between genders. However, Saudi patients reported higher satisfaction than non-Saudis (p = .001). The top-scored nursing aspects were friendliness/courtesy (70.2% "very good") and nurses' skill level (65.8% "very good"). Lower ratings occurred for nurses who introduced themselves (54.0% "very good") and for prompt response to call buttons (58.5% "very good"). Targeted improvements in communication and responsiveness could help address these gaps in patient experience scores between nursing care domains.

Conclusions

Most of the patients indicated overall positive nursing care experiences, which include opportunities for improvement in nurse introductions and responsiveness to patient needs. Boosting communication through nurses consistently introducing themselves and managing heavy workloads to allow faster call button response times could enhance patients' perceptions of their nursing care quality.

Nurse managers' perceptions of patient-centred care and its influence on quality nursing care and nurse job satisfaction: Empirical research qualitative

AIM

To explore nurse managers' perceptions of patient-centered care (PCC), its influence on quality nursing care, nurse job satisfaction, and to provide baseline data for a context-driven PCC model.

DESIGN

The study utilized a qualitative, phenomenological design, employing individual in-depth interviews to collect data on nurse managers' PCC perceptions until data saturation.

METHODS

Sampling involved purposive selection of Northern Ghana, random selection of the tertiary hospital cluster with the three participating hospitals, and purposive sampling of the nine nurse managers. Data analysis employed thematic analysis based on a six-phase framework. Methodological trustworthiness was ensured through various strategies including prolonged engagement, supervisor discussions and crosschecking with interviewees.

RESULTS

Three main themes emerged from the study including nurse managers' conceptualization of PCC, perceived patient-centred practices and its influence on nursing quality and job satisfaction. The findings emphasized the patient's individuality, cultural values, holistic care, the importance of strong nurse-patient relationships and a patient-centric environment. The nurse managers perceived PCC as positively influencing quality nursing care and nurse job satisfaction. The findings offer nuanced insights into nurse managers' perspectives on patient-centeredness and highlight areas for improvement.

Empowering nurses: exploring self-managed organizations in Indian healthcare

BACKGROUND

Given India's high patient load on the existing healthcare setup, as well as political, social, and organizational challenges, the nursing sector is facing various problems, therefore leading to substandard nursing experiences leading to poor patient care at the parallel healthcare setups, specifically homecare. This paper presents self-managed organizations (SMOs) characterized by a horizontal management structure as an effective alternative to existing hierarchical management structures overladen with bureaucracy. Therefore, we are exploring the strategies at self-managed homecare organizations that can make nursing a better and more productive experience.

METHOD

This study utilized Constructivist Grounded Theory (CGT), employing semi-structured interviews to explore nursing dynamics in horizontal organizational structures. It delved into crucial aspects like finances, organizational structure, value systems, information flow, and conflict resolution within SMOs. The methodology involved theoretical sampling, prioritizing expert self-management knowledge over mere representativeness. Seven nurses, twelve management members, and fifteen patients from self-managed homecare organizations contributed to the examination of nursing experiences. Constant comparative analysis of data led to the identification of the Qualitative Success Enablers (QSEs), revealing three themes: Insightfulness, Enhancing Nursing Experience through Job Enrichment, and Autonomy-Enabled Intrapreneurship.

RESULTS

The findings indicate that the horizontal management structure represented by the studied organization in India has shown considerable success in times laden with uncertainties during the COVID-19 pandemic, especially during the delta wave, which revealed the frailty of existing healthcare infrastructure. The organization successfully maintained a better nursing experience and gained patient and employee satisfaction, as revealed by in-depth semi-structured interviews and constant comparative analysis.

CONCLUSION

In a world of unique challenges, we stand on the brink of significant transformations. SMOs are vital in India's homecare sector for enhancing nursing experiences and overall organizational performance. Fostering a trust-based environment within SMOs is integral to delivering effective services. The autonomy to design nursing jobs, insightfulness, and innovativeness in the nursing job through suitable training activities, various job enrichment methods, and finding meaningfulness in a job through softer aspects of caregiving result in an enhanced nursing experience at SMOs. This groundbreaking approach can be extended to other homecare organizations in India, relieving the strain on the existing healthcare system.

A Scoping Review of Adult Inpatient Satisfaction with Mental Health Services

Patient satisfaction with hospital services has been increasingly discussed as an important indicator of healthcare quality. It has been demonstrated that improving patient satisfaction is associated with better compliance with treatment plans and a decrease in patient complaints regarding doctors' and nurses' misconduct. This scoping review's objective is to investigate the pertinent literature on the experiences and satisfaction of patients with mental disorders receiving inpatient psychiatric care. Our goals are to highlight important ideas and explore the data that might serve as a guide to enhance the standard of treatment and patient satisfaction in acute mental health environments. This study is a scoping review that was designed in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) statement. A systematic search was conducted in the following databases: PubMed, MEDLINE, PsycINFO, CINAHL, and EMBASE. A comprehensive review was completed, including articles from January 2012 to June 2022. Qualitative and quantitative studies were included in this review based on our eligibility criteria, such as patient satisfaction as a primary outcome, adult psychiatric inpatients, and non-review studies published in the English language. Studies were considered ineligible if they included nonpsychiatric patients or patients with neurocognitive disorders, review studies, or study measure outcomes other than inpatient satisfaction. For the eligible studies, data extraction was conducted, information was summarized, and the findings were reported. A total of 31 studies representing almost all the world's continents were eligible for inclusion in this scoping review. Different assessment tools and instruments were used in the included studies to measure the level of patients' satisfaction. The majority of the studies either utilized a pre-existing or newly created inpatient satisfaction questionnaire that appeared to be reliable and of acceptable quality. This review has identified a variety of possible factors that affect patients' satisfaction and can be used as a guide for service improvement. More than half of the included studies revealed that the following factors were strongly recommended to enhance inpatient satisfaction with care: a clear discharge plan, less coercive treatment during the hospital stay, more individualized, higher quality information and teaching about the mental disorder to patients by staff, better therapeutic relationships with staff, and specific treatment components that patients enjoy, such as physical exercise sessions and music therapy. Patients also value staff who spend more time with them. The scope of patient satisfaction with inpatient mental health services is a growing source of concern. Patient satisfaction is associated with better adherence to treatment regimens and fewer complaints against health care professionals. This scoping review has identified several patient satisfaction research gaps as well as important determinants of satisfaction and how to measure and utilize patient satisfaction as a guide for service quality improvement. It would be useful for future research and reviews to consider broadening their scope to include the satisfaction of psychiatric patients with innovative services, like peer support groups and other technologically based interventions like text for support. Future research also could benefit from utilizing additional technological tools, such as electronic questionnaires.

Patients' experiences of patient-centred care in hospital setting: A systematic review of qualitative studies

BACKGROUND

Patient-centred care (PCC) has been proposed as an appropriate approach for addressing current shifts in healthcare needs. Although the importance of PCC is generally recognised, PCC is poorly understood by patients in the hospital settings.

OBJECTIVES

To identify patients' experiences of PCC in hospital settings.

METHODOLOGICAL DESIGN

This systematic review followed the Joanna Briggs Institute's (JBI) guidance for systematic reviews of qualitative evidence and the PRISMA checklist for reporting systematic reviews. The search strategy included peer-reviewed qualitative studies published after 2010 in English or Finnish. The databases searched were SCOPUS, MEDLINE, CINAHL and Medic. Unpublished studies and grey literature were searched in MedNar. Ten qualitative studies were included, and their quality was assessed by two independent reviewers using JBI quality assessment criteria. The data were analysed using thematic analysis.

SETTING AND PARTICIPANTS

Studies were included if they had explored adult patient experiences of PCC in hospital settings.

RESULTS

A thematic analysis produced 14 subthemes which were grouped into five analytical themes: the presence of the professional, patient involvement in care, receiving information, the patient-professional relationship and being seen as a person.

CONCLUSIONS AND IMPLICATIONS

This review suggests that the implementation and provision of PCC in hospitals is incomplete and patients' involvement in their own care should be in the focus of PCC. The majority of patients experienced receiving PCC, but others did not. The need for improvement of patient involvement was strongly emphasised. Patients highlighted the importance of professionals being present and spending time with patients. Patients felt well-informed about their care but expressed the need for better communication. Meaningful patient-professional relationships were brokered by professionals demonstrating genuine care and respecting the patient as an individual. To improve the implementation of PCC, patient experiences should be considered in the development of relevant hospital care strategies. In addition, more training in PCC and patient-professional communication should be provided to health care professionals.

Can Artificial Intelligence Replace the Unique Nursing Role?

Artificial intelligence (AI) is transforming healthcare, offering potential benefits and challenges. In healthcare, AI enhances efficiency, streamlines processes, and supports decision-making. However, challenges include potential errors and biases in algorithms, data privacy concerns, legal and ethical issues, and resistance to change. In nursing, a delicate balance emerges between AI and human touch. While AI aids in data-driven decision-making and administrative tasks, it lacks the emotional intelligence, empathy, and nuanced understanding crucial to nursing care. Nurses excel in critical thinking, adaptability to dynamic situations, patient advocacy, collaboration, and establishing human connections. AI supports these functions by automating routine tasks and offering decision support tools, yet its rigidity in dynamic situations and lack of human touch pose limitations. This review underscores the necessity of careful AI integration in healthcare, acknowledging its advantages while mitigating drawbacks. In nursing, the symbiosis between AI and human qualities is vital. The role of AI should be to complement, not replace, the unique skills and empathetic aspects of nursing care. Addressing concerns related to bias, transparency, data privacy, and professional training is essential for maximizing the benefits of AI in healthcare while preserving the human touch in patient care. This article explores whether AI can replace unique nursing roles.

Occupational stress, respect, and the need for psychological counselling in Chinese nurses: a nationwide cross-sectional study

OBJECTIVES

This study aimed to explore occupational stress, perceived respect, and the need for psychological counselling among nurses in China.

STUDY DESIGN

This was a nationwide cross-sectional study.

METHODS

Chinese nurses from 311 cities were randomly selected through a simple random sampling method. Occupational stress, perceived respect, and psychological counselling need were assessed using an online questionnaire validated by experts. The underlying associated factors were analysed using multiple logistic regression analyses.

RESULTS

We collected and analysed 51,406 valid online questionnaires. Family factors and low income were the most commonly cited sources of occupational stress, and 91.9% and 80.0% of nurses, respectively, perceived that individuals in society and patients did not give adequate respect. Furthermore, 75.5% and 79.7%, respectively, believed they were not respected by clinical managers and doctors. As a result, 64.7% nurses believed they had a moderate or high need for psychological counselling. However, 80.7% indicated that receiving adequate respect could decrease the need for stress-related psychological counselling. Indeed, multiple logistic regression analyses showed that lower respect perceived by nurses was associated with higher need for psychological counselling, particularly regarding criticism that nurses perceived from nursing managers (a little: odds ratio [OR], 1.597; 95% confidence interval [CI], 1.176-2.170; P = 0.003; moderately: OR, 1.433; 95% CI, 1.180-1.741; P < 0.001) and the difficulty of receiving respect from patients and their families (a little: OR, 1.389; 95% CI, 1.044-1.850; P = 0.024).

CONCLUSIONS

Nurses in China perceive high levels of occupational stress and low levels of respect and often seek psychological counselling.

Determinants of the intention to work in aged care: a cross-sectional study to assess gerontological nursing competencies among undergraduate nursing students

BACKGROUND

There are huge demands for aged-care workers, and undergraduate gerontological nursing education plays a critical role in providing academic and professional training.

PURPOSE

To examine relationships of characteristics, aged-care education, and gerontological nursing competencies with the intention to work in aged care.

METHODS

An online survey was distributed to undergraduate nursing students between April and June 2022 to gather characteristics, relevant aged-care education, gerontological nursing competencies, and intentions to work in aged care data. Multivariate regression analyses were conducted to identify determinants of the intention to work in aged care.

RESULTS

Students (n = 358) who were older (p < 0.001) and who were married (p < 0.001) had higher intentions to work in aged care. "Promoting mental health and psychological well-being", "Providing evidence-based dementia care", and "Enabling access to technology", were also associated with positive intentions.

CONCLUSIONS

This study provides evidence on determinants of the intention to work in aged care, particularly gerontological nursing competencies.

Motivations and expectations of generation Z nursing students: A post-pandemic career choice qualitative analysis

BACKGROUND

The global nursing shortage is a growing concern so recruiting and retaining Generation Z (Gen Z) students is vital to the sustainability of the profession.

PURPOSE

To explore the perceptions and expectations of first-year nursing students regarding the nursing profession, its working conditions, and how these factors influenced their career choices.

METHOD

Descriptive qualitative research design, employing an interpretive research approach and content analysis conducted following Graneheim & Lundman's method. Our study involved 105 Generation Z nursing degree students enrolled in first year at the Mar Nursing School in Barcelona, Spain in 2021. Data collection included voluntary written narratives about their career choice and questionnaires of demographic information and their healthcare experiences.

RESULTS

It became evident that Generation Z students' perceptions and expectations of nursing don't align with the actual professional experience. This mismatch could lead to disillusionment and attrition among these students.

CONCLUSIONS

Several factors (economic, aspirational, perception of nursing during the COVID-19, or gender) influence new students' career choice. These factors shape their expectations and often do not match actual working conditions in nursing. Educational institutions must prepare students by transferring cross-cutting competencies to effectively meet these challenges and avoid potential dropout from the profession.

Artificial Intelligence and Patient Autonomy in Obesity Treatment Decisions: An Empirical Study of the Challenges

Background This study aims to explore the factors associated with artificial intelligence (AI) and patient autonomy in obesity treatment decision-making. Methodology A cross-sectional, online, descriptive survey design was adopted in this study. The survey instrument incorporated the Ideal Patient Autonomy Scale (IPAS) and other factors affecting patient autonomy in the AI-patient relationship. The study participants included 74 physicians, 55 dieticians, and 273 obese patients. Results Different views were expressed in the scales AI knows the best (μ = 2.95-3.15) and the patient should decide (μ = 2.95-3.16). Ethical concerns (μ = 3.24) and perceived privacy risks (μ = 3.58) were identified as having a more negative influence on patient autonomy compared to personal innovativeness (μ = 2.41) and trust (μ = 2.85). Physicians and dieticians expressed significantly higher trust in AI compared to patients (p < 0.05). Conclusions Patient autonomy in the AI-patient relationship is significantly affected by privacy, trust, and ethical issues. As trust is a multifaceted factor and AI is a novel technology in healthcare, it is essential to fully explore the various factors influencing trust and patient autonomy.

The effect of mHealth program on behavior modification and health outcomes among patients with diabetes: A randomized controlled trial study

Background

Mobile health presents a promising alternative in the digital era. Mobile health apps (mHealth), when combined with the concept of self-management, are considered one of the methods for incorporating technology-based interventions into the healthcare system.

Objective

This study aimed to determine the effect of mHealth (specifically, the Diabetic Care App) on foot care behavior, dietary behavior, foot condition, and fasting blood glucose levels among patients with uncontrolled diabetes mellitus.

Methods

A single randomized controlled trial was conducted at a government-run primary clinic in Northern Malaysia, involving 58 patients with uncontrolled diabetes who were assigned to two groups. The intervention group received the Diabetic Care App, attended a 2-hour face-to-face session, and was included in a WhatsApp group, while the control group received standard care. Relevant assessments were conducted for both groups in Week 1 and Week 5. The study was conducted from February 2020 to November 2020, and parametric and non-parametric statistics were used for data analysis.

Results

Pretest-posttest comparisons in both groups revealed significant findings for foot care behavior (p <0.01), dietary behavior (p <0.01), and foot condition (p <0.01), except for fasting blood glucose levels. In inter-group comparisons, a significant difference was observed only in foot care behavior (p <0.01) and dietary behavior (p <0.01).

Conclusion

The results indicate that technology-based interventions are beneficial for modifying behavior, specifically in terms of foot care and dietary behavior, in this study. The study highlights the applicability of mHealth for nurses in patient education and self-management of chronic conditions. Future research should explore app utilization among patients with chronic conditions.

Clinical trial registration number

NCT04260100 (registered at https://clinicaltrials.gov/ct2/show/NCT04260100).

Translation and validation of the Persian version of the caring nurse-patient interaction scale (CNPI-23)

INTRODUCTION AND OBJECTIVES

Although there is great emphasis on nursing care interaction, there is a lack of knowledge about the quality of nurse-patient care interactions in Iran. The lack of knowledge is mainly related to a lack of short Persian instruments that measure nurse-patient interaction from a caring perspective. The present study aimed to validate a Persian version of the nurse and patient versions of the Caring Nurse-Patient Interaction scale (CNPI-23).

METHODS

The scale (CNPI-23) was translated to Persian using the forward-backward translation method. After translation and re-translation, the scale was given to 15 nurses and faculty members of Kerman University of Medical Sciences, and CVI and CVR indices were calculated based on their opinions. The analytical cross-sectional study was conducted in Kerman/Iran in 2022. In this study, 230 working nurses and 230 hospitalized patients in hospitals affiliated with Kerman University of Medical Sciences were recruited using the convenience method to complete the 23-item Caring Nurse-Patient Interaction scale. Exploratory and confirmatory factor analyses were used to analyze the validity of the scale, and Cronbach's alpha and Raykov's rho indices were also calculated to evaluate internal consistency and composite reliability. Data were analyzed using R 4-1-2 software.

RESULTS

The scale was completed by 230 nurses and 230 patients. It included four dimensions: humanitarian care, clinical care, comforting care, and communication care. The results of the content validity ratio (CVR) and content validity index (CVI) were acceptable for all items. The minimum value of reliability was 0.49. All the items were approved at the end of the content validity assessment. In the patients' scale, these four factors explained 81% of the total variance, and for the exploratory model, all the indices show the adequacy of the model. All factor loadings were significant and higher than 0.5. Raycov's rho and Cronbach's alpha indices for all numbers were higher than 0.7. The findings of the exploratory factor analysis showed that the nurses' scale reflected four caring domains, which explained about 62% of the total variance, and the results of Raycov's rho and Cronbach's alpha indices confirmed the final fit of this model.

CONCLUSION

In general, the Persian version of the Caring Nurse-Patient Interaction scale has good validity and reliability and can be used to evaluate the quality of care interaction between Persian-speaking nurses and patients.

Nurses' Perception of Professionalism in Practice: A Review of Qualitative Studies

Professionalism is a fundamental concept in nursing and a central aspect of nursing care. The review aimed to synthesize evidence presented in qualitative studies related to the perception of professionalism in nursing practice. Six main analytical themes were generated from primary studies included in the literature review: everyday practice, ethical aspects of nursing care, nurses' identity, nurses' professional growth, achieving autonomy, complexity of relationships. Presented themes are considered key elements of nursing professionalism, are closely interconnected, and support the multidimensional structure of professionalism in nursing. Nursing professionalism means providing high-quality care while upholding the values of integrity, accountability, and respect.

Outpatients satisfaction and perceptions toward pharmaceutical services in public and private hospitals in Palestine: a cross-sectional study

BACKGROUND

Pharmaceutical care is an essential component of healthcare services, and patient satisfaction with these services is crucial for improving overall health outcomes. We aimed to evaluate patient satisfaction and perception with pharmaceutical care services provided at public and private hospitals for outpatient pharmacies. This study can provide insights into the quality of pharmaceutical services provided in both settings and identify areas for improvement.

MATERIALS AND METHODS

A cross-sectional 1-month study was conducted in three hospitals in Nablus city in the Northern District of West Bank, Palestine. Participants were a convenience sample of outpatients who attended the study-selected hospitals (two public and one private). A sample of 30 patients from each hospital was selected with a total of 90 patients. A self-administered questionnaire was used to assess socio-demographics pharmacist-related issues, waiting and working time, and medication availability.

RESULTS

A total of 90 patients were recruited. The overall level of patient satisfaction with pharmaceutical health services was moderate with a mean of 3.24 out of 5. Females represented 58.9%. The most prevalent age was (30-39) years (30%). There was a statistically significant difference in patient satisfaction with pharmaceutical services regarding working time between the morning and evening shifts (p value = 0.009) in favor of morning shift. No statistically significant differences in satisfaction with pharmaceutical treatments based on socio-demographics (age, gender, marital status, education level, family income, employment status, and living place), were found. Nearly, 70% of patients indicated having problems getting the medicine on their last visit to the hospital pharmacy. Only 66.7% of patients expressed satisfaction with the pharmacies' operating (working) hours.

CONCLUSIONS

Patient satisfaction with pharmaceutical care services could be enhanced by involving pharmacists in patient-oriented training and informing patients about the role of pharmacists. Patient satisfaction in the evening shift might be improved by establishing a system for continuous evaluation and improvement of pharmaceutical care services in hospitals to ensure the highest quality of care for patients in addition to implementing technology such as electronic prescribing and medication management systems that can improve the accuracy and efficiency of pharmaceutical services in hospitals.

Interventions co-designed by healthcare providers and clients for improving therapeutic relationships in maternal and child healthcare: a pilot study using human centered design in rural Tanzania

BACKGROUND

Research shows that poor provider-client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems.

OBJECTIVE

The study's objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach.

METHODS

A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough prototype model; (3) rough prototype validation through qualitative insight gathering using 6 FGDs with nurses and clients; (4) refinement and adaptation meetings with 14 nurses, 14 clients and 12 administrators; and (5) documentation and sharing of lessons learnt.

RESULTS

According to the community-driven research, poor service, a lack of concern, poor communication, a bad attitude, and unhappiness at work are the nurse factors that affect the relationships between nurses and their patients. Non-compliance with procedures, unfavorable attitudes, poor communication, low education, poverty, and faith in conventional healers were among the client-related factors. Inadequate funding, bad management techniques, improper policy execution, and a lack of an independent institution for handling complaints are the health system factors that affect nurse-client relationships. In response, three ideation and co-creating meetings resulted in 24 interventions. Seven (7) of these were rated as more acceptable and feasible in the local context and formed a rough prototype. During validation, there were some disagreements on the feasibility of curriculum and resource-related interventions. Refinement meetings resulted in a final prototype including four interventions: (i) promotion of patient-centred care; (ii) awards and recognition for nurses; (iii) strengthening complaints mechanisms and (iv) disciplinary measures for abusive nurses and clients. The lessons learnt have been shared through publications and institutional research meetings.

CONCLUSIONS

HCD approach provides a novel entry point for providers and clients to examine the problems and design interventions for strengthening their therapeutic relationships in MCH care. Researchers, practitioners, and policy developers are welcome to consider the emerging prototype as it was deemed acceptable and potentially feasible in rural African contexts.

Family centered nursing practices towards women and their families in the birthing context: A qualitative systematic review

AIM

Synthesize qualitative evidence examining how nurses' attitudes, beliefs, and sense of efficacy and the context surrounding birth facilitate or hinder family-centered nursing practice.

DESIGN

Thematic synthesis of qualitative studies.

METHODS

A literature search was conducted in CINAHL, MEDLINE, PsycINFO, SCOPUS, SCIENCE DIRECT, REPÈRES, CAIRN, and ÉRUDIT from October 2020 to June 2021. The PRISMA guidelines were followed, and studies were critically appraised using the Critical Appraisal Skills Programme checklist. Data were extracted by two independent reviewers, and Thomas and Harden's qualitative thematic synthesis method was performed for data analysis.

RESULTS

Thirteen studies were included. Three analytical themes were generated: (1) sharing power: opposing beliefs, (2) feeling a sense of efficacy in fulfilling one's role, and (3) managing a challenging work environment.

PATIENT OR PUBLIC CONTRIBUTION

Synthesizing nurses' experience is essential to promote implementation of favourable changes for care that is more focused on the needs of families.

Parents of children with disabilities' perceptions regarding the quality of interaction with Health professionals working in early intervention: A qualitative descriptive study

AIMS AND OBJECTIVES

The aim of this study is to explore the perceptions of parents of children with physical disabilities concerning the quality of their interaction with health professionals in early intervention programs.

BACKGROUND

Despite the consensus on the need for Patient and Family-Centered Care, there are still difficulties when executing such care. The quality of interaction among patients, families, and professionals is essential to facilitate the implementation of the programs.

DESIGN

A qualitative descriptive study with thematic analysis using a Modified Grounded Theory approach.

METHODS

Data were collected through seven focus groups with 28 parents of children with physical disabilities who were undergoing early intervention programs in three centres. The study followed the COREQ guidelines and checklist.

RESULTS

Two themes emerged from the experiences: 'exchange of information and education', which included all the activities, procedures, exercises and skills taught by the professionals to help parents care for their child; and 'interpersonal skills', which focused on the way the professional relates with the child and the parents. Several subthemes emerged within each theme.

CONCLUSIONS

This study identified which elements of the professional-parent interaction are considered by parents when evaluating the quality of their interaction with the health care provider of their children.

RELEVANCE TO CLINICAL PRACTICE

The results of this study bring to light certain behaviours and interactions that health professionals should consider in order to improve the perceptions of parents of children with disabilities regarding the quality of interaction in the context of early childhood intervention.

PATIENT OR PUBLIC CONTRIBUTION

Parents contributed to the data collected. Early intervention professionals were involved in participant checking to ensure the rigour of the study.

Slipping through the cracks-detection of sex trafficking in the adult emergency department: An integrative review

INTRODUCTION

Current research estimates that over 24 million individuals experience human trafficking worldwide. There is a growing prevalence of sex trafficking in the United States. An estimated 87% of trafficked persons visit the emergency department during their captivity. Emergency departments across the United States use differing screening methods for sex trafficking. Current screening tools return a high rate of false negatives, and the appropriate use of tools or standardised lists remains unclear.

AIMS

To explore best practices for identifying sex trafficking among adults who visit emergency departments. We sought to answer the practice question: How does the implementation of a multifaceted screening model for sex trafficking, versus the use of a list of standardised screening questions, improve the detection of trafficked persons?

METHODS

We conducted an integrative review of articles published after 2016 in PubMed, CINAHL, Embase, SCOPUS, and Web of Science databases. PRISMA checklist and guidelines were used. Whittemore and Knafl's method was used to review the literature.

RESULTS

A final selection of 11 articles were reviewed and appraised using the Johns Hopkins nursing evidence-based practice model. The synthesis of evidence yielded four themes: (1) Provider and personnel education; (2) Protocol establishment; (3) Legal consultation; and (4) Multidisciplinary teamwork.

CONCLUSION

Through this process, we learned the importance of using multifaceted screening tools for identifying persons who are experiencing sex trafficking. In addition to using multifaceted screening tools, detection is improved when all emergency department personnel receive training on sex trafficking. There is a recognised lack of education on sex trafficking recognition nationwide.

RELEVANCE TO CLINICAL PRACTICE

Notably, emergency department nurses play an essential role in sex trafficking identification due to their maximised interaction with patients and the increased perception of trust that patients have with nurses. Steps include the development of an education program to improve recognition.

NO PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement in the design or drafting of this integrative review.

Mobile care - a possible future for emergency care in Sweden

INTRODUCTION

Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving emergency care from hospitals to the home of patients. The aim of the study was therefore to describe the experiences of the mobile care in Sweden.

METHOD

Semi structured interviews were conducted with 12 persons with experience of mobile care in Sweden, such as nurses, physicians, civil servants and politicians. Qualitative latent content analysis was used as an analysis method.

RESULT

The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an inter-organizational level and on a close team-work is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is primarily provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and their relatives experience security.

CONCLUSION

Mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where there should not be any discussions about boundaries, rather, the discussion should include patient's needs and situation instead.

Nurse-Patient Communication and Relationship When Wearing Personal Protective Equipment: Nurses' Experience in a COVID-19 Ward

Little is known about which communication strategies nurses carried out and whether the nurse-patient relationship has been altered due to the mandated use of personal protective equipment during the COVID-19 pandemic. This study describes how nurse-patient communication and relationships took place from the point of view of nurses engaged in caring for patients with COVID-19. A qualitative descriptive study design following COREQ guidelines was conducted. Semi-structured telephone interviews with nurses working in the COVID ward of an Italian university hospital were performed between September 2020 and June 2021. Ten nurses were recruited using convenience sampling. One overarching theme, three main themes, and nine sub-themes were identified. The overarching theme 'The in-out relationship: 'in here and out there' and 'inside me and out of me' included the main themes 'A closed system different from normal', 'Uncovering meaningful human gestures', and 'A deep experience to live''. The relational nature of nursing-where 'me and you' and the context are the main elements-leads nurses to find new ways of interacting and communicating with patients, even in a new situation that has never been experienced. Enhancing human gestures, thinking about new contexts of care, and educating new generations to maintain human-to-human interaction, regardless of the context of care, are the directives to be explored for creating the future of nursing care.

Self-awareness, empathy, and patient-centered care among critical care nurses in Jordan

Self-awareness, empathy, and patient-centered care are essential components for nurses for improving nurse-patient relationship and providing high-quality care for the patients. There is limited research regarding these components among critical care nurses in Arab countries, including Jordan. Thus, this study purposed to evaluate the self-awareness, empathy, and patient-centered care among critical care nurses in Jordan. A cross-sectional, descriptive correlational design was applied. Data were collected from 140 registered nurses from six hospitals in different health sectors. Findings showed that the mean scores for self-awareness, empathy and patient-centered care were as follows: 1.92 (SD = 0.27), 4.87 (SD = 0.88), and 3.71 (SD = 0.80), respectively. These results indicate that nurses had a high level of self-awareness and empathy and a low level of patient-centered care. There was no relationship between self-awareness and socio-demographic variables, perceived stress, and social support. Also, there was a positive relationship between empathy and social support (r = 0.310, p < 0.001). Patient-centered care had a positive relationship with social support (r = 0.202, p < 0.05) and perceived stress (r = 0.175, p < 0.05), also, male nurses had higher patient-centered care than female encounters. Social support was a predictor of empathy, while social support and perceived stress were the main predictors for patient-centered care. The results of the study reflect the need for educational programs to promote self-awareness and empathy to enhance patient-centered care and achieve high-quality patient care. Additionally, correlating factors with PCC (social support and perceived stress) should be taken into consideration upon implementing any interventional programs.

Relieving Perception of Thirst and Xerostomia in Patients with Palliative and End-of-life Care Needs: A Rapid Review

CONTEXT

Thirst and dry mouth are interlinked symptoms that frequently cause significant distress for patients with life-limiting conditions.

OBJECTIVES

The objective of this rapid review was to identify and synthesize effective interventions that relieve perceptions of thirst and dry mouth of patients with palliative care and end-of-life care needs.

METHODS

Eligible studies were undertaken in clinical settings, with patients experiencing thirst-related distress and/or dry mouth. This review of peer-reviewed literature was conducted following aspects of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. The main outcomes of interest were: 1) efficacy of thirst and dry mouth interventions for patient, and 2) patient, caregiver, and staff acceptability and satisfaction of the interventions. Scientific journal articles were retrieved through searches in electronic databases of MEDLINE (Ovid), CINAHL (EBSCO), and AgeLine (EBSCO).

RESULTS

Eleven studies were included for analysis and synthesis of the results. Most studies either focused on a dry mouth intervention or reported dry mouth outcomes within a broader thirst intervention (n = 9/11 studies). Standard oral care was the common intervention type (n = 5/11). All but one dry mouth intervention reported statistical improvement in outcomes of interest. All studies that reported on thirst were conducted in an Intensive Care Unit (ICU) setting (n = 4/4). No studies specifically addressed thirst in patients in specialist palliative care settings.

CONCLUSION

Evidence from this review suggests that thirst interventions established within the ICU setting may prove effective for treatment of terminally ill patients receiving specialist palliative care.

Effective nursing interventions in ADL care affecting independence and comfort - a systematic review

Despite its frequent provision, evidence of nursing interventions in Activities of Daily Living (ADL) remains unclear. Hence, we addressed the research question: What are the effects of ADL nursing interventions on independence and comfort in adults across all care settings? We conducted a systematic review of randomized controlled trials and quasi-experimental studies described in systematic reviews. In three databases, we searched for systematic reviews that we used as a portal to select (quasi) experimental studies. After narratively summarizing the studies on characteristics, effects, and interventions, we assessed the risk of bias. Among the 31 included studies, 14 studies evaluated independence, 14 studies measured comfort, and three studies assessed both outcomes. Seven interventions significantly improved independence and seven interventions significantly improved comfort. The studies varied highly in intervention components, outcome measures, and quality. Evidence on ADL nursing interventions affecting independence and comfort remains fragmented and inconclusive, limiting guidance for nursing professionals.

The role of nurse-client relationships in maternal and child healthcare: a qualitative study in rural Tanzania

Background

The literature suggests that poor provider-client relationships in maternal and child healthcare (MCH) continue to impact healthcare service uptake, continuity of care, and MCH outcomes. However, there is a paucity of literature on the benefits of the nurse-client relationship for clients, nurses, and the health system, particularly in rural African contexts.

Objective

This study examined the perceived benefits and disadvantages of good and poor nurse-client relationships in rural Tanzania respectively. We present the findings of a community-driven inquiry that was the first step of a broader study that sought to co-design an intervention package for strengthening nurse-client relationships in MCH in rural contexts using a human-centred design approach.

Methods

This study used a qualitative descriptive design. Nine focus group discussions and 12 key informant interviews were conducted using semi-structured interview guides. Participants were purposefully selected nurses/midwives and clients attending MCH services, and MCH administrators. Data were managed using NVivo and analysed thematically.

Results

A range of perceived benefits of good nurse-client relationships and disadvantages of poor relationships emerged. Perceived benefits of good nurse-client relationships included: (i) benefits to clients (increased healthcare-seeking behaviours, disclosure, adherence, return to care, positive health outcomes, and referral tendencies); (ii) benefits to nurses (increased confidence, efficiency, productivity, job satisfaction, trust, and community reputation and support); and (iii) benefits to healthcare facilities/systems (increased client load and consequently income, fewer complaints and legal disputes, increased trust and facility delivery, and reduced maternal and child deaths). The disadvantages of poor nurse-client relationships were basically the opposite of their benefits.

Conclusion

The benefits of good nurse-client relationships and the disadvantages of poor relationships extend beyond patients and nurses to the healthcare system/facility level. Therefore, identifying and implementing feasible and acceptable interventions for nurses and clients could pave the way for good nurse-client relationships, leading to improved MCH outcomes and performance indicators.

Integrating shared decision-making, expressing preferences and active participation of older adults in primary care nursing: a systematic review of qualitative studies and qualitative meta-synthesis

OBJECTIVES

To systematically synthesise the results of primary qualitative studies on how community-dwelling older adults experience shared decision-making processes, express preferences and actively participate in care.

DESIGN

Systematic review of qualitative studies and qualitative meta-synthesis.

METHODS

We focused on studies about community-dwelling participants aged ≥65 undergoing a health-disease process circumscribed to a primary healthcare setting, and the central theme should focus on either shared decision-making, expressing preferences or patient participation. We searched the following databases: MEDLINE, CINAHL, Web of Science, Scopus and PsycINFO (time publication frame 2012-2022). We excluded studies in those cases where the qualitative results were not analysed or unrelated to the phenomenon addressed, phenomena were not clear enough to be included or the setting did not occur in the community.

RESULTS

A total of 12 studies were included in this meta-synthesis. We appraised the quality of the selected studies through Critical Appraisal Skills Programme (CASP) Checklist. The metasummary comprised the frequency and intensity of qualitative patterns across the included studies. The meta-synthesis revealed four influential elements in their interaction: recognising personal qualities, facing professional characteristics, experiences of discrimination and a double-edged context.

CONCLUSIONS

The phenomena studied were influenced by how older people approached their role in their binomial relationship with healthcare professionals. Those with a reinforced self-concept were better aware of health-disease-related situations regarding shared decision-making and the importance of being communicatively assertive. Professional characteristics were also crucial in how older people modulated their acting ability through their personality, communication skills and the approach healthcare professionals used towards older adults. Situations of discrimination generated through an imbalance of power inhibited the expression of preferences and hindered the active participation of older people. The context surrounding the participants influenced all these situations, key in tipping the balance between a therapeutic and a harmful side.

PROSPERO REGISTRATION NUMBER

CRD42022363515.

Reflective based learning for nursing ethical competency during clinical practices

BACKGROUND

A combination of theoretical and practical approaches is required to learn and acquire ethical competencies in caring. Occasionally, reflection on practical action differs from theoretical learning. In the context of reflective learning, issues such as ethical values can be discussed since they evoke conflict among nursing students.

AIM

To identify ethical conflicts encountered by nursing students during clinical placements and to determine their cooperation strategies.

RESEARCH DESIGN

Qualitative study with a content analysis according to Elo and Kinglas framework.

PARTICIPANTS AND RESEARCH CONTEXT

Students enrolled in a nursing program at a Spanish university aged between 22 and 35, mainly women.

METHODOLOGY

The study includes 134 ethical reflections from nursing students in the last year of the nursing program, written during their clinical practices in a variety of learning environments. The research team analyzed the reflections using an inductive content analysis method.

ETHICAL CONSIDERATIONS

Ethical permission was obtained by the management center according to Law 3/2028, and all the participants accepted to participate through the informed consent form.

FINDINGS

Three main categories emerged from the analysis of the ethical reflections: (1) evaluation of professional performance and patient care; (2) the student as the protagonist of the dilemma; (3) student coping. Student dilemmas and concerns are related to ignorance, student-patient communication, mistakes made and self-confidence. Some situations conflict with the autonomy of patients and their rights, and can contribute to stressful situations for patients. Stress factors include hospital routines, which the patient cannot modify, and asymmetric relationships with staff, which encourage passivity.

CONCLUSION

All ethical problems detected by the students begin with the professional-patient relationship, including issues related to bad news, errors or malpractice. Reflection on the ethical values of nursing, both in the classroom and in clinical practices, allows students to develop a greater ethical awareness of care, enhancing their decision-making skills in ethical dilemmas.

Nursing students' attitudes, behaviour, and knowledge toward smoking cessation: Results from a descriptive survey at a regional university

BACKGROUND

Smoking is the largest single cause of lifestyle-related preventable morbidity and mortality. Nurses form the largest cohort of health professionals and are strategically placed to implement smoking cessation interventions. However their capacity is underutilised, particularly in rural and remote areas in countries such as Australia where the incidence of smoking in is higher than average and access to healthcare is limited. One strategy to address the underutilisation of nurses in smoking cessation interventions is to include training in the university/college nursing curriculum. To effectively implement this training, it is vital to have an in-depth knowledge of student nurses' attitudes towards smoking including the role of healthcare professionals in smoking cessation, their smoking behaviour and that of their peers, and knowledge regarding smoking cessation techniques and resources.

OBJECTIVES

Investigate nursing students' attitudes, behaviour, and knowledge towards smoking cessation, determine the impact of demographics and educational experienced on these, and develop recommendations for future research and educational practice.

DESIGN

Descriptive survey.

PARTICIPANTS

Non-probability sample of undergraduate nursing students (n = 247) from a regional Australian university.

RESULTS

Significantly more participants had tried smoking cigarettes than had not (p = 0.026). There were no significant relationships between gender and smoking (p = 0.169) or e-cigarette use (p = 0.200), but a significant relationship was found between age and smoking status where older participants (48-57 years) were more likely to smoke (p < 0.001). Most participants (70 %) were supportive of public health measures to reduce cigarette smoking but felt that they lacked specific knowledge to assist their patients to cease smoking.

CONCLUSIONS

Within education there needs to be an emphasis on the central role that nurses play in smoking cessation with a greater focus on training nursing students about smoking cessation strategies and resources. There is also a need to ensure that students know it falls within their duty of care to address smoking cessation with patients.

Audiovisual Recording in the Inpatient Setting: A Method for Studying Parent-Nurse Communication

Audiovisual recordings are under-utilized for capturing interactions in inpatient settings. Standardized procedures and methods improve observation and conclusion validity drawn from audiovisual data. This article provides specific approaches for collecting, standardizing, and maintaining audiovisual data based on a study of parent-nurse communication and child and family outcomes. Data were collected using audio and video recorders at defined time points simplifying its collection. Data were downloaded, edited for size and privacy, and securely stored, then transcribed, and subsequently reviewed to ensure accuracy. Positive working relationships with families and nurses facilitated successful study recruitment, data collection, and transcript cleaning. Barriers to recruitment and data collection, such as privacy concerns and technical issues, were successfully overcome. When carefully coordinated and obtained, audiovisual recordings are a rich source of research data. Thoughtful protocol design for the successful capture, storage, and use of recordings enables researchers to take quick action to preserve data integrity when unexpected situations arise.

Effectiveness of the Primary Nursing Model on nursing documentation accuracy: A quasi-experimental study

AIMS AND OBJECTIVES

To analyse the Primary Nursing Model's effect on nursing documentation accuracy.

BACKGROUND

The Primary Nursing is widely implemented since it has been considered as the ideal model of care delivery based on the relationship between the nurse and patient. However, previous research has not examined the relationship between Primary Nursing and nursing documentation accuracy.

DESIGN

A pretest-posttest-follow-up design was used.

METHODS

The study was conducted from August 2018 to February 2020 in eight surgical and medical wards in an Italian university hospital. The Primary Nursing was implemented in four wards (study group), while in the other four, the Team Nursing was practised (control group). Nursing documentation accuracy was evaluated through the D-Catch instrument. From the eight wards, 120 nursing documentations were selected randomly for each time point (pre-test, post-test and follow-up) and in each group. Altogether, 720 nursing documents were assessed. The study adhered to the TREND checklist.

RESULTS

The Primary Nursing and Team Nursing Models exhibited significant differences in mean scores for documentation accuracy: assessment on admission, nursing diagnosis, nursing intervention and patient outcome accuracy. No differences between the two groups were found for record structure accuracy and legibility between the posttest and follow-up.

CONCLUSION

Primary Nursing exerts an overall positive effect on nursing documentation accuracy and persists over time.

RELEVANCE TO CLINICAL PRACTICE

The benefits from Primary Nursing implementation included better-documented patient outcomes. The use of Primary Nursing linked with the use of the nursing process allowed for a more individualised and problem-solving approach. Nurse managers should consider the implementation of Primary Nursing to improve care quality.

Psychometric testing of the facilitative student-patient relationship scale within six EUROPEAN countries

AIM

The aim of the study was to test the psychometric properties of the Facilitative Student-Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries.

DESIGN

A multi-country, cross-sectional survey design was applied.

METHODS

A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha.

RESULTS

Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two-factor construct explaining 47.7% of the total variance, identifying two sub-scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two-factor structure. The Cronbach alpha coefficients (0.8-0.9) indicated acceptable reliability of the scale.

Emergency department nurses’ perceptions of caring for patients with intentional self-poisoning: a qualitative study

Nurses have an important role in caring for patients with intentional self-poisoning. This study was attempted to explore the emergency department nurses' perception of caring for patients with intentional self-poisoning. The present qualitative study was performed using phenomenological method. This study was done on 14 emergency department nurses with experience in caring for patients with intentional self-poisoning. Data were collected through semi-structured interviews and transcribed verbatim. Data were analyzed using Colaizzi's method. Following data analysis, two themes and five sub-themes were extracted, which included being reluctant to provide care for patients with intentional self-poisoning (discomfort in providing care, and lack of desire to care for these patients) and comprehensive patient support (providing complete care and emotional support). Given that emergency department nurses are the first medical staff who face with intentional self-poisoning patients and play an important role in the care and treatment of these patients, it is necessary to improve their understanding of caring for these patients. In addition, their comprehensive support for these patients should be strengthened. Psychological support for nurses and training them on how to communicate with intentional self-poisoning patients and their families are also recommended.

Patient perspectives on indwelling urinary catheters and fluid balances after transsphenoidal pituitary surgery: a qualitative study

OBJECTIVES

To explore the perceptions and experiences of patients who underwent transsphenoidal pituitary gland and (para)sellar tumour surgery regarding indwelling urinary catheters (IDUCs) and the postoperative fluid balance.

DESIGN

Qualitative study using semistructured interviews based on the attitudes, social influence and self-efficacy model and expert knowledge.

PARTICIPANTS

Twelve patients who underwent transsphenoidal pituitary gland tumour surgery and received an IDUC during or after surgery.

SETTING

One patient was interviewed in the endocrinology outpatient clinic and 11 patients were interviewed on the neurosurgery ward.

RESULTS

Five major themes emerged: (1) conflicting information and preoperative expectations, (2) IDUCs perceived as patient-friendly during bedrest, particularly for women, (3) little room for patients' opinions, (4) physical and emotional limitations and (5) fluid balance causes confusion. Information regarding IDUC placement and fluid balance given to patients both preoperatively and postoperatively did not meet their expectations, which led to confusion and uncertainty. The IDUC was perceived as preferable if bedrest was mandatory, preferred particularly by women. Patient could not mobilise freely due to the IDUC and felt ashamed, judged by others and dependent on nurses.

CONCLUSIONS

This study provides insight into the challenges patients experience in relation to the IDUC and fluid balance. Perceptions on the necessity of an IDUC varied among patients and were influenced by both physical and emotional impediments. A clear, frequent and daily communication between healthcare professionals and patients to evaluate IDUC and fluid balance use is necessary to increase patient satisfaction.

Evidence-Based Performance Indicators of Positive Inpatient Experiences

GOAL

Patient experiences affect the competitiveness and financial viability of a hospital. The purpose of this research was to ascertain the factors that contribute to positive inpatient experiences by using empirical evidence from national databases and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data.

METHODS

Data were assembled from four publicly available U.S. government datasets. The HCAHPS national survey responses (n = 2,472) were based on four consecutive quarters of patient surveys. Measures of clinical complications obtained from the Centers for Medicare & Medicaid Services were used to assess hospital quality. Social determinants of health were incorporated into the analysis by including data from the Social Vulnerability Index as well as zip code-level information from the Office of Policy Development and Research.

PRINCIPAL FINDINGS

The study results show that hospital quietness, nurse communication, and care transition positively affected patient experience ratings and the patient's likelihood to recommend the hospital. In addition, findings show that hospital cleanliness positively influenced patient experience ratings. However, hospital cleanliness had little impact on the likelihood of a patient's recommending the hospital, and staff responsiveness had a negligible impact on both patient experience ratings and the likelihood to recommend the hospital. The results also revealed that hospitals with better clinical outcomes received better patient experience ratings and recommendation scores, whereas hospitals that serve more vulnerable populations received worse patient experience ratings and recommendation scores.

PRACTICAL APPLICATIONS

Findings from this research demonstrate that managing the physical surroundings by providing a clean and quiet environment, providing relationship-centered care through interactions with medical personnel, and working to engage patients in their health as they transition out of care contributed to positive inpatient experiences.

Factors that affect levels of alexithymia, empathy and communication skills of nursing students in northern Iran

AIM

The inability of nurses to express their own emotions, understand others' emotions and show empathy could result in communication gaps that could affect patient care outcomes. This study investigates the factors associated with the levels of alexithymia, empathy and communication skills among nursing students.

DESIGN

A survey was conducted among 365 nursing students, and data were collected using an online questionnaire.

METHODS

Data analyses were done using SPSS software version 22.

RESULTS

There was a significant positive association between age and empathy and a negative association between the number of times a nurse took the entrance exam. The level of education and interest in nursing correlate with communication skills. All the predictor variables of alexithymia in this current study were not significant. Emphasis should be placed on improving nursing students' empathy and communication skills. Student nurses should be taught how to recognize and express their emotions. To assess their mental health, they must be screened regularly.

Development and validation of two versions of the Nurse-Patient Mutuality in Chronic Illness scale

AIMS

The aim of the study was to develop and psychometrically test the Nurse-Patient Mutuality in Chronic Illness (NPM-CI) scale in two versions, one for nurses and one for patients.

METHOD

A multiphase methodological study was conducted. In the first phase, a qualitative investigation was conducted through interviews and an analysis of the content; inductively, the items of two instruments were generated, one for nurses and one for patients. In the second phase, the content and face validity were assessed through the expert consensus method. In the third phase, exploratory factor analysis (EFA), Cronbach's alpha test, intraclass correlation and Pearson correlation coefficients were conducted to estimate construct, criterion validity and instrument reliability. For each phase, the sample included nurses and patients recruited from a large hospital in Northern Italy. Data collection was conducted between June and September 2021.

RESULTS

Nurse and patient versions of the NPM-CI scale were developed. Two rounds of consensus reduced the items from 39 to 20; content validity index ranged between 0.78 and 1, content validity ratio was 0.94. Face validity indicated clarity and comprehensibility of the items. EFA identified three latent factors for both the scales. Internal consistency was satisfactory, with Cronbach's alphas ranging between .80 and .90. Test-retest stability was suggested, with an intraclass correlation coefficient of .96 (nurse scale) and .97 (patient scale). Predictive validity was established, with a Pearson correlation coefficient of .43 (nurse scale) and 0.55 (patient scale) between the mutuality scales and satisfaction in providing and receiving care.

CONCLUSION

The results suggest that the NPM-CI scales are sufficiently valid and reliable for the clinical practice among chronic illness patients and the nurses caring for them. A more in-depth exploration of this construct in the context of nursing and patient outcomes is warranted.

PATIENT OR PUBLIC CONTRIBUTION

Patients were involved in all study phases.

IMPACT

Mutuality is fundamental in the relationship between nurse and patient, based on trust, equality, reciprocity, and mutual respect. The NPM-CI scale was developed and psychometric estimated through a multiphase study in both nurse and patient versions. The NPM-CI scale measures the factors of 'developing and going beyond', 'being the point of reference' and 'deciding and sharing care'. The NPM-CI scale allows us to measure mutuality in clinical practice and research. Expected outcomes and influencing factors for patients and nurses could be associated.

Improving nursing education curriculum as a tool for strengthening the nurse-client relationships in maternal and child healthcare: Insights from a human-centered design study in rural Tanzania

Background

There are growing evidence of poor nurse-client relationships in maternal and child health (MCH). The nursing curriculum forms an important entry point for strengthening such relationships, consequently improving client satisfaction with nurses' competencies, confidence in the formal healthcare system, healthcare-seeking practices, continuity with care, and MCH outcomes.

Objective

MCH nurses and clients were invited to design an intervention package (prototype) to improve nurse-client relationships using a human-centered design (HCD) approach.

Methods

A multi-step HCD approach was employed to first examine the contributors of poor nurse-client relationships using nine focus group discussions with nurses and clients and 12 key informant interviews with MCH administrators. Then, three meetings were held with 10 nurses, 10 clients, and 10 administrators to co-develop an intervention package to address the identified contributors. The solutions were validated by collecting qualitative information through six focus groups with nurses and MCH clients who were not involved in the initial HCD stages. Finally, refinement and adaptation meetings were held with 15 nurses, 15 clients, and 10 administrators. The data were managed with NVivo 12 software and analyzed thematically.

Results

Nursing curriculum challenges contributing to poor nurse-client relationships in MCH care included inadequate content on nurse-client relationships specifically topics of customer care, communication skills, and patient-centered care; an inadequate practice on communication skills within nursing schools; and the absence of specific trainers on interpersonal relationships. Consequently, improving the nursing curriculum was one of the interventions proposed during the co-design and rated by participants as highly acceptable during validation and refinement meetings. Suggested improvements to the curriculum included increasing hours and credits on communication skills and patient-centered care, including customer care courses in the curriculum and creating a friendly learning environment for clinical practice on strengthening interpersonal relationships.

Conclusion

Improving the nursing curriculum was considered by nurses and clients as one of the acceptable interventions to strengthen nurse-client relations in MCH care in rural Tanzania. Nursing education policy and curriculum developers need to ensure the curriculum facilitates the development of much-needed interpersonal skills among nursing graduates for them to have positive therapeutic interactions with their clients.

Women's power in hospital-based nursing: A critical qualitative study

AIM

To understand the factors that affect power in hospital-based nursing and reveal how the female gender affects an individual's ability to feel empowered.

DESIGN

Critical qualitative research design.

METHOD

Semi-structured interviews were conducted with nurses working in inpatient hospital settings in Utah and New Mexico. Data were collected from February to March 2022. Interviews were analysed using thematic analysis.

RESULTS

Sixteen participants were interviewed. Six themes were identified from the data, four of which related to nurses' power at work, and two of which specifically related to how gender affects a nurse's ability to use power and feel empowered. These themes include supportive leaders, positive unit culture, successful advocacy, personal factors, societal gender roles and sexism.

CONCLUSION

Empowered nurses can revolutionize health care. The themes developed in this study will help nurse leaders and nurses alike increase nurses' ability to use their power and feel empowered in the workplace.

IMPACT

Nurse leaders should strive to be supportive of their nurses and build a positive work environment while also providing consistent consequences for sexist actions of staff. Nurses should take opportunities to advocate for their patients, be autonomous and build their knowledge base to improve empowerment. As nurse leaders and nurses alike work together to improve health care, nurse experience, patient and clinical outcomes will be improved.

PATIENT OR PUBLIC CONTRIBUTION

The nurses interviewed for this study contributed their experiences and insights during data collection. Some also contributed rigour to the data analysis process by participating in member checking.

Professional Quality of Life, Work-Related Stress, and Job Satisfaction among Nurses in Saudi Arabia: A Structural Equation Modelling Approach

Objective

To examine the interrelated impacts of work-related stress, compassion satisfaction (CS), and job satisfaction on burnout (BO) and secondary traumatic stress (STS) among nurses using structural equation modelling (SEM).

Methods

A cross-sectional design was used to survey 727 nurses at a teaching hospital in eastern Saudi Arabia. Three scales were used: the Quality of Life (ProQOL) scale, the Nursing Stress Scale (NSS), and the Job Satisfaction Survey (JSS). Data were analysed using SPSS and Analysis of Moment Structures (AMOS), and SEM analysis was conducted to confirm the interrelations among variables.

Results

The final model had a good fit for the obtained data (X ² = 2.726, RMSEA = 0.032). Stress is directly related to BO and STS, and the following variables were directly related to STS: job satisfaction, BO, and CS. Lastly, BO mediated the relationship between stress and STS.

Conclusion

It is crucial to analyze the effect of stress, CS, and job satisfaction which seems to have a positive and negative impact on nurses' BO and STS. Therefore, implementing a management strategy to manage stress and satisfaction can enhance nurses' quality of life, support the maintenance of positive attitudes, and enhance the standard of patient care.

How the use of an online healthcare community affects the doctor-patient relationship: An empirical study in China

Possible improvements to the doctor-patient relationship are an important subject confronting national healthcare policy and health institutions. In recent years, online healthcare communities have changed the ways in which doctors and patients communicate, especially during the COVID-19 pandemic. However, previous research on how usage of online healthcare communities has affected the doctor-patient relationship is rather limited. This paper proposes a research model to investigate the relationship between online healthcare community usage and the doctor-patient relationship. An analysis of 313 patients' data using structural equation modeling showed the following. First, the use of an online healthcare community has a positive impact on doctor-patient communication, helps improve the performance of healthcare procedures, and reduces healthcare costs. Second, doctor-patient communication and healthcare costs have a positive impact on patients' emotional dependence and patients' perception of healthcare quality, while healthcare procedures do not have this impact. Finally, patients' emotional dependence and perception of healthcare quality have a positive effect on doctor-patient relationship through the mediator of patients' satisfaction.