{"title":"Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis","authors":"Dao Weiangkham , Adinat Umnuaypornlert , Surasak Saokaew , Neeranuch Wongcharoen , Samrerng Prommongkol , Jutamas Ponmark","doi":"10.1016/j.ijnsa.2025.100316","DOIUrl":"10.1016/j.ijnsa.2025.100316","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary Tuberculosis (PTB) remains a pressing public health concern. Long hospital stays for PTB patients can overburden both patients and healthcare systems.</div></div><div><h3>Objective</h3><div>To identify the key factors contributing to extended length of stay in PTB patients.</div></div><div><h3>Information sources</h3><div>Four electronic databases (PubMed, Scopus, Embase, and CINAHL) were systematically searched from inception to January 1, 2023.</div></div><div><h3>Methods</h3><div>The articles were screened and performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Inclusion criteria were PTB patients diagnosed by doctors and studies reporting factors affecting length of stay. Exclusion criteria were review articles, case study, conferences abstract, and proceedings. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was used to analyzed risk factors for length of stay. Heterogeneity was employed using I<sup>2</sup> and Q statistics. Forest plots displayed effect sizes (ES) and 95 % confidence intervals. STATA 14.2 was used for meta-analysis.</div></div><div><h3>Results</h3><div>A total of 1,190 studies were screened from reputable electronic databases, six studies comprised of 9,231 participants were included. Meta-analysis revealed that they are six risk factors associated with longer length of stay including; older age (OR 1.50, 95 % CI 1.07–2.09, <em>p</em> = 0.019), comorbidity (OR 1.44, 95 % CI 1.17–1.78, <em>p</em> = 0.001), HIV patient (OR 1.40, 95 % CI 1.16–1.69, <em>p</em> = 0.001), patients with ADR (OR 2.19, 95 % CI 1.47–3.26, <em>p</em> < 0.001), MDR TB (OR 3.16, 95 % CI 2.31–4.32, <em>p</em> < 0.001), and miliary TB (OR 1.37, 95 % CI 1.10–1.70, <em>p</em> = 0.004) with minimal heterogeneity [(I<sup>2</sup> = 34.2 %, <em>p</em> = 0.207), (I<sup>2</sup> = 43.1 %, <em>p</em> = 0.118), (I<sup>2</sup> = 0.0 %, <em>p</em> = 0.573), (I<sup>2</sup> = 0.0 %, <em>p</em> = 0.723), (I<sup>2</sup> = 0.0 %, <em>p</em> = 0.366), and (I<sup>2</sup> = 0.0 %, <em>p</em> = 0.753), respectively]. There was no evidence of publication bias according to Begg's and Egger's test.</div></div><div><h3>Conclusions</h3><div>In conclusion, six risk factors were identified as significantly associated with longer hospital stays in PTB patients: older age, comorbidities, HIV infection, ADR, MDR-TB, and miliary TB. These findings highlight the importance of targeted interventions for these high-risk groups to reduce length of stay and alleviate the burden on healthcare systems. The results are based on a meta-analysis of six studies with minimal heterogeneity, and no evidence of publication bias was found. Future research should focus on exploring additional factors influencing length of stay, particularly in diverse populations, and evaluating the effectiveness of interventions to shorten hospital stays. Additionally, studies examining ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100316"},"PeriodicalIF":3.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessing factors associated with nurses leaving the profession: A secondary analysis of cross-sectional data","authors":"Björn Lantz , Carina Fagefors","doi":"10.1016/j.ijnsa.2025.100315","DOIUrl":"10.1016/j.ijnsa.2025.100315","url":null,"abstract":"<div><h3>Background</h3><div>Nurse turnover is a global challenge affecting workforce stability, financial sustainability of healthcare systems, and the quality of care. Despite extensive research, a limited number of researchers have explored the actual reasons behind nurses leaving the profession as opposed to leaving their job, particularly in relation to demographic variables.</div></div><div><h3>Objective</h3><div>We aimed to explore how demographic factors—age, sex, and work area—influenced nurses' experiences of key turnover factors, providing insights to inform tailored retention strategies.</div></div><div><h3>Design</h3><div>Secondary cross-sectional analysis of national survey data.</div></div><div><h3>Setting(s)</h3><div>Data were collected by Statistics Sweden through a mail survey.</div></div><div><h3>Participants</h3><div>The sample consisted of 2,860 individuals with nursing qualifications who had left the profession between 2005 and 2013 and responded to a 2016 survey.</div></div><div><h3>Methods</h3><div>The analysis involved exploratory factor analysis and structural equation modeling to identify and examine five latent factors contributing to nurses leaving the profession. The researchers assessed the impact of demographic variables on these factors.</div></div><div><h3>Results</h3><div>Five primary factors were identified: compensation and fairness, psychosocial work environment, career development constraints, non-clinical workload, and support and safety. Younger nurses and those outside primary care reported greater dissatisfaction across multiple factors, while female nurses faced heightened psychosocial strain. Work area differences also influenced perceptions of support and workload.</div></div><div><h3>Conclusions</h3><div>We have underscored the significant role of demographic variables associated with leaving the nursing profession. Tailored interventions, such as structured mentorship for younger nurses, family-supportive policies for female nurses, and workload optimization in high-stress areas, may be helpful. The results are limited by the age of the data, which predates recent healthcare shifts, emphasizing the importance of regular workforce monitoring.</div></div><div><h3>Registration</h3><div>Not registered</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100315"},"PeriodicalIF":3.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lu Zhou , Yinsong Sun , Mingzhao Xiao , Runli Yang , Shuang Zheng , Jun Shen , Qinghua Zhao
{"title":"Factors influencing patient safety competence among Chinese vocational nursing students: A mixed-methods study using COM-B model and theoretical domains framework","authors":"Lu Zhou , Yinsong Sun , Mingzhao Xiao , Runli Yang , Shuang Zheng , Jun Shen , Qinghua Zhao","doi":"10.1016/j.ijnsa.2025.100307","DOIUrl":"10.1016/j.ijnsa.2025.100307","url":null,"abstract":"<div><h3>Background</h3><div>Although patient safety education is receiving increased attention, nursing students' patient safety competency remains moderate. As an important source of future caregivers for many primary health hospitals, the level of patient safety competence of higher vocational nursing students directly affects the delivery of nursing care, which in turn affects patient safety, the patient's disease healing process, and their outcomes. There is a lack of evidence to support the factors that influence patient safety competence among nursing students.</div></div><div><h3>Objective</h3><div>The aim of this research was to explore the factors that impact patient safety competency among Chinese higher vocational nursing students.</div></div><div><h3>Design</h3><div>An explanatory sequential mixed research design was used in this study.</div></div><div><h3>Methods</h3><div>The quantitative part was a cross-sectional survey. Convenient sampling was used to conduct a questionnaire survey on 523 nursing students from a vocational college in Chongqing using the general information questionnaire, The metacognition ability scale, the general self-efficacy scale, the self-directed learning skill scale, patient safety nurse competency evaluation scale. Multiple linear regression and serial mediating effect test were used to analyze the impact factors. Qualitative research was then conducted to explain the initial quantitative research results. The qualitative research part used purposive sampling to conduct semi-structured interviews with 16 higher vocational nursing students, and the data was analyzed through content analysis. Quantitative and qualitative data are mapped to the Capability, Opportunity, Motivation, Behavior (COM-B) model.</div></div><div><h3>Results</h3><div>The quantitative findings found that metacognition had a statistically significant indirect predictive effect on patient safety competence through general self-efficacy and self-directed learning, with an indirect effect value of 0.034 (95 % CI [0.017, -0.013]). Combining quantitative and qualitative results, The Capability, Opportunity, Motivation, Behavior (COM-B) model and theoretical domains framework captures a series of factors, including Competence (professional knowledge and skills); Opportunities (resources, public opinion); Motivation (metacognitive abilities, personality, roles, beliefs, goals).</div></div><div><h3>Conclusions</h3><div>This study provides evidence for a serial mediating role of general self-efficacy and self-directed learning in the relationship between metacognition ability and patient safety competency, contributing to a psychological understanding of the underlying mechanisms of patient safety competency. Therefore, when developing interventions, consideration should be given to promoting positive behaviours in higher vocational nursing students concerning general self-efficacy and self-directed strategies to enhance metacognition, boost pa","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100307"},"PeriodicalIF":3.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Ángel Díaz-Herrera , Mónica González-Durán , Francisco Javier Rodríguez-Martínez , Gema Tujillo-Flores , Nuria Tuset-Mateu , Jose Verdú-Soriano , Vicente Gea-Caballero , Albert Sanllorente-Melenchón , Jesús Almeda-Ortega , Oriol Cunillera-Puértolas , Mateo Acedo-Anta , José Ramón Martínez-Riera
{"title":"The financial burden of chronic wounds in primary care: A real-world data analysis on cost and prevalence","authors":"Miguel Ángel Díaz-Herrera , Mónica González-Durán , Francisco Javier Rodríguez-Martínez , Gema Tujillo-Flores , Nuria Tuset-Mateu , Jose Verdú-Soriano , Vicente Gea-Caballero , Albert Sanllorente-Melenchón , Jesús Almeda-Ortega , Oriol Cunillera-Puértolas , Mateo Acedo-Anta , José Ramón Martínez-Riera","doi":"10.1016/j.ijnsa.2025.100313","DOIUrl":"10.1016/j.ijnsa.2025.100313","url":null,"abstract":"<div><h3>Background</h3><div>Chronic wounds place a substantial clinical and economic burden on health systems and significantly reduce the quality of life of those affected. However, there are no large-scale economic evaluations to assess costs based on data in a real-world environment.</div></div><div><h3>Objective</h3><div>We aimed to analyse the costs of managing patients with chronic wounds (pressure injuries, ulcers of venous aetiology, ulcers of arterial aetiology, diabetes-related foot ulcers, and lower-limb ulcers of other aetiologies) in primary care in the southern area of Barcelona, Spain, through a 3-year real-world data analysis.</div></div><div><h3>Methods</h3><div>The direct costs associated with specific treatment materials and primary care consultations were analysed using the electronic clinical records and financial management data of 54 primary care centres managed by the Catalan Institute of Health, which served a population ranging from 890,152 in 2015 to 939,747 in 2017.</div></div><div><h3>Results</h3><div>Between 2015 and 2017, total expenditure was estimated at € 34,991,854 (Euros) (USD 39,548,000 -United States Dollars-). The cost of the specific treatment materials was € 8,455,787 (USD 9,555,885), with an annual average of € 2,818,596 (USD 3,185,295) and an increase of 18.5 % over the period. The cost of the consultations for chronic wound management was € 26,536,067 (USD 29,988,409). The cumulative annual prevalence of chronic wounds per 10,000 inhabitants was 86.70‱ in 2015, 88.03‱ in 2016 and 88.7‱ in 2017. Pressure injuries accounted for 46.39 % to 42.86 % of all chronic wounds. The direct extrapolation of chronic wounds costs to the total population of Spain was € 1,763,037,849 (USD 1,993,409,074) (mean annual average € 587,679,283 -USD 664,136,358-) during the study period, with a prevalence of 388,777 and an estimated peak of 413,897 in 2017.</div></div><div><h3>Conclusion</h3><div>We found that chronic wounds have a significant economic impact and should be considered in the planning and management of healthcare resources to ensure adequate and sustainable primary care services.</div></div><div><h3>Tweetable abstract</h3><div>Chronic wounds represent a significant clinical and economic burden in medical devices and consultations, costing 34.99 million euros over three years. Effective planning is essential for the sustainability of primary care services</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100313"},"PeriodicalIF":3.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intention to leave and missed nursing care: A scoping review","authors":"Gianluca Azzellino , Angelo Dante , Cristina Petrucci , Valeria Caponnetto , Ernesto Aitella , Loreto Lancia , Lia Ginaldi , Massimo De Martinis","doi":"10.1016/j.ijnsa.2025.100312","DOIUrl":"10.1016/j.ijnsa.2025.100312","url":null,"abstract":"<div><h3>Introduction</h3><div>The nursing profession is fundamental to the functioning of healthcare systems but is often characterised by high turnover rates, considerable job dissatisfaction, and a significant intention to leave. A closely related phenomenon is \"missed nursing care,\" defined as essential nursing tasks that are omitted (partially or completely), delayed, or not performed. The relationship between missed nursing care and the intention to leave the profession represents a critical issue in modern healthcare.</div></div><div><h3>Aims</h3><div>This scoping review aims to synthesize evidence on the relationship between Missed Nursing Care (MNC) and Intention to Leave (ITL), highlighting the factors influencing both phenomena.</div></div><div><h3>Material and methods</h3><div>A scoping review was conducted to examine the relationship between \"missed nursing care\" and \"intention to leave\" among nurses. The search, conducted between May and June 2024, included PUBMED, SCOPUS, and EBSCO databases, focusing on English-language studies from the last 10 years. Zotero was used for study management, and quality assessment was performed using the \"JBI Critical Appraisal Tools.\" Two independent reviewers screened studies and resolved discrepancies through discussion and consensus.</div></div><div><h3>Results</h3><div>the electronic research strategies used produced 102 papers, of which 24 were relevant to the aims of the review. The results of this study show a clear correlation between missed nursing care and intention to leave among nurses in different healthcare settings.</div></div><div><h3>Discussion</h3><div>This literature review demonstrates a strong and consistent correlation between missed nursing care and nurses' intention to leave the profession. The findings indicate that missed nursing care is closely linked to heightened job dissatisfaction, which in turn significantly increases the likelihood of nurses considering leaving their roles.</div></div><div><h3>Conclusions</h3><div>The relationship between missed nursing care and intention to leave the profession is well documented in the literature and highlights the importance of addressing the factors that contribute to missed nursing care. Improving nurses' working conditions is essential to reduce their intention to leave the profession. To effectively tackle missed nursing care and mitigate the intention to leave, it is necessary to adopt targeted strategic and management approaches and to foster an organisational culture that prioritises the well-being of nurses.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100312"},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Wu , Yijing Wang , Lijing Ding , Yiting Xu , Xuyan Jia , Keying Huo , Xiao Yao , Wenyan Zhang , Yue Wan , Peimin Xie , Lin Ye , Rong Huang
{"title":"Breastfeeding trajectory of mothers of preterm infants within 6 months postpartum: A longitudinal study","authors":"Na Wu , Yijing Wang , Lijing Ding , Yiting Xu , Xuyan Jia , Keying Huo , Xiao Yao , Wenyan Zhang , Yue Wan , Peimin Xie , Lin Ye , Rong Huang","doi":"10.1016/j.ijnsa.2025.100311","DOIUrl":"10.1016/j.ijnsa.2025.100311","url":null,"abstract":"<div><h3>Background</h3><div>Breast milk is the nutrient of choice for preterm infants. The World Health Organization has set a target of ensuring by 2030 that 70 % of infants younger than age 6 months are exclusively breastfed. The breastfeeding status of mothers of preterm infants is far below that target. Preterm infants are a special group, and there are many difficulties in and obstacles to adhering to breastfeeding. It is urgent to understand the current situation of breastfeeding among mothers of preterm infants, the change in their breastfeeding behaviors over time, and factors influencing breastfeeding in this population during different postpartum stages.</div></div><div><h3>Objective</h3><div>We aimed to explore potential breastfeeding behavior trajectories and analyze modifiable influencing factors to provide a reference for health care staff to identify risk groups of breastfeeding attrition at an early stage and develop targeted intervention measures.</div></div><div><h3>Methods</h3><div>We conducted a prospective, single-center, longitudinal study involving a cohort of mothers of preterm infants from July 2023 to May 2024. We administered the Breastfeeding Behavior Questionnaire, Breastfeeding Intention Questionnaire, Breastfeeding Prediction Scale, Breastfeeding Knowledge Questionnaire, and Edinburgh Postnatal Depression Scale. Data were collected at four timepoints: before discharge (T0) and at 6 weeks (T1), 4 months (T2), and 6 months postpartum (T3). A mixed model of latent variable growth was used to fit the trajectory of maternal breastfeeding behavior, and multiple logistic regression analysis was used to detect factors influencing the trajectory of breastfeeding behavior.</div></div><div><h3>Results</h3><div>Three types of heterogeneity tracks were found: a \"high-level rising\" group (36.5 %), \"medium-level declining\" group (26.0 %), and \"low-level declining\" group (37.5 %). Household income, spouse's educational background, smoking in the spouse, breastfeeding patterns before discharge (T0), perceived breastfeeding control and breastfeeding intention (T1), perceived breastfeeding control, breastfeeding intention, and breastfeeding knowledge (T2), and perceived breastfeeding control, breastfeeding positive attitude, and breastfeeding negative attitude (T3) were predictors of different profiles.</div></div><div><h3>Conclusion</h3><div>Breastfeeding is of great importance to promote the growth and development of preterm infants. However, the breastfeeding situation among mothers of preterm infants 6 months after delivery is not encouraging. The rate of exclusive breastfeeding is low and needs to be improved. Clarifying those variables related to the Theory of Planned Behavior, such as breastfeeding positive and negative attitudes, perceived breastfeeding control, breastfeeding knowledge, and postpartum depression score, can provide a theoretical basis for the early identification and screening of mothers at risk of exclusive b","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100311"},"PeriodicalIF":3.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florian Schimböck , Lars Krüger , Magdalena Hoffmann , Marie-Madlen Jeitziner , Heidi Lindroth , Keibun Liu , Peter Nydahl , Rebecca Von Haken , Matthias Thomas Exl , Sibylle Fischbacher , WDAD-DACH study group
{"title":"Delirium prevalence and management in general wards, emergency departments, rehabilitation centres and nursing homes in Germany, Austria and Switzerland (DACH countries): A secondary analysis of a worldwide point prevalence study","authors":"Florian Schimböck , Lars Krüger , Magdalena Hoffmann , Marie-Madlen Jeitziner , Heidi Lindroth , Keibun Liu , Peter Nydahl , Rebecca Von Haken , Matthias Thomas Exl , Sibylle Fischbacher , WDAD-DACH study group","doi":"10.1016/j.ijnsa.2025.100309","DOIUrl":"10.1016/j.ijnsa.2025.100309","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is a common neuropsychiatric syndrome associated with an increased risk of mortality and length of stay. Current delirium prevalence, assessments and management practices of delirium in DACH countries are unknown.</div></div><div><h3>Objective</h3><div>To examine the delirium point prevalence, assessment, management practices in general wards, emergency departments, rehabilitation centres and nursing homes in DACH countries.</div></div><div><h3>Design</h3><div>Secondary data analysis from a prospective, cross-sectional, worldwide one-day point delirium prevalence study (registered in the German Registry for Clinical Trials, DRKS00030002)</div></div><div><h3>Setting(s)</h3><div>General hospital wards, emergency departments, rehabilitation centres and nursing homes excluding operating rooms, ambulatory, high acuity, intermediate care and intensive care units.</div></div><div><h3>Participants</h3><div>In total, 172 wards (majority were general wards; 91.3 %, <em>n</em> = 157) from Germany, Austria and Switzerland participated.</div></div><div><h3>Methods</h3><div>Descriptive analysis of a 39-questions online survey with aggregated routine patient and facility data completed by healthcare professionals, administrators, and researchers on World Delirium Awareness Day, March 15th, 2023. Data on delirium prevalence were collected at 8:00 A.M. and P.M. (± 4 h). Use of delirium assessments, delirium awareness structures, presence of care protocols, and barriers to delirium management structures were reported.</div></div><div><h3>Results</h3><div>Overall delirium prevalence was 7.1 % (<em>n</em> = 143/2,028) at 8:00 A.M. and 7.2 % (<em>n</em> = 133/1,842) at 8:00 P.M. There was no statistically significant difference between the delirium prevalence assessed with valid (<em>p</em> = .770) or non-valid assessment (<em>p</em> = .643). The most frequent delirium assessments were the Nursing Delirium Screening Scale (16.3 %, <em>n</em> = 28/172), the Confusion Assessment Method (15.7 %, <em>n</em> = 27/172) and the Delirium Observation Screening Scale (9.3 %, <em>n</em> = 16/172). The most reported interventions to provide delirium awareness and education were “delirium is mentioned in handovers” (53.5 %, <em>n</em> = 92/172), “availability of delirium experts” (51.2 %, <em>n</em> = 88/172) and “delirium education during the last year” (48.3 %, <em>n</em> = 83/172). An existing delirium management protocol was present in 76.7 % (<em>n</em> = 132/172) of participating wards. The most frequently reported barriers to delirium care were “shortage of staff” (45.3 %, <em>n</em> = 78/172), “patients who are difficult to assess” (32.6 %, <em>n</em> = 56/172), and “communication gaps between professions” (29.1 %, <em>n</em> = 50/172). As non-pharmacological interventions, “mobilization” (92.4 %, <em>n</em> = 159/172), “pain management” (87.8 %, <em>n</em> = 151/172), and “adequate fluids” (83.7 %, <em>n</em> = 144/172) were mostly r","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100309"},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Åsa Burström , Markus Saarijärvi , Sandra Skogby , Anna Lena Brorsson , Ewa-Lena Bratt , Carina Sparud-Lundin
{"title":"Evaluation of person-centred care within the Stepstones transition program for adolescents with congenital heart disease – a document analysis","authors":"Åsa Burström , Markus Saarijärvi , Sandra Skogby , Anna Lena Brorsson , Ewa-Lena Bratt , Carina Sparud-Lundin","doi":"10.1016/j.ijnsa.2025.100308","DOIUrl":"10.1016/j.ijnsa.2025.100308","url":null,"abstract":"<div><h3>Background</h3><div>Transition programs are pivotal in ensuring successful transition to adulthood and transfer to adult care for adolescents with chronic conditions. Healthcare providers must therefore support adolescents in increasing their empowerment to gain active participation in health and care. The Stepstones transition program is based on a person-centred care approach and has been evaluated in a randomized controlled trial. However, the extent to which the person-centred care approach was implemented needs further exploration.</div></div><div><h3>Objective</h3><div>To evaluate how a person-centred care approach was implemented based on a documentation analysis of the Stepstones transition program for adolescents with congenital heart disease.</div></div><div><h3>Design</h3><div>A deductive qualitative design employing analysis of the documentation used in the Stepstones transition program.</div></div><div><h3>Setting(s)</h3><div>The documentation derives from the consultations in the two interventions centres in the Stepstones randomized controlled trial. The trial was conducted between 2017 and 2021. Data sources included in this study were: The adolescents’ written narratives, documentation of the person-centred conversations, and goalsetting in the transition plans.</div></div><div><h3>Participants</h3><div>Documentation for adolescents with congenital heart disease, randomized to the intervention group (<em>n</em> = 59) at the two intervention centres was included.</div></div><div><h3>Methods</h3><div>Directed content analysis was used to evaluate how person-centred care was described in the documentation. The analysis was based on the three cornerstones of person-centred care: initiating, establishing and safeguarding partnership, in this study between the adolescent and the transition coordinator during the transition program. The data were deductively sorted into aspects of relevance for person-centred care and adolescent health. For the written narratives an inductive analysis was thereafter undertaken.</div></div><div><h3>Results</h3><div>A partnership between the transition coordinator and the adolescent was initiated through the adolescents’ written narrative and established using a psychosocial interview guide. This outlined a spectrum of aspects important to person-centred and adolescent-oriented approach, such as resources, risks/obstacles, and needs. The goalsetting process describes goals commonly agreed upon and how to accomplish them. A solid foundation of self-awareness regarding personal capacities and learning needs contributed to the development of knowledge, understanding, and fostered independence to various degrees.</div></div><div><h3>Conclusions</h3><div>The Stepstones transition program for adolescents with congenital heart disease implemented several person-centred components, such as eliciting narratives, collaborative goal setting, and tailoring support needs. The documentation had limitations in ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100308"},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiayuan Peng , Xiangmin Tan , Ni Ning , James Wiley , Nan Hua , Yuan Zeng , Mei Sun
{"title":"Perceived weight stigma and disordered eating behaviors among postpartum women: The mediating role of weight bias internalization and postpartum depression","authors":"Jiayuan Peng , Xiangmin Tan , Ni Ning , James Wiley , Nan Hua , Yuan Zeng , Mei Sun","doi":"10.1016/j.ijnsa.2025.100306","DOIUrl":"10.1016/j.ijnsa.2025.100306","url":null,"abstract":"<div><h3>Background</h3><div>Weight stigma is linked to adverse effects, but whether it directly heightens the risk of disordered eating behaviors or psychological factors mediate this connection among postpartum women is uncertain.</div></div><div><h3>Objectives</h3><div>To investigate the relationship between perceived weight stigma and disordered eating behaviors (restrained eating, emotional eating, and external eating) and identify the mediating role of weight bias internalization and postpartum depression (PPD).</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 507 postpartum women. Data were collected anonymously using self-reported questionnaires, including the Perceived Weight Stigma Questionnaire, Weight Bias Internalization Scale, Edinburgh Postpartum Depression Scale, and Dutch Eating Behavior Questionnaire. Data were analyzed using descriptive statistics, Pearson's correlation analysis, hierarchical linear regression, and mediation analysis.</div></div><div><h3>Results</h3><div>The results showed that the relationship between perceived weight stigma and disordered eating behaviors was fully mediated by weight bias internalization and PPD. Specifically, perceived weight stigma was associated with greater weight bias internalization, which was associated with greater PPD, and greater PPD was associated with greater disordered eating behaviors.</div></div><div><h3>Conclusion</h3><div>This may be the first study to propose a chain mediation model exploring the roles of weight bias internalization and PPD in the relationship between perceived weight stigma and disordered eating behaviors among postpartum women. The findings enhance the understanding of the psychological impacts of perinatal weight stigma and underscore the importance of addressing weight stigma in postpartum care. Comprehensive interventions should be developed to enhance postpartum health and reduce the risk of disordered eating behaviors.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100306"},"PeriodicalIF":3.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evidence adaptation and tailored implementation of family bereavement support in specialised palliative care: A multi-method study","authors":"Myrta Kohler , Qëndresa Thaqi , Silke Kuske , Torsten Schwalbach , Marco Riguzzi , Rahel Naef","doi":"10.1016/j.ijnsa.2025.100305","DOIUrl":"10.1016/j.ijnsa.2025.100305","url":null,"abstract":"<div><h3>Background</h3><div>Families experiencing the loss of their close other following advanced illness have varying degrees of needs that stretch into bereavement. Evidence-based recommendations for bereavement support are often not well implemented in palliative care services due to multiple system barriers and lack of contextual fit. To close this know-do gap, we undertook an implementation science research project.</div></div><div><h3>Objective</h3><div>To adapt evidence-informed recommendations for supporting bereaved families to the local context, and to develop a tailored implementation strategy for their integration in specialised palliative care services.</div></div><div><h3>Settings and participants</h3><div>Two specialised palliative care services located at urban teaching hospitals in German-speaking Switzerland. Participants were palliative care staff working in the service, including nurses, physicians, chaplains, psychologists, and two service users.</div></div><div><h3>Methods</h3><div>Multi-method implementation research project combining community engagement strategies, qualitative contextual analysis, and theory-driven implementation design processes for integrating evidence-informed interventions in new contexts: First, evidence was identified and adapted through co-design staff workshops and service user consultations, following intervention adaptation guidelines. Next, focus group interviews were held to identify barriers and facilitators to implementation, informed by the Consolidated Framework for Implementation Research and analysed using qualitative content analysis. Drawing on implementation mapping methodology, a systematic and participatory process was used to develop an implementation plan that specified activities needed to address identified barriers and support integration into palliative care services.</div></div><div><h3>Results</h3><div>The study resulted in an adapted bereavement support pathway with three core functions of evidence-informed practices delivered during dying, at death, three-to-six, and if necessary nine-to-twelve months post-loss: screening and assessing family needs and risks, intervention and support activities for families, and team collaboration and coordination within and across providers. Implementation was expected to be influenced by the features of the intervention itself, staff competencies, and organisational conditions, with resources required being a frequent barrier, whereas workplace culture and the project-related network acted as facilitators. A multifaceted implementation strategy with 16 distinct activities was developed to reach 70 % of bereaved families: designing a practical, implementable pathway, creating necessary team capacity and roles, optimizing workflow, offering education and clinician support, ensuring leadership and organisational commitment, and facilitating mutual exchange and learning. An implementation research logic model specified expected mechanisms ","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"8 ","pages":"Article 100305"},"PeriodicalIF":3.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}