International Journal of Nursing Studies Advances最新文献

{"title":"Job preference of nurse practitioners: A simulation approach","authors":"Yin Li ,&nbsp;John Howell ,&nbsp;Jeannie P. Cimiotti","doi":"10.1016/j.ijnsa.2025.100406","DOIUrl":"10.1016/j.ijnsa.2025.100406","url":null,"abstract":"<div><h3>Purpose</h3><div>Understanding the job preferences of nurse practitioners is crucial for developing policies that attract and retain them in the healthcare workforce, ensuring better healthcare delivery. The aim of this study was to analyze and simulate the job preferences of nurse practitioners, focusing on the impact of various job attributes such as independent practice, practice environment, and salary on their decision-making.</div></div><div><h3>Methods</h3><div>The study used a simulation approach based on a discrete choice experiment survey to predict the job choices of nurse practitioners under different scenarios. The study was conducted in the state of Georgia, USA. 372 survey respondents who were licensed and employed nurse practitioners were included. The likelihood of nurse practitioners choosing a job based on changes in job attributes was analyzed using a hierarchical Bayesian Multinomial Logit model.</div></div><div><h3>Results</h3><div>Nurse practitioners highly value an excellent practice environment and independent practice. A very cohesive interprofessional team and responsive administration significantly influenced job choices. Nurse practitioners might be willing to accept a 10 % salary decrease or a longer commute time for a job with an excellent practice environment. Conversely, they required independent practice for a 10 % salary increase to be attractive. Additionally, the preference for independent practice outweighed the importance of higher salaries and shorter commute time.</div></div><div><h3>Conclusion</h3><div>The study highlights the importance of an excellent practice environment and independent practice in the job preference of nurse practitioners. Healthcare organizations should focus on creating supportive, collaborative work environments and enabling greater autonomy for nurse practitioners. Policymakers should consider revising regulations to expand nurse practitioners' scope of practice.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100406"},"PeriodicalIF":3.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in shift patterns due to the COVID-19 pandemic: a prospective cohort study of the intensive care nursing staff in hospitals in Stockholm","authors":"Emma Brulin ,&nbsp;Emelie Thunqvist ,&nbsp;Per Gustavsson ,&nbsp;Carolina Bigert ,&nbsp;Tove Nilsson ,&nbsp;Seth Addo ,&nbsp;Abid Lashari","doi":"10.1016/j.ijnsa.2025.100408","DOIUrl":"10.1016/j.ijnsa.2025.100408","url":null,"abstract":"<div><h3>Background</h3><div>It is well known that the COVID-19 pandemic placed pressure on healthcare, leading to increased job demands for intensive care unit (ICU) nursing staff and possibly also longer working hours. Potential changes in shift patterns for ICU nursing staff are important to study as numerous studies collectively indicate that certain shift patterns, especially night shifts, increase the risk of developing various diseases, such as diabetes, cardiovascular diseases, and preterm birth among nursing staff.</div></div><div><h3>Objective</h3><div>To inform crisis planning, the aim was to investigate potential changes in shift patterns among ICU nursing staff working in public hospitals in Stockholm during the pandemic (March 1, 2020-May 31, 2022). Specifically, we investigated changes in the number of day, evening, night, and long shifts; quick returns from evening and night shifts; and mean monthly work hours corresponding to each peak of COVID-19.</div></div><div><h3>Design</h3><div>A prospective cohort study</div></div><div><h3>Setting</h3><div>ICU in four public hospitals in Stockholm</div></div><div><h3>Participants</h3><div>Nursing staff, i.e., nurses, specialist nurses, and assistant nurses working in the ICU (<em>n</em> = 1208) between 1 January 2017 and 31 May 2022.</div></div><div><h3>Method</h3><div>Data were obtained from a computerised administrative employee register in Region Stockholm, which includes detailed information on hours worked. Interrupted time series regressions, modelled with three interruptions, one for each peak of COVID-19 patient influx, were used to investigate whether COVID-19 had an impact on shift patterns.</div></div><div><h3>Results</h3><div>Results showed that the first peak of COVID-19 led to an immediate increase in the number of night shifts by 673.15 shifts (95 % confidence interval (CI): 487.25–859.04), quick returns from night shifts by 443.44 (CI 265.03–621.85) and ≥3 consecutive night shifts by 201.51 (CI 116.57–286.46). Following the first peak, both the number of night shifts and quick returns from night shifts declined. At peak two, the number of night shifts and quick return from night shifts increased by 450.01 (CI 285.85–614.18) and 397.45 (CI 220.43–574.46), respectively. At the third peak, there was an immediate decrease in the number of working days in a row. However, from the second month, a statistically significant upward trend was observed in both the number of night shifts and quick return from night shifts.</div></div><div><h3>Conclusions</h3><div>During the COVID-19 pandemic, (ICU nursing staff experienced an increase in both the number of night shifts and quick returns from night shifts. These types of shifts may lead to adverse health effects and should be minimised. Healthcare organisations should prepare for shift schedules during times of strain to prevent an increase in hazardous shifts.</div></div><div><h3>Study registration</h3><div>Not registered</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100408"},"PeriodicalIF":3.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally adapting family interventions for people with schizophrenia in Indonesia: An intervention development study using programme theory","authors":"Laoise Renwick ,&nbsp;Herni Susanti ,&nbsp;Budi-anna Keliat ,&nbsp;Dewi Wulandari ,&nbsp;Suherman ,&nbsp;Rizqy Fadilah ,&nbsp;Raphita Diorarta ,&nbsp;Helen Brooks ,&nbsp;Penny Bee ,&nbsp;Karina Lovell","doi":"10.1016/j.ijnsa.2025.100409","DOIUrl":"10.1016/j.ijnsa.2025.100409","url":null,"abstract":"<div><div>Schizophrenia is a leading cause of disability and global burden worldwide. Low- and middle-income settings are disproportionately affected, and evidence-based, psychosocial interventions are largely unavailable, undeveloped and under-researched for this population. Family interventions have a particularly strong evidence base for reducing relapse risk with medium to large effect sizes. World Health Organisation international clinical guidelines, recommend family interventions as an essential intervention in these settings. Despite this, evidence is emerging that family interventions can deliver positive outcomes in these settings and there are few studies examining the suitability and effectiveness of delivering these in settings with varied socio-economic climates and cultural differences.</div><div>We used the Medical Research Council Framework for Developing Complex Interventions, conducting a series of separate but interrelated studies to adapt a testable, evidence-based, culturally relevant family intervention for people with schizophrenia and their families in Indonesia. Our theory driven approach utilises an existing heuristic model to explore stakeholder (service-users, caregivers and healthcare professionals; n = 51) preferences and priorities about family interventions and qualitative interviews with key informants (n = 14) exploring implementation related facilitators and barriers that affect the utility and ecological validity of these interventions. We used a modified nominal group technique to allow divergent ideas to be expressed and collated identifying areas of consensus regarding the optimal content, format and delivery of family interventions.</div><div>Our theory of change outlines that while family interventions primarily target relapse, they may also influence broader outcomes like quality of life, functioning, and social inclusion, though not solely responsible for changes in these areas. Therapist confidence depends on training, supervision, and understanding family needs. Intervention components, based on mechanisms of change and stakeholder preferences, align with empirical and theoretical evidence including psychoeducation, communication skills, and relapse prevention. Addressing maladaptive beliefs about schizophrenia, such as hopelessness and blame, was theorised to foster recovery and reduce stigma, a key stakeholder concern.</div><div>This theory of change will aid the design of our evaluation, and guide local implementation strategies, inform the development of data collection protocols, and provide a framework for interpreting results. This provides an opportunity to engage stakeholders actively incorporating their perspectives and knowledge into the planning process of the intervention and its implementation, ensuring engagement with policy makers to secure knowledge mobilisation, buy-in and partnership working.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100409"},"PeriodicalIF":3.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144895173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do job resources buffer the harmful effects of job demands on burnout complaints? A 1-year cohort study of Swedish healthcare professionals","authors":"Britta E Gynning ,&nbsp;Elin Karlsson ,&nbsp;Kevin Teoh ,&nbsp;Per Gustavsson ,&nbsp;Filip Christiansen ,&nbsp;Emma Brulin","doi":"10.1016/j.ijnsa.2025.100397","DOIUrl":"10.1016/j.ijnsa.2025.100397","url":null,"abstract":"<div><h3>Background</h3><div>The job demands-resources model posits that job resources buffer the effects of job demands on subsequent strain. However, empirical support for this is inconclusive, with some studies suggesting this may be context- or even profession-specific.</div></div><div><h3>Objective</h3><div>To investigate the buffering effect in the job demands-resources model within the Swedish healthcare sector and the impact of professional differences on this effect</div></div><div><h3>Method</h3><div>Data were drawn from a 1-year cohort called the <em>Longitudinal occupational health survey for healthcare in Sweden,</em> utilising the 2022 and 2023 waves. The study sample consisted of Swedish healthcare professionals who at baseline were 69 years or younger, who participated in both survey waves. In total, the study included 4132 healthcare professionals (1649 physicians, 1631 registered nurses, and 852 nurse assistants). Descriptive statistics and ordinary least squares regression moderation analysis were carried out.</div></div><div><h3>Results</h3><div>The experience of control at work buffered the impact of several job demands, including quantitative demands (Beta coefficients [<em>B</em>] =−0.034, 95 % confidence interval [CI] [−0.05; −0.01]), illegitimate work tasks (<em>B</em>=−0.018, 95 % CI [−0.04;−0.01]), effort-reward imbalance (<em>B</em> = −0.050, 95 % CI [−0.08; −0.01]), and work-life Interference (<em>B</em> = −0.023, 95 % CI [−0.04; −0.004]) on subsequent burnout complaints. Collegial support buffered the effect of emotional demands (<em>B</em> = −0.025, 95 % CI [−0.04; −0.01]). Physicians reported a greater buffering effect from control compared with nurse assistants on the effect of illegitimate work tasks (<em>B</em> = 0.084, 95 % CI [0.01;0.16]) and effort reward imbalance (<em>B</em> = 0.120, 95 % CI [0.02;0.22]) towards subsequent burnout complaints.</div></div><div><h3>Conclusions</h3><div>We have contributed to the application of the job demands-resources model by emphasising the critical role of the type of profession in the buffering effect of resources. We have underlined the importance of profession-specific job demands and resources in understanding burnout among Swedish healthcare professionals and in other settings.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100397"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational technology enhanced interprofessional E-learning for engaging cross-institutional and cross-border healthcare students: A mixed-methods study","authors":"Siu Ling Chan (Senior Lecturer) ,&nbsp;John Tai Chun Fung (Senior Lecturer) ,&nbsp;Man Sang Wong (Associate Head (Academic) and Professor) ,&nbsp;Christopher Chi Wai Cheng (Research Assistant I) ,&nbsp;Jay Jung Jae Lee (Assistant Professor) ,&nbsp;Hye Ri Choi (Postdoctoral Fellow) ,&nbsp;Wai Hin Wan (Assistant Lecturer) ,&nbsp;Harrison Withrow (Research Assistant I) ,&nbsp;Seng-iad Sirirat (Lecturer) ,&nbsp;Wai Ho Tse (Assistant Lecturer) ,&nbsp;Rebecca Po Wah Poon (Lecturer) ,&nbsp;Choi Fung Lam (Lecturer) ,&nbsp;Hemio Chung Yan Lam (Lecturer) ,&nbsp;Chun Kit Chan (Assistant Lecturer) ,&nbsp;Chia Chin Lin (Director of School)","doi":"10.1016/j.ijnsa.2025.100404","DOIUrl":"10.1016/j.ijnsa.2025.100404","url":null,"abstract":"<div><h3>Aim</h3><div>In the post-COVID-19 era, educators in higher education are exploring innovative pedagogies to deliver effective interprofessional education in an online learning environment. This study aimed to evaluate the effectiveness of the technology-enhanced e-learning modules for undergraduate healthcare students from different cultural backgrounds. The focus was on student engagement with interprofessional learning and diversity using innovative educational technology.</div></div><div><h3>Methods</h3><div>This is a mixed-methods study including pre- and post-test evaluations and focus group interviews. The educational intervention strategies focused on applying interprofessional learning among undergraduate healthcare students by integrating education technologies (i.e., virtual reality 360 and gamification) into two e-learning modules. Three time-points involving pre and post modules’ evaluation (before and after the 1st learning module, and after the 2nd learning module) were collected using validated scales including Interprofessional Attitudes Scale and Online Student Engagement Scale. Linear mixed models were used to investigate the association between interventions and changes in outcomes from pre-to post-intervention by adjusting the covariates. To further validate the quantitative findings, focus-group interviews were conducted with a verbatim transcript obtained from participating students for content analysis.</div></div><div><h3>Results</h3><div>A total of 75 undergraduate healthcare students from Hong Kong, Mainland China, South Korea, and Thailand participated in the study. A statistically significant positive change was detected in interprofessional attitude (<em>F</em> = 5.90, <em>p</em> = 0.004), interprofessional diversity and ethics (<em>F</em> = 4.43, <em>p</em> = 0.014) and student engagement (<em>F</em> = 13.42, <em>p</em> &lt; 0.001) after the e-learning modules. A statistically significant correlation was also detected between student engagement and interprofessional attitude. From the qualitative content analysis, three core categories were identified. They were ‘Cultural diversity recognition’, ‘Acquisition of interprofessional attitudes and skills’ and ‘Active learning engagement’.</div></div><div><h3>Conclusions</h3><div>The technology-enhanced e-learning modules significantly enhanced undergraduate healthcare students’ interprofessional attitude and student learning engagement in terms of interprofessional education. Healthcare educators in higher education are encouraged to integrate educational technology as a pedagogical approach to stimulate interprofessional learning of undergraduate healthcare students.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100404"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric evaluation of the Norwegian version of the Threadgold Communication Tool","authors":"Anne-Martha Utne Øygarden ,&nbsp;Ellen Karine Grov ,&nbsp;Anne Marie Mork Rokstad ,&nbsp;Orla Brady ,&nbsp;Knut Engedal ,&nbsp;Benedicte Sørensen Strøm","doi":"10.1016/j.ijnsa.2025.100405","DOIUrl":"10.1016/j.ijnsa.2025.100405","url":null,"abstract":"<div><h3>Objectives</h3><div>The study aimed to investigate the psychometric properties of the Norwegian version of the Threadgold Communication Tool, a proxy-rated instrument assessing communication abilities in people with dementia.</div></div><div><h3>Design</h3><div>The study employed a prospective design, with two measurement points within 10 days. The Threadgold Communication Tool was translated into Norwegian following the World Health Organization's protocol for translation and back-translation.</div></div><div><h3>Setting and participants</h3><div>The study included 126 residents from ten different nursing homes and one assisted living facility in Norway. The participants consisted of 99 women (78.57 %) and 27 men (21.43 %), aged between 61 and 100 years, with a mean age of 85.67 (SD 7.59).</div></div><div><h3>Outcome measures</h3><div>The outcome measures were the internal consistency, test-retest reliability, and construct validity of the Threadgold Communication Tool.</div></div><div><h3>Results</h3><div>The Norwegian version of the Threadgold Communication Tool demonstrated satisfactory psychometric properties, with a high level of internal consistency (Cronbach’s α coefficient = 0.95) and robust test-retest reliability (<em>r</em> = 0.8, <em>p</em> &lt; 0.001). Principal Component Analysis revealed a two-component structure, explaining 62.9 % of the variance. However, the item 'vocalization' scored lower than other items and was identified as difficult to interpret by the Sonas Licensed Practitioners.</div></div><div><h3>Conclusions</h3><div>The Norwegian version of the Threadgold Communication Tool is a reliable and valid tool for assessing communication abilities in people with dementia. However, further research is needed to refine the instrument based on these findings, particularly regarding the interpretation of the 'vocalization' item.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100405"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient safety and the second victim phenomenon in nursing and medical curricula: A qualitative study","authors":"Einav Srulovici ,&nbsp;Mary-Elizabeth Tumelty ,&nbsp;Ivana Meszaros Skoumalova ,&nbsp;Patricia Vella Bonanno ,&nbsp;Erika Kubilienė ,&nbsp;José Joaquín Mira ,&nbsp;Valentina Marinkovic ,&nbsp;Anat Rafaeli ,&nbsp;Reinhard Strametz ,&nbsp;Susanna Tella ,&nbsp;Anu Venesoja ,&nbsp;Žymantė Jankauskienė ,&nbsp;Sandra C. Buttigieg","doi":"10.1016/j.ijnsa.2025.100403","DOIUrl":"10.1016/j.ijnsa.2025.100403","url":null,"abstract":"<div><h3>Background</h3><div>The second victim phenomenon—emotional and psychological distress experienced by healthcare professionals following adverse events—is increasingly recognized. However, its integration into formal nursing and medical curricula remains limited across Europe, despite its relevance to patient safety, as well as student and clinician well-being.</div></div><div><h3>Objectives</h3><div>To explore how patient safety and second victim content are incorporated into undergraduate and postgraduate nursing and medical curricula and to identify the barriers and facilitators influencing such integration across Europe.</div></div><div><h3>Design</h3><div>A qualitative cross-national interview study.</div></div><div><h3>Settings</h3><div>Medical and nursing education institutions in 10 European countries representing northern, southern, central, and eastern regions.</div></div><div><h3>Participants</h3><div>Nineteen healthcare education leaders (department heads or senior faculty) from nursing and medical programs were selected purposefully based on their leadership roles and curricular oversight responsibilities. Inclusion criteria required at least 5 years of experience in curriculum development at both undergraduate and postgraduate levels; there were no dropouts.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted in participants' native languages, translated to English, and analyzed using thematic analysis. Themes were developed inductively by a multidisciplinary research team across countries.</div></div><div><h3>Results</h3><div>Five major themes were identified: (1) Recognition of patient safety and the second victim phenomenon; (2) Curriculum development and implementation; (3) Training content and delivery; (4) Student and educator engagement; and (5) Continuous professional development. Although awareness of the second victim concept was high, formal curricular integration was rare. Barriers included curriculum overload, regulatory rigidity, and limited faculty preparedness. Facilitators included interdisciplinary collaboration, student advocacy, and openness to innovative pedagogies.</div></div><div><h3>Conclusions</h3><div>Despite broad recognition of the second victim phenomenon, its integration into European healthcare curricula remains minimal. Strategic curriculum reforms supported by interdisciplinary collaboration, institutional leadership, and student engagement may be essential to bridge the gap between awareness and educational practice. We have offered actionable guidance for advancing patient safety and clinician resilience through formal education.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100403"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram and risk stratification for predicting subsyndromal delirium in elderly patients in a post-anaesthesia care unit: A prospective cohort study","authors":"Guoting Ma ,&nbsp;Wenjun Yan ,&nbsp;Qian Yang ,&nbsp;Yanjia Li ,&nbsp;Lingkai Wang","doi":"10.1016/j.ijnsa.2025.100402","DOIUrl":"10.1016/j.ijnsa.2025.100402","url":null,"abstract":"<div><h3>Background</h3><div>Subsyndromal delirium, as a transitional state of postoperative delirium, does not meet the diagnostic threshold for delirium but independently contributes to adverse outcomes in elderly patients. Early identification and intervention can effectively prevent disease progression.</div></div><div><h3>Objective</h3><div>This study focuses on the post-anesthesia care unit, a critical window period for postoperative recovery, aiming to develop a reliable risk prediction model.</div></div><div><h3>Design</h3><div>A prospective cohort study.</div></div><div><h3>Methods</h3><div>Subsyndromal delirium was assessed with the Confusion Assessment Method at 30 min post-extubation and pre-transfer. The least absolute shrinkage and selection operator and multivariate logistic regression were applied to screen independent predictors and construct a nomogram. The performance of the model was evaluated by discrimination, calibration and clinical utility. Patients were subsequently divided into low-risk and high-risk subgroups.</div></div><div><h3>Results</h3><div>The overall incidence of subsyndromal delirium in 2636 elderly patients in the post-anesthesia care unit was 18.6 %. Age, latest neutrophil to lymphocyte ratio, nighttime surgery, intraoperative hypothermia, patient-controlled analgesia usage, and duration of mechanical ventilation in the post-anesthesia care unit were identified as independent risk factors for predicting subsyndromal delirium. The areas under the ROC curve of the model were 0.904 (95 % CI: 0.878–0.931) and 0.850 (95 % CI: 0.814–0.886) in the training and validation cohorts, respectively. The calibration curves and decision curve analysis demonstrated good consistency and clinical value. Significant differences in subsyndromal delirium rates were observed between the low-risk and high-risk groups (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The developed nomogram model incorporating six clinical variables demonstrated excellent discrimination and calibration, with its risk stratification effectively identifying high-risk subsyndromal delirium patients.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100402"},"PeriodicalIF":3.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Function focused care in hospital among nurses and patients from geriatric and neurology wards: A mixed method process evaluation","authors":"Selma Kok ,&nbsp;Elke G.E. Mathijssen ,&nbsp;Lisette Schoonhoven ,&nbsp;Carolien Verstraten ,&nbsp;Silke F. Metzelthin ,&nbsp;Nienke Bleijenberg ,&nbsp;Janneke M. de Man-van Ginkel","doi":"10.1016/j.ijnsa.2025.100401","DOIUrl":"10.1016/j.ijnsa.2025.100401","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Function Focused Care is a promising approach stimulating physical activity of patients admitted to hospital. In studying the effectiveness, patients receiving Function Focused Care in Hospital were admitted 3.3 days shorter than patients receiving usual care. However, no differences were found in functional status. Process evaluations alongside an effect studies create an understanding implementation fidelity, of mechanisms of impact, contextual factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;to gain insight into the experiences of nurses and patients, and to give insight into implementation fidelity, mechanisms of impact, and contextual factors while implementing Function Focused Care in Hospital on geriatric and neurologic hospital wards.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;convergent parallel mixed-methods study, alongside a stepped wedge clinical trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting(s)&lt;/h3&gt;&lt;div&gt;four hospital wards of two Dutch hospitals&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;nurses, nursing students and care assistants (&lt;em&gt;n&lt;/em&gt; = 123), and patients (&lt;em&gt;n&lt;/em&gt; = 24).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data for the process evaluation was collected before the implementation of Function Focused Care in Hospital (T0), directly after implementation (T1), and four months after implementation (T2). Data was obtained from patient interviews, focus group interviews with nurses, questionnaires, observations, screening of electronic patients’ records, and logbook notes. For the qualitative data thematic analyses and for quantitative data descriptive statistics were used. The results of these analyses were synthesized into overarching findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Findings from the observations showed the care delivery according to the Function Focused Care in Hospital principles increased from 60 % in the control condition to 75 % in the intervention condition. Moreover, nurses stated that patients were only assisted when needed and nurses often asked about their abilities to perform ADL and then encouraged them to do as much as they could themselves. Nevertheless, patients don’t recognize Function Focused Care in Hospital. The results suggest that the implementation fidelity was influenced by different working mechanisms and contextual factors which led to different experiences from nurses, coaches and patients in promoting patient engagement and functional independence. The synthesized findings show that lessons can be learned with regards to continuity of the care provided in the interprofessional collaboration, the challenge in providing personalized care given the current time constraints, the phenomenon of being unconscious incompetent observed in the nurses, and difficulties in demonstrating nursing leadership and autonomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Implementation of Function Focused Care in Hospital improved care delivery but highlighted challenges in personalized care, interpro","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100401"},"PeriodicalIF":3.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person-centred care of people living with dementia and its regulation in German-speaking nursing homes: A qualitative focus group study","authors":"Anna Louisa Hoffmann-Hoffrichter ,&nbsp;Andreas Hohmann ,&nbsp;Bernhard Holle ,&nbsp;Rebecca Palm ,&nbsp;Martina Roes","doi":"10.1016/j.ijnsa.2025.100400","DOIUrl":"10.1016/j.ijnsa.2025.100400","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Although nursing homes are aware of the relevance of person-centred care, the translation of this approach into practice remains difficult. This study aims to explore the meaning of person-centred dementia care and the role of internal regulations in German-speaking nursing homes in translating this concept into practice.</div></div><div><h3>Methods</h3><div>This study (a qualitative exploratory design) is part of an overall study of internal regulations about person-centred dementia care in nursing homes. In this substudy, we conducted nine virtual focus group discussions with experts from theory, practice, and regulatory authorities from Germany, Austria and Switzerland about person-centred dementia care. We analysed the data via qualitative content analysis using a deductive-inductive approach.</div></div><div><h3>Results</h3><div>For experts, the <em>leadership function</em> is crucial for the concept of person-centred dementia care in nursing homes. Leadership is inextricably linked to other elements, such as setting priorities, mindset, structural requirements, internal regulations and outcomes. Leadership therefore has a hinge function: it enables a limited and controlled rotation of connected elements to illustrate the dimensions of the individual elements from person-centred to non-person-centred. In addition to setting priorities and outcomes, mindset development and structural requirements are particularly relevant for the implementation of person-centred dementia care in nursing homes. The experts described differences between traditional internal regulations and regulations about person-centred dementia care in nursing homes. The development of internal regulations for person-centred dementia care and the content of these regulations are consequences of a circular, dialogical collective understanding process. It leads processually in a bottom-up manner to a common understanding of person-centred dementia care, which is then written down. Experts recommend formulating these regulations as concepts and options analogous to mindset development, which employees can use in the care of the resident while maintaining autonomy.</div></div><div><h3>Conclusions</h3><div>The study provides 1) insight into how person-centred dementia care and the role of internal regulation are understood in German-speaking nursing homes and 2) a precise description of the development of a mindset and regulations for person-centred dementia care in nursing homes that requires both top-down and bottom-up processes.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100400"},"PeriodicalIF":3.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}