International Journal of Nursing Studies Advances最新文献

{"title":"Undergraduate nursing students’ experiences during international clinical placement: A scoping review","authors":"Lasse Andreassen ,&nbsp;Simen A. Steindal ,&nbsp;Jyoti Sarin ,&nbsp;Benedicte Sørensen Strøm","doi":"10.1016/j.ijnsa.2025.100378","DOIUrl":"10.1016/j.ijnsa.2025.100378","url":null,"abstract":"<div><h3>Background</h3><div>Immigration, combined with the growth of multicultural societies, has increased patient diversity, highlighting the need for cultural competence in healthcare to prepare nurses to understand the nature of global health. Nurses should have knowledge to understand and respect how culture influences patients’ health needs, access to healthcare services, and the health-related decision-making process. Offering international clinical placement to nursing students is one way to increase this cultural competence. No scoping review has mapped undergraduate nursing students’ experiences during international clinical placement.</div></div><div><h3>Objectives</h3><div>To provide an overview of published studies on undergraduate nursing students’ experiences during international clinical placement.</div></div><div><h3>Design</h3><div>A scoping review.</div></div><div><h3>Methods</h3><div>A systematic search was performed in three databases (CINAHL, Medline, PubMed). The inclusion criteria were: 1) studies with quantitative, qualitative or mixed methods design, 2) studies reporting undergraduate nursing students’ experiences of international clinical placement and 3) studies published in peer-reviewed journals in the English language between January 2008 and February 2023. Pairs of authors independently assessed eligibility and extracted data. Data were thematically grouped.</div></div><div><h3>Results</h3><div>42 papers were included, 39 studies employed a qualitive design, while 3 studies employed a quantitative design. All studies included students from Western countries with international clinical placement in non-Western countries. Most students had international clinical placement in hospitals, with a wide range of length of exchange. Four thematic groupings were identified: 1) developing cultural competence through culture shock, 2) a novel way of practicing nursing due to a different nursing role, 3) the essential role of the supervisor in learning outcomes and 4) the impact of language barriers on learning outcomes.</div></div><div><h3>Conclusions</h3><div>Students developed cultural competence by experiencing culture shock when exposed to an unfamiliar cultural environment. While they often reacted negatively to these differences, they often adjusted their prejudices and biases over time. Language skills were the greatest barrier to achieving learning outcomes, creating more frustration than cultural barriers. There is a need to investigate how non-Western students experience studying in a Western country.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100378"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723998","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":"Characteristics of emergency nurse practitioner professional identity: A multicenter qualitative study","authors":"Aline Chenou ,&nbsp;Loïc Brillouet ,&nbsp;Stéphane Guillon ,&nbsp;Pascal Bilbault ,&nbsp;Thierry Pelaccia","doi":"10.1016/j.ijnsa.2025.100384","DOIUrl":"10.1016/j.ijnsa.2025.100384","url":null,"abstract":"<div><h3>Context</h3><div>The first emergency nurse practitioners have been working in France for two years now. Their arrival may raise questions, but they are seen as a potential solution to the crisis of overcrowding in emergency department. As a new profession in the emergency department, it is crucial to study the characteristics of the professional identity in order to provide the keys to understanding their place and the role they can play within systems of care.</div></div><div><h3>Aims</h3><div>We wanted to explore the perceived characteristics of the emergency nurse practitioners by the physicians, nurses, health care managers, and emergency nurse practitioners themselves</div></div><div><h3>Methods</h3><div>This is a multicenter qualitative study. 21 semi-structured interviews were conducted in 5 distinct hospitals from April to June 2024. Participants included nurses, emergency nurse practitioners, physicians, and healthcare managers. Data were analyzed using thematic coding.</div></div><div><h3>Results</h3><div>Four themes emerged concerning the characteristics of emergency nurses practitioners professional identity: A combination of skills in a variety of fields (1), a pivotal professional, expert in the care pathway, at the interface with other emergency professions (2), a dual identity anchor: nurse and emergency professional, (3) and a position that is still in its nascent stages, plagued by uncertainty and obstacles (4).</div></div><div><h3>Conclusion</h3><div>This study revealed the characteristics of the professional nursing identity. It emerges that professionals see the emergency nurse practitioners as an intermediary player in the care response and as an expert in the care pathway.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100384"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686113","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":"Temporary nurse deployments: a time-series analysis of shift scheduling dynamics and staffing level alignment","authors":"Maryam Ahmadi Shad ,&nbsp;MohammadHossein Khorasanizadeh ,&nbsp;Sarah N Musy ,&nbsp;Franziska Zúñiga ,&nbsp;Fatemeh Atoof ,&nbsp;Michael Simon","doi":"10.1016/j.ijnsa.2025.100383","DOIUrl":"10.1016/j.ijnsa.2025.100383","url":null,"abstract":"<div><h3>Introduction</h3><div>Hospitals deploy temporary nurses to bridge staffing gaps. However, evidence remains inconclusive regarding the extent, patterns, and factors driving temporary deployment. This study aimed to describe how temporary nurses are deployed as a response to shift-level schedule deviations and shortfalls in planned schedules.</div></div><div><h3>Methods</h3><div>Our four-month time-series analysis covered 1344 shifts across two medical and two surgical units in a tertiary hospital in Iran. Shift-level data included nursing staff numbers, the skill mix, staff absences and the patient count and turnover. The patient-to-nurse ratio was used to gauge staffing levels. Data were analysed using both descriptive and analytical approaches, including the fitting of three generalized linear mixed models to assess potential drivers of shifts involving temporary RNs.</div></div><div><h3>Results</h3><div>Temporary nurses worked on 12.2 % of shifts with the majority being Registered Nurses (RNs) (81.7 %). Only 28.5 % of deviations led to temporary RN deployments. While students and aides were sometimes reallocated to fill absences, the majority of absences (57.1 %) went unaddressed. Temporary staff mainly worked on shifts with below-average RN-staffing. Unit-level deployment rates varied widely (3.6 %–55.9 %). Model 1 revealed that RN absence increased the odds of using a temporary RN by 2.14 times (AIC = 785.1). Model 2 indicated that each additional patient, increased the odds by 11 % (AIC = 740.7). Model 3 showed that when RN-staffing was below-average the odds of using a temporary RN were 3.96 times higher than the average level (AIC = 707.4).</div></div><div><h3>Conclusion</h3><div>Temporary nurse deployment was relatively infrequent. While temporary nurses were strategically deployed to address understaffing and short-notice deviations, their deployment did not fully bridge the staffing needs. On high-demand units, temporary staff were commonly supplemented by reallocating students. Some temporary deployments occurred even where RN-staffing was at an average level. These findings indicate an urgent need to enhance the effectiveness of temporary deployment and optimize workforce resources to ensure high-quality care.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100383"},"PeriodicalIF":3.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904059","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":"Acceptance and Commitment Therapy-based empowerment intervention for asthma management in parent-child dyads: A pilot randomised controlled trial","authors":"Xu Wang ,&nbsp;Wai Tong Chien ,&nbsp;Yuen Yu Chong","doi":"10.1016/j.ijnsa.2025.100381","DOIUrl":"10.1016/j.ijnsa.2025.100381","url":null,"abstract":"<div><h3>Background</h3><div>Asthma in school-age children adversely affects their daily lives and increases parental stress that may further compromise asthma management and worsen asthma control. Few interventions address both aspects simultaneously.</div></div><div><h3>Aim</h3><div>To evaluate the feasibility, acceptability, and preliminary efficacy of an Acceptance and Commitment Therapy-based empowerment intervention for asthma management in school-age children with asthma and their parents.</div></div><div><h3>Design</h3><div>A parallel, two-arm pilot randomised controlled trial.</div></div><div><h3>Setting</h3><div>Three paediatric respiratory clinics in Chengdu, China.</div></div><div><h3>Participants</h3><div>Children aged 6 to 12 years with asthma receiving daily controller medications and their parents.</div></div><div><h3>Methods</h3><div>Fifty-six parent-child dyads were randomised to either a 5-week intervention or usual asthma care. The intervention integrated Acceptance and Commitment Therapy, family empowerment strategies, and asthma education and self-management training, delivered weekly through three online parent sessions and two face-to-face parent-child sessions. Feasibility was assessed via recruitment, attrition, and intervention completion rates and acceptability through satisfaction questionnaires and focus group interviews. Preliminary efficacy was evaluated through asthma control and parental stress (primary outcomes); children’s asthma self-management ability; parental symptoms of anxiety and depression; psychological flexibility; asthma knowledge; and family empowerment in asthma management (secondary outcomes), measured at baseline and immediately post-intervention.</div></div><div><h3>Results</h3><div>We achieved 61.5 % recruitment, 71.4 % intervention completion rates, and low attrition (children 3.5 %, parents 10.7 %). High satisfaction (93–100 %) and positive qualitative feedback indicated good acceptability despite challenges, including disruptions from children during online sessions and barriers to attending face-to-face sessions. The intervention group demonstrated statistically-significant improvements in asthma control, parental stress, children's self-management ability, parental asthma knowledge, and family empowerment in asthma management, compared to controls. No statistically-significant between-group differences were observed for other outcomes.</div></div><div><h3>Conclusion</h3><div>We found that the intervention demonstrated feasibility, acceptability, and promising effects on asthma control, parental stress, and secondary outcomes related to asthma management. Future fully-powered trials should implement enhanced strategies to further improve intervention completion rates and optimise online learning environments to improve parental psychological outcomes and should include extended follow-up assessments to establish long-term efficacy.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100381"},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605087","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 leadership in residential care for older people from the perspective of registered nurses: A qualitative study","authors":"Marie Jönsson ,&nbsp;Anna-Karin Edberg ,&nbsp;Malin Sundström ,&nbsp;Anneli Orrung Wallin ,&nbsp;Annica Backman","doi":"10.1016/j.ijnsa.2025.100377","DOIUrl":"10.1016/j.ijnsa.2025.100377","url":null,"abstract":"<div><h3>Introduction</h3><div>Registered nurses’ leadership involves promoting and implementing the recommended model of care, person-centred care, in residential care facilities. Research on registered nurses’ leadership of person-centred care is, however, limited. The aim was to explore person-centred leadership in residential care for older people from the perspective of registered nurses.</div></div><div><h3>Methods</h3><div>Focus-group and individual interviews were conducted with registered nurses (<em>n</em> = 15) working clinically in residential care facilities in seven municipalities in southern and northern Sweden. All interviews were performed digitally. Data were analysed using qualitative content analysis.</div></div><div><h3>Results</h3><div>Person-centred leadership meant leading through sense-making person-centredness in a complex care environment. This required both skills and abilities in leading person-centred care, while simultaneously managing various challenges in leading person-centred care.</div></div><div><h3>Conclusions</h3><div>This study explores the skills required for person-centred leadership and the challenges of applying these skills. The results advance our knowledge by conceptualising person-centred leadership among registered nurses in residential care facilities by sense-making person-centredness in a fragmented organisation. The results indicate that registered nurses’ person-centred leadership is defined by their beliefs, abilities, and actions and not always by their position of authority.</div></div><div><h3>Implications</h3><div>Person-centred leadership has the potential to improve the person-centred care of older people, which is why the challenges encountered in practice need to be addressed. Knowledge of registered nurses’ experiences of person-centred leadership can be used to improve their skills and abilities in leading person-centred care and to appropriately address the organisational challenges encountered in residential care facilities.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100377"},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654426","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":"Reconsidering the use of race, sex, and age in clinical algorithms to address bias in practice: A discussion paper","authors":"Reanna Panagides ,&nbsp;Jessica Keim-Malpass","doi":"10.1016/j.ijnsa.2025.100380","DOIUrl":"10.1016/j.ijnsa.2025.100380","url":null,"abstract":"<div><div>Clinical algorithms are commonly used as decision-support tools, incorporating patient-specific characteristics to predict health outcomes. Risk calculators are clinical algorithms particularly suited for resource allocation based on risk estimation. Although these calculators typically use physiologic data in estimation, they frequently include demographic variables such as race, sex, and age as well. In recent years, the inclusion of race as an input variable has been scrutinized for being reductive, serving as a poor proxy for biological differences, and contributing to the inequitable distribution of services. Little attention has been given to other demographic features, such as sex and age, and their potential to produce similar consequences. By applying a framework for understanding sources of harm throughout the machine learning life cycle and presenting case studies, this paper aims to examine sources of potential harms (i.e. representational and allocative harm) associated with including sex and age in clinical decision-making algorithms, particularly risk calculators. In doing so, this paper demonstrates how systematic discrimination, reductive measurement practices, and observed differences in risk estimation between demographic groups contribute to representational and allocative harm caused by including sex and age in clinical algorithms used for resource distribution. This paper ultimately, urges clinicians to scrutinize the practice of including reductive demographic features (i.e. race, binary-coded sex, and chronological age) as proxies for underlying biological mechanisms in their risk estimations as it violates the bioethical principles of justice and nonmaleficence. Practicing clinicians, including nurses, must have an underlying model literacy to address potential biases introduced in algorithm development, validation, and clinical practice.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100380"},"PeriodicalIF":3.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604529","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":"Working time distribution and administrative burden in Austrian community health nursing: A cross-sectional survey","authors":"Raimund M. Kovacevic ,&nbsp;Doris A. Behrens ,&nbsp;Walter Hyll","doi":"10.1016/j.ijnsa.2025.100375","DOIUrl":"10.1016/j.ijnsa.2025.100375","url":null,"abstract":"<div><h3>Background</h3><div>Community health nursing was introduced in Austria in 2022. As the 117 pilot projects now transition into centrally managed services, data on nurses’ working time distribution and client contact patterns are essential for workforce and location planning to ensure optimal service delivery.</div></div><div><h3>Objective</h3><div>To analyse the working time distribution and client contact patterns of Austrian community health nurses during the pilot phase (2022–2024).</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting(s)</h3><div>An online survey (April to June 2023) among community health nurses captured their working time distribution and client contact patterns.</div></div><div><h3>Participants</h3><div>Out of the N = 220 eligible community health nurses, 121 (55%) nurses answered the questions relevant to working time analysis and 115 (52%) for studying regional disparity of service delivery.</div></div><div><h3>Methods</h3><div>The analysis used descriptive statistics, statistical tests, and regression analysis, employing Excel®, Stata® and R.</div></div><div><h3>Results</h3><div>Our analysis shows that 92% of the community health nurses in Austria work in non-urban areas. On average, they have one client contact every five working hours, lasting around 75 minutes. Seventy per cent of these encounters result in follow-ups, usually within ten days. Across all regions, 28% of the Austrian community health nurses’ working time is dedicated to home visits and in-office consultations, 7% to outreach efforts aimed at attracting new clients, and 6% to travelling. Further, 29% of time is spent on administration and project management, 8% on team meetings, and 20% on networking and public relations. Service delivery varies significantly by region: rural nurses report fewer consultation hours and more time spent on travelling. Regardless of geography, the time spent on organisational tasks increases disproportionately—and more than any other activity—as total working hours increase.</div></div><div><h3>Conclusions</h3><div>Each hour spent with a client requires an hour of administration, with no observable efficiency gains in administrative tasks as working hours increase. These findings highlight the need to explore whether targeted organisational support, such as administrative assistance or digital documentation tools, may improve efficiency. Additionally, current restrictions on client outreach and age eligibility may unnecessarily hinder service effectiveness and accessibility.</div></div><div><h3>Tweetable abstract</h3><div>Study of Austrian community health nurses reveals: for every hour with clients, nurses spend an equal hour on administration. Administrative burden grows disproportionately with longer working hours, with no efficiency gains.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100375"},"PeriodicalIF":3.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605088","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":"Sick leave due to musculoskeletal disorders: A prospective cohort study","authors":"Rigmor Harang Knutsen ,&nbsp;Morten Birkeland Nielsen ,&nbsp;Lars Kristian Lunde ,&nbsp;Knut Inge Fostervold ,&nbsp;Håkon A. Johannessen","doi":"10.1016/j.ijnsa.2025.100376","DOIUrl":"10.1016/j.ijnsa.2025.100376","url":null,"abstract":"<div><h3>Background</h3><div>In Norway, home care workers experience particularly high levels of medically-certified sick leave. A substantial percentage of sick leave is due to musculoskeletal disorders, which may be attributed to risk factors at work. Due to limited knowledge of the impact of working conditions on sick leave in this sector, an improved understanding of occupation-specific risk factors is needed.</div></div><div><h3>Objective</h3><div>To examine the impact of psychosocial and mechanical work factors on subsequent sick leave due to musculoskeletal disorders.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>A probability sample of 130 Norwegian municipalities and their respective home care services.</div></div><div><h3>Participants</h3><div>1819 home care workers.</div></div><div><h3>Methods</h3><div>Participants were surveyed on work environment factors and followed for 26 months between 2019 and 2021 using registry data on sick leave from the Norwegian Labour and Welfare Administration. Registry data comprised complete registrations of all medically-certified sick leave, including the relevant diagnostic codes of the International Classification of Primary Care system. Incidence risk ratios and 95 % confidence intervals were calculated using negative binomial regression with robust standard deviations. Population attributable risk and population preventable fractions were calculated to estimate the contribution of the significant work factors to sick leave in the sample.</div></div><div><h3>Results</h3><div>The following factors were associated with excessive risk of sick leave due to musculoskeletal disorders: Lifting or supporting the patient between bed and chair or wheelchair, heavy physical exertion without aids or assistance, heavy physical exertion despite aids or assistance, walking/standing, forward bending of the upper body, squatting/kneeling, and experiencing the work as physically demanding. Control over work pacing, fair leadership, empowering leadership, and support from immediate supervisor were associated with reduced risk of sick leave.</div></div><div><h3>Conclusions</h3><div>Preventive efforts to reduce sick leave due to musculoskeletal disorders among home care workers should adopt a multifactorial approach, including both psychosocial and mechanical work factors and the context in which they occur. There may be considerable potential for risk reduction by targeting awkward postures and heavy physical exertions, facilitating control over work pacing, and developing relationship-oriented leadership skills.</div></div><div><h3>Registration</h3><div>Clinical Trials - NCT03855163.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100376"},"PeriodicalIF":3.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604530","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 Fever-Sugar-Swallow Protocols improve nurses' and physicians' satisfaction with the management of fever, hyperglycemia and dysphagia in stroke patients: A pre-and post-implementation survey of the “Quality in Acute Stroke Care” (QASC) Program‘","authors":"Anne-Kathrin Cassier-Woidasky ,&nbsp;Winfried Zinn ,&nbsp;Sandy Middleton ,&nbsp;Simeon Dale ,&nbsp;Waltraud Pfeilschifter","doi":"10.1016/j.ijnsa.2025.100374","DOIUrl":"10.1016/j.ijnsa.2025.100374","url":null,"abstract":"<div><h3>Background</h3><div>Nurses play a key role for delivery of high-quality patient care in the interprofessional stroke team. Nurses’ autonomy and advanced competencies are essential to a positive work environment, yet, are not well developed in Germany.</div></div><div><h3>Objective</h3><div>To assess whether using the Fever-Sugar-Swallow (FeSS) Protocols in stroke care improves: a) nurses’ satisfaction regarding their ability to autonomously manage fever, hyperglycemia, and dysphagia; and b) physicians’ satisfaction regarding the management of these parameters in German stroke units.</div></div><div><h3>Design</h3><div>A pre-test/post-test survey administered to nursing and medical staff in eight stroke units was conducted prior to and following implementation of the FeSS Protocols.</div></div><div><h3>Methods</h3><div>An online survey, comprising items regarding global job satisfaction, the target parameters and control parameters, was distributed to participating stroke units. T-tests were calculated for significance between pre-post implementation, Cohen’s d was used to measure the effect size.</div></div><div><h3>Results</h3><div>A total of 308 respondents (nurses <em>n</em> = 112 [pre], <em>n</em> = 65 [post]; physicians <em>n</em> = 82 [pre], <em>n</em> = 49 [post]) from 8 stroke units completed the survey (response rates: 49 % nurses; 53 % physicians). There were no significant differences regarding global job satisfaction, but nurses were significantly more likely to report improvements in autonomy regarding fever management (able to act autonomously (<em>p</em> = 0.006) and competently (<em>p</em> &lt; 0.001)); perceived self-efficacy (<em>p</em> &lt; 0.001), regarding blood glucose management (able to act timely (<em>p</em> = 0.002) and competently (<em>p</em> = 0.007); perceived self-efficacy (<em>p</em> &lt; 0.001)), and dysphagia management (able to act autonomously (<em>p</em> = 0.005) and timely (<em>p</em> = 0.007)). In the medical profession, improvements were reported in training activities of new colleagues, not only regarding FeSS parameters fever (<em>p</em> &lt; 0.001) and dysphagia (<em>p</em> &lt; 0.001), but also regarding management of other clinical issues which were not the subject of our intervention (restlessness (<em>p</em> &lt; 0.001), and sleep disorders (<em>p</em> &lt; 0.001)).</div></div><div><h3>Conclusions</h3><div>Despite a tightly-regulated mandatory quality assurance system with well-established therapy guidelines, the implementation of the FeSS Protocols in German stroke units revealed potential for improvement by improving autonomy for nurses as a regular part of nurses’ work clinical practice, as it is common in other countries of the world. This would not only improve the quality of care, but could also contribute to increase attractiveness of work at the stroke unit.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100374"},"PeriodicalIF":3.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604528","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":"Explore the extended impacts on psychological well-being in older adults through application of virtual reality technology: An integrative review","authors":"Irene Yuen Fung Wong,&nbsp;Leona Yuen Ling Leung","doi":"10.1016/j.ijnsa.2025.100371","DOIUrl":"10.1016/j.ijnsa.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>The application of virtual reality technology is often presented as an emergent method to reduce older adults’ mental problems however the results of evaluations remain inconsistent. There has been little exploration of the extended impacts of virtual reality technology on older adults’ psychological well-being and, in particular, on their underlying psychological demands.</div></div><div><h3>Objectives</h3><div>This study aims to conduct an integrative review of recent literature to explore the extended impacts on the psychological well-being in older adults through application of virtual reality technology.</div></div><div><h3>Design</h3><div>This study adopted Whittemore and Knafl’s integrative review methodology.</div></div><div><h3>Methods</h3><div>Four major databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Medical Literature Analysis and Retrieval System Online (MEDLINE), ProQuest, and Web of Science were searched. The included studies were in full text, peer reviewed, English written, published from January 2020 to October 2024, involved a primary experimental virtual reality-based intervention for older adults aged 60 or above, and reported at least one or more psychological well-being impacts. Among the 13 included literature, 6 were randomized controlled trial studies and 7 were quasi-experimental studies, of which, 8 used quantitative design, 2 used qualitative design and 3 used mixed-methods research design. A total of 952 participants were involved. The research settings included nursing homes/elderly care facilities, university aging centre, medical centre, and designated research site. Critical Appraisal Skills Programme (CASP) Checklists were adapted and employed to appraise the study quality. Ryff’s framework of Psychological Well-Being was used as the underpinning idea.</div></div><div><h3>Results</h3><div>Among the 13 articles, 46% (n=6) were published in 2023 and 2024. The included studies were conducted in diverse geographical locations including the Middle East (n=2, 15.4%), Asia (n=5, 38.5%), Europe (n=4, 30.8%), North America (n=1, 7.7%), and Australia (n=1, 7.7%). The virtual reality interventions included reminiscence activities, recreation gaming, entertainment and relaxation experiences, therapeutic exercise, social virtual platforms and combined therapy intervention. Five extended impacts were identified finally.</div></div><div><h3>Conclusions</h3><div>Through this review, we highlight nurse professionals should take note of the extended impacts and the fulfilment on older adults’ underlying psychological demands through application of virtual reality technology.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100371"},"PeriodicalIF":3.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570856","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}