Katherine Kruger , Petra Brysiewicz , Jody Lori , Sue Anne Bell
{"title":"The role of the nursing workforce in health system resilience during disasters: a scoping review of empirical studies","authors":"Katherine Kruger , Petra Brysiewicz , Jody Lori , Sue Anne Bell","doi":"10.1016/j.ijnsa.2025.100361","DOIUrl":"10.1016/j.ijnsa.2025.100361","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to explore the extent to which the nursing workforce contributes to health system resilience globally through a scoping review of peerreviewed literature.</div></div><div><h3>Introduction</h3><div>The World Health Organization (WHO) has emphasized the need for the development of resilient health systems to meet current and future disaster readiness needs. The WHO has also emphasized mechanisms that will achieve this goal including a focus on strengthening the global nursing workforce to achieve the Sustainable Development Goals. However, there is limited synthesized research focusing on the contributions of the nursing workforce in developing and fostering health system resilience globally.</div></div><div><h3>Methods</h3><div>Using Joanna Briggs Institute methodology for scoping reviews, three key databases (PubMed, CINAHL, and Scopus) were searched for publications from 2006 until April 2024. English-language, research studies, and quality or process improvement projects were included. Systematic and scoping reviews, as well as studies focused on individual resilience, were excluded. Studies meeting search criteria were exported and screened first by title and abstract and subsequently underwent a full-text review using Covidence software. Quantitative and qualitative data from studies meeting inclusion criteria were extracted and analyzed according to study objectives to create a narrative synthesis. This study was registered in Open Science Framework on May 28, 2024.</div></div><div><h3>Results</h3><div>Eleven articles were included of the 795 total retrieved. Overall, there is limited discussion of the nursing workforce in health system resilience. Eight of the 11 articles (73 %) suggest that the nursing workforce is involved in operationalizing resilience during disasters, 10 articles (91 %) call for nurses to be leaders in policy and the development of resilient health systems, however, this review found zero reports in the literature of the nursing workforce’s role in the planning, development, and leadership of resilient systems.</div></div><div><h3>Implications</h3><div>Nurses are essential to resilient health systems, however, there is limited research examining the nursing workforce and its contributions to resilient health systems, particularly within disaster contexts. More targeted research on nursing workforce contributions to achieve resilient health systems is needed.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100361"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144299037","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}
Signe Østrem , Anna Strömberg , Kari Hanne Gjeilo , Marianne Storm , Ingvild M. Morken
{"title":"The process of self-care in patients with heart failure after nurse-assisted remote patient monitoring: A qualitative longitudinal approach","authors":"Signe Østrem , Anna Strömberg , Kari Hanne Gjeilo , Marianne Storm , Ingvild M. Morken","doi":"10.1016/j.ijnsa.2025.100426","DOIUrl":"10.1016/j.ijnsa.2025.100426","url":null,"abstract":"<div><h3>Background</h3><div>Effective self-care, including symptom monitoring and treatment adherence, is essential for individuals with heart failure. It can enhance quality of life, improve survival, and reduce hospital admissions. The home is the primary setting where individuals with heart failure perform self-care. However, many struggle to recognize symptoms that indicate worsening of their condition. Remote patient monitoring allows nurses to track symptoms, weight, and blood pressure while supporting self-care behaviours that help prevent exacerbations. A clearer understanding of these interventions is needed, particularly regarding how they influence patients’ views on self-care over time.</div></div><div><h3>Objective</h3><div>This study explored short- and long-term experiences of self-care among individuals with heart failure after a six-week, nurse-assisted remote patient monitoring intervention.</div></div><div><h3>Setting</h3><div>Twelve participants were recruited from the intervention group in a randomised controlled trial. Clinical trial ID 301472.</div></div><div><h3>Methods</h3><div>This study employed a qualitative longitudinal approach. Eleven semi-structured interviews were conducted at two time points: at time one, immediately after participants had completed the nurse-assisted remote patient monitoring intervention; and at time two, six months post-discharge. One participant did not respond to the second interview, resulting in 23 interviews in total. A qualitative content analysis was undertaken to explore the evolving self-care process over time.</div></div><div><h3>Results</h3><div>‘Transition from digital dependence to independent self-care management’ emerged as the overarching theme describing participants’ experiences at both time points. This theme was illustrated by four subthemes identified at time one: (1) guidance to interpret symptoms and bodily signs; (2) establishing a daily routine in monitoring vital signs; (3) support for changes in lifestyle and medication adherence; and (4) sense of security. At time two, three subthemes were identified: (1) increased confidence in bodily awareness and symptom monitoring; (2) recognition of self-care routines; and (3) feeling in control due to prior feedback from a previous nurse navigator.</div></div><div><h3>Conclusions</h3><div>Individuals with heart failure experienced self-care as an evolving process. This was demonstrated by their transition from reliance on digital support from nurses and the remote patient monitoring intervention to increased independence and proactivity in managing their self-care. There is an urgent need to respond to the pressures facing overburdened health-care systems. These findings highlight the importance of developing a digital environment that supports sustainable transitional care from hospital to home for individuals with heart failure.</div></div><div><h3>Registration</h3><div>The main randomised controlled trial project, “eHealth","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100426"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424326","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":"Nurse-led fall prevention programs in acute care settings: An integrative review","authors":"Sahar Abdulkarim AlGhareeb , Nora Ghalib AlOtaibi , Lujain Adel Sallam , Adnan Innab","doi":"10.1016/j.ijnsa.2025.100440","DOIUrl":"10.1016/j.ijnsa.2025.100440","url":null,"abstract":"<div><h3>Background</h3><div>Falls in acute care settings are associated with negative consequences to patients and the healthcare system. Despite growing awareness of the importance of fall prevention in healthcare, there remains a notable lack of comprehensive reviews specifically evaluating nurse-led fall prevention programs in acute care settings.</div></div><div><h3>Objectives</h3><div>This integrative review aimed to synthesize the current evidence on the nurse-led programs designed to prevent falls among adult inpatients in acute care settings.</div></div><div><h3>Methods</h3><div>This integrative review has been registered on the International Prospective Register of Systematic Reviews (PROSPERO). The review was guided by Whittemore and Knafl's five-stage integrative review framework. A systematic literature search was conducted across the CINAHL, Scopus, Medline, Web of Science, and ProQuest databases. Only studies published in English between 2016 and 2024, involving adult populations in acute care settings, were included, regardless of geographic location. Three reviewers independently reviewed and assessed the data extraction and methodological quality of each study using the Mixed Methods Appraisal Tool. The results were then analyzed and synthesized through narrative synthesis.</div></div><div><h3>Results</h3><div>Of 873 articles screened, 23 were included in the review. Four primary themes related to fall prevention strategies have been identified: the fall prevention strategies, nursing training and education, fall rate outcomes, and organizational and environmental factors.</div></div><div><h3>Conclusion</h3><div>This integrative review highlights the critical role of nurse-led interventions in reducing inpatient falls within acute care settings. Analyzing the key features of these prevention strategies may enable future researchers to enhance and recommend employing multiple intervention strategies for more effective methods for minimizing fall incidents in such environments. Using a single fall prevention strategy demonstrated lower effectiveness than the multiple strategies.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100440"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424421","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}
Cora Lunn , Claire O’ Donnell , Sarah MacCurtain , Alice Coffey
{"title":"Realigning identity: Nurse executives' experiences within a new socio-professional group – A classic grounded theory study","authors":"Cora Lunn , Claire O’ Donnell , Sarah MacCurtain , Alice Coffey","doi":"10.1016/j.ijnsa.2025.100367","DOIUrl":"10.1016/j.ijnsa.2025.100367","url":null,"abstract":"<div><h3>Background</h3><div>Nurse executives play a crucial role in adapting to the evolving needs of healthcare communities. Existing research demonstrates the positive impact of nursing leadership practices on workforce retention, job satisfaction and overall well-being. The complexities surrounding role transitioning for nurse executives remains under explored.</div></div><div><h3>Objective</h3><div>This study aims to deepen the understanding of how nurse executive leaders navigate the intricate process of role transitioning, providing insights into their experiences and challenges.</div></div><div><h3>Design</h3><div>This study was conducted using Glaser's classic grounded theory.</div></div><div><h3>Setting</h3><div>This study was carried out in acute hospital settings at seven different sites in the Republic of Ireland.</div></div><div><h3>Participants</h3><div>Participants were 12 nurse executives who were working in the Republic of Ireland, with additional reflective diary notes gathered from conversations with six international nurse executives.</div></div><div><h3>Methods</h3><div>Data were collected through unstructured interviews conducted between January 2020 and September 2022. The process of data collection and analysis occurred simultaneously, with the data being analysed based on the principles of classic grounded theory.</div></div><div><h3>Results</h3><div>This study introduces the theory of Identity Realigning, which describes the leadership development of nurse executives through three stages: identity earning, role transitioning, and self-integrating. Identity Earning involves forming a new identity within a new socio-professional group. Role transitioning is the psychological process of moving from one role to another, encompassing various stages. Self-Integrating refers to the extent of assimilation into the new role and socio-professional group. Factors such as organisational design and resources were identified as contextual conditions that can either facilitate or impede success for nurse executives.</div></div><div><h3>Conclusion</h3><div>The theory of Identity Realigning provides significant insights for educators, leaders, and policymakers by explaining the intricate process of role transitioning for nurse executives. It establishes a clear link between shifts in professional identity and the processes of role transitioning and integration. This connection underscores the critical importance of developing executive skills and highlights the necessity for tailored professional development strategies for this cohort.</div><div>Identity realigning theory; Nurse executive; Identity earning; Role transition; Self-integration</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100367"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314356","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}
Daniele Cristina Bosco Aprile , Karina Aparecida Lopes da Costa , Renata Eloah de Lucena Ferretti-Rebustini , Vinicius Batista Santos , Mirian Ueda Yamaguchi , Camila Takáo Lopes
{"title":"Evaluation of the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument for individuals with heart failure","authors":"Daniele Cristina Bosco Aprile , Karina Aparecida Lopes da Costa , Renata Eloah de Lucena Ferretti-Rebustini , Vinicius Batista Santos , Mirian Ueda Yamaguchi , Camila Takáo Lopes","doi":"10.1016/j.ijnsa.2025.100391","DOIUrl":"10.1016/j.ijnsa.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>Digital health literacy is a critical skill for heart failure self-care, which should be assessed through valid and reliable instruments.</div></div><div><h3>Objective</h3><div>To evaluate the psychometric properties of the Brazilian version of the Digital Health Literacy Instrument in individuals with heart failure.</div></div><div><h3>Design</h3><div>A psychometric study analyzing internal structure validity and reliability.</div></div><div><h3>Settings</h3><div>The participants were recruited at the cardiomyopathy outpatient clinic of a public hospital in São Paulo, Brazil.</div></div><div><h3>Participants</h3><div>Outpatients with heart failure who used the internet.</div></div><div><h3>Methods</h3><div>The instrument was administered to 127 individuals, with bootstrapping to 500. Internal structure validity and reliability were assessed through Exploratory and Confirmatory Factor Analyses. Dimensionality was determined via Parallel Analysis, and data extraction employed Robust MORGANA factor analysis. Measure of Sampling Adequacy and Kaiser-Meyer-Olkin were expected to be close to 1 and Bartlett’s test should have <em>p</em> < 0.05. Target explained variance was approximately 60 %, with factor loadings >0.3 and communalities >0.4. Fit indices (Comparative Fit Index, Tucker-Lewis Index and Goodness of Fit Index) should be approximately 1 and Root Mean Square Error of Approximation should be 0.05–0.08. Reliability was measured using ordinal alpha and McDonald’s omega (>0.9).</div></div><div><h3>Results</h3><div>A unidimensional model emerged. Five items were removed due to factor loadings <0.2, Heywood case, excessive residuals, and double saturation. The final 16-item model had Kaiser-Meyer-Olkin = 0.86, Measure of Sampling Adequacy >0.75, explained variance = 59 %, factor loadings 0.53–0.86, and communalities 0.28–0.74. Reliability was high (alpha= 0.94, omega= 0.95). The adjusted model showed Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99 and Goodness of Fit Index = 0.98 and Root Mean Square Error of Approximation = 0.07.</div></div><div><h3>Conclusions</h3><div>The Brazilian version of the Digital Health Literacy Instrument demonstrated strong internal structure validity and reliability for individuals with heart failure, supporting its use in research and clinical practice.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100391"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864674","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}
Emma Brulin , Emelie Thunqvist , Per Gustavsson , Carolina Bigert , Tove Nilsson , Seth Addo , Abid Lashari
{"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 , Emelie Thunqvist , Per Gustavsson , Carolina Bigert , Tove Nilsson , Seth Addo , 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":"2025-12-01","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}
Mariëlle Van Mersbergen-de Bruin , Catharina Van Oostveen , Anne Marie Weggelaar-Jansen
{"title":"Nurses’ challenges and strategies for safeguarding care quality and safety: A qualitative study on situated resilience","authors":"Mariëlle Van Mersbergen-de Bruin , Catharina Van Oostveen , Anne Marie Weggelaar-Jansen","doi":"10.1016/j.ijnsa.2025.100365","DOIUrl":"10.1016/j.ijnsa.2025.100365","url":null,"abstract":"<div><h3>Background</h3><div>Most healthcare delivery succeeds in safeguarding high-quality care and safety. This is largely due to the adaptive capacity and situated resilience work of healthcare professionals as nurses who keeps things on track<em>.</em> However, much of their situated resilience work in complex everyday practice remains hidden or is done behind the scenes.</div></div><div><h3>Objective</h3><div>To explore situated resilience in everyday nursing practice and shed light on the often invisible efforts of nurses as they manage immediate challenges and navigate complex processes to ensure care quality and safety.</div></div><div><h3>Design</h3><div>A qualitative design.</div></div><div><h3>Setting(s)</h3><div>The surgical and an ambulatory care team of an urban, 600-bed Dutch teaching hospital.</div></div><div><h3>Participants</h3><div>Nurses (<em>N</em> = 37), nurse practitioners (<em>N</em> = 2), managers (<em>N</em> = 5),</div></div><div><h3>Methods</h3><div>Data were collected through 80 hours of non-participant non-participant observations, three semi-structured interviews with nurses and one monodisciplinary (i.e. nurses) focus group. Thereafter, two multidisciplinary focus groups were conducted. Data were analysed using thematic analysis. The research protocol was approved by the ethical review board of Erasmus University Rotterdam under number ETH2122-0079.</div></div><div><h3>Results</h3><div>Nurses are dedicated providing the high-quality care that ensures patient safety. In daily practice they face challenges that require them to make changes to system standards. We identified three key triggers for change and emerging strategies to handle these triggers: 1) when standard risk assessment does not fit nursing practice, nurses a) seem to comply with the system, b) adopt an investigative, attentive approach. 2) when protocols and guidelines do not align with daily practices, nurses a) proactively identify potential and actual changes, b) find the \"golden mean\" through relational negotiation and patient advocacy. 3) when nurses and other healthcare professionals hold differing values on care quality and safety, nurses a) find allies, and b) applied various indirect means.</div></div><div><h3>Conclusions</h3><div>Our study reveals that situated resilience in nursing is not only a television series of actions to fix misalignments or to deal with unexpected change. It unfolds as a relational process in which nurses adapt their behaviour intuitively according to a patient’s unique situation, values, and interests. By balancing the individual patient’s needs and values with organizational systemic demands nurses exhibit situated resilience. By recognizing and supporting situated resilience practices, organizations not only enhance the quality of daily practice but also structurally strengthen their adaptive and resilient capacities. Further research into the role of nurses in system-level resilience and the impact of experience o","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100365"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322585","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}
Britta E Gynning , Elin Karlsson , Kevin Teoh , Per Gustavsson , Filip Christiansen , Emma Brulin
{"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 , Elin Karlsson , Kevin Teoh , Per Gustavsson , Filip Christiansen , 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":"2025-12-01","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}
Nicole Williams , Walter Wittich , M.Kathleen Pichora-Fuller , Joseph B. Orange , Dawn M. Guthrie
{"title":"Examining the ability of the interRAI communication collaborative action plan to identify individuals with sensory challenges: A retrospective cohort study","authors":"Nicole Williams , Walter Wittich , M.Kathleen Pichora-Fuller , Joseph B. Orange , Dawn M. Guthrie","doi":"10.1016/j.ijnsa.2025.100424","DOIUrl":"10.1016/j.ijnsa.2025.100424","url":null,"abstract":"<div><h3>Background</h3><div>The current study evaluated the performance of the interRAI communication collaborative action plan (CAP) to flag individuals with sensory impairments who could benefit from intervention. Investigators also examined how the CAP can help facilitate client-centered care planning and service delivery by exploring three unique case studies.</div></div><div><h3>Method</h3><div>This retrospective cohort study utilized secondary data collected using the Resident Assessment Instrument for Home Care (RAI-HC) across Canada. The sample included individuals aged 65 years or older who had two RAI-HC assessments completed between 2008 and 2020 (n=508,856). At time 1, individuals were categorized into three mutually exclusive groups based on their CAP triggering level: not triggered, triggered to facilitate improvement, or triggered to prevent decline. The three groups were compared across demographic characteristics, sensory impairments, cognitive challenges, and disease diagnoses. Transitions between triggering levels from time 1 and time 2 were analyzed using Sankey diagrams. Three case studies were examined to identify the reasons why someone may no longer trigger on the CAP at time 2.</div></div><div><h3>Results</h3><div>The median time between an individual’s intake and most recent assessment was 21 months (standard deviation=24.7 months). The majority of individuals did not trigger on the CAP at time 1 (77.7 %; n=395,309), while 9.5 % (n=48,263) triggered to facilitate improvement and 12.5 % (n=65,284) triggered to prevent decline. For each of the sensory impairments, the majority of individuals were more likely to fall into the triggered to facilitate improvement group.</div></div><div><h3>Conclusions</h3><div>The communication CAP was robust in flagging individuals with sensory impairments as these individuals are more likely to fall into the triggered to facilitate improvement group. The three case studies highlight the importance of assessing all aspects of communication (e.g., cognitive, and sensory challenges, receptive and expressive communication), as they are all necessary components when considering decision-support tools and next steps.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100424"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265291","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":"Impact of a decision-making support framework on nurse burnout and quality of end-of-life care: A before-and-after study in intensive care units","authors":"Yoshihiko Takahashi , Shu Utsumi , Kenji Fujizuka , Hiroyuki Suzuki , Yumiko Takadera , Mitsunobu Nakamura","doi":"10.1016/j.ijnsa.2025.100438","DOIUrl":"10.1016/j.ijnsa.2025.100438","url":null,"abstract":"<div><h3>Background</h3><div>The high incidence of burnout syndrome among intensive care unit nurses highlights the need for effective prevention strategies. Poor decision-making in end-of-life care contributes to nurse burnout syndrome through a decline in the quality of end-of-life care; however, the effects of enhancing decision-making support remain unclear.</div></div><div><h3>Objectives</h3><div>To examine the relationship between enhanced decision-making support in end-of-life care, nurse burnout syndrome, and the quality of end-of-life care.</div></div><div><h3>Methods</h3><div>A before-and-after intervention study was conducted in a 24-bed mixed intensive care unit at a tertiary emergency medical center in Japan. In September 2022, a decision-making support framework, developed through an international Delphi meeting in 2020, was introduced. Pre- and post-intervention questionnaires (August 2022, 2023) assessed nurse burnout syndrome using the Maslach Burnout Inventory and nurses' evaluation of end-of-life care using the Quality of Dying and Death scale. Univariate analysis used <em>t</em>-tests or Mann–Whitney U tests for continuous variables and chi-squared or Fisher’s exact tests for categorical variables. Multivariate analysis used multiple regression, adjusting for nurses' age, sex, and intensive care unit experience.</div></div><div><h3>Results</h3><div>Among the 70 nurses, 51 (73%) completed pre- and post-intervention surveys. While the Maslach Burnout Inventory showed no statistically significant change (15 vs. 11, p = 0.177), the subscales of emotional exhaustion (15 vs. 14, p = 0.089) and depersonalization (12 vs. 10, p = 0.087) showed trends toward improvement. No significant subgroup differences were observed based on sex, age, or intensive care unit experience. However, the Quality of Dying and Death scale showed a significant improvement (33 vs. 27, p = 0.002), which remained significant in the multivariate analysis (β = 5.015, p = 0.02). Subgroup analysis revealed more pronounced improvements in the Quality of Dying and Death scale among female nurses, those under 30, and nurses with less than five years of intensive care unit experience.</div></div><div><h3>Conclusions</h3><div>The decision-making support framework was associated with a non-significant reduction in burnout syndrome but a significant improvement in nurses' evaluation of end-of-life care. This suggests that factors contributing to burnout syndrome in end-of-life care may have improved. Further large-scale, multicenter studies are required to determine whether this intervention ultimately contributes to mitigating burnout syndrome.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"9 ","pages":"Article 100438"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424327","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}