BMC Nursing最新文献

{"title":"Digitalization in the operating theatre- an interview study of operating room nurses' and nurse anesthetists' experiences in Norway.","authors":"Ann-Chatrin Linqvist Leonardsen, Vivian Nystrøm, Anne Kristin Hole Trollnes, Renate Slang, Eilen Olsen","doi":"10.1186/s12912-024-02574-9","DOIUrl":"https://doi.org/10.1186/s12912-024-02574-9","url":null,"abstract":"<p><strong>Background: </strong>Digitalization in the health sector requires adaptive change in human attitudes and skills. The operating theatres have been introduced to digital innovations through centuries. The aim of this study was to explore operating room (OR) nurses' and Nurse Anesthetists' (NAs) experiences with digitalization in the operating theatre.</p><p><strong>Methods: </strong>The study had a qualitative design, using individual interviews with OR nurses and NAs at a Norwegian hospital. Data were analyzed using reflexive thematic analysis in-line with recommendations from Braun & Clarke.</p><p><strong>Results: </strong>Two themes were identified, namely (1) Impacting the work processes, and (2) Implications for patient safety. The OR nurses and NAs experienced that digitalization impacted on their work processes positively through making these smoother, but also negatively making the work processes vulnerable for disruptions, leading to a need for parallel actions. Digitalization was experienced to positively impact patient safety for example through making information more accessible. However, digital tools reduced focus on the patient, and then represented a risk to patient safety.</p><p><strong>Conclusion: </strong>OR nurses and NAs perceive that digitalization on one side may facilitate work processes and information flow. However, on the other side digitalization may steel focus on the patient. These aspects should be taken into consideration in quality improvement initiatives and when introducing new digital tools.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"899"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on nurse outcomes in the private sector of South Africa: a cross-sectional study.","authors":"Granny Solofelang Gohentsemang, Siedine Knobloch Coetzee, Stephani Botha, Erika Fourie","doi":"10.1186/s12912-024-02559-8","DOIUrl":"https://doi.org/10.1186/s12912-024-02559-8","url":null,"abstract":"<p><strong>Background: </strong>This study explored and described the impact of the COVID-19 pandemic on nurse outcomes in the private sector of South Africa. National research shows that nurses had poor nurse outcomes prior to the pandemic, amidst these issues the COVID-19 pandemic occurred, with nurses having to play a key role in the public health response. International studies have shown that although nurses were willing to serve in this manner, they experienced moderate to high burnout, anxiety, depression, fear and exhaustion. However, this topic has received comparatively little attention in African countries.</p><p><strong>Methods: </strong>A cross-sectional survey design was conducted. Multistage sampling was applied in selection of provinces, hospital groups, hospitals, units, and nursing personnel. Valid and reliable tools were used to measure nurse outcomes. Data was collected from April 2021 until January 2022.</p><p><strong>Results: </strong>Nurses described having high levels of compassion satisfaction, moderate levels of compassion fatigue, and high levels of burnout. Nurses appeared satisfied with their job and career. Almost a quarter of nurses reported the intention to leave their job, and of those about a fifth indicated that they intended to leave the profession. The nurses who routinely cared for COVID-19 patients had a small statistically significant increase in compassion fatigue, compassion satisfaction, emotional exhaustion and, job turnover intention, and a small statistically significant decrease in job satisfaction. Increased exposure to death and dying showed small correlations with emotional exhaustion and career turnover intentions.</p><p><strong>Conclusion: </strong>The results of this study show that nurses were impacted by COVID-19 and death and dying during the pandemic, and that follow-up studies are needed post-pandemic.</p><p><strong>Implications of study: </strong>It is important that burnout and compassion fatigue be addressed on an organizational level, as nurse outcomes were already negative prior to the pandemic, and all global evidence points to the worsening of these outcomes post-pandemic. There were many psychological support interventions with proven effectiveness that should be explored and applied for the South African context.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"892"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of an escape room game on students' academic self-efficacy and motivation for critical thinking: oncology nursing course.","authors":"Betül Çakmak, Tuğçe Türten Kaymaz","doi":"10.1186/s12912-024-02586-5","DOIUrl":"https://doi.org/10.1186/s12912-024-02586-5","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effect of an escape room game on oncology nursing course students academic self-efficacy and motivation for critical thinking.</p><p><strong>Methods: </strong>This study adopted a one-group pretest-posttest experimental research design. The sample consisted of forty-two nursing students. Data were collected using a personal information form, the Academic Nurses' Self- Efficacy Scale, and the Critical Thinking Motivational Scale. The data were analyzed using descriptive statistics, t-test, Pearson-Spearman, Wilcoxon test.</p><p><strong>Results: </strong>None of the nursing students had played an escape room game for educational purposes before (100%; n = 42). The escape room game helped nursing students develop academic self-efficacy and boosted their motivation for thinking critically respectively (t = -3.252, p = 0.002; Z = -2.027, p = 0.043). More than 90% of the students reported that the escape room game helped them understand the subject, retain information, and apply it effectively.</p><p><strong>Conclusion: </strong>Universities should incorporate escape room games within the scope of oncology nursing courses as an alternative teaching approach to help students enhance their academic self-efficacy and critical thinking motivation. Researchers should plan studies with different samples to investigate the impact of escape room games on academic self-efficacy and critical thinking motivation.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"910"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of postoperative delirium prevention, diagnosis, and intervention protocol in patients monitored in the intensive care unit after cardiac surgery: a quasi-experimental study.","authors":"Gönül Kara Söylemez, Hülya Bulut","doi":"10.1186/s12912-024-02547-y","DOIUrl":"https://doi.org/10.1186/s12912-024-02547-y","url":null,"abstract":"<p><strong>Background: </strong>The incidence of delirium is high in the intensive care unit (ICU) after cardiac surgery. The development of evidence-based care protocols for delirium management and training of nurses in this regard can ensure effective management of delirium. This quasi-experimental study aimed to assess the effectiveness of a postoperative delirium prevention, diagnosis, and intervention protocol in patients undergoing monitoring in the ICU after cardiac surgery.</p><p><strong>Methods: </strong>This study included 64 patients who underwent cardiac surgery and met the inclusion criteria, along with 14 nurses working in the ICU. Patients were divided into control (n = 32) and intervention (n = 32) groups. The study comprised three phases: determining the incidence of delirium in the control group and the delirium diagnosis status of the nurses; providing training to nurses on postoperative delirium prevention, diagnosis and intervention protocol; implementing a preliminary study of the protocol; and finally, implementing the protocol in the intervention group. Statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>While there was no significant agreement in delirium diagnosis between researcher and nurses in the control group (kappa: 0.207) (p > 0.05), significant agreement was observed in the intervention group (kappa: 1.00) (p < 0.001). The delirium diagnosis rate of the nurses was 14.3% in the control group and 100% in the intervention group, which was a significant difference. The incidence of delirium was 21.9% in the control group and 9.4% in the intervention group, although the difference was not significant.</p><p><strong>Conclusion: </strong>Postoperative delirium prevention, diagnosis, and intervention protocol effectively enhance delirium diagnosis compliance among researchers and nurses and improve the accuracy of delirium diagnosis among postcardiac surgery ICU patients. The implementation of this protocol is recommended for delirium management in such patients.</p><p><strong>Trial registration: </strong>This study was retrospectively registered at Clinicaltrials.gov on 19.02.2024 (Clinical Trials ID: NCT06268119).</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"904"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparation of nursing students in nursing informatics competencies for the South African healthcare practice environment.","authors":"Loretta le Roux, Million Bimerew, Jennifer Chipps","doi":"10.1186/s12912-024-02614-4","DOIUrl":"https://doi.org/10.1186/s12912-024-02614-4","url":null,"abstract":"<p><strong>Background: </strong>Rapid technology advancements highlight the importance for nursing education to prepare competent nurses in informatics and technology integrated practice. This study examined nursing informatics in an undergraduate curriculum and competency levels at a selected South African university.</p><p><strong>Method: </strong>A survey measured nursing informatics competencies among undergraduate nursing students using the TANIC© nursing informatics scale. In addition, curriculum mapping was done to assess the inclusion of relevant content in the undergraduate curriculum. Mean scores out of 4 indicated competency levels from novice to proficient. Descriptive analysis was undertaken and 95% confidence intervals were computed for computer literacy, clinical information management, and information literacy domains. Independent Samples Wilcoxon U Tests compared competency level differences by year per domain. Curriculum mapping assessed technology-related activities across the four-year programme.</p><p><strong>Results: </strong>Of the 222 respondents (79.9% response rate), competence levels increased by year level. Computer literacy had the highest rating (3.33/4, ± 0.48), nearing proficient levels. This was followed by information literacy (2.81/4, ± 0.68), falling within a comfortable competency range, and clinical information management, (2.73/4, ± 0.77) indicating advanced beginner competency. Curriculum mapping revealed the absence of information management training.</p><p><strong>Conclusion: </strong>A need exists to increase NI integration in the curriculum, and better equip nurse educators to prepare students for technologically infused healthcare environments.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"923"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological distress, suicidality and resilience of Lithuanian nurses.","authors":"Povilas Kavaliauskas, Evaldas Kazlauskas, Giedre Smailyte","doi":"10.1186/s12912-024-02632-2","DOIUrl":"https://doi.org/10.1186/s12912-024-02632-2","url":null,"abstract":"<p><strong>Background: </strong>Nurses, like other healthcare workers, are prone to poorer mental health, increased burnout, and may have an increased risk of suicide.</p><p><strong>Purpose: </strong>This study aimed to evaluate mental health problems among Lithuanian nurses and explore factors associated with them.</p><p><strong>Method: </strong>The survey was completed by 533 nurses. Mental health was assessed using the Depression, Anxiety, and Stress Scale-21, and suicidal ideation was measured with the Suicidal Behaviours Questionnaire-Revised (SBQ-R).</p><p><strong>Findings: </strong>A large proportion of nurses in the study had high psychological distress, with 18% having high depression, 29.3% - high anxiety, and 17.1% - high stress. 21.2% of the sample had an increased suicide risk. 64.9% of nurses considered changing their careers to a non-medical profession in the last 12 months.</p><p><strong>Discussion: </strong>Addressing mental health issues in the national healthcare system is critical to avoiding the loss of valued medical community members and ensuring that patients do not lose their critical caretakers.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"922"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing caregiver stress and resource needs in pediatric cancer care.","authors":"Shaimaa Mohamed Amin, Mahmoud Abdelwahab Khedr, Azza Medhat Aziz Mansy, Ahmed Hashem El-Monshed, Mohamed Gamal Noaman Malek, Ayman Mohamed El-Ashry","doi":"10.1186/s12912-024-02483-x","DOIUrl":"https://doi.org/10.1186/s12912-024-02483-x","url":null,"abstract":"<p><strong>Background: </strong>Caregivers of pediatric cancer patients often face significant stress and emotional strain, which can negatively impact their well-being and the quality of care provided to their children. Understanding the socio-demographic factors influencing caregiver stress and identifying the specific needs and resources required by caregivers are crucial for improving support systems in pediatric cancer care.</p><p><strong>Aim of the study: </strong>This study aimed to analyze the levels of caregiver stress and their resource needs within pediatric cancer care.</p><p><strong>Methods: </strong>A cross-sectional descriptive design was used, and the study was conducted at El-Minia Oncology Center outpatient clinics, Egypt. The sample included 258 pediatric cancer caregivers selected based on predefined eligibility criteria. Data were collected using the Caregiver Needs and Resources Assessment (CNRA) and the King Stone Caregiver Stress Scale (KCSS), both of which demonstrated strong reliability and validity. Descriptive statistics, t-tests, ANOVA, and Pearson correlation coefficients were employed for data analysis using SPSS version 29, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>Caregivers reported moderate to high stress levels, with an average stress score of 34.59 (SD = 7.649). Age, education level, marital status, and income were significant predictors of caregiver stress (p < 0.001), with lower income and higher educational levels contributing to increased stress. The number of children, child's age, and duration since cancer diagnosis also significantly impacted stress levels (p < 0.001). Correlation analysis revealed that psychological needs were positively related to stress (r = 0.488, p < 0.001), while spirituality was negatively associated with stress (r = -0.241, p < 0.001). Regression analysis indicated that physiological needs (ß = 0.331) and role conflict (ß = 0.294) were the strongest predictors of stress (R² = 0.636).</p><p><strong>Conclusion and implications: </strong>This study emphasizes the impact of socio-demographic factors on caregiver stress in pediatric cancer care. Targeted interventions that address caregivers' psychological, social, and financial needs are essential to alleviate stress. Implementing caregiver-centered support programs in pediatric oncology can enhance the well-being of both caregivers and patients. Future research should explore sustainable strategies to further reduce caregiver burden.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"911"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers to AI adoption in nursing practice: a qualitative study of registered nurses' perspectives.","authors":"Osama Mohamed Elsayed Ramadan, Majed Mowanes Alruwaili, Abeer Nuwayfi Alruwaili, Mohamed Gamal Elsehrawy, Sulaiman Alanazi","doi":"10.1186/s12912-024-02571-y","DOIUrl":"https://doi.org/10.1186/s12912-024-02571-y","url":null,"abstract":"<p><strong>Background: </strong>Integrating Artificial Intelligence (AI) in nursing practice is revolutionising healthcare by enhancing clinical decision-making and patient care. However, the adoption of AI by registered nurses, especially in varied healthcare settings such as Saudi Arabia, remains underexplored. Understanding the facilitators and barriers from the perspective of frontline nurses is crucial for successful AI implementation.</p><p><strong>Aim: </strong>This study aimed to explore registered nurses' perspectives on the facilitators and barriers to AI adoption in nursing practice in Saudi Arabia and to propose an extended Technology Acceptance Model for AI in Nursing (TAM-AIN).</p><p><strong>Methods: </strong>A qualitative study utilising focus group discussions was conducted with 48 registered nurses from four major healthcare facilities in Al-Kharj, Saudi Arabia. Thematic analysis, guided by the Technology Acceptance Model framework, was employed to analyse the data.</p><p><strong>Results: </strong>Key facilitators of AI adoption included perceived benefits to patient care (85%), strong organisational support (70%), and comprehensive training programs (75%). Primary barriers involved technical challenges (60%), ethical concerns regarding patient privacy (55%), and fears of job displacement (45%). These findings led to the development of TAM-AIN, an extended model that incorporates additional constructs such as ethical alignment, organisational readiness, and perceived threats to professional autonomy.</p><p><strong>Conclusions: </strong>AI adoption in nursing practice requires a holistic approach that addresses technical, educational, ethical, and organisational challenges. The proposed TAM-AIN offers a comprehensive framework for optimising AI integration into nursing practice, emphasising the importance of nurse-centred implementation strategies. This model provides healthcare institutions and policymakers with a robust tool to facilitate successful AI adoption and enhance patient outcomes.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"891"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace interpersonal relationships and turnover intentions among care workers working in older adult care facilities in Japan: a mediation analysis comparing direct and mediated effects via psychological distress.","authors":"Shinya Takeda, Toshiki Fukuzaki","doi":"10.1186/s12912-024-02520-9","DOIUrl":"https://doi.org/10.1186/s12912-024-02520-9","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between workplace interpersonal relationships, psychological distress, and turnover intentions among care workers working in older adult care facilities.</p><p><strong>Methods: </strong>An anonymous online survey among 811 care workers in Tottori Prefecture, Japan, was conducted between November and December 2023. The data were collected using the Workplace Interpersonal Problems Scale for care workers (WIPS), the K6 scale to assess psychological distress, the Turnover Intention Scale and basic attributes. Responses were obtained from 254 participants with a response rate of 31.3%. The low response rate suggests that selection bias may have affected the results of this study.</p><p><strong>Results: </strong>The results of the mediation analysis for the WIPS subscale which was adjusted for basic attributes show that the direct effects of insufficient communication and a sense of unfair workload were stronger than the mediating effects of psychological distress (Insufficient communication: direct effect: β = 0.319 [95% CI = 0.192, 0.459]; mediation effect: β = 0.194 [95% CI = 0.105, 0.285]), sense of unfair workload: direct effect: β = 0.314 [95% CI = 0.187, 0.443]; mediation effect: β = 0.190 [95% CI = 0.113, 0.268]). In these other four WIPS subscales, psychological distress was partially mediated (bullying: direct effect: β = 0.207 [95% CI = 0.091, 0.322]; mediation effect: β = 0.204 [95% CI = 0.135, 0.290], different attitudes to care work: direct effect: β = 0.278 [95% CI = 0.140, 0.401]; mediation effect: β = 0.204 [95% CI = 0.128, 0.293], difficulty in guidance for subordinates/new staff: direct effect: β = 0.207 [95% CI = 0.072, 0.329]; mediation effect: β = 0.219[95% CI = 0.141, 0.313], labeling: direct effect: β = 0.198 [95% CI = 0.073, 0.330]; mediation effect: β = 0.211 [95% CI = 0.143, 0.287]).</p><p><strong>Conclusions: </strong>This study revealed that some workplace interpersonal problems have a stronger direct effect on turnover intentions, whereas others have a stronger mediating effect on turnover intentions through psychological distress. Workplace interpersonal problems are predictors of turnover intentions among care workers working in elderly care facilities, and different workplace interpersonal problems may be targeted for intervention to reduce turnover intentions.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"914"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From need to action: decoding the role of motivation in adherence to home-based cardiac rehabilitation exercise in chronic heart failure patients.","authors":"Zhen Yang, Hao Huang, Linyu Xu, Yu Gao, Chunqi Zhang, Aiping Wang","doi":"10.1186/s12912-024-02617-1","DOIUrl":"https://doi.org/10.1186/s12912-024-02617-1","url":null,"abstract":"<p><strong>Background: </strong>Adherence to home-based cardiac rehabilitation exercise remains suboptimal, and motivation may be the intrinsic driving force. This study aimed to explore the role of exercise regulatory motivation in mediating the relationship between psychological needs and exercise adherence among chronic heart failure patients, and to develop a mechanism model.</p><p><strong>Methods: </strong>This study adopted an explanatory sequential mixed-methods design. A hypothesized model of adherence behavior was developed. A survey was used to test the theory-driven model. A semi-structured interview delved deeper into chronic heart failure patients' experiences with HBCR exercise, identifying reasons behind significant mediation effects and refining the mechanism model.</p><p><strong>Results: </strong>A total of 248 eligible chronic heart failure patients participated in the quantitative study. Exercise regulatory motivation partially mediated the relationship between psychological needs and exercise adherence. In the qualitative study, 18 chronic heart failure patients from the quantitative sample were purposefully selected. Five sub-themes emerged from the textual data, which were distilled into two overarching themes: \"Specific Functions of Pathway Variables\" and \"Reasons for Mediation Path Significance.\" Integrating the qualitative and quantitative results, it was found that satisfying patients' psychological needs for exercise activates regulatory motivation, which in turn triggers sustained exercise behavior. As motivation becomes increasingly internalized, patients are able to set clear goals and maintain or adjust their home-based cardiac rehabilitation exercise over the long term.</p><p><strong>Conclusion: </strong>From a health psychology perspective, this study is the first to reveal the role of exercise regulatory motivation in linking psychological needs and exercise adherence among chronic heart failure patients, ultimately developing a mechanism model.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"23 1","pages":"913"},"PeriodicalIF":3.1,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}