Journal of Nursing Management最新文献

{"title":"Beyond Borders: Exploring the Experiences and Challenges of Ghanaian Nurses in Barbados Through Video-Based Analysis","authors":"Emmanuel Graham Nyameke,&nbsp;John Windie Ansah,&nbsp;Isaac Defiin","doi":"10.1155/jonm/8401519","DOIUrl":"https://doi.org/10.1155/jonm/8401519","url":null,"abstract":"<div>\u0000 <p>Migration of nurses continues to be a problem facing most African countries because governments are not able to absorb graduate nurses into the local health system. Because of this, some governments have resorted to bilateral agreements with other western countries to export nurses. Ghana has not been immunised against this social phenomenon. The government, through a bilateral agreement with the government of Barbados, has sent some nurses to the island. However, among the studies that have looked at the experiences of migrant nurses, the challenges and experiences of Ghanaian nurses in Barbados have not been explored. This paper explored the experiences and challenges of Ghanaian nurses in Barbados using video-based analysis, relying on three already existing videos of some of the nurses on YouTube. It was found that although the political environment was not favourable, the nurses were happy with the government’s decision to export nurses. Further, it was found that the government of Ghana does not play its supervisory role over the contracts to ensure that items in the contract are observed, which affects the nurses sent there.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/8401519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Association Between Patient–Nurse Ratio and Nurses’ Occupational Stressors: A Cross-Sectional Study","authors":"Yi-Chuan Chen,&nbsp;Hsueh-Ching Wu,&nbsp;Jiune-Jye Ho,&nbsp;Nai-Yun Cheng,&nbsp;Yue Leon Guo,&nbsp;Judith Shu-Chu Shiao","doi":"10.1155/jonm/6160674","DOIUrl":"https://doi.org/10.1155/jonm/6160674","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> The patient-nurse ratio significantly influences nursing workloads, but its specific relationship with nurses’ occupational stressors is poorly understood.</p>\u0000 <p><b>Aim:</b> This study aimed to examine the association between patient-nurse ratio and occupational stressors among nurses, highlighting understaffing as a potential driver of stress in clinical environments.</p>\u0000 <p><b>Methods:</b> A self-administered questionnaire was distributed to full-time nurses in the medical and surgical wards of accredited hospitals. Data collected included the average daily patient-nurse ratio, subscale scores from the Nurses’ Occupational Stressor Scale (NOSS), and demographic and workplace variables such as sex, age, educational attainment, marital status, hospital ownership, unit type, major shift in the past 3 months, work tenure, sleeping hours, and weekly working hours. Logistic regression models and restricted cubic splines were used to analyze associations between the average daily patient-nurse ratio and elevated nursing stressors. The study followed the STROBE guidelines for cross-sectional research.</p>\u0000 <p><b>Results:</b> Among the 996 nurses surveyed, a higher average daily patient-nurse ratio was significantly associated with increased stress levels across all subscales of the NOSS. Restricted cubic spline analysis revealed that a lower average daily patient-nurse ratio corresponded to reduced probabilities of encountering higher stressors related to work demands, insufficient support from coworkers or caregivers, organizational challenges, and difficulty taking leave. Conversely, higher average daily patient-nurse ratios were linked to greater stress probabilities in all measured domains.</p>\u0000 <p><b>Conclusion:</b> This study demonstrates that higher average daily patient-nurse ratios significantly increase occupational stress among nurses. Reducing the patient-nurse ratio may mitigate these stressors and improve the overall well-being of nursing staff.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/6160674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144125841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Long-Term Impact of Emotional Exhaustion on Frontline Nurse Managers Post-COVID-19: A Qualitative Study","authors":"David Sanabria-Delgado,&nbsp;Sergio Barrientos-Trigo,&nbsp;Ana María Porcel-Gálvez","doi":"10.1155/jonm/9280686","DOIUrl":"https://doi.org/10.1155/jonm/9280686","url":null,"abstract":"<div>\u0000 <p><b>Aim:</b> To explore emotional exhaustion in frontline nurse managers after 3 years of COVID-19, considering their essential role in healthcare systems and the prolonged impact of the pandemic on staff well-being and organizational effectiveness.</p>\u0000 <p><b>Design:</b> A qualitative phenomenological study was used. This approach attempts to uncover the essence of the experiences that nurse managers may have had.</p>\u0000 <p><b>Method:</b> Semi-structured interviews were conducted with 12 frontline nurse managers at a tertiary-level university hospital in Spain during May 2023. The data were analyzed using thematic analysis. A thematic framework was developed, and coding was guided by a well-established methodological approach.</p>\u0000 <p><b>Results:</b> Five categories were established after the analysis: general difficulties related to fear and uncertainty, and continuous changes in protocols, availability of human resources, accessibility to material resources, management carried out with relatives of patients, and emotional management.</p>\u0000 <p><b>Results:</b> Following the analysis, five key categories were identified that reflect the main challenges faced by nurse managers: (1) general difficulties related to fear and uncertainty, aggravated by frequent changes in protocols and the work environment; (2) availability of human resources, marked by high absenteeism and work overload; (3) accessibility to material resources, where the shortage of protective equipment and medical supplies generated ethical dilemmas and operational tensions; (4) management with patients’ relatives, a significant emotional component that required balancing empathy and safety measures in high-conflict contexts; and (5) emotional management of managers, which evidenced a significant emotional impact, highlighting the need for clear strategies to prevent burnout and foster resilience in these critical roles.</p>\u0000 <p><b>Conclusions:</b> Nursing managers experienced emotional exhaustion during the pandemic, not only due to the health consequences of the virus but also due to the complex management of material, human, and family resources. They faced difficult situations with families justifiably separated from their vulnerable loved ones. This highlights the need for specific interventions, such as psychological support, leadership training, and better allocation of resources, to reduce the risk of burnout and strengthen a more resilient healthcare system.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/9280686","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Political Competence Scale for Nurses (PCS-N): Instrument Development and Psychometric Evaluation","authors":"Nam Kyung Han,&nbsp;Gwang Suk Kim,&nbsp;Sunah Kim,&nbsp;Tae Wha Lee,&nbsp;Woojin Chung","doi":"10.1155/jonm/4683994","DOIUrl":"https://doi.org/10.1155/jonm/4683994","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Few tools are available to measure nurses’ political competence, and the existing ones have limitations in reflecting the multidimensional factors of competence. This study developed a multidimensional political competence measurement tool—the Political Competence Scale for Nurses (PCS-N)—and assessed its validity and reliability in measuring nurses’ political competence levels.</p>\u0000 <p><b>Methods:</b> This methodological study was based on the tool development and tool-test stages suggested by DeVellis.</p>\u0000 <p><b>Results:</b> The validity and reliability of the PCS-N were established. The PCS-N was tested for construct validity through content validity, item-total correlations of preliminary items, and exploratory factor analysis. The PCS-N comprises 35 items across four factors: political knowledge, political efficacy, political interaction, and political activity. The suitability of this measurement tool was established through construct validity and confirmatory factor analysis. Concurrent validity was verified and was significantly correlated with existing political science measurement tools, political efficacy, and political interest (<i>r</i> = 0.511, <i>p</i> &lt; 0.001). Internal consistency reliability (Cronbach’s <i>α</i> = 0.951) and test–retest reliability were also established, confirming the stability of the PCS-N.</p>\u0000 <p><b>Conclusions:</b> The PCS-N can be used to evaluate nurses’ political competence and provide a basis for constructing education and training programs to strengthen political competence and evaluate their effectiveness.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/4683994","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Empathy, Moral Sensitivity, and Spiritual Care Competence Among Nurses: A Cross-Sectional Study","authors":"Yanjia Li,&nbsp;Xin Wen,&nbsp;Yanyun Su,&nbsp;Xiaoying Zeng","doi":"10.1155/jonm/8245283","DOIUrl":"https://doi.org/10.1155/jonm/8245283","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> As the global population ages and the number of patients with chronic illnesses increases, caregivers need to consider not only the physical and psychological health of patients but also their spiritual needs when providing care. In providing spiritual care, caregivers must have empathy, moral sensitivity, and spiritual care competence. By exploring the relationship between the three variables, it is essential to improve the overall quality of care and promote patient recovery.</p>\u0000 <p><b>Aims:</b> The purpose of this study was to explore the relationship between empathy, moral sensitivity, and spiritual care competence of nurses.</p>\u0000 <p><b>Methods:</b> A total of 390 nurses from three hospitals in China were surveyed using an online questionnaire that included nurses’ sociodemographic, empathy, moral sensitivity, and spiritual care competence. The data were analyzed using statistical software IBM SPSS 27.0.</p>\u0000 <p><b>Results:</b> The results showed that the total score of nurses’ spiritual care competence was 47.92 ± 8.71. The relationship between empathy, moral sensitivity, and spiritual care competence was significant, with correlation coefficients ranging from 0.400 to 0.574 (<i>p</i> &lt; 0.01). The results of multivariate analysis show that empathy, moral sensitivity, and other variables were the main predictors of nurses’ spiritual care competence, explaining 30.3% of the total variation.</p>\u0000 <p><b>Conclusions:</b> This study found that empathy and moral sensitivity of nurses may be an effective way to improve nurses’ spiritual care competence. The results of this study not only provide reference for improving the spiritual care competence of nurses but also improve the quality of care and patient care experience.</p>\u0000 <p><b>Implications for Nursing Management:</b> The results of this study suggest that nursing managers and educators should pay attention to nurses’ empathy and moral sensitivity and take timely intervention measures to improve nurses’ spiritual care competence. To achieve the goal, comprehensively improving the professional quality of nurses and promoting the development of whole-person nursing is essential.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/8245283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Implementation of Infection Prevention and Control Procedures in Primary Care During the COVID-19 Pandemic: A Qualitative Study of Nursing Roles","authors":"Samina Idrees,&nbsp;Maria Mathews,&nbsp;Lindsay Hedden,&nbsp;Julia Lukewich,&nbsp;Emily Gard Marshall,&nbsp;Kelly Kean,&nbsp;Rhiannon Lyons,&nbsp;Jamie Wickett,&nbsp;Leslie Meredith,&nbsp;Dana Ryan,&nbsp;Sarah Spencer,&nbsp;Émilie Dufour,&nbsp;Paul Gill","doi":"10.1155/jonm/6634676","DOIUrl":"https://doi.org/10.1155/jonm/6634676","url":null,"abstract":"&lt;div&gt;\u0000 &lt;p&gt;&lt;b&gt;Introduction:&lt;/b&gt; During the COVID-19 pandemic, primary care practices felt poorly supported by existing infection prevention and control (IPAC) guidelines, which focused primarily on acute care facilities. This issue was further complicated by insufficient provision of personal protective equipment in primary care settings, which limited clinic capacity and the ability of primary care to provide in-person services. Nurses play an integral role in the implementation of IPAC procedures and the provision of ongoing primary care during a health crisis; however there is limited literature related to nurses’ roles in the enactment of IPAC procedures in primary care settings. This paper aims to describe primary care nurses’ experiences and roles in implementing IPAC during the COVID-19 pandemic.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Design:&lt;/b&gt; Qualitative analysis of interviews as part of a larger mixed methods case study.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; We conducted semistructured qualitative interviews with primary care nurses across four Canadian regions in the provinces of British Columbia, Ontario, Nova Scotia, and Newfoundland and Labrador. During the interviews, we asked participants to describe the roles they enacted during the various stages of the pandemic, any facilitators and challenges they encountered, and the potential roles that nurses could have played. We employed a thematic analysis approach, and, for the purposes of this paper, we analyzed themes relevant to the implementation of IPAC.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; We interviewed 76 nurses across the four regions and identified two overarching themes: (1) nurse-led transformation of clinic operations and (2) impact on workload. Primary care nurses developed and implemented IPAC policies, educated staff, and made critical decisions about patient care, often out of necessity and ahead of regional guidelines. In addition, nurses adapted workflows, managed supplies, and balanced in-person and virtual care to protect both patients and staff from COVID-19 exposure.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Conclusion:&lt;/b&gt; Despite the additional responsibilities and challenges that nurses faced in response to evolving guidelines, their IPAC efforts were pivotal in maintaining primary care clinic operations during the pandemic. The findings from this study underscore primary care nurses’ capacity to adapt and apply evidence-based practices and demonstrate the need for better pandemic planning to support primary care. IPAC guidance documents, suitable for primary care settings and informed by experiences from the COVID-19 pandemic, should be included in future pandemic plans.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Implications for Nursing Management:&lt;/b&gt; Our findings highlight the need for stronger institutional support and preparedness for primary care nurses during a pandemic. Nursing management should ensure that IPAC responsibilities are explicitly recognized within primary care nursing roles and supported ","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/6634676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies Used by Emergency Department Clinical Champions to Sustain Improvements in Intimate Partner Violence Screening: A Longitudinal Qualitative Study","authors":"Elham Saberi,&nbsp;John Hurley,&nbsp;Marie Hutchinson","doi":"10.1155/jonm/6615231","DOIUrl":"https://doi.org/10.1155/jonm/6615231","url":null,"abstract":"<div>\u0000 <p><b>Aim:</b> To identify the strategies that clinical champions implemented within emergency departments to initiate and sustain routine intimate partner violence (IPV) screening.</p>\u0000 <p><b>Background:</b> For effective IPV identification and responses to occur within healthcare settings, new attitudinal and practice changes are required. This paper adds to the body of knowledge about champions and their role within healthcare settings to achieve this end.</p>\u0000 <p><b>Design:</b> This qualitative study involved semistructured interviews with 23 individuals over a 2-year period who identified as champions and worked to introduce routine IPV screening in two hospital emergency departments. Data from transcribed interviews were analysed thematically using an interpretive framework and a process of constant comparison.</p>\u0000 <p><b>Results:</b> Champions detailed a range of strategies they employed to foster practice change. The primary strategies were as follows: normalising enquiring about IPV through narrative practice, building understanding and ownership, providing accompaniment, serving as an educator and resource person, and managing resistance.</p>\u0000 <p><b>Conclusions and Implications:</b> This paper highlights the specific complexities champions face when bringing about practice change in the area of IPV. The findings suggest nurse champions, particularly those working in the IPV space, adopt unique strategies compared to those described in the mainstream literature on champions. This evidence has implications for best practice and can ensure that the champion role is more effectively utilised by health services to better meet the needs of individuals experiencing IPV. It is recommended that champions be established as part of any IPV practice change process. Introduction of IPV education into nursing undergraduate and postgraduate education and workplace ongoing education and training is also recommended to strengthen the capacity of nursing staff to serve as IPV practice change champions.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/6615231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Nurses’ Emotional Exhaustion and Turnover Intentions: The Role of Prosocial Orientation and Perceived Patient Gratitude in a Moderated Mediation Model","authors":"Ferdinando Toscano,&nbsp;Teresa Galanti,&nbsp;Michela Cortini","doi":"10.1155/jonm/4445460","DOIUrl":"https://doi.org/10.1155/jonm/4445460","url":null,"abstract":"<div>\u0000 <p><b>Aims:</b> This study investigates the relationship between prosocial orientation and turnover intention among Italian nurses, examining the mediating role of emotional exhaustion and the moderating effect of perceived patient gratitude.</p>\u0000 <p><b>Design:</b> Cross-sectional quantitative study.</p>\u0000 <p><b>Methods:</b> A sample of 162 nurses employed in Italian hospitals completed an online survey on the Qualtrics platform assessing prosocial orientation, patient gratitude, emotional exhaustion, and turnover intention. Data were analyzed through a moderated mediation model via the PROCESS macro in JASP.</p>\u0000 <p><b>Results:</b> Prosocial orientation was negatively associated with turnover intention, with emotional exhaustion acting as a mediator in this relationship. Perceived patient gratitude moderated the impact of prosocial orientation on emotional exhaustion. The conditional indirect effect of prosocial orientation on turnover intention through emotional exhaustion was significant at average and high levels of patient gratitude, but not at low levels.</p>\u0000 <p><b>Conclusion:</b> The findings suggest that fostering prosocial orientation perceptions and enhancing patient gratitude and its perceptions can mitigate emotional exhaustion and reduce turnover intentions among nurses.</p>\u0000 <p><b>Implications for Nursing Management:</b> Healthcare organizations can promote prosocial orientation and patient gratitude through training, feedback, and recognition events to reduce nurses’ emotional exhaustion and turnover.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/4445460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Issues Encountered by Nurse Managers Working With Older Adults in Long-Term Care Settings: A Qualitative Interview Study","authors":"Anna-Liisa Arjama,&nbsp;Riitta Suhonen,&nbsp;Mari Kangasniemi","doi":"10.1155/jonm/3978256","DOIUrl":"https://doi.org/10.1155/jonm/3978256","url":null,"abstract":"&lt;div&gt;\u0000 &lt;p&gt;&lt;b&gt;Introduction:&lt;/b&gt; Nurse managers (NM) face ongoing ethical issues when they work with older adults in long-term care settings (LTCS), including around end-of-life care. Legislation and healthcare ethics guide the provision of ethical care to older adults in a changing societal and global context.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Research Aim:&lt;/b&gt; Our aim was to describe the ethical issues encountered by NMs.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; This qualitative study involved 23 NMs from seven randomly selected organisations who participated in semistructured focus group interviews in 2021. We analysed the data using inductive content analysis.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Ethical Considerations:&lt;/b&gt; The subject of this study was sensitive and reflected the participants’ individual views. They provided informed consent and their anonymity was guaranteed.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Ethical issues faced by NMs are related to residents’ rights to self-determination, ethical decision-making about staff and procedures, providing ethical leadership despite having conflicting roles, and defending ethics in LTCS on a societal level. NMs struggled to spend sufficient time supporting their staff during everyday care.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The ethical issues encountered by NMs are multidimensional and have both external and internal causes. NMs often deal with ethical issues on their own. Structuring their roles so that they can focus more on daily care could help NMs to provide more effective leadership and get more involved in their organisation’s decision-making. Further research into the impact of NMs’ backgrounds on their performance and responsibilities could provide new insight which would be useful in educating NMs and designing relevant organisational structures.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Implications for Nursing Management:&lt;/b&gt; Our research can be applied to practice, policy, education and research.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Practice:&lt;/b&gt; NMs’ daily work should be organised in a way that enables them to work closely with residents and staff. Reducing their secondary tasks could increase the time available to manage staff and provide individual coaching for those with different independent abilities. Being present during daily care would make it easier to deal with ethical issues in a timely manner, which could reduce staff’s moral distress and increase their well-being at work.&lt;/p&gt;\u0000 &lt;p&gt;&lt;b&gt;Policy:&lt;/b&gt; Understanding the importance of the role of NMs could help policy makers in planning LTCS care. Involving NMs in decision-making in organisations and society could increase awareness about the relevant ethical issues and improve the care that residents receive and the well-being of staff and new members. For example, how many employees a single NM can manage could be defined in the same way as the number of staff per resident has been determined. Implementing ethics committees in LTCS could provide a mechanism for consi","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/3978256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Adverse Drug Reactions for Older People in the Community: Evaluating the Validity and Reliability of the ADRe Profile","authors":"Vera Logan,&nbsp;Neil Carter,&nbsp;David Hughes,&nbsp;Adam Turner,&nbsp;Sue Jordan","doi":"10.1155/jonm/9921349","DOIUrl":"https://doi.org/10.1155/jonm/9921349","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Adverse drug reactions (ADRs), particularly in the context of polypharmacy, remain a persistent, unresolved problem for patients and healthcare professionals. The ADRe Profile identifies medicine-related harms, and supports their resolution, thereby improving care quality and preventing future problems.</p>\u0000 <p><b>Objective:</b> The objective of this study was to assess the validity and reliability of the ADRe Profile (https://www.swansea.ac.uk/adre/) in U.K. primary care general practices, building on assessments in other settings.</p>\u0000 <p><b>Methods:</b> The ADRe Profile’s validity and reliability were investigated using complementary mixed methods: content validity index, contrast group construct validity, cognitive interviewing, and inter-rater reliability.</p>\u0000 <p><b>Results:</b> Cognitive interviews (<i>n</i> = 5) confirmed that the ADRe Profile needed only minor adjustments. The scale-level content validity index was 0.67 (<i>n</i> = 14), items ranging from 0.08 to 1. Significant differences in signs and symptoms associated with ADRs between service users taking different numbers of regular prescribed medicines confirmed construct validity (<i>n</i> = 68, <i>U</i> = 870.50, <i>p</i> &lt; 0.001). Inter-rater reliability testing showed substantial agreement between service users and research nurse: 10 items had 100% agreement. Overall <i>kappa</i> mean was 0.71 (range: 0.31–1), (<i>n</i> = 42).</p>\u0000 <p><b>Conclusions and Relevance:</b> The ADRe Profile is suitable for use with older service users in primary care who live at home. Users understood the questions and provided meaningful answers. ADRe Profile responses were sufficiently reliable to be used as a basis for further investigations, prescriber referral and clinical actions. However, clinician judgement of content validity may depend on knowledge and experience, highlighting the importance of training. Clinicians acknowledged that the ADRe Profile was comprehensive but identified practical difficulties. Instruments to reduce ADRs should be validated before testing in feasibility studies and randomised controlled trials.</p>\u0000 <p><b>Implications for Nursing Management:</b> Managers need to optimise patient safety by introducing patient-centred symptom monitoring, with decision support. Before instruments are adopted, managers should check the reliability and validity data.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT04663360</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2025 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/9921349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}