Journal of Clinical Nursing最新文献

{"title":"Response to the Letter to the Editor-Comment on 'The Effect of Theory-Guided Positive Psychological Interventions for Patients With Breast Cancer: A Systematic Review and Meta-Analysis'.","authors":"Sek Ying Chair, Myrian Sze Nga Fan, Ruitong Gao","doi":"10.1111/jocn.70415","DOIUrl":"10.1111/jocn.70415","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5134-5135"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'The Relationship Between Transition Shock and Missed Nursing Care Among New Graduate Nurses: A Cross-Sectional Study'.","authors":"Necip Hanci, Sergül Duygulu","doi":"10.1111/jocn.70403","DOIUrl":"10.1111/jocn.70403","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5131-5133"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Physical Restraint Decision Tree on Reducing Physical Restraint Use in an Adult Intensive Care Unit.","authors":"Rui Cao, Jin Li, Lu Li, Shuhan Cai, Xinbo Ding, Jing Ma, Xing Fu, Dandan Xu, Yaxi Suo, Bo Hu, Jie Chen, Xiaoping Zhu, Fen Hu","doi":"10.1111/jocn.70436","DOIUrl":"10.1111/jocn.70436","url":null,"abstract":"<p><strong>Objective: </strong>To construct and evaluate a decision tool that minimizes physical restraint (PR) use while maintaining positive patient outcomes in an adult intensive care unit (ICU). It also aimed to understand nurses' perspectives regarding implementing the decision tool into routine ICU practice.</p><p><strong>Design: </strong>A mixed-method design.</p><p><strong>Methods: </strong>This study employed a mixed-method design, consisting of a Delphi study to develop a physical restraint decision tree (PRDT), a quasi-experimental study to evaluate the effect of PRDT on minimizing PR use in an adult ICU, and a qualitative interview to understand nurses' perspective and satisfaction of using the PRDT in daily practice. We compared the data on PR use and patient outcomes before and after applying the PRDT in an ICU.</p><p><strong>Results: </strong>The PR rate was 48.1% before applying the PRDT from January to June 2018, significantly dropped to and maintained at 10.1% after implementing the PRDT from October 2018 to December 2022. After the implementation of the PRDT, the average length of ICU stays significantly reduced from 4.66 to 3.71 days; the average daily cost of ICU stays per patient dropped from 5084.13 CNY to 4312.02 CNY. No adverse events, such as catheter extrusion and fall, had occurred. Nurses encountered high satisfaction regarding integrating the PRDT into ICU practice.</p><p><strong>Conclusions: </strong>The PRDT provides a structured, evidence-based approach to guide clinical decisions of lowering PR use in daily ICU practice. Implementation of the PRDT significantly reduced PR use without increasing adverse events.</p><p><strong>Implications for clinical practice: </strong>The PRDT can serve as a tool for standardizing practices across the ICU, ensuring that restraint use is consistent with best practice guidelines and minimizing variability in care.</p><p><strong>Reporting method: </strong>SQUIRE 2.0 guidelines.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4806-4815"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Knocking on the Door, Saying, \"Can We Come in?\"': Carers' Experiences of Engagement With Healthcare Workers in Inpatient Mental Health Services.","authors":"Birhanie Mekuriaw, Natalie Ann Cutler, Tim Luckett, Jo River","doi":"10.1111/jocn.70423","DOIUrl":"10.1111/jocn.70423","url":null,"abstract":"<p><strong>Aim: </strong>This study explores carers' experiences of engagement with mental healthcare workers in public inpatient mental health services to better understand how carers can be optimally supported to contribute to recovery-oriented care.</p><p><strong>Design: </strong>An exploratory qualitative descriptive study.</p><p><strong>Method: </strong>We conducted semi-structured interviews with ten carers using a reflexive thematic analysis that emphasised systematic coding and reflexivity to enhance rigour.</p><p><strong>Results: </strong>Three overarching themes were identified, including: Exclusion and tokenism, which captures carers' experiences of limited inclusion and superficial participation in inpatient mental health services; Fractured and medicalised system, which highlights the disconnect between the rhetoric of recovery and the reality of highly medicalised and risk-averse practice; and Occasional care, which describes genuine collaboration and shared understanding between carers and mental healthcare workers that are intermittently present, supporting trust and hope in some instances, but absent in others.</p><p><strong>Conclusion: </strong>Carers experience significant challenges when engaging with mental healthcare workers. The findings suggest the need for a genuine transformation of mental health systems and practice, with meaningful carer engagement central to relational recovery and recovery-oriented care.</p><p><strong>Relevance to mental health services: </strong>Findings from this study indicate that carers often lack consistent recognition and access to appropriate support, needed to fulfil their potential in supporting recovery. Strengthening formal support pathways for carers is therefore essential to promoting recovery that is relational, sustainable and shared.</p><p><strong>Patient or public contribution: </strong>A professional carer peer worker was consulted on the development of the study design and questions. Carers participated through in-depth interviews.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5044-5057"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring General Practice Nurses' Experiences of an Intervention to Support Social Connectedness Among Older Adults: A Qualitative Descriptive Study.","authors":"Cristina Thompson, Kath Peters, Amy Montgomery, Elizabeth Halcomb","doi":"10.1111/jocn.70388","DOIUrl":"10.1111/jocn.70388","url":null,"abstract":"<p><strong>Aim: </strong>This paper explores the experience of general practice nurses implementing a nurse-led social prescribing intervention to improve older people's social connectedness.</p><p><strong>Design: </strong>Qualitative descriptive study within a multi-phase mixed methods project.</p><p><strong>Methods: </strong>Eight Australian general practice nurses working in a health connector role participated in semi-structured interviews at implementation-end (n = 8) and 12 months later (n = 5), and two focus groups, held during implementation. Interviews addressed participants' reasons for engaging in the intervention, perceptions of training, the experience of intervention delivery and sustainability. Focus groups explored participants' views of challenges and achievements. Data were analysed inductively using thematic analysis.</p><p><strong>Results: </strong>Participants reported 'alignment between their current nursing role and the additional health connector role' regarding their scope of practice and philosophy of care. 'Preparedness to be a health connector' explained how participants' primary care nursing skills equipped them to intervene, however, additional training and resources were essential. Older people were positively impacted by the intervention, and this motivated participants to sustain elements of the intervention. With support, participants leveraged existing skills and worked to their full scope of practice. This resulted in practice improvements in caring for older people at risk of loneliness and social isolation, and professional gains for nurses.</p><p><strong>Conclusion: </strong>Despite challenges in sustaining the intervention as designed, participants integrated the health connector intervention into their practice within the context of their nursing role and continued this work with older people and other patient groups.</p><p><strong>Implications: </strong>Facilitating general practice nurses to undertake a social prescribing intervention had benefits for nurses and patients.</p><p><strong>Impact: </strong>Nurse-led social prescribing interventions can support older people to reactivate or maintain their social connections within the context of their health.</p><p><strong>Reporting method: </strong>Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4946-4956"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses' Experiences With Remote Paediatric Patient Asthma Care to Inform Enhanced Implementation: A Descriptive Qualitative Study.","authors":"Souline P Heil, Laurien Kanis, Lara S van den Wijngaart, Martinus C Oppelaar, Maud Heinen","doi":"10.1111/jocn.70431","DOIUrl":"10.1111/jocn.70431","url":null,"abstract":"<p><strong>Aim: </strong>To gain insight into the experiences of nurses in outpatient paediatric asthma care regarding how their profession changed, with an emphasis on workload, nurse-patient relationship, and task shifting, after the implementation of a remote patient care platform (called Airbridge (Luchtbrug)).</p><p><strong>Design: </strong>A descriptive qualitative study.</p><p><strong>Methods: </strong>Semi-structured face-to-face interviews were conducted from February 2023 to May 2023, with nurses who were working with Airbridge. Nurses were recruited using a purposive sampling method. An interview guide was developed partly based on the Technology Acceptance Model. Interviews were audio recorded, transcribed, and analysed according to Braun and Clarke's six phases of Thematic Analysis.</p><p><strong>Results: </strong>Eleven nurses participated in the interviews. Patient centred care and changes of professional practice due to working with remote patient care were identified as the main themes in relation to experiences of nurses after the introduction of a remote patient care platform.</p><p><strong>Conclusion: </strong>Nurses are pivotal in the successful implementation and sustainability of remote patient care (RPC) platforms, yet they require adequate time and organisational support. As primary users alongside patients, nurses should actively be involved in remote patient care (RPC) practices and take leadership in defining their responsibilities. This study enhances understanding of nurses' experiences with remote patient care (RPC), emphasizing the importance of their role in maintaining the nurse-patient relationship in an advanced professional nursing practice.</p><p><strong>Impact: </strong>These findings contribute to the understanding of the experience of nurses when working with a remote patient care (RPC) platform regarding effective implementation.</p><p><strong>Reporting method: </strong>This study adhered to the COREQ guideline.</p><p><strong>Public contributions: </strong>No paper or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5073-5083"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes and Practice of Stroke Prevention and Pre-Hospital Management Among Community Nurses and Other Health Professionals: A Cross-Sectional Study.","authors":"Chenxi Zhou, Mulugeta M Birhanu, Lulu Guo, Zhiguang Ping, Hongyu Meng, Shanshan Wang, Zhenxiang Zhang, Dominique A Cadilhac, Monique F Kilkenny, Beilei Lin","doi":"10.1111/jocn.70424","DOIUrl":"10.1111/jocn.70424","url":null,"abstract":"<p><strong>Aim: </strong>To explore the knowledge, attitudes and practices of community nurses and other health professionals (e.g., physicians, pharmacists) regarding stroke prevention and pre-hospital management.</p><p><strong>Methods: </strong>From May to July 2023, a cross-sectional online survey was undertaken with community nurses and other health professionals in a city located in central China. The questionnaire included demographic information and knowledge, attitudes and practices assessments. Data analysis included descriptive statistics and multinomial logistic regression models for each item score of knowledge, attitudes and practices questionnaire with adjustment for potential confounders.</p><p><strong>Results: </strong>Overall 233/250 health professionals (93.2%) participated (58% community nurses; 87% female). Compared with other health professionals, community nurses were more likely to be female (99% vs. 69%) and younger (mean age: 33 years vs. 39 years). Compared with other health professionals, community nurses were less likely to have knowledge of mnemonics of the 'stroke risk score card' (OR = 0.48; 95% CI: 0.24-0.92), the pathophysiological relationships with common complications (OR = 0.43; 95% CI: 0.23-0.80), the ability to use stroke risk predictive tools (OR = 0.53; 95% CI: 0.31-0.93) and the practice of using stroke risk predictive tools (OR = 0.55; 95% CI: 0.31-0.96).</p><p><strong>Conclusion: </strong>Although overall knowledge was demonstrated in awareness of common stroke signs, symptoms and risk factors, community nurses exhibited significant knowledge gaps compared to other healthcare professionals in critical aspects of stroke prevention and pre-hospital management. Targeted evidence-based training is urgently required to improve their stroke prevention and pre-hospital management capabilities.</p><p><strong>Clinical relevance: </strong>Targeted training in stroke pathophysiology, risk management tools and symptom recognition protocols is critical for equipping community nurses to address knowledge-practice gaps in stroke prevention.</p><p><strong>Reporting method: </strong>This study was reported based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for cross-sectional studies.</p><p><strong>Patient or public contribution: </strong>Health professionals were recruited to perform the knowledge, attitudes and practices of stroke prevention and pre-hospital management survey in the phase of data collection.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4913-4923"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Unmet Needs in Patients With Multiple Sclerosis: A Cross-Sectional Study.","authors":"Francesco Pastore, Barbara Forastefano, Valentina Simonetti, Tommaso Guerra, Giancarlo Cicolini, Pietro Iaffaldano, Dania Comparcini","doi":"10.1111/jocn.70396","DOIUrl":"10.1111/jocn.70396","url":null,"abstract":"<p><strong>Aims: </strong>To identify a correlation between unmet needs and HL levels in people with Multiple Sclerosis (pwMS) and to evaluate how sociodemographic characteristics influence HL levels and unmet needs.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>The study was conducted using a questionnaire including the HLS₁₉-Q12 to assess HL and the Long-term Unmet Needs in Multiple Sclerosis tool, which evaluates five domains (neuropsychological, ambulation, physical, interpersonal relationship, and informational) and identifies whether needs are met or unmet and the desire for support.</p><p><strong>Results: </strong>Among the 116 participants included in the study, the overall HL level was sufficient. Mean scores across unmet needs domains were comparable. A significant difference in HL emerged in the informational domain, where participants reporting informational needs and a desire for support showed higher mean ranks. Although not significant, participants who acknowledged a need and expressed a desire for help showed higher mean ranks in HLS₁₉-Q12 scores across several domains. No significant correlations were found between HL and unmet needs domains.</p><p><strong>Conclusion: </strong>HL levels may enhance patients' ability to recognize and express needs without necessarily ensuring that these needs are met.</p><p><strong>Implications for the profession and/or patient care: </strong>Routine assessment of both HL and unmet needs may help healthcare professionals identify patients who recognize problems but lack the structural support to address them.</p><p><strong>Impact: </strong>The impact of HL on need recognition and communication, together with the complexity and interconnectedness of unmet needs, highlights the need for healthcare systems to implement organizational, systemic, and multidimensional interventions aimed at promoting HL and effectively addressing patients' needs. Such strategies may support better disease management and improve quality of life in pwMS.</p><p><strong>Reporting method: </strong>This study was reported according to STROBE checklist.</p><p><strong>Patient or public contribution: </strong>None.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4816-4827"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Latent Profile Analysis of Preoperative Frailty in Cardiac Surgery Patients: Implications for Individualised Nursing Care'.","authors":"Yiyuan Chen, Jing Liu, Haiou Yan","doi":"10.1111/jocn.70427","DOIUrl":"10.1111/jocn.70427","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5138-5139"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Severity of Nurse-Sensitive Adverse Events in Older Adults After Physical Trauma: A Medical Record Review.","authors":"Hanna Järbrink, Kristofer Bjerså, Hanna Falk Erhag, Jörgen Lundälv, My Engström","doi":"10.1111/jocn.70399","DOIUrl":"10.1111/jocn.70399","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the incidence and characteristics of nursing-sensitive adverse events (NSAEs) in older adults (≥ 65 years) hospitalised with traumatic injuries, and to explore associations with frailty, demographic factors, injury characteristics and hospital-related factors.</p><p><strong>Design: </strong>NSAEs were identified through a retrospective medical record review of a prospectively collected cohort.</p><p><strong>Methods: </strong>Patients ≥ 65 years admitted with physical trauma to a Swedish level I trauma centre between 2020 and 2024 were included. NSAEs were identified using a modified trigger tool chart review. Descriptive statistics were used to determine the incidence and characteristics of NSAEs in the whole cohort. Group differences, associations and predictors were examined using exact, non-parametric, or logistic regression methods.</p><p><strong>Results: </strong>A total of 270 trauma patients ≥ 65 years were included, of whom 25.6% had experienced at least one NSAE. The overall incidence was 38.2 events per 100 admissions, with hospital-acquired infections being the most common type of NSAE (16.7%), followed by overdistended bladder (6.3%) and pressure injuries (5.6%). Frailty and length of hospital stay were associated with an increased likelihood of NSAEs, with hospital length of stay emerging as the strongest predictor in multivariable analysis.</p><p><strong>Conclusion: </strong>NSAEs are common among older trauma patients and are associated with frailty, injury characteristics and length of stay. Improving early risk identification and ensuring timely preventive nursing care may enhance patient safety in this vulnerable population.</p><p><strong>Implications for the profession and/or patient care: </strong>The findings highlight the important role of nursing in the care of older trauma patients and the need for consistent delivery of fundamental nursing care. Strengthening clinical practices that support early identification of high-risk patients and the timely implementation of preventive interventions may improve patient safety and outcomes in this vulnerable population.</p><p><strong>Impact: </strong>This study addresses the knowledge gap regarding NSAEs in older trauma patients, a population with increased vulnerability to adverse outcomes. The findings provide insights into the occurrence and risk factors of NSAEs in this group and highlight the importance of translating risk assessment into effective clinical action. These results may inform clinical practice and support the development of strategies to improve patient safety in trauma care for older adults.</p><p><strong>Reporting method: </strong>This study was informed by the Standard Elements in Studies of Adverse Events and Medical Error (SESAME). The completed SESAME checklist is provided in the Supporting Information S1.</p><p><strong>Patient or public contributions: </strong>No patient or public contributions.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4839-4849"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}