Journal of Clinical Nursing最新文献

{"title":"The Effectiveness of Family Health Conversations Delivered by Nurses: A Systematic Review.","authors":"Birte Østergaard, Erla Kolbrun-Svavarsdottir, Anne Brødsgaard, Stine Rosenstrøm, Cristina Garcia-Vivar, Hanne Konradsen, Karin Brochstedt-Dieperink, Lorenz Imhof, Romy Mahrer-Imhof, Marie Louise Luttik","doi":"10.1111/jocn.70058","DOIUrl":"https://doi.org/10.1111/jocn.70058","url":null,"abstract":"<p><strong>Aim: </strong>To extract and interpret quantitative data exploring the effectiveness of family health conversations (FHCs) on family functioning, perceived support, health-related quality of life, caregiver burden and family health in families living with critical or chronic health conditions.</p><p><strong>Background: </strong>Addressing the health of families affected by critical or chronic illnesses requires focused attention. The effective integration of FHCs is hampered by a scarcity of rigorous quantitative studies that provide solid evidence on best practices and outcomes.</p><p><strong>Design: </strong>A systematic review following the Joanna Briggs Institute guidelines.</p><p><strong>Methods: </strong>The review is reported according to the PRISMA 2020 checklist. Appropriate studies were searched in PubMed, CINAHL, PsycINFO, Scopus and Cochrane Databases. Results of the search were imported into the Covidence web-based program. Included were studies with a quantitative research design, delivered to families with critical or chronic health conditions, describing FHCs based on the Calgary Family Assessment Model and/or the Calgary Family Intervention Model, and/or the Illness Beliefs Model, using reliable and validated instruments, published between 2008 and 2023, and written in English.</p><p><strong>Results: </strong>In total, 24 papers met the inclusion criteria. Sixteen papers used a quasi-experimental design, eight of which included a control group. Two papers used a mixed methods design, and six papers were randomised controlled trials (RCTs). A statistically significant effect of FHCs on family functioning was reported in two RCTs and three quasi-experimental papers. We also found that a statistically significant effect of FHCs was reported on perceived support in 9 of 15 papers, quality of life in 4 of 11 papers and caregiver burden in 1 of 3 papers.</p><p><strong>Conclusion and implications for clinical practice: </strong>The interventions reviewed revealed variability and partial results concerning the effectiveness of FHCs on family functioning. More rigorous research about short-term, intermediate- and long-term effectiveness is needed before conclusions can be drawn.</p><p><strong>Reporting method: </strong>The study is reported according to the PRISMA 2020 (Preferred Reporting Items for Systematic reviews and Meta-Analyses) (File S1).</p><p><strong>Patient or public contribution: </strong>No patient or public contribution. Data were gathered from previously published studies.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785854","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 'How Nurses' Interventions Promote Health Literacy in Patients With Noncommunicable Diseases: A Systematic Review'.","authors":"Xiaoyi Huang, Guihao Huang, Chutong Zhang, Man Jiang, Guiju Wei","doi":"10.1111/jocn.70065","DOIUrl":"https://doi.org/10.1111/jocn.70065","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785845","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":"Digital Exclusion and Health Literacy Among Older Adults: The Mediating Effects of Social Support and Self-Efficacy.","authors":"Chenxi Zhou, Yangchun Xiao, Mei Wang, Yun Wang, Xiao Yue","doi":"10.1111/jocn.70004","DOIUrl":"https://doi.org/10.1111/jocn.70004","url":null,"abstract":"<p><strong>Background: </strong>Digital exclusion has been linked to adverse health outcomes among older adults. However, its relationship with health literacy, a midstream determinant of health outcomes in aging populations, remains insufficiently explored.</p><p><strong>Aim: </strong>To investigate the relationship between digital exclusion and health literacy among older adults, and to assess the mediating effects of social support and self-efficacy.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>Data from the 2021 Psychology and Behaviour Investigation of Chinese Residents (PBICR) survey were used. Digital exclusion was assessed through self-reported non-use of computers or smartphones. Health literacy, social support and self-efficacy were measured using the Short-Form Health Literacy Instrument, the 12-item Perceived Social Support Scale and the New General Self-Efficacy Scale. Generalised linear models (GLM) were employed to examine the relationships between digital exclusion and health literacy, while mediation analysis with bootstrapping assessed the mediating roles of social support and self-efficacy.</p><p><strong>Results: </strong>A total of 1147 older adults participated in the study, with 27.64% identified as digitally excluded and a moderate level of health literacy. GLM analysis identified several significant factors influencing health literacy, including digital exclusion, social support, self-efficacy, higher education levels, household monthly income per capita > 3000 RMB, non-agricultural hukou, chronic conditions and medication use. Mediation analysis revealed that digital exclusion negatively impacted health literacy. Social support and self-efficacy partially mediated the relationship between digital exclusion and health literacy.</p><p><strong>Conclusion: </strong>Digital exclusion is negatively associated with health literacy among older adults, with social support and self-efficacy partially mediating the relationship.</p><p><strong>Implications for the profession and/or patient care: </strong>This study underscores the importance of addressing digital exclusion, as well as promoting social support and self-efficacy to enhance health literacy in ageing populations.</p><p><strong>Impact: </strong>This study provides insights into the relationship between digital exclusion and health literacy among older adults, as well as the mediating effects of social support and self-efficacy, offering potential targets for health literacy improvement.</p><p><strong>Reporting method: </strong>STROBE Statement (STrengthening the Reporting of OBservational studies in Epidemiology).</p><p><strong>Patient or public contribution: </strong>No patient or public contribution was involved.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776770","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":"Latent Profile Analysis of Dyadic Decision Self-Efficacy Among Stroke Patients and Their Caregivers.","authors":"Yinan Shi, Mei Sin Chong, Yongxia Mei, Zhenxiang Zhang, Yating Liu, Sixun Zhang, Beilei Lin, Suyan Chen, Xin Li","doi":"10.1111/jocn.70061","DOIUrl":"https://doi.org/10.1111/jocn.70061","url":null,"abstract":"<p><strong>Objective: </strong>To explore the latent categories and influencing factors of dyadic decision self-efficacy among stroke patients and their caregivers.</p><p><strong>Methods: </strong>A cross-sectional survey involving 305 patient-caregiver pairs was conducted using standardised questionnaires. Latent profile analysis was used to identify dyadic self-efficacy categories and multinomial logistic regression was employed to analyse influencing factors.</p><p><strong>Results: </strong>The dyadic decision self-efficacy of stroke patients and their caregivers was classified into three categories: low common decision self-efficacy group (35.6%), patients' high decision self-efficacy and caregivers' moderate decision self-efficacy group (38.6%), and high common decision self-efficacy group (25.8%). Influencing factors included patients' education level, income and health literacy, as well as caregivers' education, caregiving duration and social support.</p><p><strong>Conclusion: </strong>The levels of dyadic decision self-efficacy among stroke patients and their caregivers are heterogeneous. Clinicians can develop targeted interventions involving both patients and caregivers, based on the population's characteristics and influencing factors, to improve their dyadic decision self-efficacy.</p><p><strong>Reporting method: </strong>This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776773","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":"Understanding How Caregiver Burnout Leads to Elder Abuse in Nursing Homes: New Research Directions.","authors":"Zilin Zhao, Xiaojing Zhang, Yiping Lu","doi":"10.1111/jocn.70064","DOIUrl":"https://doi.org/10.1111/jocn.70064","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776775","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":"Pressure Injury Assessment Tools for Oncology Patients: A Systematic Review.","authors":"Wei Zou, Juan Liu, Xinxiang Du, Hui Yang","doi":"10.1111/jocn.70053","DOIUrl":"https://doi.org/10.1111/jocn.70053","url":null,"abstract":"<p><strong>Aim: </strong>The objective of this systematic review was to evaluate the measurement properties of pressure injury risk assessment tools for cancer patients using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology, and to serve as a reference for clinical nurses in their hospital duties when choosing high-quality assessment tools.</p><p><strong>Design: </strong>A systematic review based on COSMIN methodology.</p><p><strong>Data sources: </strong>The English literature in PubMed, Embase, Web of Science, Cochrane Library, CINAHL and the search period ranged from the inception of the database to September 30, 2024.</p><p><strong>Methods: </strong>Two reviewers independently screened the studies, extracted the data, and evaluated the methodological quality and measurement properties of the included studies.</p><p><strong>Results: </strong>Seven studies met the inclusion criteria. Two tools-the PUSO (Pressure Ulcer Scale in Oncology) and the Cuire scale-demonstrated sufficient evidence of content validity and structural validity, meeting the COSMIN quality standards. None of the studies reported the cross-cultural validity, stability, and measurement error of the assessment tool.</p><p><strong>Conclusion: </strong>Following the COSMIN assessment, the PUSO and the Cuire were developed using rigorous procedures, ensuring sufficient overall quality for content validity, structural validity, and other measurement properties. We recommend their use across various environments, based on the quantity and content of specific items. The PUSO was recommended for clinical screening, whereas the Cuire scale was deemed more suitable for use in outpatient, community, and scientific research settings. However, these measurement properties are not without flaws, and their clinical application requires further validation.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776774","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":"Ignite the Parent-Child Bond: A Qualitative Exploration of Perspective and Need About Family Functioning Among Patients With Advanced Cancer and Their Adolescent Children.","authors":"Jingjing Jiao, Jingxing Tan, Jun Yu, Jinnan Xiao, Chongmei Huang, Gui Xiao, Jiaying Xie, Jinfeng Ding, Siyuan Tang, Andrew Hunter","doi":"10.1111/jocn.17794","DOIUrl":"https://doi.org/10.1111/jocn.17794","url":null,"abstract":"<p><strong>Background: </strong>Advanced cancer not only affects the physical, psychological, and social functions of patients, but it also impacts their adolescent children. There is a dearth of information regarding the understanding of family functioning and specific needs of patients with advanced cancer and their adolescent children.</p><p><strong>Purpose: </strong>This qualitative study aimed to explore the experience and needs regarding family functioning of patients with advanced cancer and their adolescent children, as well as understanding potential approaches for maintaining positive family functioning.</p><p><strong>Design: </strong>A descriptive qualitative study was employed.</p><p><strong>Settings and participants: </strong>This study was conducted at three tertiary hospitals in Changsha, China, from January to September 2023. Purposive sampling was adopted to recruit participants. 17 stage III and IV patients with cancer and 11 adolescent children were interviewed.</p><p><strong>Methods: </strong>Face-to-face individual interviews were conducted among patients with advanced cancer and their adolescent children. The data analysis employed Braun and Clarke's thematic analysis method. The McMaster family functional model theoretical framework was utilised to facilitate the identification and organisation of topics, ensuring a comprehensive analysis of the data.</p><p><strong>Findings: </strong>Six themes were identified: communication challenges; impaired family role functioning; positive/negative feelings; over-involvement; change of behaviour control pattern; Needs for medical and psychological support. Both patients with advanced cancer and their adolescent children expressed collective views and needs regarding family functioning.</p><p><strong>Conclusions: </strong>The findings of this study reveal an understanding of family functioning and needs among patients with advanced cancer and their adolescent children. The identified themes provide valuable insights for designing and implementing targeted intervention strategies.</p><p><strong>Clinical relevance: </strong>Nursing interventions should focus on helping patients with advanced cancer and their adolescent children improve family functioning and communication skills. The findings indicate that communication challenges are a significant aspect of impaired family functioning, necessitating targeted interventions to enhance communication. Healthcare providers should be trained to recognise the diverse communication needs of families, which include providing resources for age-appropriate communication, counselling, and guidance on maintaining family routines. Enhancing the communication skills of patients and their children is crucial for addressing problem-solving needs and mitigating negative feelings, thereby fostering a more supportive family environment.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776771","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":"Is the Active Involvement of Family Caregivers in Adult Hospital Care Effective to Improve Patient Outcomes? A Systematic Review.","authors":"Daphne Bloemberg, Mark L van Zuylen, Selma C W Musters, Demi de Jong, Anne Marthe Schreuder, Faridi S Jamaludin, Benedikt Preckel, Els Nieveen van Dijkum, Anne M Eskes","doi":"10.1111/jocn.70059","DOIUrl":"https://doi.org/10.1111/jocn.70059","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effects of active involvement of family caregivers in adult in-hospital care on patients' readmissions, complications, mortality, length of hospital stay, quality of life, psychological distress and activities of daily living, as well as on the satisfaction of patients, HCPs and family caregivers.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Data sources: </strong>Ovid Medline, Ovid Embase, EBSCO CINAHL, Cochrane Library (from inception to February 2024).</p><p><strong>Methods: </strong>The PRISMA 2020 statement was followed. Prospective controlled studies focusing on active involvement of family caregivers in adult in-hospital care were included. Two independent teams of authors conducted study selection, quality assessment and data extraction.</p><p><strong>Results: </strong>Thirteen studies were included, comprising 11 randomised controlled trials. The clinical and methodological heterogeneity precluded a meta-analysis. Six of these studies were performed in stroke patients. Some studies reported statistically significant benefits of active family involvement on readmission rates, hospital LOS, ADL, psychological distress for patients and family members, QoL and satisfaction of family caregivers. However, others did not observe differences in these outcomes. For complication rates, mortality and satisfaction of patients and HCPs, no studies demonstrated significant differences between groups.</p><p><strong>Conclusion: </strong>Further research is needed to provide a conclusive answer as to whether active family caregiver involvement improves outcomes of adult hospitalised patients.</p><p><strong>Implications for patient care: </strong>Despite the inconclusive findings of this review, advocating for active involvement of family caregivers in adult in-hospital care fits the perspective of patient- and family-centred care.</p><p><strong>Impact: </strong>As the care of hospitalised adults is shifting to a more family-centric approach, investigating the effects of an active role of family caregivers in adult in-hospital care is necessary. However, the small number of studies available and heterogeneity between studies included in this review hamper firm conclusions. Further evaluations through well-designed studies are required.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776772","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":"Co-Designing a Model of Brilliant Care for Older People.","authors":"Ann Dadich, Rachael Kearns, Ben Harris-Roxas, Katherine Boydell, Peter Gonski, Friedbert Kohler, David Lim, Éidín Ní Shé, Carmen Amato, Imelda Gilmore, Brian Lane, Jane Mears, Frank Schaper, Rosslyn Sleeman, Elise Tcharkhedian, Varsha Tembe, Shannon Azzopardi, Kim Delbaere, Tamar Krebs, Elizabeth Paterson-Finlay, Danielle Ni Chroinin","doi":"10.1111/jocn.70049","DOIUrl":"https://doi.org/10.1111/jocn.70049","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to co-design a model of brilliant care for older people that provides clear, actionable principles to guide how brilliant care for older people can be realised.</p><p><strong>Background: </strong>As the demand for and international importance of care for older people grows, so too does the negative discourse about care for older people. This ongoing focus on deficiencies can have implications for patients, carers, clinicians, health services, and policymakers, overshadowing opportunities for innovation and positive change.</p><p><strong>Design: </strong>Experience-based co-design informed this study, grounded in the lived experiences of key stakeholders.</p><p><strong>Methods: </strong>Three scaffolded co-design workshops were facilitated, involving lived experience experts, managers, professionals, clinicians, and an academic (n= 13). The data collected during these workshops were analysed using a qualitative descriptive method and documented according to COREQ guidelines to optimise rigour and transparency.</p><p><strong>Results: </strong>The participants co-designed a model of brilliant care for older people, comprising principles to promote connection and innovation. To promote connection, the model includes protecting staff member time to deliver meaningful care and demonstrating that everyone matters. To promote innovation, it encourages role flexibility, curiosity, small improvements, and the recognition of brilliant practices.</p><p><strong>Conclusions: </strong>This article presents a co-designed model of brilliant care for older people, incorporating principles of connection and innovation that can be enacted through simple, resource-efficient practices.</p><p><strong>Relevance to clinical practice: </strong>For those who manage and deliver care for older people, the model encompasses simple, accessible, and cost-effective principles to: positively deviate from norms within the sector, offering care to older people; and to deliver brilliant care for older people. Furthermore, given that the model was co-designed with lived experience experts, managers, professionals, and clinicians, its principles are imbued with their experiential insights, which served to bring particular priorities to the fore.</p><p><strong>Patient or public contribution: </strong>The co-designers, who included lived experience experts, were invited to participate in workshops to co-design a model of brilliant care for older people, during which they discussed and critiqued the findings constructed from the data and co-designed the model.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762158","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":"Reporting Grounded Theory: Is COREQ Enough?","authors":"Martina Barbieri, Andrea Moro, Mariarosaria Gammone, Daniela Cattani, Lara Delbene, Talita Sallai, Roger Watson, Gianluca Catania, Milko Zanini, Loredana Sasso, Annamaria Bagnasco","doi":"10.1111/jocn.70052","DOIUrl":"https://doi.org/10.1111/jocn.70052","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735033","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}