Journal of Clinical Nursing最新文献

{"title":"Nutritional Risk Screening by Trained Nurses in Patients Admitted to Internal Medicine and Orthopaedics: Results From the VAL-NUT Cross-Sectional Study.","authors":"Luisella Canta, Elena Lenta, Francesca Savigliano, Chiara Grasso, Silvano Andorno, Riccardo Sperlinga, Chiara Rustichelli, Claudia Cravero, Ilaria Isoardi, Mara Oberto, Sabrina Panebianco, Giancarlo Mercurio, Sabrina Contini","doi":"10.1111/jocn.70193","DOIUrl":"10.1111/jocn.70193","url":null,"abstract":"<p><strong>Aims: </strong>To assess the prevalence of malnutrition risk, especially of undernutrition, among patients admitted to the Internal Medicine and Orthopaedics wards at Michele and Pietro Ferrero Hospital, Italy, using the Nutritional Risk Screening 2002 (NRS-2002) tool, administered by trained nursing staff, and to evaluate the adherence to related care interventions.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We included 248 adult patients, screened by trained nurses for nutritional risk within 48 h of admission using the NRS-2002 tool, which takes into account patients' Body Mass Index, recent weight loss, reduced dietary intake, and disease severity. Information on nursing interventions was also collected.</p><p><strong>Results: </strong>We identified 36 subjects at risk of malnutrition with NRS ≥ 3. Prevalence was higher in Internal Medicine, reflecting differences in patient characteristics and clinical complexity. Patients at risk were older, had longer hospital stays, and higher risks of falls and pressure sores. Nursing interventions such as proper meal selection, administration of hypercaloric-hyperproteic supplements, and completion of food diary were implemented in most cases, although adherence was not complete. Post-training questionnaire showed that, overall, nurses integrated nutritional screening into practice, but areas for improvement were identified.</p><p><strong>Conclusion: </strong>Results confirmed the high prevalence of malnutrition risk in hospitalised patients, especially in Internal Medicine. Proper training and empowerment can enable nurses to effectively identify and manage patients at intermediate risk of malnutrition.</p><p><strong>Implications for the profession and/or patient care: </strong>Nurses can play key roles in hospital nutritional care by facilitating early identification and appropriate management of patients at malnutrition risk.</p><p><strong>Impact: </strong>Malnutrition is very common among inpatients. Trained and empowered nurses can perform nutritional screening at admission to identify and early manage patients at risk, thereby helping to prevent increased morbidity, mortality and healthcare costs.</p><p><strong>Reporting method: </strong>STROBE guidelines.</p><p><strong>Patient or public contribution: </strong>None.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2672-2682"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953669","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":"Relationship Between Nurses' Decision-Making Styles and Stage-Specific Missed Care in Oncology: A Nursing Process Perspective.","authors":"Wenqi He, Haiyan Hu, Jianan Sun, Qing Zhang, Wei Luo, Hua Yuan, Hui Xue, Xiuying Zhang","doi":"10.1111/jocn.70195","DOIUrl":"10.1111/jocn.70195","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the relationship between nurses' decision-making styles and missed care across different stages of the nursing process (assessment and evaluation, planning, implementation) in oncology care settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted among oncology nurses from three hospitals using convenience sampling. Data were collected through a sociodemographic questionnaire, the Oncology Missed Nursing Care Self-Rating Scale (OMNCS) and the General Decision-Making Style Scale (GDMS). Mann-Whitney U tests and binary logistic regression were employed to analyse the associations between different decision-making styles and missed care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Missed care was commonly reported across all dimensions, with the highest prevalence observed in the planning stage. The rational decision-making style was dominant, with significantly higher scores in the non-omission group. It was negatively associated with missed care during the implementation stage (OR = 0.460, 95% CI 0.251-0.844; p = 0.012). The intuitive-impulsive decision-making style showed a protective effect in all dimensions (OR = 0.254-0.337, 95% CI 0.128-0.501, 0.172-0.661; p &lt; 0.01). In contrast, the dependent and avoidant styles both significantly increased the risk of missed care during the assessment and evaluation stage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Nurses' decision-making styles play a crucial role in the occurrence of missed care, with different styles exerting varying influences across stages of the nursing process. Therefore, nursing managers should recognise the role of these styles in nursing quality and tailor interventions to support nurses with dependent or avoidant decision-making styles. Moreover, using simulated training or decision support systems to transition between rational and intuitive approaches offers a promising strategy to reduce stage-specific missed care, enhance oncology nursing quality and improve patient safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for the profession and/or patient care: &lt;/strong&gt;Identifying high-risk stages for missed care, incorporating assessments of nurses' decision-making styles and implementing personalised interventions provide a new management pathway to reduce missed care and enhance patient safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;What problem did the study address?: This study provides new evidence that nurses' decision-making styles are significantly associated with missed care, with this relationship varying across different stages of the nursing process. What were the main findings?: The rational style was the most common decision-making style among oncology nurses, with the non-omission group scoring significantly higher than the omission group. The intuitive-impulsive style consistently showed a protective effect across all stages. In contrast, both dependent and avoidant styles increased the risk of missed care during the assessment and evaluation ","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2683-2695"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901632","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 'Comfort Needs of Kidney Transplant Recipients: A Qualitative Analysis Based on Kolcaba's Comfort Theory'.","authors":"Hongxuan Li, Xin Liu, Zheyi Xu","doi":"10.1111/jocn.70224","DOIUrl":"10.1111/jocn.70224","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2890-2892"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203622","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 'Unpacking Mechanisms of Rapid Response for Mental State Deterioration: A Realist-Informed Analysis of Field Observations in Acute Hospital Settings'.","authors":"Yiqi Guo, Lijuan Chen","doi":"10.1111/jocn.70225","DOIUrl":"10.1111/jocn.70225","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2893-2894"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047321","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 a Hybrid Pulmonary Rehabilitation Programme Feasible and Effective in Individuals With COPD After an Exacerbation-Related Hospitalisation: A Mixed Methods Study.","authors":"Sarah Gephine, Elise Meto, Olivier Le Rouzic, Robert Launois, Jean-Marie Grosbois","doi":"10.1111/jocn.70234","DOIUrl":"10.1111/jocn.70234","url":null,"abstract":"<p><strong>Aim: </strong>To combine qualitative and quantitative data to evaluate the feasibility, participant satisfaction and effectiveness of a hybrid pulmonary rehabilitation programme following hospital discharge for an exacerbation of chronic obstructive pulmonary disease (COPD).</p><p><strong>Design: </strong>Convergent parallel mixed method study nested in a larger ongoing prospective study; this report includes a subset of 21 participants who complete the qualitative and quantitative assessments between May 2023 and January 2024.</p><p><strong>Methods: </strong>Semi structured interviews using open-ended questions were conducted and analysed using a thematic analysis approach. Participants were interviewed after completing an 8-week hybrid home-based rehabilitation programme, including four face-to-face and four remote sessions. Quantitative assessments-covering disease impact, anxiety and depressive symptoms, and exercise tolerance-were conducted at the beginning and end of the intervention in the same participants who took part in the interviews, and a 10-item satisfaction questionnaire was also completed after the programme.</p><p><strong>Data sources: </strong>May 2023 to January 2024.</p><p><strong>Reporting method: </strong>GRAMMS checklist was followed.</p><p><strong>Results: </strong>21 people with chronic obstructive pulmonary disease (11 females; mean age 62 ± 7 years; mean FEV₁ 30% ± 10% of predicted) were interviewed. Five major themes were identified: (i) accessibility and adaptation to individual needs; (ii) confidence in the transdisciplinary care manager model, confirmed by high satisfaction score (95/100); (iii) integration of informal carers; (iv) perceived benefits supporting maintenance of health behaviour, consistent with the statistically and clinically significant improvements observed across all quantitative outcomes; and (v) hybrid programme challenges (technical issues and preference for face-to-face visits).</p><p><strong>Conclusion: </strong>The hybrid programme resulted in significant improvements in physical and psychological outcomes, and participants reported high levels of satisfaction. Qualitative findings highlighted the value of home-based delivery, supervision by a single care manager, informal carer involvement and emotional support in shaping feasibility and satisfaction. However, challenges related to remote sessions indicate that telerehabilitation may not be suitable for all patients and should not be used as a standalone PR option.</p><p><strong>Relevance for clinical practice: </strong>Given the strong preference of participants for face-to-face visits over remote visits, telerehabilitation should always include a minimum of individual or group face-to-face supervised sessions. The balance between supervision modalities should be personalised according to participants' needs and progress.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2658-2671"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120947","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":"Letter to the Editor Regarding 'Risk Prediction Models for Enteral Nutrition Aspiration in Adult Inpatients: A Systematic Review and Critical Appraisal'.","authors":"Xudong Wang","doi":"10.1111/jocn.70223","DOIUrl":"10.1111/jocn.70223","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2888-2889"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047349","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":"Community Dwelling Adults' Lived Experiences of Participating in Death Cafés: A Phenomenological Study With Photovoice.","authors":"Wei How Darryl Ang, Noriko Yamamoto-Mitani, Ming Jun Kang, Wai Her Loke, Jia Wen Joel Nai, Wan Ru Deiondre Tan, Wei Liang Xavier Toh, Nicholas Woong, Jung Jae Lee","doi":"10.1111/jocn.70202","DOIUrl":"10.1111/jocn.70202","url":null,"abstract":"<p><strong>Aim: </strong>To explore community dwelling adults' lived experiences of participating in death café in Singapore.</p><p><strong>Design: </strong>A descriptive phenomenological study with Photovoice.</p><p><strong>Methods: </strong>A purposive sample of community dwelling adults who participated in a community-based death café was recruited for this study. Data was collected through online individual semi-structured interviews. The Colaizzi's six-step descriptive phenomenological analysis was conducted for data analysis.</p><p><strong>Results: </strong>Twenty community dwelling adults who participated in a death café were recruited. Participants' experiences of the death café were expounded in four themes: appeals of attending death cafés, enabling features of death café, engaging in die-logues, and perceived impacts of death café on everyday lives. The participants were attracted to death cafés for various reasons including curiosity and grief. A comfortable environment, accompanied by open dialogues and refreshments, was credited as enablers for death conversations. Through these 'die-logues', the participants had a deeper understanding of death and began engaging in advance planning.</p><p><strong>Conclusions: </strong>Death cafés provide a supportive environment for individuals to engage in death-related conversations that may not easily occur in daily life. By engaging in conversations about mortality within death cafés, participants are encouraged to take proactive steps towards advance planning.</p><p><strong>Implications for the profession and/or patient care: </strong>Findings from this study can guide the development of community-based interventions by highlighting the essential components required for a death café tailored to the Asian context.</p><p><strong>Impact: </strong>This study describes the community dwelling adults' lived experiences of participating in a death café. The findings from this study underscore the role of informal conversations about death as a tool to promote population health based palliative care initiatives such as overcoming death taboos and stimulating advance care planning among community dwelling adults.</p><p><strong>Reporting method: </strong>The Consolidated Criteria for Reporting Qualitative Studies was used.</p><p><strong>Patient and public contribution: </strong>Community-dwelling adults participated in the interviews.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2785-2796"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960251","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":"Unpacking Mechanisms of Rapid Response for Mental State Deterioration: A Realist-Informed Analysis of Field Observations in Acute Hospital Settings.","authors":"Tendayi Bruce Dziruni, Alison M Hutchinson, Sandra Keppich-Arnold, Tracey Bucknall","doi":"10.1111/jocn.70197","DOIUrl":"10.1111/jocn.70197","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Managing patients' mental state deterioration in acute hospital settings is a critical challenge, requiring prompt specialised intervention to mitigate adverse outcomes. Current responses vary widely across health systems. Integrating rapid response systems that incorporate mental health expertise offers a promising approach to reduce risks and adverse outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;To evaluate how a response system manages patient mental state deterioration in acute hospital settings, focusing on the mechanisms driving system effectiveness, for whom it works and under what circumstances, using a realist-informed theory-testing approach with field observation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted non-participant field observations in one trauma and one surgical unit over 4 months to examine the contexts, mechanisms and outcomes shaping a mental state deterioration response system. Observations captured multidisciplinary interactions, escalation processes and decision-making. Structured field notes were thematically coded using a realist framework to refine program theories and identify key factors influencing timely intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty responses were observed, most in the trauma unit. The system worked best when bedside nurses escalated early signs of deterioration, prompting timely intervention. Multidisciplinary collaboration involving nurse unit managers, liaison psychiatry, doctors and allied health professionals activated mechanisms of integrated assessment and coordinated care, enabling both medical and mental health needs to be addressed. Competing medical acuity demands at times reduced system availability. Teleconferencing supported specialist input when in-person attendance was not possible, ensuring person-centred care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;System functioning depended on early risk communication by bedside nurses and proactive multidisciplinary collaboration. Organisational support and staff training are essential to address operational challenges. Findings provide evidence for strengthening response systems to deliver timely, comprehensive interventions that improve physical and mental health outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for the profession and/or patient care: &lt;/strong&gt;DIvERT (De-escalation, Intervention, Early, Response, Team) is a proactive rapid response model of care piloted to improve the management and outcomes of patients experiencing mental state deterioration in acute hospital settings. The model achieves this through structured escalation pathways, proactive interventions and coordinated multidisciplinary collaboration to integrate medical and mental health care. Strengthening organisational support and staff training further reduces reliance on restrictive practices and promotes safer, person-centred care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;What problem did the study address? Acute hospitals face persistent challenges in respo","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2768-2784"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960237","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 Potential Workflow- and Comparator-Driven Bias in the Reported 24-Hour Superiority of Dev-NSRAS Over Glamorgan.","authors":"Yue Zhang","doi":"10.1111/jocn.70222","DOIUrl":"10.1111/jocn.70222","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2886-2887"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094711","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 'Incidence Rate and Risk Factors for Oral Endotracheal Tube-Related Mucous Membrane Pressure Injury in Critically Ill Patients: A Systematic Review and Meta-Analysis'.","authors":"Pravin Dani, Manisha Gadade, Bhagyashree Jogdeo","doi":"10.1111/jocn.70199","DOIUrl":"10.1111/jocn.70199","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"2864-2866"},"PeriodicalIF":3.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936026","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}