Journal of Clinical Nursing最新文献

{"title":"Letter to the Editor Regarding 'Developing and Evaluating the Use of ChatGPT as a Screening Tool for Nurses Conducting Structured Literature Reviews'.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1111/jocn.70042","DOIUrl":"https://doi.org/10.1111/jocn.70042","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627606","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":"The Usability and Experience of Artificial Intelligence-Based Conversational Agents in Health Education for Cancer Patients: A Scoping Review.","authors":"Kun Li, Siyuan Wu, Ying Zhang, Binbin Zhu, Ziyi Qi, Sijia Hou, Wei Wang","doi":"10.1111/jocn.70020","DOIUrl":"https://doi.org/10.1111/jocn.70020","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence-based conversational agents (CAs) have shown transformative potential in healthcare, yet their application in cancer health education has remained underexplored, particularly regarding usability and patients' experiences. Existing reviews lack a dedicated focus on user perspectives, limiting insights into how CAs can be optimised for patient needs.</p><p><strong>Aim: </strong>To explore the usability and experience of artificial intelligence-based conversational agents in health education for cancer from the user perspective.</p><p><strong>Design: </strong>A scoping review was conducted with the Joanna Briggs Institute Scoping Reviews conduct guidance and reported according to the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist.</p><p><strong>Methods: </strong>A search was performed in PubMed, Embase, CINAHL, Web of Science, PsycINFO, IEEE Xplore Digital Library and ACM Digital Library from their inception to March 6, 2024. The references to the articles included were also searched. The Pillar Integration Process was employed to chart data.</p><p><strong>Results: </strong>A total of 12 studies were included in this scoping review, which revealed that CAs supported diverse educational contexts, including cancer-related knowledge (41.7%), pretest genetics (33.3%), self-management (16.7%) and psychological skills (8.3%). Three studies reported that patients preferred interactions with multiple options or 'read more' functions. Patients were generally optimistic about the CAs and reported that CAs provided informational, physical, and psychological support for them. However, limitations such as insufficient customisation, lack of empathy, and defects in understanding free-input questions were noted.</p><p><strong>Conclusion: </strong>This review demonstrated that CAs are promising complementary tools in cancer education, alleviating healthcare burdens while enhancing patient engagement, which was particularly critical in resource-limited settings. However, clinical implementation requires more rigorous validation of safety protocols and high-quality original studies.</p><p><strong>Relevance to clinical practice: </strong>Nurses and policymakers should consider CAs valuable tools to enhance cancer health education, provided that they align with patient needs and institutional safety standards.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627610","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":"Impact of Nurses' Knowledge, Self-Efficacy and Clinical Reasoning Competency on Difficulties in Caring for Patients With Delirium in the Intensive Care Unit: A Cross-Sectional Study.","authors":"Jing Dong, Weijing Sui, Xiaoyan Gong, Li Wang, Qiqi Ni, Ran Yan, Jia Yi, Ying Ding, Yiyu Zhuang","doi":"10.1111/jocn.70034","DOIUrl":"https://doi.org/10.1111/jocn.70034","url":null,"abstract":"<p><strong>Aim: </strong>To examine the impact of critical care nurses' delirium knowledge, self-efficacy and clinical reasoning competency on delirium care difficulties based on the information-motivation-behavioural (IMB) skills model from a behavioural perspective.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A total of 440 critical care nurses from five hospitals in China were selected using convenience sampling and invited to complete an online questionnaire for measurement. Data were collected in November 2024 and analysed using SPSS/AMOS with descriptive statistics, Pearson's correlation coefficient and multiple regression. Structural equation modelling was constructed to test the hypothesised relationships among the variables, with bootstrapping to assess mediation effects.</p><p><strong>Results: </strong>The level of delirium care difficulties was moderated. Delirium care difficulties were negatively correlated with delirium knowledge, self-efficacy and clinical reasoning competency. Clinical reasoning competency partly mediated delirium knowledge and self-efficacy with regard to delirium care difficulties.</p><p><strong>Conclusion: </strong>Delirium knowledge, self-efficacy and clinical reasoning competency are essential for improving critical care nurses' delirium care competencies. The role of clinical reasoning competency in the relationship between the other two variables and delirium care difficulties was highlighted. Establishing multifaceted innovative delirium education programmes, emphasising individuals' sense of competence and enhancing clinical reasoning competency as behavioural skills were supported. Exploring these pathways using a nurse behaviour change-based perspective is critical.</p><p><strong>Implications for the profession and/or patient care: </strong>Critical care managers should value nurses' delirium care competencies. Enhancing continuing professional development through system-level support with high reliability and multiform professional education, including innovative theoretical and practical training; advancing policies that increase work motivation and self-planning to stimulate self-efficacy; and exercising critical and reflective thinking to improve clinical reasoning competency may enhance nurses' delirium recognition and care competencies, including prioritisation, potentially improving delirium care dilemmas and patient outcomes.</p><p><strong>Reporting method: </strong>The STROBE checklist was used as a guideline.</p><p><strong>Patient or public contribution: </strong>Nurses completed questionnaires.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2400092177). https://www.chictr.org.cn/bin/project/edit?pid=249216.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627605","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":"Caregiver-Related Risk Factors Contributing to Abuse Tendency in Nursing Homes: A Structural Equation Model.","authors":"Jin Huang, Yingying Chen, Meng Wang, Huiyun Luo, Bingjie Fan, Yeqin Yang","doi":"10.1111/jocn.70002","DOIUrl":"https://doi.org/10.1111/jocn.70002","url":null,"abstract":"<p><strong>Aims and objectives: </strong>To identify modifiable caregiver factors influencing abuse tendency in Chinese nursing homes and delineate pathways for intervention.</p><p><strong>Background: </strong>Discerning the risk factors associated with elder abuse is paramount for enhancing prevention and intervention strategies.</p><p><strong>Design: </strong>Cross sectional study.</p><p><strong>Methods: </strong>Using validated tools (Caregiver Abuse Screen, Maslach Burnout Inventory, Fatigue Scale-14, Barthel Index), 241 caregivers from 24 nursing homes in Wenzhou City, Zhejiang Province, China were surveyed. Structural equation modelling analysed the direct/indirect pathways linking caregiving stress, caregiving difficulty, job burnout and abuse tendency.</p><p><strong>Results: </strong>The prevalence of abuse tendency amongst caregivers in the previous year was 40.7%. The model explained 83% of the total variance in abuse tendency. The best-fitting model indicated that abuse tendency was directly affected by job burnout. Caregiving difficulty and stress indirectly affected abuse tendency through job burnout.</p><p><strong>Conclusions: </strong>This study identified job burnout as a modifiable mediator linking caregiving difficulties, caregiving stress, and abuse tendency amongst nursing home caregivers. To disrupt the pathways to abuse tendency, clinical administrators should prioritise routine burnout screening coupled with structured resilience-building programmes. Simultaneously, optimising staffing ratios and enhancing caregiving competencies may foster safer care environments for caregivers and residents.</p><p><strong>Relevance to clinical practise: </strong>This study identified job burnout as a direct driver of abuse tendency, providing information for clinical managers and targeted interventions to mitigate elder abuse risk. Additionally, it revealed the indirect effects of caregiving difficulty and stress via job burnout, emphasising the need to optimise staffing allocation and workflow design to foster system-level improvements in caregiver mental health and service quality.</p><p><strong>Reporting method: </strong>The study adhered to the STROBE checklist of observational surveys.</p><p><strong>Patient or public contribution: </strong>Caregivers voluntarily completed questionnaires.</p><p><strong>Impact statement: </strong>This study identifies job burnout, caregiving difficulty, and caregiving stress as key risk factors for abuse tendency amongst nursing home caregivers. The validated model demonstrates the direct and indirect effects of these factors on abuse tendency, emphasising the need for targeted interventions to prevent and mitigate abuse.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621045","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":"Associations Between Workplace Violence and Work Performance Among Nurses: A Longitudinal Study Based on Affective Events Theory.","authors":"Yifei Pei, Yiping Xiao, Xuan Zhang, Yan'e Lu, Meng Sun, Ran Lyu, Fenglin Cao","doi":"10.1111/jocn.70040","DOIUrl":"https://doi.org/10.1111/jocn.70040","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to examine the chain-mediating effects of affective reactions and burnout on the relationship between workplace violence and work performance among nurses while distinguishing between physical and psychological violence.</p><p><strong>Design: </strong>A longitudinal study was conducted between October 2020 and October 2022. The study took place in four tertiary hospitals of Shandong Province, China. A total of 1086 nurses were recruited.</p><p><strong>Methods: </strong>Workplace psychological violence, workplace physical violence, work performance, affective reactions (including anxiety and depressive symptoms) and burnout were assessed using self-report questionnaires. Data were analysed using multiple linear regressions and structural equation modelling on SPSS and AMOS.</p><p><strong>Reporting method: </strong>The STROBE checklist was used for this study.</p><p><strong>Results: </strong>Workplace psychological violence, but not physical violence, was associated with nurses' work performance. Burnout mediates the relationship between workplace psychological violence and work performance. Affective reactions and burnout play serial intermediary roles in the relationship between workplace psychological violence and work performance.</p><p><strong>Conclusions: </strong>Interventions aimed at reducing anxiety, depressive symptoms, and burnout among nurses who have experienced psychological violence may enhance their work performance.</p><p><strong>Practical implications: </strong>Hospital administrators should prioritise the development of strategies to prevent psychological violence (e.g., anti-bullying training and counselling support) and enhance nurse performance through burnout screening and targeted interventions.</p><p><strong>Limitations: </strong>This study was conducted in Shandong Province, China, and relied on self-reported data, which may be subject to social desirability bias.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610240","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":"Prevalence and Risk Factors of Delirium Subtypes in the Surgical Intensive Care Unit: A Retrospective Study.","authors":"Sun Young Yun, Sun Ju Chang","doi":"10.1111/jocn.70031","DOIUrl":"https://doi.org/10.1111/jocn.70031","url":null,"abstract":"<p><strong>Objectives: </strong>Delirium is a frequent, yet often underdiagnosed, condition in intensive care units (ICUs), especially in postoperative patients. It has three subtypes: hyperactive, hypoactive and mixed, each with distinct clinical manifestations and outcomes. A deeper understanding of each subtype's prevalence and risk factors is essential for improving ICU patient care. This study aims to figure out the prevalence of each type of delirium and risk factors associated with each subtype of delirium.</p><p><strong>Methods: </strong>This retrospective study included 4234 postoperative patients admitted to the surgical ICU between January 2017 and June 2019. Delirium was diagnosed using the Confusion Assessment Method for the ICU, and subtypes were determined using the RASS score. Multivariate logistic regression analysis was used to identify the risk factors associated with each delirium subtype. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.</p><p><strong>Results: </strong>The prevalence of delirium was 8.7%, with mixed delirium being the most common subtype (47.7%), followed by hypoactive delirium (40.3%) and hyperactive delirium (12.0%). Each subtype was linked to different risk factors: hypoactive delirium was correlated with shorter ICU stays and pH and O₂ imbalances, hyperactive delirium was associated with physical restraints and mixed delirium was linked to sedative medication and restraint use.</p><p><strong>Conclusion: </strong>Among postoperative ICU patients, mixed delirium was the most prevalent subtype, followed by the hypoactive and hyperactive forms. Identifying the unique risk factors for each subtype highlights the need for targeted prevention and management approaches in ICU. Further research is warranted to investigate the underlying mechanisms and to develop effective interventions tailored to each delirium subtype.</p><p><strong>Relevance to clinical practice: </strong>This study is distinct from previous research in that it comparatively analysed the risk factors for delirium according to subtype. By distinguishing between the subtypes of delirium and identifying their incidence and risk factors, it is possible to enhance the overall understanding of delirium, particularly given that some of the known risk factors are more strongly associated with certain types of delirium. Identifying risk factors according to the type of delirium can facilitate the planning of proactive interventions based on risk factors. Furthermore, it can serve as a valuable resource for the development of tools for predicting different types of delirium to provide more tailored and evidence-based care for patients with delirium.</p><p><strong>Patient of public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610241","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":"A Systematic Review and Meta-Analysis of Randomised Controlled Trials on the Effect of Cognitive Behavioural Therapy for People With Dementia.","authors":"Ita Daryanti Saragih, Herry Susanto, Ice Septriani Saragih, Ping-Jen Chen, Bih-O Lee, Ruth Palan Lopez","doi":"10.1111/jocn.70005","DOIUrl":"https://doi.org/10.1111/jocn.70005","url":null,"abstract":"<p><strong>Background: </strong>Cognitive Behavioural Therapy (CBT) has demonstrated positive effects on emotional well-being and quality of life in individuals with dementia. Limited evidence constrains the generalisability of these findings.</p><p><strong>Methods: </strong>This review was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) that implemented CBT and assessed cognitive function, depressive symptoms, anxiety and quality of life in individuals with dementia were included. Seven databases-APA PsycINFO, CINAHL, Cochrane Library, Embase, MEDLINE, PubMed and Web of Science-were searched up to 10 October 2024. The Risk of Bias 2 (RoB-2) tool was used to evaluate the methodological quality of included studies. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome.</p><p><strong>Results: </strong>A total of 10 RCTs, involving 1412 individuals with dementia and published between 2011 and 2024, were included in the analysis. CBT was associated with a reduction in anxiety (pooled SMD = -0.94; 95% CI = -1.33 to -0.55; I² = 0.00%; p < 0.04). No significant differences were found in cognitive function, depression or quality of life between those receiving CBT and those in the control groups.</p><p><strong>Conclusions: </strong>This study suggests that CBT alleviates anxiety in people with dementia. However, further investigation is required to clarify its effects on cognitive function, depressive symptoms and quality of life. Future research should focus on the development of CBT protocols, alongside the exploration of relevant outcome measures.</p><p><strong>Relevance to clinical practice: </strong>CBT has shown potential in improving emotional well-being and quality of life in individuals with dementia. The findings inform healthcare professionals about its clinical utility and effectiveness in dementia care.</p><p><strong>Patient or public contributions: </strong>The findings suggest that traditional CBT may not fully address the needs of people with dementia, emphasising the importance of incorporating multisensory stimulation and caregiver involvement to enhance therapeutic outcomes.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610239","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":"Individual and Organisational Factors Influencing Knowledge, Attitude and Practice Regarding Post-Extubation Dysphagia in ICU Nurses: A Cross-Sectional Multicentre Study.","authors":"Long Huang, Fan Zeng, Anqi Liang, Lu Wang, Chun-Feng Luo","doi":"10.1111/jocn.70032","DOIUrl":"https://doi.org/10.1111/jocn.70032","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia is a prevalent and critical issue in critically ill patients who have undergone mechanical ventilation. The knowledge, attitude, and practice (KAP) of ICU nurses are determinants of the effectiveness of post-extubation dysphagia (PED) management. However, existing evidence regarding the current KAP status of PED among ICU nurses remains insufficient.</p><p><strong>Objectives: </strong>This study aimed to assess the current status of ICU nurses' KAP regarding PED, along with associated individual and organisational factors.</p><p><strong>Methods: </strong>From August to September 2024, a cross-sectional, multicentre study was conducted on a convenience sample of 305 ICU nurses from 15 tertiary hospitals in 10 cities of Guangdong Province, China. An online self-reported structured questionnaire was used to collect data on the KAP of PED among ICU nurses.</p><p><strong>Results: </strong>A total of 305 valid questionnaires were analysed. The overall mean score was (70.08 ± 15.34). The mean scores of knowledge, attitude, and practice were (78.10 ± 28.98), (80.02 ± 13.27), and (52.13 ± 22.94), respectively. Multivariate analysis revealed that the individual factors related to the total score included confidence in PED management (β = 0.356, p < 0.001), and the organisational factors included leadership support (β = 0.210, p < 0.001), unit compliance with PED screening and treatment protocols (β = - 0.169, p = 0.001), and availability of PED educational resources (β = 0.156, p = 0.002).</p><p><strong>Conclusions: </strong>ICU nurses possess a relatively extensive knowledge base and exhibit positive attitudes toward PED, but there is still room for practice improvement. Besides strengthening the training of ICU nurses on PED-related knowledge, formulating standardised protocols, establishing a multidisciplinary management team, creating a favourable improvement atmosphere, and providing sufficient training resources are indispensable measures for enhancing the quality of clinical PED management.</p><p><strong>Relevance to clinical practice: </strong>To enhance the quality of PED management, it is advisable to formulate a multi-aceted support strategy targeting both organisations and individuals, thereby facilitating the implementation of relevant practices.</p><p><strong>Reporting method: </strong>The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement of cross-sectional studies was followed for reporting in the study.</p><p><strong>Patient or public contribution: </strong>No patient or public involvement.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602088","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":"Clinical Practice Based on Theory: Reflections on Mudd et al.'s Review for Excellence in Nursing","authors":"Lisbeth Uhrenfeldt,&nbsp;Kathleen Galvin,&nbsp;Marianne Dyrby Lorenzen,&nbsp;Bente Martinsen,&nbsp;Mette Stie","doi":"10.1111/jocn.70028","DOIUrl":"10.1111/jocn.70028","url":null,"abstract":"<p>In the Southern Denmark Region, Lillebaelt Hospital (LH) has been developing an approach to underpin personcentred care which we call ‘patient first’ (Drenkard <span>2022</span>). To put the ‘patient first’, according to LH, four core values—patients should be met with results, decency, co-operation and excellence. In order to enact these goals in practice a group of clinical nurses and clinical nurse specialists supported by nurse leaders developed a framework to strive for excellence in nursing and develop a deeper understanding of what is meant by ‘excellent nursing’ (EN). The EN framework that emerged is currently being consolidated draws on European philosophies and is being established within diverse clinical departments (Stie et al. <span>2024</span>; Petersen et al. <span>2024</span>). The framework is constituted by seven core values: wellbeing, relational, trust, ethical, professionalism, personcentred, authentic presence (Figure 1).</p><p>In our desire to establish EN as a programme in Denmark, we read and reflected on the way the fundamentals of care (FoC) framework has approached nursing theory (Mudd et al. <span>2020</span>). Our rationale is twofold: firstly to reflect on fundamentals of nursing which is a commonly used conceptual framework in Denmark and secondly to draw inspiration from Mudd et al.'s critical analysis of nursing theory. What follows is a discussion of reflections where we are in agreement with Mudd et al.'s analysis., the ‘what’ of theory and the ‘how’ of practice and challenges in application of nursing theory to practice. The EN approach is trying to close a theory practice gap, (which has been a longstanding and pernicious challenge) in a particular way. In contrast, our approach is ‘bottom up’, that is, use of theory to give us a more comprehensive and nuanced understanding of practice and <i>primarily</i> a more comprehensive understanding of the patient and their lived situation. We aim to understand our own practice in light of theory, in order to better grasp the patient's experience, using both guided and spontaneous reflection. We conclude with how EN may offer one distinctive approach to supporting nursing practice.</p><p>We particularly valued the authors consideration that their review provided opportunity to reflect on the FoC, that is, strengths, deficiencies and areas for further refinement and clarity about ‘gaps’ that are timely to consider in the context of developing a Framework for EN in Denmark. A supportive care context represents one of the three key dimensions within the FoC Framework, which underpins the delivery of high-quality fundamental care. The FoC Framework defines the context of care as encompassing both system-level factors—such as resources, culture, leadership, evaluation and feedback—and policy-level factors, including financial considerations, quality and safety, governance, regulation and accreditation. However, in their narrative review and synthesis of key nursing theo","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":"34 8","pages":"3047-3050"},"PeriodicalIF":3.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocn.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602087","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":"Rethinking VR for Surgical Anxiety: The Need for Patient Stratification and Contextual Adaptation.","authors":"Yujie Xu, Hua Xu","doi":"10.1111/jocn.70017","DOIUrl":"https://doi.org/10.1111/jocn.70017","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602089","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}