Journal of Clinical Nursing最新文献

{"title":"Variability in Vascular Access Device Use, Dwell Time and Failure: Insights From Routine Nursing Documentation in a Multicentre Cohort Study.","authors":"Ismael Fernández-Fernández, Enrique Castro-Sánchez, Miguel Ángel Rodríguez-Calero, Jesús Bujalance-Hoyos, José Luís Cobo-Sánchez, Gaizka Parra-García, Maria Antonia Cubero-Pérez, Juan Manuel García-Garrido, Ian Blanco-Mavillard","doi":"10.1111/jocn.70397","DOIUrl":"10.1111/jocn.70397","url":null,"abstract":"<p><strong>Aims: </strong>To describe and compare institutional patterns of vascular access device use, dwell time, and failure, and to explore their implications for nursing practice.</p><p><strong>Design: </strong>Retrospective multicentre observational cohort study.</p><p><strong>Methods: </strong>Routinely collected nursing records of vascular access device insertion and removal were analysed from seven public hospitals over a one-year period. All devices inserted in hospitalised adults were included, with each device treated as an independent episode. Device failure was defined as removal due to any complication. Device use, dwell time, and failure were summarised by device type and institution. Time-to-event analyses were used to describe complication-free device survival.</p><p><strong>Results: </strong>More than 200,000 vascular access device episodes were identified, of which ~85,000 had complete data for dwell time and removal reason. Short peripheral intravenous catheters accounted for the majority of devices and reportedly had the shortest dwell time and highest proportion of failure. Medium and long duration devices remained in situ for longer periods and had lower rates of failure, although their use varied substantially between hospitals. Marked inter-institutional variability was observed in device mix, reported dwell time, complications, and data completeness, with substantial missingness in key variables across hospitals.</p><p><strong>Conclusions: </strong>Substantial variability exists in vascular access device use, duration, and failure across hospitals. The use of short peripheral intravenous catheters dominates clinical practice despite early failure and limited alignment with expected treatment duration. These findings highlight opportunities to improve device selection and support more consistent, evidence-based nursing practice, but also underline the need to strengthen institutional data infrastructure and standardise vascular access documentation to enable reliable benchmarking and quality improvement.</p><p><strong>Implications for the profession and/or patient care: </strong>Optimising vascular access device selection according to anticipated treatment duration may reduce repeated insertions, improve patient comfort, and decrease nursing workload associated with device failure.</p><p><strong>Impact: </strong>What problem did the study address? ○ Inconsistent use, duration, and documentation of vascular access devices in routine hospital nursing practice. What were the main findings? ○ Short peripheral intravenous catheters were widely used and failed early, while longer-duration devices were used less frequently despite lower failure rates. Important gaps in data completeness were also identified across hospitals, particularly for dwell time and removal outcomes. Where and whom will the research have an impact? ○ The findings are relevant to nurses, nurse leaders, and healthcare organisations involved in vascular acc","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4828-4838"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273668","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":"Challenges and Strategies in Interviewing People With Acquired Brain Injury and Communication Impairment in Qualitative Interview Studies: A Secondary Analysis of Interview Data.","authors":"Henrietta Gustavsson, Eva Jangland, Lena Nyholm","doi":"10.1111/jocn.70437","DOIUrl":"10.1111/jocn.70437","url":null,"abstract":"<p><strong>Aims: </strong>To explore challenges involved in designing and conducting qualitative interviews with people with communication impairment due to acquired brain injury, as well as analysing data from such interviews, and to map strategies used to facilitate participation.</p><p><strong>Design: </strong>Secondary analysis of qualitative interview data.</p><p><strong>Methods: </strong>A secondary qualitative content analysis was conducted using data from a previous multiple-case interview study on daily life without cranial bone protection. Data comprised interviews with patients with acute severe brain injury, family members and staff, as well as logbook notes and field notes incorporated into transcripts.</p><p><strong>Results: </strong>Findings are presented as a timeline and thematic categories, highlighting challenges related to planning, interviewing people with communication impairment, and interpreting fragmented or partly non-verbal narratives. Strategies included flexible interview procedures, the use of logbooks for planning and analysis, and field notes to capture non-verbal cues. Involvement of family members facilitated participation and interpretation.</p><p><strong>Conclusion: </strong>Despite challenges throughout planning, interviewing, and analysis, individuals with communication impairment due to acquired brain injury contributed valuable insights. Involving persons close to the patient enriched and confirmed patient narratives, while direct questioning and documentation of non-verbal communication added depth and breadth that could not be gathered from other sources.</p><p><strong>Implications for the profession and/or patient care: </strong>The findings provide practical guidance for researchers and clinicians seeking to include people with communication impairment in qualitative research.</p><p><strong>Impact: </strong>What problem did the study address? ○ People with communication impairment after acquired brain injury are often excluded from qualitative interview research. What were the main findings? ○ Meaningful participation was facilitated through flexible interviewing, communication support, field notes, and involvement of family members. Where and on whom will the research have an impact? ○ The findings may support researchers and clinicians working with people with communication impairment following acquired brain injury.</p><p><strong>Reporting method: </strong>COREQ.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5084-5098"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431326","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":"Parents' Experiences of Psychosocial Support in the Neonatal Intensive Care Unit: A Qualitative Study.","authors":"Hanna Seppänen, Eeva Talus, Ulla Sankilampi, Krista Koivula, Ilona Luoma, Tarja Pölkki","doi":"10.1111/jocn.70417","DOIUrl":"10.1111/jocn.70417","url":null,"abstract":"<p><strong>Aim: </strong>To explore parents' experiences of psychosocial support in the neonatal intensive care unit (NICU).</p><p><strong>Design: </strong>A qualitative descriptive study.</p><p><strong>Methods: </strong>The study involved nine individual and three pair interviews; in total, 15 parents described their experiences of psychosocial support in the neonatal intensive care units. The data were analysed using inductive content analysis.</p><p><strong>Results: </strong>Parents' experiences of psychosocial support consisted of four main categories: (1) supporting parenting; (2) strengthening the sense of security; (3) social support; and (4) mental wellbeing support. Parents described how important it was to receive support in caring for an infant, to be able to participate in decision-making or to feel safe despite a difficult situation.</p><p><strong>Conclusion: </strong>Even though parents described peer support and trauma-informed care as important forms of support, many NICUs lacked these. The results provide essential information to healthcare professionals, enabling them to understand and support parents. This can increase parental satisfaction and improve the wellbeing of families, as well as support parents during neonatal intensive care and after discharge.</p><p><strong>Implications for the profession and patient care: </strong>This study provides tailored information on parents' experiences of psychosocial support in neonatal intensive care units. The results can be used in the education of healthcare professionals and to assist them in integrating psychosocial support methods into their practice, such as consistent emotional support.</p><p><strong>Impact: </strong>The findings emphasise the importance of systematically asking parents about their experiences in order to identify their needs and the various forms of psychosocial support they require. These insights can guide healthcare professionals in providing personalised psychosocial support to parents in NICUs.</p><p><strong>Reporting method: </strong>The reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.</p><p><strong>Patient or public contribution: </strong>Parents contributed to the study through data collected from the national peer support association (Kevyt) in Finland.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5029-5043"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334099","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":"Parents' Experiences of Patient Safety Incidents During Their Child's Hospitalization: A Qualitative Study.","authors":"Mi Young Kim, Yujeong Kim","doi":"10.1111/jocn.70395","DOIUrl":"10.1111/jocn.70395","url":null,"abstract":"<p><strong>Aims: </strong>Patient safety incidents involving hospitalized children can have significant impacts on both patients and their families. However, previous research has primarily focused on healthcare professionals' perspectives, and studies exploring parents' experiences of patient safety incidents in paediatric settings remain limited. This study aimed to identify parents' experiences of patient safety incidents during their child's hospitalization.</p><p><strong>Design: </strong>Qualitative study.</p><p><strong>Methods: </strong>Data were collected through individual interviews conducted between August 15 and December 23, 2023. Participants were seven parents who had experienced patient safety incidents while their children were hospitalized in South Korea. Data were analysed using deductive content analysis.</p><p><strong>Results: </strong>Six themes were identified from parents' experiences, which were organized into three theme clusters: 'the indelible pain of patient safety incidents,' 'limitations of the pediatric healthcare system' and 'the need for an integrated management system to strengthen pediatric patient safety.'</p><p><strong>Conclusion: </strong>This study highlights the importance of healthcare environments that reflect the unique characteristics of paediatric patients and patient safety strategies based on parental engagement, as revealed by the experiences of parents whose children experienced patient safety incidents. Our findings underscore the need to develop and implement paediatric-centered healthcare services, as well as programs and policies aimed at creating safer care environments for hospitalized children.</p><p><strong>Implications for the profession and patient care: </strong>Enhancing paediatric patient safety requires family-centered care that actively involves parents and promotes effective communication between healthcare professionals and parents. Additionally, transparent disclosure and support systems following patient safety incidents should be strengthened, and parent-engagement-based patient safety programs should be expanded in clinical practice.</p><p><strong>Reporting method: </strong>The study adheres to the Consolidated criteria for Reporting Qualitative research (COREQ) guidelines.</p><p><strong>Patient or public contribution: </strong>Parents participated as interview respondents.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4980-4990"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213232","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":"Preferences of Stroke Survivors for Mental Health Service: A Discrete Choice Experiment.","authors":"Bowen Liu, Meili Wang, Yinxia Dou, Lingling Wang, Nan Zhao, Mei Sin Chong, Beilei Lin, Jing Chen, Chunhui Zhang, Qiushi Zhang, Yongxia Mei, Zhenxiang Zhang","doi":"10.1111/jocn.70422","DOIUrl":"10.1111/jocn.70422","url":null,"abstract":"<p><strong>Aim: </strong>To investigate stroke survivors' preferences and preference heterogeneity regarding mental health services in China.</p><p><strong>Design: </strong>A cross-sectional study design was employed.</p><p><strong>Methods: </strong>A discrete choice experiment was conducted to elicit preferences for mental health services among 322 stroke survivors recruited from three tertiary hospitals in Henan Province. Six key attributes were identified through literature review, qualitative interviews and expert consultation: service content, delivery method, group size, provider type, session duration and out-of-pocket expenses. Mixed logit and latent class models were used to analyse preferences and explore heterogeneity.</p><p><strong>Reporting method: </strong>This study followed the STROBE checklist.</p><p><strong>Results: </strong>Patients showed a strong preference for less expensive services, smaller group sizes and shorter session durations. Services provided by clinical nurses and delivered face-to-face were also preferred, although delivery mode was less influential overall. Emotion regulation was the most favoured content type. Latent class analysis revealed three distinct preference groups: a general-oriented group, a face-to-face prioritized group (primarily older patients) and a personalization-focused group (primarily higher-income patients). Patient age, income level and prognosis were significant factors influencing preference heterogeneity.</p><p><strong>Conclusion: </strong>Mental health service preferences among Chinese stroke survivors vary considerably. Out-of-pocket costs, group size and session length are key determinants of choice. Tailoring service delivery to reflect patient preferences, such as offering nurse-led, cost-effective and flexible interventions may enhance acceptance and adherence. Policymakers and healthcare administrators should integrate preference-based strategies into stroke care planning to improve psychological outcomes.</p><p><strong>Patient or public contribution: </strong>Stroke patients were involved as participants in this study for data collection.</p><p><strong>Impact: </strong>Mental health service content, delivery method, group size, service providers, duration of each session and out-of-pocket expenses have an impact on mental health service preferences of stroke patients. Mental health services whose content is emotion regulation, face-to-face, small group (3-5 participants), provided by clinical nurses and with a single session lasting 15 to 30 min are more likely to be accepted by patients. There is heterogeneity in mental health services for stroke patients, and this study highlights the importance of tailored mental health services.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4900-4912"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632556","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":"Family Functioning and Medication Self-Management in Rural Older Adults With Chronic Comorbidities: The Mediating Role of Self-Efficacy.","authors":"Ruofan Qiao, Jixuan Zheng, Ying Qin, Xiao Yang, Xiaofan Wang, Chunhui Zhang, Xian Zhang","doi":"10.1111/jocn.70435","DOIUrl":"10.1111/jocn.70435","url":null,"abstract":"<p><strong>Aims: </strong>To examine the mediating role of self-efficacy for appropriate medication use in the relationship between family functioning and medication self-management among rural older adults with chronic comorbidities.</p><p><strong>Background: </strong>Effective medication self-management is vital for rural older adults with chronic comorbidities. However, despite the recognized clinical importance of family functioning, self-efficacy for appropriate medication use and medication self-management, the relationships among these factors in this population remain underexplored.</p><p><strong>Design: </strong>A cross-sectional design.</p><p><strong>Methods: </strong>Between June and July 2025, 539 rural older adults with chronic comorbidities were recruited from a county-level hospital in Henan Province, China using a convenience sampling method. Standardized instruments assessed demographic characteristics, family functioning, self-efficacy for appropriate medication use and medication self-management. PROCESS Model 4 tested the mediation effect.</p><p><strong>Results: </strong>The median score for medication self-management was 61.0 (54.0, 70.0), and significant positive correlations were found among all three variables. Path analysis revealed that self-efficacy for appropriate medication use partially mediated the relationship between family functioning and medication self-management, with the direct and indirect effects accounting for 52.46% and 47.54% of the total effect, respectively.</p><p><strong>Conclusions: </strong>Medication self-management requires further improvement among rural older adults with chronic comorbidities. Self-efficacy for appropriate medication use serves as a partial mediator between family functioning and medication self-management.</p><p><strong>Implications for the profession and/or patient care: </strong>These findings support family-integrated nursing interventions, including family-centred education and collaborative medication planning, to strengthen family functioning, enhance patients' self-efficacy and improve medication self-management in rural older adults.</p><p><strong>Impact: </strong>This study clarifies the mechanism linking family functioning to medication self-management in rural older adults, identifying self-efficacy as a mediator. This evidence supports interventions that enhance family support and patient confidence.</p><p><strong>Patient or public contribution: </strong>Rural older adults with chronic comorbidities participated voluntarily in this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4924-4933"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399710","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 Multiple Sclerosis: Mechanistic Interpretations and Practice Implications.","authors":"Yiqi Guo, Ran Xing","doi":"10.1111/jocn.70426","DOIUrl":"10.1111/jocn.70426","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5136-5137"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370558","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":"Nurses' and Physicians' Experiences With Digital Remote Patient Monitoring-Transforming the Boundaries of Breast Cancer Care.","authors":"Maren-Kathrine Guriby Spillum, Guro Kristine Kleivi Sahlberg, Helle Kristine Skjerven, Nina Helen Mjøsund","doi":"10.1111/jocn.70394","DOIUrl":"10.1111/jocn.70394","url":null,"abstract":"<p><strong>Aim: </strong>To explore expectations and experiences of nurses and physicians with remote care monitoring for breast cancer patients within the Norwegian specialist health service.</p><p><strong>Design: </strong>Qualitative exploratory study.</p><p><strong>Methods: </strong>Individual semi-structured interviews were conducted with nine nurses and physicians before and after the implementation of remote patient monitoring. The data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three key themes were developed: (1) 'Navigating patient empowerment: Reassurance, misinterpretation and guidance in remote patient monitoring communication'; (2) 'Digital care impacts the workflow: Efficiency gains and hidden burdens'; and (3) 'Clinical judgement in a digital context: Balancing standardisation and clinical discretion'.</p><p><strong>Conclusion: </strong>While remote patient monitoring increased flexibility and targeted follow-up, it also reshaped roles and workloads and introduced new interpretive demands that often lack formal delegation, highlighting the need for clearer task allocation and organisational support.</p><p><strong>Implications for the profession: </strong>Remote patient monitoring expands nurses' roles in symptom assessment and digital follow-up. As such, clear role boundaries and support for clinical judgement are essential for its successful implementation.</p><p><strong>Impact: </strong>The results are relevant for management in healthcare services, nurses and other healthcare professionals implementing remote patient monitoring.</p><p><strong>Reporting method: </strong>The study followed CORQ guidelines.</p><p><strong>Patient or public contribution: </strong>Four user representatives with lived experience of breast cancer contributed to the design of the study and gave input regarding the interview guide.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4969-4979"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240524","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":"Current Situation and Factors Influencing Person-Centered Dementia Care in Nursing Homes: A Cross-Sectional Survey.","authors":"Xin Guan, Jia-Bao Ren, A-Min Duan, Gong-Kai Xin, Jan Oyebode, Yu Liu","doi":"10.1111/jocn.70440","DOIUrl":"10.1111/jocn.70440","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Person-centered dementia care (PCDC) is considered the gold standard in nursing homes, but evidence on influencing factors remains limited by qualitative designs and lack of validated tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To describe the current level of PCDC in nursing homes in northeastern China and to analyse multi-level factors influencing its implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A cross-sectional survey.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Settings: &lt;/strong&gt;Sixteen nursing homes across six cities in Liaoning Province, China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;One Hundred Eighty-Nine Participants, Including 170 Nursing and Care Staff and 19 Managers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Person-Centered Care Assessment Tool (P-CAT) and a newly developed questionnaire, Influencing Factors on PCDC (IF-PCDC), were administered. Kruskal-Wallis tests, Spearman's rank correlations, and multiple linear regression were used for analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The overall P-CAT score was 76% (individualized care and environmental accessibility 80%; organizational support 73%). Regression analysis showed that PCDC was associated with factors from all four IF-PCDC dimensions, including work-related stress (β = -0.242, p &lt; 0.001), knowledge of people with dementia (β = 0.238, p &lt; 0.001), and dementia care knowledge (β = 0.194, p &lt; 0.001); nursing home type (β = 0.317, p &lt; 0.001), teamwork (β = 0.187, p = 0.002), and star rating (β = 0.140, p = 0.004); family trust in staff (β = 0.123, p = 0.023); and workload and working hours (β = 0.121, p = 0.046).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PCDC levels in northeastern Chinese nursing homes are reasonably good. This study is the first to systematically identify multi-level influencing factors using a newly developed, preliminarily validated questionnaire. Findings highlight the importance of reducing staff stress, enhancing dementia care knowledge, strengthening teamwork, building family trust, and optimizing workloads to improve PCDC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;This study provides quantitative evidence on PCDC and its influencing factors in Chinese nursing homes. The findings may facilitate nursing home managers, policymakers, and nursing professionals to develop targeted strategies to strengthen PCDC and improve dementia care quality in long-term care settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Contribution to the wider global clinical community: &lt;/strong&gt;This study contributes quantitative evidence on PCDC from a non-Western nursing home context, addressing a gap in the international literature. By examining multilevel factors influencing care implementation, the findings enhance global understanding of PCDC across diverse health system and cultural contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting method: &lt;/strong&gt;This study was reported in accordance with the STROBE guidelines for cross-sectional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient or public contribution: &lt;/strong&gt;No patient or public contribution.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;T","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4934-4945"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438785","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":"Influence of a Multifaceted Nursing Practice Bundle to Support Hospitalised Adults With Cognitive Impairment: A Longitudinal Qualitative Study.","authors":"Erin Rachel Davis, Christina Aggar, Michelle Bissett","doi":"10.1111/jocn.70404","DOIUrl":"10.1111/jocn.70404","url":null,"abstract":"<p><strong>Aim: </strong>To explore nurses' perceptions of the influence of a multifaceted nursing practice bundle, and the factors affecting practice change over time.</p><p><strong>Design: </strong>A longitudinal qualitative study with recurrent cross-sectional analysis over two timepoints.</p><p><strong>Methods: </strong>Thematic analysis of focus groups and interviews with nurses.</p><p><strong>Results: </strong>17 nurses participated, and four themes emerged. Two described how the bundle influenced nursing practice: supporting positive nonpharmacological practices and strengthening communication, collaboration, and relationships. Two addressed the factors affecting practice change: leadership driving practice change and purpose-driven nursing.</p><p><strong>Conclusion: </strong>Nurses reported a positive influence of the bundle on practice. Leadership and the bundle's strong alignment with nurses' professional and personal values appeared to drive perceived practice change over time.</p><p><strong>Implications for the profession: </strong>This study highlights the potential of a multifaceted nursing practice bundle to enhance care for adults with cognitive impairment in hospital. The multifaceted approach may facilitate adoption across health services, with ongoing practice change driven by supportive leadership and alignment with nurses' values.</p><p><strong>Impact: </strong>Nonpharmacological interventions are internationally recommended to support adults with cognitive impairment, but are underutilised by nurses in hospital. Nurses described enhanced practice following implementation of the bundle, with leadership and alignment to nurses' values perceived as key drivers of practice change. This study provides recommendations for organisation-led programs to support nursing practices and improve the quality of care for hospitalised adults with cognitive impairment.</p><p><strong>Reporting method: </strong>Reported in accordance with COREQ.</p><p><strong>Patient or public contribution: </strong>No direct patient or public contribution.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5006-5015"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297207","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}