Journal of Clinical Nursing最新文献

{"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}

{"title":"Evaluating Advanced Practice Nursing Implementation and Activity Indicators in Oncology and Haemato-Oncology.","authors":"Valentin Precourt, Eva Ester Molina Bertran, Arnaud Crochet, Florent Alcade, Sophie Bazin, Agnès Rozier, Christelle Galvez","doi":"10.1111/jocn.70400","DOIUrl":"10.1111/jocn.70400","url":null,"abstract":"<p><strong>Aim: </strong>To describe the 2024 clinical activity of advanced practice nurses in oncology and haemato-oncology across a national cancer network, identify barriers to collecting activity indicators and propose improvements.</p><p><strong>Design: </strong>National descriptive cross-sectional survey.</p><p><strong>Methods: </strong>An anonymous electronic questionnaire was administered in February 2025 to all advanced practice nurses working in 20 comprehensive cancer centres. It collected 2024 activity volumes based on predefined indicators, along with perceptions of their relevance and feasibility. The survey also included optional free-text fields to contextualise responses. Quantitative data were analysed descriptively, and free-text comments were reviewed to complement and clarify the quantitative findings.</p><p><strong>Results: </strong>Fifty-three of 69 nurses responded (77%). Most qualified between 2020 and 2023. On average, 68% of time was devoted to direct clinical care, 15% to administration/coordination, 10% to teaching and 7% to research. The median number of distinct patients followed per nurse in 2024 was 266. Inpatient interventions remained limited. Respondents considered current indicators useful to quantify activity but insufficient to assess care quality; they prioritised adding patient-centred outcomes (satisfaction, adherence, unplanned hospitalisations) and harmonising/automating data capture. Main barriers were heterogeneous information systems and reliance on manual collection.</p><p><strong>Conclusion: </strong>Clinical activity expanded markedly and nurses play a central role in coordination and follow-up. Existing indicators are predominantly quantitative and should be complemented with outcome measures and automated capture.</p><p><strong>Implications for the profession and/or patient care: </strong>Enriching indicator sets with patient-reported experience and outcome measures and integrating automated collection into hospital systems will strengthen evaluation, visibility, and sustainability of advanced nursing roles.</p><p><strong>Impact: </strong>Problem: Lack of consolidated, comparable indicators to evaluate advanced nursing practice in oncology at scale.</p><p><strong>Main findings: </strong>High activity volumes; barriers to indicator capture; strong demand for patient-centred outcomes and automation. Who/where it impacts: Oncology services and patients managed by advanced practice nurses across comprehensive cancer centres.</p><p><strong>Reporting method: </strong>The study adhered to the STROBE checklist for cross-sectional studies.</p><p><strong>No patient or public involvement: </strong>This study did not include patient or public involvement in its design, conduct, or reporting.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4850-4863"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273626","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":"Catheter-Day Denominators in CVADs Care Bundles Studies: Does a Reduction in Infection Events Indicate Reduced Risk?","authors":"Wanchen Zhao, Hui Zhang, Na Guo","doi":"10.1111/jocn.70428","DOIUrl":"10.1111/jocn.70428","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5140-5141"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370594","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":"Perspectives About Older Adult and Family Member Engagement in Medication Management Across Transitions of Care.","authors":"Grace Marconi, Maneesh Prasad, Kerry Hwang, Caitlin Deery, Kelly Ottosen, Elizabeth Manias","doi":"10.1111/jocn.70405","DOIUrl":"10.1111/jocn.70405","url":null,"abstract":"<p><strong>Aim: </strong>To explore perspectives of older patients, family members, and healthcare professionals regarding patient and family engagement in medication management across transitions of care.</p><p><strong>Design: </strong>A qualitative study utilising semi-structured interviews with patients aged ≥ 65, family members and healthcare professionals.</p><p><strong>Methods: </strong>Participants were recruited from four hospital sites from a major public hospital system which services a large socioeconomically diverse population of metropolitan Melbourne. Interviews were analysed using inductive content analysis.</p><p><strong>Results: </strong>In total, 67 patients, 66 family members, and 69 healthcare professionals participated in the study (n = 202). The three themes generated were: challenges in supporting patients and families in communication, factors influencing patient and family ability to communicate, and approaches to enhanced engagement.</p><p><strong>Conclusion: </strong>There is a need for strategies which empower and encourage patients and family members to engage in medication management, which, despite complex barriers, could be achieved through enhanced communication.</p><p><strong>Implications for patient care: </strong>Proposed strategies present possibilities for older patients and families to engage in medication management across transitions of care, providing opportunities to reduce medication errors and adverse events with the potential to improve patient outcomes.</p><p><strong>Impact: </strong>This research uncovers the complexities relating to older patient and family engagement and decision-making, and generates strategies to improve communication in medication management.</p><p><strong>Reporting method: </strong>Conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research.</p><p><strong>Patient or public contribution: </strong>This study sought insights from older patients who were admitted to hospital and family members, with experience in managing medications across transitions of care. Two consumers with lived experience as caregivers for older patients and involved in medication management were invited to contribute to manuscript preparation and provided detailed feedback, which was implemented in the final manuscript.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry (ANZCTR) on 24 July 2024: ACTRN12624000901505.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5016-5028"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284533","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":"Potentially Stressful Care Interactions in Hospitalized Children: Incidence and Associated Factors During a 6-h Observation Period.","authors":"Danton Matheus de Souza, Larissa Soares Butrico, Caroline Knoner Monteiro, Gabriela Silveira Valério, Lisabelle Mariano Rossato","doi":"10.1111/jocn.70407","DOIUrl":"10.1111/jocn.70407","url":null,"abstract":"<p><strong>Aim: </strong>To determine the incidence of potentially stressful care interactions and their associated factors in hospitalized children observed over a 6-h period.</p><p><strong>Design: </strong>Observational, longitudinal, and prospective study.</p><p><strong>Methods: </strong>The study was conducted in a paediatric inpatient unit at a teaching hospital in São Paulo, Brazil, with 75 hospitalized children aged between 28 days and under 10 years. The children were observed for 6 h during morning and afternoon periods to record the number of potentially stressful care interactions. Descriptive and inferential analyses were performed.</p><p><strong>Results: </strong>Eight hundred and fifty-nine potentially stressful care interactions were recorded, corresponding to a mean of 11 per child. Physical examinations were the most frequent procedure (n = 363; mean = 4.8), followed by vital signs measurements (n = 182; mean = 2.4) and nasal lavage (n = 119; mean = 1.6). The factors associated with a higher number of manipulations were younger children (p < 0.001), with emphasis on infants (mean = 16.7); those observed during the morning shift (mean = 12.3) (p = 0.04); and those with an underlying chronic condition (mean = 13.9) (p = 0.036).</p><p><strong>Conclusion: </strong>Over a short observation period of hospitalized children, a high number of potentially stressful care interactions were observed, demonstrating the need to reflect on current care routines and identify opportunities for change.</p><p><strong>Implications for the profession and/or patient care: </strong>This study has practical implications for healthcare professionals-particularly nursing staff-who routinely perform potentially stressful care interactions. These professionals must consider strategies to minimize frequent manipulations and/or reframe them through appropriate preparation of the child and family.</p><p><strong>Reporting method: </strong>STrengthening the Reporting of OBservational studies in Epidemiology.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4864-4876"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297220","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":"Best Evidence Summary on Nutritional Risk Screening and Nutritional Assessment in Adult Critically Ill Patients.","authors":"Dan Luo, Taoxue Wen, Qionghui Wu, Yanhong Liu, Fei Xiong, Ling Chen","doi":"10.1111/jocn.70432","DOIUrl":"10.1111/jocn.70432","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To retrieve, evaluate, and summarize the evidence related to nutritional risk screening and assessment in adult critically ill patients, providing an evidence-based decision-making reference for clinical healthcare professionals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence-based Nursing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;According to the '6S' model of evidence resources, evidence on nutritional risk screening and assessment in adult critically ill patients was retrieved, including clinical decision-making, best practices, guidelines, evidence summaries, expert consensus, and systematic evaluations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data: &lt;/strong&gt;Up to date, BMJ Best Practice, Cochrane Library, Joanna Briggs Institute (JBI), Embase, PubMed, WanFang Medical, China Biomedical Literature Database, CNKI, and relevant professional society websites including the National Institute for Health and Care Excellence (NICE), GIlN, the National Guideline Clearinghouse, and Yi Maitong were searched from the establishment of these databases to Dec. 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eleven literature sources were included, comprising 8 guidelines, 2 expert consensuses, and 1 evidence summary. Through rigorous synthesis, 18 best practice recommendations were distilled across eight critical domains: multidisciplinary team formation, screening targets, screening timing, screening instruments, screening frequency, assessment targets, assessment core parameters, and assessment frequency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study summarizes the current best evidence regarding nutritional risk screening and assessment in adult critically ill patients, providing optimal evidence support for standardizing nutritional risk screening and assessment in this population. In clinical practice, it is essential to select the best evidence for localized and individualized application while continuously updating the evidence to standardize nursing practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for the profession and patient care: &lt;/strong&gt;Clinical medical staff are encouraged to use evidence-based recommendations for the screening and assessment of nutritional risks in adult critically ill patients. By implementing these best evidence practices, healthcare professionals can enhance patient care and improve clinical outcomes, ensuring that nutritional needs are effectively addressed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;The effective screening and assessment of nutritional risk in critically ill patients are crucial for optimizing patient outcomes. This study summarizes 18 pieces of best evidence concerning nutritional risk screening and assessment, highlighting their importance in clinical practice. Implementing these recommendations can enhance the quality of nutritional care, reduce complications, and ensure that patients receive appropriate nutritional interventions tailo","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5117-5130"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413444","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":"Nurse-Reported Patient Safety Incidents in an Italian Teaching Hospital: A 10-Year Retrospective Study of Trends, Contributory Factors, and Implications for Nursing Practice.","authors":"Gianmarco Sirago, Fiorenza Zotti, Dania Comparcini, Giancarlo Cicolini, Alessandro Dell'Erba, Davide Ferorelli","doi":"10.1111/jocn.70409","DOIUrl":"10.1111/jocn.70409","url":null,"abstract":"<p><strong>Aims: </strong>To examine 10-year trends in nurse-submitted patient safety incident reports and to identify report characteristics associated with perceived preventability, contributory factors, and harm severity in a large Italian teaching hospital.</p><p><strong>Background: </strong>Incident-report counts reflect both reporting behaviour and underlying safety events. Because voluntary systems are subject to under-reporting and reporting-culture effects, they are best interpreted as learning signals rather than direct measures of harm. Nurse-specific longitudinal analyses may clarify profession-specific patterns in reporting-system use and highlight priorities for local safety learning.</p><p><strong>Design: </strong>Retrospective observational study reported following the STROBE guideline.</p><p><strong>Methods: </strong>We analysed all 216 nurse-submitted incident reports recorded between July 2015 and June 2025 using descriptive statistics, negative binomial regression for annual counts, and logistic and ordinal models. Denominator-adjusted reporting-intensity metrics were calculated for 2020-2024 using ordinary admissions, total hospitalisations, and patient-days. Models were interpreted as exploratory because staffing, workload, case-mix, and independent outcome denominators were unavailable.</p><p><strong>Results: </strong>Nurse-submitted reports increased over the period. Aggression and violence (44.0%) and falls (15.7%) were the most frequent categories. Most reports described no harm (48.6%) or mild harm (22.7%). Perceived preventability and system-factor attribution increased over time, and denominator-adjusted reporting intensity also rose between 2020 and 2024, suggesting the increase was not explained only by hospital activity volume; true incident incidence could not be inferred.</p><p><strong>Conclusions: </strong>The study demonstrates longitudinal changes in nurse reporting patterns, not direct changes in patient harm. Incident-report analytics can inform local safety learning when interpreted cautiously and triangulated with independent indicators.</p><p><strong>Relevance to clinical practice: </strong>Nurse managers may use feedback loops, safety huddles, and action-tracking to convert reports into learning. Violence and falls prevention emerged as nurse-reported priorities, but interventions should be evaluated prospectively.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4877-4885"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279672","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":"Latvian Nursing Students' Experience of Workplace Violence During Clinical Placement.","authors":"Jolanta Pupure, Yeter Sinem Üzar-Özçetin, Renārs Erts, Eva Jakubova, Iveta Strode, Stephen Tee","doi":"10.1111/jocn.70414","DOIUrl":"10.1111/jocn.70414","url":null,"abstract":"<p><strong>Aim: </strong>To explore workplace violence (WPV) amongst Latvian undergraduate nursing students during clinical placements.</p><p><strong>Background: </strong>Workplace violence has profound consequences. Nursing students on placement are often victims of non-verbal and verbal abuse, physical or sexual violence, causing psychological problems, hindering their professional identity and causing them to leave the nursing profession. Numerous studies indicate the problem's extent, yet reporting in the Baltic region has been absent in the literature.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Methods: </strong>This study, conducted October to December 2023, was based on similar studies in Australia and the UK, using a validated 4-point Likert scale with 24 questions assessing WPV. Questions were uploaded to a commercial internet survey provider, distributed across three universities providing nursing programs in Latvia. Ethical approval was obtained from the University of Latvia's Ethics Committee. Participation was voluntary, involving 119 students (21% from three universities).</p><p><strong>Reporting method: </strong>STROBE checklist: cross-sectional studies.</p><p><strong>Results: </strong>The majority of nursing students (52.9%) on placement experienced bullying (n = 63). Perpetrators included registered nurses and patients. Exposure included negative non-verbal behaviour (69.8%, n = 83), being ignored (55.5%, n = 66), neglected (52.1%, n = 62), and unfairly criticized (51.3%, n = 61). Only 13.4% (n = 16) reported these episodes. There was a significant association between bullying and students considering leaving the nursing profession.</p><p><strong>Conclusions: </strong>Latvian nursing students experience various forms of WPV, including emotional bullying (e.g., negative non-verbal behaviour, being ignored, neglected, unfairly criticized, verbally abused), physical abuse (e.g., being pushed), sexual harassment (e.g., inappropriate touching, sexist remarks). The lack of reporting may result in unresolved issues for both students and nursing profession.</p><p><strong>Implications for the profession and/or patient care: </strong>Clinical nurses working directly in healthcare settings and academic facilitators/lecturers involved in teaching and training should collaborate on implementing targeted training programs addressing WPV. This ensures that both practical and theoretical WPV-handling aspects are covered comprehensively.</p><p><strong>Patient or public contribution: </strong>None.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4886-4899"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297212","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":"Togetherness in Couples Living With Chronic Obstructive Pulmonary Disease: An Interpretive Interview Study.","authors":"Louise Muxoll Gronhaug, Ingeborg Farver-Vestergaard, Yoon Frederiksen, Annamaria Giraldi, Anders Løkke","doi":"10.1111/jocn.70430","DOIUrl":"10.1111/jocn.70430","url":null,"abstract":"<p><strong>Aim: </strong>To explore how persons with chronic obstructive pulmonary disease (COPD) and partners experience illness-related changes in shared everyday life and intimacy, and how these changes affect well-being.</p><p><strong>Design: </strong>An interpretive phenomenological interview study.</p><p><strong>Methods: </strong>Individual, in-depth telephone interviews were conducted with persons with moderate to very severe COPD and partners recruited through a survey. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis informed by hermeneutic phenomenology.</p><p><strong>Results: </strong>Ten persons with COPD and five partners were included. One overarching theme was generated: Togetherness in light and darkness-transformation of couplehood when living with COPD, and three interrelated themes: (1) Living in sync and out of step-breathlessness slowed everyday life and limited shared activities and physical intimacy; (2) Holding on and holding back-togetherness was nurtured through emotional presence and challenged by protective restraint; (3) Becoming another we-meaning and continuity were sought amid loss, and shared identity was renewed or faded.</p><p><strong>Conclusion: </strong>COPD transformed couplehood and intimacy, creating risks of disconnection while also opening possibilities for renewal and strengthened belonging. Breathlessness disrupted shared life, roles and identity; however, aligning pace and emotional presence fostered togetherness and well-being for both partners.</p><p><strong>Implications for patient care: </strong>The findings may guide nurses to initiate and navigate conversations about how COPD affects shared activities, intimacy and emotional connection, thereby facilitating couple-centred care.</p><p><strong>Impact: </strong>Relationship and intimacy changes in couples living with COPD remain largely overlooked. This study provides new insights into how breathlessness slows and reshapes shared everyday life, connection, and couple identity, highlighting aspects of well-being that may otherwise remain unaddressed in clinical encounters.</p><p><strong>Reporting method: </strong>SRQR.</p><p><strong>Patient and public contribution: </strong>Preliminary interviews with six participants refined the study focus from sexual health toward changes in shared everyday life and intimacy, and informed study design.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"5058-5072"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388284","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":"Identifying Barriers and Facilitators to Providing Psychologically Safe Care in Inpatient Mental Healthcare. A Theoretical Domains Framework-Informed Qualitative Study.","authors":"Bethany Griffin, Chris Keyworth, Judith Johnson, John Baker","doi":"10.1111/jocn.70402","DOIUrl":"10.1111/jocn.70402","url":null,"abstract":"<p><strong>Aim(s): </strong>To explore the facilitators and barriers to staff providing psychologically safe care in inpatient mental healthcare when restrictive practices are used.</p><p><strong>Design: </strong>Qualitative descriptive interview study.</p><p><strong>Methods: </strong>Twenty semi-structured interviews were conducted with staff with experience working in inpatient mental healthcare in England. Analysis included principles of framework analysis, informed by the Theoretical Domains Framework.</p><p><strong>Results: </strong>Access to resources and a safe environment for both patients and staff were recognised as important (environmental context and resources) but access was impacted by competing organisational priorities and expectations (beliefs about capabilities). Participants recognised knowledge gaps in themselves and their colleagues (knowledge). Being able to confidently make decisions about risk was seen as central to the staff role (social/professional role and identity). Collaboration between staff is needed to make positive change and progression towards psychologically safe care (social influences). Empathy and compassion were driving factors in participants trying to use psychologically informed alternatives, but burnout hindered this (emotions).</p><p><strong>Conclusion: </strong>Ensuring that staff feel supported in their role to implement psychosocial informed alternatives to restrictive practices, as well as providing safe environments for both patients and staff, could support the integration of psychologically safe care on inpatient mental health wards.</p><p><strong>Implications for the profession and/or patient care: </strong>Key facilitators and barriers to staff providing psychologically safe care are identified to support practice and improvements to patient care.</p><p><strong>Reporting method: </strong>Consolidated criteria for reporting qualitative studies (COREQ).</p><p><strong>Patient or public contribution: </strong>Former patients and members of the public were involved in the conceptualisation of key concepts and design of this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":"4991-5005"},"PeriodicalIF":3.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260347","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}