Journal of Clinical Nursing最新文献

{"title":"Caring for Patients With Infectious Diseases: Nurses' Risk Perception, Moral Distress, Professional Ethos and Emotional Labor: A Mixed Methods Study.","authors":"Naimi Etti, Bluvstein Irit, Itzhaki Michal","doi":"10.1111/jocn.17750","DOIUrl":"https://doi.org/10.1111/jocn.17750","url":null,"abstract":"<p><strong>Aims: </strong>To examine the relationship between hospital nurses' self-perceived risk when caring for patients with infectious diseases and their moral distress, and how this relationship affects their emotional labour, while examining the moderating role of professional ethos.</p><p><strong>Design: </strong>Mixed methods research using quantitative and qualitative approaches.</p><p><strong>Methods: </strong>The research was conducted in a hospital in northern Israel among 139 nurses from 11 inpatient departments. Data were collected through structured self-administered questionnaires, including socio-demographic questions and measures examining risk perception, moral distress, professional ethos and emotional labor. Two open-ended questions were included for qualitative analysis.</p><p><strong>Results: </strong>A significant positive correlation was found between risk perception and moral distress. Nurses showed an intermediate level of risk perception, demonstrating a balanced awareness of occupational hazards while maintaining a high professional ethos and experiencing relatively low moral distress. Our analysis revealed that risk perception, along with experienced emotions and emotional gaps, were significant predictors of emotional labor. The qualitative findings revealed a wide spectrum of emotions among the nursing staff. Positive emotions included empathy, identification with patients, caring, compassion and tolerance, while negative emotions included anger, fear, frustration and helplessness. Participants described various coping strategies, both emotional and practical, including the use of protective equipment, adherence to hand hygiene, participation in workshops and conversations with colleagues for emotional processing of nursing experiences.</p><p><strong>Conclusion: </strong>The research raises awareness of the moral distress that nursing staff experience, not only during emergencies like a global pandemic but also in routine situations where they regularly care for patients with various infectious diseases. Significant organisational support and implementation of effective coping strategies are required to maintain nurses' well-being.</p><p><strong>Reporting method: </strong>The study adhered to the relevant EQUATOR guidelines and used the Good Reporting of a Mixed Method Study (GRAMM).</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p><p><strong>Impact: </strong>The research illuminates the unique challenges experienced by nursing staff in treating infectious diseases both in routine and emergency situations. The findings indicate the need for systemic support and the development of effective coping strategies. The research is relevant to all nursing staff in hospitals and healthcare system decision-makers.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677407","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":"Study on the Construction of Infection Risk Prediction Model for Central Venous Catheterisation in PICU and Preventive Measures.","authors":"Zile Zhang, Xiong Qiu Zhuoma, Tingting Deng","doi":"10.1111/jocn.17749","DOIUrl":"https://doi.org/10.1111/jocn.17749","url":null,"abstract":"<p><strong>Aim(s): </strong>To analyse the risk factors for central venous catheter-related infections in Paediatric Intensive Care Unit (PICU) patients, construct a risk prediction model and propose preventive strategies to reduce infection rates and improve patient outcomes.</p><p><strong>Design: </strong>A retrospective cohort study was conducted to identify risk factors and develop a predictive model for central venous catheter-associated infections in PICU patients.</p><p><strong>Methods: </strong>Clinical data from 312 PICU patients with central venous catheters hospitalised between September 2020 and August 2022 were retrospectively analysed. Patients were divided into an infection group (55 cases) and a no-infection group (257 cases). Univariate analysis identified potential risk factors, and multivariate logistic regression was used to construct a predictive model. The model's performance was evaluated using Receiver Operating Characteristic (ROC) curves, calibration curves and decision curve analysis.</p><p><strong>Results: </strong>The incidence of central venous catheter-related infections in PICU patients was 17.26%. Prolonged catheter retention and repeated catheterisation were identified as independent risk factors, while heparin sealing and increased frequency of auxiliary material changes were protective factors. The predictive model achieved an area under the curve (AUC) of 0.793, demonstrating good accuracy and clinical utility.</p><p><strong>Conclusion: </strong>The risk prediction model for central venous catheter-associated infections in PICU patients is simple, accurate and clinically valuable. It supports early identification of high-risk patients and informs targeted preventive measures to reduce infection rates and improve patient outcomes.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676934","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 of the Impact of Nursing Triage on Length of Stay in Paediatric Emergency Department.","authors":"Luma Ghazi Alzamel, Duaa Fayiz Al-Maghaireh, Khitam Alsaqer","doi":"10.1111/jocn.17741","DOIUrl":"https://doi.org/10.1111/jocn.17741","url":null,"abstract":"<p><strong>Background: </strong>Paediatric emergency departments (PEDs) treat children in urgent medical situations, and nursing triage plays a crucial role in determining their length of stay (LOS), a key metric for evaluating healthcare efficiency. This systematic review investigates the impact of nursing triage on LOS in paediatric emergency departments.</p><p><strong>Methods: </strong>Searching electronic databases identified relevant studies meeting inclusion criteria, focusing on nursing triage and length of stay in the paediatric emergency department. Utilising the Let Evidence Guide Every New Decision (LEGEND) approach, quality assessment and data extraction were conducted independently by two reviewers.</p><p><strong>Results: </strong>Six studies met the inclusion criteria and were analysed. The review highlights multiple factors influencing LOS, including triage accuracy, patient acuity levels, nurse staffing and overcrowding. Inefficient triage processes and delays were identified as key contributors to prolonged LOS.</p><p><strong>Discussion: </strong>This review underscores the critical role of efficient nursing triage in optimising patient flow and reducing LOS in paediatric emergency settings. Challenges such as nurse shortages, high patient volumes and inappropriate triage categorizations contribute to delays. Future research should focus on evaluating specific triage protocols, nurse training programmes, and integrating advanced technology to improve triage accuracy and efficiency. Implementing evidence-based strategies could significantly enhance patient outcomes and experiences in PEDs.</p><p><strong>Reporting method: </strong>The study adhered to the relevant EQUATOR reporting guidelines: the PRISMA Checklist for Systematic review was used.</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":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677405","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 Barriers and Enablers to Implementing Nurse-Initiated Protocols in the Emergency Department: A Focus Group Study.","authors":"Julie Gawthorne, Kate Curtis, Andrea McCloughen","doi":"10.1111/jocn.17744","DOIUrl":"https://doi.org/10.1111/jocn.17744","url":null,"abstract":"<p><strong>Aim: </strong>To identify the barriers and enablers to implementing nurse-initiated protocols in an emergency department.</p><p><strong>Background: </strong>Nurse-initiated protocols empower emergency nurses to autonomously initiate interventions, investigations and treatments based on predefined clinical guidelines. These protocols reduce waiting times and enhance staff and patient satisfaction. However, their uptake remains inconsistent, and the reasons for this variability are not well understood.</p><p><strong>Method: </strong>Focus groups were conducted with emergency nurses using an interview guide informed by the theoretical domains framework to explore perceived barriers and enablers to protocol implementation. Audio recordings were transcribed and analysed using inductive content analysis.</p><p><strong>Results: </strong>Six focus groups with 34 participants identified seven categories influencing protocol implementation. Barriers were: (i) nurses' workload and psychological stress, (ii) lack of competence, confidence and experience, and (iii) documentation burden and limited access to resources. Enablers were: (i) education and clinical support, (ii) improved clinical practice, and (iii) positive healthcare outcomes. The nurses and doctor relationship was identified as both a barrier and an enabler.</p><p><strong>Conclusion: </strong>Effective implementation of nurse-initiated protocols requires systemic changes that empower nurses within a well-supported, adequately resourced environment. Addressing structural and professional development challenges is crucial to ensuring these protocols are consistently integrated into emergency departments.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor 'Incidence and Risk Factors of Post-Operative Delirium in Glioma Patients: A Prospective Cohort Study in General Wards'.","authors":"Zhenhong Pan, Kaikai Huang, Zhirong Yang, Yinxing Huang","doi":"10.1111/jocn.17746","DOIUrl":"https://doi.org/10.1111/jocn.17746","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659420","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' Perceptions of Facilitators and Barriers to Their Acceptance of Electronic Health Records: A Mixed-Method Systematic Review.","authors":"Sinead Corbett, Rajinikanth Maruthu, Mohamad M Saab, Elaine Lehane","doi":"10.1111/jocn.17736","DOIUrl":"https://doi.org/10.1111/jocn.17736","url":null,"abstract":"<p><strong>Background: </strong>International eHealth strategies incorporate the adoption of electronic health records to enhance the delivery of integrated healthcare and improve patient outcomes. Nurses' acceptance of electronic health records is crucial for their successful implementation.</p><p><strong>Aim: </strong>To synthesise evidence from empirical studies to explore the nurses' perceptions of facilitators and barriers and the influence of moderating factors on their acceptance of electronic health records.</p><p><strong>Design: </strong>A convergent integrated mixed-method systematic review following the JBI methodology.</p><p><strong>Data sources: </strong>CINAHL Plus with Full Text, Medline [EBSCO], ProQuest, PubMed, Scopus, Google Scholar and Open Grey were searched on 28 March 2023 for primary research studies published between 2018 and 2023.</p><p><strong>Review methods: </strong>Studies were screened by two independent reviewers adhering to predetermined inclusion criteria. A convergent integrated synthesis was conducted and deductive analysis was framed by The Unified Theory of Acceptance and Use of Technology model.</p><p><strong>Results: </strong>Thirteen studies were included and appraised using the mixed-method appraisal tool. Facilitators of nurses' acceptance of electronic health records included increased efficiency, improved access to information, management support and training. Nurses identified increased documentation burden, threats to patient confidentiality, difficult navigation and inadequate IT support and training as barriers to their acceptance. The influence of moderators on nurses' acceptance of electronic health records remains unclear.</p><p><strong>Conclusion: </strong>This review provides insights into nurses' perceptions of factors influencing electronic health record acceptance. Addressing these issues during adoption and further exploring the impact of moderators can improve acceptance and minimise unintended consequences.</p><p><strong>Implications: </strong>Nurse leaders are key in empowering nurses to accept electronic health records. The nursing profession must participate in all phases of electronic health record design and implementation to ensure that they complement nursing practice.</p><p><strong>Reporting method: </strong>PRISMA 2020 Statement.</p><p><strong>No patient or publication contribution: </strong>This is a review of primary research.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659421","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 Development of a Model to Predict Cognitive Decline Within 12 Months in Home Care Clients.","authors":"Gary Cheung, Ruth Teh, Eamon Merrick, Nicole Williams, Dawn M Guthrie","doi":"10.1111/jocn.17726","DOIUrl":"https://doi.org/10.1111/jocn.17726","url":null,"abstract":"<p><strong>Aim: </strong>To develop and validate a model to predict cognitive decline within 12 months for home care clients without a diagnosis of dementia.</p><p><strong>Design: </strong>We included all adults aged ≥ 18 years who had at least two interRAI Home Care assessments within 12 months, no diagnosis of dementia and a baseline Cognitive Performance Scale score ≤ 1. The sample was randomly split into a derivation cohort (75%) and a validation cohort (25%). Significant cognitive decline was defined as an increase (deterioration) in Cognitive Performance Scale scores from '0' or '1' at baseline to a score of ≥ 2 at the follow-up assessment.</p><p><strong>Methods: </strong>Using the derivation cohort, a multivariable logistic regression model was used to predict cognitive decline within 12 months. Covariates included demographics, disease diagnoses, sensory and communication impairments, health conditions, physical and social functioning, service utilisation, informal caregiver status and eight interRAI-derived health index scales. The predicted probability of cognitive decline was calculated for each person in the validation cohort. The c-statistic was used to assess the model's discriminative ability. This study followed the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) reporting guidelines.</p><p><strong>Results: </strong>A total of 6796 individuals (median age: 82; female: 60.4%) were split into a derivation cohort (n = 5098) and a validation cohort (n = 1698). Logistic regression models using the derivation cohort resulted in a c-statistic of 0.70 (95% CI 0.70, 0.73). The final regression model (including 21 main effects and 8 significant interaction terms) was applied to the validation cohort, resulting in a c-statistic of 0.69 (95% CI 0.66, 0.72).</p><p><strong>Conclusion: </strong>interRAI data can be used to develop a model for identifying individuals at risk of cognitive decline. Identifying this group enables proactive clinical interventions and care planning, potentially improving their outcomes. While these results are promising, the model's moderate discriminative ability highlights opportunities for improvement.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659355","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":"Current Status and Factors Influencing Nutrition Literacy in Stroke Patients: A Cross-Sectional Study.","authors":"Weibin Liu, Nan Jiang, Yuan Li, Shuhua Cheng","doi":"10.1111/jocn.17742","DOIUrl":"https://doi.org/10.1111/jocn.17742","url":null,"abstract":"<p><strong>Aims: </strong>This study investigated the current status of nutrition literacy and related influencing factors in stroke patients, with a view to providing a reference for the development of targeted interventions.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A convenience sampling method was used to select 342 stroke patients from June to November 2024 as the study population, and a cross-sectional survey was conducted using the General Information Questionnaire, Nutrition Literacy Scale, Herth Hope Scale, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale. Descriptive analysis, independent samples t-test, one-way ANOVA, Pearson's correlation analysis and multiple linear regression analysis were used for data analysis.</p><p><strong>Results: </strong>The results showed that the nutrition literacy score of stroke patients was 122.24 ± 16.66, and gender, age, education level, monthly per capita family income, nutrition education, hope level, self-efficacy and social support were the factors affecting the nutrition literacy of stroke patients (all p < 0.05).</p><p><strong>Conclusion: </strong>According to the study, stroke patients' nutrition literacy has to be raised, and medical practitioners should create focused intervention plans to raise patients' nutrition literacy levels.</p><p><strong>Relevance to clinical practice: </strong>Healthcare professionals should assess the level of nutritional literacy in order to provide targeted interventions. The establishment of a multidisciplinary care team and implementation of long-term nutritional management after stroke are essential to reduce stroke recurrence and mortality.</p><p><strong>Reporting method: </strong>The study adhered to the STROBE checklist.</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":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Measurement Properties of Patient-Reported Outcome Measures for Women With Dysmenorrhea: A Systematic Review'.","authors":"Katharina Piontek, Christian Apfelbacher","doi":"10.1111/jocn.17739","DOIUrl":"https://doi.org/10.1111/jocn.17739","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659328","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":"Cross-Cultural Adaptation and Cross-Validation of the Italian Version of the EPICC Spiritual Care Competency Self-Assessment Tool for Clinical Nurses.","authors":"Michela Piredda, Alessio Lo Cascio, Maddalena De Maria, Roberto Latina, Anna Marchetti, Anna De Benedictis, Giorgia Petrucci, Linda Ross, Wilfred McSherry, Maria Grazia De Marinis","doi":"10.1111/jocn.17738","DOIUrl":"https://doi.org/10.1111/jocn.17738","url":null,"abstract":"<p><strong>Aim: </strong>To cross-culturally adapt and psychometrically test the Italian version of the EPICC Spiritual Care Competency Self-Assessment Tool for clinical nurses (EPICC Tool-It).</p><p><strong>Design: </strong>Multicentre, cross-sectional validation study.</p><p><strong>Methods: </strong>The 28-item EPICC Tool was translated into Italian and culturally adapted following a rigorous methodology. A nationwide survey was conducted. Psychometric evaluation included content validity, structural validity (exploratory and confirmatory factor analyses), construct validity (known group analysis) and reliability using Cronbach's alpha, McDonald's omega and factor score determinacy.</p><p><strong>Results: </strong>The sample included 725 clinical nurses (76% female, 80% hospital-based), on average 38.7 years old (SD 11.33), with 14.6 years (SD 11.03) of experience. Confirmatory factor analysis supported a four-factor model (Knowledge of spirituality, Attitudes towards spirituality and spiritual care, Knowledge of spiritual care and Skills in spiritual care), with a second-order factor for the EPICC Tool-It. Construct validity was supported through known group analysis, showing score variation based on nurses' experience, education and religiosity. Internal consistency was excellent across all factors and the overall scale.</p><p><strong>Conclusion: </strong>A valid, multidimensional instrument is provided to assess spiritual care competencies in Italian-speaking nurses. The EPICC Tool-It is suitable for research and practice, facilitating evaluation of self-perceived competencies and educational effectiveness.</p><p><strong>Implications for the profession and/or patient care: </strong>The use of the EPICC Tool-It by nursing managers, educators and clinicians is recommended in both clinical and research settings to support education on spiritual care competencies.</p><p><strong>Impact: </strong>The EPICC Tool-It sets reliable measurement standards for spiritual care competencies, enhancing holistic care and comprehensive understanding of competencies globally.</p><p><strong>Reporting: </strong>This study adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines.</p><p><strong>Patient or public contribution: </strong>Patients, service users, caregivers, or the public were not involved in the study. However, nurses as target users of the tool participated in the cultural adaptation and validation process.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659331","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}