Journal of Clinical Nursing最新文献

{"title":"From Empathy to Exhaustion: A Qualitative Phenomenological Study on Compassion Fatigue in Emergency Department Nurses.","authors":"İlknur Tura, Sevilay Erden","doi":"10.1111/jocn.70592","DOIUrl":"https://doi.org/10.1111/jocn.70592","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to describe the experiences of emergency department nurses with compassion fatigue.</p><p><strong>Design: </strong>A qualitative phenomenological design was used.</p><p><strong>Methods: </strong>This study was conducted with 10 nurses working in the emergency department in July 2026. Interviews were documented through handwritten notes, expanded into digital format within 24 h, and complemented by observational notes. Data were analysed manually, without the use of qualitative data analysis software. Data analysis was performed in accordance with Colaizzi's seven-stage phenomenological analysis method, including identifying meaningful statements, formulating meanings, developing thematic clusters and validating findings through participant feedback.</p><p><strong>Results: </strong>Among the primary themes of compassion fatigue, 3 secondary themes emerged: emotional strain with regard to a sense of powerlessness, incompetence and guilt as a result of intense empathic involvement, emotional transformation in terms of waning empathetic engagement and distancing from others' feelings and adaptation and self-defence including coping methods such as setting an emotional distance, increasing one's psychic distance from sources of exposure or re-creating work-life balance.</p><p><strong>Conclusion: </strong>Compassion fatigue in the emergency department is a dynamic process, which is initiated with empathy and encumbrance of emotional stress over time will transform the nurse's emotion and care giving. These results emphasize the need for context-sensitive and nurse-focused intervention to enhance the emotional resilience of nurses. Framing these interventions around a structured well-being model such as PERMA may offer healthcare organizations a practical, multidimensional pathway for sustaining nurses' emotional resilience and safeguarding compassionate care in high-acuity settings.</p><p><strong>Reporting method: </strong>This qualitative phenomenological study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (see Supplementary Appendix A).</p><p><strong>Patient and public contribution: </strong>Nurses who had cared for patients within high-acuity clinical environments were included in interviews, providing experiential knowledge that informed the data analysis and supported the clinical relevance of findings.</p><p><strong>Impact: </strong>Among nurses working in challenging clinical settings, compassion fatigue remains an underdeveloped threat to both nurse well-being and the sustainability of high-quality patient care. Findings of the study illustrates how compassion fatigue evolves out of cumulative emotional strain and how nurses actively manage this by developing emotional boundaries and creating self-protection strategies in order to remain functional within difficult care situations. By shining a spotlight on these lived experiences, the findings highlight th","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171966","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":"Electronic Intensive Care Unit Diaries: A Scoping Review of Applications, Implementation, and Evaluation.","authors":"Yajing Shi, Jiangxia Li, Gaiying Jiang, Xiaoyue Lin, Lihong Ding","doi":"10.1111/jocn.70598","DOIUrl":"10.1111/jocn.70598","url":null,"abstract":"<p><strong>Aim(s): </strong>To map evidence on the applications, implementation, and evaluation of electronic intensive care unit diaries in critical care.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Methods: </strong>Joanna Briggs Institute methodology guided eligibility, independent screening and data extraction, and descriptive and framework-guided narrative synthesis. Methodological quality was not appraised because the review aimed to map evidence.</p><p><strong>Data sources: </strong>Twelve databases and two registries were searched from inception to 17 September 2026.</p><p><strong>Results: </strong>Fifteen sources of evidence published between 2012 and 2026 represented eight distinct programmes; sources were from the Netherlands, China, the United States, Italy and the United Kingdom. Five broad platform or delivery modes were identified: web-based platforms, mobile or tablet applications, an online document platform, an electronic clinical record-integrated diary module and digital scrapbooking. Framework-guided synthesis identified multilevel implementation determinants, while reported strategies varied by implementation stage. Evaluations covered platform- and user-related, implementation and patient- and family-related outcomes, but evidence on sustained implementation and benefits was limited.</p><p><strong>Conclusion: </strong>Electronic intensive care unit diaries are implemented through diverse digital platforms and participation models, but implementation and evaluation remain heterogeneous, and evidence on sustained use and benefits is limited.</p><p><strong>Implications for the profession and/or patient care: </strong>Nurses and organisations should clarify writing roles and content boundaries, integrate diary work into workflows, provide training and support, protect privacy and monitor sustained use.</p><p><strong>Impact: </strong>The review identifies nursing-relevant requirements for workflow integration, role clarity, training, organisational support and privacy. Findings can inform nurses, nurse leaders, critical care teams and healthcare organisations implementing digital diary programmes.</p><p><strong>Reporting method: </strong>Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171235","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":"\"I Didn't Realise It Still Impacted Me, but Obviously, It Still Does:\" Personal Outcomes of Code Grey Events for Healthcare Professionals.","authors":"Adam Searby, Alison M Hutchinson, Elisa Ilarda, Louise Alexander, Susan Perlen, Nicole Davies, Trish Mant, Angela Skazlic, Joanna Petrunic, Rachel Mrhar, Debra Kerr","doi":"10.1111/jocn.70594","DOIUrl":"https://doi.org/10.1111/jocn.70594","url":null,"abstract":"<p><strong>Aim: </strong>To explore the personal effects of aggression and violence towards healthcare professionals, specifically before, during and after Code Grey events.</p><p><strong>Design: </strong>Qualitative descriptive study design.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 35 healthcare professionals, including 33 nurses, analysed using a reflexive thematic analysis approach and reported in accordance with the Consolidated Checklist for Reporting Qualitative Data (CORE-Q) guidelines.</p><p><strong>Findings: </strong>Three themes emerged during data analysis: (1) You're a tough nurse, you'll be fine: The long-term personal impact of Code Grey events, (2) I just hope there's a solution to stop all this abuse: Feeling a responsibility for staff and patients during the Code Grey event, and (3) It's just a nice, beautiful circle of terribleness: Issues related to the response adding to the impact of the Code Grey event. Participants in our study described ongoing burnout related to Code Grey responses, and aggression and violence generally. They also reported that Code Grey events caused fear and significant disruption to their work, with concerns about their safety when faced with situations requiring a Code Grey response.</p><p><strong>Conclusion: </strong>Occupational aggression and violence are substantial issues in contemporary healthcare settings. Not only must healthcare services equip clinical staff with the skills necessary to prevent Code Grey events, but they must also be mindful that these events can have a lasting impact on healthcare professionals.</p><p><strong>Patient or public contribution: </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":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170371","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 Relationship Between Kinesiophobia, Anxiety and Depression in Patients With Heart Failure: The Role of Patients' Perception of Nursing Care.","authors":"Asma Pourmorad, Simin Jahani, Marzieh Asadizaker, Saeed Ghanbari, Ali Kardooni","doi":"10.1111/jocn.70597","DOIUrl":"https://doi.org/10.1111/jocn.70597","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is associated with psychological and behavioural challenges. Kinesiophobia and perceived nursing care may influence psychological outcomes, but their relationships remain unclear. This study examined the links between kinesiophobia, perceived nursing care, anxiety and depression in heart failure patients.</p><p><strong>Methods: </strong>A cross-sectional descriptive-correlational study using structural equation modelling was conducted with 300 hospitalized patients. Data were collected using the Tampa Scale for Kinesiophobia, Hospital Anxiety and Depression Scale and Patient-Centred Care Scale and analysed via correlation multiple regression and structural equation modelling.</p><p><strong>Results: </strong>Prevalence of high kinesiophobia was 39.3%, severe depression 43.7% and severe anxiety 17.0%. Kinesiophobia correlated positively with anxiety (r = 0.119) and depression (r = 0.290). Better perceived care correlated negatively with anxiety (r = -0.142) and depression (r = -0.241). Regression showed care negatively predicted anxiety (β = -0.13) and kinesiophobia positively predicted depression (β = 0.27). The final structural model revealed that care was negatively associated with anxiety (β = -0.202) and depression (β = -0.302), while kinesiophobia was positively associated only with depression (β = 0.225), not anxiety (p = 0.129). Model fit was suboptimal (RMSEA = 0.095).</p><p><strong>Conclusion: </strong>Although associations were modest, kinesiophobia and perceived nursing care were linked to psychological distress. Addressing movement-related fears and patient-centred care is important in multidimensional heart failure management.</p><p><strong>Relevance to clinical practice: </strong>Nurses should screen for kinesiophobia and psychological distress alongside routine assessments. Identifying fear-related barriers to physical activity and addressing concerns through person-centred communication, tailored education and appropriate referral can support more responsive and holistic nursing care.</p><p><strong>Reporting method: </strong>The STROBE statement checklist was used as a guide to reporting this cross-sectional study.</p><p><strong>Patient/public contribution: </strong>No patient or public contribution was involved in the design, conduct, analysis or interpretation of this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171318","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":"Development and Psychometric Validation of the Self-Care of Cancer Inventory (SC-CI).","authors":"Carla Amato, Laura Rasero, Camilla Elena Magi, Khadija El Aoufy, Yari Longobucco, Lorenzo Di Stefano, Chiara Guglielmini, Stefano Bambi, Lorenzo Antonuzzo, Annamaria Tognoni, Izabella Uchmanowicz, Marco Di Nitto, Barbara Riegel, Ercole Vellone, Paolo Iovino","doi":"10.1111/jocn.70591","DOIUrl":"https://doi.org/10.1111/jocn.70591","url":null,"abstract":"<p><strong>Aim: </strong>To develop a generic instrument for measuring self-care behaviours in adults with cancer and to evaluate its initial psychometric properties.</p><p><strong>Design: </strong>A psychometric validation study was conducted within the ONCO-SHIELD longitudinal observational study at Careggi University Hospital (Florence, Italy) enrolling adult patients with metastatic solid tumours receiving first-line systemic anticancer therapy and an ECOG Performance Status of 0-2.</p><p><strong>Methods: </strong>The SC-CI was developed through a theory-driven process including item generation, expert validation, and cognitive interviews, and subsequently evaluated using confirmatory factor analysis, McDonald's omega, test-retest reliability, item response theory, differential item functioning, and convergent validity analyses.</p><p><strong>Results: </strong>A total of 305 patients were included (mean age 68.4 years, 68.2% male), mainly with lung (28.2%), lower gastrointestinal (23.3%), and genitourinary cancers (22.0%). Content validity was excellent across domains. Confirmatory factor analysis supported the multidimensional structure of the instrument, with acceptable-to-good fit after minor item refinement. Internal consistency was adequate to good (ω = 0.74-0.85), and test-retest reliability was satisfactory (ICC = 0.70-0.74). Convergent validity was supported by positive correlations with health literacy and by associations of monitoring and management with doctors' health locus of control. Differential item functioning by sex and age was limited and showed negligible practical impact.</p><p><strong>Conclusion: </strong>The SC-CI provides promising initial psychometric evidence as a multidimensional, theory-based tool for assessing self-care in patients with metastatic solid tumours receiving systemic anticancer therapy.</p><p><strong>Implications for the profession and/or patient care: </strong>SC-CI may support nursing practice by helping identify patients with unmet self-care needs and guide tailored educational and symptom-management interventions in this population. Further validation in independent and more diverse oncology populations is warranted before broader clinical application.</p><p><strong>Patient or public contribution: </strong>Patients contributed to SC-CI development through cognitive interviews assessing item relevance, comprehensibility, and comprehensiveness, informing refinement before psychometric testing.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147923","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":"Loneliness as an Embodied and Existential Phenomenon in Later Life: A Qualitative Meta-Synthesis of European Studies.","authors":"Rikke Krogh Glud, Marie Dahl, Susanne Friis Søndergaard","doi":"10.1111/jocn.70585","DOIUrl":"https://doi.org/10.1111/jocn.70585","url":null,"abstract":"<p><strong>Aim: </strong>To explore how loneliness is characterised among community-dwelling older adults in European qualitative research.</p><p><strong>Design: </strong>A qualitative meta-synthesis following Sandelowski and Barroso's interpretive framework.</p><p><strong>Methods: </strong>Qualitative studies published from 2015 onwards that explored loneliness among community-dwelling adults aged 65 years or older in Europe were included. Data were extracted and synthesised using constant targeted comparison to identify similarities and differences across studies. A meta-summary was followed by an interpretive synthesis to develop an integrated understanding. Each study was appraised for methodological quality and typology of findings.</p><p><strong>Data sources: </strong>CINAHL and PubMed were searched in March 2025 and updated in January 2026. PsycINFO was added in January 2026, supplemented by reference and citation tracking.</p><p><strong>Results: </strong>Fourteen articles from seven countries were included. Two themes were generated: Loneliness as an embodied and enduring condition in later life describes how loneliness shifts from an emotional experience to one shaping identity, daily rhythms and coherence. The burden of silence illustrates how physical decline, reduced social access and stigma contribute to withdrawal, concealment and protective quietness that preserves dignity while deepening isolation. Together, the themes depict loneliness as an embodied and existential phenomenon shaping identity, everyday life and ageing.</p><p><strong>Conclusion: </strong>Loneliness in later life is an embodied and existential phenomenon that extends beyond social disconnection.</p><p><strong>Implications for the profession and/or patient care: </strong>These findings can help nurses recognise loneliness beyond social isolation and respond with person-centred care that supports dignity and meaningful everyday life.</p><p><strong>Impact: </strong>This review addresses limited understanding of how loneliness is lived in later life. Loneliness may become embodied, shape identity and everyday routines, and be concealed through silence. The findings may inform nurses caring for community-dwelling older adults in European contexts.</p><p><strong>Reporting method: </strong>Reported in accordance with ENTREQ guidelines.</p><p><strong>Patient or public contribution: </strong>There was no patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Loneliness in later life is an embodied and existential experience that extends beyond social isolation and influences how older adults experience everyday life. Nurses should recognise that loneliness may be communicated through silence, changing routines and altered identity rather than through direct disclosure. Understanding loneliness as a lived experience can support more person-centred, relational nursing care that promotes dignity and meaningful engagement.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149844","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":"Effectiveness of Organisational Support for Healthcare Professionals Involved in Clinical Incidents: A Mixed-Methods Systematic Review.","authors":"Melanie Buhlmann, Amineh Rashidi, Jennifer Hamilton, Pauline Murray-Parahi, Beverley Ewens","doi":"10.1111/jocn.70590","DOIUrl":"https://doi.org/10.1111/jocn.70590","url":null,"abstract":"<p><strong>Aim: </strong>To systematically identify and synthesise the existing literature on the effectiveness of organisational support for healthcare professionals after clinical incidents.</p><p><strong>Design: </strong>Convergent-integrated mixed methods systematic review approach.</p><p><strong>Methods: </strong>Quantitative data were 'qualitised' as text descriptions and pooled with qualitative extracts for thematic synthesis to categorise findings by similarity in meaning and develop analytical themes.</p><p><strong>Data sources: </strong>CINAHL Ultimate, MEDLINE (PubMed) and Web of Science were searched. Primary quantitative, qualitative and mixed methods studies written in English and published within 2013-2026 met the eligibility criteria. Thirty-six quality appraised studies were included: 16 quantitative, 10 qualitative and 10 mixed methods.</p><p><strong>Results: </strong>The most prevalent support approaches included peer support programmes, leadership support, debriefings and employee assistance programmes. Strong support, especially from healthcare leaders, mitigated the emotional and professional disruption which was linked to enhanced job satisfaction, reduced staff turnover and positive workplace cultures. A lack of support or punitive approaches exacerbated distress, hindered recovery and increased intentions to leave the professions.</p><p><strong>Conclusions: </strong>The establishment of robust systems and proactive engagement from healthcare leaders contributed to reducing psychological, physical and professional distress. Yet, when organisations failed to provide adequate support, trust eroded and intentions to leave the profession increased.</p><p><strong>Implication for the profession: </strong>Improved organisational support has the potential to counteract attrition in healthcare professionals and impact on projected international workforce shortages.</p><p><strong>Impact: </strong>Healthcare professionals may feel traumatised following clinical incidents. Healthcare leaders can mitigate emotional and professional disruption. Organisations, healthcare leaders and policy makers can strengthen the provision of workplace support.</p><p><strong>Reporting method: </strong>Updated Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.</p><p><strong>No patient or public involvement: </strong>No patient or public contribution.</p><p><strong>Registration: </strong>https://www.crd.york.ac.uk/prospero/CRD42023460099, registered 17 December 2023.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137754","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":"Needs of Families of Critically Ill Patients in Latin America: A Multicenter Study.","authors":"Diana Marcela Achury Saldaña, Edith Cavallo, Luisa Fernanda Achury Beltrán, Ana Cristina Ulloa, Sandra Rodriguez Colmenares, Herly Ruth Alvarado Romero, Virginia Merino, Ligia Maria Rosado Alcocer, Sandra Sonali Olvera, Julio Cadena Estrada, Tania Lizeth Jimenez Arias, María Cristina Cometto, Diana Yibi Martinez Galeano, Marcia Andrea Quiñonez Mora, Claudia Viviana Camacho Falla, Katy Yolanda Ramirez Baquero, Luisa Fernanda Alzate Zapata, Pilar Buchanan, Jhonatan Miguel Ortega Jaimes, Andrea Mecchia, Soledad Romano, Paula González, Doraly Muñoz, Monica Zurita, Marcelo Morales, Norma Ochoa, Rocio Alonso, Adriana Mariela Cruz, Sebastian Piermattei, David Andrade, Laura Beatriz Bongiovanni, Gladis Isabel Torres","doi":"10.1111/jocn.70546","DOIUrl":"https://doi.org/10.1111/jocn.70546","url":null,"abstract":"<p><strong>Background: </strong>Care in ICUs is often focused on critically ill patients, leaving the needs of their families overlooked. In Latin America, it is necessary to gain insight into these needs for future standardised protocols focused on family-centred care.</p><p><strong>Objective: </strong>To determine the needs of family members of patients hospitalised in intensive care units (ICUs) in five Latin American countries: Colombia, Argentina, Mexico, Ecuador, and Peru.</p><p><strong>Methods: </strong>Multicentre cross-sectional descriptive observational study. The short version of the CCFNI scale (Critical Care Family Needs Inventory) was applied to identify the needs of families of critically ill patients. A total of 1843 family members were included. The statistical software Jamovi 2.3.28.0 was used for data analysis. Descriptive and inferential statistics were used to present the results. The STROBE checklist for cross-sectional studies was used in this study.</p><p><strong>Results: </strong>Total of 1843 participants from five Latin American countries were analysed; 63.05% were women, and the median age was 44 years (IQR: 34-55). The overall median family-needs score was 21 (IQR: 17-24). The greatest perceived needs were identified in the 'Information and family satisfaction' and 'Perceived improvements' dimensions, whereas lower levels of need were reported in 'Proximity and safety' and 'Care provided by healthcare staff.' Scores differed significantly by ICU type (p < 0.001), being higher in surgical ICUs and lower in maternal ICUs. Participants who travelled less than 10 min to the hospital reported lower needs than those with longer travel times (p = 0.005).</p><p><strong>Conclusion: </strong>Families of critically ill patients in five Latin American countries reported prominent needs related to information and family satisfaction, as well as perceived improvements in care, with family-needs scores varying according to ICU type and travel time to the hospital.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Dwelling Cancer Survivors' Perception and Readiness for Advance Care Planning: An Interpretive Description Qualitative Study.","authors":"Wei How Darryl Ang, Terina Yan Wen Tay, Melvin Tai Loong Poon, Sarina Enami, Hyojin Yoon, Khairul Dzakirin Bin Rusli, Vivien Xi Wu, Betsy Seah","doi":"10.1111/jocn.70587","DOIUrl":"https://doi.org/10.1111/jocn.70587","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore perceptions and readiness to engage in advance care planning (ACP) among community-dwelling cancer survivors.</p><p><strong>Design: </strong>An interpretive description qualitative study with reflexive thematic analysis.</p><p><strong>Methods: </strong>Cancer survivors who had completed primary cancer treatment and had not previously completed ACP were recruited from community settings in Singapore. Audio- and video-recorded semi-structured online interviews were conducted. The interviews were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Twenty-one adult cancer survivors who had completed primary cancer treatment and had not previously embarked on an ACP discussion participated in the study. Two themes and six subthemes emerged: (1) Personal and relational perceptions towards advance care planning and (2) Illness and psychosocial contexts influence readiness for advance care planning were elucidated. Participants valued ACP for preserving autonomy and reducing potential burden on their families, but often perceived its relevance as contingent on future deterioration. Perceived recovery or clinical stability could therefore position ACP as something to be deferred. Readiness to engage was further shaped by emotional preparedness, cultural and familial considerations, informational needs and healthcare-system support.</p><p><strong>Conclusions: </strong>Cancer survivors view ACP as a tool to preserve autonomy and control. Their engagement towards ACP is dynamic and shaped by relational values, sociocultural norms, and evolving perceptions of illness.</p><p><strong>Implications for the profession and/or patient care: </strong>Proactive, culturally sensitive and nurse-led approaches are needed to address misconceptions, support emotional readiness and facilitate meaningful ACP discussions throughout the survivorship trajectory.</p><p><strong>Impact: </strong>This study highlights a paradox in cancer survivorship whereby clinical stability may create an opportunity for ACP while simultaneously reducing its perceived relevance. Findings also suggest that overall readiness may coexist with emotional hesitation, supporting approaches to ACP that attend to personal, familial and structural dimensions of readiness rather than assuming uniform preparedness to engage.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139236","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":"Patient Perspectives on a Nurse-Led Personalised Cardiovascular Risk Intervention in Type 2 Diabetes: A Qualitative Study Within the VOLTAIRE Trial.","authors":"Ruofei Trophy Chen, Mihirika Pincha Baduge, Robyn A Clark, Adam J Nelson, Sophia Zoungas, Stephen J Nicholls","doi":"10.1111/jocn.70589","DOIUrl":"https://doi.org/10.1111/jocn.70589","url":null,"abstract":"<p><strong>Aims: </strong>To explore patient perspectives on the acceptability of a nurse-led personalised cardiovascular risk intervention in Type 2 diabetes.</p><p><strong>Design: </strong>A qualitative study nested within a randomised controlled trial.</p><p><strong>Methods: </strong>Two online focus groups (n = 5 per group) were conducted with adults who received personalised cardiovascular risk information through computed tomography coronary angiography or polygenic risk scores within a nurse-led intervention. A co-designed discussion guide explored risk understanding, views of the nurse-led consultation, emotional responses, behaviour change and feasibility. Data were analysed using reflexive thematic analysis informed by the Theoretical Framework of Acceptability.</p><p><strong>Results: </strong>Five interrelated themes were identified: (1) making personalised risk tangible; (2) interpretation requires relationship; (3) channelling concern into action; (4) from insight to incremental agency; and (5) feasibility and system conditions for scale.</p><p><strong>Conclusion: </strong>Among focus group participants who completed the intervention, the model was highly acceptable, with nurse-led translation of complex risk information supporting engagement and behaviour change.</p><p><strong>Implications for the profession and patient care: </strong>Cardiovascular nurse coaching may strengthen the clinical value of personalised risk tools by supporting understanding, emotional response and translation into achievable prevention goals.</p><p><strong>Impact: </strong>This study addressed the limited understanding of how adults with Type 2 diabetes perceive personalised cardiovascular risk communication. It found that acceptability was dynamic and improved when nurse-led explanation and goal setting supported behavioural engagement, with implications for cardiovascular nurses and services implementing personalised prevention.</p><p><strong>Reporting method: </strong>This study adhered to the consolidated criteria for reporting qualitative research.</p><p><strong>Patient or public contribution: </strong>Participants contributed to study design through co-development of the focus group guide and informed interpretation of findings.</p><p><strong>Trial and protocol registration: </strong>ClinicalTrials.gov (NCT07091162).</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138264","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}