Journal of Clinical Nursing最新文献

{"title":"Relationship Between Weight Loss and Problems With Oral Intake in Institutionalised Older Adults: A Japanese Multi-Institutional 1-Year Follow-Up Study.","authors":"Eri Nishioka, Chika Momoki, Tomoe Fukumura, Nagomi Ito, Nana Yunoki, Hirokazu Oyamada, Yoko Urata, Harumi Imura, Jun Ookita, Seiko Wada, Masashi Futamata, Sachiyo Kami, Noriko Wajima, Chizuru Takatori, Michiko Tabata, Eri Shibata, Hirotsugu Ishida, Jyunko Masuo, Yoshinari Matsumoto, Daiki Habu","doi":"10.1111/jocn.70083","DOIUrl":"10.1111/jocn.70083","url":null,"abstract":"<p><strong>Aim: </strong>To examine the relationship between weight loss and problems with oral intake in institutionalised older adults.</p><p><strong>Design: </strong>A 1-year longitudinal observational study.</p><p><strong>Methods: </strong>Data were obtained from a prospective study conducted in three nursing homes and two long-term care facilities in Japan. Participants' problems with oral intake were assessed using items published in 2021 by the Japanese Ministry of Health, Labour and Welfare. Baseline and follow-up factors were compared between individuals who experienced a weight loss of 5% or more and those who did not. Separate multivariable logistic regression models were constructed for each oral intake assessment item to examine its independent association with weight loss of 5% or more, accounting for transitions in each item between baseline and the 1-year follow-up.</p><p><strong>Results: </strong>In total, 172 institutionalised older adults were included in the analysis. Among them, 57 (33.1%) participants experienced a weight decrease of 5% or more. The emergence of somnolence or clouding of consciousness during meals at the 1-year follow-up in participants without these signs at baseline was independently associated with a weight loss of 5% or more, after adjustment for baseline characteristics.</p><p><strong>Conclusion: </strong>Recognising signs of somnolence or clouding of consciousness during meals may be useful for the early detection and prevention of weight loss in institutionalised older adults.</p><p><strong>Implications for the profession and/or patient care: </strong>Early detection of individuals at risk is essential to prevent significant weight loss and its associated adverse outcomes. Recognising somnolence or clouding of consciousness during meals may enable earlier detection and intervention to prevent weight loss and improve the quality of care for older adults.</p><p><strong>Reporting method: </strong>Strengthening the Reporting of Observational Studies in Epidemiology.</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":3.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876567","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 Digital Alert Feedback System (Aged Care Electronic Dashboard Information Tool, ACED-IT) to Enhance Quality Nursing Care: Participatory Action Research.","authors":"Kasia Bail, Juliana Fernandes Barreto De Mendonca, Laura Hants, Stephen Isbel, Nathan M D'Cunha, Mark Sheldon-Stemm, Matt Elks, Desmond McGuirk, Joshua Roussos, Ping Yu, Bernice Redley, Diane Gibson","doi":"10.1111/jocn.17854","DOIUrl":"https://doi.org/10.1111/jocn.17854","url":null,"abstract":"<p><strong>Aims: </strong>Develop and simulate test a digital alert dashboard drawing from existing data to support nurses, care workers and managers in residential aged care.</p><p><strong>Design: </strong>Participatory action research, co-designing for an Australian 64-bed residential site.</p><p><strong>Methods: </strong>Qualitative data were collected through focus groups and analysed using reflective thematic analysis.</p><p><strong>Results: </strong>Nursing-theory and evidence-based Nursing Data Domain Standards (NDDS) were developed to support internal triaging of fundamental and clinical care in a non-clinical environment. A co-designed retrospective digital alert dashboard (Aged Care Electronic Dashboard Information Tool-ACED-IT) representing the Standards was created and tested. Twenty aged care nurses, care workers and managers found it had promise in enhancing quality of care, improving resident health and reducing adverse events.</p><p><strong>Conclusions: </strong>Maximising efficient use of resident-level data with a system that empowers nurse decision-makers is crucial to support effective care design and harm prevention.</p><p><strong>Implications for the profession and/or patient care: </strong>ACED-IT has the potential to improve visibility of resident needs, support staff to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care and reduce preventable complications.</p><p><strong>Impact: </strong>Digital systems that enable nursing care escalation and triaging for early intervention are needed in residential aged care settings. The co-designed system was perceived by registered nurses, care workers and managers to have the potential to improve care quality and efficiency. Using an evidence-informed nursing framework to identify day-to-day care indicators can be widely implemented by government regulators, software providers and residential care providers on an international scale to improve resident experience.</p><p><strong>Reporting method: </strong>This study adhered to the relevant EQUATOR guidelines, specifically the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist.</p><p><strong>Patient or public contribution: </strong>A member of the public participated in the Advisory Group, observed and contributed to the co-design process and reviewed the manuscript.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856875","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":"Commentary on 'Engagement in Medication Communication During Transitions of Care for Rural Aged Care Residents and Family Caregivers: A Qualitative Study'.","authors":"Chang Hu","doi":"10.1111/jocn.70078","DOIUrl":"https://doi.org/10.1111/jocn.70078","url":null,"abstract":"","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856922","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":"Assessing Clinical Deterioration in Children With Dark-Coloured Skin: A Scoping Review.","authors":"Chelsea Kelly, Gavin D Leslie, Pamela Laird, Scott Stokes, Fenella J Gill","doi":"10.1111/jocn.70060","DOIUrl":"https://doi.org/10.1111/jocn.70060","url":null,"abstract":"<p><strong>Background: </strong>Signs of clinical deterioration may appear differently in children with dark-coloured skin. How to assess children in this cohort is currently poorly defined.</p><p><strong>Aim: </strong>To explore available information on the assessment of clinical deterioration in children with dark-coloured skin and identify research deficits.</p><p><strong>Methods: </strong>A scoping review following Arksey and O'Malley and PRISMA-ScR frameworks. Five online databases, grey literature and reference lists of eligible documents were searched. Source titles, abstracts and full texts were screened. Included documents were assessed for level of evidence according to the Joanna Briggs Institute. Data were charted on a pre-defined data collection tool and analysed through descriptive and content analysis.</p><p><strong>Results: </strong>Out of 2382 documents screened, 37 were included. Document types included 16 quantitative studies, 14 opinion papers, five reviews and two reports. Most sources (21) were low-level evidence. Sixty-six unique terms were used to describe dark-coloured skin. Eighteen documents reported use of a skin classification system, including race/ethnicity, established colour scales, cosmetic references and observer opinion. Twelve focused on newborn hyperbilirubinaemia. Considerations for assessing jaundice, pallor, cyanosis, pulse oximetry, petechiae and signs of shock were reported. Techniques to improve assessment included optimising the environment, identifying baseline skin colour, and involving families and patients in assessment. No documents reported on assessment of mottling or capillary refill time for children with dark-coloured skin.</p><p><strong>Linking evidence to action: </strong>Assessment of clinical deterioration for children with dark-coloured skin is highly relevant to health professional practice. There is an overall deficit in high-quality research. Specific information gaps in assessment are considerations for mottling, capillary refill time, APGAR scoring, and clinical implications of device overestimation of bilirubin and oxygen saturations in children with dark-coloured skin. Health professionals are encouraged to use devices cautiously. Greater accuracy and objectivity are necessary to fill these gaps and support effective detection of signs of clinical deterioration.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838469","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":"Organisational Interventions for Compassionate Care: The Perspectives of Healthcare Professionals. A Qualitative Evidence Synthesis.","authors":"Lydia Tunstall, Philip Molyneux, Tim Alexander","doi":"10.1111/jocn.70073","DOIUrl":"https://doi.org/10.1111/jocn.70073","url":null,"abstract":"<p><strong>Background: </strong>In response to global outcries of poor healthcare, organisational interventions have been implemented with the aim of promoting compassionate care. An overall synthesis of qualitative data, including the perspectives of healthcare staff who have attended interventions, can establish 'what works' and inform future interventions.</p><p><strong>Aims: </strong>To synthesise existing research exploring how healthcare staff experience organisational interventions for compassionate care.</p><p><strong>Design: </strong>Qualitative evidence synthesis.</p><p><strong>Methods and data sources: </strong>A qualitative evidence synthesis was conducted in August 2023. Five databases were searched: MEDLINE, Academic Search Premier, CINAHL, APA PsycInfo and APA PsycArticles. Articles met the following criteria: (a) reported on the experiences of healthcare staff who had participated in organisational interventions for compassionate care, (b) taken place in a healthcare setting, (c) use of a qualitative or mixed-methods methodology, (d) published in English and (e) published since 2010. A thematic synthesis was conducted using NVivo software to synthesise findings. Data from the complete 'findings/results' sections were included in the synthesis. The final search protocol and search strategy were registered on PROSPERO (ID: CRD42023472404) and are reported using the PRISMA guidelines.</p><p><strong>Results: </strong>Eighteen qualitative or mixed-methods studies were included in the review, encapsulating the experiences of healthcare staff across eight countries. Four themes were identified: (1) holding back, (2) humanising healthcare, (3) values are instilled and (4) sustainability is important.</p><p><strong>Conclusion: </strong>Organisational interventions for compassionate health care are valued and appreciated by healthcare staff and foster reflection and connection. Interventions facilitate clinical creativity, improve staff well-being and strengthen communication between staff.</p><p><strong>Implications: </strong>The implementation of organisational interventions for compassionate care should be encouraged in healthcare settings. Interventions that consider organisational cultures are driven by organisational values and are embedded with sustainability in mind can improve staff well-being and positively impact the provision of patient care.</p><p><strong>Reporting method: </strong>PRISMA guidelines were followed in the reporting of this review.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818129","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":"Psychological Distress in Surgical Lung Cancer Patients: Trajectories, Influencing Factors and Impacts on Quality of Life.","authors":"Jina Li, Congyu Yin, Man Ye, Lu Kang, Jie Zhu, Lingzhi Huang","doi":"10.1111/jocn.17841","DOIUrl":"https://doi.org/10.1111/jocn.17841","url":null,"abstract":"<p><strong>Aims: </strong>To investigate psychological distress trajectories in surgical lung cancer patients and their influencing factors, and explore the impact of trajectories on quality of life (QoL).</p><p><strong>Design: </strong>Prospective longitudinal study.</p><p><strong>Methods: </strong>Data from 324 patients at a Chinese tertiary hospital were collected within 48 h of admission (T0), 3 days after surgery (T1), 2 weeks (T2), 3 months (T3), 6 months (T4) and 1 year after discharge (T5). Latent class growth models identified psychological distress trajectories, logistic regression analysed their influencing factors, and linear regression analysed the effects of psychological distress trajectories on QoL.</p><p><strong>Results: </strong>Psychological distress peaked at T1, then decreased steadily. Three trajectories emerged: low-level stable group (Class 1, 45.06%), intermediate-level decreased group (Class 2, 39.51%) and high-level stable group (Class 3, 15.43%). Compared with Class 1, Class 3 was predicted by surgical modality, lymph node metastasis, postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy, while Class 2 was predicted by surgical modality, postoperative adjuvant therapy and self-efficacy. Furthermore, psychological distress trajectories negatively predicted QoL.</p><p><strong>Conclusions: </strong>Surgical lung cancer patients experience an initial increase in psychological distress, followed by a gradual decline, with three distinct trajectories. Surgical modality, lymph node metastasis, and postoperative adjuvant therapy, symptom burden, anxiety and self-efficacy were the major influencing factors of psychological distress trajectories. Persistent distress adversely impacts QoL, underscoring the need for early, personalised psychological interventions to improve long-term outcomes.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823135","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":"How Often Are Hospitalised Children Physically Restrained During Painful and Stressful Procedures?","authors":"Danton Matheus de Souza, Lucy Bray, Vanderlei Amadeu Rocha, Edmara Bazoni Soares Maia, Aline Santa Cruz Belela Anacleto, Lisabelle Mariano Rossato","doi":"10.1111/jocn.70068","DOIUrl":"https://doi.org/10.1111/jocn.70068","url":null,"abstract":"<p><strong>Aim: </strong>To analyse the incidence of physical restraint use during painful and stressful procedures in hospitalised children, as well as the factors associated with its use.</p><p><strong>Design: </strong>Observational, longitudinal and prospective study.</p><p><strong>Methods: </strong>Children aged between 28 days and 10 years in a public hospital in Brazil were each observed undergoing clinical procedures over a 6-h period. Data were collected on demographics, observed pain using validated measures, stress behaviours, and the use of physical restraint. Descriptive and inferential analyses were performed. National ethical guidelines were strictly followed.</p><p><strong>Results: </strong>1210 procedures were observed on 75 children, including 351 painful and 859 stressful procedures. Physical restraint was used in 270 (22.3%) procedures; of these, 131 (48.5%) were painful procedures and 139 (51.5%) were stressful procedures. In stressful procedures, at least one stress-related behaviour was observed before the initiation of physical restraint. Factors associated with increased use of physical restraint during painful procedures were younger children, with higher levels of care dependency, higher pain scores during procedures, and those who underwent intravenous medication administration, airway suctioning, tube insertion, and fixation changes. In stressful procedures, the factors associated with higher use of physical restraint were younger children, hospitalisation due to respiratory conditions, those who underwent physical examinations, inhaled medication, and nasal lavage; and the child's expression of stress behaviour before the procedure starts. Predictors of physical restraint included morning period, younger age group, male or female sex, and transfer from the Intensive Care Unit.</p><p><strong>Conclusion: </strong>A high incidence of physical restraints was observed across multiple painful and stressful procedures performed within a 6-h period, associated with variables related to both the child's characteristics and the procedures.</p><p><strong>Implications for the profession and/or patient care: </strong>This study aims to encourage reconsideration of the frequent use of physical restraint in paediatric procedures, calling for a reframing of its application as an unquestioned practice toward an approach that prioritises protecting and respecting a child as a subject with needs, rights, and desires.</p><p><strong>Reporting method: </strong>Strengthening the Reporting of Observational studies in Epidemiology (STROBE).</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818128","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":"Quantifying Patient-Level Factors Associated With Mobilisation in Intensive Care: A Prospective Study.","authors":"Hui Zhang, Shanshan Bai, Yu Sheng, Zhenwei Dai, Zunzhu Li, Hongbo Luo, Qinglai Zhang, Frances Fengzhi Lin","doi":"10.1111/jocn.70066","DOIUrl":"https://doi.org/10.1111/jocn.70066","url":null,"abstract":"<p><strong>Aim: </strong>To quantify how specific patient-level characteristics influence the actual amount of mobilisation received during ICU care, thereby identifying key predictors to support individualised mobilisation strategies.</p><p><strong>Study design: </strong>A prospective observational study was conducted in four tertiary hospitals among a convenience sample of 141 critically ill patients from July to November 2023. Data on mobilisation and patient characteristics were collected using standardised data collection tools, including a mobilisation log and a demographic information sheet. Data were analysed using non-parametric tests, Spearman correlation analysis, and multivariate regression to examine associations between early mobilisation and patient-related factors.</p><p><strong>Results: </strong>Males and surgical patients engaged in more activity (p < 0.001). Muscle strength (r = 0.568, p < 0.001) and haemoglobin levels (r = 0.207, p = 0.014) were positively associated with mobilisation, while higher disease severity (r = -0.321, p < 0.001) and greater pain (r = -0.284, p < 0.001) were linked to reduced activity. Muscle strength, disease severity, surgical status, and sex were independent predictors, explaining 32.5% of the variance.</p><p><strong>Conclusion: </strong>Early mobilisation in the ICU is influenced by various patient-related factors. Protocols should be tailored to individual patient profiles to enhance outcomes.</p><p><strong>Implications for clinical practice: </strong>This study provides guidance for ICU clinicians to develop targeted mobilisation strategies that consider patients' specific clinical profiles. Tailored approaches may help optimise early mobilisation practices and patient outcomes.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818130","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":"Mental Health Services Provided by Nurses in Schools and Higher Education Institutions in the Post COVID-19 Era: Impeding Factors From a National Online Survey.","authors":"Li-Chun Chang, Chun-Hsia Huang, Chia-Yi Wu, Hsing-Yi Yu","doi":"10.1111/jocn.17833","DOIUrl":"https://doi.org/10.1111/jocn.17833","url":null,"abstract":"<p><strong>Aim (s): </strong>To examine competencies, attitudes, barriers and factors that influence the provision of mental health services by nurses in schools and higher education institutions in the post COVID-19 era in Taiwan.</p><p><strong>Design: </strong>This cross-sectional study used nationwide proportionate stratified random sampling to recruit nurses from K-12 schools and higher education institutions.</p><p><strong>Methods: </strong>Data were collected through an online survey administered between July and December 2024, with 305 responses received (response rate = 46.4%).</p><p><strong>Results: </strong>Among the respondents, 55.1% provided advanced mental health services, while 38.3% delivered basic mental health services. The main barriers to the delivery of mental health services were lack of mental health-screening training (63.3%), insufficient brief screening tools (46.2%) and time constraints (42.6%). Nurses in junior and senior high schools were 5.78 and 3.07 times more likely, respectively, to provide advanced mental health services compared to those in universities. Furthermore, significant predictors of the provision of advanced mental health services included working in junior or senior high school, higher competence, and more positive attitudes; perceiving time constraints was a significant barrier.</p><p><strong>Conclusion: </strong>Working in junior and senior high school settings was the most significant predictor of delivering advanced mental health services. These results underscore the need for targeted professional training, enhanced resources, and inter-professional collaboration to improve the quality of school-based mental health services.</p><p><strong>Implications for nursing practice: </strong>Enhancing the attitudes and competencies of nurses in schools and higher education institutions towards mental health care is essential. Training should target nurses working in junior and senior high schools. Administrators must improve workflows, provide better tools and address barriers such as time constraints and limited referrals to support students' mental well-being.</p><p><strong>Reporting method: </strong>This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p><p><strong>Impact: </strong>This study examined the barriers to mental health service delivery among nurses in schools and higher education institutions and identified key determinants influencing their provision of such services. Nurses in schools and higher education institutions face challenges in providing mental health services due to a lack of mental health training, insufficient brief screening tools and time constraints. Advanced services were more common in junior and senior high schools, with competence and attitude being key predictors of their delivery.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805207","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' Self-Reported Professional Competence: A Cross-Sectional Study at a Regional Teaching Hospital in Sweden.","authors":"Anne Flodén, Margret Lepp, Per Tilander, Ann Svensson, Jan Nilsson","doi":"10.1111/jocn.70057","DOIUrl":"https://doi.org/10.1111/jocn.70057","url":null,"abstract":"<p><strong>Aim: </strong>To investigate and compare the self-assessed professional competence of registered nurses, specialist nurses and midwives at a regional teaching hospital in Sweden. Moreover, to explore associations between potential predictive background factors and self-assessed professional competence.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>Convenience sample of 615 nurses answered a questionnaire; sociodemographic data, 35-item Nurse Professional Competence Scale, Occupational Self-Efficacy Scale.</p><p><strong>Statistical analyses: </strong>Fisher's non-parametric permutation test, Kruskal-Wallis test, Mantel-Haenszel chi-square test, Spearman rank correlation test, calculating sum score. Multiple linear regressions and reliability testing with Cronbach's alpha.</p><p><strong>Results: </strong>Response rate, 58.7%; mean age, 44.7 years; work experience, 0.2 years to 45 years (mean 16.4 years); 83.4% women. 82.4% bachelor's degree; out of these, 34.3% with an additional master's degree. 17.6% nursing diploma without an academic degree. The highest mean scores for the NPC Scale were in Value-based nursing care, Medical and technical care. The lowest were in Care pedagogics and Development, leadership and organisation of nursing care. Total mean score 84.3, (79.3-90.0). Specialist nurses scored higher in all areas except Care pedagogics. Predictive factors indicated being a woman was positively associated with higher competence scores in all six areas, β coefficients 2.2-5.3 with p < 0.05. Longer nursing experience was positively associated with higher competence in Nursing care (β 0.17 per year, p = 0.01), Medical and technical care (β 0.14 per year, p = 0.01). The occupational self-efficacy scale was strongly positively associated with higher competence in all areas, β per scale step 0.42-0.63 with p < 0.0001. Nurses without academic degree had lower competence scores in several areas compared to bachelor's degree, β ranges from -3.47 to -2.31, p < 0.05.</p><p><strong>Conclusion: </strong>Utilising competence data, the Swedish Enhanced Competence Development Model (vKUM) can effectively support the planning and management of ongoing professional competence development.</p><p><strong>Reporting method: </strong>Study methods and results reported in adherence to STROBE checklist.</p><p><strong>Patient or public contribution: </strong>The nurses contributed their consent, time and data to this study.</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805179","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}