International Journal of Nursing Studies最新文献

{"title":"Which individual and organizational factors shape nurses' attitudes toward family involvement in nursing care? A multicenter cross-sectional study","authors":"Jessica Longhini ,&nbsp;Federica Canzan ,&nbsp;Erika Bassi ,&nbsp;Alberto Dal Molin ,&nbsp;Beatrice Albanesi ,&nbsp;Tatiana Bolgeo ,&nbsp;Anna Brugnolli ,&nbsp;Sara Campagna ,&nbsp;Valerio Dimonte ,&nbsp;Alvisa Palese ,&nbsp;Elisa Ambrosi","doi":"10.1016/j.ijnurstu.2026.105358","DOIUrl":"10.1016/j.ijnurstu.2026.105358","url":null,"abstract":"<div><h3>Background</h3><div>Family involvement in care has been shown to improve patient outcomes and reduce family caregiver burden. However, nurses' attitudes toward family participation vary widely and are influenced by multiple individual and contextual factors. Despite international evidence, there is a lack of data in relation to individual psycho-emotional and organizational predictors across settings.</div></div><div><h3>Aim</h3><div>To assess nurses' attitudes toward involving families in care and individual and organizational factors associated with these attitudes.</div></div><div><h3>Methods</h3><div>A multicenter cross-sectional study between April 2024 and April 2025 across 16 local health authorities in Northern Italy. A total of 1288 registered nurses completed an anonymous online survey. Data included sociodemographic, professional, psychological (burnout, family functioning, caregiver support), and organizational variables, along with the Families' Importance in Nursing Care – Nurses' Attitudes (FINC-NA) scale. Hierarchical linear regression models were used to explore the role of individual and organizational predictors of attitudes across four FINC-NA subscales.</div></div><div><h3>Results</h3><div>Overall, nurses reported positive attitudes toward family involvement (FINC-NA mean = 100.5). Attitudes were most favorable in pediatric and primary care settings and less so in intensive care. Key individual predictors of positive attitudes included lower depersonalization, higher personal accomplishment, and greater perceived support from caregivers. Burnout, particularly depersonalization and emotional exhaustion, significantly predicted negative perceptions of families as burdens. Shift profile (day–night rotation) and lower private family functioning were also linked to more negative attitudes. Organizational factors, such as the presence of institutional caregiver procedures and unrestricted family access, were associated with more favorable attitudes but did not reduce perception of family as a burden. Notably, traditional variables such as age, gender, education, and work experience showed no influence.</div></div><div><h3>Conclusion</h3><div>Nurses' attitudes toward family involvement are shaped by a dynamic interplay of psychological, relational, and organizational factors. Structural policies, while necessary, are insufficient on their own. Promoting family-centered care requires addressing nurses' emotional well-being and supporting relational competencies, particularly in high-stress settings. These findings call for integrated interventions and further longitudinal research to explore how attitudes evolve over time and respond to systemic changes.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105358"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a short version of the Delirium Observation Screening Scale (s-DOSS): A psychometric validation study","authors":"Koen Milisen ,&nbsp;Sining Zeng ,&nbsp;Ellen Bruynseraede ,&nbsp;Anke Ceusters ,&nbsp;Geert Verbeke ,&nbsp;Kelu Yang ,&nbsp;Steffen Rex ,&nbsp;Marieke Schuurmans ,&nbsp;Elke Detroyer","doi":"10.1016/j.ijnurstu.2026.105362","DOIUrl":"10.1016/j.ijnurstu.2026.105362","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is associated with increased mortality and morbidity, prolonged hospital stays, and a heightened risk of developing dementia, while its complete prevention remains challenging. Therefore, an efficient and time-saving screening tool is essential for the timely detection of delirium, enabling prompt intervention and reducing the associated healthcare burden. The original 13-item Delirium Observation Screening Scale (DOSS) is widely used and well-validated, but its relatively high workload leaves room for simplification.</div></div><div><h3>Objective</h3><div>This study aimed to develop and validate a shortened version of the DOSS (s-DOSS) to reduce screening burden while maintaining diagnostic accuracy.</div></div><div><h3>Methods</h3><div>The s-DOSS was developed in two phases. First, the content validity index (CVI) of the original 13-item DOSS was assessed through ratings from 14 delirium experts. Second, psychometric properties were assessed using 16,110 routine DOSS assessments from hospitalized patients. Item response theory parameters, classical test theory indices, and inter-item correlations were examined to inform item retention or deletion. A refined factor structure of the s-DOSS was subsequently evaluated. Finally, psychometric validation of the s-DOSS was conducted via secondary analysis of a prospective study, comparing its diagnostic performance to the Confusion Assessment Method (CAM) in 113 paired patient assessments.</div></div><div><h3>Results</h3><div>Four items were removed from the original DOSS. “Attention to conversation” was excluded due to conceptual redundancy, a low collected item-total correlation, and limited information contribution. The items ‘remembers events’, ‘pulls tubes’, and ‘sudden emotional’ were removed because of poor content validity, redundancy or local dependence, and weak internal coherence with the remaining items. The resulting 9-item s-DOSS demonstrated an average scale-level CVI (S-CVI/Ave) of 0.833 and a Cronbach's α of 0.853. Using a cutoff point of two, s-DOSS achieved a sensitivity of 90.9% (95% CI: 62–98), a specificity of 92.2% (95% CI: 85–96), and an overall diagnostic accuracy of 92.0% (95% CI: 86–96). The area under the ROC curve (AUC) was 0.935 (95% CI: 0.822–1.000).</div></div><div><h3>Conclusion</h3><div>The first validation of the 9-item s-DOSS suggests that it is a reliable and efficient tool for delirium screening, maintaining high diagnostic accuracy while reducing workload. Further adequately powered, multi-site validation studies are required to confirm the robustness of the cut-off and diagnostic performance across clinical settings.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105362"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a nurse-led, mHealth-based cardiac rehabilitation program on cardiorespiratory fitness and physical activity in youth with congenital heart disease: A randomized controlled trial","authors":"Yuan Li ,&nbsp;Yaxin Zhou ,&nbsp;Yinyue Zhang ,&nbsp;Hanmei Peng ,&nbsp;Mei R. Fu ,&nbsp;Miao Chen ,&nbsp;Ying Xu ,&nbsp;Biru Luo","doi":"10.1016/j.ijnurstu.2026.105370","DOIUrl":"10.1016/j.ijnurstu.2026.105370","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Youth living with congenital heart disease face impaired cardiorespiratory fitness and reduced physical activity, compromising long-term health outcomes. Cardiac rehabilitation is crucial for optimizing functional capacity and preventing secondary complications, yet access barriers limit participation in traditional center-based programs. Nurse-led, mHealth-based models may improve accessibility and effectiveness.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the effectiveness of a nurse-led, mHealth-based cardiac rehabilitation program (HeartFIT) versus usual care on cardiorespiratory fitness and physical activity in youth with congenital heart disease.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A prospective, randomized, open-label, parallel-group controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Two tertiary hospitals in Chengdu, China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Youth aged 8 to 18 years, ≥&lt;!--&gt; &lt;!--&gt;6 months post-correction for congenital heart disease, with impaired exercise capacity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Participants (N = 68) were randomized (1:1) to HeartFIT or usual care. HeartFIT comprised a 12-week, nurse-led, home-based mHealth cardiac rehabilitation intervention (via WeChat), with the entire program design grounded in the Individual and Family Self-Management Theory and incorporating specific Behavior Change Techniques. The program featured individualized exercise prescriptions based on baseline cardiopulmonary exercise testing and risk stratification, tailored health education, goal-setting with self-monitoring, and remote nursing support. The primary outcome was change in cardiorespiratory fitness (peak oxygen uptake, VO&lt;sub&gt;2 peak&lt;/sub&gt;) measured by cardiopulmonary exercise testing. Secondary outcomes included other cardiopulmonary exercise testing parameters (oxygen pulse, exercise duration, maximal workload, ventilatory efficiency) and physical activity levels assessed by accelerometry and the Physical Activity Questionnaire. Analysis of covariance (ANCOVA), adjusting for baseline values, was used to determine between-group differences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The HeartFIT group demonstrated statistically significantly greater improvement in VO&lt;sub&gt;2 peak&lt;/sub&gt; versus controls (adjusted mean difference: 3.60 ml·kg&lt;sup&gt;−1&lt;/sup&gt;·min&lt;sup&gt;−1&lt;/sup&gt;, 95% CI 1.48 to 5.73; &lt;em&gt;P&lt;/em&gt; = 0.001). Significant improvements favoring HeartFIT were also observed in oxygen pulse (0.78 ml·beat&lt;sup&gt;−1&lt;/sup&gt;), exercise duration (0.76 min), maximal workload (11.70 W), and physical activity levels (&lt;em&gt;P&lt;/em&gt; = 0.004 for accelerometry; &lt;em&gt;P&lt;/em&gt; = 0.001 for Physical Activity Questionnaire). No serious adverse events occurred.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The nurse-led, mHealth-based cardiac rehabilitation program effectively improved cardiorespiratory fitness and physical activity in youth with congenital heart disease, offering a safe and scalable approach for ac","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105370"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and nurse perceptions of electronic medical records in an acute setting: A multi-method qualitative study","authors":"Marina Bogiatzis ,&nbsp;Wendy Smyth ,&nbsp;Mariann Hadland ,&nbsp;Laura Irving ,&nbsp;Cate Nagle","doi":"10.1016/j.ijnurstu.2026.105363","DOIUrl":"10.1016/j.ijnurstu.2026.105363","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Electronic medical records are progressively replacing paper records in many healthcare settings worldwide. However, the patient experience is not well represented in the published literature. Research on nurses' experience using the electronic medical record has shown increased documentation burden, time spent-on-computers and concerns for the negative impacts on patient-centred care. Further understanding is warranted of both patient and nurse experience of the electronic medical record.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aim&lt;/h3&gt;&lt;div&gt;This study aimed to explore the experiences of patients and nurses with electronic medical records, and the impact of computers on nurses' documentation, practice, and interaction with patients in their care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A multi-method qualitative study comprising an ethnographic observational component, followed by interviews of nurses and patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;The Cardiac Centre (cardiac ward and coronary care unit) in a regional tertiary hospital in northern Australia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Inpatients and nurses working clinically in the Cardiac Centre were invited to participate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The initial phase, during April–July 2022, involved in-depth observations of the impact of the electronic medical record and computers-on-wheels on nurses' practice and interactions with patients. The second phase, during January 2023, comprised semi-structured interviews with patients and nurses to further explore their perspectives and attitudes towards electronic medical records and computers. Information sheets were provided, and written consent forms were obtained, for both phases. Field notes were analysed deductively, and interview transcriptions were analysed thematically. Findings have been presented descriptively with themes explained using quotes from participants supported by observations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Observation periods totalled 1220 min. In the times observed, nurses spent approximately one-third of their time using the computer. Interviews and observations revealed two themes: ‘Moving ahead with the times’ and ‘A balancing act’. Both patients and nurses agreed that accessible information in the electronic medical record improved timely communication between health professionals; however, balancing nursing care with managing digital technologies presented physical and professional challenges for the nurses. Despite these challenges, the patients were supportive of the technology and saw it as beneficial to their health outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;While patients and nurses generally accepted the electronic medical record, our findings reveal tensions between technological adaptation and clinical practice, underscoring the need to include patient and nurse perspectives to ensure digital systems support person-centred care. Balancing the demands of clinical r","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105363"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout levels among nursing home care workers and its associations with workplace and individual factors: Results from a multicenter cross-sectional study","authors":"Lisa Geyskens ,&nbsp;Nasrin Khan ,&nbsp;Anja Declercq ,&nbsp;Lode Godderis ,&nbsp;Pieter Heeren ,&nbsp;Lien Janssens ,&nbsp;Şirin Özkan ,&nbsp;Jeroen Trybou ,&nbsp;Ellen Vlaeyen ,&nbsp;Franziska Zúñiga ,&nbsp;Koen Milisen ,&nbsp;Mieke Deschodt","doi":"10.1016/j.ijnurstu.2026.105367","DOIUrl":"10.1016/j.ijnurstu.2026.105367","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Nursing homes face substantial challenges due to increasingly complex care needs, and difficulties in recruiting and retaining care workers. High job demands and stressful work conditions contribute to burnout risk, exacerbating workforce shortages and potentially impacting care quality.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To determine the level of burnout and examine its association with workplace and individual factors among nursing home care workers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A secondary analysis using cross-sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February to July 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting and participants&lt;/h3&gt;&lt;div&gt;A total of 1416 care workers from 25 Flemish nursing homes were included, comprising care assistants (42.7%), registered nurses (20.6%), support staff (15%), allied health professionals (15.6%), and team leaders (6.0%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Burnout levels were assessed using the short Burnout Assessment Tool (BAT-12). Linear mixed models were used to examine associations between burnout and workplace factors (including facility characteristics and work environment factors) and individual factors (including care worker characteristics and personal resources). Both univariable and multivariable analyses were conducted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the nursing home care workers, 12.7% were identified as being at risk for burnout, and 6.3% were likely suffering from burnout, resulting in a total of 19.0%. Among facility characteristics, lower staffing levels were statistically significantly associated with higher burnout levels in the unadjusted analysis, though this effect attenuated once additional factors were included in the model. Regarding the work environment, the multivariable model showed that higher perceived role clarity and skill use were significantly associated with lower levels of burnout, whereas greater emotional burden and work-life interference were related to higher levels of burnout. Care worker characteristics also appear to play a role: younger age, longer work experience, higher employment rates (&gt;&lt;!--&gt; &lt;!--&gt;50%), and alternating between day and night shifts were significantly associated with higher levels of burnout. Also, care assistants experienced higher burnout levels than other care worker groups. Finally, personal resources, including self-efficacy, resilience, and optimism, were protective factors against burnout.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our study showed that burnout risk is prevalent among nursing home care workers and is associated with both work environment and individual factors. These findings underscore the need for integrated strategies that improve workplace conditions and strengthen personal resources, while accounting for individual differences, to promote well-being and prevent burnout among all care workers in nursing homes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Registra","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105367"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of pain care services for people with Parkinson's disease from the perspective of healthcare providers: A qualitative descriptive study","authors":"Anthony Mezzini ,&nbsp;Saravana Kumar ,&nbsp;Sue Sharrad ,&nbsp;Joanne Harmon ,&nbsp;Marion Eckert","doi":"10.1016/j.ijnurstu.2026.105364","DOIUrl":"10.1016/j.ijnurstu.2026.105364","url":null,"abstract":"<div><h3>Purpose</h3><div>Pain is a common, complex, and debilitating non-motor symptom of Parkinson's disease that often requires a multidisciplinary and multimodal approach to care. However, little is known about how healthcare providers experience and navigate pain care provision in Parkinson's disease, particularly within the Australian healthcare context. This study aimed to explore the perspectives of Australian healthcare providers involved in the management of pain in people with Parkinson's disease.</div></div><div><h3>Methods</h3><div>A qualitative descriptive research methodology was used to underpin this study. Healthcare providers involved in the management of pain in people with Parkinson's disease were recruited using a quota sampling strategy. Data were collected using semi-structured interviews and analyzed thematically.</div></div><div><h3>Results</h3><div>Nineteen healthcare providers participated, including five from nursing, five from neurology, five from physiotherapy, three from exercise physiology, and one from general practice. Analysis of the data resulted in six themes: (1) collaborating for holistic pain management; (2) determining etiology; (3) screening and managing the non-motor symptoms of Parkinson's disease that interact with pain and its treatment; (4) provider focus drives nuanced pain therapy; (5) involving carers in the assessment and treatment of pain; and (6) educating patients and healthcare providers to achieve effective pain management. Within these themes, participants highlighted the central role of Parkinson's nurse specialists in coordinating care, facilitating communication across disciplines, and supporting both patients and healthcare providers through education and guidance.</div></div><div><h3>Conclusion</h3><div>This study offers the first in-depth exploration of healthcare providers' perspectives on pain care in Parkinson's disease within Australia. The findings highlight the need for a collaborative, multidisciplinary approach supported by targeted patient and healthcare provider education to enhance communication and continuity of care, with Parkinson's nurse specialists playing a pivotal role in coordinating services and serving as a resource across the care network. Strengthening these elements presents a clear pathway for advancing the provision of pain care services in people with Parkinson's disease.</div></div><div><h3>Reporting method</h3><div>Standards for Reporting Qualitative Research (SRQR) guidelines.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105364"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a classification system for long-term care service needs among the elderly based on cluster analysis and machine learning: A multi-center, cross-sectional study in central China","authors":"Fang Li ,&nbsp;Weihong Huang ,&nbsp;Yuting Zeng ,&nbsp;Yanfang Long ,&nbsp;Jing Peng ,&nbsp;Jianzhong Hu ,&nbsp;Jing Li ,&nbsp;Xi Chen ,&nbsp;Li Li","doi":"10.1016/j.ijnurstu.2026.105344","DOIUrl":"10.1016/j.ijnurstu.2026.105344","url":null,"abstract":"<div><h3>Background</h3><div>Rapid global aging has led to an increasing demand for long-term care services for the elderly; however, current long-term care systems are underdeveloped and under-resourced. It is essential to develop an effective classification system to guide resource allocation that is tailored to the needs of the elderly.</div></div><div><h3>Objectives</h3><div>This study aimed to construct a classification system for long-term care service needs among the elderly based on cluster analysis and machine learning.</div></div><div><h3>Design</h3><div>Multi-center, cross-sectional study.</div></div><div><h3>Settings</h3><div>Community and nursing homes in Changsha, Hunan Province, China.</div></div><div><h3>Participants</h3><div>1270 elderly aged ≥<!--> <!-->65 years, who were randomly divided into the training set (70%) and test set (30%).</div></div><div><h3>Methods</h3><div>Cluster analysis was conducted based on service time from caregivers, nurses, and doctors. Machine learning approaches were used to determine classification criteria based on sociodemographic information and 17 secondary indicators of long-term care service needs. The best model was selected based on its accuracy and area under the curve in the test set and was then interpreted using Shapley Additive exPlanations.</div></div><div><h3>Results</h3><div>Five clusters of needs for long-term care services were identified, with the number and proportion of participants in each cluster as follows: 612 (48.2%), 299 (23.5%), 172 (13.5%), 150 (11.8%), and 37 (2.9%), respectively. The five clusters varied significantly in sociodemographic characteristics and long-term care service needs. The random forest model demonstrated the best predictive performance among the five models tested. The Shapley Additive exPlanations method identified the 10 most influential features that impacted the random forest model predictions.</div></div><div><h3>Conclusions</h3><div>The classification system for long-term care service needs can accurately distinguish among the elderly with varying levels of long-term care needs, guiding optimal service allocation and promoting the sustainable development of the long-term care service system.</div></div><div><h3>Trial registration</h3><div>The trial is registered at the Ethics Committee of Xiangya Hospital, Central South University (No. 202105083). Registration date 05/2021. First recruitment 06/2021.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105344"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145995297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why primary caregivers fail to report pediatric pain: A qualitative study","authors":"Qiao Shen ,&nbsp;Xiaoqiong Wei ,&nbsp;Dong Roman Xu ,&nbsp;Xiaoping Jiang ,&nbsp;Hangyang Li ,&nbsp;Hongyao Leng ,&nbsp;Xianlan Zheng","doi":"10.1016/j.ijnurstu.2026.105339","DOIUrl":"10.1016/j.ijnurstu.2026.105339","url":null,"abstract":"<div><h3>Background</h3><div>In many East Asian hospital settings where family members are closely involved in bedside care, caregivers play a crucial role in recognizing and reporting children's pain during hospitalization. Yet they often fail to inform healthcare providers, leading to inadequate interventions and prolonged suffering. While previous studies focused on whether pain is reported, the psychological mechanisms underlying non-reporting remain poorly understood, limiting the development of effective support strategies.</div></div><div><h3>Objective</h3><div>To explore why primary caregivers failed to report pediatric pain to healthcare providers, focusing on their decision-making process and influencing factors.</div></div><div><h3>Design</h3><div>Qualitative descriptive study.</div></div><div><h3>Setting(s)</h3><div>Multiple medical and surgical wards of a tertiary pediatric hospital in Chongqing, China.</div></div><div><h3>Participants</h3><div>Seventeen primary caregivers who observed their child in pain but did not report it to healthcare providers were purposively recruited.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted between January and March 2025. Data were analyzed using directed content analysis guided by Protection Motivation Theory.</div></div><div><h3>Results</h3><div>Five themes and 17 subthemes were identified, revealing that caregivers' failure to report pediatric pain is a dynamic process shaped by attention activation, threat appraisal, coping appraisal, individual factors, and environmental factors. The process often begins with attentional filtering, where pain cues are overlooked due to competing demands or perceived normality. Once attention is activated, caregivers engage in threat and coping appraisals, which may involve underestimating the threat of pain, valuing pain tolerance, doubting reporting efficacy, holding strong self-management beliefs, or anticipating costs. These dual-path appraisals are influenced by personal traits and prior experiences, along with environmental factors like verbal persuasion, observational learning, and healthcare constraints, with some directly impeding communication. Together, these elements interact to suppress reporting, often accompanied by alternative soothing strategies.</div></div><div><h3>Conclusions</h3><div>Caregivers' failure to report pediatric pain is not a simple omission but a result of complex cognitive and contextual processes. Attentional disengagement and biased appraisals, shaped by personal beliefs and environmental cues, jointly suppress reporting behaviors. Understanding these mechanisms offers a foundation for targeted interventions that enhance caregiver awareness, reshape pain perceptions, and promote supportive communication in pediatric care.</div></div><div><h3>Registration</h3><div>Not registered.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"177 ","pages":"Article 105339"},"PeriodicalIF":7.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing for brain health: A call to action.","authors":"Qi Xie,Siying Tian,Hui Feng,Hong Chang,Yanhong Dong","doi":"10.1016/j.ijnurstu.2026.105540","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105540","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"8 1","pages":"105540"},"PeriodicalIF":8.1,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Effectiveness of a technology-enhanced, integrated community health and wellness program for seniors: A non-randomized, cluster-allocated, quasi-experimental study” [Int. J. Nurs. Stud. 178 (2026) 105373 (June)]","authors":"Jae Yoon Yi, Young-il Jung, Hyoungshim Choi, Hongsoo Kim","doi":"10.1016/j.ijnurstu.2026.105518","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2026.105518","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"16 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}