International Journal of Nursing Studies最新文献

{"title":"Effectiveness of the CANCER-AIMS intervention on nutritional status and symptom management in patients with gastric cancer following gastrectomy: A randomized controlled trial","authors":"Liping Ren ,&nbsp;Yanan Fu ,&nbsp;Zhonghong Wang ,&nbsp;Chunqing Ma ,&nbsp;Sukhee Ahn ,&nbsp;Qinghui Meng","doi":"10.1016/j.ijnurstu.2024.104873","DOIUrl":"10.1016/j.ijnurstu.2024.104873","url":null,"abstract":"<div><h3>Background</h3><p>Dietary education and modification interventions are valuable and feasible strategies for enhancing nutritional status and managing symptoms in patients with gastric cancer following gastrectomy. In alignment with administrative policies prioritizing shorter hospital stays and enhanced postoperative self-management, the provision of a simplified nutritional management approach following gastrectomy holds promise for preventing weight loss and expanding resources for monitoring both the nutritional and symptomatic aspects of these patients.</p></div><div><h3>Objective</h3><p>This study evaluated the effectiveness of an integrative approach involving the five sequential steps of Conversation, Assessment, Nutrition plan, Complications, Evaluation, and Reassurance or Removal (CANCER) into Altering Intake and Managing Symptoms (AIMS), with specific focus on enhancing nutritional status and symptom management.</p></div><div><h3>Design</h3><p>A single-blind, two-arm, randomized controlled trial.</p></div><div><h3>Setting</h3><p>This study was conducted at a tertiary hospital in Shandong province, China.</p></div><div><h3>Participants</h3><p>Patients with total or subtotal gastrectomy for gastric cancer.</p></div><div><h3>Methods</h3><p>The participants were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received a 16-week CANCER-AIMS intervention program. The control group received usual routine care dietary guidance. Questionnaires and electronic medical records of each patient were used to assess dietary intake, dietary symptoms, and subjective and objective nutritional status. Outcomes were assessed at four specific time points: the day before discharge and at 4-, 8-, and 16-weeks following hospital discharge.</p></div><div><h3>Results</h3><p>Thirty-eight participants completed the study. The findings revealed significant interaction effects between group and time for dietary intake, dietary symptoms, and nutritional status between intervention and control groups (<em>P</em> &lt; 0.001). The intervention group had significantly higher dietary intake, fewer dietary symptoms, and better nutritional status post-intervention than the control group (<em>P</em> &lt; 0.001). Moreover, there were significant differences in dietary intake, dietary symptoms, and nutritional status according to time in both the intervention and control groups.</p></div><div><h3>Conclusion</h3><p>The CANCER-AIMS intervention for patients with gastric cancer following gastrectomy may be efficient at enhancing nutritional intake, reducing negative dietary symptoms, and thus improving both their subjective and objective nutritional status.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104873"},"PeriodicalIF":7.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057128","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":"The effects of a facilitator-enabled online multicomponent iSupport for dementia programme: A multicentre randomised controlled trial","authors":"Lily Xiao ,&nbsp;Shahid Ullah ,&nbsp;Rujun Hu ,&nbsp;Jing Wang ,&nbsp;Huali Wang ,&nbsp;Chia-Chi Chang ,&nbsp;Timothy Kwok ,&nbsp;Mingxia Zhu ,&nbsp;Julie Ratcliffe ,&nbsp;Henry Brodaty ,&nbsp;Bianca Brijnath ,&nbsp;Hui-Chen (Rita) Chang ,&nbsp;Bel Wong ,&nbsp;Yunrui Zhou ,&nbsp;Jinjie He ,&nbsp;Mengmeng Xia ,&nbsp;Jhih-Yang Hong ,&nbsp;Shirley Che ,&nbsp;Rachel Milte","doi":"10.1016/j.ijnurstu.2024.104868","DOIUrl":"10.1016/j.ijnurstu.2024.104868","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;This study aimed to partner with health and social care organisations to evaluate the effects of a facilitator-enabled online multicomponent Chinese iSupport programme, which included psychoeducation using the iSupport programme, facilitator-enabled carer support groups and access to care services.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;A multicentre randomised controlled trial.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings and participants&lt;/h3&gt;&lt;p&gt;Participants were family carers in Australia and greater China. We recruited participants to the study from 1st November 2021 to 30th June 2022.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;The intervention group received the Chinese iSupport programme delivered online. The intervention lasted for 6 months. Our primary outcome was carers' quality of life. Our secondary outcomes were carers' self-efficacy, social support, distress reactions to changed behaviours, care recipients' frequency of changed behaviours, quality of life, unplanned hospital admissions, emergency department presentations and permanent admissions to nursing homes. The outcomes were measured at baseline (T0), 6 months (T1) and 9 months (T2). We applied a multivariate mixed effect linear regression model to capture the group effect, time effect and their interaction.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In total, 266 eligible family carers agreed to participate and were randomly assigned to an intervention group (n = 131) or a usual care group (n = 135). Most carers were women with a mean age of 53 years. The intervention group showed a statistically significant higher score of mental-health-related quality of life (mean difference = 4.1, 95 % CI: 1.5, 6.8, p = 0.002), self-efficacy in controlling upsetting thoughts (mean difference = 7.1, 95 % CI: 2.2, 12.0, p = 0.005) and lower score of distress reactions to changed behaviours (mean difference = −&lt;!--&gt; &lt;!--&gt;0.1, 95 % CI: −&lt;!--&gt; &lt;!--&gt;0.3, −&lt;!--&gt; &lt;!--&gt;0.03, p = 0.012) than the usual care group at T1.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The facilitator-enabled online multicomponent Chinese iSupport programme demonstrated positive effects for carers on mental health-related quality of life, controlling upsetting thoughts and distress reactions to changed behaviours of people with dementia.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;p&gt;This study is registered in the Australia New Zealand Clinical Trials Registry on 12th March 2021 (","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104868"},"PeriodicalIF":7.5,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924001810/pdfft?md5=c2aa0b185f1c78650e77667db910d419&pid=1-s2.0-S0020748924001810-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142002637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response to “Comment on Yu et al. (2024) ‘Effects of interventions to promote resilience in nurses: A systematic review’”","authors":"Fiona Yu ,&nbsp;Ginger Chu ,&nbsp;Tzupei Yeh ,&nbsp;Ritin Fernandez","doi":"10.1016/j.ijnurstu.2024.104870","DOIUrl":"10.1016/j.ijnurstu.2024.104870","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104870"},"PeriodicalIF":7.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990780","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":"Comment on Yu et al. (2024) ‘Effects of interventions to promote resilience in nurses: A systematic review’","authors":"Paulo Santos-Costa ,&nbsp;Inês F. Almeida ,&nbsp;Rafael A. Bernardes","doi":"10.1016/j.ijnurstu.2024.104869","DOIUrl":"10.1016/j.ijnurstu.2024.104869","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104869"},"PeriodicalIF":7.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978801","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":"The influence of culture and spirituality on maternal grief following stillbirth in China: A qualitative study","authors":"Qiong Zheng ,&nbsp;Xiuxiu Yin ,&nbsp;Lu Liu ,&nbsp;Cecilia Jevitt ,&nbsp;Dongmei Fu ,&nbsp;Yaping Sun ,&nbsp;Xiaoyan Yu","doi":"10.1016/j.ijnurstu.2024.104863","DOIUrl":"10.1016/j.ijnurstu.2024.104863","url":null,"abstract":"<div><h3>Background</h3><p>Stillbirth is a unique phenomenon with various manifestations influenced by cultural contexts and spiritual beliefs. Chinese cultural and spiritual practices produce different post-stillbirth grief experiences for bereaved mothers in China. However, the majority of research on perinatal loss and grief has been conducted in Western cultures. In the Chinese cultural context, the post-stillbirth grief experience of bereaved mothers may differ from the types of Western bereavement examined in the dominant research.</p></div><div><h3>Objective</h3><p>This study investigated the influence of culture and spirituality on grieving mothers who had experienced a stillbirth in China.</p></div><div><h3>Methods</h3><p>This qualitative study was grounded in an interpretivist constructionist epistemology. In-depth interviews were conducted with mothers who had experienced a stillbirth within the previous year. Thematic analysis was used to analyse the data.</p></div><div><h3>Findings</h3><p>A total of 28 women were interviewed by trained interviewers. Three key themes were identified: 1) The influence of culture on grief expression, with four subthemes: restrained expressions of grief, unattainable mourning ceremonies, hospital policy as a barrier to grieving, and others-oriented self; 2) Cultural characteristics of post-stillbirth experiences, with four subthemes: paternalistic medical culture, “Kong yuezi”, embarrassment during postpartum visits, and cultural taboos on dealing with deceased babies' possessions; and 3) Finding significance in spiritual healing process, with four subthemes: seeking meaning in the event, accepting and reconciling with the event, reshaping beliefs and views about life and death, and achieving personal growth.</p></div><div><h3>Conclusion</h3><p>Chinese culture and spirituality have different influences on bereaved mothers' expressions of grief and post-stillbirth healing. This research demonstrates specific aspects of spirituality that contribute to or hinder the grieving process and the different roles of Chinese culture and spirituality for individuals. The findings suggest the need for the development of culturally sensitive interventions and support systems to assist mothers in navigating grief and healing. Future studies could explore the roles of Chinese culture and spirituality over time in the different stages of grief and healing after stillbirth.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"160 ","pages":"Article 104863"},"PeriodicalIF":7.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924001767/pdfft?md5=80de4aa1ce5d9eabe04f816b64473f34&pid=1-s2.0-S0020748924001767-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informing or concealing — Dynamics of telling disease-related bad news among family members of older cancer patients: A qualitative study","authors":"Xiaoyu He ,&nbsp;Jiagui Liang ,&nbsp;Hanchang Liang ,&nbsp;Peng Yue ,&nbsp;Dumin Zeng ,&nbsp;Ni Gong","doi":"10.1016/j.ijnurstu.2024.104871","DOIUrl":"10.1016/j.ijnurstu.2024.104871","url":null,"abstract":"<div><h3>Background</h3><p>With the dramatic rise in the number of older cancer patients, the question of whether or not to tell older patients of bad news becomes an urgent and common challenge. However, existing studies concentrated on the three types of disclosure decisions and their reasons, including full disclosure, partial disclosure, and avoidance of disclosure, and the evolution process and factors influencing family members' disclosure decisions are unclear.</p></div><div><h3>Objective</h3><p>Explore the experience and factors of the shift between disclosure and concealment among family members of older cancer patients.</p></div><div><h3>Methods</h3><p>A qualitative study was employed. Semi-structured interviews were conducted with 33 family members at two general hospitals and one community hospital between December 2022 and June 2023. The interview data were analyzed using a content analysis approach.</p></div><div><h3>Results</h3><p>The treatment plan symbolizes the “hope of survival” and it is the fundamental factor for the shift between concealment and disclosure. There are three themes of family members in making decisions during the diagnostic and therapeutic process: (a) When bad news is approaching: Keep calm in the midst of chaos, (b) when a treatment plan is determined: Hope for survival dictates disclosure decisions, and (c) when the patient's disease deteriorated: Finding hope in hopelessness.</p></div><div><h3>Conclusions</h3><p>Disclosure and concealment are a complex and dynamic process. The factor of the shift lies in the “hope of survival” symbolized by the treatment plan. The key to disclosure by family members is to give patients enough hope to control or cure a patient's disease, or prolong the life of patients and improve their quality of life.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104871"},"PeriodicalIF":7.5,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142084084","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":"External validation of the Khorana score for the prediction of venous thromboembolism in cancer patients: A systematic review and meta-analysis","authors":"Xuan Huang ,&nbsp;Hongxiu Chen ,&nbsp;Sha Meng ,&nbsp;Lihui Pu ,&nbsp;Xueqiong Xu ,&nbsp;Ping Xu ,&nbsp;Shengyuan He ,&nbsp;Xiuying Hu ,&nbsp;Yong Li ,&nbsp;Guan Wang","doi":"10.1016/j.ijnurstu.2024.104867","DOIUrl":"10.1016/j.ijnurstu.2024.104867","url":null,"abstract":"<div><h3>Background</h3><p>Venous thromboembolism is the leading cause of death in cancer patients, second only to tumor progression. The Khorana score is recommended by clinical guidelines for identifying ambulatory cancer patients at high risk of venous thromboembolism during chemotherapy. However, its predictive performance is debated among cancer patients.</p></div><div><h3>Objectives</h3><p>To map the applicability of the Khorana score in cancer patients and to assess its predictive performance across various cancer types, providing guidance for clinicians and nurses to use it more appropriately.</p></div><div><h3>Design</h3><p>Systematic review and meta-analysis.</p></div><div><h3>Methods</h3><p>A comprehensive literature search of the electronic database was first conducted on August 30, 2023, and updated on May 20, 2024. Studies examining the Khorana score's predictive performance (including but not limited to the areas under the curve, C-index, and calibration plot) in cancer patients were included. The Prediction Model Risk of Bias Assessment Tool (PROBAST) was applied to evaluate the methodological quality of the included studies. Data synthesis was achieved via random-effects meta-analysis using the R studio software. The subgroup analysis was performed according to the study design, clinical setting, cancer type, anti-cancer treatment stage, and country.</p></div><div><h3>Results</h3><p>The review incorporated 67 studies, including 58 observational studies and nine randomized controlled trials. All included studies assessed the Khorana score's discrimination, with the C-index ranging from 0.40 to 0.84. The pooled C-index for randomized controlled trials was 0.61 (95 % CI 0.51–0.70), while observational studies showed a pooled C-index of 0.59 (95 % CI 0.57–0.60). Subgroup analyses revealed the pooled C-index for lung cancer, lymphoma, gastrointestinal cancer, and mixed cancer patients as 0.60 (95 % CI 0.53–0.67), 0.56 (95 % CI 0.51–0.61), 0.59 (95 % CI 0.39–0.76), and 0.60 (95 % CI 0.58–0.61), respectively. Inpatient and outpatient settings had the pooled C-index of 0.60 (95 % CI 0.58–0.63) and 0.58 (95 % CI 0.55–0.61), respectively. Calibration was assessed in only four studies. All included studies were identified to have a high risk of bias according to PROBAST.</p></div><div><h3>Conclusion</h3><p>The Khorana score has been widely validated in various types of cancer patients; however, it exhibited poor capability (pooled C-index<!--> <!-->&lt;<!--> <!-->0.7) in accurately discriminating VTE risk among most types of cancer patients either in inpatient or outpatient settings. The Khorana score should be used with caution, and high-quality studies are needed to further validate its predictive performance.</p></div><div><h3>Registration</h3><p>The protocol for this study is registered with PROSPERO (registration number: CRD42023470320).</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104867"},"PeriodicalIF":7.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990779","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":"Symptom-specific non-pharmacological interventions for behavioral and psychological symptoms of dementia: An umbrella review","authors":"Eunhee Cho ,&nbsp;Ji Yeon Lee ,&nbsp;Minhee Yang ,&nbsp;Jiyoon Jang ,&nbsp;Jungwon Cho ,&nbsp;Min Jung Kim","doi":"10.1016/j.ijnurstu.2024.104866","DOIUrl":"10.1016/j.ijnurstu.2024.104866","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Non-pharmacological interventions are considered the first-line treatment for managing the behavioral and psychological symptoms of dementia. Given the heterogeneous characteristics of these symptoms, which vary for each individual and tend to fluctuate, a symptom-specific approach is necessary for providing individualized non-pharmacological interventions for people with dementia. However, clear guidelines regarding the appropriate types of interventions for individual symptoms or clusters of behavioral and psychological symptoms of dementia are lacking.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;The aim of this umbrella review was to summarize the current evidence on non-pharmacological interventions for behavioral and psychological symptoms of dementia and provide guidance for determining the appropriate types of interventions for each behavioral and psychological symptom of dementia.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;An umbrella review of systematic reviews and/or meta-analyses.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;The Cochrane methodology for umbrella reviews was employed for this review, and the review protocol was registered. PubMed, CINAHL, Embase, PsycINFO, and Cochrane databases were searched for relevant reviews using the ‘population, intervention, control, and outcomes’ formulation. Two reviewers independently screened the extracted articles for eligibility. The quality of each selected review was independently assessed by the two reviewers using A Measurement Tool to Assess Systematic Reviews 2. The results were narratively synthesized and categorized according to each symptom.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Thirty-five systematic reviews, 71 % of which were also meta-analyses, were included in this review. The methodologies employed in the included reviews were significantly heterogeneous. The qualities of the reviews ranged from low to moderate. Diverse types of non-pharmacological interventions were identified in the reviews, with music therapy being the most frequently discussed. Among the various symptoms, depression was most frequently addressed, followed by overall symptoms, agitation, anxiety, sleep problems, and apathy. Music therapy was found to be effective for improving both overall and specific symptoms, including depression and anxiety. Notably, relatively weak evidence supports the effectiveness of exercise in addressing each symptom. Aromatherapy could be considered for agitation, whereas reminiscence may be effective in managing overall and specific symptoms, such as depression.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;The results showed that the evidence of symptom-specific effectiveness of non-pharmacological interventions varied across the different behavioral and psychological symptoms of dementia, highlighting the need for a symptom-specific approach in future research. Furthermore, future research is needed to facilitate the development of symptom-specific guidelines that can enhance the quality of ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104866"},"PeriodicalIF":7.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006763","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":"Promoting resilience in mental health nurses: A partially clustered randomised controlled trial","authors":"Kim Foster ,&nbsp;Ian Shochet ,&nbsp;Jane Shakespeare-Finch ,&nbsp;Darryl Maybery ,&nbsp;Minh Viet Bui ,&nbsp;Ian Gordon ,&nbsp;Kathleen L. Bagot ,&nbsp;Michael Roche","doi":"10.1016/j.ijnurstu.2024.104865","DOIUrl":"10.1016/j.ijnurstu.2024.104865","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;There is a critical global shortage of nurses in mental health, with workforce attrition due in large part to workplace stressors. Proactive strengths-based interventions to strengthen nurses' capacity to manage stress and improve mental health, wellbeing and resilience may also support workforce retention.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;To determine the effects of a resilience-building programme on mental health nurses' coping self-efficacy (primary outcome), and psychological distress, wellbeing, resilience, posttraumatic growth, emotional intelligence behaviours, workplace belonging, and turnover intention (secondary outcomes).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;Partially clustered randomised controlled trial.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;p&gt;Large tertiary metropolitan mental health service in Australia.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;p&gt;A total of 144 registered and enrolled nurses working clinically ≥&lt;!--&gt; &lt;!--&gt;0.6 full-time equivalent (73/intervention, 71/control), with 122 completing 3-month follow-up.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;The Promoting Resilience in Nurses programme is an evidence-based workplace intervention delivered by trained facilitators across two workshops. Surveys were administered online upon registration and prior to randomisation (Time 1) into Intervention or Control (no intervention) arms, and immediately after the final workshop (Time 2), and at three months follow-up (Time 3). Linear mixed models for outcome measures were fitted to Time 2 and 3 responses.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;There were seven intervention groups, with seven to 13 participants per group. Coping self-efficacy improved at Time 2 (estimated intervention effect 21.2 units, 95 % Confidence Intervals: 13.3 to 29.0) and Time 3 (12.1 units, 4.7 to 19.6), as well as wellbeing (Time 2: 9.2 units, 5.0 to 13.4), resilience (Time 2: 0.24 units, 0.01 to 0.46) and posttraumatic growth (Time 2: 16.1 units, 7.0 to 25.3). Psychological distress reduced (Time 2: −&lt;!--&gt; &lt;!--&gt;3.7 units, −&lt;!--&gt; &lt;!--&gt;6.2 to −&lt;!--&gt; &lt;!--&gt;1.31). All were sustained at three months. Emotional intelligence behaviours were improved (Time 2: 3.5 units, 0.6 to 6.5) but not sustained. Workplace belonging improved at Time 3 (0.34 units, 0.02 to 0.65) only. No statistically significant effects for turnover intention.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Despite major contextual challenges, the Promoting Resilience in Nurses programme achieved the aims of promoting nurses' efficacy to cope with stress and regulate their emotions and improving mental health and wellbeing. The findings support the programme as a feasible and successful intervention for nurses across other settings and contexts.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Trial registration&lt;/h3&gt;&lt;p&gt;Australian New Zealand Clinical Trials Registry (ACTRN12620001052921). Registered 15/10/2020. First recruitment 04/02/2021.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Tweetable abstract&lt;/h3&gt;&lt;p&gt;Promoting Resilience in Nurses intervention improved co","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"159 ","pages":"Article 104865"},"PeriodicalIF":7.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924001780/pdfft?md5=f368a7ecbbc0054808ddc5fa9fd8459f&pid=1-s2.0-S0020748924001780-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The inner struggle of nurses, exploring moral distress among hospital nurses: A cross-sectional study","authors":"Wendy H. Oldenmenger ,&nbsp;Elke Berger ,&nbsp;Arianne Stoppelenburg","doi":"10.1016/j.ijnurstu.2024.104864","DOIUrl":"10.1016/j.ijnurstu.2024.104864","url":null,"abstract":"<div><h3>Background</h3><p>As frontline caregivers, nurses often find themselves at the crossroads of complex ethical decisions that can significantly impact patient outcomes and their own well-being. Identifying the areas of experienced moral dilemmas in the workplace and gaining insight into the prevalence of moral distress can lead to a healthier workplace environment.</p></div><div><h3>Objective</h3><p>This study aims to examine the frequency, intensity and level of moral distress among nurses who work in a hospital, and to identify the variables associated with the level of moral distress.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>One university hospital and six general hospitals.</p></div><div><h3>Participants</h3><p>654 of the 1095 nurses working on inpatient units filled out the questionnaire (response rate 60 %).</p></div><div><h3>Methods</h3><p>The intensity and frequency of moral distress was assessed using the Moral Distress Scale-Revised (MDS-R). We also asked two additional questions about considering leaving their job, and if they could describe a distressing case and how moral distress was discussed. Multivariable regression analysis was conducted to identify the variables associated with the level of moral distress.</p></div><div><h3>Results</h3><p>The overall mean MDS-R score of the 654 included nurses was low at 36.4 (SD 26). Nurses reported to have frequent dilemmas regarding organizational aspects and aspects of end-of-life care. The multivariable analyses showed that higher levels of moral distress were experienced by registered nurses, nurses working on a medical ward, and nurses who had ever left or considered leaving their job, or considering leaving their job at the moment.</p></div><div><h3>Conclusions</h3><p>Although nurses in our study experiences low levels of moral distress, they do experience moral dilemmas related to organizational topics and end of life care. We all need to pay attention to these dilemmas and how to discuss them in order to achieve a resilient nursing profession at a time of major nursing shortages.</p></div><div><h3>Tweetable abstract</h3><p>Caring for increasingly complex patients in a dynamic healthcare system is likely to continue to produce morally challenging scenarios.</p></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"158 ","pages":"Article 104864"},"PeriodicalIF":7.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0020748924001779/pdfft?md5=9ecaf8ef45249e3b6253b142c30fcb59&pid=1-s2.0-S0020748924001779-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141836748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}