International Journal of Nursing Studies最新文献

{"title":"Effectiveness of dementia literacy interventions for caregivers of people with dementia: A meta-analysis of randomized controlled trials","authors":"Widiyaningsih , Anung Ahadi Pradana , Herry Susanto , Huei-Ling Chiu","doi":"10.1016/j.ijnurstu.2025.105191","DOIUrl":"10.1016/j.ijnurstu.2025.105191","url":null,"abstract":"<div><h3>Background</h3><div>Dementia is a significant global health challenge, placing a considerable burden on caregivers. Dementia literacy encompasses the ability to seek, evaluate, and apply dementia-related information, influencing dementia prevention and care. Interventions aimed at improving dementia literacy among caregivers have the potential to support caregiving by enhancing knowledge, confidence, and coping strategies. However, the effectiveness of these interventions in reducing caregiver burden remains unclear.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of dementia literacy interventions for caregivers of people with dementia.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Randomized controlled trials of dementia literacy interventions were searched comprehensively in PubMed, Embase, and Web of Science up to July 12, 2024. Trials included family caregivers of people with dementia. Primary outcomes were caregiver burden; secondary outcomes included knowledge, attitudes toward dementia, and self-efficacy. Two authors independently reviewed the eligible studies, evaluated their quality, and extracted relevant data. The risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool for randomized trials. Meta-analysis was conducted using Comprehensive Meta-Analysis vers. 3.0, while narrative synthesis was applied when meta-analysis was not suitable.</div></div><div><h3>Results</h3><div>40 eligible studies, comprising a total of 4336 caregivers were analyzed. Interventions varied in structure, delivery modes, durations, and frequencies and included education on dementia, caregiving techniques, stress management, and communication skills. The findings revealed that dementia literacy interventions significantly reduced caregivers' burden (Hedges' g = −<!--> <!-->0.446, <em>p</em> < 0.001) and improved caregivers' knowledge (Hedges' g = 0.806, <em>p</em> < 0.001), attitudes toward dementia (Hedges' g = 0.621, <em>p</em> = 0.002), and self-efficacy (Hedges' g = 0.272, <em>p</em> < 0.001). Subgroup analyses and meta-regression indicated that the different intervention characteristics influenced caregiver burden, knowledge, and attitudes toward dementia, such as session duration, intervention frequency, mode of delivery, use of technology, total intervention duration, and number of sessions. However, significant heterogeneity and risks of bias were observed across studies.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential of dementia literacy interventions to address caregiver challenges and improve outcomes, emphasizing the importance of structured and sustained programs tailored to caregivers' needs. Future research should focus on optimizing intervention designs, such as session length and delivery methods, to maximize their impact and ensure long-term effectiveness.</div></div><div><h3>Registration</h3><div>The pro","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105191"},"PeriodicalIF":7.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912834","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":"Omission of regular medications in aged care facilities: a retrospective observational study","authors":"Stephanie M. Garratt ,&nbsp;Maneesh Prasad ,&nbsp;Kelly Ottosen ,&nbsp;Elizabeth Manias","doi":"10.1016/j.ijnurstu.2025.105187","DOIUrl":"10.1016/j.ijnurstu.2025.105187","url":null,"abstract":"<div><h3>Background</h3><div>In aged care facilities, medications are typically administered to older adults by authorized aged care workers. Medication dose omissions may occur during this process, where a prescribed dose is not administered before the next scheduled dose time. Published research on medication dose omissions almost exclusively focuses on hospital settings, with dose omissions described as mistakes or a form of administration error. There is very little empirical evidence about medication dose omissions in aged care facilities, how they occur, the medications omitted, and why.</div></div><div><h3>Aim</h3><div>The aim of this study was to characterize medication dose omissions in the context of Australian aged care facilities, outlining the prevalence of omissions, most commonly omitted medications, omission categories, timing of omissions, and reasons behind medication dose omissions.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted using de-identified secondary medication administration data from two national electronic medication chart providers, spanning from March 17th 2023 to March 18th 2024. All regular medication dose omission events over the timeframe were included. Data included resident demographics, aged care workers role permissions, and free-typed reasons and rationales aged care workers had recorded for each dose omission. Data were analyzed using descriptive statistics, independent sample t-tests, activity pattern analysis, and Spearman's correlation.</div></div><div><h3>Results</h3><div>In total, 12,438 residents lived in aged care facilities during the timeframe, across 287 aged care facilities. Residents experienced a median of one dose omission per 100 doses dispensed (IQR 0.45–2.66). Certified nursing staff were the primary recorders of omitted doses (60 %). The Anatomical Therapeutic Chemical classifications most omitted were alimentary tract and metabolism medications (one dose omission per 26.84 doses), and nervous system medications (one dose omission per 53.65 doses). The most omitted medications included forms of paracetamol, laxatives, and lubricating eye drops. In all, 56 % of medication omission records lacked corresponding details about the factors or decision-making that led to the omission.</div></div><div><h3>Conclusions</h3><div>Regular medications were omitted, but inconsistently recorded in Australian aged care facilities. Standardization and education around managing and recording omissions may improve resident-centric medication administration in aged care facilities, better support aged care workers' clinical decision-making, and help to inform more nuanced medication reviews.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105187"},"PeriodicalIF":7.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889320","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":"Emotions as social informational cues: A multi-source diary study explaining how nurses' perceptions of patients' relatives shape patients experiences of missed nursing care","authors":"Mirit Cohen ,&nbsp;Anat Drach-Zahavy ,&nbsp;Einav Srulovici","doi":"10.1016/j.ijnurstu.2025.105190","DOIUrl":"10.1016/j.ijnurstu.2025.105190","url":null,"abstract":"<div><h3>Background</h3><div>Patient-reported missed nursing care is a critical indicator of care quality, while existing research focuses on nurses' workload and resource constraints as primary triggers, the role of emotional and interpersonal factors during nurse–patient encounters remains underexplored.</div></div><div><h3>Objectives</h3><div>To examine how nurses' emotions and perceptions of patients' families jointly influence patient-reported missed nursing care, using the Emotions as Social Information (EASI) model.</div></div><div><h3>Design</h3><div>A multi-source, nested, diary study design.</div></div><div><h3>Setting</h3><div>The study was conducted in internal medicine, surgical, orthopedic, and geriatric wards across two public hospitals.</div></div><div><h3>Participants</h3><div>142 registered nurses and 638 patients formed 638 nurse–patient dyads.</div></div><div><h3>Methods</h3><div>Over 3–5 morning shifts, nurses completed surveys assessing their perceptions of families and emotions during specific encounters. Patients concurrently reported on missed nursing care. Mixed linear models analyzed the nested data.</div></div><div><h3>Results</h3><div>Significant interaction emerged: (1) High positive emotions combined with perceiving families as a resource increased missed care (β = 0.028, p &lt; 0.05); (2) High negative emotions combined with perceiving families as a burden increased missed care (β = 0.086, p &lt; 0.05); and (3) High negative emotions combined with viewing families as their own resource decreased missed care (β = −<!--> <!-->0.235, p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>This study introduces the emotions as social information model to healthcare, revealing how nurses' emotions and perceptions of families jointly shape patient-reported missed care. Findings underscore the need for healthcare organizations to support nurses in managing their emotions and optimizing family involvement to enhance care delivery and patient satisfaction.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105190"},"PeriodicalIF":7.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004125","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":"Identifying risk prediction models and predictors for hospital readmission in patients with medical conditions: A systematic review and meta-analysis","authors":"Nanna Selmer ,&nbsp;Connie Berthelsen ,&nbsp;Bastiaan Van Grootven ,&nbsp;Gabriele Meyer ,&nbsp;Mia Ingerslev Loft","doi":"10.1016/j.ijnurstu.2025.105188","DOIUrl":"10.1016/j.ijnurstu.2025.105188","url":null,"abstract":"<div><h3>Background</h3><div>Hospital readmission is a frequent adverse outcome among patients with medical conditions, with approximately 20% being readmitted within 30 days of discharge. However, the factors that significantly influence early readmission remain poorly understood, and it is unclear how to comprehensively evaluate predictors to identify patients at higher risk of readmission effectively.</div></div><div><h3>Objective</h3><div>To identify internally validated prediction models for all-cause readmission within 28-31 days of patients with medical conditions and to summarize the types of candidate and final predictors as well as the predictive performance of the models.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of observational studies.</div></div><div><h3>Methods</h3><div>Electronic databases (CINAHL, MEDLINE, and EMBASE) were searched until January 2024, along with the reference lists on the included studies from the search. Data from the included studies were extracted using the CHARMS checklist for prediction models. The PROBAST toll for prediction models assessed the risk of bias and applicability.</div></div><div><h3>Results</h3><div>24,322 studies were retrieved, and after the selection process, 16 prediction studies were included in the review. 12 of the studies were retrospective cohorts and exclusively used administrative data. The most commonly reported predictors with a significant impact on 28-31 day readmissions are age, higher Charlson index score, congestive heart failure, chronic obstructive lung disease, chronic renal insufficiency, arrhythmia and atrial fibrillation, length of stay, emergency department visits within six months, number of admissions last year, cancer and oncology services, polypharmacy, low sodium level, low hemoglobin level, and lower albumin level. Most studies had a high risk of bias, primarily in the analysis domain. 13 models reported the AUC, and the pooled AUC value was 0.71 (0.68, 0.74), indicating a moderate performance.</div></div><div><h3>Conclusion</h3><div>Although most of the included studies demonstrated moderate to good discrimination, many models exhibited a high overall risk of bias. Assessing key predictors can be challenging, as they are often not routinely captured in administrative data.</div></div><div><h3>Registration</h3><div>The protocol was registered in Open Science Framework (OSF) on March 2024 (<span><span>doi.org/10.17605/OSF.IO/PDSH5</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105188"},"PeriodicalIF":7.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887469","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 “The relationship between specialty nurse certification and patient, nurse and organizational outcomes: A systematic review” [Int. J. Nurs. Stud. 93 (2019) 1–11]","authors":"Lisa Whitehead,&nbsp;Manonita Ghosh,&nbsp;Deborah Kirk Walker,&nbsp;Dianne Bloxsome,&nbsp;Caroline Vafeas,&nbsp;Anne Wilkinson","doi":"10.1016/j.ijnurstu.2025.105184","DOIUrl":"10.1016/j.ijnurstu.2025.105184","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105184"},"PeriodicalIF":7.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810263","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":"Nonpharmacological interventions for childbirth-related post-traumatic stress disorder and accompanying symptoms: A network meta-analysis of randomized controlled trials","authors":"Ming Jun Wen ,&nbsp;Jin Hui Li ,&nbsp;Zhong Fan Peng ,&nbsp;Gong Chen ,&nbsp;Jing Ling Li ,&nbsp;Li Cheng ,&nbsp;Jun Yan Li ,&nbsp;Tao Tao Zhang ,&nbsp;Xiao Fei Nie","doi":"10.1016/j.ijnurstu.2025.105186","DOIUrl":"10.1016/j.ijnurstu.2025.105186","url":null,"abstract":"<div><h3>Background</h3><div>Childbirth-related post-traumatic stress disorder (CB-PTSD) often coexists with depression and anxiety, but there's a lack of tailored, comparative non-pharmacological treatments.</div></div><div><h3>Objective</h3><div>This study investigated the efficacy of non-pharmacological interventions in the prevention and alleviation of symptoms associated with CB-PTSD and its accompanying symptoms.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including PubMed, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang, and China Biology Medicine, up to September 2024. The study included all randomized controlled trials (RCTs) that reported on non-pharmacological interventions for CB-PTSD. Two reviewers independently extracted data, assessed the risk of bias, evaluated the quality of the evidence, and conducted the sub-group analysis and meta-regression. The effectiveness of the intervention strategies was analyzed using a network meta-analysis, with the primary outcome being childbirth-related PTSD and its associated symptoms. The protocol of this study was registered on PROSPERO (ID: CRD42024588020).</div></div><div><h3>Results</h3><div>This study included a total of 42 RCTs, encompassing 18 distinct intervention types, categorized into three prevention levels: primary prevention during pregnancy (n = 5), aimed at eliminating or mitigating risk factors for CB-PTSD; secondary prevention (n = 26), targeting the reduction of CB-PTSD symptoms following a traumatic birth; and tertiary prevention (n = 11), focusing on the management of women already diagnosed with CB-PTSD.</div><div>Comprehensive analysis revealed that in the primary prevention stage, the Birth plan intervention was most effective in reducing CB-PTSD symptom scores compared to conventional postpartum care, while Nurse-led peer support was most effective in reducing depression symptom scores. In the secondary prevention stage, Couples' self-disclosure intervention showed superior efficacy in alleviating CB-PTSD symptoms, and Counseling was most effective for depression and anxiety. At the tertiary prevention stage, Counseling emerged as the most effective intervention for managing CB-PTSD symptoms, whereas Expressive Writing was most effective for depression and anxiety compared to conventional postpartum care.</div></div><div><h3>Conclusions</h3><div>Non-pharmacological interventions represent a crucial and viable approach for alleviating the symptoms of CB-PTSD. It is imperative to select appropriate and efficacious intervention measures for women during the tertiary prevention phase. Future research can further explore the underlying psychopathology, and relevant clinical guidelines on perinatal mental health may also serve as a valuable reference.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105186"},"PeriodicalIF":7.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842507","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 relationship between different missed care activities and patient outcomes: A systematic review","authors":"Wenqi He ,&nbsp;Hua Yuan ,&nbsp;Wei Luo ,&nbsp;Meixue Hou ,&nbsp;Meiyan Liu ,&nbsp;Hui Xue ,&nbsp;Xiuying Zhang","doi":"10.1016/j.ijnurstu.2025.105183","DOIUrl":"10.1016/j.ijnurstu.2025.105183","url":null,"abstract":"<div><h3>Background</h3><div>Missed care is a key indicator of nursing quality and has been linked to negative patient outcomes. However, the rates of missed care vary across different nursing activities. Treating missed care as a composite indicator may lack specificity in relation to patient outcomes.</div></div><div><h3>Objective</h3><div>This review aims to explore the relationship between different missed care activities and patient outcomes.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Scopus, Web of Science, and CINAHL databases for relevant studies published up to November 2024. Studies examining the relationship between missed care activities and patient outcomes were included. The risk of bias was evaluated using the NICE public health review guidelines, and the PRISMA guidelines were followed in reporting this review. The review protocol was registered on PROSPERO (CRD42024618442).</div></div><div><h3>Results</h3><div>After screening, 17 articles were included. Most studies were cross-sectional, relying on nurse or patient self-reporting to assess missed care. This review found that different types of missed care activities were related to various patient outcomes. The main findings were as follows: 1) missed clinical care activities were closely linked to patient safety outcomes. Specifically, omissions in patient monitoring, basic care, treatment and symptom management were significantly associated with adverse events such as falls, readmissions, mortality, urinary tract infections, and bloodstream infections; 2) missed communication and basic care were strongly associated with reduced patient satisfaction; 3) additionally, specific patient outcomes, such as time to achieve full oral feeding and length of hospital stay, were also associated with missed clinical care activities.</div></div><div><h3>Conclusion</h3><div>Although high-quality evidence remains limited, it is clear that different missed care activities are linked to varying patient outcomes, suggesting that their effects on the patient outcomes differ across activities. Future research should focus on developing targeted intervention strategies to reduce missed care activities that are closely linked to patient outcomes.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105183"},"PeriodicalIF":7.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887470","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 global landscape of the evolving nurses' roles and core competency in primary healthcare: An expanding umbrella review","authors":"Doris Sau Fung Yu ,&nbsp;Feng Chen ,&nbsp;An-Ran Li ,&nbsp;Cathy Wai Ying Wong ,&nbsp;Jinghe Chen ,&nbsp;Shiyin Zhan ,&nbsp;Sally Wai Chi Chan ,&nbsp;Eleanor Holroyd ,&nbsp;Sek Ying Chair ,&nbsp;Chan Yuk Sim ,&nbsp;William Chi Wai Wong","doi":"10.1016/j.ijnurstu.2025.105177","DOIUrl":"10.1016/j.ijnurstu.2025.105177","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;A transformative primary healthcare system that delivers effective, efficient and equitable care services is imperative to tackle the ever-emerging challenges to population health such as the surging major lifestyle risks, mental health issues, the burden of chronic care and novel infectious diseases. Nurses, as one of the major service stakeholders in this global agenda, needs to proactively seek role advancement and competency development in primary healthcare. This process can be facilitated by seeking a comprehensive understanding of the global landscape of nurses' roles and competencies in primary healthcare.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To identify nurses' roles and competencies in PHC from a global perspective, and to explore how different nurses' roles evolve in different healthcare systems over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Umbrella review.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A comprehensive search was conducted in nine databases from 1980 to April 2, 2025. We included all types of review papers published in English or Chinese, with the aim of exploring the changing roles of nurses in PHC. Two reviewers independently screened search records, conducted quality appraisals, and extracted data from the included reviews. An integrative framework of core competencies for primary care nurses was developed, based on the prescriptions of different health authorities from around the world, to guide the synthesis of data on nurses' roles in PHC. Data extraction and integration from the original studies in each review were performed to identify role differentiation among nurses of different ranks. Stacked area charts were created to visualize the evolvement of nurses' role in PHC over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 54 reviews published over two decades were identified. The nurses' roles covered eight domains: professional practice, case management, communication and collaboration, health promotion and education, legal, ethical and safety, professional development and research, leadership, and administrative actions. Over the decades, nurses' roles have expanded from conducting primary care practice to engaging in research, interdisciplinary communication, and quality assurance, with landmark years for such changes identified. Role differentiation across nursing ranks was noted, with advanced practice nurses (APN) more engaged in professional development, research, and leadership functions. A dearth of research conducted in low- and middle-income countries was observed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This expanding umbrella review delineates the scope and evolvement of nurses' roles in primary healthcare from a global perspective. The findings provided important insights to inform the advancement of nurses' competency frameworks, advanced role specialization, pre-registration nursing education in primary healthcare.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Systematic review registration&lt;","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105177"},"PeriodicalIF":7.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889321","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":"Optimizing a complex intervention for community-dwelling frail older adults: A factorial randomized trial within the multiphase optimization strategy framework","authors":"Xuemei Sun ,&nbsp;Yinyan Gao ,&nbsp;Jinlu Song ,&nbsp;Wenqi Liu ,&nbsp;Linqi Li ,&nbsp;Hui Sun ,&nbsp;Weiru Zhang ,&nbsp;Irene X.Y. Wu","doi":"10.1016/j.ijnurstu.2025.105181","DOIUrl":"10.1016/j.ijnurstu.2025.105181","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of resistance exercise in improving frailty among community-dwelling frail older adults has been well-proved. However, poor adherence has threatened its effectiveness.</div></div><div><h3>Objective</h3><div>To optimize a previously developed complex intervention to enhance its efficiency and disseminability.</div></div><div><h3>Design</h3><div>2 × 2 × 2 full factorial randomized trial.</div></div><div><h3>Settings</h3><div>This study was conducted at five community health service centers in Hunan Province, China.</div></div><div><h3>Participants</h3><div>A total of 114 pre-frail or frail community-dwelling older adults.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to one of eight intervention groups (corresponding to all possible combinations of the three implementation components of goal setting, feedback and reinforcement guidance) to receive a 12-week intervention, with all receiving the core intervention (group elastic-band resistance exercise and community education). Outcomes were measured at baseline, 6 weeks, and 12 weeks. Primary outcomes included frailty and resistance exercise adherence. Mean difference (MD) and 95 % confidence interval (CI) were calculated to estimate effectiveness using a linear mixed-effects model. Intervention costs were assessed from the viewpoint of service providers (community organizations and research teams).</div></div><div><h3>Results</h3><div>The goal-setting on group exhibited statistical significance in improving frailty (week 6: MD: −<!--> <!-->0.25, 95 % CI: −<!--> <!-->0.47 to −<!--> <!-->0.02) and resistance exercises adherence (week 6: MD: 6.37, 95 % CI: 2.40 to 10.30; week 12: MD: 6.42, 95 % CI: 2.45 to 10.40). No statistically significant differences were found among the other implementation component groups. Compared to other implementation components, goal setting demonstrated superior implementation. The total intervention cost was 41,072.00 Chinese yuan, among which the goal-setting was 4560.00 Chinese yuan.</div></div><div><h3>Conclusion</h3><div>The optimized intervention identified in this study, which combines group elastic-band resistance exercise with community-based education and goal-setting, is expected to facilitate the delivery of an efficient, effective, and disseminable intervention for frail older adults in community settings.</div></div><div><h3>Registration</h3><div><span><span>chictr.org.cn</span><svg><path></path></svg></span> (No. ChiCTR2300070392). Registration date: 11 April, 2023. First recruitment date: 21 April, 2023.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105181"},"PeriodicalIF":7.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842506","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":"Identifying decision-making biases in self-care behaviours among patients with type 2 diabetes mellitus: A qualitative study from a behavioural economics perspective","authors":"Fanghong Yan ,&nbsp;Guotian Peng ,&nbsp;Ruiyi Sun ,&nbsp;Yanan Zhang ,&nbsp;Pengyu Qiao ,&nbsp;Meimei Liu ,&nbsp;Yuxia Ma ,&nbsp;Lin Han","doi":"10.1016/j.ijnurstu.2025.105182","DOIUrl":"10.1016/j.ijnurstu.2025.105182","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 2 diabetes mellitus often make self-care behaviour decisions according to their immediate needs and desires in the real world. Deviations from optimal choices in seeking satisfying options are known as decision-making biases, which are not obvious in the self-care behaviours of patients with type 2 diabetes mellitus. Qualitative research can provide insights into patients' descriptions of and experiences in self-care, aiding in systematically identifying decision-making biases.</div></div><div><h3>Objective</h3><div>To identify the decision-making biases of patients with type 2 diabetes mellitus from their descriptions of and experiences in self-care to guide targeted strategies for supplementing existing intervention paradigms.</div></div><div><h3>Design</h3><div>Qualitative, descriptive design.</div></div><div><h3>Participants</h3><div>We used purposive sampling to recruit 18 participants with type 2 diabetes mellitus at the endocrinology outpatient unit of a large urban general hospital in Lanzhou, China, between July and September 2023.</div></div><div><h3>Methods</h3><div>We conducted individual, semi-structured interviews to identify decision-making biases of self-care behaviours from the behavioural economics perspective. The interviews were transcribed verbatim, and the thematic analysis approach was utilized to code the transcribed data and identify themes.</div></div><div><h3>Results</h3><div>We found that patients with type 2 diabetes mellitus showed emotion-driven and short-term-oriented decision-making biases regarding self-maintenance. Self-monitoring decisions tend to be personal experiences and based on individual perceptions. Self-management decisions depend heavily on accessibility to and sources of information.</div></div><div><h3>Conclusions</h3><div>Decision-making biases clearly impact the self-care behaviours of patients with type 2 diabetes mellitus. We identified 10 decision-making biases related to self-care behaviour maintenance, monitoring, and management, suggesting that future research can leverage these biases to improve the health-related behaviours of patients with type 2 diabetes mellitus.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"171 ","pages":"Article 105182"},"PeriodicalIF":7.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889319","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}