Applied Nursing Research最新文献

{"title":"Development of an evaluation index system for assessing the information support effect on patients with breast cancer undergoing radiotherapy","authors":"Xiaocen Chen ,&nbsp;Zhao Wang ,&nbsp;Huiying Liu ,&nbsp;Fang Zhang ,&nbsp;Yixuan Liu ,&nbsp;Xiaotong Yang","doi":"10.1016/j.apnr.2026.152049","DOIUrl":"10.1016/j.apnr.2026.152049","url":null,"abstract":"<div><h3>Introduction</h3><div>Delivering comprehensive information support is essential for the successful completion of radiotherapy in breast cancer patients. The absence of a standardized tool to evaluate the effectiveness of this support currently limits the precision of clinical interventions.</div></div><div><h3>Objective</h3><div>This study aimed to develop a comprehensive indicator system for evaluating the efficacy of information support provided to breast cancer patients undergoing radiotherapy.</div></div><div><h3>Methods</h3><div>Guided by the Knowledge-Attitude-Practice (KAP) model, a multi-disciplinary team conducted this study from March to August 2024. A mixed-methods approach was adopted. First, a preliminary item pool was developed through a literature review and semi-structured interviews. The items were subsequently screened and refined via a two-round Delphi expert consultation. Finally, the Analytic Hierarchy Process (AHP) was used to determine the weight of each indicator.</div></div><div><h3>Results</h3><div>The effective response rates for the two Delphi rounds were 88.9% and 100%, with authoritative coefficients of 0.932 and 0.943, respectively. Kendall's W coefficients for all tiers of indicators ranged from 0.244 to 0.365 in the first round and 0.313 to 0.459 in the second round (all <em>P</em> &lt; 0.01), demonstrating a high degree of expert consensus and authority. The final evaluation system comprises 3 first-level, 14 second-level, and 51 third-level indicators. These indicators are organized into three core dimensions: Health Knowledge (e.g., radiotherapy basics, medication, complication management), Health Attitude (e.g., perception, health motivation), and Health Practice (e.g., symptom management, nutritional management, treatment adherence), systematically capturing the patient's progression from knowledge acquisition to belief internalization and behavioral change.</div></div><div><h3>Conclusion</h3><div>The developed indicator system is scientifically sound and practical. It provides a valuable tool for clinicians to systematically assess the effectiveness of information support and to formulate personalized health guidance plans for breast cancer patients receiving radiotherapy.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"88 ","pages":"Article 152049"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146006586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical care nurses are interested in participating in research but more needs to be done to prepare them: a systematic review","authors":"JoAnne McIntyre ,&nbsp;Anne Mette Adams ,&nbsp;Xia Jin ,&nbsp;Frances Lin","doi":"10.1016/j.apnr.2025.152031","DOIUrl":"10.1016/j.apnr.2025.152031","url":null,"abstract":"<div><h3>Background</h3><div>Clinical research is vital in critical care settings to support evidence-based care for critically ill patients. However, critical care nurses' knowledge, attitudes, and experiences with research remain underexplored. Given that nurses' attitudes may influence the quality and rigour of research, understanding these perspectives is essential.</div></div><div><h3>Aim</h3><div>To review the literature describing critical care nurses' knowledge, attitudes, and experiences with clinical research conducted in critical care units.</div></div><div><h3>Design</h3><div>This is a narrative systematic review.</div></div><div><h3>Methods</h3><div>This mixed-methods systematic review followed the Joanna Briggs Institute methodology. Seven databases were searched. Studies were restricted to full text in English between January 2000 and March 2025. Methodological quality was assessed using the Mixed Methods Appraisal Tool version 2018. Results were synthesised narratively.</div></div><div><h3>Results</h3><div>Of 1038 records, 11 studies met inclusion criteria, covering 31 adult ICUs (<em>n</em> = 1075) and 19 paediatric/neonatal ICUs (<em>n</em> = 1428). Methodological quality varied; only three studies met all criteria, with common limitations in measurement tools and sample representativeness. Five key themes emerged: (1) positive attitudes to research, (2) inconsistent research involvement, (3) variable research education and capability, (4) insufficient research communication and dissemination, and (5) barriers and facilitators to research engagement.</div></div><div><h3>Conclusions</h3><div>Critical care nurses valued clinical research, but engagement was limited by workload, research education, communication challenges, and institutional constraints. While many critical care nurses cared for patients enrolled in trials, fewer were involved in study design or dissemination.</div></div><div><h3>Registration</h3><div>PROSPERO Registration Number CRD42024541761.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152031"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers affecting evidence-based practice among nurses in Saudi Arabia: A systematic review","authors":"Dr. Naif S. Alzahrani PhD, MSN, RN, CNL ,&nbsp;Dr. Abdulaziz Mofdy Almarwani PhD, RN","doi":"10.1016/j.apnr.2025.152029","DOIUrl":"10.1016/j.apnr.2025.152029","url":null,"abstract":"<div><h3>Aim</h3><div>To synthesize and analyze the literature on evidence-based practice among nurses, with a specific focus on assessing the factors influencing the application of EBP among nurses.</div></div><div><h3>Background</h3><div>Evidence-based practice has gained prominence as a cornerstone in nursing, emphasizing the integration of clinical expertise, patient values, and the most current research evidence to inform decision-making. As crucial healthcare team members, nurses play a pivotal role in implementing EBP to ensure that the latest research findings and best available evidence inform their practice.</div></div><div><h3>Design</h3><div>This was a systematic review study.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted to identify quantitative studies published between 2000 and 2024. Studies were included if they focused on clinical nurses practicing in Saudi Arabia and examined factors influencing EBP. The Joanna Briggs Institute (JBI) Critical Appraisal Tools were used to assess methodological quality. Data were extracted, summarized in a standardized table, and analyzed thematically. We conducted the review on 11 eligible studies that met all inclusion criteria.</div></div><div><h3>Results</h3><div>The findings of this systematic review provide valuable insights into the facilitators and barriers to utilizing evidence-based practice (EBP) among nurses in Saudi Arabia. The review encompassed a total of 2725 participants across eleven studies, including two quantitative correlational design studies, two pre-experimental pilot studies, and seven cross-sectional design studies. Facilitators included organizational factors, including allocation of resources, increased support, and adequate time provision. On the personal factor, nurses' skills are enhanced through continuous training and promoting research utilization. Conversely, barriers included organizational barriers like time constraints, limited authority, resistance from administration, and inadequate facilities. Personal factors include a lack of education on EBP and difficulty understanding research reports. Communication barriers involve a scarcity of readily available research and insufficient physician cooperation. The innovation domain introduces uncertainties about the believability and justification of research conclusions. Additionally, lack of EBP mentors and role models.</div></div><div><h3>Conclusions</h3><div>Addressing these barriers and facilitators is crucial for fostering a supportive environment, empowering nurses, and advancing evidence-based practices. This review provides a foundational understanding, prompting targeted initiatives and ongoing research to fortify the integration of evidence-based approaches in nursing care within Saudi Arabia.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152029"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of organizational culture on nursing perception of quality of healthcare services and intent to stay among nurses employed in public hospitals: A cross-sectional study","authors":"Ahmad Rayan RN, PhD (Associate Professor, Dean) ,&nbsp;Ibtihal Al-Jaafreh MSN ,&nbsp;Manal Hassan Baqeas RN, PhD ,&nbsp;Fadwa Alhalaiqa ,&nbsp;Suhair Al-Ghabeesh RN, MsN, PhD (Prof) ,&nbsp;Hanan Alyami RN, MSN, PhD (Assistant Professor)","doi":"10.1016/j.apnr.2025.152042","DOIUrl":"10.1016/j.apnr.2025.152042","url":null,"abstract":"<div><h3>Background</h3><div>Organizational culture significantly shapes nurses' perceptions of healthcare quality and their intention to stay, yet its specific impact on these outcomes remains underexplored in Jordanian public hospitals, where retention and healthcare quality challenges persist.</div></div><div><h3>Aim</h3><div>This study aims to investigate the influence of organizational culture on nurses' perceptions of healthcare service quality and their intention to stay in Jordanian public hospitals.</div></div><div><h3>Methods</h3><div>A descriptive correlational design was applied. Validated scales of organization culture, quality of healthcare, and intention to stay were used to gather data on 131 nurses in a large governmental hospital in Jordan. It was analyzed by the use of descriptive statistics, <em>t-</em>tests, ANOVA, Pearson correlation, and multiple linear regression.</div></div><div><h3>Results</h3><div>The sample was predominantly female (64.9 %), married (63.4 %), aged 21–30 years (47.3 %), and held bachelor's degrees (78.7 %). Organizational culture subscale scores ranged moderately high, reflecting a positive culture perception. Nurses generally perceived healthcare service quality favorably. Male gender was significantly associated with higher intention to stay, and greater nursing experience correlated with better perceived care quality. All four organizational culture types (Clan, Hierarchy, Adhocracy, Market) showed strong positive correlations with perception of healthcare quality but no significant correlations with intention to stay.</div></div><div><h3>Conclusions</h3><div>The findings underscore the crucial role of organizational culture in shaping perceptions of care quality but suggest that nurses' retention decisions may depend on other factors. Hospital administration should strengthen organizational culture to enhance care quality while addressing broader workforce needs to improve retention.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152042"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed nursing care in surgical units: A cross-sectional study on prevalence, causes, and influencing factors","authors":"Susanne Ahlstedt Karlsson ,&nbsp;Elin Svenningsson ,&nbsp;Hanna Järbrink ,&nbsp;Ingela Thylén ,&nbsp;My Engström","doi":"10.1016/j.apnr.2025.152041","DOIUrl":"10.1016/j.apnr.2025.152041","url":null,"abstract":"<div><h3>Background</h3><div>Missed nursing care (MNC) is defined as any aspect of patient care that is either omitted (in part or in whole) or delayed. Consequently, the potential risks associated with MNC represent a significant threat to patient safety. Identifying MNC is essential for enhancing patient safety, the quality of care, and the overall efficiency of the healthcare system.</div></div><div><h3>Aim(s)</h3><div>To investigate the type, prevalence, and reasons for MNC within a surgical context, and to investigate associations between MNC, work-related factors, and individual characteristics of the nursing staff.</div></div><div><h3>Methods</h3><div>A cross-sectional design was employed. Data were collected online from November to December 2024 using the MISSCARE survey – Swedish Version 2.0. Registered nurses (RNs) and nurse assistants (NAs) from three surgical units at one Swedish university hospital participated (<em>n</em> = 84).</div></div><div><h3>Results</h3><div>Most MNC involved basic care and individual needs, with the most frequently missed items being ambulation (78.0 %), mouth care (77.1 %), and turning (73.5 %). The main reason for MNC was lack of labor resources (59.7 %). Over three-quarters of the respondents reported inadequate staffing, interruptions/multitasking, and unexpected increases in patient volume or acuity as significant reasons. Analysis of associated factors indicated that reported MNC and contributing factors may vary according to professional role, work experience, and unit type as less experienced nurses reported higher MNC rates in an acute setting.</div></div><div><h3>Conclusion</h3><div>MNC frequently occurs in surgical units, and is particularly reported in acute care. The discrepancy between nursing staff levels and patient acuity forces the prioritization of essential nursing tasks.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152041"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a nurse-managed alcohol withdrawal syndrome pathway: A symptom-triggered protocol study","authors":"Megan Burnette ,&nbsp;Amy Cooley ,&nbsp;Mary Mills ,&nbsp;Meredith Lucas ,&nbsp;Olawunmi Obisesan","doi":"10.1016/j.apnr.2025.152047","DOIUrl":"10.1016/j.apnr.2025.152047","url":null,"abstract":"<div><h3>Aim</h3><div>This retrospective, single-center nursing research study evaluates the effectiveness of a standardized, stepwise, nurse-managed protocol for Alcohol Withdrawal Syndrome (AWS). The primary objective was to determine how nursing process measures—specifically Time to First AWS Assessment—associate with inpatient Length of Stay (LOS).</div></div><div><h3>Background</h3><div>AWS significantly affects resource utilization. While symptom-triggered protocols are standard, empirical evidence is needed regarding nurse-managed models that grant autonomy in medication titration.</div></div><div><h3>Methods</h3><div>We analyzed 419 patients managed under a nurse-managed Lorazepam protocol. Predictors of LOS were evaluated via hierarchical multiple regression, controlling for demographics and baseline severity.</div></div><div><h3>Results</h3><div>Participants had an average age of 54.03 years (±14.98), with 72.3 % identifying as male and 83.8 % as White. The median time from admission to the first AWS assessment was 7 hours. The percentage of patients with moderate to severe withdrawal symptoms decreased from 48.3 % at the first AWS assessment to 21.7 % at the last evaluation. Hierarchical regression confirmed that Time to First AWS Assessment was a significant independent predictor of LOS (<em>p</em> &lt; 0.05, 95 % CI [0.025, 0.125]), with every minute of delay associated with a proportional increase in stay duration.</div></div><div><h3>Conclusions</h3><div>Formalizing nurse autonomy through structured protocols improves clinical efficiency. While limited by its single-center design, the study suggests that early nursing intervention is a critical driver of reduced LOS.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152047"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network modeling of the relationship between intestinal symptoms and depression: A cross-sectional study using NHANES data","authors":"Qian Ye ,&nbsp;Ying Liu","doi":"10.1016/j.apnr.2025.152028","DOIUrl":"10.1016/j.apnr.2025.152028","url":null,"abstract":"<div><h3>Objective</h3><div>The “brain-gut axis” theory highlights the link between depression and gastrointestinal symptoms, garnering increasing attention. This research aims to apply a network analysis model to identify key symptoms and their relationships in both depression and gastrointestinal disorders. The goal is to aid nursing staff in implementing targeted interventions and personalized care.</div></div><div><h3>Methods</h3><div>Data were collected from the NHANES 2009–2010 cycle, involving 5196 participants. We assessed symptom scores and clinical information using the depression screening questionnaire (DPQ) and the bowel health questionnaire (BHQ). R package bootnet was used to create a regularized partial correlation network to explore the relationship between depression and gastrointestinal symptoms. To ensure stability and accuracy, we conducted Bootstrap analysis and applied a residual-based method to account for confounding factors in the symptom network.</div></div><div><h3>Result</h3><div>The network analysis shows that “hopelessness” is the key node in the cluster of depressive symptoms, while among gastrointestinal symptoms, “constipation” demonstrated the highest centrality score, indicating its prominence within the symptom network. Additionally, “fatigue” is closely related to both “diarrhea” and “constipation,” and “sleep problems” are notably linked to constipation. Overall, the network model exhibits strong stability.</div></div><div><h3>Conclusion</h3><div>The study identified “fatigue” and “sleep problems” as key connections between depression and gastrointestinal symptoms. This finding suggests a potential avenue for clinical intervention: for patients experiencing diarrhea and constipation, enhancing sleep quality and reducing fatigue may help improve these intestinal issues. By addressing sleep and fatigue, we could potentially break the vicious cycle of psychosomatic symptoms that links depression with gastrointestinal problems.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152028"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for adverse clinical outcomes in elderly patients with heart failure and cognitive frailty","authors":"Marta Wleklik ,&nbsp;Dorota Diakowska ,&nbsp;Christopher S. Lee ,&nbsp;Ercole Vellone ,&nbsp;Magdalena Lisiak ,&nbsp;Remigiusz Szczepanowski ,&nbsp;Heba M. Aldossary ,&nbsp;Maria Jędrzejczyk ,&nbsp;Izabella Uchmanowicz","doi":"10.1016/j.apnr.2025.152043","DOIUrl":"10.1016/j.apnr.2025.152043","url":null,"abstract":"<div><h3>Aims</h3><div>Cognitive frailty, defined as the coexistence of frailty and cognitive impairment, poses</div><div>a dual burden in elderly heart failure (HF) patients. Its impact on clinical outcomes, particularly hospitalization duration, rehospitalization, and survival, remains unclear. This study examines the relationship between frailty, cognitive impairment, and cognitive frailty with adverse clinical outcomes over 12 months.</div></div><div><h3>Methods and results</h3><div>A prospective cohort study included 250 elderly HF patients (mean age 72.32 ± 6.73 years), categorized into four groups: non-frailty/non-cognitive impairment (non-CI), frailty/non-CI, non-frailty/CI, and cognitive frailty. Baseline assessments included clinical, laboratory, and psychological evaluations. Outcomes measured were hospitalization length (&gt;6 days), rehospitalization, and survival. Patients with cognitive frailty had significantly longer hospital stays (<em>p</em> &lt; 0.0001). Elevated NT-proBNP levels were the sole predictor of prolonged hospitalization in this group (HR: 0.99, <em>p</em> = 0.048). In frail patients without CI, NT-proBNP was also a predictor (HR: 0.99, <em>p</em> = 0.004), along with lower BMI (HR: 0.88, <em>p</em> &lt; 0.001), higher creatinine (HR: 3.42, <em>p</em> = 0.042), lower haemoglobin (HR: 1.41, <em>p</em> = 0.008), and anxiety levels (HR: 0.031, <em>p</em> = 0.005). No significant differences in rehospitalization or survival rates were observed among groups.</div></div><div><h3>Conclusion</h3><div>Cognitive frailty was associated with prolonged hospitalization among older patients with heart failure. Early identification and comprehensive care planning may help guide management and support this high-risk group.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152043"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a nurse-led, triangle-based hierarchical management model on patients undergoing maintenance hemodialysis: A randomized controlled trial","authors":"Fei Zha ,&nbsp;Liqiong Tang ,&nbsp;Wenwen Li ,&nbsp;Jianming Shen ,&nbsp;Yanyan Deng","doi":"10.1016/j.apnr.2025.152045","DOIUrl":"10.1016/j.apnr.2025.152045","url":null,"abstract":"<div><h3>Background</h3><div>Maintenance hemodialysis (MHD) imposes a high disease burden, leading to diminished quality of life (QoL) and poor treatment adherence. Conventional nursing often lacks individualized, risk-stratified strategies. This study aimed to evaluate the effectiveness of a nurse-led, Triangle-Based Hierarchical Management model on patient outcomes.</div></div><div><h3>Methods</h3><div>In this prospective, single-center, cluster-randomized trial, 80 MHD patients were assigned to an observation group (<em>n</em> = 40) receiving the 24-week Triangle model intervention or a control group (n = 40) receiving routine care. The primary outcome was the change in Kidney Disease Quality of Life-Short Form (KDQOL-SF™) KDTA score. Secondary outcomes included self-management, adherence, knowledge, and hospitalization rates. Intention-to-treat analysis was performed using ANCOVA.</div></div><div><h3>Results</h3><div>Seventy-one patients completed the study. The observation group demonstrated significantly greater improvement in the primary KDTA score compared to controls (mean difference: 7.59; 95 % CI: 3.54 to 11.64; <em>P</em> &lt; 0.001). Significant improvements were also observed in self-management (mean difference: 6.63; 95 % CI: 3.10 to 10.16; <em>P</em> &lt; 0.001) and treatment adherence (mean difference: 10.09; 95 % CI: 5.61 to 14.57; P &lt; 0.001). Furthermore, the hospitalization rate was significantly lower in the observation group (11.1 % vs. 28.6 %; <em>P</em> = 0.048).</div></div><div><h3>Conclusion</h3><div>The nurse-led Triangle Hierarchical Management model significantly improved quality of life, self-management, and adherence, while reducing hospitalizations in MHD patients. These findings support the adoption of risk-stratified nursing models in chronic disease management.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152045"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and practices of surgical nurses in perioperative hypothermia management: Implications for surgical patient safety and outcomes","authors":"Derya Gezer ,&nbsp;Hamide Şişman ,&nbsp;Şeyma Yurtseven","doi":"10.1016/j.apnr.2025.152027","DOIUrl":"10.1016/j.apnr.2025.152027","url":null,"abstract":"<div><h3>Background</h3><div>Perioperative hypothermia is a common yet preventable condition in surgical patients and is associated with serious adverse outcomes, including increased bleeding, surgical site infections, cardiac events, and prolonged hospital stays. Effective hypothermia prevention is a critical indicator of surgical patient safety. This study examines the knowledge and practices of surgical nurses in managing perioperative hypothermia, highlighting implications for evidence-based nursing care and patient safety.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional design was used, including 108 surgical nurses from a university hospital. Data were collected through face-to-face interviews using a structured questionnaire whose content validity was confirmed by experts and pilot tested.</div></div><div><h3>Results</h3><div>Among participants, 63.8 % had not received prior training on hypothermia management. Nurses without training had a mean knowledge score of 14.1 ± 3.8, significantly lower than those with prior training. The most commonly employed active warming method was the forced-air warming system (97.4 %), while the most common passive method was the use of socks (97.4 %). Knowledge levels were positively associated with education, professional position, and years of clinical experience, whereas age and length of service in surgical units showed a slight negative association. Furthermore, the number of warming methods used correlated positively with knowledge level.</div></div><div><h3>Conclusions</h3><div>Surgical nurses demonstrate a moderate level of knowledge regarding perioperative hypothermia management, with gaps particularly evident in thermal protection strategies for normothermic patients and the application of certain active warming methods. Findings underscore the importance of structured, continuous professional education to enhance nurses' competence and improve perioperative patient safety.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"87 ","pages":"Article 152027"},"PeriodicalIF":2.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}