Journal of Nursing Scholarship最新文献

{"title":"Workplace Discrimination and Career Plateauing Among Perioperative Nurses: A Multicenter Cross-Sectional Study of Parallel Indirect Associations","authors":"Jamshid Eslami, Bahareh Mahdood, Fatemeh Davodabadi, Amirali Alizadeh","doi":"10.1111/jnu.70136","DOIUrl":"10.1111/jnu.70136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Workplace discrimination has been associated with poorer psychological well-being and perceived constraints on professional development. However, little is known about its association with career plateauing among perioperative nurses or the potential roles of burnout and compassion satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A multicenter cross-sectional study examining parallel statistical indirect associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected from 342 perioperative nurses employed in 15 public/teaching and private hospitals across five geographical regions of Iran between January and April 2026. Participants completed measures of workplace discrimination, burnout, compassion satisfaction, and career plateauing. Associations were estimated using ordinary least-squares regression-based path analysis with 10,000 bootstrap resamples. Models were adjusted for age, gender, operating room experience, weekly working hours, number of monthly shifts, and 14 hospital indicator variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Workplace discrimination was positively associated with burnout and negatively associated with compassion satisfaction. Burnout was positively associated with career plateauing, whereas compassion satisfaction was negatively associated with career plateauing. The adjusted total association between workplace discrimination and career plateauing was significant (<i>B</i> = 0.082, 95% CI [0.054, 0.110], <i>p</i> < 0.001). The direct association remained significant after inclusion of burnout and compassion satisfaction (<i>B</i> = 0.035, 95% CI [0.011, 0.059], <i>p</i> = 0.004). Positive statistical indirect associations were observed involving burnout (effect = 0.031, 95% bootstrap CI [0.014, 0.049]) and compassion satisfaction (effect = 0.016, 95% bootstrap CI [0.004, 0.030]). The contrast between the two indirect estimates included zero (effect = 0.015, 95% bootstrap CI [−0.005, 0.035]). The final career plateauing model explained 46.8% of the variance (<i>R</i><sup>2</sup> = 0.468; adjusted <i>R</i><sup>2</sup> = 0.431).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Workplace discrimination was associated with greater career plateauing, with parallel statistical indirect associations involving higher burnout and lower compassion satisfaction. Because the data were cross-sectional, these <i>associations</i> should not be interpreted as temporal or causal mechanisms. Organizations could consider evaluating equitable career-development sy","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnet Recognition, Leadership Responsiveness, and Nurse Moral Distress: A Multilevel Mediation Analysis","authors":"Hyunmin Yu, Daniel McNeish, Celsea Tibbitt, Christin Iroegbu, Matthew D. McHugh","doi":"10.1111/jnu.70144","DOIUrl":"10.1111/jnu.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Moral distress is a pervasive challenge in nursing and has been associated with burnout, job dissatisfaction, and turnover. Although Magnet Recognition has been associated with more favorable nursing practice environments and nurse outcomes, little is known about the association between Magnet status and nurses' experiences of moral distress or the role of leadership responsiveness in this association. This study examined whether management responsiveness to patient care concerns accounted for part of the association between hospital Magnet status and nurse moral distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This was a cross-sectional observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the 2024 Penn Nurses4All Survey and the 2023 American Hospital Association Annual Survey were linked. The analytic sample included 18,678 direct care nurses from 1829 hospitals across 10 US states. The dependent variable was nurse moral distress, the independent variable was hospital Magnet status, and the mediator was nurse-reported management responsiveness to patient care concerns. A 2-1-1 multilevel mediation model using multilevel structural equation modeling was estimated to distinguish within- and between-hospital associations while accounting for the clustering of nurses within hospitals. Models adjusted for nurse- and hospital-level characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nurses in Magnet hospitals reported lower levels of moral distress and more favorable assessments of management responsiveness than nurses in non-Magnet hospitals. At the between-hospital level, Magnet status was associated with higher management responsiveness (unstandardized coefficient <i>b</i> = 0.18, 95% CI = 0.15 to 0.21, <i>p</i> < 0.001), and higher management responsiveness was associated with lower moral distress (<i>b</i> = −0.31, 95% CI = −0.39 to −0.23, <i>p</i> < 0.001). Greater management responsiveness was also associated with lower moral distress at the within-hospital level (<i>b</i> = −0.34, 95% CI = −0.35 to −0.33, <i>p</i> < 0.001). The direct between-hospital association between Magnet status and moral distress remained statistically significant after accounting for management responsiveness (<i>b</i> = −0.05, 95% CI = −0.08 to −0.01, <i>p</i> = 0.011). The between-hospital indirect association between Magnet status and moral distress involving management responsiveness was statistically significant (<i>b</i> = −0.06, Monte Carlo 95% CI = −0.08 to −0.04, <i>p</i> <","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Influencing Factors of Pain Crisis in Cancer Patients: A Systematic Review and Meta-Analysis","authors":"Fengjuan Wang,&nbsp;Huifen Tong,&nbsp;Limei Gao,&nbsp;Gantang Zhang","doi":"10.1111/jnu.70145","DOIUrl":"10.1111/jnu.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To systematically evaluate the incidence and influencing factors of pain crisis in cancer patients, providing evidence for targeted preventive interventions and optimized clinical nursing strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A systematic review and meta-analysis following PRISMA guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>PubMed, Cochrane Library, Web of Science, CINAHL, Embase, SinoMed, CNKI, Wanfang, and VIP were searched from inception to February 2026.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>Literature screening, quality assessment, and data extraction were performed independently by two researchers. Meta-analysis was conducted using RevMan 5.4. Heterogeneity was assessed using the <i>I</i>² statistic, and effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies involving 1865 cancer patients were included. The pooled incidence of pain crisis was 37%. Significant influencing factors included bone metastasis (OR = 3.91), radiotherapy and chemotherapy (OR = 3.23), social support (OR = 0.88), and age (OR = 0.92). Anxiety (mild OR = 8.00, moderate OR = 9.15, severe OR = 10.99) and depression (mild OR = 6.54, moderate OR = 6.46) were also significant predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of pain crisis in cancer patients is relatively high and is influenced by bone metastasis, chemoradiotherapy, social support, age, and emotional states. Nurses should dynamically assess risk, identify factors, and implement individualized interventions to prevent pain crisis and improve quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact</h3>\u0000 \u0000 <p>This meta-analysis provides robust evidence for identifying high-risk cancer patients for pain crisis. The findings underscore the need for integrating routine psychological assessment and tailored pain management strategies into clinical oncology nursing practice to reduce the occurrence of pain crises and enhance patient well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Not applicable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Multidisciplinary Non-Pharmacological Program to Improve Urinary Incontinence in an Intermediate Care Hospital","authors":"Susana Malgrat-Caballero,&nbsp;Maite Franco,&nbsp;Oriol Planesas-Pérez,&nbsp;Estefania Garbero Garcia,&nbsp;Eleonora Alexandrova,&nbsp;Maria Z. Techera,&nbsp;M. Perea-Garcia,&nbsp;Belen Sendra Criado,&nbsp;Aida Ribera","doi":"10.1111/jnu.70139","DOIUrl":"https://doi.org/10.1111/jnu.70139","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Urinary incontinence (UI) is a prevalent geriatric syndrome that significantly affects the physical, psychological, and social well-being of older adults. Non-pharmacological interventions are recommended as the first-line approach, especially in frail older adults.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This was a prospective pre–post observational study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study included sixty-one patients with rehabilitable UI who were admitted to an intermediate care hospital. The nurse-led multidisciplinary program integrated education, hygiene-dietary measures, pelvic floor physiotherapy, behavioral strategies, and transcutaneous electrical nerve stimulation (TENS). The primary outcomes were UI severity (International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)), voiding awareness, diurnal and nocturnal voids, disposable absorbent product use, functional status (Barthel Index), cognitive status (Pfeiffer test), and quality of life (EQ-5D). Data were collected at baseline and discharge.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data from 61 participants were analyzed. Significant improvements were observed in the ICIQ-SF scores (16.72 ± 3.39 vs. 9.10 ± 5.86; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), daytime voiding awareness (83.6% vs. 100%; &lt;i&gt;p&lt;/i&gt; = 0.002), nocturnal voiding awareness (66.7% vs. 88.5%; &lt;i&gt;p&lt;/i&gt; = 0.002), nocturnal voids (3.46 ± 2.22 vs. 2.35 ± 1.68; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), Barthel Index (49.83 ± 23.84 vs. 70.33 ± 19.59; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and EQ-5D scores (0.39 ± 0.28 vs. 0.56 ± 0.26; &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The use of disposable absorbent products decreased from 98.36% to 62.30% (&lt;i&gt;p&lt;/i&gt; = 0.065). The patient's cognitive status remained stable. The mean satisfaction with the program was 8.53/10.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A nurse-led, multidisciplinary, non-pharmacological intervention effectively reduced UI severity, increased voiding awareness, enhanced functional autonomy, and improved the quality of life in older adults. These findings support the implementation of individualized, evidence-based programs in intermediate care settings.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Clinical Relevance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Non-pharmacological interventions led by advanced practice nurses provide effective, patient-centered management of urinary incontinence, improving autonomy and quality of life while potentially reducing healthcare costs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149100278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients in Every Practice: Health Status and Health Experiences of an International Sample of Adults Born Preterm","authors":"Michelle M. Kelly,&nbsp;Kathyrn King,&nbsp;Caitlyn Ng,&nbsp;Lauren Ingledow,&nbsp;Margaret Brace","doi":"10.1111/jnu.70137","DOIUrl":"10.1111/jnu.70137","url":null,"abstract":"<div>\u0000 <section>\u0000 <h3> Introduction</h3>\u0000 <p>Due to the increased survival and stable prevalence rates of preterm birth, every clinician, regardless of the patient population or practice setting, has cared for someone born preterm. Unfortunately, most healthcare teams fail to consider preterm birth as a risk factor to adult health, missing a critical opportunity to mitigate risk in this vulnerable population. The purpose of the study was to explore the health status and health experience of adults born preterm with comparisons between birth year cohorts and gestational age categories.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Design</h3>\u0000 <p>The study utilized a cross-sectional, quantitative descriptive comparative design, augmented by qualitative analysis of open-ended questions.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Methods</h3>\u0000 <p>The health status and health experience survey was developed in collaboration with leaders of an advocacy group for adults born preterm and based on the available research. Convenience, snowball sampling among members of the advocacy network and other preterm birth groups provided an international sample of participants (<i>N</i> = 80).</p>\u0000 </section>\u0000 <section>\u0000 <h3> Results</h3>\u0000 <p>Chronic conditions or symptoms, representing health status, were reported by 85.7% of participants, with 75% of those participants taking medications for the condition. Participants born less than 32 weeks of gestation reported experiencing health conditions significantly more than those born at later gestations (91.8% vs. 62.5%, <i>p</i> = 0.008); there was no difference in birth year cohort. The most commonly reported conditions were respiratory, mental health, neurodevelopmental, and musculoskeletal. Two-thirds of participants reported never being asked about preterm birth history by healthcare teams. Healthcare experiences were described as ambivalent or dismissive among those who chose to disclose preterm birth status to providers.</p>\u0000 </section>\u0000 <section>\u0000 <h3> Conclusions</h3>\u0000 <p>Chronic and comorbid conditions associated with preterm birth are common among adults born preterm. These conditions are responsive to prevention and mitigation strategies and, as such, failure to identify adults born preterm as a population susceptible to chronic health conditions results in unidentified, unmanaged risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Care Behaviors in Osteoporosis: A Cross-Cultural Study Using Multidimensional Analysis of Textual Data","authors":"Chiara Tedesco,&nbsp;Vicente Bernalte-Martí,&nbsp;Adela Melgarejo Uréndez,&nbsp;Arantxa Conesa,&nbsp;María Desamparados Bernat-Adell,&nbsp;Mara Tormen,&nbsp;Gianluca Pucciarelli,&nbsp;Ercole Vellone,&nbsp;Maddalena De Maria,&nbsp;Emanuela Basilici Zannetti,&nbsp;Noemi Cittadini,&nbsp;Annalisa Pennini,&nbsp;Umberto Tarantino,&nbsp;Rosaria Alvaro,&nbsp;Mariachiara Figura","doi":"10.1111/jnu.70134","DOIUrl":"10.1111/jnu.70134","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Osteoporosis is a chronic skeletal condition that significantly affects daily life and may benefit from adequate self-care. The Middle-Range Theory of Self-Care of Chronic Illness conceptualizes self-care as a naturalistic process encompassing maintenance, monitoring, and management, also shaped by contextual and cultural factors. Despite this theoretical framework, limited evidence exists on how people with osteoporosis conceptualize and enact self-care in different cultural contexts. Italy and Spain provide comparable yet distinct settings for exploring cultural influences on self-care practices. This study aims to explore and compare self-care behaviors among Italian and Spanish people with osteoporosis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A cross-national qualitative study was conducted using an Automatic Analysis of Textual Data approach within the Exploratory Multidimensional Data Analysis framework.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Forty people with osteoporosis (38 women and 2 men; mean age 68.6 years, SD = 5.74) were recruited, equally distributed between Italy (&lt;i&gt;n&lt;/i&gt; = 20) and Spain (&lt;i&gt;n&lt;/i&gt; = 20). Data were analyzed using Labbé's intertextual distance and correspondence analysis to examine lexical similarities, differences, and semantic structures of self-care narratives.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Although moderate intra-national lexical similarity was observed within each national group, substantial inter-national differences emerged between Italian and Spanish participants in the discursive construction of self-care. Italian participants described self-care as a medically mediated and system-oriented process, closely linked to professional guidance, diagnostic procedures, and prescribed treatments. In contrast, Spanish participants framed self-care as embodied, routine-based, and emotionally expressive, grounded in daily practices and bodily awareness. These findings indicate that participants relied on distinct cultural and epistemic models when interpreting and organizing self-care experiences.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study highlights clear cross-cultural differences in how people with osteoporosis narrate and conceptualize self-care. Methodologically, it illustrates the potential of multidimensional analysis to support systematic and transparent comparison of qualitative datasets. The findings are consistent with the","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Count and Perceived Workload Associations With Missed Nursing Care: A Multicenter Repeated-Measures Study","authors":"Dhurata Ivziku,&nbsp;Daniela Tartaglini,&nbsp;Federica Maria Pia Ferramosca,&nbsp;Angelo Lanzara,&nbsp;Francesca Reato,&nbsp;Iliriana Bajrami,&nbsp;Marzia Lommi,&nbsp;Rosario Caruso","doi":"10.1111/jnu.70135","DOIUrl":"10.1111/jnu.70135","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Missed nursing care threatens quality and safety, but patient counts may not capture shift-level demands. We examined associations of patient-count and perceived workload indicators with missed care, separating within- and between-nurse effects.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A multicenter observational study using repeated shift-level measurements.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study included 502 shift records from 213 nurses in 16 medical–surgical units across six Italian hospitals; the primary analysis included 480 records from 196 nurses. Patient-count indicators were nurse-reported numbers of assigned, isolated, and specialist-care patients; perceived workload included work rhythm/quantity, mental workload, emotional workload, and work organization. Grouped-binomial generalized estimating equations modeled the proportion of applicable activities missed, with nurse clustering, robust standard errors, exchangeable correlation, and hospital fixed effects. Workloads were decomposed into within- and between-nurse components, and four missed-care domains were examined.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nurses reported a mean of 6.5 missed activities per shift; 29.9% of shifts had no missed care. The seven workload indicators were jointly associated with missed care (robust Wald &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;[7] = 22.95, &lt;i&gt;p&lt;/i&gt; = 0.002). Work rhythm/quantity was the only individual indicator with a nominal &lt;i&gt;p&lt;/i&gt;-value below 0.05 (OR 1.24 per SD, 95% CI 1.03–1.49; &lt;i&gt;p&lt;/i&gt; = 0.023), but it did not remain significant after Benjamini–Hochberg correction (&lt;i&gt;q&lt;/i&gt; = 0.159). Assigned patient count was not clearly associated (OR 1.14, 95% CI 0.94–1.40; &lt;i&gt;p&lt;/i&gt; = 0.192). In exploratory within–between analyses, the between-nurse work rhythm/quantity component was associated with missed care (OR 1.42, 95% CI 1.11–1.82; &lt;i&gt;p&lt;/i&gt; = 0.005), whereas the within-nurse component was not (OR 1.03, 95% CI 0.90–1.17; &lt;i&gt;p&lt;/i&gt; = 0.649). Domain-specific associations did not remain significant after multiplicity adjustment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The workload indicators were jointly associated with missed nursing care, with secondary analyses indicating that the global signal was evident in the perceived-workload block. However, no individual workload indicator remained statistically significant after multiplicity adjustment. Work rhythm/quantity and its between-n","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Worldwide Guidelines, Protocols, and Health Care Standards for Provision of Palliative Care Services in Progressive Neurological Disorders","authors":"Jessica Kaplonyi,&nbsp;Samantha M. Loi,&nbsp;Julie C. Stout,&nbsp;Jennifer Philip,&nbsp;Rosalie Gebert,&nbsp;Anita M. Y. Goh","doi":"10.1111/jnu.70130","DOIUrl":"10.1111/jnu.70130","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Progressive neurological disorders (PNDs) are life-limiting conditions with complex trajectories. PNDs require holistic, person-centred care that responds to the needs of both individuals and their families, including the provision of palliative and end-of-life (EOL) care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review aimed to identify and synthesize existing international guidelines addressing palliative and EOL care in adult PND populations, with particular attention to their quality and scope.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We searched databases and gray literature sources for guidelines published between January 2013 and February 2026. Thirty-three guidelines were included for review. We appraised guidelines to assess quality and comprehensiveness against the World Health Organization's (WHO) domains of palliative care. We conducted inductive content analysis to identify key themes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Guidelines predominantly were published from high-income countries and focused on dementia. Overall guideline quality was high. Most addressed physical, psychosocial, and social dimensions of care of the WHO domains; however, spiritual wellbeing was inconsistently addressed. Six interrelated themes emerged: (i) holistic symptom management; (ii) recognition of families and caregivers as partners in care; (iii) early and ongoing communication; (iv) value-aligned decision-making; (v) multidisciplinary team expertise; (vi) navigation of medicolegal complexities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Findings indicate broad international consensus on the principles of high-quality palliative care in PND, while highlighting gaps in disease/diagnosis representation, spiritual care, and global equity. Future research could consider the importance of disease-specific guidelines, covering regions and countries from across a range of high-, middle-, and lower-income countries.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Clinical Relevance&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinicians caring for people with progressive neurological disorders can draw on the internationally consistent principles identified in this review including early integration of palliative care, proactive and open communication, and recognition of families as partners in care to benchmark and strengthen their practic","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Policy Analysis of HPV Vaccination Guidelines: Actors, Context, Content, and Process Across Eight Countries","authors":"Grace K. Kyei,&nbsp;Lingling Zhang","doi":"10.1111/jnu.70131","DOIUrl":"10.1111/jnu.70131","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To compare HPV vaccination policies across eight countries and examine how actors, context, policy content, and implementation processes influence program performance and coverage outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Comparative policy analysis using a qualitative cross-case document analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Data Sources&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Official national HPV vaccination guidelines, technical advisory documents, WHO and UNICEF monitoring reports, and peer-reviewed literature published between January 2006 and December 2024. Sources were identified through structured searches of PubMed, CINAHL, Scopus, and Web of Science.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The Health Policy Triangle framework guided analysis across four domains: Actors, Context, Content, and Process. A standardized data extraction template was applied across eight countries: Australia, Brazil, Japan, Nigeria, Rwanda, Sweden, the United Kingdom, and the United States. Data were synthesized in comparative matrices and analyzed using iterative cross-case analysis, with coding verified by a second reviewer.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Five policy archetypes were identified: school-based universal programs, decentralized federal models, gender-neutral vaccination strategies, resource-constrained but high-performing systems, and the policy recovery model exemplified by Japan. School-based delivery supported by nursing and school health workforces consistently achieved the highest and most equitable coverage. Rwanda achieved 98% coverage despite a girls-only, donor-supported model, indicating that governance quality and community trust may outweigh policy design alone. The global transition to single-dose HPV vaccination schedules requires country-specific adaptation that accounts for population-based eligibility exceptions and evidence gaps, including the absence of clinical trial data on single-dose protection in males and against non-cervical HPV-associated diseases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;HPV vaccination outcomes are shaped by governance structures, implementation capacity, nursing workforce infrastructure, and public trust. Strengthening school-based delivery, expanding single-dose schedules where supported by evidence, and investing in nursing-led outreach are critical to ","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips for Getting Your Research Published","authors":"Susan Gennaro","doi":"10.1111/jnu.70133","DOIUrl":"10.1111/jnu.70133","url":null,"abstract":"","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}