Journal of Advanced Nursing最新文献

{"title":"Nurse Roles Implementing the Choice for Self-Collection Cervical Screening in Rural Settings: A Qualitative Study Following National Policy Change.","authors":"Tessa Saunders,Lucy Boyd,Ana Machado Colling,Jessie He,Kerryann Wyatt,Claire Nightingale","doi":"10.1111/jan.70286","DOIUrl":"https://doi.org/10.1111/jan.70286","url":null,"abstract":"AIMTo explore the key factors influencing nurses' capability, opportunity and motivation to offer the choice for self-collection for cervical screening within rural primary care services, following a national policy change in Australia.DESIGNA qualitative study informed by implementation and behavioural change frameworks.METHODSPrimary health nurses working in Victoria were invited to participate in semi-structured interviews via video or telephone between December 2022 and March 2023. Eighteen nurses from 18 clinics participated. Interview data were analysed following a Framework analysis approach, and themes were mapped to the COM-B model.RESULTSNurses were highly motivated to offer the choice for self-collection due to perceived advantages for their patients and potential opportunities for reaching people hesitant to screen. There was variation in how nurses offered this choice, and to whom. Some nurses were concerned about lost opportunities to visualise the vulval area or cervix, or to have broader health and wellbeing conversations with patients. Views were mixed about how self-collection would impact nurse roles, and several external factors were impacting their opportunities as cervical screening providers.CONCLUSIONSAppropriately trained nurses have the capability and motivation to incorporate the choice for self-collection within their screening practice; however, their opportunity to maximise equity and increase participation is impacted by funding models and structures that limit their autonomy.IMPACTPeople living outside major cities experience greater healthcare inequities. Australia introduced access to the choice for self-collection for all eligible individuals in 2022, in part to achieve greater equity in the national screening program. Nurses can play a key role in program delivery. Understanding how they incorporate self-collection into their practice, and the key factors influencing implementation in rural primary care settings, can inform future program implementation and improve outcomes for patients.REPORTING METHODWe have adhered to COREQ reporting guidelines.PATIENT OR PUBLIC INVOLVEMENTThis study did not include patient or public involvement in its design, conduct or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"18 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277336","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":"Cultivating Compassion in Students for End-Of-Life Processes: A Mixed-Methods Participatory Research Protocol.","authors":"Eva Abad-Corpa,Miriam Espinosa-Sánchez,Pilar Barnestein-Fonseca,Rafaela Camacho-Bejarano,Pilar Delgado-Hito,Rosa Miró-Bonet, ","doi":"10.1111/jan.70235","DOIUrl":"https://doi.org/10.1111/jan.70235","url":null,"abstract":"AIMSTo analyse the impact of a participatory process of awareness and reflection on compassion, in the face of end-of-life processes, in students aged 12-23 years in six Spanish regions, and to understand how the participatory process can transform their compassion.DESIGNMixed sequential transformative methodology with different phases. In the first phase, a prospective quasi-experimental design with evaluation pre-post in a single group will be adopted. The second phase is the intervention under study, which will consist of a Participatory Action Research with concurrent evaluations.METHODSIn the quantitative phase, 1390 students aged 12-23 from a Public University and a Public Secondary Education Institute across six different Spanish regions will be included. A single questionnaire will be administered before and after the Participatory Action Research to contribute to the process evaluation, incorporating four scales (compassion for others' lives, Death Anxiety Scale, basic empathy modified for adolescents and self-compassion). Responses will be recorded in the Research Electronic Data Capture system. For data analysis, comparison groups, change evolution and associations between variables will be examined, along with multivariate logistic regression models. In the qualitative phase of participatory action research, a promoter group will be established in each university and secondary school in every region. Qualitative data will be analysed following the authenticity, transferability, auditability and neutrality criteria. Discourse analysis triangulation will be conducted to achieve data saturation.CONCLUSIONSImplementing participative action research in the educational environment to improve students' compassion makes them capable of founding compassion communities to help those who have a terminal illness.REPORTING METHODThis study will adhere to the relevant EQUATOR guidelines, such as the Good Reporting of a Mixed Methods Study guideline, to efficiently report its results through the different steps of this mixed-methods study.PATIENT OR PUBLIC CONTRIBUTIONParticipatory action research is a method that enables participants to act as researchers of the phenomenon under study, facilitating the immediate application of results within the context. Although students did not participate in the writing of the proposal grant or the research design.TRIAL AND REGISTRATIONThis study registered on Clinical Trials (NCT06310434), was initiated in January 2024, and it will continue up to December 2026.NURSING IMPLICATIONSThis multicentre study will contribute to the nursing community with an overview of compassion for those at the end of their lives among young people and provide the knowledge needed to cultivate compassion at universities and schools.IMPACTImplementing compassion programmes and death education in the educational environment will empower students to create a compassionate community. The double evaluation of the process will contribute ","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"36 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261288","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":"The Historical Foundations of Advanced Practice Nursing: Tracing American Origins for Global Understanding","authors":"Roberto Galao‐Malo, Rita D'Aoust, Alison Davidson, Kim Curry","doi":"10.1111/jan.70279","DOIUrl":"https://doi.org/10.1111/jan.70279","url":null,"abstract":"Aim(s)To examine the historical origins of ‘advanced’ nursing as a concept.DesignHistorical analysis using primary source documentation.MethodsHistorical analysis of articles published in the American Journal of Nursing by the National League of Nursing Education from 1928 to 1950, supplemented by books and articles addressing nursing specialisation history. Articles were analysed chronologically to trace terminology development and strategic decision‐making processes during this foundational period.Results and Discussion‘Advanced’ terminology was first introduced in 1933 by Isabel Stewart to distinguish university‐based clinical specialisation from exploitative hospital ‘postgraduate courses’. The term served as a strategic tool for legitimacy and professional differentiation. World War II accelerated development through federal funding and increased specialisation demands. Louise McManus provided the first conceptual framework in 1949, defining ‘advanced’ education as ‘planned forward movement’ requiring new learning experiences beyond basic preparation. Master's degree requirements were established in 1952, creating educational structures that persist today.ConclusionThe strategic introduction of ‘advanced’ terminology in the 1930s established foundational concepts that continue to influence contemporary advanced practice nursing development internationally.Implications for the Profession and/or Patient CareUnderstanding these historical origins enables more informed policy development for countries implementing advanced nursing roles and helps resolve ongoing definitional confusion in international nursing practice.ImpactThis research addresses the gap in historical understanding of advanced practice nursing terminology origins. Main findings reveal the strategic nature of professional language in nursing's professionalisation. The research impacts international nursing education policy and contemporary advanced nursing role development across diverse healthcare systems.Reporting MethodThis study adhered to guidelines for historical research methodology.Patient or Public ContributionThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"33 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260664","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":"Beyond the Feed: A Descriptive Qualitative Study of Parental Experiences in Managing Paediatric Feeding Disorders in Children With Chronic Conditions","authors":"Brenda Jinyu Ng, Marion Margaret Aw, Qiao Xin Jamie Ng, Nicholas Beng Hui Ng, Shefaly Shorey","doi":"10.1111/jan.70284","DOIUrl":"https://doi.org/10.1111/jan.70284","url":null,"abstract":"AimTo explore the experiences of Singaporean parents managing care for children with underlying chronic medical conditions and Paediatric Feeding Disorders.DesignDescriptive qualitative.MethodsData were collected via semi‐structured interviews from 4 July 2024 to 4 October 2024. Fourteen English‐speaking Singaporean parents were recruited via purposive sampling at an outpatient paediatric feeding clinic in a public tertiary hospital in Singapore. Data were thematically analysed using Braun and Clarke's six‐step inductive approach.ResultsThree themes and nine sub‐themes were identified. The three themes were: (1) Caregiver's Compass: From Survival to Stability, (2) Navigating Emotional Terrain in Caregiving, (3) Feeding Suck‐cess: Systemic, Medical, and Societal Challenges.ConclusionThe findings reflected the experiences of parents managing Paediatric Feeding Disorders. Parents transitioned from survival‐focused to development‐focused care, balancing medical guidance with parental instinct while navigating emotional strain, gendered caregiving roles, fragmented healthcare, and cultural conflicts.Implications for Patient CareNurses are vital in supporting parents by recognising their lived experiences and caregiving challenges. By incorporating family‐centered interventions, nurses can foster shared‐decision making and provide culturally sensitive care. Providing tailored education and collaboration with multidisciplinary teams will enable nurses to empower caregivers with essential knowledge and resources, such as accessible and culturally attuned digital health solutions.ImpactThis study contributes to the limited body of qualitative research on parents of chronically ill children with Paediatric Feeding Disorders in Singapore and underscores the need for culturally sensitive, multidisciplinary support models to address the manifold responsibilities parents face in managing feeding issues. These insights may have broader implications for diverse populations managing similar caregiving complexities, informing family‐centered interventions and healthcare policies that better support parents managing chronically ill children.Reporting MethodCOREQ checklist.Patient or Public ContributionThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"121 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260665","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":"Assessments Under Pressure: Interviews With Triage Nurses in Emergency Departments: An Exploratory Descriptive Qualitative Study.","authors":"Hugh Gorick,Marie McGee,Toby O Smith","doi":"10.1111/jan.70283","DOIUrl":"https://doi.org/10.1111/jan.70283","url":null,"abstract":"AIMSTo understand the experiences and decision-making practices of registered nurses when assessing acuity at triage in emergency departments.DESIGNThe study utilised a qualitative exploratory-descriptive design.METHODSPurposive sampling recruited 11 registered nurses with triage experience from across the United Kingdom. Semi-structured online interviews, incorporating practice-based vignettes, were conducted between April and November 2024. Thematic analysis was selected to analyse the data.RESULTSThree themes were identified: (1) Pressurised decisions, highlighting the effects of overcrowding, staffing shortages and operational burdens; (2) Holistic assessments, revealing the shift from structured to intuitive decision-making as nurses gain experience; and (3) Confidence, competence and emotional wellbeing, illustrating the psychological impacts of triage and the importance of experience and support.CONCLUSIONSThis study provides novel insight into how triage nurses navigate acuity assessment in high-pressure environments. It shows how experience, training and institutional culture influence decision-making and wellbeing. It identifies key areas for targeted intervention.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARETriage nurses face substantial cognitive and emotional strain, which may compromise assessment quality and safety. Findings highlight the urgent need for structured triage training, protected time for assessment and access to wellbeing and peer support systems.IMPACTWhat problem did the study address?: A need for current literature exploring the practices and experiences of triage nurses. What were the main findings?: Triage nurses experience significant environmental and emotional pressures, develop decision-making strategies through experience and require enhanced training and support to ensure safe, effective care. Where and on whom will the research have an impact?: Findings are relevant to emergency departments internationally, triage nurses, nurse educators and healthcare leaders.REPORTING METHODThis study adheared to COREQ reporting guidelines, and a copy of the checklist is attached as Data S1.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"88 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261522","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":"Tensive Adaption: A Grounded Theory on the Process of Nurses' Dealing With Workplace Violence","authors":"Mohammad Reza Aryaee Far, Kiana Babaei, Seyedeh Maryam Seyedi, Vahid Moeini, Ali Movahedi","doi":"10.1111/jan.70238","DOIUrl":"https://doi.org/10.1111/jan.70238","url":null,"abstract":"AimTo explore the process of how nurses experience and deal with workplace violence based on nurses' perceptions and experiences in Iran.MethodsAn exploratory qualitative study was conducted using grounded theory approach. Participants included 17 nurses working in 4 hospitals in 2 urban areas in Iran with at least 1 year of clinical experience in emergency departments and intensive care units. Data were collected through in‐depth, semi‐structured individual interviews conducted between August 2024 and March 2025. The constant comparative analysis approach was used for data analysis. This research method was carried out in five stages: open coding to identify concepts; development of concepts in terms of their characteristics and dimensions; contextual analysis; integration of the process to data analysis; and final category integration.FindingsThe main concern of participants in dealing with workplace violence was a ‘multidimensional security threat’. ‘Perpetrator response to nursing care’ (at the individual level) and ‘organisational inefficiency’ (at the organisational level) provided the context for this threat. A general theme entitled ‘tensive adaptation’ was the core category in this research and included four main categories: ‘tolerant reactions’, ‘seeking help’, ‘passive reactions’ and ‘hostile reactions’. ‘Organisational damage’, ‘nurse damage’ and ‘patient damage’ were the outcomes.ConclusionThe theoretical model of ‘tensive adaptation’ provides a new perspective on ‘what’ and ‘how’ nurses experience and manage workplace violence. Effective strategies for managing violence such as effective communication, empathy, providing appropriate care, anger management, self‐care, effective teamwork and requesting support can be considered by nursing administrators and incorporated into training programmes for nurses and nursing students. The adverse consequences of nurses' exposure to workplace violence should receive greater attention, as the entire healthcare system is affected by this exposure.Implications for the Profession and/or Patient Care<jats:list list-type=\"bullet\"> <jats:list-item>Workplace violence leads to physical and psychological problems, reduced job satisfaction, diminished performance, negative effects on personal and family life and decreased quality of patient care.</jats:list-item> <jats:list-item>The main concern of participants in dealing with workplace violence was ‘multidimensional security threat’. This concept includes three characteristics: ‘psychological health threats’, ‘physical health threats’ and ‘professional position threat’.</jats:list-item> <jats:list-item>‘Perpetrator response to nursing care’ (individual level) and ‘organisational inefficiency’ (organisational level) served as contextual conditions that expose nurses to workplace violence.</jats:list-item> <jats:list-item>In ‘tensive adaptation’, nurses attempt to respond to workplace violence through strategies such as ‘tolerant reactions’, ‘seeking help","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"1 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260750","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":"The Association Between Caregiving Context and the Health and Well‐Being of Carers and Their Care Recipients Living With Dementia: A Cross‐Sectional Study","authors":"Cheng‐Ya Lee, Yun‐Hee Jeon, Judith Fethney, Karen Watson, Lee‐Fay Low, Loren Mowszowski, Robert T. Woods","doi":"10.1111/jan.70278","DOIUrl":"https://doi.org/10.1111/jan.70278","url":null,"abstract":"Aim(s)To examine the association between caregiving context and the health and well‐being of community‐dwelling people with dementia (functional ability, physical function, depression, quality of life and health‐related quality of life) and their informal carers (health‐related quality of life) at the pre‐rehabilitation stage and the potential mediating role of caregiving context variables.DesignCross‐sectional study.MethodsSecondary analysis of baseline data from a randomised controlled trial of 130 dementia care dyads—the Interdisciplinary Home‐based Reablement Programme (2018–2022). Bivariate analyses were applied to identify key caregiving context variables—co‐residence, sole carer status, additional caring responsibilities, client‐carer relationship and subjective carer burden (carer burden hereafter)—associated with health outcomes. Subsequently, multivariable linear regression models were developed. To examine carer burden, two models were run for each outcome: one with caregiving context variables and covariates, and the other adding carer burden. The mediating effects of the identified caregiving context variable were examined using post hoc mediation analysis.ResultsSpouse/partner carer relationship was significantly associated with better client well‐being, including lower depressive symptoms and higher quality of life scores compared to adult child and other relationships. Higher carer burden was strongly associated with lower functional ability, more depressive symptoms, lower quality of life for clients and lower health‐related quality of life for both clients and carers. Including carer burden in regression models explained the greatest variance across most models. Carer burden fully mediated the association between additional caring responsibilities and client functional ability, and partially mediated the association between other carers and client depression.ConclusionCarer burden needs to be carefully considered in supporting the health and well‐being of dementia carer dyads.ImplicationsAddressing carer burden and tailoring support to carers are essential for optimising health impacts for dementia carer dyads.Reporting MethodSTROBE checklist.Patient or Public ContributionNone.Trial RegistrationClinicalTrials.gov identifier: ACTRN12618000600246","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"8 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260754","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":"Insights and Perceptions of Gender Discrimination in a Woman-Dominated Profession: A Cross-Sectional Study of Women in Nursing.","authors":"Patricia Gauci,Lauretta Luck,Kate O'Reilly,Wenpeng You,Kath Peters","doi":"10.1111/jan.70282","DOIUrl":"https://doi.org/10.1111/jan.70282","url":null,"abstract":"AIMThe overarching aim was to explore women registered nurses' perceptions of gender discrimination in the workplace.DESIGNA descriptive cross-sectional exploratory survey within a sequential explanatory mixed methods study.METHODSBetween September and December 2023, data were collected from 173 registered nurses who self-identified as women. The survey captured demographic data, attitudes to gender discrimination in society using the 'Contemporary Gender Discrimination Attitude Scale' and perceptions of workplace gender discrimination in nursing across four dimensions, assessed using the 'Perception of Workplace Gender Discrimination for Women Nurses Scale' (PWGD-WN). Descriptive statistics presented as means and standard deviations were used to describe and interpret data. Regression analysis and chi-square tests were employed to examine associations between key variables.RESULTSThe mean score on the Contemporary Gender Discrimination Attitude Scale was 4.56 (on a 6-point scale), indicating that on average respondents agreed that gender discrimination remains an issue in society. The PWGD-WN scale mean scores for the dimensions of gender discrimination (5-point scale) from lowest to highest were: 'Gender bias from other women' (Mean: 3.13, SD: 1.147), 'Interpersonal discrimination' (Mean: 3.30, SD: 1.135), 'Glass escalator' (Mean: 3.77, SD: 0.946) and 'Primary carer' (Mean: 3.86, SD: 0.796); higher scores indicated agreement with items. 'Primary carer' was the strongest predictor of attitude, followed by the 'Glass escalator'. Highest qualification obtained was highlighted as a key predictor of nurses' perceptions of workplace discrimination.CONCLUSIONThe results of this study highlight that women in nursing perceive that systemic and multidimensional discrimination exists in the workplace.IMPLICATIONS FOR THE PROFESSIONThe results can be utilised to understand how discrimination manifests in the workplace for women in a woman-dominated profession.IMPACTThis research provides the first quantitative measure of perceived workplace gender discrimination for Australian women registered nurses.REPORTING METHODWe have adhered to relevant EQUATOR guidelines-STROBE.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"121 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261193","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":"Effectiveness, Process, and Economic Outcomes of Integrated Care for Community‐Dwelling Frail Older Adults: A Systematic Review and Meta‐Analysis","authors":"Jiaqi Yu, Huaxin Si, Wendie Zhou, Yang Yang, Yanyan Li, Xue Wang, Hejing Chen, Cuili Wang","doi":"10.1111/jan.70275","DOIUrl":"https://doi.org/10.1111/jan.70275","url":null,"abstract":"AimsTo assess the effectiveness, process, and economic outcomes of integrated care for community‐dwelling frail older adults.DesignA systematic review and meta‐analysis.Data SourcesWe searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.Review MethodsRandomised controlled trials and non‐randomised studies of interventions involving integrated care for community‐dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta‐Analysis software.ResultsThis review included 12 studies involving 6819 community‐dwelling frail older adults from high‐income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost‐effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.ConclusionIntegrated care improves frailty and functional ability in community‐dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost‐effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.ImpactThis implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.Reporting MethodPRISMA 2020 Checklist.Patient or Public ContributionNo patient or public contribution.<jats:styled-content style=\"fixed-case\">PROSPERO</jats:styled-content> Registration NumberCRD42024568811","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"71 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260666","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":"Effectiveness of the Preschool Children eHealth Cardiac Rehabilitation Program After Congenital Heart Surgery: A Randomised Controlled Trial.","authors":"Wenyi Luo,Lin Chen,Xiaoman Cai,Zhimin Yang,Hanfang Deng,Yichao Xu,Patricia Hickey,Yaqing Zhang","doi":"10.1111/jan.70217","DOIUrl":"https://doi.org/10.1111/jan.70217","url":null,"abstract":"AIM(S)To develop the Preschool Children eHealth Cardiac Rehabilitation programme based on the Interaction Model of Client Health Behaviour, and to evaluate its effects on children after congenital heart surgery.DESIGNA parallel two-arm randomised controlled trial was conducted.METHODSA total of 84 participants were recruited from July 2022 to June 2023 and randomly assigned to either the intervention group (n = 40) or control group (n = 44). The intervention group participated in a 3-month eHealth Cardiac Rehabilitation programme, while the control group received routine care. Outcomes were measured at baseline, 3 months post baseline (intervention endpoint), and 6 months post baseline. Eighty participants completed the study.RESULTSCompared to the intervention group, the control group demonstrated significantly worse outcomes at both 3 and 6 months, including a higher risk of heart failure, lower left ventricular ejection fraction scores, and shorter 6-min walk distance tests. The intervention group engaged in significantly more vigorous physical activity. Significant between group differences were also observed in parental knowledge, attitudes, behaviours and trust levels. Additionally, the proportion of parents experiencing anxiety decreased significantly more in the intervention group by 6 months post baseline.CONCLUSIONThis pioneering eHealth programme transforms home-based rehabilitation for preschool children with congenital heart disease, addressing a critical gap in accessible and long-term paediatric cardiac rehabilitation care.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CAREThe use of eHealth programmes is valuable for improving paediatric cardiac rehabilitation by empowering parents, enhancing care continuity, and reducing barriers to accessing specialised services in paediatric care, especially in areas with limited medical resources.IMPACTThis study establishes the first validated eHealth framework for family-centred cardiac rehabilitation in preschool children following congenital heart surgery, addressing the critically low uptake of previously home-based rehabilitation. It also provides clinicians with a scalable solution for delivering care in underserved regions lacking access to specialised cardiac services.REPORTING METHODThis study adhered to the CONSORT checklist guidelines for reporting randomised controlled trials.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.TRIAL AND PROTOCOL REGISTRATIONThis study was a randomised controlled clinical trial. The research protocol was registered with the China Clinical Trial Registration Center (registration number: ChiCTR2200062022; https://www.chictr.org.cn/showproj.html?proj=174261).","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"22 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261146","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}