Journal of Advanced Nursing最新文献

{"title":"Intervention and Strategies to Prevent Workplace Violence From Patients and Visitors Against Nurses: An Integrative Review.","authors":"Islam Qasem,Gordon L Gillespie","doi":"10.1111/jan.70192","DOIUrl":"https://doi.org/10.1111/jan.70192","url":null,"abstract":"AIMTo synthesise the existing literature on effective interventions aligned with the 2015 U.S. Occupational Safety and Health Administration guidelines to address workplace violence against nurses.DESIGNAn integrative review.METHODSPubMed, Embase, CINAH, and PsycINFO databases were searched for articles published between 2010 and 2023. Articles addressing WPV interventions and published in English were included.RESULTSThirty-seven of 834 articles met the inclusion criteria. The review revealed several strategies to address workplace violence in healthcare settings, with staff training being the most common strategy. However, most interventions were researcher-designed, often excluding input from nurses or other stakeholders. Limited managerial support for nurses following the incidents was another prominent finding.CONCLUSIONAlthough safety training programmes are common, there are critical gaps in managerial support and nurse involvement in intervention development. Further research should focus on incorporating nurse contributions and strengthening managerial support to enhance prevention efforts.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CAREAddressing workplace violence in healthcare settings requires a comprehensive approach beyond safety training. Active nurses' participation in intervention design and enhanced managerial support are essential for creating effective solutions. Healthcare administrators should create environments that empower nurses to contribute to solutions.IMPACTThis review highlights existing gaps in interventions and emphasises the need for collaborative and nurse-centered approaches to address workplace violence.REPORTING METHODThe reporting of this review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.PATIENT OR PUBLIC CONTRIBUTIONNo patient or public contribution.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"64 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018130","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":"Mitigating Nurse Turnover in Urban China: Income Inequality and Nurse-Patient Relationships as Moderators of Occupational Stress.","authors":"Zhichao Wang,Zhongliang Zhou,Guanping Liu,Hongbin Fan,Yan Zhuang,Xiaohui Zhai","doi":"10.1111/jan.70118","DOIUrl":"https://doi.org/10.1111/jan.70118","url":null,"abstract":"AIMThis study examined the moderating effects of income inequality and nurse-patient relationships on the association between occupational stress and nurse turnover intentions in large urban hospitals in China, providing evidence for developing targeted retention strategies.DESIGNA cross-sectional study.METHODSData from 13,298 nurses in 46 hospitals in Xi'an, China (October-December 2023) were analysed using hierarchical regression to assess associations between occupational stress, organisational and professional turnover intentions and the moderating roles of the expected income achievement rate (calculated as [actual/expected income] × 100%) and nurse-patient relationship quality.RESULTSEighty-three percent of nurses reported moderate-to-severe occupational stress. Compared to nurses experiencing mild stress, those with moderate/severe stress demonstrated significantly higher organisational and professional turnover intentions. After adjusting for covariates, significant interaction effects were observed. Higher expected income achievement rate showed a modest but significant moderating effect, associated with reduced turnover intentions. While the nurse-patient relationship also moderated this relationship, its protective effect was attenuated under conditions of severe stress. Despite small effect sizes, the consistent patterns and theoretical coherence of these interactions warrant further investigation.CONCLUSIONOccupational stress significantly predicts nurse turnover intentions in urban Chinese hospitals, with income inequality and nurse-patient relationship quality serving as modifiable moderating factors. Interventions should integrate equitable compensation, nurse-patient relationship enhancement programmes and stress management initiatives.IMPACTThis study demonstrates that equitable income consistently buffers the effects of occupational stress on nurse turnover, while nurse-patient relationships show stress-level-dependent moderation. By implementing region-specific compensation benchmarks and structured communication training, healthcare policymakers can effectively address economic security and relational care quality in workforce stabilisation.REPORTING METHODThe study has been reported following the STROBE guidelines.PATIENT OR PUBLIC CONTRIBUTIONNo patient or public contribution.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"37 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018133","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":"eHealth Literacy Mediating Social Support and Technology Acceptance Among Patients With Chronic Illnesses: A Cross-Sectional Study.","authors":"Lian-Shin Shiu,Yu-Shan Huang,Chieh Yu Liu,Yu-Shan Cheng,Yu-Chi Chen","doi":"10.1111/jan.70207","DOIUrl":"https://doi.org/10.1111/jan.70207","url":null,"abstract":"AIMTo examine the relationships among social support, eHealth literacy and eHealth technology acceptance among patients with chronic illnesses, and investigate whether eHealth literacy plays a mediating role.DESIGNA cross-sectional correlational study.METHODSA total of 202 patients with chronic illnesses were recruited from outpatient clinics and communities in Taiwan. Data were collected via structured questionnaires and analysed using SPSS and PROCESS macro with 1000 bootstrap samples.RESULTSeHealth literacy was the strongest predictor of technology acceptance. Although social support was positively associated with eHealth literacy, it did not directly predict technology acceptance after controlling for eHealth literacy, indicating a full mediation effect.CONCLUSIONSeHealth literacy is a crucial mechanism through which social support influences health technologies acceptance. Interventions to improve eHealth literacy, particularly those integrated with social support strategies based on different cultural backgrounds, enhance digital engagement among chronic illnesses.IMPLICATIONS FOR PROFESSION AND/OR PATIENT CAREHealthcare professionals and policy-makers should design literacy-sensitive interventions that leverage social networks and involve significant others to promote meaningful eHealth engagement in disease management.IMPACTeHealth literacy fully mediates the relationship between social support and eHealth technology acceptance, proving that social support alone does not directly increase adoption without improving eHealth literacy. eHealth literacy is the strongest predictor of eHealth technology acceptance, emphasising its central role in bridging the gap between social support and eHealth engagement.REPORTING METHODThis study followed the STROBE checklist guideline.PATIENT OR PUBLIC CONTRIBUTIONNo patient or public involvement.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018225","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":"Research Priorities for Nursing and Allied Health: A Priority‐Setting Project Using a Partnership Approach","authors":"Marina Weckend, Lucy Gent, Erin Godecke, Linda Coventry, Gemma Doleman, Amanda Towell‐Barnard, Lisa Whitehead","doi":"10.1111/jan.70190","DOIUrl":"https://doi.org/10.1111/jan.70190","url":null,"abstract":"BackgroundResearch priorities guide research activities, funding and resources within health services. To ensure that research efforts are meaningful and impactful, it is vital that organisational research agendas reflect the priorities of both healthcare consumers and staff, alongside broader national and international research frameworks. This paper outlines a research priority‐setting project conducted across two hospitals in Western Australia, aimed at identifying shared research priorities through a collaborative and inclusive approach.AimTo identify the top ten nursing and allied health research priorities for two hospitals in Western Australia.MethodsA modified James Lind Alliance Priority Setting Partnership approach was used, involving health services users, nurses, allied health professionals, and community members in a co‐design approach across three phases. In phase 1, four community conversations were conducted to elicit an initial set of research topics. This data‐informed phase 2, a survey to collect diverse views from a wider participant pool. In phase 3, a pre‐selected sample of potential research priorities was discussed in a consensus workshop to reach a group consensus of the top ten research priorities. Qualitative data was analysed using multi‐step thematic analysis, and quantitative data was analysed using descriptive statistics.ResultsA total of 67, 151 and 18 people participated across study phases 1, 2 and 3, respectively, comprising nurses, allied health professionals, healthcare users, carers, and interested community members. The top ten research priorities reflected three areas: healthcare systems re/design (streamlining care; access to healthcare; patient journey and quality of care), workforce needs (workforce well‐being, retention and adequate staffing; workforce training), and specific health issues and needs (dementia and delirium; mental health; caring for carers; Aboriginal and Torres Strait Islander health; palliative care and elderly people).ConclusionThe research priorities identified in this study for two hospitals in Western Australia reflect the strong desire of nurses, allied health professionals, healthcare users and community members to improve structural issues in healthcare systems. This includes how healthcare systems are designed and integrated with each other, how workforce needs affect service delivery, and a greater focus on holistic service provision for specific health issues and needs.Patient or Public ContributionHealthcare consumers were an integral part of this study. Healthcare consumers were involved in the design of the study, the conduct of the study, and the review of the data analysis.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"24 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002776","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":"Grief, Uncertainty and Community: A Qualitative Study on Parental Experiences of Paediatric Feeding Disorders and Feeding Tube Use in Singapore","authors":"Sydney Xi Ning Koh, Marion Margaret Aw, Jing Shi Chua, Jamie Qiao Xin Ng, Nicholas Beng Hui Ng, Shefaly Shorey","doi":"10.1111/jan.70209","DOIUrl":"https://doi.org/10.1111/jan.70209","url":null,"abstract":"AimTo explore the perceptions and experiences of parents caring for children with paediatric feeding disorders requiring feeding tubes (PFD‐T).Study DesignA descriptive qualitative approach was adopted in this study.MethodsUsing purposive sampling, 12 parents were recruited from paediatric inpatient wards and the outpatient paediatric feeding clinic at a tertiary public hospital in Singapore. Data collection was done from July to December 2024. Semi‐structured one‐on‐one interviews were conducted with the parents (fathers or mothers) until data saturation. Thematic analysis was used to identify themes from the interview content.ResultsA total of three themes and six subthemes were identified, encapsulating the challenges experienced by parents with caregiving and feeding tube management, as well as the sources of support they had. The themes are: (1) A sense of community, (2) Grieving over the loss of normalcy and (3) Facing the unknown.ConclusionParents in this study felt supported being in a community of other parents with children who have PFD‐T. It enabled them to gain valuable information and offered them a space where they felt understood. At the same time, they expressed feelings of guilt and isolation, as the caregiving demands led to limited capacity to cater to or interact with other loved ones. Additional challenges parents faced included transitioning between types of feeding tubes and insufficient support from healthcare professionals.Trial and Protocol RegistrationEthical approval was obtained from the National Health Group Domain Specific Review Board (DSRB 2024/00064) on 8 May 2024.Reporting MethodThis study followed the reporting guidelines outlined by the COnsolidated criteria for REporting Qualitative (COREQ) research checklist.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":"30 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002779","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":"Family Bereavement Support Interventions in Specialist Adult Palliative Care: A Rapid Mixed‐Methods Systematic Review","authors":"Torsten Schwalbach, Marco Riguzzi, Myrta Kohler, Rahel Naef","doi":"10.1111/jan.70193","DOIUrl":"https://doi.org/10.1111/jan.70193","url":null,"abstract":"AimTo synthesise evidence on the impact of pre‐ and post‐loss family support interventions on bereavement outcomes and families' perceptions of their usefulness and benefits in specialist palliative care.DesignA rapid mixed‐methods systematic review drawing on JBI and Cochrane guidance. Study quality was appraised using the Mixed‐Methods Appraisal Tool. Qualitative and quantitative data were analysed using a meta‐aggregation and narrative analysis approach combined with narrative synthesis.Data SourceWe searched Medline, CINAHL, PsycINFO, Embase and Cochrane Library and included articles published between 2004 and 2024 that evaluated pre‐ and post‐loss family support in specialist adult palliative care and assessed bereavement outcomes.ResultsThe search yielded 3682 records. We included thirty‐nine mostly moderate to high‐quality studies (57% quantitative). Results suggest that pre‐loss support, like family‐focused interventions and communication during dying, may mitigate post‐loss anxiety, depression and grief. Individual and group post‐loss support interventions may reduce anxiety, distress and grief while improving well‐being. Families desire individualised and comprehensive pre‐ and post‐loss support, with few not needing or accepting it. Stigma associated with bereavement, support and barriers can hinder access.ConclusionIncluded studies demonstrated mixed effects of pre‐ and post‐loss family support interventions, suggesting they are beneficial when accessible and tailored to family needs. High‐quality intervention research assessing a broader range of family bereavement outcomes is needed.ImpactPalliative care nurses and other health professionals should tailor their care to family needs, start family support before patient death and ensure equitable access to bereavement services. Our results may guide palliative care professionals in designing effective, personalised and accessible services and policymakers in allocating resources for bereavement care. Findings highlight research needs, including investigating barriers to care and accessibility of services. High‐quality research is needed to understand who benefits the most from health‐promoting bereavement support and why.Reporting MethodWe adhered to the PRISMA guideline.Patient and Public ContributionNo Patient and Public Contribution.Protocol RegistrationOpen Science Framework <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://osf.io/36jeu\">https://osf.io/36jeu</jats:ext-link>","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"204 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002775","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":"Developing an Intervention to Improve Sexual Health Assessment and Care in Men With Inflammatory Bowel Disease","authors":"Sara Ma, Greg Forshaw, Mona Kanaan, Peter Knapp, Wayne Robinson, Christian Selinger, Paul Galdas","doi":"10.1111/jan.70199","DOIUrl":"https://doi.org/10.1111/jan.70199","url":null,"abstract":"AimTo co‐produce a prototype intervention to help nurses improve the assessment and care of the sexual health needs of men with inflammatory bowel disease.BackgroundInflammatory bowel disease can have a significant impact on the sexual health and well‐being of men, but has largely been neglected in research and clinical guidelines. Men with the disease report that sexual health is not discussed during consultations, while healthcare practitioners describe a lack of confidence to initiate sexual health assessments. At present, no evidence‐based tool exists to support nurses in detecting, assessing, and providing care for the sexual health of men with the disease.DesignA mixed‐methods study shaped by phase 1 of the Medical Research Council's framework for the development of complex interventions.Methods(1) Cross‐sectional surveys of (i) men with inflammatory bowel disease, (ii) nurses, and (iii) inflammatory bowel disease services to determine the current state of sexual health provision across the UK National Health Service. (2) Semi‐structured interviews with men and the partners of men with IBD and asynchronous focus groups with health professionals to explore appropriate and acceptable ways to provide sexual healthcare. (3) Three consecutive co‐production workshops inclusive of men with the disease, healthcare professionals, and stakeholders to formulate a prototype intervention.Implications for the Profession and/or Patient CareThis study will create an evidence‐based prototype intervention that will provide nurses with the knowledge and skills required to effectively assess the sexual health needs of men with inflammatory bowel disease and provide appropriate, patient‐centred care.Patient ContributionThe study design was supported by a patient group. The study delivery will be supported by a patient co‐investigator and stakeholder group inclusive of men with lived experience of the disease.Reporting MethodThis report adheres to the SPIRIT 2013 checklist for standard protocol items for clinical trials.Trial Registration<jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://clinicaltrials.gov\">clinicaltrials.gov</jats:ext-link> ID: NCT06562751","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"40 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002778","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":"Exploring the Role of Primary Care Nurses in Dietary Management for Migrants With Diabetes: A Scoping Review","authors":"Keycee Silang, Vainess Mbuzi, Coralie Graham, Leah East","doi":"10.1111/jan.70208","DOIUrl":"https://doi.org/10.1111/jan.70208","url":null,"abstract":"Aim(s)To explore how primary care practitioners, including nurses, provide dietary diabetes management to migrants.DesignThe scoping review followed, a refined and structured methodological framework and adhered to the Joanna Briggs Institute Scoping Review guidelines.Methods and Data SourcesSearches were conducted across CINAHL, PubMed, and Scopus databases to identify studies published between 2000 and 2024 that focus on dietary diabetes care for migrants in Primary Health Care settings. Data were synthesised using thematic analysis.ResultsThe search identified 377 studies, with 30 meeting the inclusion criteria. Analysis revealed four themes: (1) cultural influences on diabetes management, (2) culturally tailored dietary interventions, (3) communication challenges and (4) access and availability of diabetes care.ConclusionCulturally competent primary care practices are crucial for effective diabetes dietary management for migrants, as they can enhance patient engagement, adherence, and overall health outcomes. Primary care nurses are uniquely positioned to address the barriers experienced by migrant populations through tailored care delivery.Implications for Patient CareThe findings provide actionable guidance for nurses to implement targeted and culturally responsive approaches in delivering dietary diabetes management, aiming to improve patient adherence and health outcomes among migrants.ImpactThis review identified significant literature gaps in how primary care nurses provide culturally responsive dietary guidance for migrant patients with diabetes. The four themes identified have emphasised the need for culturally preserving care to enhance patient engagement and adherence to clinical guidance. The findings will directly impact nursing practice, education, and clinical guidelines globally, enabling nurses to deliver more effective and culturally responsive diabetes care that improves diabetes‐related disparities among migrants globally.Reporting MethodThe review adhered to PRISMA‐Sc guidelines.Patient or Public ContributionNo patient or public contribution. This review received no funding from public, commercial or not‐for‐profit sectors.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"35 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002807","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":"When Words Fail: ICU Nurses' Experiences Caring for Patients With Limited English Proficiency in the United States","authors":"Adrianna Lorraine Watson, Jeanette Drake, Melanie Livingston, Samuel Bennett Watson, Hiromi Tobe, Petr Ruda, Matthew Anderson, Jennifer Rigby, Saydie Holyoak, Ruthie Cook, Nadia Devol, Gabriela Marquez, Carol Urry, Rachel Detrick","doi":"10.1111/jan.70203","DOIUrl":"https://doi.org/10.1111/jan.70203","url":null,"abstract":"AimsTo explore the lived experiences of intensive care nurses caring for patients with limited English proficiency.DesignA hermeneutic, interpretive phenomenological design was used.MethodsSemi‐structured interviews were conducted with intensive care nurses recruited through purposive sampling. Data collection included Qualtrics screening surveys and semi‐structured Zoom interviews. The research team, comprising linguistically diverse faculty and undergraduate research assistants, employed reflexivity techniques to minimise bias and enhance interpretive rigour. Data were analysed via inductive analysis using the hermeneutic circle.ResultsFive main themes emerged organically from the data: <jats:list> <jats:list-item><jats:italic>Complications of Care Relating to Verbal Communication Challenges.</jats:italic></jats:list-item> <jats:list-item><jats:italic>Benefits and Barriers of Nursing Informatics in Linguistic Care.</jats:italic></jats:list-item> <jats:list-item><jats:italic>The Universal Language: Nursing Effort Builds Trust.</jats:italic></jats:list-item> <jats:list-item><jats:italic>The Ripple Effect: Chronological Considerations for Patient Care.</jats:italic></jats:list-item> <jats:list-item><jats:italic>Moving Forward: Where Do We Go From Here?</jats:italic></jats:list-item> </jats:list>Based on these findings, a four‐phase model was developed to guide individual and system‐level interventions to reduce nurse moral distress and improve language equity in critical care.ConclusionLanguage barriers in the intensive care unit hinder communication, increase stress for patients and nurses, and impact care quality. While nurses' efforts to bridge these gaps are valued, systemic changes (such as expanded interpreter availability and improved cultural safety training) are necessary to support culturally, linguistically, and medically appropriate care.Implications for the Profession and/or Patient CareFindings highlight the need for increased institutional support, additional resources for night‐shift staff, and the integration of cultural humility education into intensive care training. The <jats:italic>Limited English Proficiency Moral Distress Action Cycle for Critical Care Nursing</jats:italic>, developed from this study, offers a flexible framework to guide the implementation of these improvements and reduce nurse moral distress. Future research should explore interventions to promote cultural and linguistic competence in multilingual patient populations.Impact<jats:italic>Q: What problem did the study address?</jats:italic>A: The nurse‐identified clinical, ethical, and workflow risks created when interpreters or translation tools are inadequate for critical care.<jats:italic>Q: What were the main findings?</jats:italic>A: Language barriers jeopardise teaching, informed consent, and symptom reporting. Video and phone interpreters or translation apps are vital but are often scarce, unreliable, or impersonal, particularly during night shifts. Nur","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"33 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002777","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":"Frail Older Patients' Experiences During Boarding in the Emergency Department: A Qualitative Study","authors":"Charlotte Bjurbo, Ulrika Eriksson, Åsa Muntlin","doi":"10.1111/jan.70173","DOIUrl":"https://doi.org/10.1111/jan.70173","url":null,"abstract":"AimTo explore how frail older patients experience their stay and nursing care during boarding time at the emergency department.DesignA qualitative explorative interview study.MethodPurposive sampling was used, with a two‐step selection process: (1) Patients 65 years or older spending at least 4 h at the emergency department waiting for a hospital bed, referred to as boarding time, were (2) screened for frailty using the FRail Elderly Support researcH group screening instrument. If screening identified a patient as frail, they were eligible for an interview. Individual semi‐structured interviews (<jats:italic>n</jats:italic> = 19) were conducted during patients' boarding time at the emergency department. Data was collected between March and April 2019. The theoretical Fundamentals of Care framework shaped the interview guide. Interviews were transcribed and an inductive latent content analysis was performed.ResultsThe findings resulted in four main categories: Frail older patients felt <jats:italic>disregarded</jats:italic>, <jats:italic>defenceless</jats:italic>, and <jats:italic>resigned</jats:italic> during boarding time at the emergency department, yet also <jats:italic>hopeful</jats:italic>. The experience of hope resulted from confidence in the nurses, good nursing care, patience towards one's situation, and hope in emergency care.ConclusionThe frail older patient experienced boarding time in the emergency department through an overarching theme: ‘being left in no‐man's land in the emergency department but still feeling hopeful’. A trusting nurse–patient relationship, integrating the provision of fundamental care, is a favourable factor for the well‐being of the frail older patient.ImpactThe study addressed the increased number of older adults with complex health needs, coupled with overcrowded emergency departments. Frail older patients perceive the boarding time as being left in a ‘no‐man's‐land’, addressing unclear information and lack of caregiver responsibility. This highlights the need for tailored guidelines and care practices that promote person‐centred care and ensure safety for this vulnerable group in emergency settings.Patient or Public ContributionNot applicable.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"44 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930133","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}