The journal of nursing research : JNR最新文献

{"title":"Parental Perceptions of Physical Therapy Use Among Children With Cerebral Palsy: A Meta-Synthesis.","authors":"Maggie Dumsile Dlamini, Ying-Ju Chang, Zama Mkhonta","doi":"10.1097/jnr.0000000000000692","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000692","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy (CP), the most common cause of childhood motor disability, is often associated with comorbidities such as epilepsy and spasticity. CP is a heterogeneous group of disorders attributed to the nonprogressive injury of the developing brain during fetal life or infancy affecting posture and movement. Physical therapy, the most important current intervention for CP, targets the relief of muscle stiffness, reduction of perceived pain, and improvement of patient mobility.</p><p><strong>Purpose: </strong>This study was designed to synthesize the qualitative evidence on the perceptions of parents regarding the utilization of physical therapy in the treatment of children with cerebral palsy.</p><p><strong>Methods: </strong>Four electronic databases, including CINAHL, Embase, OVID Medline, and ERIC, were searched for relevant qualitative studies in March 2023. The included studies were critically appraised using the Critical Appraisal Skills Program tool for qualitative research by 2 independent reviewers, and a content thematic approach was used to synthesize the qualitative findings.</p><p><strong>Results: </strong>The 8 studies published between 1990 and 2022 included in this review covered data from 150 participants. The 47 findings extracted from these studies were grouped into 11 subthemes and finally into the following 4 synthesized themes: (1) physical therapy is an essential treatment with many positive outcomes, (2) the success of physical therapy depends on realistic partnerships, (3) honest and organized communication flow is critical, and (4) key challenges in physical therapy include service delivery, personal and family adjustments.</p><p><strong>Conclusions: </strong>Overall, the parents in the included studies perceived physical therapy as an ideal treatment associated with many positive outcomes for their children with disabilities and as a source of hope for their children's future. Notably, the parents required clear information on the goals of therapy from the outset and to be involved in all care planning to promote therapy compliance.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resonant Leadership and Proactive Vitality Management in Nurses: The Mediating Role of Post-COVID-19 Organizational Compassion.","authors":"Nadia Hassan Ali Awad, Nariman Ahmed Mohamed Elbassal, Heba Mohamed Al-Anwer Ashour","doi":"10.1097/jnr.0000000000000695","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000695","url":null,"abstract":"<p><strong>Background: </strong>In the post-COVID-19 era, health care organizations must become more compassionate and focus on empathizing with their employees, noticing change in their behavior through continuous assessment, and responding to their suffering. Thus, health care organization leaders must be more emotionally responsive and provide compassionate support to the nurses through a resonant leadership style. Resonant leaders exhibit passionate insights, are attuned to the emotions of their followers, employ empathy, and effectively manage their feelings to build strong, trustworthy relationships and foster an environment of hope that motivates dedication. Consequently, applying a resonant leadership style in the presence of organizational compassion can enhance nurses' proactive vitality to success in dealing with challenging and uncertain circumstances, especially during and after pandemics.</p><p><strong>Purpose: </strong>This study was designed to develop a structural equation model to investigate the impact of resonant leadership on the proactive vitality management of nurses, with organizational compassion as a mediating variable.</p><p><strong>Methods: </strong>A cross-sectional survey with a convenience sampling technique was used on 520 nurses recruited from 3 public general hospitals in Alexandria, Egypt. Three instruments were used to collect the required data from January 2023 to June 2023, including the resonant leadership scale, nurses' proactive vitality management scale, and organizational compassion scale.</p><p><strong>Results: </strong>The results of the structural equation model showed that the degree of fit for each index model was good, indicating all of the study variables, including resonant leadership and nurses' proactive vitality management were directly affected by organizational compassion, confirming organizational compassion to be a mediating variable between resonant leadership and proactive vitality management.</p><p><strong>Conclusions: </strong>Organizational compassion is a mediating factor that enhances resonant leadership and stimulates nurses' proactive vitality management. The research results suggest valuable protocols for health care organizations seeking to encourage nurses' proactive vitality through effective emotional and resonant leadership in the context of organizational compassion.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Resistance Exercise in Older Adults With Sarcopenic Obesity: A Systematic Review and Meta-Analysis.","authors":"Su-Ru Chen, Mei-Chuan Chen, Wen-Hsuan Hou, Pi-Chu Lin","doi":"10.1097/jnr.0000000000000685","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000685","url":null,"abstract":"<p><strong>Background: </strong>In Taiwan's aging society, age-related sarcopenic obesity has gradually become an important health issue. Sarcopenic obesity is associated with functional limitations, falls, disabilities, mental health problems, and even mortality.</p><p><strong>Purpose: </strong>The aim of this meta-analysis was to examine the effects of resistance exercise on body composition and physical functioning in older adults with sarcopenic obesity.</p><p><strong>Methods: </strong>A search of randomized controlled trials was conducted in six electronic medical databases from their inception to December 2023.</p><p><strong>Results: </strong>Twelve studies were included in the systematic review and meta-analysis, with results indicating a significant increase in grip strength (effect size=1.560, 95% confidence interval [CI]=[0.178, 2.941]; p=.027) and significant reduction in body fat percentage (effect size=-1.737, 95% CI=[-2.563, -0.912], p<.001) in the experimental group versus the control group. However, gait speed and body mass index were not significantly improved by resistance exercise interventions.</p><p><strong>Conclusions: </strong>The findings support a positive effect of resistance exercise on grip strength and body fat percentage in older adults with sarcopenic obesity.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Auricular Acupressure on Glycemic Markers, Stress, and Sleep in Older Adult Patients With Type 2 Diabetes: A Randomized Controlled Trial.","authors":"Hyejin Lee, Bomi Kim, Hyojung Park","doi":"10.1097/jnr.0000000000000683","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000683","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of diabetes is a significant concern and is particularly impactful on the older adult population. Auricular acupressure is recognized as an effective complementary treatment for Type 2 diabetes.</p><p><strong>Purpose: </strong>The purpose of this study is to examine the effect of auricular acupressure on glycemic markers, stress, and sleep quality in older adults with Type 2 diabetes in South Korea.</p><p><strong>Methods: </strong>The study involved weekly acupressure therapy sessions for 8 weeks, with 25 participants in the intervention group and 26 in the placebo group. Specific acupoints associated with diabetes, sleep, and stress were targeted in the intervention group, while unrelated acupoints were used in the control group. Subjective indicators such as stress and sleep scales, along with objective measures such as blood tests, heart rate variability, and sleep activity recorders, were employed in the analysis.</p><p><strong>Results: </strong>Significant differences were observed in blood sugar (F=5.20, p <.001) and glycated hemoglobin (Z=-2.345, p=.019) between the two groups after administration of the acupressure therapy. However, no significant between-group differences were found in either glycated albumin or fructosamine. Also, activity in the sympathetic and parasympathetic nerves showed significant between-group variation. Although no significant between-group differences were found for subjective sleep indicators, notable changes in the number of awakenings, duration of awakening, REM sleep, and deep sleep conditions were identified.</p><p><strong>Conclusions: </strong>Although the effects are not strong, the findings suggests auricular acupressure influences glycemic index, stress, and sleep quality in older individuals with type 2 diabetes positively. The results of this study support the potential of using auricular therapy as a nursing intervention in diabetes management.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Burden: Exploring Key Factors in Dementia Caregiving in Residential Care Homes.","authors":"Yi-Heng Chen, Li-Chan Lin, Pei-Hao Chen, I-Hsuan Lu","doi":"10.1097/jnr.0000000000000690","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000690","url":null,"abstract":"<p><strong>Background: </strong>The factors of influence on caregiver burden with regard to dementia care provided in residential care homes are multifaceted. Few studies in the literature have simultaneously investigated the variables related to residential care recipients with dementia and their formal caregivers.</p><p><strong>Purpose: </strong>This study was designed to assess caregiving burden in formal caregivers of residential care recipients with dementia and to identify significant predictors of this burden associated with these care recipients and their caregivers.</p><p><strong>Methods: </strong>This prospective cross-sectional study enrolled 206 registered nurses and nursing assistants working as formal caregivers, as well as 256 residents with dementia across 6 residential care homes. Structured questionnaires were used to collect data on the sociodemographic characteristics, attitudes, dementia care knowledge, and caregiver burden of nursing staff, as well as data on the sociodemographic characteristics, daily functional ability, cognitive functioning, and neuropsychiatric symptoms of residential care recipients with dementia.</p><p><strong>Results: </strong>The formal caregivers in this study reported experiencing mild to moderate care burden. Stepwise linear regression analysis identified prior dementia care training, confidence in care provision, and attitude in the formal caregivers and number of medications and agitation/aggression levels in the residents as significant predictors of caregiving burden, explaining 32% of the variance. Unexpectedly, the basic dementia care knowledge of the caregivers and the physical dependence and other neuropsychiatric symptoms of the residents were not identified as significant predictors of caregiver burden.</p><p><strong>Conclusions/implications for practice: </strong>The findings of this study underscore the critical importance of caregiver attitude, confidence, and coping skills in determining caregiving burden, noting that not all behavioral and psychological symptoms impact this burden equally. These insights emphasize the need to enhance confidence and positive attitudes in formal caregivers and to effectively manage residents' aggressive behaviors through both pharmacological and nonpharmacological approaches to ameliorate the high caregiver burden associated with dementia care.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Influence of Mindful Self-Care on Workplace Engagement Among Nurses: A Path Analysis.","authors":"Nasra Abdelhadi, Irit Bluvstein, Ronit Kigli-Shemesh, Semyon Melnikov","doi":"10.1097/jnr.0000000000000688","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000688","url":null,"abstract":"<p><strong>Background: </strong>Work engagement in nurses is influenced by a variety of factors, with compassion fatigue identified as a negative predictor and resilience identified as a positive predictor. Although mindful self-care (MSC) may influence work engagement, this potential relationship has not been validated in the literature.</p><p><strong>Purpose: </strong>This study was designed to examine the relationship between MSC and work engagement in a sample population of nurses in Israel and to investigate the potential mediating effects of compassion fatigue, resilience, and internal health locus of control (IHLC) on this relationship.</p><p><strong>Methods: </strong>A quantitative cross-sectional study design was used, and data were collected from 845 nurses working in different clinical settings in Israel. A self-administered questionnaire was administered online between March and June 2023 to assess MSC, compassion fatigue, resilience, IHLC, and work engagement. A hypothesized model based on the Job Demands-Resources Theory was proposed. Descriptive statistics and path analysis were utilized in data analysis.</p><p><strong>Results: </strong>The proposed model demonstrated a good fit with the empirical data, explaining 17.2% of the variance in work engagement. Direct relationships were identified between work engagement and, respectively, MSC, compassion fatigue, resilience, and IHLC (β=-0.131, p < .01; β=0.011, p < .01; β=0.116, p < .05; β=0.280, p < .01, respectively). The relationship between MSC and work engagement was shown to be mediated by compassion fatigue and resilience (β=0.068, p < .01), while compassion fatigue was shown to partially mediate the relationship between MSC and resilience (β=0.025, p <01). IHLC was not found to be significantly associated with work engagement.</p><p><strong>Conclusions: </strong>MSC is a significant predictor of work engagement among nurses. Practicing MSC increases personal resilience and prevents compassion fatigue, leading to higher work engagement. Thus, we recommend nurse managers promote the regular practice of MSC, along with traditional self-care behaviors, among nurses to improve work engagement.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Technologies in Community-Based Older Adult Care: The Perception of Nurses.","authors":"Sivia Barnoy, Tal Soffer, Yoel Raban, Irit Schwartz-Attias, Mali Kusha, Hagar Wechsler, Sigalit Warshawski","doi":"10.1097/jnr.0000000000000687","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000687","url":null,"abstract":"<p><strong>Background: </strong>Concurrent with a growing shortage of nurses, the number of older adults living with chronic conditions and disabilities in the community is increasing. Emerging technologies present solutions that may impact nurses' training and patient care.</p><p><strong>Purpose: </strong>This study was designed to explore (a) the familiarity of nurses with emerging technologies, their need for additional training, and their perception of the effects of these technologies on the care of older adults in the community and (b) the relationships between the research variables and, respectively, sociodemographic and professional data.</p><p><strong>Methods: </strong>A descriptive, cross-sectional design was used, and a structured questionnaire was distributed to community nurses throughout Israel between November 2022 and February 2023.</p><p><strong>Results: </strong>Positive associations were found between nurses' familiarity with technology, the need for additional training, and the perceived general and specific effects of these technologies on older adult care. Moreover, technological familiarity and the need for training predicted the perceived impact of these technologies on older adult care.</p><p><strong>Conclusions/implications for practice: </strong>The results highlight the importance of familiarizing nurses in community settings with emerging and advanced technologies. This may promote and improve the quality of care provided to older adults in the community. Moreover, continuing training and education for nurses on emerging technologies are essential to familiarize nurses with new technologies, increase technology acceptance, and enhance the quality of care provided to older adults in the community.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Willingness: What Drives Dialysis Withdrawal Decisions in Patients With End-stage Renal Disease? A Cross-sectional Study.","authors":"Cheng-Pei Lin, Jung-Chi Lee, Chi-Feng Pan, Yu-Chi Chen","doi":"10.1097/jnr.0000000000000684","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000684","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Withdrawal from dialysis in patients with end-stage renal disease (ESRD) can mitigate futile treatments and facilitate early end-of-life care preparation. However, the reasons patients willingly withdraw from elective dialysis under varying disease prognoses, and the factors that influence these decisions, remain unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To explore the factors influencing the willingness to electively withdraw from dialysis in patients with ESRD at different disease prognoses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional observational study was conducted in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Using convenience sampling, patients aged ≥ 45 who had regularly undergone hemodialysis for more than 6 months were recruited from a medical center and a local clinic. We used structured questionnaires and chart reviews to collect data from February to April 2021. Descriptive analysis, Pearson's correlations, and stepwise regression were employed to assess willingness to electively withdraw from dialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 121 participants enrolled were of an average age of 61.09 years, had undergone dialysis for 7 years, and had a median of four comorbidities. Willingness to withdraw from dialysis increased as their disease worsened. However, more than half preferred to continue dialysis, with the number of patients decreasing from 76% to 53.7% across the disease deterioration trajectory. The participants identified nephrologists as the most influential individuals in their dialysis withdrawal discussions. Factors associated with dialysis withdrawal decisions across all hypothetical prognosis scenarios (current disease conditions, irreversible complications, and estimated survival &lt; 6 mo) included poor quality of dialysis, lower educational level (junior high school), and better knowledge of palliative care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions/implications for future practice: &lt;/strong&gt;Willingness to withdraw from dialysis is associated with dialysis quality, educational level, and palliative care knowledge under different hypothetical prognosis scenarios. Nephrologists play a pivotal role in initiating withdrawal discussions and influencing decision-making. Health care providers should consider these factors during routine renal nursing care and identify the appropriate time to initiate advanced care planning discussions. Regular monitoring of dialysis-related symptoms and quality (measured by Kt/V) and evaluating patients' understanding of palliative care are both essential in ESRD care. As primary caregivers, nurses play a crucial role in integrating these assessments into routine care to identify patients considering dialysis withdrawal. Collaborative efforts between nurses and nephrologists are vital to initiate timely end-of-life care discussions and preparations, improve patient-centered care, and improve end-of-life o","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronotype and Sleep Quality in College Students Undergoing Clinical Placement: A Moderated Moderation Model of Sleep Reactivity and Resilience.","authors":"Renny Wulan Apriliyasari, Jia-Wei Liu, Chia-Wen Chou, Jin-Hua Chen, Pei-Shan Tsai","doi":"10.1097/jnr.0000000000000681","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000681","url":null,"abstract":"<p><strong>Background: </strong>Chronotype, also referred to as morningness and eveningness, describes the natural preference of the body for wakefulness or sleep at different times during a 24-hour period. Individuals demonstrating late chronotypes and low resilience tend to have poor sleep quality, and the association between late chronotypes and sleep quality is known to be moderated by sleep reactivity. The mediating roles of sleep reactivity and psychological resilience in the association between chronotype and sleep quality in college students under situations of high stress have yet to be investigated.</p><p><strong>Purpose: </strong>This study was designed to evaluate the degree to which resilience moderates the moderating role of sleep reactivity on the association between chronotype and sleep quality in college students undergoing clinical placement.</p><p><strong>Methods: </strong>A cross-sectional study involving 225 college students undergoing clinical placement was conducted. The Chinese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality, chronotype was assessed using the Morningness-Eveningness Questionnaire, sleep reactivity and resilience were respectively assessed using Ford's Insomnia Response to Stress Test and Brief Resilience Scale, and the SPSS PROCESS macro Version 4.3 (Hayes) was employed in moderated moderation analysis.</p><p><strong>Results: </strong>Resilience was shown to moderate the relationship between sleep reactivity and sleep quality (β=0.079, P=0.039) as well as the moderating role of sleep reactivity in the chronotype-sleep quality relationship (β=-0.002, P=0.027).</p><p><strong>Conclusions: </strong>In this study, sleep reactivity and chronotype both exhibited inverse effects on sleep quality in the moderate- and high-resilience groups. However, those in the low-resilience group with high sleep reactivity exhibited low sleep quality regardless of chronotype. Considering these findings, sleep reactivity and resilience should be adequately monitored during interventions designed to enhance sleep quality.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Entrustable Professional Activity-Based Assessment Scale for Nurse Practitioners in Taiwan.","authors":"Sophia Huey-Lan Hu, Shiow-Luan Tsay, Sheng-Shiung Huang, Heng-Hsin Tung, Ying-Ru Chen, Ling-Chun Lu, Chi Chang, Jia-Ying Hu, Wei-Chieh Hung","doi":"10.1097/jnr.0000000000000682","DOIUrl":"https://doi.org/10.1097/jnr.0000000000000682","url":null,"abstract":"<p><strong>Background: </strong>Competency-based education is essential for training nurse practitioners (NPs). Although entrustable professional activities (EPAs) have been widely used to assess competency in health professionals, a valid EPA-based assessment scale is required to assess the clinical competencies of NPs in acute care settings.</p><p><strong>Purpose: </strong>The aim of this study was to develop and examine the reliability and validity of an EPA-based assessment scale for NPs.</p><p><strong>Methods: </strong>A psychometric study with a cross-sectional survey was used in this study. The participants included NP instructors as evaluators and novice NPs currently in clinical practice as test takers. Convenience sampling was used to recruit participants from among members of the Taiwan Association of Nurse Practitioners. First, five EPA focus groups were used to develop five EPAs using a template and following the suggested steps. Second, a consensus validation was conducted using the Delphi study. Third, content validity was performed through a national study involving 218 novice NPs as test takers and 57 certified clinical NP educators serving as observers to test the EPAs. The Cronbach's alpha and intraclass correlation coefficient were calculated to examine EPA-based assessment scale reliability, and exploratory factor analysis, concurrent validity, and discriminant validity were applied to assess the validity of the EPAs. Finally, the EPA-based assessment scale of NP care for patients with fever was used in data analysis.</p><p><strong>Results: </strong>The final version of the EPA-based assessment scale included a 22-item observable checklist scale designed to evaluate the clinically independent performance (1-5) of nine key NP competencies. The Cronbach's alpha coefficient for the overall scale was .95. The results revealed that the EPA-based assessment scale addressed two key factors of direct patient-centered care and communication/time management. Factor loadings for each item ranged from .58 to .83, accounting for 70.83% of the total variance in the EPA-based assessment scale. Concurrent validity indicated a high correlation between the developed EPA-based assessment scale and the Ottawa Clinic Assessment Tool (r = .96, p < .001). The results of the discriminant validity analysis indicated a statistically significant difference between novice and expert NPs (F = 7.84, p < .001).</p><p><strong>Conclusions/implications for practice: </strong>The novel EPA-based assessment scale developed in this study demonstrated satisfactory reliability and validity, thereby supporting its application in evaluating the clinical competencies of NPs.</p>","PeriodicalId":94242,"journal":{"name":"The journal of nursing research : JNR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}