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Aim: The aim of this study is to analyse the risk factors for unplanned readmissions within 1 month after hospital discharge to develop a seamless support system from discharge to home care. Background: With shorter hospital stay lengths, understanding the characteristics of patients with multiple risk factors is important to prevent rehospitalization. Design: This is a single‐centre retrospective descriptive study. Methods: Logistic regression and decision tree analyses were performed using eight items from the records of 3117 patients discharged from a university hospital between April–September 2017 as risk factors. Results: Unplanned readmission risk was significantly associated with emergency hospitalization (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.04–4.77), malignancy (OR: 2.16, 95% CI: 1.44–3.24), non‐surgical admission (OR: 1.76, 95% CI: 1.07–2.88), hospital stay of ≥ 15 days (OR: 1.66, 95% CI: 1.14–2.43) and decline in activities of daily living owing to hospitalization (OR: 1.68, 95% CI: 1.06–2.64). The highest risk combinations for rehospitalization were as follows: emergency hospitalization and malignancy; emergency admission, non‐malignancy and a hospital stay of ≥15 days; and scheduled hospitalization, no surgery and a hospital stay of ≥15 days. Conclusions: Patients with multiple risks for unplanned readmission should be accurately screened and provided with optimal home care. Summary statement: What is already known about this topic? Although the characteristics of patients at high risk of rehospitalization include malignancy, heart failure, conditions such as chronic obstructive pulmonary disease and other diseases prone to recurrence, old age, reduced activities of daily living and emergency hospitalization, few studies have reported on cases with multiple risks. What this paper adds? The most frequent risk types for unplanned readmissions within a month were emergency admissions for malignant tumours, emergency admissions for non‐malignant tumours with a hospital stay of 2 weeks or more and scheduled admissions for non‐surgical purposes with a length of stay of 2 weeks or more. The implications of this paper: The risk of unplanned readmission within 1 month of discharge increased due to a combination of multiple risks.This study helps us identify patients who are at high risk for readmission early in the hospitalization process and in providing nursing support for transition to their homes. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Design: Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Methods: Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Results: Participants continued to deliver a significant proportion of patient care inperson. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. Conclusion: The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. Impact: The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Reporting method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or public contribution: This was a workforce study so there was no patient or public contribution. Implications for the profession and patient care: The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward. [ABSTRACT FROM AUTHOR]

Background: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. Design: This study was designed as an instrument development study. Methods: This study aimed to develop a scale to measure the attitudes of parents with children aged 0–5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item‐level test–retest analyses for reliability. Results: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28‐item two factors = 62.47%). Conclusion: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health‐care services based on the results of the measurement. Summary statement: What is already known about this topic? Vaccination plays an important role in health practice.Parents' attitudes towards vaccination affect their children's vaccination status.Increasing vaccination rates in children will contribute to the reduction of infectious diseases and mortality. What this paper adds? A new valid and reliable measurement tool for determining vaccine hesitancy has been developed.The validity and reliability of the scale of attitudes towards vaccination among parents of children aged 0–5 years were tested.The tool could be used to determine the attitudes of parents of children aged 0–5 years towards vaccination. The implications of this paper The scale may help in determining factors affecting parents' attitudes on vaccination.The scale can generate data to guide nursing practices to increase vaccination rates.The scale can be used to influence nursing practices to increase vaccination rates and promote vaccine awareness, trust and acceptance. [ABSTRACT FROM AUTHOR]

Background: Vaccination is a crucial protective intervention to prevent adult mortality and morbidity. Personal perceptions and resources have an important place in the vaccination decision. Aim: This study aimed to modify the Public Attitude Towards Vaccination–Health Belief Model scale for adult vaccines and evaluate its psychometric properties. Methods: Overall, 626 people participated in this methodological study. Content validity index, confirmatory factor analysis, internal consistency and item‐total score correlation were used for validity and reliability. The independent samples t test, logistic regression analysis and ROC analysis were used for criterion and concurrent validity. Results: In confirmatory factor analysis, values of fit indices were excellent or acceptable. The Cronbach alpha value was between 0.83 and 0.92. According to criterion validity, the susceptibility, severity, benefit, and health motivation scores of those with the vaccine were higher than those without, whereas their barrier score was lower. The barrier subscale was a risk factor, whereas the benefit score was a protective factor that increased the likelihood of vaccination. The concurrent validity of the scale was tested with the COVID‐19 vaccine. While the barrier subscale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is excellent, it is acceptable for the other subscales. Conclusion: Modified PAVS‐HBM is valid and reliable for adult vaccines. This scale was associated with vaccination behaviour and distinguished between vaccinated and unvaccinated individuals. Summary statement: What is already known about this topic? Vaccination rates are low in many countries due to issues of access, economy and infrastructure and in countries that provide vaccines.Low vaccination rates in adults are associated with mortality and morbidity.Vaccination management success is enhanced by orientation towards individual perceptions. What this paper adds? The modified Public Attitude Towards Vaccination Scale–Health Belief Model (PAVS‐HBM) was demonstrated as a reliable and valid scale.This scale explains the vaccination behaviour for different adult vaccines.This scale's ability to distinguish between vaccinated (specificity) and unvaccinated (sensitivity) individuals is acceptable to excellent. The implications of this paper for practice: The scale can be used as a tool for researchers to evaluate the probability of individuals being vaccinated and to determine risk groups for vaccine refusal.It can be integrated with many models focused on behaviour change, and when used with a health model, the scale's explanation of individuals' vaccination behaviour can guide the structuring of nursing interventions for vaccination. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the complexity of the needs of people with delirium superimposed on dementia • To enhance your knowledge of second-generation activity theory • To recognise the consequences of the separation of physical health and mental healthcare. Background: Delirium superimposed on dementia (DSD) affects the physical, mental and cognitive well-being of the person. The separation of physical health and mental health means that the care of people with DSD is at odds with the multifaceted aetiology and presentation of the condition. There is a lack of research on DSD from a mental health perspective. Aim: To explore UK mental health nurses’ experiences of providing care for people with DSD. Method: Individual semi-structured interviews were conducted with seven mental health nurses from one NHS trust in England. Participants’ experiences were considered through the lens of second-generation activity theory. Data were analysed using framework analysis. Findings: Six themes were identified: awareness of guidance and tools; guidance or tools as ‘paper exercises’; knowing the patient; the multidisciplinary team; care burden; and mental health versus physical health. Conclusion: When providing care for people with DSD, mental health nurses use their skills in knowing patients as individuals. However, this aspect of ‘knowing’ cannot be readily translated into the use of a numerical scoring tool. An integrated approach is required to support the care of people with DSD. [ABSTRACT FROM AUTHOR]

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Background: Nursing interventions in the post‐operative time period including psychological and emotional support, adverse event education, and instructions for follow‐up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post‐anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post‐operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. Aims: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated‐measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. Methods & Materials: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)‐approved study was a repeated‐measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. Results: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post‐operative Day 1. Fifty‐nine participants (78%) completed the surveys on post‐operative Day 14. Discussion: As the frequency of outpatient treatment increases, nurses conducting post‐operative research will need to collect the data outside of the hospital setting. Conclusion: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non‐traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to present a mixed methods study of child criminal exploitation (CCE), particularly in the form of "county lines", in three local authorities in southeast England. The data is analysed using a framework constructed from two relevant contextual and relational theories to understand experiences of CCE and the safeguarding responses undertaken to protect young people from harm. Design/methodology/approach: Data were drawn from a survey (n = 118); interviews (n = 5) and focus groups (n = 15) with professionals; interviews with parents (n = 4); and from secondary analysis of eight interviews with young people affected by criminal exploitation. The analytic framework was applied to the data to answer two research questions: what is the role and significance of young people's interactions with peers, parents and professionals in their CCE trajectories; and how do professionals understand and address risks within contexts in which young people are exposed to CCE? The mixed methods data collected by the authors were coded and analysed using this framework. Findings: Although professionals were aware of contexts and relational power dynamics, the situated and temporal nature of CCE remained overlooked within safeguarding systems. Professionals required more space, time and support to fully and flexibly engage with young people and their families to increase safety. Originality/value: There is limited research available that critically examines safeguarding responses to CCE in diverse geographic and cultural contexts. This paper contributes a critical account of how professionals might create connections and opportunities for change with young people, identifying structural constraints within practice systems alongside emerging examples of effective practice. [ABSTRACT FROM AUTHOR]

Background: The aim of the research was to translate, culturally adapt and validate the Caring Behaviors Assessment (CBA) tool in Spain, ensuring its appropriateness in the Spanish cultural context. Methods: Three-phase cross-cultural adaptation and validation study. Phase 1 involved the transculturation process, which included translation of the CBA tool from English to Spanish, back-translation, and refinement of the translated tool based on pilot testing and linguistic and cultural adjustments. Phase 2 involved training research assistants to ensure standardized administration of the instrument. Phase 3 involved administering the transculturally-adapted tool to a non-probabilistic sample of 402 adults who had been hospitalized within the previous 6 months. Statistical analyses were conducted to assess the consistency of the item-scale, demographic differences, validity of the tool, and the importance of various caring behaviors within the Spanish cultural context. R statistical software version 4.3.3 and psych package version 2.4.1 were used for statistical analyses. Results: The overall internal consistency of the CBA tool was high, indicating its reliability for assessing caring behaviors. The subscales within the instrument also demonstrated high internal consistency. Descriptive analysis revealed that Spanish participants prioritized technical and cognitive aspects of care over emotional and existential dimensions. Conclusions: The new version of the tool proved to be valid, reliable and culturally situated, which will facilitate the provision of objective and reliable data on patients beliefs about what is essential in terms of care behaviors in Spain. Key points: • This paper provides a culturally translated, adapted, and validated version of the Caring Behaviors Assessment tool in the Spanish context, which can be used to obtain reliable and culturally adapted data on essential aspects of patient care. • The findings of this study contribute to the wider global clinical community by demonstrating the importance of considering cultural factors when assessing and evaluating patient care from patients' own perspective, and also emphasizes the need for culturally sensitive approaches in healthcare settings. • This validated instrument facilitates the measurement of caring behaviors in the Spanish context, allowing for objective evaluation and improvement. Use of the Caring Behaviors Assessment tool could thus serve as a valuable resource for both future research and clinical practice. [ABSTRACT FROM AUTHOR]

Objective: It is widely understood that a key means of improving health systems and patient outcomes is through research – accessing, understanding, generating and applying research evidence-based practice. To promote more targeted and strategic research in Allied Health practice, this study sought to establish the principles, areas and priorities for clinical research as perceived by Allied Health leaders in the South Australian public health system. Methods: The study used a mixed-methods design (full, sequential and equal model). Participants were recruited from the South Australian Department of Health and Wellbeing employment lists for Allied Health senior leaders. Consenting participants attended face-to-face focus groups; after an overview presentation, they discussed the principles for Allied Health research, followed by areas and priorities for research. Summaries of the responses were themed descriptively and circulated electronically so participants could confirm the research areas and ascribe priority ratings, clinical populations and services. Results: A total of 28 people attended the stakeholder forum (5 online); 20 responded to the second-round electronic summary. Nine principles of research action were agreed. Fourteen research areas were identified and prioritised. There was a relatively consistent prioritisation of measuring Allied Health value, Allied Health workforce, hospital avoidance and closing the gap for Aboriginal and Torres Strait Islander peoples health outcomes – whether the individuals were thinking about their own service or the state as a whole. Conclusions: Allied Health leadership identified key principles and priorities for research to improve service delivery and patient outcomes. These priorities should generate further discussion and interest for novice and experienced researchers and leaders and can be used to inform granting and project plans. What is known about the topic? Allied Health are well equipped to engage in research but have limited capacity. What does this paper add? We have identified key priorities and principles to inform Allied Health research activity. What are the implications for practitioners? Practitioners, funders and other stakeholders can develop these identified principles and priorities to direct research time and resources for the most impact on health outcomes. [ABSTRACT FROM AUTHOR]

Background: Haptic feedback has been shown to be an effective facilitator of the learning of scientific concepts in a series of studies. However, little is known about the underlying salient learning mechanisms, which are activated when learning from haptic feedback. Objectives: We investigate the learning mechanism in a higher chemistry education setting, in which the students learned about the abstract concept of potential energy in a quantum chemical context. Methods: In this work, we present a mixed‐methods problem‐solving prior to instruction (PS‐I) study with chemistry bachelor students. In an interactive quantum chemistry learning environment, the students explored the energetic profiles of nucleophilic substitution reactions and the corresponding activation barriers experienced as repulsion and attraction. We measured cognitive and affective mechanisms which have been shown to be activated in PS‐I designs, such as knowledge gap awareness, state curiosity, and positive affect as well as the learning outcome quantitatively and the learning trajectories qualitatively. Results and Conclusions: Planned contrasts revealed a small hindering effect of the haptic feedback on the learning outcome. Thematic analysis of the qualitative data lets us attribute this effect to the lack of scaffolding of the haptic feedback and the spontaneous atomic movements in the simulation, which may be interpreted as a visual representation of force in itself. This work highlights the importance of accurate mappings of the haptic feedback unto the target domain and further delivers insight into the prior conceptions of chemistry undergraduate students. Lay Description: What is already known about this topic: Haptic feedback can facilitate learning by grounding abstract concepts in sensory experiences.While previous studies have reported positive affective results, the cognitive results are ambiguous.Moreover, it was frequently reported that the learning of potential energy in a (quantum) chemical context is particularly difficult due to (i) the lack of grounding opportunities and (ii) the diverse previous conceptions. What this paper adds: A learning environment to interact with molecular systems in real‐time is proposed.The concept of activation energy is grounded in sensory experience of pushing and being pulled.The mixed‐methods design allows to explore cognitive and affective variables as well as the specific prior conceptions activated by the environment. Implications for practice and/or policy: We found a small negative effect of the haptic feedback on the learning outcome, potentially due to insufficient introduction of it to the students.The spontaneous movement of the atoms was identified as a more suitable external representation of the force.Future studies should investigate, if explicit introduction of the embodied metaphor can reverse this effect. [ABSTRACT FROM AUTHOR]

While bystander intervention education has demonstrated promise as a strategy to reduce dating and sexual violence (DSV) on campus, little is known about whether survivors on whose behalf the interventions take place find these helpful. This paper uses qualitative, in-depth interviews with 33 DSV survivors to explore their perspectives on bystander intervention. Results indicate that while some interventions were identified as helpful, especially those that provided support to the survivor, many were not helpful enough or even harmful. Further work is needed to understand the consequences of bystander action. [ABSTRACT FROM AUTHOR]

Introduction: Telepractice service delivery of allied health interventions to people with disability can potentially reduce access barriers and improve service equity. However, questions remain regarding telepractice functionality for people with disability. This study addressed questions related to how allied health clinicians and managers perceive telepractice as functioning in the provision of therapy services to people with disability. Methods: Thirteen interviews of allied health clinicians and managers from across Australia were conducted between 21 November and 22 February via MS teams. Qualitative methodology and critical realist theoretical paradigm underpin the study. Data analysis was completed using a reflective thematic analysis method and five themes were generated and described utilising an analytic metaphor. Results: The study themes were described in relation to a shopping for shoes analytic metaphor and the five themes included (1) a shoe for every foot, (2) planned purchases, (3) shoe on the other foot, (4) you need both shoes and (5) help choosing their shoes. In summary, the function of telepractice fits differently for each individual, similar to pairs of shoes. Conclusions: Telepractice has its own strengths and weaknesses and isn't a direct substitute for in‐person sessions, much like left and right shoes are similar but not the same. The results support participant perceptions that telepractice functions best as an adjunct to in‐person sessions through a flexible hybrid delivery model in the provision of therapy services to people with a disability. A strategy for improving perceived usefulness may involve positioning telepractice as unique with strengths and weaknesses, not replacing in‐person care. Patient or Public Contribution: The paper forms part of a larger codesign process which included customer and carer participants throughout the design and planning of the project, inclusion of a peer researcher, and the selection of the analytic metaphor including in the findings of this article production. [ABSTRACT FROM AUTHOR]

Contemporary welfare organizations engage in various evaluation practices to assess the quality of their services. In this paper we report a qualitative exploration of how technology-enabled evaluations are understood by organizational members who participate in quality assurance activities in Swedish social services. The study contributes to critical information systems literature, focusing on the tensions professionals experience in relation to the digital systems they use for evaluations. For example, "quantities" take precedence over the qualities of such work, as information systems constrain ambitions to realize knowledge-based social services. The results reveal three tensions in professionals' evaluation-related activities arising from conflicting uses or desires. One is between desires for flexible systems that enable reflection and standardized digital support systems. Another is between uses or desires for indicators that are meaningful at the operational level and for general, comparable measures at the management level. The third is between desires to use evaluation procedures for learning and control. The study contributes to both theory and practice related to technology-enabled evaluation of welfare services, and critical perspectives on information systems. [ABSTRACT FROM AUTHOR]