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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]

Background: There is growing evidence that sex and onset age are important factors of clinical features in Parkinson's disease. Aim: The study aimed to identify nonmotor symptoms based on sex and onset age in people with Parkinson's disease. Design: This is a cross‐sectional descriptive study. Methods: A total of 210 participants were recruited from the university hospital and the Parkinson's disease association. This study measured the Korean version of the nonmotor symptoms questionnaire which includes gastrointestinal, urinary, apathy/attention/memory, hallucination/delusions, depression/anxiety, sexual function, cardiovascular, sleep disorder, and miscellaneous domains. Results: All participants reported at least one nonmotor symptom. The most commonly reported symptoms were nocturia (65.7%) and constipation (61.9%). The male participants reported more dribbling of saliva, constipation, and impaired sexual function, whereas the female reported more weight change. Young‐onset people with Parkinson's disease reported more depression than late‐onset people with Parkinson's disease. Conclusion: This study contributes to the understanding of symptom experience beyond motor‐related symptomatology for those with Parkinson's disease and adds to the current literature. Individualized symptom assessment and management should be provided by prioritizing prevalent sex or onset age‐specific symptoms, rather than addressing with all nonmotor symptoms. Summary statement: What is already known about this topic? Most people with Parkinson's disease experience nonmotor symptoms including autonomic nervous symptoms as the disease progresses.Nonmotor symptoms can affect quality of life of people with Parkinson's disease, but related factors are not fully understood. What this paper adds? This paper identified the presentations of nonmotor symptoms in people with Parkinson's disease based on sex and onset age. The implications of this paper: Nurses enable people with Parkinson's disease to actively engage in self‐care of their own symptoms by educating Parkinson's disease related and how to cope with the symptoms in advance.Individualized nursing care reflecting the disease characteristics is needed to improve patient engagement in symptom management. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test the effect of Otago exercises on fear of falling, balance, empowerment and functional mobility in older people living in nursing homes. Methods: This study is a parallel‐group randomized controlled trial. In total, 56 individuals were stratified randomized according to age‐gender. Participants were recruited from September 2021 to August 2022. Data were collected at baseline, in the 8th and 12th weeks. The researcher gave Otago exercise training to the intervention group three times per week for the first 4 weeks and applied it to the individuals, and in the next 8 weeks, the researcher visited the institution to ensure the continuity of the exercises and contacted the individuals by phone. Friedman test and generalized linear model were used in the analysis of data. Results: In the study, group and time interaction were found to be significant in terms of the Berg balance scale, 30‐second sit‐and‐stand test, elderly empowerment scale and timed up‐and‐go test. It was determined that the intervention did not improve fear of falling, upper extremity strength and 6‐min walk test results. Conclusion: Health personnel and administrators should have increased awareness about Otago exercises and can recommend implementation of the programme. Summary statement: What is already known about this topic? Otago exercises are an evidence‐based, home‐based programme for improving balance.What this paper adds? Otago exercises can improve the balance, lower‐extremity strength, elderly empowerment score and timed up‐go test score of older people living in nursing homes.The Otago exercise programme did not improve the fear of falling, the strength of the upper extremities and the 6‐min walk test results for older people living in nursing homes.The implications of this paper: Health personnel and administrators should be aware of the potential benefits of Otago exercises and can recommend implementation of the programme.Nurses working in nursing homes can be taught how to deliver the programme and to plan training to roll out the programme. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Seclusion is a harmful and traumatising intervention for people accessing mental health services.People who are subject to seclusion in inpatient mental health services often first experience this within the first 24 h following admission.There is limited research examining how recent contact with services impacts the likelihood of seclusion when people are admitted to inpatient services. What the paper adds to existing knowledge?: Males, Māori and Pasifika experience higher rates of seclusion within the first 24 h following inpatient admission.People perceived by clinicians as overactive, aggressive, disruptive or agitated are seven times more likely to be secluded within the first 24 h.People referred from police or justice services are three times more likely to be secluded within the first 24 h.People who had frequent contact with community mental health services prior to inpatient admission were less likely to be secluded. What are the implications for practice?: The first 24 h of inpatient admission is a critical focus for eliminating the use of seclusion. Initial interactions with people recently admitted should focus on nurturing relationships and reducing distress.Mental health staff should consider the person's cultural needs, referral pathway, recent service contact and baseline ratings on the Health of the Nation Outcomes Scales (HoNOS) when working proactively to prevent the use of seclusion in the first 24 h following admission.Strengthening the focus on nurturing relationships, cultural understanding and non‐coercive de‐escalation approaches requires leadership support and strategic workforce development. Introduction: People who experience seclusion in inpatient mental health services often do so within the first 24 h following admission. There is limited research examining the potential contributing factors, particularly recent contact with services. Aim/Question: To identify factors associated with seclusion within the first 24 h following admission into acute inpatient mental health services. Method: A retrospective analysis was undertaken using routinely collected data from Aotearoa New Zealand mental health services. Results: A higher likelihood of seclusion within the first 24 h following admission was associated with: males, Māori, Pasifika, referrals from police/justice services, inpatient transfers, recent contact with crisis assessment teams and clinician perceptions of aggression, problematic substance use, cognitive problems and hallucinations or delusions. Recent contact with community mental health services was associated with a lower likelihood. Discussion: People's cultural needs, referral pathway, recent service contact and HoNOS scores should be considered when working to prevent the use of seclusion in the first 24 h following admission. Implications for Practice: The first 24 h following inpatient admission is a critical period for preventing the use of seclusion. Nurturing relationships, cultural understanding and use of non‐coercive de‐escalation approaches can support better outcomes for people recently admitted. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: People diagnosed with serious mental illness have a high risk of diabetes and are more likely to develop type 2 diabetes at ages below 60 years.Effective diabetes self‐care behaviours among people diagnosed with serious mental illness can improve glycaemic control and reduce vascular complications.Few studies have investigated diabetes self‐care behaviours and their associations with health literacy and self‐efficacy in people diagnosed with serious mental illness. What the paper adds to existing knowledge?: Diabetes self‐care behaviours in people diagnosed with serious mental illness were suboptimal; the least frequently performed self‐care activities were self‐monitoring of blood glucose.Factors associated with diabetes self‐care behaviours are gender, age, communicative and critical health literacy and self‐efficacy.Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid serious mental illness and type 2 diabetes. What are the implications of practice?: Mental health nurses should assess diabetes‐specific health literacy of people diagnosed with serious mental illness to ensure that they possess the knowledge and skills related to diabetes self‐care.When treating young people and those with newly diagnosed type 2 diabetes, nurses should incorporate strategies to minimise their perceptions of diabetes‐related distress and increase their confidence in managing comorbid diabetes. Introduction: People diagnosed with serious mental illness (SMI) experience greater challenges in managing their type 2 diabetes mellitus (T2DM) than do those diagnosed with T2DM alone. Aim: This study investigated diabetes self‐care activities and the factors associated with these activities in people diagnosed with SMI in a hospital setting. Methods: A cross‐sectional correlational study was conducted among 126 people diagnosed with comorbid SMI and T2DM in Taipei, Taiwan, between October 2020 and April 2021. Data were collected using self‐report questionnaires and a chart review. Three‐step hierarchical multiple regression analysis was used to identify factors associated with diabetes self‐care behaviours. Results: Diabetes self‐care behaviours in people diagnosed with SMI were suboptimal overall. Hierarchical multiple regression analyses revealed that age (β = 0.18, p =.037) and self‐efficacy (β = 0.27, p =.004) significantly associated with diabetes self‐care behaviours. Discussion: Self‐efficacy is the strongest predictor of self‐care behaviours among people diagnosed with comorbid SMI and T2DM. Implications for Practice: Mental health professionals should focus on enhancing confidence in managing comorbid diabetes in people diagnosed with comorbid SMI, especially young people and those with newly diagnosed T2DM. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to adapt the Nurse Turnover Intention Scale to Turkish and test its validity and reliability. Methods: This methodological study was conducted with 200 nurses. The Personal Information Form and the Nurse Turnover Intention Scale were used for data collection between November and December 2021. Language and content validity, explanatory and confirmatory factor analysis, criterion validity, Cronbach's alpha coefficient, item–total score correlation and test–retest reliability methods were used for the validity and reliability analysis of the scale. Results: Exploratory factor analysis showed that the Nurse Turnover Intention Scale had a single factor. Its single factor structure was confirmed using confirmatory factor analysis. Cronbach's alpha coefficient of the scale was 0.902, and factor loading was between 0.60 and 0.78. Statistical analyses indicated that each item in the Turkish version of the scale had a high internal consistency. The test–retest correlation value was found as p < 0.05. Conclusion: The Nurse Turnover Intention Scale has been confirmed to be a suitable, valid and reliable measurement tool for Turkish society. Nurse turnover intention is the most powerful predictor of actual turnover within the nursing profession. This scale will help to easily attain valid and reliable outcomes. Summary statement: What is already known about this topic? Nursing is a profession with a high rate of turnover intention.Nurse turnover intention is the most powerful predictor of actual turnover.There is no measurement tool in Turkey to evaluate the turnover intention specific to nurses. What this paper adds? The revised structure that was developed in this study comprised of 10 items was found to be appropriate, valid and reliable for the Turkish nursing population.Nurse turnover intention can now be measured using a valid and reliable tool. The implications of this paper: By using this scale, nursing services can contribute to the determination of the turnover intention levels of nurses and their reasons to take necessary precautions in the institution. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationships between self‐efficacy, uncertainty and anxiety among nursing graduates waiting for a mandatory nursing licensing test that was postponed due to the COVID‐19 pandemic. Methods: A total of 352 graduates of nursing education programs participated in this mixed‐methods study. The data were collected using an online questionnaire in June 2020. Results: The participants demonstrated high uncertainty and anxiety and low self‐efficacy towards the ability to succeed in the licensing exam. Graduates, who started working, reported lower uncertainty. Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of 24% of the variance of the anxiety. The qualitative analysis revealed three themes: (a) emotional distress, cognitive challenge and social implications, (b) consequences for significant others and (c) strengthening of professional values and norms. Conclusions: A significant crisis like a pandemic is accompanied by acute cognitive burden and stressful emotional experiences and creates an unconventional situation that requires unusual solutions. Granting a temporary permit for employment as a nurse following the postponement of a licensing test contributed to the ability of nursing graduates to cope with the situation. Policies to deal with similar situations in the future emergencies should be developed and implemented. Summary statement: What is already known about this topic? The COVID‐19 pandemic changed all the rules when the licensing examination was postponed at relatively short notice.The graduates found themselves without a work permit and also outside the education system.Many graduates reported economic challenges and feelings of uncertainty and fear of the future. What this paper adds? The participants demonstrated high levels of uncertainty and anxiety, with low self‐efficacy.Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of the anxietyQualitative analysis supported these findings through examples that paint the whole picture in vivid colours. The implications of this paper: The study emphasizes the importance of providing emotional support and information to the students in times of crisis, while communicating policy decisions.Granting a temporary permit for employment as a registered nurse following the postponement of the licensing test contributed to the ability of nursing graduates to contend with the situation.There is a need to formulate policies to deal with similar situations in the future. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Many studies have investigated the attitudes of mental health nurses towards a range of targets. These targets are person‐oriented (for example groups of people with a similar mental health diagnosis) or practice‐oriented (for example practices such as seclusion or restraint).It is thought that attitudes contribute to the practice of mental health nurses because research suggests attitudes have a role in shaping behaviour. What the paper adds to existing knowledge?: To date, research about mental health nurses' attitudes has examined different attitudes in isolation from one another. By demonstrating a lack of connectedness across studies this paper highlights the need for new theory‐informed approaches to attitudinal research.By standardizing measurements across different studies this review demonstrates that the most negatively appraised attitudinal targets—indicated by large proportions of respondents who appraise negatively—concern people with diagnoses of borderline personality disorder, substance misuse, and acute mental health presentations. What are the implications for practice?: Significant numbers of mental health nurses may have attitudes, especially towards people with borderline personality diagnoses and those who misuse substances, that may not be concordant with good practice.There is insufficient evidence about what the actual implications this has for practice because the body of relevant research lacks coherence, interconnectedness and a grounding in contemporary theoretical developments.Training programmes that focus on attitudinal change need to be more rigorously evaluated. Introduction: Attitudes are considered integral to mental health nursing practice. Aims: To comprehensively describe the (i) measured attitudes of UK mental health nurses towards people and practice; (ii) effectiveness of interventions to change attitudes; and (iii) relationships between their attitudes, other variables/constructs and practice. Methods: Using systematic review methodology, multiple databases (CINAHL, Scopus, PsycINFO, Web of Science Core Collection, Google Scholar) were searched. Eligible studies involved measurement of UK‐based mental health nurses' attitudes with multi‐item scales. Studies were quality appraised, mean (SD) attitudinal data were standardized, and other results converted to standardized effect sizes. Results: N = 42 studies were included. Negatively appraised attitudinal targets were people with a borderline personality disorder diagnosis, substance misuse, and acute mental health presentations. Educational interventions were associated with immediate increases in positive appraisals but sustainability was poorly evidenced. There was very limited study of attitude‐practice links. Discussion: This review identifies priority attitudinal targets for action but also demonstrates that future work must consider the interconnectedness of attitudes and their relationship with practice. Implications for Practice: Priority areas for consideration are attitudes to borderline personality disorder, substance misuse and mental health co‐morbidity. Addressing disparities between nurses' attitudes and those of service users is important. More robust research is required into the effectiveness of interventions to change attitudes and into attitude‐practice links. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Depression is a leading cause of disability worldwide that negatively impacts quality of life. Talk therapy such as cognitive behavioural therapy is an effective treatment for depression. The Internet is an important tool for mental healthcare delivery. Internet‐delivered or online talk therapy interventions are associated with lower costs and improved accessibility.Current reviews do not address the effectiveness of Internet‐delivered cognitive behavioural therapy (iCBT) on quality of life (QoL). What the paper adds to existing knowledge: Interventions for iCBT have better QoL improvements for individuals with greater depressive symptom severity, females, young adults and individuals with complex comorbid disorders. Support from a healthcare provider for iCBT interventions have better outcomes than self‐guided therapy interventions. Tailoring the iCBT intervention to the specialized needs of the population is beneficial. What are the implications for practice: There is potential to address treatment gaps for managing the care of individuals with depression. Utilizing iCBT promotes the integration of accessible mental healthcare in clinical settings.Healthcare providers can have a more comprehensive approach to delivering iCBT by considering adaptations relevant to the clinical population being treated. Introduction: Major depressive disorder (MDD) is a leading cause of disability resulting from social, psychological and biological factors affecting quality of life (QoL). Cognitive behavioural therapy (CBT) is an effective psychotherapy for MDD. Internet‐delivered CBT (iCBT) is associated with lower costs and improved accessibility. Aim: We aimed to examine the effectiveness of iCBT on QoL in adults with depression. Method: PubMed, Embase and PsycINFO were searched between 2010 and 2022. Inclusion criteria were experimental designs, adults ≥18 years old, depression diagnosis or valid self‐report measure, iCBT intervention; and QoL outcome. Exclusion criteria were studies without depression analysis and intellectual disabilities or psychosis. Results: Seventeen articles were included, with a negative correlation between depression severity and QoL. Sex, age and physical comorbidity positively influenced effectiveness. Depressive severity, dysfunctional attitude and negative thinking were predictors and moderators of QoL. Clinician support can impact social interactions and sense of belonging. Discussion: Internet‐delivered cognitive behavioural therapy is effective for improving QoL in adults with MDD. Severe depression, females, younger age and comorbid disorders were associated with greater QoL improvements. Implications for Practice: The findings suggest iCBT could address depression treatment gaps related to improving QoL. Utilizing iCBT potentially improves the care continuum for individuals with complex disorders. [ABSTRACT FROM AUTHOR]

Aims: This study aims to explore the relationship between regular exercise, social support and depression in community‐dwelling older people and find out the predictors of depression. Methods: Cross‐sectional and correlation designs were used. The participants were recruited from August to October in 2020. The STROBE was used as a checklist for this study. Results: The study found that female gender, older age, poor sleep quality, irregular exercise and low social support were the main predictors of depression among the community‐dwelling older people. Conclusion: It is suggested that healthcare professionals motivate the older people to exercise regularly in the community using individualized exercise routines designed according to their physical conditions such as different types, frequencies and intensity of exercise. Providing social support to each other at the community care site should be encouraged, and regular assessment of the mental health of community‐dwelling older people should be done. It is also recommended to organize a timely depression‐related education course for older people in the community. Summary statement: What is already known about this topic? In older people depression can lead to further physical and psychological problems. What this paper adds? This study provides information about regular exercise, social support and depression in community‐dwelling older people.Female gender, older age, poor sleep quality, irregular exercise and low social support were the main predictors of depression among these community‐dwelling older people. The implications of this paper for policy/practice/research/education It is suggested that healthcare professionalss motivate older people to exercise regularly in the community care site using individualized exercise routines designed according to their physical condition. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the relationship between family caregivers' health‐related quality of life and health outcomes in care recipients. Methods: A total of 160 female caregivers in Japan were initially assessed using self‐reported baseline questionnaires to determine physical and mental aspects of their health‐related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. Results: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. Conclusion: Caregivers' poor health‐related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health. Summary statement: What is already known about this topic? Family caregivers reportedly have lower quality of life than noncaregivers.While factors associated with decreased quality of life of caregivers such as high caregiving burden and longer care duration are being identified, they remain difficult to prevent.Lower caregiver quality of life may negatively influence the care recipients. What this paper adds? Poor mental health in caregivers, calculated with health‐related quality of life scores, is associated with health deterioration of care recipients.Physical health in caregivers is not associated with health deterioration of care recipients. The implications of this paper: Support for improving the health‐related quality of life of caregivers is necessary, especially in relation to their mental health, from the viewpoint of maintaining the health status of care recipients. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the distribution of foot conditions, the risk of foot ulceration and its associated factors in patients with diabetes. Few studies have focused on the risk of foot ulceration in patients with diabetes. Methods: A total of 267 patients with diabetes who attended outpatient clinics in two tertiary referral hospitals were recruited from June to September 2016. The risk of foot ulceration was classified using the American Diabetes Association (ADA), International Working Group on the Diabetic Foot (IWGDF) and Scottish Intercollegiate Guidelines Network (SIGN) classification systems. The risk categories of each system were reclassified into high‐ (categories of 2 and 3 for the ADA and IWGDF systems and high for the SIGN system) and low‐risk. Results: Foot deformity was the most prevalent condition (38.2%). Among 261 patients without active ulcers, between 17.6% to 35.2% were classified in the high‐risk group and overall agreement among systems ranged from.42 to.56 of the kappa statistic. Insulin treatment was consistently associated with a high‐risk of foot ulceration. Conclusions: As the risk varies between systems, nurses should select a suitable classification system through validation studies and assess the risk in patients with diabetes, particularly, those receiving insulin treatment. Summary statement: What is already known about this topic? Foot ulceration is a major complication of diabetes and may cause serious health issues, adversely affecting the patient's quality of life.Although risk assessment of foot ulceration in patients with diabetes is regarded as a critical preventive measure, implementation of diabetic foot examinations by health‐care providers varies among countries.Only 6.1% of patients with diabetes have received a foot examination in the last 2 years in South Korea, and there are few studies on the distribution of risk factors for diabetic foot ulceration. What this paper adds? Among participants, 73.4% had at least one foot condition and between 17.6% to 35.2% of patients were classified in the high‐risk group, depending on the system.Overall agreement among systems ranged from.42 to.56 of the kappa statistic.Participants with diabetes on insulin treatment were found to be at a higher risk of foot ulceration. The implications of this paper: As the risk of foot ulceration varies between international systems, nurses need to select the most suitable one through validation studies.Although the prevalence of active foot ulcers is very low, two to four of every 10 patients with type 2 diabetes attending outpatient clinics in tertiary referral hospitals in South Korea are at high‐risk for foot ulceration. Therefore, nurses should regularly assess the risk of foot ulceration, particularly in high‐risk patients, such as those receiving insulin treatment. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate psychosocial, demographic and obstetric factors that affect health practices in pregnancy. Methods: This cross‐sectional study was conducted with pregnant women selected by using random sampling in a public hospital in Turkey. The pregnant women (n = 383) completed the Health Practices Questionnaire in Pregnancy, the Center for Epidemiologic Studies Depression Scale, the Beck Anxiety Inventory and the Multidimensional Scale of Perceived Social Support. Multiple linear regression was used to examine predictors of participation in health practices. The variables were subjected to multiple linear regression analysis to estimate the effect of each independent variable (depression, anxiety, perceived social support, age, educational level, gestational week and parity) on the dependent variable (health practices). Results: Depression and anxiety were not significantly related to gestational health practices. The multiple linear regression model showed that inadequate social support, low education level, early gestational week and high parity were significant predictors of nonengagement in favourable health practices during pregnancy. Conclusions: Pregnant women with inadequate social support and specific demographic and obstetric characteristics are less likely to participate in gestational health practices. This study suggests that more attention should be paid to these groups to improve the health practices of pregnant women. Summary statement: What is already known about this topic? There are significant effects of health practices in pregnancy on maternal, fetal and newborn health.Some maternal factors may be associated with adverse health practices. What this paper adds? Social support was a significant predictor of gestational health practices.Low education level, early gestational week and high parity were predictors of nonengagement in favourable health practices during pregnancy.Depression and anxiety were not significantly related to gestational health practices. The implications of this paper: Health‐care professionals should be aware of psychological factors related to gestational health practices. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Nursing Practice (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Nursing Practice (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics. Design: A cross‐sectional survey was used. Methods: Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST. Results: Compared with patients having high PNST, patients with mild‐moderate PNST experienced lower self‐efficacy, hope, optimism, PsyCap and social/family well‐being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well‐being of patients with high PNST. Conclusion: The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild‐moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild‐moderate PNST. Impact: It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The quality of life (QoL) of people with severe mental illness (SMI) is a growing international concern.Many earlier studies report the determinants and correlates of QoL and functioning in people with SMI in Western countries.The QoL and functioning of Asian inpatients with SMI are largely unknown, particularly at the point where they have been assessed as being ready for hospital discharge. What the paper adds to existing knowledge?: Physical health, social functioning and community living skills, and negative symptoms are important areas of concern immediately pre‐discharge.Social relationship related QoL, overall symptoms, unemployment, education level, living situation, physical illness and treatment duration predict functioning levels. What are the implications for practice?: Mental health nurses should consider interventions beyond the traditional focus on psychopathology to improve functioning outcomes in people with SMI recently discharged from hospital.Inpatient services should utilise the opportunity to monitor and address physical health problems before discharge from inpatient care. Introduction: There is a lack of evidence on quality of life (QoL) and functioning in Asian people with severe mental illness (SMI) immediately prior to hospital discharge. This information could have major implications for treatment. Aim: To profile perceived quality of life, symptom severity and level of functioning among people with SMI. Methods: A cross‐sectional study involving 347 adult inpatients with SMI. QoL (WHO Quality of Life ‐ Brief Form), symptom severity (Positive and Negative Syndrome Scale) and level of functioning (Specific Level of Functioning) were measured immediately pre‐discharge. Results: Participants reported low social relationship‐related QOL. Weak correlations were found between functioning, QoL and symptoms. Regression analysis identified the social relationship QoL domain, employment status, education level, living situation, physical illnesses, overall symptoms and the duration of receiving psychiatric services were statistically significant predictors of functioning levels. Discussion: The findings may highlight a need for interventions beyond the traditional emphasis on psychiatric symptoms in order to improve functioning following an inpatient admission. Implications for practice: Interventions to improve functioning in recently discharged people with SMI may need to be specifically designed to improve patients' social relationships, support return to employment and minimise the risk of physical illness. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the level of spiritual care and compassion among midwives working in delivery rooms and associated factors. Methods: A descriptive design was utilized to collect data using self‐report questionnaires from 181 midwives working in delivery rooms in Turkey. Data were collected between 1 February 2020 and 20 March 2020. Results: The mean Spiritual Care‐Giving Scale (SCGS) (min: 25‐ max: 175) and Compassion Scale (CS) (min: 24– max: 120) scores were 147.88 ± 17.84 and 96.37 ± 12.84. It was determined that there was a significant difference between the SCGS and CS scores of the midwives based on age, working year, work schedule, job satisfaction and traumatic birth experiences. Furthermore, there were positive correlations between scores on certain SCGS and CS subdimensions. Conclusion: Midwifery is a continuously evolving profession based on helping others. However, long working hours and their exposure to traumatic birth events negatively affect both spiritual caregiving and compassion levels of midwives. Working conditions of midwives need to improve and this would contribute to the quality of maternal healthcare. Also, studies should be conducted in different contexts, societies and cultures to identify barriers to compassionate and spiritual care during childbirth. Summary Statement: What is already known about this topic? Compassion and spirituality play a significant role in the quality of care in midwifery, similar to other healthcare fields.There are limited studies on the level of spiritual care and compassion in midwives working in delivery rooms, reflecting the situation in only certain contexts, societies and cultures. What is already known about this topic (research findings/key new information)? Barriers to the spiritual and compassionate care of midwives working in the delivery room in Turkish society have been identified.Year of working, work schedule, job satisfaction and exposure to traumatic birth events affect both spiritual caregiving and compassion levels of midwives. The implications of this paper (how findings influence or can be used to change policy/practice/research/education): For quality care in maternity services, the woman should be given compassionate care that includes spiritual care practices.Working conditions of midwives need to improve.Studies should be conducted in different contexts, societies and cultures to identify the barriers to this care. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood.FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals.While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees. What does the paper add to existing knowledge?: The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact.Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post‐traumatic stress disorder correlated with a higher FM impact. What are the implications for practice?: The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees.Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM.Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions. Introduction: Fibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees. Aim: To assess the impact of FM and its associated factors in female refugees. Methods: A cross‐sectional study was conducted. The impact of FM, anxiety, post‐traumatic stress (PTSD) and insomnia was investigated. Results: 288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact. Conclusion: Mental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD. Implications for practice: Mental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions. [ABSTRACT FROM AUTHOR]

Aims: The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift‐related factors predispose nurses to higher levels of occupational stress and anxiety. Design: This is a cross‐sectional study. Methods: From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety. Results: The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non‐Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night‐shift frequency of 3–4 times per month, night‐shift durations of 9–12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift‐related factors that increased the levels of occupational stress and anxiety. Conclusion: The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety. Impact: By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well‐being and work schedules. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis. Design: Qualitative. Methods: Eighty‐one patients with breast cancer‐related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1‐, 3‐, 6‐, 9‐ and 12‐month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted. Results: Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post‐diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1‐, 3‐, 6‐, 9‐ and 12 months post‐diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns. Conclusion: Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns. Implications for the Profession and/or Patient Care: During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions. Impact: To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence‐based professional guidance on reproductive preservation techniques. Reporting Method: The study was reported using the consolidated criteria for reporting qualitative research guidelines. Patient or Public Contribution: Patients contributed to data collection through interviews. [ABSTRACT FROM AUTHOR]

Background: The Nursing Care Continuity Report (NCCR) is a tool for evaluating the quality of nursing care during hospital admission. Aim: To explore the role of the NCCR in predicting longer length of stay (LOS) in older adults (≥65 years) admitted to a tertiary hospital and determine possible clinical differences at discharge between patients who had a short LOS (≤7 days) and a prolonged LOS (>7 days). Research Design and Setting: A retrospective cohort study was conducted including all patients with a completed NCCR admitted to the hospital between 2015 and 2019. Sociodemographic data, risk of pressure injuries, level of dependence, presence and intensity of pain, and presence and type of pressure injury were the variables registered in the NCCR. Results: A total of 41,354 patients were included in this study, with a mean age of 78 years, of whom 47% were female. At admission, 21% of patients were at potential risk of developing pressure ulcers. Age, admission to the internal or respiratory medicine unit, and having at least medium risk of developing pressure ulcers were the predictors of prolonged LOS using a random sample of 950 patients. At discharge, patients with prolonged LOS presented higher risk of pressure ulcers and a higher level of dependency and were more likely to present hospital‐acquired pressure ulcers. Conclusions: Older adults from the internal or respiratory medicine unit who exhibited higher risk of pressure ulcers were related to a prolonged LOS, a higher level of dependency, and hospital‐acquired ulcers at hospital discharge. Relevance to Clinical Practice: Identifying clinical data that have a greater relationship with LOS could be a useful tool for nursing management and for the implementation of strategies to prevent adverse events during hospitalisation. No Patient or Public Contribution: No direct patient contact was made during the data collection. [ABSTRACT FROM AUTHOR]

Aims: To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents. Design: A cross-sectional study design. Methods: In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage= 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis. Results: All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females. Conclusion: Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours. Impact: Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking. [ABSTRACT FROM AUTHOR]

Background: Improving triage accuracy for accurate patient identification and appropriate resource allocation is essential. Little is known about the trend of triage accuracy, and factors associated with mistriage vary from study to study. Aim: To identify incidence and risk factors of mistriage, such as overtriage and undertriage. Design: This is a cross-sectional study. Methods: The data came from the National Emergency Department Information System database in 2016–2020. All patients 15 years and older visiting emergency departments in Korea were assessed for eligibility, and 20,641,411 emergency patients' data were used. Multivariable logistic regressions were conducted to confirm the associated factors with overtriage and undertriage compared to expected triage. Demographic characteristics, disease-related signs and triage-related factors were independent variables. Results: Expected triage decreased from 96.8% in 2016 to 95.7% in 2020. Overtriage (0.5%–0.7%) and undertriage (2.4%–3.3%) increased. The occupation that performed triage the most (over 85%) was nurses. Associated factors with overtriage were demographic characteristics (40–64 age group, female), disease-related signs (known disease, direct visit) and triage-related factors (regional emergency medical centre). Risk factors to undertriage were disease-related signs (systolic/diastolic blood pressure and pulse rates within normal range). Conclusions: While the acuity degree remained within the recommended range, the accuracy of triage decreased, and there was a gradual increase in mistriaged cases. Nurses have performed most of the triage and played a key role in expected triage. Associated factors with overtriage were demographic characteristics, disease-related signs and triage-related factors and risk factors to undertriage were disease-related signs. Patient or public contribution: No patient or public contribution. Implications for the profession: Nurses should be aware of what factors are associated with mistriage and why the factors cause mistriage to improve the triage accuracy because they are responsible for the majority of the triage assessments. [ABSTRACT FROM AUTHOR]

Background: Medication self‐management (MSM) is defined as a person's ability to cope with medication treatment for a chronic condition, along with the associated physical and psychosocial effects that the medication causes in their daily lives. For many patients, it is important to be able to self‐manage their medication successfully, as they will often be expected to do after discharge. Aim: The aim of this study was to describe the willingness and attitudes of patients with schizophrenia spectrum or bipolar disorders regarding MSM during hospital admission. A secondary aim was to identify various factors associated with patient willingness to participate in MSM and to describe their assumptions concerning needs and necessary conditions, as well as their attitudes towards their medication. Methods: A multicentre, quantitative cross‐sectional observational design was used to study the willingness and attitudes of psychiatric patients regarding MSM during hospitalisation. The study adhered to guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: In this study, 84 patients, of which 43 were patients with schizophrenia spectrum disorders and 41 were patients with bipolar disorders, participated. A majority of the patients (81%) were willing to participate in MSM during their hospitalisation. Analysis revealed patients are more willing to MSM if they are younger (r = −.417, p <.001) and a decreasing number of medicines (r = −.373, p =.003). Patients' willingness was positively associated with the extent of support by significant others during and after hospitalisation (Pearson's r =.298, p =.011). Patients were convinced that they would take their medication more correctly if MSM were to be allowed during hospitalisation (65%). Conclusion: Most of the patients were willing to self‐manage their medication during hospitalisation, however, under specific conditions such as being motivated to take their medication correctly and to understand the benefits of their medication. Relevance to Clinical Practice: From a policy point of view, our study provided useful insights into how patients look at MSM to enable the development of future strategies. Since patients are willing to self‐manage their medication during hospitalisation, this may facilitate its implementation. Patient contribution: Patients were recruited for this study. Participation was voluntary, and signed informed consent was obtained from all participants prior to the questionnaire. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study was conducted to examine the possible aetiology of nocturia in patients with long‐term COVID‐19. Background: Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID‐19, 10–14 weeks after the illness. Design: A descriptive design. Methods: The study consisted of 70 patients who had experienced COVID‐19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the 'TANGO' nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist. Results: When the nocturia effects of long‐term COVID‐19 were examined it was determined that the urinary tract was the 'priority' aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p <.05). According to post‐hoc analysis, the mean age of patients with a dominant cardio‐metabolic factor was found to be significantly younger (p <.05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p <.05). Conclusions: It was found that the urinary tract aetiological factor was dominant in patients with long‐term COVID‐19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor. Relevance to Clinical Practice: Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post‐COVID‐19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia. Patient or Public Contribution: The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID‐19 infection. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the relationship between burnout and post‐traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. Background: The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID‐19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. Design: An online cross‐sectional survey of targeted local 327 nurses who went to assist the COVID‐19 epidemic situation in Wuhan during the initial outbreak. Methods: This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. Results: Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. Conclusions: Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. Relevance to Clinical Practice: PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. Patient or Public Contribution: Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to investigate the prevalence of post‐traumatic stress symptoms, and to identify possible predictive factors in Norwegian intensive care unit survivors, 6 months after admission to the intensive care unit with COVID‐19. Background: The SARS CoV‐2 virus causing COVID‐19 has spread worldwide since it was declared a pandemic in March 2020. The most severely ill patients have been treated in the intensive care due to acute respiratory failure and also acute respiratory distress syndrome. It is well documented that these severe conditions can lead to complex and long‐lasting symptoms, such as psychological distress, and was, therefore, investigated for the specific COVID‐19 population. Design: Prospective observational study. Methods: Clinical data and patient reported outcome measures were collected by the Norwegian Intensive Care and Pandemic Registry and by the study group 6 months after admission to an intensive care unit. Results: Among 222 COVID‐19 patients admitted to Norwegian intensive care units between 10 March and 6 July 2020, 175 survived. The study sample consisted of 131 patients who responded to at least one patient reported outcome measure at 6 months following admission. The primary outcome was self‐reported post‐traumatic stress symptoms, using the Impact of Event Scale‐6 (n = 89). Of those, 22.5% reported post‐traumatic stress symptoms 6 months after admission. Female gender, younger age and having a high respiratory rate at admission were statistically significant predictive factors for reporting post‐traumatic stress symptoms. Conclusions: The result is in accordance with previously published research with comparable populations, suggesting that for many COVID‐19 survivors psychological distress is a part of the post‐acute sequelae. Results from the present study should be replicated in larger datasets. Relevance to Clinical Practice: This project provides important insight to post‐acute sequelae after COVID‐19 that patients may experience after critical illness. [ABSTRACT FROM AUTHOR]

Aims: To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID‐19. Background: Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID‐19 pandemic. Design: A cross‐sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID‐19 pandemic between 4 and 19 January 2021. Methods: The Maslach Burnout Inventory‐Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS‐CoV‐2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. Results: Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b = 1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b = 1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b = −1.37; 95%CI ‐2.17 to −0.47) was related to lower EE. HCWs working in wards for patients with COVID‐19 reported lower EE (b = −1.39; 95%CI ‐2.45 to −0.32). HCWs who contracted COVID‐19 reported lower DP (b = −0.71, 95%CI ‐1.30 to −0.12). Conclusions: Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. Relevance to clinical practice: Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale. Design: Cross‐sectional study. Methods: Conducted in a 2600‐bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut‐off value were assessed using receiver operating curve (ROC). Results: The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut‐off value of 19 yielded the best predictive performance with a Yoden index of 0.710. Conclusion: PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut‐off value of 19 showing improved predictive accuracy. Patient or Public Contribution: Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work. [ABSTRACT FROM AUTHOR]

Aim: To describe a Delphi study regarding practice variation in needs assessment by Dutch home care nurses, to define practice variation in home care nursing and explore which factors may have a role in this needs assessment. Design: A Delphi study was conducted with the participation of home care representatives. Method: A Delphi questionnaire was developed, preceded by literature research and an expert meeting. The Delphi study took place between December 2020 and February 2021. The goal was to achieve a consensus level of at least 70%. Results: After three rounds, 32 experts reached a consensus about definitions regarding variation in needs assessment, warranted and unwarranted variation. In total, 59 factors were determined related to (1) the client and health, (2) the clients' context, (3) nurses and (4) the nurses' context. Thirty‐four factors scored warranted of influence and 18 (of 34) were client related. Most of the factors that scored unwarranted influencing needs assessment (17 of 26) were related to the home care nurses' context. Conclusion: Having a consensus about the definition of practice variation in needs assessment and possible influencing factors support the professionals to discuss and improve the unity and quality of their decision‐making process in home care. This may contribute to more righteous care for clients in need of home care. Impact: Since 2015, home care nurses in the Netherlands are responsible for determining the amount, type and duration of care for clients in need of home care. This so‐called needs assessment legitimizes the payment by health insurers. Signals of practice variation in needs assessment are heard in home care field. Although practice variation may be justified, it can lead to over or underuse of care, which may affect clients' outcomes. If we can identify influencing factors and find patterns that contribute to practice variation, we might gain a better understanding of the process and improve home care. Patient or public contribution: In this study, there was no patient or public involvement. Client representatives were included in this research as experts in the home care field, and they participated in three rounds of the Delphi study. They contributed by sharing their expert opinion on the definitions presented and the factors possibly influencing needs assessment. [ABSTRACT FROM AUTHOR]

Aim: To describe positive and negative spiritual responses to providing COVID‐related nursing care among nurses working in hospitals. Background: The COVID pandemic has intensified and publicised the threats to nurse well‐being. Absent from the recommendations for promoting nurse well‐being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well‐being. Design: Cross‐sectional, descriptive observational, mixed methods study. Methods: Data were collected from 523 registered nurses employed in three Southern California hospitals during March–May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale–Short Form, Moral Injury Symptom Scale–Healthcare Professionals, Post‐traumatic Growth Inventory and demographic and work‐related items. STROBE guidelines for cross‐sectional observational studies were observed. Results: The mean for religious/spiritual struggles was 1.98 (range of 1–5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%–36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1–10); applying established criteria indicated it was troubling for at least 50%. The mean for post‐traumatic growth was 4 (on a scale of 0–6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. Conclusion: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. Relevance to Clinical Practice: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy—and allow spiritual transformation. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to examine the relationship between professional attitude and compassion among nurses. Material and Methods: The sample of the crossectional study recruited 202 nurses who accepted participation and working in a state hospital. Data were collected between 20 June 2019 and 2 August 2019 with a questionnaire form, Inventory of Professional Attitude at Occupation (IPA) and Compassion Scale. Data were collected via face‐to‐face method. Form and scales were completed by the participants. The study was reported according to the STROBE. Results: The mean IPA was 134.57 ± 15.43. The mean score of the Compassion Scale was 73.89 ± 11.54. The mean scores of the Compassion Scale's sub‐dimensions were 16.17 ± 3.22 for kindness, 8.62 ± 3.44 for indifference, 15.45 ± 3.17 for common humanity, 9.02 ± 3.46 for separation, 15.95 ± 3.00 for mindfulness, 8.67 ± 3.44 for disengagement. There were positive correlations between kindness (r =.356), common humanity (r =.214), mindfulness (r =.297) subscales and there were negative correlations between indifference (r = −.441), separation (r = −.411) and disengagement (r = −.415) subscales and the Inventory of IPA. There was a negative correlation between IPA and total Compassion Scale scores (r = −.140). IPA scores were significantly different according to sex, age, working duration, weekly working time, satisfied with colleague relationships. Compassion scores were significantly different for weekly working time, satisfaction with colleague relationships, suitability of the nursing profession and working in emergency and outpatient clinics (p <.05). Conclusion: As nurses' professional attitude scores increased, kindness, common humanity and mindfulness subscales scores increased, while indifference, separation and disengagement subscales scores of the compassion scale decreased. Relevance to clinical practice: Increasing the awareness about professional attitude and compassion in nursing should start with undergraduate education of nurses, and it is recommended to organise in‐service training to develop professional attitudes and compassion in occupational life and to research patient perspectives about compassion. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore caller satisfaction with interaction, and the association to overall satisfaction with calls. Background: In the era of expanding healthcare at distance, the telephone remains a common tool for the provision of nursing care. Interaction between telenurse and caller in telenursing is vital for safety, satisfaction and adherence reasons. Few studies have quantitatively explored interaction in calls and how it relates to overall satisfaction with calls. Design: Cross‐sectional survey study with a deductive approach. Methods: A total of 466 callers to the Swedish Medical Advisory Service completed the Telenursing Interaction and Satisfaction Questionnaire. Satisfaction with four theoretically defined components of interaction were compared using repeated measures ANOVA. Associations between satisfaction with interaction and overall satisfaction with calls were evaluated with ordinal logistic regression models with and without adjustment for age, sex, health status, waiting time, time for call, main result of the call and expectations. The study followed the STROBE checklist. Results: Callers were most satisfied with affective support, followed by professional‐technical competence, health information and decisional control—in that order. A summated score of satisfaction with interaction was positively and significantly associated with overall satisfaction with calls before and after adjustment for waiting time, main result of call and variables related to the individual caller. Conclusions: Caller satisfaction with interaction is generally high but can be improved, especially regarding decisional control. Satisfaction with interaction is important for overall satisfaction with calls. Relevance to clinical practice: This study provides support for professionals at all levels in telenursing organisations to pay attention to interactional matters. The development of best practice for telenurses needs to consider all four components of interaction to enhance satisfaction with calls. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to determine the prevalence and predictive factors of sexual dysfunction and quality of sexual life in women with heart failure. Background: Symptoms of heart failure may cause a decrease in sexual performance, sexual satisfaction and sexual desire. Methods: This cross‐sectional study was conducted between December 2019 and June 22, 2020. The findings were reported according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines (n = 356). Results: The majority of the participants had sexual dysfunction (84.8%), mainly a reduction in sexual desire. Participants had a mean SQOL‐F score of 75.49 ± 19.37. More than a quarter of the participants stated that they were afraid of dying during sex (29.2%). There were changes in sexual dysfunction based on the class of medications that participants used regularly. Almost all participants stated that they were never informed by nurses or other healthcare professionals about sex (98%). Menopausal women are seven times more likely to develop sexual dysfunction than non‐menopausal women (OR = 7.0, p <.001). Conclusion: Women with heart failure are more likely to develop sexual dysfunction. Many factors affect sexual dysfunction and sexual quality of life. Therefore, nurses should take sexual dysfunction into account when caring for women with heart failure. They should monitor them for risk factors and side effects, draw up and implement plans to respond to problems. Relevance to Clinical Practice: Sexual dysfunction is quite high in women with heart failure. Nurses should encourage these patients to talk about sexual problems and provide sexual health education and counselling regardless of the level of their sexual problems. Patient or Public Contribution: The patients evaluated the suitability of the questions at the pre‐application stage. We finalised the demographic questionnaires with their suggestions. The patients spent time filling out the questionnaires during the data collection phase and answered the questions sincerely. [ABSTRACT FROM AUTHOR]

Background: Postoperative delirium is one of the common complications after any major surgery such as gastrointestinal surgery. And it is related to increased mortality and morbidity and other serious surgical outcomes. Aims: This study aims to identify risk factors for postoperative delirium in patients undergoing gastrointestinal surgery. Materials and Methods: Relevant studies published before August 2021 were searched on Pubmed, Embase and Medline. The risk of bias of included studies was assessed by Newcastle–Ottawa Scale (NOS). A random‐effects model of DerSimonian‐Laird was used to synthesise the overall ORs or RRs for all risk factors. MOOSE checklist was used to review this manuscript. Results: A total of 21 studies including 6165 patients were finally included for quantitative analysis. The pooled incidence of postoperative delirium is 11% (95% CI: 9%‐15%). 16 risk factors were identified, in which age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative C‐reactive protein (CRP) levels, operation time, blood loss and perioperative blood transfusion were statistically significant while smoking, American Society of Anesthesiologists (ASA) score, performance status, diabetes and operation approach were insignificant. Discussion: This meta‐analysis may provide tips for nursing staff and surgeons to design and implement prevention programmes to reduce the incidence of postoperative delirium. Conclusion: Potential risk factors of delirium after gastrointestinal surgery are age, sex, alcohol consumption, cerebrovascular diseases, cardiovascular diseases, use of sleeping pills, history of delirium, preoperative CRP levels, operation time, blood loss and blood transfusion. [ABSTRACT FROM AUTHOR]

Aims and objectives: To test whether the revised Wilson and Cleary model could identify which factors contribute to health‐related quality of life in chronic kidney disease. Background: Chronic kidney disease affects a person's health‐related quality of life detrimentally although nursing practice informed by theory is only beginning to emerge. Design: A cross‐sectional study reported using the STROBE guidelines. Methods: About 886 participants with chronic kidney disease (varying grades) completed validated measures of symptoms (renal version of the Integrated Palliative care Outcome Scale), and general health perceptions and health‐related quality of life (European Quality of Life five‐dimension three‐level). Socio‐demographic and renal characteristics were also collected. Data were analysed using descriptive statistics and structural equation modelling. Results: Biological function (decreased kidney function and haemoglobin and greater number of comorbidities), directly contributed to increased symptom burden. Symptoms demonstrated strong negative relationships with both general health perceptions and health‐related quality of life. General health perceptions had a direct positive relationship with health‐related quality of life. As age increased, health‐related quality of life decreased. The only environmental characteristic of significance was the distance between home and hospital although it was not directly associated with health‐related quality of life. Overall, the model explained approximately half of the deterioration in health‐related quality of life. Conclusions: The model demonstrated how various factors influence alteration of health‐related quality of life in people with chronic kidney disease. Early identification of these factors could assist nurses to introduce effective management strategies into patient care plans proactively. Relevance to clinical practice: Comprehensive symptom assessment needs to occur not only in kidney failure but in earlier chronic kidney disease grades to enable timely interventions targeted at improving people's wellbeing. Patient or public contribution: Validated interviewer administered questionnaires were completed by participants with chronic kidney disease in this study. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the use of physical restraints in aged care facilities(ACFs)and analyse its associated risk factors. Background: Physical restraints have been widely used in ACFs worldwide, but they can cause physical and mental harm to older people. It is important to regulate the use of physical restraint. Design: A cross‐sectional observational and correlational multicentre study. Methods: By convenience sampling method, we selected eight ACFs in four representative regions of Hunan province, China, for this study. The ACF‐related information was obtained by interviewing the managers and reviewing records. We conducted investigation and observation on the elderly in the ACFs to understand the use of physical restraints at three different times: 9:30–11:30, 16:00–18:00 and 19:30–21:30 on a working day. The STROBE checklist was followed for this cross‐sectional study. Results: This study found that the utilisation rate of physical restraints was 23.2%. The critical risk factors affecting the use of physical restrains include the following: (1) the ratio of nursing staff to the elderly residents; (2)whether there is a dementia care unit at the facility; (3) the number of elderly residents in each room; (4) the elderly residents' age, degree of education, marital status, care dependence and cognitive impairment; (5) whether the elderly has suffered from a stroke or senile dementia; (6) whether the elderly carries medical catheters. Conclusion: There is a lack of standardisation in the use of physical restraints in ACFs of central China. Chinese ACFs should develop guidelines and reduction measures to standardise the use of physical restraints, basing on the key factors affecting the use of physical restraints. Relevance to clinical practice: The use of physical restraints in ACFs is threatening the safety of the elderly residents. Understanding the implementation of physical restraint in ACFs can provide reference for reducing the use of physical restraint. [ABSTRACT FROM AUTHOR]

Aims: To determine factors associated with poor sleep quality among patients with pre‐dialysis chronic kidney disease. Design: This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statements and checklist. Data Sources: Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. Review Methods: Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle–Ottawa Scale by two doctorial prepared nursing scientists. Results: A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal‐related and cognitive arousal behaviours were associated with poor sleep quality. Conclusion: Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre‐dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. Impact Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self‐management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease. [ABSTRACT FROM AUTHOR]

Aims: To identify specific patterns of lifestyle behaviours among young adults and examine the relationships of the patterns to sociodemographic characteristics and health conditions (hypertension, diabetes and obesity). Design: Descriptive, correlational study. Methods: Data from a nationally representative sample of 4562 young adults aged 19–39, who participated in the 2016–2018 Korea National Health and Nutrition Examination Survey, were analysed. Latent class analysis was used to identify the patterns of lifestyle behaviours, including smoking, alcohol use, physical activity and vaccination. Generalized linear regression analysis was used to examine the relationships among lifestyle behaviour patterns, sociodemographic characteristics and health conditions. Results: Three patterns of lifestyle behaviours were identified: physically active (6.9%), high risk (21.5%) and passive (71.6%). The membership of these three patterns was significantly associated with sociodemographic characteristics (age, sex, education level, occupation and living arrangement). Among the three groups, young adults in the high‐risk group were found to be significantly associated with all three health conditions (hypertension, diabetes and obesity) while controlling for sociodemographic characteristics. Conclusion: These results indicate that young adults are likely to engage in unhealthy lifestyle behaviours that are related to individual socioeconomic conditions, which could negatively affect their health conditions. Impact This study provides insights into the lifestyle behaviours among young adults who have been recognized to be socially disadvantaged. This could help develop education and prevention programmes tailored to specific patterns of lifestyle behaviours for improving health while considering their socioeconomic contexts. No Patient or Public Contribution: This applies to this research as the focus was on young adults in South Korea only. [ABSTRACT FROM AUTHOR]

Aim: To examine the mediating effect of sleep quality on the relationship between lower urinary tract symptoms and health‐related quality of life in women with type‐II diabetes. Design: A cross‐sectional study. Methods: A study questionnaire comprising three valid instruments was used to obtain data about lower urinary tract symptoms, sleep quality and physical and mental component summary health‐related quality of life between July 2017 and December 2018 (n = 343). Pearson's correlation coefficients were estimated initially to examine the relationships between the three variables. Multiple regression models were tested using a regression‐based approach Hayes PROCESS macro for SPSS to examine the significance of proposed mediation effects. Results: Most participants experienced at least one urinary symptom (n = 268, 78.1%). The total number of types of lower urinary tract symptoms experienced by participants was significantly inversely correlated with physical and mental component summary health‐related quality of life, and sleep quality. Participants' sleep quality was significantly correlated with physical and mental component summary health‐related quality of life. The relationships of lower urinary tract symptoms with physical and mental component summary health‐related quality of life were, respectively, fully and partially mediated by sleep quality. Conclusion: Sleep quality played a mediating role on the relationship between lower urinary tract symptoms and health‐related quality of life. Our findings could lead to improvements of diabetes care in nursing and healthcare practices. Impact Understanding the role of sleep quality in the adverse effects of lower urinary tract symptoms on health‐related quality of life contributes to the development and delivery of appropriate strategies to promote optimal health‐related quality of life. We recommended including assessments of lower urinary tract symptoms, sleep and health‐related quality of life in routine diabetes management. Nurses and healthcare professionals should concurrently reduce lower urinary tract symptoms and improve sleep to achieve this population's optimal health‐related quality of life. Patients or public contribution: We recruited a sample of older women with type‐II diabetes at the endocrinology and metabolism outpatient departments of two hospitals. Study participants provided responses on the study questionnaires. The two hospitals provided needed supports (e.g., height/weight scales, suitable places for interview) during the data collection process. [ABSTRACT FROM AUTHOR]

Aim(s): To identify, describe and assess research evidence on factors that promote working until and beyond the official retirement age among nurses. Design: A mixed‐methods systematic review. Prospero ID CRD42022303890. Data Sources: The CINAHL, PsycINFO, MEDLINE, Scopus, SocINDEX and Web of Science databases were searched in December 2021. Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) checklist was followed. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals. Data‐based convergent synthesis and thematic analysis were used. Results: Eighteen studies were included, most of which were survey‐based. Eleven studies were quantitative, six were qualitative and one used mixed methods. Our results reveal that willingness to continue in work increased with age. Six factors promoted working until and beyond the official retirement age among nurses: good health and work ability, the significance of work sufficient income, meaningful relationships and support in the working community, individually tailored work arrangements, and organizational support and recognition. Conclusion: To sustain experienced nurses in working life and promote their working beyond retirement age organizations urgently need to apply throughout working lives supporting age management schemes. Interventions should target supportive relations and individual and flexible arrangements at the workplace. Scarce studies investigated factors contributing to an extension of working life among nurses. Most published evidence on this topic is based primarily on nurses' subjective opinions and preferences: no intervention studies or objective evaluations of factors affecting retirement were found. Impact The available evidence suggests the most critical factors for extending nurses' working lives are support and individual and flexible arrangements in the workplace. There is a need to test interventions and evaluate the effectiveness of measures encouraging nurses to extend their working lives. No Patient or Public Contribution: Systematic review. [ABSTRACT FROM AUTHOR]

Aims: A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background: Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design: A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods: Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results: Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions: The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace. Design: A qualitative descriptive methodology. Method: Twenty healthcare managers working in Australia participated in semi‐structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis. Results: All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce. Conclusion: Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co‐exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work. Impact The global ageing population will result in a rise in complex age‐related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to understand the risk factors that contribute to medical device‐related (MDR) nasal mucosal membrane pressure injuries (MM PI) in ICU patients. Background: ICU patients require substantial tube‐based life support such as oxygen tubes, tracheal intubation and indwelling gastric tubes. As a result, there is an increased risk of PI occurrence; however, few studies have assessed the risk factors associated with nasal mucosal MDR‐MMPI in ICU patients. Design: A cross‐sectional study design was performed. Methods: From January 2019 to June 2020, data from 912 patients treated in the ICU of a tertiary first‐class a hospital in China were collected. The occurrence of PI of the nasal mucosa was obtained by nasopharyngoscope when replacing the nasal catheter fixation patch every day. The study methods were followed by the STROBE guidelines. Results: The incidence of nasal mucosal MDR‐MM PI was 10.9%. The degree of nasal mucosal MM PI was mainly grade 1 (62cases, 62.6%), and no grade 4 were observed. The columella (58 cases, 58.6%) was the most common site of nasal mucosal MM PI followed by the anterior septum (18 cases, 18.2%). A high patient APACHE‐Ⅱ score, the disturbance of consciousness, a history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and the use of vasoconstrictors were identified as significant influencing factors of nasal MM PI in ICU patients (p <.05). Conclusions: A high APACHE‐Ⅱ score, disturbance of consciousness, history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and use of vasoconstrictive drugs were risk factors for nasal mucosal MDR‐MM PI in ICU patients. This study informs on the risk factors of nasal mucosal MM PI that will allow medical support staff to carry out key interventional measures to prevent nasal mucosal MM PI. Relevance to clinical practice: This study illustrates the characteristics and risk factors of nasal mucosal pressure injury in intensive care units, potentially contributing to the prevention of the incidence of nasal mucosal MDR‐PI in ICU patients. [ABSTRACT FROM AUTHOR]

Aims and Objective: To investigate the incidence, characteristics and risk factors of delirium in the ICU. Background: Identifying the risk factors of delirium is important for early detection and to prevent adverse consequences. Design: An observational cohort study conducted according to STROBE Guidelines. Method: The study was conducted with patients who stayed in ICU ≥24 h and were older than 18 years. Patients were assessed twice daily using the RASS and CAM‐ICU until either discharge or death. Cumulative incidence was calculated. Demographic/clinical characteristics, length of stay and mortality were compared between patients with and without delirium. A logistic regression model was used to investigate risk factors. Results: The incidence of delirium was 31.8% and hypoactive type was the most frequent (41.5%). The median onset of delirium was 3 days (IQR = 2) with a mean duration of 5.27 ± 2.32 days. Patients with delirium were significantly older, had higher APACHE‐II, SOFA and CPOT scores, higher blood urea levels, higher requirements for mechanical ventilation, sedation and physical restraints, longer stays in the ICU and higher mortality than those without delirium. The logistic regression analysis results revealed that a CPOT score ≥3 points (OR = 4.70, 95% CI: 1.05–20.93; p =.042), physical restraint (OR = 10.40, 95% CI: 2.75–39.27; p =.001) and ICU stay ≥7 days (OR = 7.26, 95% CI: 1.60–32.84; p =.010) were independent risk factors of delirium. Conclusions: In this study, the incidence of delirium was high and associated with several factors. It is critical that delirium is considered by all members of the healthcare team, especially nurses, and that protocols are established for improvements. Relevance to the clinical practice: Based on the results of this study, delirium could be decreased by preventing the presence of pain, prudent use of physical restraints and shortening the ICU stay. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the prevalence and the associated factors of self‐perceived medical errors among Chinese emergency department nurses. Background: The emergency department is a place with a high incidence of medical errors. Studies about the occurrence and related influencing factors of medical errors among emergency nurses in China are very insufficient. Design: A nationwide cross‐sectional study. Methods: A nationwide cross‐sectional study was conducted from July 2018–August 2018. A total of 17,582 emergency department nurses from 31 provinces across China were eventually included in the analysis. Logistic regression is applied to examine the association of the independent variables with the perceived medical errors. The reporting of this study was compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Results: Of 17,582 participating nurses, 4445 (25.28%) reported self‐perceived medical errors in the past 3 months. Nurses who were serving as nurses‐in‐charge; who reported fair or bad physical health; who reported staff shortage; who were exposed to more verbal abuse at work; who experienced effort–reward imbalance; who reported more over‐commitment; or who had depressive symptoms were more likely to report medical errors. Older age and female gender were protective factors. Conclusions: In this study, a quarter of the emergency nurses reported that they had made medical errors in the past 3 months. Self‐perceived medical errors are associated with multiple domains of work‐related factors and personal distress. Feasible measures should be taken to reduce nurses' workload, improve their working environment, monitor and minimise the occurrence of medical errors among emergency department nurses. Relevance to clinical practice: Emergency nurses, who are the most frequently in contact with patients, play an important role in identifying risk factors and preventing medical errors. Identifying risk factors that may lead to medical errors in the medical environment from both internal and external aspects will help nursing practitioners, hospital administrators and policy makers to take timely preventive measures to reduce the occurrence of medical errors and reduce harm to patients. [ABSTRACT FROM AUTHOR]

Aim: To map the factors associated with nurses' positive attitudes towards families' involvement in nursing care and to identify any existing gaps in knowledge. Background: Several tools have been proposed to assess the attitudes, beliefs and practices of nurses towards families in different care contexts. However, there is a knowledge gap on how the results of these tools can identify the factors that are associated with more positive attitudes of nurses. Design: A scoping review based on the steps proposed by the Joanna Briggs Institute. Methods: Three independent reviewers searched the databases: PUBMED/Medline; LILACS; Virtual Health Library; PsycInfo; Google Scholar; SCOPUS and CINAHL, from 2006 to August 2021, guided by the question: What are the factors associated with nurses' positive attitudes towards families´ involvement in nursing care, in studies that used one or both of the following two scales 'Families' Importance in Nursing Care‐ Nurses' Attitudes' and 'Family Nursing Practice Scale'? This review was conducted in accordance with PRISMA‐ScR. Results: Twenty‐six primary studies were identified, in which 9,620 nurses participated. Positive attitudes were associated with three types of variables: (a) personal—longer working career (42.3%) and older age (26.9%); (b) educational—higher level of academic education (30.8%) and family nursing education (23.0%); and (c) workplace—working in primary health care and/or outpatient clinics (34.6%) or in a unit with philosophy/approach to families (23.0%). Conclusions: Personal variables such as age and time of service are non‐modifiable aspects, but educational and workplace variables are subject to intervention to improve nurses' attitudes towards families' involvement in nursing care. Continuing development programmes about family care can constitute important strategies to improve positive attitudes of nurses towards families in practice. Relevance to clinical practice: Recognising the characteristics associated with nurses´ positive attitudes towards families may enable the development of tailored interventions that promote family‐focused care. [ABSTRACT FROM AUTHOR]