J Nurs Scholarsh [JOURNAL]
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200 papers
Health outcomes in children with prenatal opioid exposure with and without neonatal abstinence syndrome in the first seven years of life: An observational cohort study.
Lambert J, Arter S, Duah H … +2 more , Xavier T, Sprague JE
J Nurs Scholarsh · 2024 Nov · PMID 39560001 · Publisher ↗
INTRODUCTION: Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis...
INTRODUCTION: Prenatal opioid exposure (POE) is a major public health consequence of the opioid epidemic. Long-term health outcomes associated with POE remain unclear, especially for children with POE without a diagnosis of neonatal abstinence syndrome (NAS). Here, we aimed to describe the health outcomes of children with POE and with POE and NAS compared to unexposed children during the first 7 years of life. DESIGN: In this retrospective observational cohort study, children born between 2015 and 2022 were identified from the Maternal and Infant Data Hub (MIDH), a data repository that continuously integrates maternal, neonatal, and pediatric records from two academic medical centers and one pediatric hospital system in the Midwest, USA. METHODS: International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10 CM) chapters A00-N99 served as outcomes of interest. Annual incidence and crude incidence rate ratios were calculated to explore descriptive differences between the exposed and unexposed groups. RESULTS: The study included 22,002 children, 20,130 (91.5%) of whom were unexposed and 1872 (8.5%) were exposed. Of the 1872 exposed children, 371 (19.8%) received a diagnosis of NAS (POE + NAS) and 1501 were in the POE-NAS group. Across all 7 years, exposed children had a higher incidence of diagnoses in most ICD-10 CM chapters compared to unexposed children. A consistently higher incidence rate ratio of diagnosis was observed in both POE-NAS and POE + NAS groups (vs. unexposed) related to mental and behavioral disorders, eye diagnoses, and diseases of the musculoskeletal system and gastrointestinal systems. CONCLUSIONS: POE is associated with an increased risk of diagnoses in a number of ICD-10 CM chapters throughout childhood. These findings underscore the need for early screening and targeted interventions to support exposed children and improve their well-being. Further research is required to explore underlying mechanisms and develop preventive measures for at-risk populations. CLINICAL RELEVANCE: Understanding the conditions more often diagnosed in children with prenatal opioid exposure will help to improve care provided to this population. As a result of study findings, nurses who provide care to children with prenatal opioid exposure can prioritize their assessments and allocate time, resources, and education toward areas more likely to be affected.
Response to a Letter to the Editor on "The Role of Nurses' Adherence to Clinical Safety Guidelines in Linking Nurse Practice Environment to Missed Nursing Care".
Labrague LJ, Al Sabei S, AbuAlRub R … +2 more , Burney I, Al Rawajfah O
J Nurs Scholarsh · 2025 Jan · PMID 39552161 · Publisher ↗
Abstract loading — click title to view on PubMed.
Missed nursing care: Expanding the research scope for a comprehensive understanding.
He Y, Zhang X
J Nurs Scholarsh · 2025 Jan · PMID 39552148 · Publisher ↗
Abstract loading — click title to view on PubMed.
Transcutaneous electrical acupoint stimulation for preventing postoperative nausea and vomiting after laparoscopic surgery: A meta-analysis.
Yuan L, Quan SJ, Li XY … +3 more , Chen BZ, Huang YB, Zheng H
J Nurs Scholarsh · 2025 May · PMID 39523483 · Publisher ↗
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common adverse event after general surgery. This study aimed to examine the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for...
BACKGROUND: Postoperative nausea and vomiting (PONV) is a common adverse event after general surgery. This study aimed to examine the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) for the prevention of nausea and vomiting after laparoscopic surgery. METHOD: The Cochrane Library, Pubmed, Embase, and Web of Science databases were accessed from inception to 23 January 2024. The incidence of PONV was the primary outcome measure. The required information size (RIS) of each outcome was estimated by Trial sequential analysis (TSA). The RoB 2.0 tool was used to assess the risk of bias and GRADE to assess the quality of evidence. RESULTS: Seventeen RCTs including 3698 participants were included. In comparison to the control group, TEAS reduced the incidence of PONV (13 trials, n = 3310; RR, 0.56; 95% CI, 0.46-0.67; I = 64%; p < 0.01; RIS = 1100), with the level of evidence graded as low. TEAS reduced the incidence of PON (9 trials, n = 2762; RR, 0.64; 95% CI, 0.52-0.79; I = 57%, p < 0.01; RIS = 1595), and was also associated with a lower incidence of POV (9 trials, n = 2797; RR, 0.53; 95% CI, 0.45-0.63; I = 0%, p < 0.01; RIS = 773). CONCLUSION: The current meta-analysis and TSA provide reliable evidence that TEAS is an effective and safe method to prevent PONV. It may reduce the workload of nursing professionals, alleviate emotional stress, and decrease exposure risk. Adverse events related to TEAS were mild. CLINICAL RELEVANCE: Nurses can incorporate TEAS into the rehabilitation nursing of patients experiencing PONV.
Beneficial effects of non-pharmacological interventions for post-stroke pain: A meta-analysis.
Saragih ID, Suarilah I, Mulyadi M … +2 more , Saragih IS, Lee BO
J Nurs Scholarsh · 2025 Mar · PMID 39513537 · Publisher ↗
PURPOSE: Pain is a frequent post-stroke health concern, and several non-pharmacological interventions are commonly employed to manage it. However, few reviews have examined the effectiveness of such interventions, making...
PURPOSE: Pain is a frequent post-stroke health concern, and several non-pharmacological interventions are commonly employed to manage it. However, few reviews have examined the effectiveness of such interventions, making it difficult to draw conclusions about their usefulness. Furthermore, subgroup analysis based on post-stroke pain level or intervention characteristics is rarely performed. This study aimed to investigate the effectiveness of non-pharmacological interventions and evaluate the significant factors associated with post-stroke pain through subgroup analysis. DESIGN: Systematic review and meta-analysis. METHODS: Relevant studies were obtained from seven databases, from their commencement up to March 2024, as well as from the gray literature. The PICOS approach was used to evaluate the eligibility criteria of the studies. The RoB-2 tool was used to determine the risk of bias in each randomized trial. Pooled estimations of standardized mean difference and heterogeneity (quantified with I) were obtained using a random-effects model. The stability of the pooled result was then assessed using the leave-one-out approach. STATA 17.0 was used to run the meta-analysis. FINDINGS: Non-pharmacological interventions were effective in reducing pain immediately after intervention (pooled SMDs: -0.79; 95% confidence interval [CI]: -1.06 to -0.53; p < 0.001). The approach involving acupuncture, aquatic therapy, or laser therapy and rehabilitation training was effective for post-stroke hemiplegic shoulder pain. A pooled analysis of non-pharmacological interventions showed that both less than 4 weeks and more than 4 weeks of interventions were effective in alleviating pain in stroke patients. CONCLUSION: Non-pharmacological approaches appear to be beneficial for reducing post-stroke pain. The outcomes based on the modalities merit further research. CLINICAL RELEVANCE: Further studies are needed to determine the effects of different modalities on pain intensity following a stroke. Furthermore, to avoid overestimation of intervention efficacy, future randomized trials should consider blinding approaches to the interventions delivered.
Developing a clinical decision support framework for integrating predictive models into routine nursing practices in home health care for patients with heart failure.
Chae S, Davoudi A, Song J … +9 more , Evans L, Bowles KH, Mcdonald MV, Barrón Y, Min SH, Oh S, Scharp D, Xu Z, Topaz M
J Nurs Scholarsh · 2025 Jan · PMID 39508345 · Full text
BACKGROUND: The healthcare industry increasingly values high-quality and personalized care. Patients with heart failure (HF) receiving home health care (HHC) often experience hospitalizations due to worsening symptoms an...
BACKGROUND: The healthcare industry increasingly values high-quality and personalized care. Patients with heart failure (HF) receiving home health care (HHC) often experience hospitalizations due to worsening symptoms and comorbidities. Therefore, close symptom monitoring and timely intervention based on risk prediction could help HHC clinicians prevent emergency department (ED) visits and hospitalizations. This study aims to (1) describe important variables associated with a higher risk of ED visits and hospitalizations in HF patients receiving HHC; (2) map data requirements of a clinical decision support (CDS) tool to the exchangeable data standard for integrating a CDS tool into the care of patients with HF; (3) outline a pipeline for developing a real-time artificial intelligence (AI)-based CDS tool. METHODS: We used patient data from a large HHC organization in the Northeastern US to determine the factors that can predict ED visits and hospitalizations among patients with HF in HHC (9362 patients in 12,223 care episodes). We examined vital signs, HHC visit details (e.g., the purpose of the visit), and clinical note-derived variables. The study identified critical factors that can predict ED visits and hospitalizations and used these findings to suggest a practical CDS tool for nurses. The tool's proposed design includes a system that can analyze data quickly to offer timely advice to healthcare clinicians. RESULTS: Our research showed that the length of time since a patient was admitted to HHC and how recently they have shown symptoms of HF were significant factors predicting an adverse event. Additionally, we found this information from the last few HHC visits before the occurrence of an ED visit or hospitalization were particularly important in the prediction. One hundred percent of clinical demographic profiles from the Outcome and Assessment Information Set variables were mapped to the exchangeable data standard, while natural language processing-driven variables couldn't be mapped due to their nature, as they are generated from unstructured data. The suggested CDS tool alerts nurses about newly emerging or rising risks, helping them make informed decisions. CONCLUSIONS: This study discusses the creation of a time-series risk prediction model and its potential CDS applications within HHC, aiming to enhance patient outcomes, streamline resource utilization, and improve the quality of care for individuals with HF. CLINICAL RELEVANCE: This study provides a detailed plan for a CDS tool that uses the latest AI technology designed to aid nurses in their day-to-day HHC service. Our proposed CDS tool includes an alert system that serves as a guard rail to prevent ED visits and hospitalizations. This tool can potentially improve how nurses make decisions and improve patient outcomes by providing early warnings about ED visits and hospitalizations.
Reflections on nursing leadership in socio-contextual and interconnected global scenarios.
Stievano A, Shaffer F
J Nurs Scholarsh · 2024 Nov · PMID 39501513 · Publisher ↗
Abstract loading — click title to view on PubMed.
Precision health: Determining the capacity of practicing nurses across the United States.
Fangonil-Gagalang E, Schultz MA, Huryk LA … +3 more , Payne PA, Schoenbaum AE, Velez K
J Nurs Scholarsh · 2025 Mar · PMID 39460550 · Publisher ↗
INTRODUCTION: Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental inf...
INTRODUCTION: Precision Health (PH) holds the promise of revolutionizing healthcare by enabling personalized disease prevention and management through the integration of genomic data, lifestyle factors, environmental influences, and other social determinants of health (SDoH). However, the absence of a baseline assessment of knowledge, skills, and attitudes (KSAs) of practicing nurses' capacity for PH hinders its integration. The purpose of this study is to determine the capacity of practicing Registered Nurses (RNs) for PH across the United States and to assess the validity and reliability of a tool designed for this use-the Precision Health Nurse Capacity Scale (PHNCS). DESIGN/METHOD: A descriptive exploratory study was conducted to evaluate the capacity of practicing RNs for this evolving phenomenon, PH, using a convenience sample. The survey was sent via email and made available to all members of the American Nurses Association (ANA) who work in a variety of practice environments. The ANA represents the over 4 million nurses practicing in the United States. RESULTS: The majority of nurse respondents felt it is important for nurses to become more educated about all aspects of PH including SDoH but they lack confidence in the integration of PH. The PHNCS was found to be a valid and reliable tool in measuring the capacity of nurses to practice PH. CONCLUSION: The incorporation of PH into nursing practice suffers an immediate impediment: the lack of know-how of the US nursing workforce. This inaugural data on KSAs for PH establishes a logical baseline from which the requisite education and training should commence. CLINICAL RELEVANCE: Precision Health is an emerging healthcare approach in the United States and globally. Enabling it will require a nursing workforce prepared with the requisite KSAs. Determining the capacity of the nursing workforce is a foundational step to begin this process.
Effectiveness of integrated care models for stroke patients: A systematic review and meta-analysis.
Liu B, Cai J, Zhou L
J Nurs Scholarsh · 2025 Mar · PMID 39315522 · Publisher ↗
INTRODUCTION: Given that stroke is a leading cause of disability and mortality worldwide, there is an urgent need for a coordinated healthcare approach to mitigate its effects. The objectives of this study were to perfor...
INTRODUCTION: Given that stroke is a leading cause of disability and mortality worldwide, there is an urgent need for a coordinated healthcare approach to mitigate its effects. The objectives of this study were to perform a systematic review and meta-analysis of stroke integrated care models and develop recommendations for a representative model. DESIGN: A systematic review and meta-analysis. METHODS: The literature search identified randomized controlled trials comparing integrated care models with standard care for stroke patients. The included studies followed PICOs inclusion criteria. The qualitative analysis included creating a flowchart for the literature screening process, and tables detailing the basic characteristics of the included studies, the adherence to the ten principles and the results of the quality assessments. Subsequently, quantitative meta-analytical procedures were conducted to statistically pool the data and quantify the effects of the integrated care models on stroke patients' health-related quality of life, activities of daily living, and depression. The China National Knowledge Infrastructure (CNKI), Wanfang Data, Chongqing VIP Chinese Science and Technology Periodical Database (VIP), China Biology Medicine Disc (CBMDISC), Cochrane Library, Cumulated Index to Nursing and Allied Health Literature (CINAHL), PubMed, Web of Science, Embase, Google Scholar, and Clinical Trials were searched from inception to March 13, 2024. RESULTS: Of the 2547 obtained articles, 19 were systematically reviewed and 15 were included in the meta-analysis. The integrated care models enhanced stroke patients' health-related quality of life, ability to perform activities of daily living, and reduced depression. Adherence to the 10 principles varied: comprehensive services, patient focus, and standardized care delivery had strong implementation, while gaps were noted in geographic coverage, information systems, governance structures, and financial management. CONCLUSION: Integrated care models improve outcomes for stroke patients and adherence to the 10 principles is vital for their implementation success. This study's findings call for a more standardized approach to implementing integrated care models, emphasizing the need for integrated services, patient-centred care, and interdisciplinary collaboration, while also addressing the identified gaps in terms of integration efforts. CLINICAL RELEVANCE: This study provides evidence-based recommendations on the most effective integrated care approaches for stroke patients, potentially leading to better patient outcomes, reduced healthcare costs, and improved quality of life.
Decoding machine learning in nursing research: A scoping review of effective algorithms.
Choi J, Lee H, Kim-Godwin Y
J Nurs Scholarsh · 2025 Jan · PMID 39294553 · Full text
INTRODUCTION: The rapid evolution of artificial intelligence (AI) technology has revolutionized healthcare, particularly through the integration of AI into health information systems. This transformation has significantl...
INTRODUCTION: The rapid evolution of artificial intelligence (AI) technology has revolutionized healthcare, particularly through the integration of AI into health information systems. This transformation has significantly impacted the roles of nurses and nurse practitioners, prompting extensive research to assess the effectiveness of AI-integrated systems. This scoping review focuses on machine learning (ML) used in nursing, specifically investigating ML algorithms, model evaluation methods, areas of focus related to nursing, and the most effective ML algorithms. DESIGN: The scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: A structured search was performed across seven databases according to PRISMA-ScR: PubMed, EMBASE, CINAHL, Web of Science, OVID, PsycINFO, and ProQuest. The quality of the final reviewed studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI). RESULTS: Twenty-six articles published between 2019 and 2023 met the inclusion and exclusion criteria, and 46% of studies were conducted in the US. The average MERSQI score was 12.2, indicative of moderate- to high-quality studies. The most used ML algorithm was Random Forest. The four second-most used were logistic regression, least absolute shrinkage and selection operator, decision tree, and support vector machine. Most ML models were evaluated by calculating sensitivity (recall)/specificity, accuracy, receiver operating characteristic (ROC), area under the ROC (AUROC), and positive/negative prediction value (precision). Half of the studies focused on nursing staff or students and hospital readmission or emergency department visits. Only 11 articles reported the most effective ML algorithm(s). CONCLUSION: The scoping review provides insights into the current status of ML research in nursing and recognition of its significance in nursing research, confirming the benefits of ML in healthcare. Recommendations include incorporating experimental designs in research studies to optimize the use of ML models across various nursing domains. CLINICAL RELEVANCE: The scoping review demonstrates substantial clinical relevance of ML applications for nurses, nurse practitioners, administrators, and researchers. The integration of ML into healthcare systems and its impact on nursing practices have important implications for patient care, resource management, and the evolution of nursing research.
The effects of applying artificial intelligence to triage in the emergency department: A systematic review of prospective studies.
Yi N, Baik D, Baek G
J Nurs Scholarsh · 2025 Jan · PMID 39262027 · Full text
INTRODUCTION: Accurate and rapid triage can reduce undertriage and overtriage, which may improve emergency department flow. This study aimed to identify the effects of a prospective study applying artificial intelligence...
INTRODUCTION: Accurate and rapid triage can reduce undertriage and overtriage, which may improve emergency department flow. This study aimed to identify the effects of a prospective study applying artificial intelligence-based triage in the clinical field. DESIGN: Systematic review of prospective studies. METHODS: CINAHL, Cochrane, Embase, PubMed, ProQuest, KISS, and RISS were searched from March 9 to April 18, 2023. All the data were screened independently by three researchers. The review included prospective studies that measured outcomes related to AI-based triage. Three researchers extracted data and independently assessed the study's quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) protocol. RESULTS: Of 1633 studies, seven met the inclusion criteria for this review. Most studies applied machine learning to triage, and only one was based on fuzzy logic. All studies, except one, utilized a five-level triage classification system. Regarding model performance, the feed-forward neural network achieved a precision of 33% in the level 1 classification, whereas the fuzzy clip model achieved a specificity and sensitivity of 99%. The accuracy of the model's triage prediction ranged from 80.5% to 99.1%. Other outcomes included time reduction, overtriage and undertriage checks, mistriage factors, and patient care and prognosis outcomes. CONCLUSION: Triage nurses in the emergency department can use artificial intelligence as a supportive means for triage. Ultimately, we hope to be a resource that can reduce undertriage and positively affect patient health. PROTOCOL REGISTRATION: We have registered our review in PROSPERO (registration number: CRD 42023415232).
Machine learning methods to discover hidden patterns in well-being and resilience for healthy aging.
Austin RR, Jantraporn R, Michalowski M … +1 more , Marquard J
J Nurs Scholarsh · 2025 Jan · PMID 39248511 · Full text
BACKGROUND: A whole person approach to healthy aging can provide insight into social factors that may be critical. Digital technologies, such as mobile health (mHealth) applications, hold promise to provide novel insight...
BACKGROUND: A whole person approach to healthy aging can provide insight into social factors that may be critical. Digital technologies, such as mobile health (mHealth) applications, hold promise to provide novel insights for healthy aging and the ability to collect data between clinical care visits. Machine learning/artificial intelligence methods have the potential to uncover insights into healthy aging. Nurses and nurse informaticians have a unique lens to shape the future use of this technology. METHODS: The purpose of this research was to apply machine learning methods to MyStrengths+MyHealth de-identified data (N = 988) for adults 45 years of age and older. An exploratory data analysis process guided this work. RESULTS: Overall (n = 988), the average Strength was 66.1% (SD = 5.1), average Challenges 66.5% (SD = 7.5), and average Needs 60.06% (SD = 3.1). There was a significant difference between Strengths and Needs (p < 0.001), between Challenges and Needs (p < 0.001), and no significant differences between average Strengths and Challenges. Four concept groups were identified from the data (Thinking, Moving, Emotions, and Sleeping). The Thinking group had the most statistically significant challenges (11) associated with having at least one Thinking Challenge and the highest average Strengths (66.5%) and Needs (83.6%) compared to the other groups. CONCLUSION: This retrospective analysis applied machine learning methods to de-identified whole person health resilience data from the MSMH application. Adults 45 and older had many Strengths despite numerous Challenges and Needs. The Thinking group had the highest Strengths, Challenges, and Needs, which aligns with the literature and highlights the co-occurring health challenges experienced by this group. Machine learning methods applied to consumer health data identify unique insights applicable to specific conditions (e.g., cognitive) and healthy aging. The next steps involve testing personalized interventions with nurses leading artificial intelligence integration into clinical care.
Are we making the most of safe staffing research.
Steven A, Bernardes RA, Bianchi M … +6 more , Cornally N, Costa AI, Pursio K, Di Nitto M, Zanini M, Luiking ML
J Nurs Scholarsh · 2025 Mar · PMID 39212124 · Publisher ↗
INTRODUCTION: The uptake of research evidence on staffing issues in nursing by nursing leadership, management and into organizational policies seems to vary across Europe. This study wants to assess this uptake of resear...
INTRODUCTION: The uptake of research evidence on staffing issues in nursing by nursing leadership, management and into organizational policies seems to vary across Europe. This study wants to assess this uptake of research evidence. DESIGN: Scoping survey. METHOD: The presidents of twelve country specific Sigma Chapters within the European Region answered written survey questions about work organisation, national staffing levels, national skill mix levels, staff characteristics, and education. RESULTS: Seven of the 12 chapters could not return complete data, reported that data was unavailable, there was no national policy or only guidance related to some settings. CONCLUSION: Enhancing the awareness of nursing research and of nursing leaders and managers regarding staffing level evidence is not enough. It seems necessary to encourage nurse leaders to lobby for staffing policies. CLINICAL RELEVANCE: Research evidence on staffing issues in nursing and how it benefits health care is available. In Europe this evidence should be used more to lobby for change in staffing policies.
The impact of gender on the nursing figure and nurses' interprofessional relationships: A multimethod study.
Piervisani L, Maria M, Spagnuolo S … +4 more , Nazzaro P, Rocco G, Vellone E, Alvaro R
J Nurs Scholarsh · 2025 Mar · PMID 39199007 · Publisher ↗
AIMS: To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implica...
AIMS: To identify the current presence of stereotypes about the nursing profession in Italy and to understand how gendered processes and modalities are regulated and expressed in the physician-nurse dyad, and the implications for professional identity and autonomy. DESIGN: Qualitative multimethod design. METHODS: Forty-five interviews were conducted with nurses and physicians. The collected qualitative data underwent automatic textual data analysis using a multidimensional exploratory approach and a gender framework analysis. RESULTS: In Italy, nurses' roles are still associated with gender stereotypes stemming from the predominant male culture, which affects sexual and gender identity, the division of labor, and access to career paths. This leads to disadvantages in the nursing profession, which is heavily dominated by women. CONCLUSION: Biological differences between sexes generate an unconscious yet shared symbolic gender order composed of negative stereotypes that influence nurses' professional roles and activities. They follow behaviors that enter the work routine and institutionalize organizational processes. These effects are also seen in the asymmetric, limited, and reciprocal interprofessional relationships between male physicians and female nurses, where the former hinders the latter's professional autonomy and access to top positions. IMPLICATIONS FOR THE PROFESSION: This survey raises awareness of gender issues and stimulates reflection. It also enables health and nursing organizations to take action to raise gender awareness and education by countering the image of a non-autonomous profession. The analysis of gender processes allows us to identify interventions that can counteract forms of oppression in the work environment that lead to the emergence of nursing as a non-autonomous profession.
Nurses during war: Profiles-based risk and protective factors.
Hamama L, Amit I, Itzhaki M
J Nurs Scholarsh · 2025 Mar · PMID 39188125 · Full text
INTRODUCTION: Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify t...
INTRODUCTION: Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]). DESIGN: This study utilizes a cross-sectional design. METHOD: Two hundred nurses at a major public hospital in southern Israel completed self-report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software. FINDINGS: Two distinct profiles were identified: "reactive" and "resilient." The "reactive" group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the "resilient" group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the "reactive" group were younger, with greater seniority, worse self-rated health, and a higher frequency of kidnapped family members compared to nurses from the "resilient" group. CONCLUSION: Nurses in wartime are at risk if identified as "reactive." Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well-being. CLINICAL RELEVANCE: Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime.
Evaluating the combination of in-person and electronic social networking services for family caregivers of stroke survivors: A quasi-experimental analysis.
Kuo WY, Chen CY, Wang J … +3 more , Wang CM, Chen MC, Chang TY
J Nurs Scholarsh · 2025 Mar · PMID 39187961 · Publisher ↗
INTRODUCTION: The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the fe...
INTRODUCTION: The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms. DESIGN: Quasi-experimental design. METHODS: This study included 105 caregiver-survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022. RESULTS: The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms. CONCLUSION: Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life. CLINICAL RELEVANCE: This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.
Implementation of a structured oral hygiene program through nursing assistant education to address non-ventilator hospital-acquired pneumonia: A quasi-experimental study.
Kozub E, Gorzycki E, Sidebottom A … +2 more , Castro-Pearson S, Bryant R
J Nurs Scholarsh · 2025 Mar · PMID 39185740 · Full text
INTRODUCTION: Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate ora...
INTRODUCTION: Non-ventilator hospital-acquired pneumonia (NV HAP) is a common complication for hospitalized patients. NV HAP develops when patients aspirate oral secretions containing pathogenic bacteria. Appropriate oral hygiene can help mitigate NV HAP development. Hospital staff, including nursing assistants, play an important role in ensuring that these cares are completed. DESIGN: A quasi-experimental pre-post design was used to evaluate outcomes before and after implementation of a structured oral hygiene education program. METHODS: A structured oral hygiene program was developed and implemented in a large quaternary hospital. Change in NA knowledge, attitudes, and behaviors before and after implementation of the oral hygiene program was evaluated. Retrospective patient outcomes before and after the intervention were analyzed to detect changes in NV HAP rates. RESULTS: Following the education, nursing assistant knowledge of recommended frequency of oral care for patients who are NPO increased (67.2% vs. 82.1%, p = 0.003). NAs were more likely to report oral hygiene tools including oral suctioning (80.8% vs. 90.2%, p = 0.005) and toothbrushes (89.3% vs. 95.3%, p = 0.031). The unadjusted incidence of NV HAP was significantly lower in the post-intervention cohort (0.25%) compared to the pre-intervention cohort (0.74%), p < 0.001. In the adjusted model, non-invasive positive pressure ventilation increased the odds of NV HAP by nearly sevenfold (AOR = 6.88, 95% CI: 3.99, 11.39). CONCLUSION: Focused education for NAs is an effective strategy to increase knowledge related to oral hygiene. Implementing a structured oral hygiene program for NAs appears to be a promising practice to decrease NV HAP.
"Doing the right thing": Moral conflicts and ethical issues experienced by military nurses during wartime.
Agazio J, Padden DL
J Nurs Scholarsh · 2024 Nov · PMID 39177236 · Publisher ↗
INTRODUCTION: The War on Terrorism, which included Operation Enduring Freedom (OEF) in Afghanistan from 2001 to 2014 and the concurrent Operation Iraqi Freedom (OIF) from 2003 to 2011, exposed military nurses to situatio...
INTRODUCTION: The War on Terrorism, which included Operation Enduring Freedom (OEF) in Afghanistan from 2001 to 2014 and the concurrent Operation Iraqi Freedom (OIF) from 2003 to 2011, exposed military nurses to situations and challenges for which many reported feeling unprepared. Clinically, nurses faced multi-trauma injuries and devastating wounds suffered by military troops and civilians alike. Cultural issues and harsh living conditions added further complications to the care environment. The purpose of this study was to address the research question: How do military nurses identify, assess, manage, and personally resolve ethical issues occurring in nursing practice during wartime deployments? DESIGN: Qualitative grounded theory provided the design for this study. METHODS: Using the constant comparative method, data collection, and data analysis occurred simultaneously to build a theory of ethical issues management during wartime. Using a focused interview guide responsive to emerging themes and developing theory, interviews were conducted until theoretical saturation was achieved. Participants represented primarily Army (55%) active duty (83%) female nurses (71%) who had deployed to Iraq (52%), Afghanistan (32%), or both (16%). A sampling grid was used to recruit nurses representative of the demographics deployed in support of OIF and OEF. Data analysis used grounded theory methods to identify a core construct to detail proposed relationships and concepts. Rigor was maintained in study methods and analysis using established tenets to support trustworthiness. RESULTS: The nurses shared stories regarding their experiences during deployment. Many struggled to find internal resolutions regarding the care of detainees, cultural differences, end-of-life decision-making, pain management, and care of civilian casualties. CONCLUSION: The study described the ethical issues military nurses encountered during wartime and the strategies used to mitigate moral conflict. By better understanding how nurses define, assess, and manage ethical situations, we can better prepare our deploying nurses for future conflicts. CLINICAL RELEVANCE: Military nurses returning from wars with unresolved moral conflicts are at risk for moral distress. Moral distress has been associated with burnout, dissatisfaction with and leaving the nursing profession, compassion fatigue, and disinterest in the provision of quality patient care. In the interest of preserving the health of military nurses, steps need to be taken to provide resources for helping them prepare for, encounter, and cope with the ethical situations inherent in wartime nursing care.
Clinical nursing information systems based on standardized nursing terminologies: How are we doing?
Cesare M, Zega M
J Nurs Scholarsh · 2024 Sep · PMID 39169799 · Publisher ↗
Abstract loading — click title to view on PubMed.
The role of nurses' adherence to clinical safety guidelines in linking nurse practice environment to missed nursing care.
Labrague LJ, Al Sabei S, AbuAlRub R … +2 more , Burney I, Al Rawajfah O
J Nurs Scholarsh · 2025 Mar · PMID 39160684 · Publisher ↗
INTRODUCTION: While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this...
INTRODUCTION: While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care. METHODS: This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale. RESULTS: A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, p < 0.001) and a lower frequency of missed nursing care (β = -0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = -0.055, p < 0.001). CONCLUSION: Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care. CLINICAL RELEVANCE: Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.
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