J Nurs Scholarsh [JOURNAL]
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200 papers
Profiling vaccine hesitancy in nursing to tailor public healthcare policies: A cross-sectional international study.
McCready J, Erfani G, Comparcini D … +5 more , Cicolini G, Mikkonen K, Keisala J, Tomietto M, Sigma IMPACT Research team
J Nurs Scholarsh · 2025 Mar · PMID 39143721 · Full text
INTRODUCTION: Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing...
INTRODUCTION: Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community. DESIGN: This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023. METHODS: Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters. RESULTS: Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A). CONCLUSIONS: This study has identified specific sociodemographic and occupational factors that are related to vaccine hesitancy in an international sample of nurses. Additionally, attitudes contributing to hesitancy were identified, with worries about unforeseen future effects of the vaccine being identified as a critical attitude that may undermine confidence and increase hesitancy in nursing. This study also sheds light on the influence that social media platforms have on vaccine hesitancy and, as such, indicates which platforms are effective to disseminate vaccination campaigns to global nursing communities. CLINICAL RELEVANCE: Global vaccination campaigns should focus on specific profiles and clusters to promote vaccination in the international nursing community. Empowering nurses early in their careers will help to instill positive vaccination behaviors, ensuring a sustained uptake of vaccinations throughout the individual's career and beyond, with an impact on promoting vaccination at the public health level as well.
Prevalence and incidence of pressure injuries among nursing home residents with darker skin tones: A prospective cohort study.
Sugathapala RDUP, Latimer S, Gillespie BM … +2 more , Balasuriya A, Chaboyer W
J Nurs Scholarsh · 2024 Nov · PMID 39129213 · Publisher ↗
AIM: To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes. BACKGROUND: Pressure injury prevalence and incidence are indicators of safety...
AIM: To measure the prevalence and incidence of nursing home-acquired pressure injuries in older adults residing in Sri Lankan nursing homes. BACKGROUND: Pressure injury prevalence and incidence are indicators of safety and quality of care. A significant portion of the global population has a skin color dominated by the presence of melanin. Yet, the number of nursing home residents with darker skin tones who develop pressure injuries in nursing homes is relatively unknown. DESIGN: Prospective multisite cohort study conducted in nine nursing homes in Sri Lanka. The sample comprised 210 residents aged ≥60 years old. METHODS: Semi structured observations and chart audits were used to gather data from July to October 2023. Head-to-toe visual skin assessment to check for nursing home- acquired pressure injuries, Braden pressure injury risk scale and Fitzpatrick skin tone assessments were conducted on all recruited residents at baseline. All recruited residents were followed-up weekly for 12 weeks until detection of a new pressure injury, death, discharge, or transfer. RESULTS: Pressure injury point prevalence at baseline was 8.1% (17/210). Cumulative incidence was 17.1% (36/210). Incidence density was 15.8 per 1000 resident weeks. Most nursing home-acquired pressure injuries were located on the ankle at baseline (29.4%; 5/17) and in the follow-up period (27.8%; 10/36). Stage I pressure injuries were most common: 58.8% (10/17) and 44.4% (16/36) at baseline and during follow-up respectively. CONCLUSIONS: About one in six nursing home residents developed a new pressure injury over the 12-week follow-up period. Despite staff and resource constraints, there remains a need to focus on the prevention of pressure injuries in Sri Lankan nursing homes. CLINICAL RELEVANCE: Studies on the burden of pressure injuries among darker skin tone nursing home residents are lacking and the current evidence available are predominantly from Western countries. The findings of this study highlight the need of targeted preventive measures for nursing home residents with darker skin tones.
Family involvement in mental healthcare practice: Perspectives of mental health nurses, patients, and caregivers.
Hsiao CY, Lu HL, Wu KY … +3 more , Li CC, Li CR, Tsai YF
J Nurs Scholarsh · 2025 Mar · PMID 39123284 · Publisher ↗
INTRODUCTION: Family engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partne...
INTRODUCTION: Family engagement in care has been advocated to promote recovery for patients with mental health conditions. Attitudes of mental health nurses toward the importance of families influence the way they partner with families in mental healthcare. However, little is known about how mental health nurses engage with families and quality of family-centered care (FCC) perceived by patients and caregivers. The study aimed to examine the mediating effect of family nursing practice on the association between mental health nurses' attitudes toward integrating families into care and quality of FCC perceived by patients with schizophrenia and caregivers. DESIGN: A cross-sectional study was conducted. METHODS: A convenience sample of 143 dyads of patients with schizophrenia and their caregivers and 109 mental health nurses were recruited from inpatient wards at two psychiatric hospitals in Taiwan. Demographic and clinical questionnaires, Families' Importance in Nursing Care-Nurses' Attitudes scale, Family Nursing Practice Scale, and Measure of Process of Care for Adults were used to collect data. Data were analyzed using descriptive statistics, independent-sample t-tests, one-way analysis of variance, Pearson correlation coefficients, paired-sample t-tests, and intraclass correlation coefficient (ICC). Mediation analyses were performed using Hayes' PROCESS macro in SPSS (Model 4) with bootstrapping. RESULTS: Mental health nurses exhibited supportive attitudes toward integrating families into care (Mean = 98.96) and greater perceptions of family nursing practice (Mean = 2.44). The concordances between patients and caregivers on perceived quality of family-centered care were significant (ICC = 0.63-0.77). Attitudes of mental health nurses toward integrating families into care had both the total and direct effects on all domains of quality of FCC perceived by patients and caregivers, respectively. The indirect effects of mental health nurses' attitudes toward integrating families into care on aspects of quality of FCC through family nursing practice were significant for patients (95% bias-corrected bootstrap CI of 0.015-0.053) and caregivers (95% bias-corrected bootstrap CI of 0.004-0.041). The magnitude of the indirect effects was medium to large for patients (ES = 0.209-0.257) and caregivers (ES = 0.148-0.221). CONCLUSION: Family nursing practice partially mediated the association between mental health nurses' attitudes toward integrating families into care and aspects of quality of FCC from perspectives of patients and caregivers. CLINICAL RELEVANCE: Interventions tailoring mental health nurses' practice skills and reciprocity with families have the potential to enhance supportive attitudes of mental health nurses toward working with families and further improve perceived quality of FCC in patient-caregiver dyads in mental healthcare practice.
Effectiveness of spaced education pedagogy in enhancing Nurses' knowledge on emotional resilience-A quasi-experimental trial.
Lim SH, Ang SY, Lim YYA … +4 more , Leow WXB, Binte Sunari RN, Foo XA, Aloweni F
J Nurs Scholarsh · 2025 Mar · PMID 39118269 · Publisher ↗
INTRODUCTION: Building resilience among nurses has been postulated as one of the key strategies to support nurses and retain them in the profession. This study aimed to evaluate the effectiveness, of spaced education ped...
INTRODUCTION: Building resilience among nurses has been postulated as one of the key strategies to support nurses and retain them in the profession. This study aimed to evaluate the effectiveness, of spaced education pedagogy in enhancing Nurses' knowledge on emotional resilience. Secondary objectives include evaluation of the usability and acceptability of delivery of the training via a mobile application in one's own mobile device. DESIGN: A quasi-experimental study with single group pre-test and post-test trial was conducted. METHODS: Full-time registered nurses working in an acute care hospital were invited to participate from June 2021 to June 2022. The group used the mobile application daily for 1 month. Pre-test measurement includes socio-demographic data and baseline resilience level before the intervention. Post-test measurement includes resilience level, usability and acceptability of mobile-assisted cognitive-behavioral therapy measured upon completion of the training. The mobile application enabled the delivery of resilience educational content in small quantities through a repeating manner, with a concurrent evaluation of learner's understanding. RESULTS: When compared to their baseline (mean = 24.38, SD = 5.50), participants reported significant increase in the Connor-Davison Resilience Scale score (mean = 26.33, SD = 5.57) (t = -4.40, p < 0.001). Upon 1 month usage of the mobile application, a higher percentage of the participants reported intermediate to high level of resilience (57.4%), as compared to prior usage (54.7%). Respondents reported knowledge of most useful strategies for their daily lives including: (i) managing negative emotions (54.1%); (ii) psychoeducation about mental health and the risks of burnout (44.7%); (iii) achieving work and life balance (43.5%); and (iv) depiction of workplace scenarios to demonstrate what can be and cannot be controlled during times of change (43.5%). Participants reported usability of the mobile application with a mean SUS score 70.5 (SD = 13.0), which was considered "acceptable." Overall, 82.3% of the participants found the mobile application appealing, 64.7% reported they were likely to use the mobile application in the future and 72.9% would recommend it to other nurses. CONCLUSION: The mobile application provided nurses with the availability and convenience to access resilience building learning content integrated with the spaced education pedagogy. CLINICAL RELEVANCE: The use of mobile-assisted cognitive behavioral training can aid in increasing nurses' resilience level. Nurses provided acceptable usability ratings and satisfactory acceptance of receiving training via the mobile application, showing promising opportunities in the improvement of overall well-being.
Effectiveness of digital interventions to reduce school-age adolescent sexual risks: A systematic review.
Aguilar-Quesada A, Sierra-Yagüe A, González-Cano-Caballero M … +2 more , Zafra-Egea JA, Lima-Serrano M
J Nurs Scholarsh · 2025 Mar · PMID 39118266 · Full text
INTRODUCTION: The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital intervent...
INTRODUCTION: The increase in risky sexual behaviors among adolescent students has sparked alarm and has become an area of research interest. As adolescents prioritize confidentiality and accessibility, digital interventions are becoming increasingly relevant in sex education. We therefore posed the following research question: Are digital application interventions effective to prevent risky sexual behaviors in school adolescents? DESIGN: A systematic peer review was conducted between January and December 2023 in five databases (PubMed, Web of Science, Scopus, EMBASE, and PsycINFO) without restricting for language or year of publication. METHOD: We included randomized control trials or quasi-experimental studies that measured the effectiveness of interventions targeting young people aged 10-19 years or their parents and developed in a school setting. Interventions aimed at young people with intellectual disabilities, learning difficulties, or any disease requiring a specific intervention were excluded. RESULTS: The search ultimately yielded 27 studies covering a total of 18 digital interventions that demonstrated positive effects, not maintained over time, on knowledge, attitudes, and behaviors, although the latter to a lesser extent. DISCUSSION: We have found very interesting digital interventions with effects, among others, on knowledge, attitudes, and contraceptive use in adolescents. In general, digital interventions have positive effects on knowledge and attitudes, but it is more difficult to modify behaviors with strictly digital interventions or combined with complementary face-to-face sessions or group class activities. CONCLUSION: We thus believe that digital interventions are adequate to reduce adolescent sexual risk behaviors, and our systematic review facilitates the implementation of these interventions by sharing existing digital interventions that have had positive effects, as well as the main characteristics a digital intervention should possess to reduce sexually risky behaviors in adolescents. CLINICAL RELEVANCE: Digital interventions with adolescents improve sexual behaviors and can be a valuable resource in education on this topic due to their accessibility and confidentiality, two key points for young people.
Can digital leadership transform AI anxiety and attitude in nurses?
Tarsuslu S, Agaoglu FO, Bas M
J Nurs Scholarsh · 2025 Jan · PMID 39086074 · Full text
BACKGROUND: The lack of artificial intelligence applications in nursing education and the nursing profession in Turkey and the need for strategies for integrating artificial intelligence into the nursing profession conti...
BACKGROUND: The lack of artificial intelligence applications in nursing education and the nursing profession in Turkey and the need for strategies for integrating artificial intelligence into the nursing profession continues. At this point, there is a need to transform the negative attitudes and anxiety that may occur in nurses. OBJECTIVES: It was aimed to reorganize the professional transformation in this parallel by analyzing the effect of digital leadership perception, which is explained as how nurses approach digital technologies and innovations and their awareness of how and with which methods they can use these technologies on artificial intelligence anxiety and attitude in the nursing profession. DESIGN: The study was designed as descriptive, correlational, and cross-sectional. PARTICIPANTS: The research was conducted by reaching 439 nurses working in hospitals operating in three different regions of Turkey by simple random sampling method. METHODS: In the first part of the data collection tool used in this study, digital leadership scale, artificial intelligence use anxiety, and artificial intelligence attitude scales were used, including questions determining the demographic information of nurses, their relationship with technology, artificial intelligence usage status and its importance in the profession. RESULTS: It was determined that 29.8% of the nurses had a good relationship with technology, 66.3% knew about using artificial intelligence in health, and 27.3% wanted it to be more involved in their lives. It was determined that nurses' perceptions of digital leadership were at a medium level of 46.9% and a high level of 41.7%, 82.7% had a positive attitude towards artificial intelligence, and 82.7% had low or medium level anxiety when their artificial intelligence anxiety status was examined. There was a significant and negative relationship between digital leadership and AI anxiety (r = -0.434; p < 0.01), a significant and positive relationship between digital leadership and AI attitude (r = 0.468; p < 0.01), and a significant and negative relationship between AI attitude and AI anxiety (r = -0.629; p < 0.01). Finally, it was determined that nurses' perception of digital leadership indirectly affected AI anxiety through AI attitude (β = -0.230, 95% CI [-0.298, -0.165]). CONCLUSION: It is suggested that the anxiety and attitude towards artificial intelligence can be transformed positively with the effect of digital leadership, and in this parallel, the digital leadership phenomenon should be evaluated as a practical implementation strategy in integrating artificial intelligence into the nursing profession. CLINICAL RELEVANCE: Our study showed that artificial intelligence attitude has a mediating role in the indirect effect of the perception of digital leadership in nursing on AI anxiety. It was determined that nurses' digital leadership perception, artificial intelligence anxiety, and artificial intelligence attitude differed significantly with demographic variables.
Association between nurses' personal, professional and work characteristics, and engagement in hospital-based clinical research.
Colwill J, DiCioccio HC, Bena JF … +5 more , Morrison SL, Hall A, Masina V, Vanek R, Albert NM
J Nurs Scholarsh · 2024 Nov · PMID 39086028 · Publisher ↗
PURPOSE: The purpose of this study was to assess the associations between demographic, professional and other personal nurse characteristics, social support factors and comfort in conducting research with nurses' level o...
PURPOSE: The purpose of this study was to assess the associations between demographic, professional and other personal nurse characteristics, social support factors and comfort in conducting research with nurses' level of active participation in clinical research. DESIGN: A prospective, cross-sectional, correlational design was used. METHODS: Clinical nurses working in a multihospital healthcare system were recruited by email to complete an anonymous survey that used multiple valid and reliable scales to assess demographic and professional work characteristics, curiosity, grit, locus of control, perceived social support (for research activities), comfort in conducting research, and level of being research-active. Univariate and multivariable analyses were completed. RESULTS: Of 310 participants, 274 (88.4%) were female and mean (SD) age was 42.9 (13.1) years. After condensing 11 levels of research activity to four categories, 179 (57.7%) were not research-active, and 91 (29.4%), 26 (8.3%) and 14 (4.5%) were engaged at low, moderate, and high levels, respectively. Of 78 factors, 69 (88.5%) were associated with being research-active in univariate analyses. In multivariable analysis that adjusted for age, personal experience as a patient, years as a nurse and hours in direct patient care, professionalism characteristics, higher curiosity, internal locus of control, grit perseverance, support of a nurse scientist and nurse friends, and comfort in conducting research remained associated with higher levels of being research-active (all p < 0.01). CONCLUSION: Research-active nurses were more likely to be engaged professionally in hospital-based activities beyond their work roles and displayed higher levels of positive psychological characteristics and mentorship that supported research capacity. CLINICAL RELEVANCE: Research-active nurses were more likely to have internal factors and external resources that promoted higher levels of being research-active. A strong professional governance model may enhance clinical nurses research activities.
Empowering nurses to champion Health equity & BE FAIR: Bias elimination for fair and responsible AI in healthcare.
Cary MP, Bessias S, McCall J … +4 more , Pencina MJ, Grady SD, Lytle K, Economou-Zavlanos NJ
J Nurs Scholarsh · 2025 Jan · PMID 39075715 · Full text
BACKGROUND: The concept of health equity by design encompasses a multifaceted approach that integrates actions aimed at eliminating biased, unjust, and correctable differences among groups of people as a fundamental elem...
BACKGROUND: The concept of health equity by design encompasses a multifaceted approach that integrates actions aimed at eliminating biased, unjust, and correctable differences among groups of people as a fundamental element in the design of algorithms. As algorithmic tools are increasingly integrated into clinical practice at multiple levels, nurses are uniquely positioned to address challenges posed by the historical marginalization of minority groups and its intersections with the use of "big data" in healthcare settings; however, a coherent framework is needed to ensure that nurses receive appropriate training in these domains and are equipped to act effectively. PURPOSE: We introduce the Bias Elimination for Fair AI in Healthcare (BE FAIR) framework, a comprehensive strategic approach that incorporates principles of health equity by design, for nurses to employ when seeking to mitigate bias and prevent discriminatory practices arising from the use of clinical algorithms in healthcare. By using examples from a "real-world" AI governance framework, we aim to initiate a wider discourse on equipping nurses with the skills needed to champion the BE FAIR initiative. METHODS: Drawing on principles recently articulated by the Office of the National Coordinator for Health Information Technology, we conducted a critical examination of the concept of health equity by design. We also reviewed recent literature describing the risks of artificial intelligence (AI) technologies in healthcare as well as their potential for advancing health equity. Building on this context, we describe the BE FAIR framework, which has the potential to enable nurses to take a leadership role within health systems by implementing a governance structure to oversee the fairness and quality of clinical algorithms. We then examine leading frameworks for promoting health equity to inform the operationalization of BE FAIR within a local AI governance framework. RESULTS: The application of the BE FAIR framework within the context of a working governance system for clinical AI technologies demonstrates how nurses can leverage their expertise to support the development and deployment of clinical algorithms, mitigating risks such as bias and promoting ethical, high-quality care powered by big data and AI technologies. CONCLUSION AND RELEVANCE: As health systems learn how well-intentioned clinical algorithms can potentially perpetuate health disparities, we have an opportunity and an obligation to do better. New efforts empowering nurses to advocate for BE FAIR, involving them in AI governance, data collection methods, and the evaluation of tools intended to reduce bias, mark important steps in achieving equitable healthcare for all.
Optimizing pain management in breast cancer care: Utilizing 'All of Us' data and deep learning to identify patients at elevated risk for chronic pain.
Park JI, Johnson S, Pruinelli L
J Nurs Scholarsh · 2025 Jan · PMID 39056443 · Full text
PURPOSE: The aim of the study was to develop a prediction model using deep learning approach to identify breast cancer patients at high risk for chronic pain. DESIGN: This study was a retrospective, observational study....
PURPOSE: The aim of the study was to develop a prediction model using deep learning approach to identify breast cancer patients at high risk for chronic pain. DESIGN: This study was a retrospective, observational study. METHODS: We used demographic, diagnosis, and social survey data from the NIH 'All of Us' program and used a deep learning approach, specifically a Transformer-based time-series classifier, to develop and evaluate our prediction model. RESULTS: The final dataset included 1131 patients. We evaluated the deep learning prediction model, which achieved an accuracy of 72.8% and an area under the receiver operating characteristic curve of 82.0%, demonstrating high performance. CONCLUSION: Our research represents a significant advancement in predicting chronic pain among breast cancer patients, leveraging deep learning model. Our unique approach integrates both time-series and static data for a more comprehensive understanding of patient outcomes. CLINICAL RELEVANCE: Our study could enhance early identification and personalized management of chronic pain in breast cancer patients using a deep learning-based prediction model, reducing pain burden and improving outcomes.
Comparing different scoping and mapping review methodologies: A practical example using the nursing mobile workstation.
Vanmeenen M, Hirt J, Malfait S … +1 more , Möhler R
J Nurs Scholarsh · 2024 Nov · PMID 39039692 · Publisher ↗
AIMS: To provide (1) an overview of core characteristics of scoping and mapping review methodologies and (2) to illustrate the differences and similarities of these methodologies using literature on nursing mobile workst...
AIMS: To provide (1) an overview of core characteristics of scoping and mapping review methodologies and (2) to illustrate the differences and similarities of these methodologies using literature on nursing mobile workstations. DESIGN: Systematic review. METHODS: Systematic searches were conducted to identify (1) scoping and mapping review methodologies used in the field of nursing and (2) literature on nursing mobile workstations. For each systematic search, two reviewers independently screened all titles, abstracts, and full texts. We conducted narrative syntheses for both review questions. Publications on scoping and mapping review methodologies in the field of nursing were searched in MEDLINE (PubMed), Web of Science, Scopus, and CINAHL (September 2022). Publications on nursing mobile workstations were searched in MEDLINE (PubMed), CINAHL, and Web of Science (April 2022). RESULTS: We identified six scoping and mapping review methodologies (aim 1): bibliometric analysis, evidence mapping, focused mapping review and synthesis, and scoping review. The methodologies aim to provide a graphical, tabular, or narrative overview without a formal critical assessment of the literature. We provide an overview of key variables that reflect the different focus of these methodologies. We also included 26 publications on nursing mobile workstations (aim 2). Nineteen different terms were used to describe the workstations. An overall definition of the nursing mobile workstation was not found. CONCLUSION: Scoping and mapping methodologies are regularly applied in nursing research. Although there is overlap between the different methodologies, we found some unique characteristics. Despite the regular use of nursing mobile workstations, little is known about their impact in care processes and important features. Future studies on nursing mobile workstations could explore the impact of the workstations in the care process and the current functions of the workstations. A universal definition of the workstations is warranted. CLINICAL RELEVANCE: Most publications address aspects of practicability of nursing mobile workstations, but we found no universal definition. Little knowledge is available on the impact of the workstations in clinical practice.
Patient racism toward nurses in a divided society: The case of Jews and Arabs in Israel.
Halamish-Leshem R, Bokek-Cohen Y, Tarabeih M … +1 more , Azuri P
J Nurs Scholarsh · 2024 Nov · PMID 39010188 · Publisher ↗
AIM: This study examines whether racism exists among Jewish and Arab patients in Israel, as reflected in patient preference for receiving treatment from a nurse with the same ethnic background. BACKGROUND: We examine the...
AIM: This study examines whether racism exists among Jewish and Arab patients in Israel, as reflected in patient preference for receiving treatment from a nurse with the same ethnic background. BACKGROUND: We examine the relationship between racism and the level of trust in a nurse from a different ethnic group than the patient, as well as the preferred level of social distance, in the context of ongoing conflicts between the Jewish majority and the Arab minority in Israel. METHODS: A cross-sectional study was conducted using a unique study questionnaire that asked 534 Jewish and 478 Arab respondents to express their preference for an Arab and a Jewish nurse. RESULTS: Among both the Jews and the Arabs, there is a similar tendency of racism toward nurses of the dissimilar ethnic group. This racism was also prevalent among participants who live in a mixed environment or those who studied or are studying and worked or work in a mixed environment. As the trust in nursing staff members from the other group increases, the level of racism decreases. The greater the social distance the participants felt from the members of the other group, the more racist the attitudes they expressed. CONCLUSIONS: Both Jews and Arabs preferred to be treated by nurses of their own ethnic group. In contrast to the contact hypothesis theory, participants who live in a mixed environment did not express fewer racist preferences. We conclude with some useful practical suggestions aimed at decreasing racism in health care. CLINICAL RELEVANCE: Findings imply that prospective patients prefer to receive nursing care from nurses of their own ethnic group and trust these nurses more than they trust nurses of different ethnic group.
Does synthetic data augmentation improve the performances of machine learning classifiers for identifying health problems in patient-nurse verbal communications in home healthcare settings?
Scroggins JK, Topaz M, Song J … +1 more , Zolnoori M
J Nurs Scholarsh · 2025 Jan · PMID 38961517 · Full text
BACKGROUND: Identifying health problems in audio-recorded patient-nurse communication is important to improve outcomes in home healthcare patients who have complex conditions with increased risks of hospital utilization....
BACKGROUND: Identifying health problems in audio-recorded patient-nurse communication is important to improve outcomes in home healthcare patients who have complex conditions with increased risks of hospital utilization. Training machine learning classifiers for identifying problems requires resource-intensive human annotation. OBJECTIVE: To generate synthetic patient-nurse communication and to automatically annotate for common health problems encountered in home healthcare settings using GPT-4. We also examined whether augmenting real-world patient-nurse communication with synthetic data can improve the performance of machine learning to identify health problems. DESIGN: Secondary data analysis of patient-nurse verbal communication data in home healthcare settings. METHODS: The data were collected from one of the largest home healthcare organizations in the United States. We used 23 audio recordings of patient-nurse communications from 15 patients. The audio recordings were transcribed verbatim and manually annotated for health problems (e.g., circulation, skin, pain) indicated in the Omaha System Classification scheme. Synthetic data of patient-nurse communication were generated using the in-context learning prompting method, enhanced by chain-of-thought prompting to improve the automatic annotation performance. Machine learning classifiers were applied to three training datasets: real-world communication, synthetic communication, and real-world communication augmented by synthetic communication. RESULTS: Average F1 scores improved from 0.62 to 0.63 after training data were augmented with synthetic communication. The largest increase was observed using the XGBoost classifier where F1 scores improved from 0.61 to 0.64 (about 5% improvement). When trained solely on either real-world communication or synthetic communication, the classifiers showed comparable F1 scores of 0.62-0.61, respectively. CONCLUSION: Integrating synthetic data improves machine learning classifiers' ability to identify health problems in home healthcare, with performance comparable to training on real-world data alone, highlighting the potential of synthetic data in healthcare analytics. CLINICAL RELEVANCE: This study demonstrates the clinical relevance of leveraging synthetic patient-nurse communication data to enhance machine learning classifier performances to identify health problems in home healthcare settings, which will contribute to more accurate and efficient problem identification and detection of home healthcare patients with complex health conditions.
The quality of clinician and student quality improvement reports: An analysis of 8 years of submissions.
Kennedy MS, Barnsteiner J
J Nurs Scholarsh · 2024 Nov · PMID 38940058 · Publisher ↗
INTRODUCTION: Many papers reporting on QI projects are not publishable for a variety of reasons. We compared manuscripts submitted as QI reports between June 2014 and June 2016 (prior to publication of the revised Standa...
INTRODUCTION: Many papers reporting on QI projects are not publishable for a variety of reasons. We compared manuscripts submitted as QI reports between June 2014 and June 2016 (prior to publication of the revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) with papers submitted to the American Journal of Nursing between July 2016 and December 2022). The aim was to evaluate any changes in the quality of manuscripts and identify problems that led to rejection; we also compared the quality of students with non-student submissions. METHODS: We conducted a non-randomized descriptive study to evaluate 349 papers submitted as QI project reports between June 2014 and December 2022 using screening templates based on the SQUIRE 2.0 checklist and findings of the INANE Working Group on Student Papers. RESULTS: Manuscripts designated as QI reports accepted for publication increased from 4% during 2014-2016 (T1) to 14% during 2016-2022 (T2); one student submission was accepted. There was a slight decrease in submissions designated as QI that were not QI: 36% of student submissions during T1 and 31% of student submissions during T2. Among clinician submissions, 44% in T1 designated as QI reports were not QI versus 31% submitted during T2. There was a decrease in student submissions that followed the SQUIRE guidelines (36% during T1 to 24% during T2). CONCLUSIONS: Findings demonstrate that by following the SQUIRE 2.0 guidelines, authors submit more complete manuscripts with fewer missing components. However, there are still misconceptions about what constitutes QI versus research and how to report QI initiatives. After comparing the findings from both periods, it is noteworthy that there is essentially the same level of inaccuracy and lack of acceptable manuscripts. CLINICAL RELEVANCE: Sharing findings from QI activities through presentations and publications is a vital way of helping spread the learnings from these projects and improve health care for a wider audience. Clinicians, academicians, and students must understand the elements of the SQUIRE guidelines and ensure that this framework is used for both designing and submitting QI projects for publication.
Nurses' perceptions of the design, implementation, and adoption of machine learning clinical decision support: A descriptive qualitative study.
Wieben AM, Alreshidi BG, Douthit BJ … +4 more , Sileo M, Vyas P, Steege L, Gilmore-Bykovskyi A
J Nurs Scholarsh · 2024 Jun · PMID 38898636 · Full text
INTRODUCTION: The purpose of this study was to explore nurses' perspectives on Machine Learning Clinical Decision Support (ML CDS) design, development, implementation, and adoption. DESIGN: Qualitative descriptive study....
INTRODUCTION: The purpose of this study was to explore nurses' perspectives on Machine Learning Clinical Decision Support (ML CDS) design, development, implementation, and adoption. DESIGN: Qualitative descriptive study. METHODS: Nurses (n = 17) participated in semi-structured interviews. Data were transcribed, coded, and analyzed using Thematic analysis methods as described by Braun and Clarke. RESULTS: Four major themes and 14 sub-themes highlight nurses' perspectives on autonomy in decision-making, the influence of prior experience in shaping their preferences for use of novel CDS tools, the need for clarity in why ML CDS is useful in improving practice/outcomes, and their desire to have nursing integrated in design and implementation of these tools. CONCLUSION: This study provided insights into nurse perceptions regarding the utility and usability of ML CDS as well as the influence of previous experiences with technology and CDS, change management strategies needed at the time of implementation of ML CDS, the importance of nurse-perceived engagement in the development process, nurse information needs at the time of ML CDS deployment, and the perceived impact of ML CDS on nurse decision making autonomy. CLINICAL RELEVANCE: This study contributes to the body of knowledge about the use of AI and machine learning (ML) in nursing practice. Through generation of insights drawn from nurses' perspectives, these findings can inform successful design and adoption of ML Clinical Decision Support.
Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study.
J Nurs Scholarsh · 2024 Jul · PMID 38887898 · Publisher ↗
Abstract loading — click title to view on PubMed.
Predicting sepsis at emergency department triage: Implementing clinical and laboratory markers within the first nursing assessment to enhance diagnostic accuracy.
Sisto UG, Di Bella S, Porta E … +10 more , Franzoi G, Cominotto F, Guzzardi E, Artusi N, Giudice CA, Dal Bo E, Collot N, Sirianni F, Russo S, Sanson G
J Nurs Scholarsh · 2024 Nov · PMID 38886920 · Publisher ↗
BACKGROUND: Early identification of sepsis in the emergency department (ED) triage is both valuable and challenging. Numerous studies have endeavored to pinpoint clinical and biochemical criteria to assist clinicians in...
BACKGROUND: Early identification of sepsis in the emergency department (ED) triage is both valuable and challenging. Numerous studies have endeavored to pinpoint clinical and biochemical criteria to assist clinicians in the prompt diagnosis of sepsis, but few studies have assessed the efficacy of these criteria in the ED triage setting. The aim of the study was to explore the accuracy of clinical and laboratory markers evaluated at the triage level in identifying patients with sepsis. METHODS: A prospective study was conducted in a large academic urban hospital, implementing a triage protocol aimed at early identification of septic patients based on clinical and laboratory markers. A multidisciplinary panel of experts reviewed cases to ensure accurate identification of septic patients. Variables analyzed included: Charlson comorbidity index, mean arterial pressure (MAP), partial pressure of carbon dioxide (PetCO), white cell count, eosinophil count, C-reactive protein to albumin ratio, procalcitonin, and lactate. RESULTS: A total of 235 patients were included. Multivariable analysis identified procalcitonin ≥1 ng/mL (OR 5.2; p < 0.001); CRP-to-albumin ratio ≥32 (OR 6.6; p < 0.001); PetCO ≤ 28 mmHg (OR 2.7; p = 0.031), and MAP <85 mmHg (OR 7.5; p < 0.001) as independent predictors for sepsis. MAP ≥85 mmHg, CRP/albumin ratio <32, and procalcitonin <1 ng/mL demonstrated negative predictive values for sepsis of 90%, 89%, and 88%, respectively. CONCLUSIONS: Our study underscores the significance of procalcitonin and mean arterial pressure, while introducing CRP/albumin ratio and PetCO as important variables to consider in the very initial assessment of patients with suspected sepsis in the ED. CLINICAL RELEVANCE: Early identification of sepsis since the emergency department (ED) triage is challenging Implementing the ED triage protocol with simple clinical and laboratory markers allows to recognize patients with sepsis with a very good discriminatory power (AUC 0.88).
Titles.
Gennaro S
J Nurs Scholarsh · 2024 Jul · PMID 38877372 · Publisher ↗
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Applying machine learning to construct an association model for lung cancer and environmental hormone high-risk factors and nursing assessment reconstruction.
Lee PC, Lin MW, Liao HC … +2 more , Lin CY, Liao PH
J Nurs Scholarsh · 2025 Jan · PMID 38837653 · Full text
INTRODUCTION: To utilize machine learning techniques to develop an association model linking lung cancer and environmental hormones to enhance the understanding of potential lung cancer risk factors and refine current nu...
INTRODUCTION: To utilize machine learning techniques to develop an association model linking lung cancer and environmental hormones to enhance the understanding of potential lung cancer risk factors and refine current nursing assessments for lung cancer. DESIGN: This study is exploratory in nature. In Stage 1, data were sourced from a biological database, and machine learning methods, including logistic regression and neural-like networks, were employed to construct an association model. Results indicate significant associations between lung cancer and blood cadmium, urine cadmium, urine cadmium/creatinine, and di(2-ethylhexyl) phthalate. In Stage 2, 128 lung adenocarcinoma patients were recruited through convenience sampling, and the model was validated using a questionnaire assessing daily living habits and exposure to environmental hormones. RESULTS: Analysis reveals correlations between the living habits of patients with lung adenocarcinoma and exposure to blood cadmium, urine cadmium, urine cadmium/creatinine, polyaromatic hydrocarbons, diethyl phthalate, and di(2-ethylhexyl) phthalate. CONCLUSIONS: According to the World Health Organization's global statistics, lung cancer claims approximately 1.8 million lives annually, with more than 50% of patients having no history of smoking or non-traditional risk factors. Environmental hormones have garnered significant attention in recent years in pathogen exploration. However, current nursing assessments for lung cancer risk have not incorporated environmental hormone-related factors. This study proposes reconstructing existing lung cancer nursing assessments with a comprehensive evaluation of lung cancer risks. CLINICAL RELEVANCE: The findings underscore the importance of future studies advocating for public screening of environmental hormone toxins to increase the sample size and validate the model externally. The developed association model lays the groundwork for advancing cancer risk nursing assessments.
"Perinatal loss, a devastating cyclone": A situation-specific nursing theory.
Furtado-Eraso S, Marín-Fernández B, Escalada-Hernández P
J Nurs Scholarsh · 2024 Sep · PMID 38828753 · Publisher ↗
PURPOSE: The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy...
PURPOSE: The aim of this paper is to develop a preliminary theory that explores in depth into understanding the experiences of women who have suffered a spontaneous perinatal loss during any trimester of their pregnancy regarding their emotional response to this loss. DESIGN: A grounded theory approach was used, and 25 in-depth interviews were conducted with Spanish women who suffered a spontaneous perinatal loss. METHODS: Theoretical sampling and constant comparative analysis were used to reach theoretical saturation. EQUATOR guidelines were followed, using the COREQ checklist. RESULTS: The "Perinatal loss, a devastating cyclone," a situation-specific nursing theory, explains the process that a woman experiences when she loses her baby at any stage of pregnancy, drawing an analogy with tropical cyclones as natural disasters that destroy everything in their path. This situation-specific theory includes three dimensions, explaining the phases identified in the perinatal loss process (phase prior to impact [before the perinatal loss], impact phase [diagnostic moment], emergency phase [hospital care], relief or honeymoon phase [return home], disillusionment or stock-taking phase [after the first postloss days at home], reconstruction and recovery phase [grief construction process] and consequences [with an eye to the future]). Three intervention areas were described around the perinatal loss process: "rescue area" (partner, grandparents, and siblings of the deceased baby), "relief area" (healthcare professionals), and "base camp" (society). CONCLUSION: The situation-specific nursing theory "Perinatal loss, a devastating cyclone" is the final product of a grounded theory study that provided an in-depth analysis of women's experiences when they suffer a spontaneous perinatal loss at any point in their pregnancy. CLINICAL RELEVANCE: The situation-specific theory "Perinatal loss, a devastating cyclone" with the seven identified phases and the three areas of intervention could be used as a framework for healthcare professionals in their clinical practice as a guide to support women in this disfranchised grief.
Letter to the Editor regarding "Lived experiences: Growing up with a seriously mentally ill parent".
Chun L, Wei LC
J Nurs Scholarsh · 2024 Nov · PMID 38828752 · Publisher ↗
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