Journal Of Advanced Nursing[JOURNAL]
Sun
200 papers
Reimagining Nursing PhD Education for Real-World Impact.
Stirling C, McCormack B, Salamonson Y … +1 more , Jackson D
J Adv Nurs · 2026 May · PMID 41607295 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evaluating the WE CARE Program's Impact on Job Satisfaction and Intent to Leave.
Montgomery AP, Travis JR, Stevens JB … +4 more , Werthman JA, Carter JL, Polancich S, Patrician PA
J Adv Nurs · 2026 Jan · PMID 41607286 · Publisher ↗
AIM: This project team aims to (1) evaluate the effectiveness of the Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE) program in improving the work environment, workplace mental heal...
AIM: This project team aims to (1) evaluate the effectiveness of the Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE) program in improving the work environment, workplace mental health, and nurse outcomes, and (2) examine underlying factors influencing job satisfaction and intent to leave among staff nurses. DESIGN: Quasi-experimental designs with one-group pre-post program design using online surveys. METHODS: Pre-program data were collected in June 2022 (n = 706), followed by the implementation of multifaceted, evidence-based interventions delivered by the WE CARE team, such as wellness rounding and resilience education. Post-program data were collected in November 2024 (n = 417). Mixed-effects regression models were utilised for analysis. RESULTS: The WE CARE program was associated with statistically significant improvements in the overall work environment, workplace mental health (excluding resilience), and nurse outcomes, including job satisfaction and intent to leave. Job satisfaction positively correlated with a supportive work environment, recognition, and trust in supervisors, and negatively correlated with burnout, compassion fatigue, and distress. Higher levels of burnout and distress significantly increased the likelihood of nurses intending to leave their jobs, while greater trust in leadership and perceived organisational support were protective factors against leaving the job. CONCLUSION: The project supports the effectiveness of evidence-based workforce engagement interventions in real-world healthcare settings to enhance the work environment, workplace mental health, and nurse outcomes. Interventions targeting emotional well-being, recognition, burnout reduction, and leadership trust may improve job satisfaction and reduce nurses' turnover intentions. IMPACT: The program directly resulted in nurse leaders recognising the value of the WE CARE initiative and sustaining the team beyond the funding period. This project addresses a significant gap in the nurse well-being literature by demonstrating the effectiveness of a nurse-led, multifaceted wellness program designed specifically for nurses. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Becoming, Being and Building: A Qualitative Descriptive Study of the Experiences of Clinical Research Nurses.
Chen LH, Edvardsson D, Butler AE
J Adv Nurs · 2026 Jan · PMID 41607023 · Publisher ↗
AIM: To explore the experience and practices of clinical research nurses in Victoria, Australia. DESIGN: Qualitative descriptive design with reflexive thematic analysis. METHODOLOGY: Semi-structured interviews were condu...
AIM: To explore the experience and practices of clinical research nurses in Victoria, Australia. DESIGN: Qualitative descriptive design with reflexive thematic analysis. METHODOLOGY: Semi-structured interviews were conducted with ten clinical research nurses between October and December 2023 in Victoria, Australia. RESULTS: Three phases (overarching themes) were generated: (1) Becoming a clinical research nurse, occurred by chance with a stressful and unsupportive transition period; (2) Being a clinical research nurse, was described as an ongoing development of confidence, specialised skills and knowledge; and (3) Building a clinical research nurse role, was described as challenging due to limited educational and career opportunities. CONCLUSION: Clinical research nurses experienced a limited number of clear educational and career pathways that they could use to plan and grow in the nursing profession. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Addressing support and career development needs may ease clinical research nurses' transition and improve career planning. IMPACT: This study addresses a gap by highlighting the limited structured career pathways, formal mentorship and ongoing educational planning for clinical research nurses. Findings illustrate that clinical research nurses often begin unprepared, gradually develop confidence and skills, but continue to struggle with unclear career development plans. The findings can inform nursing leadership, educators and policymakers to better support clinical research nurses. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Self-Management of Chronic Illness Among Chinese Immigrants: An Integrative Review.
Lin J, David D, Cao X … +2 more , Magny-Normilus C, Schulman-Green D
J Adv Nurs · 2026 Jan · PMID 41607016 · Publisher ↗
AIM: To advance the understanding of chronic illness self-management among Chinese immigrants in Western countries by synthesising evidence and through the lens of the Middle Range Theory of Self- and Family Management o...
AIM: To advance the understanding of chronic illness self-management among Chinese immigrants in Western countries by synthesising evidence and through the lens of the Middle Range Theory of Self- and Family Management of Chronic Illness. DESIGN: Integrative review following Whittemore and Knafl. METHODS: Two reviewers used Covidence software to screen potential articles. After identifying the sample, reviewers extracted data into a matrix and appraised study quality using Critical Appraisal Skills Programme checklists. Reviewers used the constant comparative method to categorise data into categories: (1) facilitators/barriers, (2) processes and (3) outcomes. Findings were then synthesised and mapped to the theory domains. DATA SOURCES: MEDLINE, CINAHL, Web of Science, Embase, PsycINFO and ProQuest Central (database inception-August 2025). RESULTS: Of 3205 records screened, 20 studies met the inclusion criteria with acceptable quality. Personal characteristics/health status, resources/environment, Chinese-Western cross-cultural experiences, family and healthcare systems, and linguistic barriers shaped the processes of Focusing on Illness Needs (developing illness insights, taking ownership of health needs, and health promotion); Activating Resources (Western health care, traditional Chinese practices, community and family support, and blended spiritual resources); and Living with a Chronic Illness (processing emotions, adjusting, integrating, and meaning-making). These processes lead to outcomes including improved disease control, psychological/cognitive well-being, and healthcare utilisation and unintended negative consequences such as emotional burden and delayed care-seeking. CONCLUSION: While Chinese immigrants share certain aspects of self-management with Western populations, their approaches are shaped by culturally grounded, family-centred values, traditional health practices, and immigrant experiences, which underscore the need for culturally and contextually sensitive self-management support. The findings also expand the applicability of the guiding theory by identifying new cultural elements. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Nurses can support self-management among Chinese immigrants by developing culturally and linguistically tailored interventions, engaging family members in health education and treatment planning, enhancing accessible digital, community and navigational resources, providing language assistance and strengthening staff training. REPORTING METHOD: We used the PRISMA 2020 checklist for adherence to review protocols. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.
Healthcare Professionals' Perceptions of Artificial Intelligence in Healthcare-A Systematic Review of Qualitative Studies.
Sini H, Kristina M, Erika J … +4 more , Petra S, Assi K, Jae LJJ, Anne O
J Adv Nurs · 2026 Jan · PMID 41588866 · Publisher ↗
AIM: To identify the experiences and perceptions of healthcare professionals on artificial intelligence in healthcare. DESIGN: Systematic literature review of qualitative studies and meta-aggregation. DATA SOURCES: CINAH...
AIM: To identify the experiences and perceptions of healthcare professionals on artificial intelligence in healthcare. DESIGN: Systematic literature review of qualitative studies and meta-aggregation. DATA SOURCES: CINAHL, PubMed, Scopus, Medic and ProQuest were systematically searched on December 9, 2024. RESULTS: Twenty-six studies were included in the review, of which 25 were analysed using meta-aggregation, and the results of one study were reported narratively. A total of 185 findings were identified from the included studies that addressed the research question. These findings were aggregated into 33 categories and then into five synthesised findings as follows: (1) Perceived benefits of AI in healthcare; (2) Perceived impact of AI on professional roles and workforce dynamics; (3) Perceived impacts of AI in communication and interaction; (4) Perceived challenges of AI related to technical, financial and systemic factors; (5) Perceived ethical, cultural and regulatory considerations regarding the use of AI. CONCLUSION: While AI holds significant potential to enhance efficiency and improve patient outcomes, it is essential to address the concerns raised by healthcare professionals regarding workforce dynamics, communication and ethical considerations. IMPLICATIONS FOR THE PROFESSION: The results can inform and support the implementation of AI in healthcare and the development of AI-related education and training to meet the demands of future healthcare work. REPORTING METHOD: The review was conducted and reported in accordance with the PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: None. TRIAL REGISTRATION: PROSPERO (CRD1073200).
Student Perceptions of Interprofessional Education Innovation to Address Pain Management and Substance Use: A Qualitative Descriptive Analysis.
Kobayashi R, Miller JC, Remsberg CM … +4 more , McKennon S, Bindler RJ, DeWitt DE, Wilson M
J Adv Nurs · 2026 May · PMID 41588839 · Full text
AIMS: The aim of this study was to understand student perspectives regarding an interprofessional education (IPE) innovation using a single standardised patient (SP) in a large-group setting for a pain management and sub...
AIMS: The aim of this study was to understand student perspectives regarding an interprofessional education (IPE) innovation using a single standardised patient (SP) in a large-group setting for a pain management and substance use simulation. DESIGN: A qualitative descriptive design was used. METHOD: Students representing eight health science programs from four universities were invited to participate in a simulation-based IPE program blending asynchronous and synchronous learning. DNP students were one of the largest professions represented (n = 92, 30%) along with students enrolled in Doctor of Pharmacy (n = 111) and Doctor of Medicine (n = 69) programs. Students were invited to complete a post-activity survey asking what parts of the IPE activity were most valued and what could be improved. Student responses were themed using a qualitative descriptive approach with inductive coding and constant comparison. RESULTS: Of 304 participating students, 155 (51%) responded to one or both open-ended questions. Respondents highly valued interprofessional team diversity. Responses highlighted the importance of: (1) using simulation with student teams to foster active learning, (2) student preparation using relevant curricular resources and (3) grounding interprofessional collaboration activities in student engagement and professional respect. CONCLUSION: Findings confirmed that a cost-effective IPE activity using one SP within deliberately planned interprofessional activities can be engaging and meaningful. Students valued team-based collaboration across the disciplines of nursing, pharmacy and medicine. IMPACT: Educators gathered evidence on the merits of a replicable, cost-effective IPE structure intended to expand team-based simulation learning opportunities. High-priority public health topics such as pain and substance use require multidisciplinary, integrative care to maximise health outcomes. To better prepare nurses and their health science collaborators, novel pedagogy in IPE may optimise student learning experiences. REPORTING METHOD: We followed the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC CONTRIBUTION: Health sciences faculty served as facilitators in the IPE sessions. Facilitators were provided 1 h of training and observed student team breakout rooms to ensure that students were engaged and understood the assigned task. They provided feedback to session leaders after the sessions.
Recent Trends in Doctoral Theses in Nursing Across Eight Countries: A Scoping Review.
Podgorica N, Červený M, de Rezende H … +9 more , Horta Reis da Silva T, Ivziku D, Mew L, Nagórska M, Sampaio F, Shao CH, Teixeira-Santos L, Warshawski S, Luiking ML
J Adv Nurs · 2026 May · PMID 41588837 · Publisher ↗
AIM: To explore and map the landscape of doctoral nursing research across eight countries. DESIGN: A scoping review. METHODS: This review followed the Joanna Briggs Institute methodology for scoping reviews and included...
AIM: To explore and map the landscape of doctoral nursing research across eight countries. DESIGN: A scoping review. METHODS: This review followed the Joanna Briggs Institute methodology for scoping reviews and included doctoral theses in nursing defended between 2020 and 2023 in Austria, Italy, Israel, the Netherlands, Poland, Portugal, Slovakia and the United Kingdom. DATA SOURCES: Searches were conducted across 15 national and university repositories (4 national, 11 university) in the eight participating countries. RESULTS: This review included 431 doctoral nursing theses, the majority of which employed quantitative methodologies and focused on patient populations and healthcare professionals. Key topics included clinical nursing care, quality of care, quality of life, home care, perinatal care and the work environments. CONCLUSION: Nursing doctoral research shows progress in healthcare delivery, patient care and education via digital tools, holistic approaches and professional development. Yet gaps persist in mental health, paediatrics and marginalised groups. Limited qualitative/mixed-methods research and weak interdisciplinary collaboration reveal further opportunities. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This review underscores that nursing doctoral research is addressing major healthcare and professional challenges. Nonetheless, the identified gaps emphasise the need for more comprehensive and inclusive research to enhance equity and guide future nursing practices and policies. IMPACT: This review provides an overview of the scope of doctoral nursing research across eight countries, identifying key trends and research gaps. The findings are expected to inform nursing academia, policymakers, and healthcare professionals by guiding future research priorities, fostering interdisciplinary collaboration, and promoting equitable, patient-centred care practices. PATIENT OR PUBLIC CONTRIBUTION: No direct involvement in data collection; one lay reviewer gave feedback on readability and practice implications, informing minor refinements.
Anticipated Stigma in Nursing: A Concept Analysis Informed by Cannabis Use Disclosure.
King DD
J Adv Nurs · 2026 Jan · PMID 41588830 · Publisher ↗
AIM: To clarify the concept of anticipated stigma and examine its relevance to cannabis use disclosure in nursing using an evolutionary concept analysis approach. DESIGN: Concept analysis guided by Rodgers and Knafl's ev...
AIM: To clarify the concept of anticipated stigma and examine its relevance to cannabis use disclosure in nursing using an evolutionary concept analysis approach. DESIGN: Concept analysis guided by Rodgers and Knafl's evolutionary method. DATA SOURCES: An interdisciplinary purposive literature review was conducted using empirical and theoretical sources drawn from nursing, public health, psychology and sociology. Literature published between 1963 and 2024 was included, with specific emphasis on health-related stigma, disclosure and cannabis use. REVIEW METHODS: Rodgers and Knafl's evolutionary method was used to identify the defining attributes, antecedents, consequences, related concepts and contextual variations of anticipated stigma. Empirical and conceptual literature were synthesised to reflect cross-disciplinary themes. A model case was constructed to illustrate the concept's application in a nursing context, followed by a critical synthesis of implications for nursing theory, research and practice. RESULTS: Anticipated stigma is a future-oriented expectation of devaluation or discrimination associated with disclosing a stigmatised identity or behaviour. Five core attributes were identified. Antecedents include individual identity salience, sociocultural norms and structural factors. Consequences include psychological distress, concealment and reduced healthcare engagement. CONCLUSION: Anticipated stigma is a dynamic and under-theorised concept that hinders therapeutic communication and person-centred care in nursing settings. IMPACT: This analysis offers conceptual clarity and supports stigma-informed approaches to assessment and communication in nursing education and practice, especially when addressing cannabis use and other stigmatised health behaviours. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Care Without Judgement: Political Awareness in Nursing Beyond Divides.
Bond C, Jackson D, Watson A
J Adv Nurs · 2026 Jul · PMID 41578641 · Publisher ↗
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Letter to the Editor: What Kind of Support Do SMA Families Need?-Reflections Based on Caregiving Roles.
Shen H
J Adv Nurs · 2026 Jan · PMID 41574944 · Publisher ↗
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Letter to the Editor: Nursing the Dementia Pathway: Turning the 75+ Health Assessment From Checklist to Care Loop.
Wenyan F, Wang Q
J Adv Nurs · 2026 Jan · PMID 41574922 · Publisher ↗
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A Realist Evaluation of a Rapid Response System for Mental State Deterioration in Acute Hospital Settings.
Dziruni TB, Hutchinson AM, Keppich-Arnold S … +1 more , Bucknall T
J Adv Nurs · 2026 Jan · PMID 41566876 · Publisher ↗
BACKGROUND: Patient mental state deterioration presents significant challenges in acute hospital settings, affecting outcomes, increasing reliance on restrictive interventions, and placing additional strain on healthcare...
BACKGROUND: Patient mental state deterioration presents significant challenges in acute hospital settings, affecting outcomes, increasing reliance on restrictive interventions, and placing additional strain on healthcare staff. Despite its prevalence, consensus on best practice remains limited. The De-escalation, Intervention, Early Response Team (DIvERT) is a pilot rapid response system introduced to improve early identification, enable timely interventions, reduce crisis incidents, and support ward staff in caring for patients with mental state deterioration. METHODS: A realist evaluation approach was used to test, validate, and refine program theories explaining DIvERT's mechanisms. Data collection included a cross-sectional survey, semi-structured interviews, field observations, a medical record audit, and incident report analysis. Analysis was guided by the Context-Mechanism-Outcome framework to explain DIvERT's effective functioning in responding to patient deterioration. FINDINGS: DIvERT facilitated early intervention through multidisciplinary collaboration, though organisational factors such as staffing constraints, workload pressures, and inconsistent assessment practices influenced effectiveness. Key mechanisms included structured escalation pathways, clinical skills, staff training, and interprofessional collaboration. Challenges included limited after-hours availability, reflecting the constraints of a pilot initiative, underreporting of incidents, and hierarchical decision-making. While causation cannot be directly established, trends indicate DIvERT was associated with fewer Code Grey responses, particularly during initial episodes of mental state deterioration. CONCLUSION: This realist evaluation highlights the value of structured escalation pathways, multidisciplinary collaboration, organisational support, and tailored training in managing mental state deterioration. Preliminary trends suggest DIvERT may enable more proactive and timely early intervention, whereas traditional reactive hospital emergency response for aggression (Code Grey) was more often linked to repeat incidents. Workforce constraints and inconsistent assessment limited effective functioning, underscoring the need for strengthened training, integration into workflows, and improved after-hours coverage to support scalability and long-term success. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: This study demonstrates that a proactive rapid response model (DIvERT) can strengthen the recognition and management of mental state deterioration in acute hospital settings. By formalising escalation pathways, improving interdisciplinary collaboration, and tailoring training to staff needs, the model supports safer and more timely responses to patient deterioration. Embedding such approaches into organisational workflows has implications for patient safety, staff confidence, and system efficiency. IMPACT: The study addressed the challenge of inconsistent and reactive responses to patient mental state deterioration, which are often reliant on crisis interventions such as Code Grey. DIvERT facilitated early intervention through structured escalation processes, improved interdisciplinary collaboration, and enhanced staff skills. However, organisational barriers such as workforce constraints, after-hours gaps, and inconsistent use of mental state deterioration assessment tools limited its effective functioning. Findings are directly relevant to clinicians in acute hospital settings (particularly nursing and allied health staff), hospital administrators responsible for patient safety and workforce planning, and policymakers overseeing standards for recognising and responding to acute deterioration. The results highlight where investment in training, structured escalation systems, and organisational support can reduce reliance on restrictive interventions and improve both patient and staff safety. REPORTING METHOD: This evaluation adhered to the Realist And Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) II reporting standards for realist evaluations, as outlined in the EQUATOR Network guidelines. PATIENT OR PUBLIC INVOLVEMENT: This study did not include patient or public involvement in its design, conduct, or reporting.
Nursing at the Interface: Care, Control and Artificial Intelligence (AI).
Jackson D
J Adv Nurs · 2026 Jun · PMID 41566796 · Publisher ↗
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Core Components of Effective Home Visiting Programmes and Parenting Interventions Delivered by Nurses and Midwives-A Scoping Review.
Savolainen O, Rouvinen H, Barry MM
J Adv Nurs · 2026 Jan · PMID 41566748 · Publisher ↗
AIM: To investigate international evidence on home visits and parenting interventions delivered by nurses and midwives and to identify core components, such as intervention content, programme characteristics, contextual...
AIM: To investigate international evidence on home visits and parenting interventions delivered by nurses and midwives and to identify core components, such as intervention content, programme characteristics, contextual factors and implementation elements shared by effective interventions. DESIGN: Scoping Review. DATA SOURCES: Nine academic databases and grey literature were searched between June and August 2024 for studies published between 2020 and 2024. METHODS: Screening and data extraction were independently conducted by two reviewers using covidence. The intervention characteristics were described using the TIDieR framework, and the content was analysed thematically. RESULTS: Of the 3217 screened studies, 23 met the inclusion criteria. The studies employed various designs, including RCTs, quasi-experimental, cohort, cross-sectional, register-based and single-case experimental studies. Interventions were typically guided by theories of human ecology, attachment and self-efficacy. Most used structured materials and were delivered via face-to-face home visits by trained nurses, starting during pregnancy and continuing for up to 2 years. Visits ranged from weekly to monthly, mainly to family homes. Interventions were often tailored to family needs and cultural contexts. Five core themes emerged: (1) parenting education, (2) maternal and infant health, (3) mental health and psychosocial support, (4) community connections and (5) cultural sensitivity. CONCLUSION: Effective interventions should be early, structured and tailored. Integrating parenting education, health, mental well-being and cultural sensitivity improves outcomes and scalable family care practices. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Findings highlight the need for structured training and support for nurses and midwives. Integrating these interventions into routine services, with attention paid to equity and proportionate universalism, can enhance family outcomes. IMPACT: This review addressed the lack of clarity regarding what makes nurse- or midwife-led interventions effective. It identified key components that support child and family well-being and offers guidance for designing scalable, evidence-based interventions in maternal and child health services. REPORTING METHOD: The EQUATOR guidelines for PRISMA were met. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contributions.
Getting Person-Centred Fundamental Care Right: Past Discourse and Future Directions.
Kitson AL
J Adv Nurs · 2026 Jul · PMID 41552841 · Full text
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Innovation Competence in Healthcare: Individual, Environmental and Organisational Factors-A Mixed-Method Systematic Review.
Saukkoriipi M, Kanste O, Jarva E … +2 more , Hyrkäs P, Mikkonen K
J Adv Nurs · 2026 Jul · PMID 41546155 · Full text
AIMS: To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors amo...
AIMS: To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals. DESIGN: A mixed-methods systematic review. METHODS: Researchers independently screened original studies by title and abstract (n = 2996) and then full text (n = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively. DATA SOURCES: The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024. RESULTS: From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation-related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career-related, organisational, and academic factors. CONCLUSIONS: Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity. IMPACT: Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement was included in this study. TRIAL REGISTRATION: PROSPERO: CRD42024614551.
Short Delays in Time to First Contact With Community Health Services and Risk of Emergency Hospital Attendance: Retrospective Observational Study.
Cameron L, Sutton M, Parkinson B … +1 more , Meacock R
J Adv Nurs · 2026 Jan · PMID 41546141 · Publisher ↗
AIM: To explore whether a delay from referral to first contact with nurse-led community health services is associated with the likelihood of subsequent emergency department attendance. DESIGN: We use individual linked ad...
AIM: To explore whether a delay from referral to first contact with nurse-led community health services is associated with the likelihood of subsequent emergency department attendance. DESIGN: We use individual linked administrative data on use of community health and hospital services. We identify a cohort of 343,721 individuals referred to community health services in England by their primary care provider in 2019. We then track their subsequent community healthcare contacts and emergency department attendances. METHODS: We exploit variation in the time to contact caused by weekend delays, which create longer times to first contact for people referred later in the working week. The main analysis compares patients referred on Thursday with those referred on Tuesday. RESULTS: We show that 6.7% of patients referred on Thursday wait an extra two days for their first community contact relative to those referred on Tuesday. Despite this delay, we find no evidence that people referred on Thursday are more likely to have a subsequent emergency department attendance compared to those referred on Tuesday. CONCLUSIONS: We do not find delayed community health services contact to be associated with an increased risk of emergency attendance amongst patients referred to community services by their primary care provider. This suggests that short delays in contact time are not detrimental for this group. IMPACT: Shifting care from hospital to community settings is a key priority for health systems internationally. In England, community health services face significant staffing shortages, limiting the extent to which services can be responsive and support the desired strategic shift. Our findings suggest that these constrained community providers could use their limited capacity to prioritise responding quickly to other patients without harming those referred via primary care. REPORTING METHOD: STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.
Association Between Activities of Daily Living Profiles and Memory Decline in Community-Dwelling Older Adults Without Cognitive Impairment: An Observational Panel Study.
Chen SY, Chen KM, Belcastro F
J Adv Nurs · 2026 Jan · PMID 41546139 · Publisher ↗
AIM: To explore baseline activities of daily living (ADL) profiles and their association with memory decline over time in cognitively healthy, community-dwelling older adults. DESIGN: Observational panel study. METHODS:...
AIM: To explore baseline activities of daily living (ADL) profiles and their association with memory decline over time in cognitively healthy, community-dwelling older adults. DESIGN: Observational panel study. METHODS: This study analysed data from Waves 7-10 of the English Longitudinal Study of Ageing (the search was performed on May 28, 2024), including 2925 older adults aged above 65 with no dementia or cognitive impairments at baseline (Wave 7, 2014-2015). To categorise participants by their daily functional abilities at baseline, latent class analysis was conducted to derive participants' activities of daily living profiles. A linear mixed model was used to explore whether these baseline activity profiles might predict different memory decline rates (trajectories) over time, accounting for baseline demographic factors (gender, age, ethnicity, education, marital status and chronic diseases). RESULTS: Social demographics (younger age, female gender, white ethnicity, higher education and being partnered) and ADL profiles outweigh health conditions in predicting participants' memory function. Different baseline profiles were linked to different memory decline trajectories. An impairment profile with grocery shopping capability was linked to slower memory decline. CONCLUSION: This study showed that ADL profiles had a substantial correlation with memory decline, accounting for the significant impact of sociodemographic factors. An impairment profile that preserved grocery shopping abilities appeared to offer protective benefits and potentially slow memory decline. IMPACT: Strengthening nursing strategies that support older adults in maintaining the ability to grocery shop, such as guiding caregivers to promote involvement rather than shopping for the older adults entirely, or accompanying older adults grocery shopping as part of community nursing care, might help delay age-related memory decline in this population. PATIENT OR PUBLIC CONTRIBUTION: Patients or members of the public were not directly involved in the study's design, conduct, reporting, or dissemination plans.
The Impact of Assessing Patients' Sense of Security on Nurses' Intent to Report Safety Events: A Factorial Survey Experiment.
Groves PS, Perkhounkova Y, Hein M … +1 more , Abad PJ
J Adv Nurs · 2026 Jan · PMID 41546133 · Publisher ↗
AIMS: To evaluate whether information about patients' poor sense of security in hypothetical vignette scenarios increases nurses' projected intent to report safety events. DESIGN: Quantitative, cross-sectional factorial...
AIMS: To evaluate whether information about patients' poor sense of security in hypothetical vignette scenarios increases nurses' projected intent to report safety events. DESIGN: Quantitative, cross-sectional factorial survey vignette experiment administered online. METHODS: A convenience sample of 60 nurses from adult inpatient hospital units at a Midwest academic medical center participated in February 2025. Participants responded to demographic questions and eight factorial vignettes, each describing a patient-reported safety breach and incorporating four patient-related factors. Four vignettes included information that the patient had a poor sense of security, and four did not, presented in random order. Following each vignette, participants rated their level of concern about the patient's report, perceived harm to the patient, and likelihood of reporting the patient's concern. A linear mixed-effects modelling approach, accounting for clustering within participants, was used to estimate the effects of the sense of security information factor on nurses' responses. RESULTS: The sense of security information was associated with higher ratings of (a) degree of concern, (b) perceived harm to the patient, and (c) intent to report the patient's concern, after adjusting for vignette- and participant-level covariates. The vignette patient's perception of physical harm was positively associated with all three ratings. Nurses' greater hospital experience was associated with lower ratings across outcomes. CONCLUSION: Obtaining information that the patient felt insecure was associated with heightened concern about the safety event, greater perceived harm, and increased intent to report the concern. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Sense of security assessment may be a risk-agnostic, patient-centered intervention that nurses can routinely perform, regardless of the safety event circumstances. IMPACT: Although a system of evidence-based practices within a safety culture is essential to hospital safety efforts, nurses' judgements of and responses to patient safety concerns play a critical role and should not be overlooked. REPORTING METHOD: STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.
Fifty Years of Children's Nursing: Reflections on Practice, Research and Future Directions.
Coyne I
J Adv Nurs · 2026 Jul · PMID 41546130 · Full text
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