Search Results (707)

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

Background/Objectives: For kidney transplantation, it is very important to provide effective post-transplantation interventions to help patients achieve continuous and efficient self-management. Therefore, we review the self-management interventions applied to kidney transplant recipients and suggest the optimal approach to increase the effectiveness of future self-management interventions. Design: Systematic review. Methods: Search terms and strategies included kidney transplantation; self-management; intervention; systematic review. We searched MEDLINE via PubMed, Excerpta Media dataBASE, Cochrane Register Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and one domestic Korean database to identify studies of self-management interventions for kidney transplant recipients aged ≥ 18 years published in English or Korean until 14 May 2025. Two reviewers independently selected related studies and extracted relevant data. Identified studies were assessed for quality and bias. Results: Of 1340 studies identified, 27 with 1912 participants met the inclusion criteria. Educational interventions were the most common self-management interventions and were provided 3 months to 1 year after kidney transplantation; most interventions were administered by nurses. Outcome variables were divided into cognitive, behavioral, affective, and health outcomes. Educational interventions were effective in improving cognitive, behavioral, and affective aspects. Some differences were observed, depending on the study. Conclusions: We recommend that nurse-involved educational interventions be included when developing self-management interventions and guidelines for kidney transplant recipients in clinical and community nursing settings. Full article

Sexual health constitutes a fundamental aspect of overall well-being, with direct implications for individual development and the broader social and economic progress of communities. Promoting environments that ensure sexual experiences free from coercion, discrimination, and violence is a key public health priority. Sexuality, in this regard, should be understood as an inherent dimension of human experience, shaped by biological, cultural, cognitive, and ideological factors. Accordingly, sexual health education requires a holistic and multidimensional approach that integrates sociocultural, biographical, and professional perspectives. This study aims to examine the level of knowledge and training in sexual health among nursing students and healthcare professionals, as well as to assess the extent to which sexual health content is incorporated into nursing curricula at Spanish universities. A scoping review was conducted using the Dialectical Structural Model of Care (DSMC) as the theoretical framework. The findings indicate a significant lack of knowledge regarding sexual health among both nursing students and healthcare professionals, largely due to educational and structural limitations. Furthermore, sexual health education remains underrepresented in nursing curricula and is frequently addressed from a narrow, fragmented biomedical perspective. These results highlight the urgent need for the comprehensive integration of sexual health content into nursing education. Strengthening curricular inclusion is essential to ensure the preparation of competent professionals capable of delivering holistic, inclusive, and empowering care in this critical area of health. Full article

Introduction: The increasing cultural diversity of patients poses new challenges for nurses. Cultural competence, especially knowledge of the cultural determinants of health and illness, is an important element of professionalism in nursing care. The aim of this study was to analyse nurses’ self-assessment of cultural knowledge, with a focus on the six dimensions of the Giger and Davidhizar model, prior to formal training in this area. Methods: A triangulation method combining qualitative and quantitative analysis was used. The analysis included 353 statements from 36 master’s student nurses. Data were coded according to six cultural phenomena: biological factors, communication, space, time, social structure, and environmental control. Content analysis, ANOVA, Spearman’s rank correlation, and cluster analysis (k-means) were conducted. Results: The most frequently identified that categories were environmental control (34%), communication (20%), and social structure (16%). Significant knowledge gaps were identified in the areas of non-verbal communication, biological differences, and understanding space in a cultural context. Three cultural knowledge profiles of the female participants were distinguished: pragmatic, socio-reflective, and critical–experiential. Conclusions: The cultural knowledge of the participants was fragmented and simplified. The results indicate the need to personalise cultural learning and to take into account nurses’ level of readiness and experience profile. The study highlights the importance of the systematic development of reflective and contextual cultural knowledge as a foundation for competent care. Full article

Background: Intermediate care units face growing complexity due to aging populations and chronic illnesses. Non-technical skills such as empathy and communication are crucial for quality care. We aimed to examine the relationship between communication skills, self-efficacy, and sense of coherence among intermediate care nurses. Methods: We conducted an observational, cross-sectional study with 60 intermediate care nurses from three units in a Catalan hospital, Spain. Participants engaged in high-fidelity simulation using geriatric end-of-life scenarios with an ultra-realistic manikin representing a geriatric patient at the end of life. NTSs were measured using validated tools: the Health Professionals Communication Skills Scale (HP-CSS), the General Self-Efficacy Scale, and the Sense of Coherence Questionnaire (OLQ-13). Sessions followed INACSL standards, including prebriefing, simulation, and debriefing phases. Results: Post-simulation outcomes revealed significant gains in interpersonal competencies, with men reporting higher assertiveness (p = 0.015) and greater satisfaction with both the simulation experience (p = 0.003) and the instructor (p = 0.008), underscoring gender-related perceptions in immersive training. Conclusions: Ultra-realistic clinical simulation is effective in enhancing NTS among intermediate care nurses, contributing to improved care quality and clearer professional profiles in geriatric nursing. Full article

Aim: To explore the experiences, beliefs, and values of patients who participated in a two-arm randomized clinical trial assessing a nurse-led intervention program for chronic pain self-management, which demonstrated positive effects on pain reduction, depression, and anxiety, and on health-related quality of life 24 months after completion of the program. Design: Descriptive phenomenological qualitative study. Methods: Patients were recruited via telephone, informed about the study, and invited to participate in an individual interview at a place of their choice (hospital or home). All interviews were audiotaped, and an inductive thematic analysis was performed. Results: Seven interviews were carried out between both groups. Six emerging categories were found: effective relationship with the healthcare system, learning to live with pain, family and social support, behaviors regarding pain, resources for self-management, and concomitant determinants. Conclusions: Patients report key aspects that help us to understand the impact of this type of nurse-led group intervention: the intrinsic therapeutic effect of participating in the program itself, the ability to learn to live with pain, the importance of family and social support, the modification of pain-related behaviors, and the identification of resources for self-care. The findings highlight the need for gender-sensitive, individualized care approaches to chronic pain, addressing stigma and social context. Expanding community-based programs and supporting caregivers is essential, as is further research into gender roles, family dynamics, and work-related factors. Full article

In recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media. Full article

Background: Psychological problems post-stroke can negatively impact stroke survivors. Although general psychological services exist (e.g., NHS Talking Therapies), access remains limited, particularly for individuals with post-stroke communication and cognitive impairments. Stroke service staff report low confidence in managing psychological distress. This study is the first to explore the barriers and facilitators to implementing a novel intervention package comprising a cross-service care pathway and staff training to enhance post-stroke psychological provision. Methods: Staff from stroke and mental health services in four UK regions, recruited through purposive sampling to ensure diversity of services and professional roles, participated in semi-structured interviews or focus groups, guided by the Theoretical Domains Framework (TDF), before and after implementation of the intervention package. Pre-implementation interviews/groups identified anticipated barriers and facilitators to implementation and training needs, informing the development of site-specific intervention packages; post-implementation interviews/groups explored experienced barriers, facilitators and perceptions of the intervention. Interviews underwent thematic analysis using the TDF. Results: Fifty-five staff participated pre-implementation and seventeen post-implementation, representing stroke (e.g., nurse, physiotherapist, consultant) and psychology (e.g., counsellor, psychological therapist) roles across acute, rehabilitation, community, and voluntary services. Challenges anticipated pre-implementation included: limited specialist post-stroke psychological support; low staff confidence; and fragmented service pathways. Post-implementation findings indicated increased staff knowledge and confidence, enhanced screening and referral processes, and stronger inter-service collaboration. Implementation success varied across sites (with some sites showing greater ownership and sustainability of the intervention) and across staff roles (with therapy staff more likely than nursing staff to have received training). Conclusions: Effective implementation of an intervention package to increase psychological provision post-stroke requires staff engagement at all levels across all services. Staff investment influenced ownership of the intervention package, beliefs about priorities and overall enhancement of service capability. Full article

The preparedness of healthcare workers for disaster situations depends on their technical skills, disaster knowledge, and psychosocial strength, including teamwork and emotional regulation. This study aims to assess disaster preparedness among healthcare professionals in primary healthcare centers (PHCs) in Alqurayat, Saudi Arabia, with a specific focus on evaluating technical competencies, psychosocial readiness, and predictive modeling of preparedness levels. A mixed-methods approach was employed, incorporating structured questionnaires, semi-structured interviews, and observational data from disaster drills to evaluate the preparedness levels of 400 healthcare workers, including doctors, nurses, and administrative staff. The results showed that while knowledge (mean: 3.9) and skills (mean: 4.0) were generally moderate to high, notable gaps in overall preparedness remained. Importantly, 69.5% of participants reported enhanced readiness following simulation drills. Machine learning models, including Random Forest and Artificial Neural Networks, were used to predict preparedness outcomes based on psychosocial variables such as emotional intelligence, teamwork, and stress management. Sentiment analysis and topic modeling of qualitative responses revealed key themes including communication barriers, psychological safety, and the need for ongoing training. The findings highlight the importance of integrating both technical competencies and psychosocial resilience into disaster management programs. This study contributes an innovative framework for evaluating preparedness and offers practical insights for policymakers, disaster planners, and health training institutions aiming to strengthen the sustainability and responsiveness of primary healthcare systems. Full article

Background: Early identification of sepsis is critical for improving outcomes, particularly in low-resource emergency settings. In Thai community hospitals, where physicians may not always be available, triage is often nurse-led. Selecting accurate and practical sepsis screening tools is essential not only for timely clinical decision-making but also for timely diagnosis and promoting appropriate antibiotic use. Methods: This cross-sectional study analyzed 475 adult patients with suspected sepsis who presented to the emergency department of a Thai community hospital, using retrospective data from January 2021 to December 2022. Six screening tools were evaluated: Systemic Inflammatory Response Syndrome (SIRS), Quick Sequential Organ Failure Assessment (qSOFA), Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), National Early Warning Score version 2 (NEWS2), and Search Out Severity (SOS). Diagnostic accuracy was assessed using International Classification of Diseases, Tenth Revision (ICD-10) codes as the reference standard. Performance metrics included sensitivity, specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic (AUROC) curve, all reported with 95% confidence intervals. Results: SIRS had the highest sensitivity (84%), while qSOFA demonstrated the highest specificity (91%). NEWS2, NEWS, and MEWS showed moderate and balanced diagnostic accuracy. SOS also demonstrated moderate accuracy. Conclusions: A two-step screening approach—using SIRS for initial triage followed by NEWS2 for confirmation—is recommended. This strategy enhances nurse-led screening and optimizes limited resources in emergency care. Early sepsis detection through accurate screening tools constitutes a feasible public health intervention to support appropriate antibiotic use and mitigate antimicrobial resistance, especially in resource-limited community hospital settings. Full article

Background: After an older person moves into a nursing home, the next of kin often continues to participate in the care provided there. This participation in care may contribute valuable knowledge of the preferences and wishes of the older person, thereby helping nursing staff deliver personalised care. Objectives: The aim of this study was to explore how next of kin experience their participation in the care of older persons residing in nursing homes after educating nursing staff about participation in palliative care. Methods: This follow-up study used a qualitative design based on semi-structured interviews with 37 next of kin. A thematic analysis was applied. Results: Participation of the next of kin involved active communication and collaboration with nursing staff, expressed in three themes: striving to achieve co-created care, navigating involvement through presence, and building commitment through communication and information. The dual role of being an emotionally close next of kin and a participant in the relative’s care was challenging and became increasingly burdensome and often overwhelming when the older person’s health deteriorated. Conclusions: This study reveals the need to develop and implement a policy for the participation of next of kin in the care of older people living in nursing homes. In addition, support groups can increase well-being through dialogue with other next of kin, thereby alleviating emotional strain. Increased implementation of life stories and the use of digital communication would keep the next of kin informed about the older person’s condition, especially when they cannot be present in person. Life story is a valuable tool for person-centred care and strengthens the relationships between the next of kin, the older person, and the nursing staff. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with rural populations experiencing higher prevalence and worse outcomes. This paper explores the transformative potential of nurse-led palliative care models in addressing the unique challenges faced by rural patients with COPD and their informal caregivers and synthesizes current evidence on nurse-led palliative care interventions, highlighting their impact on symptom management, advance care planning, and psychosocial support. Methods: This is a comprehensive synthesis of nurse-led palliative care programs, focusing on home-based care, telehealth, community outreach, and primary care integration. Results: Nurse-led interventions significantly improve patient satisfaction, reduce symptom burden, and enhance the likelihood of advance care planning discussions. Home-based care models and telehealth are particularly effective in rural settings, offering accessible and continuous support. Conclusions: Nurses have a critical role in bridging the palliative care gap for rural patients with COPD and their informal caregivers. Expanding nurse-led palliative care services can improve quality of life, reduce healthcare utilization, and promote health equity. Future research should focus on long-term outcomes, cost-effectiveness, and strategies for scaling nurse-led palliative care programs in rural contexts. Full article

Background/Objectives: The role of the primary health care nurse has evolved since the Spanish Ministry of Health officially established the professional profile of the nurse specialist in Primary Health Care in 2005. Despite the potential benefits of this new professional profile in the population’s health, their actual scope of practice is still unknown and still largely underutilized. This study aimed to explore demands and expectations of adult primary health care service users regarding the role of the nurse specialist in primary health care. Methods: A nationwide cross-sectional study consisted of a computer-assisted telephone survey to a random sample of 1200 adults living in Spain. A self-developed 19-item instrument assessed population’s perception of the role of the nurse specialist in primary health care. Descriptive, bivariate and logistic regression models explored associations between sociodemographic characteristics with perception of the nurse specialist role. Results: Most participants (82.3%) would choose a nurse specialist in primary health care and consider that the nurse specialist in primary health care should expand their scope of practice requesting diagnostic test (70%) and prescribing medications for chronic diseases (63.8%). Conclusions: Results show a population’s positive perception towards expanding the scope of practice of the nurse specialist in primary health care in the Spanish healthcare system. Primary health care models should acknowledge the potential of expanding the competencies of this professional profile. Full article

This article describes a case study of the partnership between Healthy Birth Initiatives, a community-based organization (CBO) and Black-led public health nurse home visiting program, and the maternal health division of the Providence Health System located in the Pacific Northwest. This study’s purpose was to explore the formation, significance, and impact of this partnership from the perspectives of staff and leadership members from both organizations. We conducted a case study through qualitative interviews with staff, participant observation, and debrief of leadership meetings. We completed a hybrid deductive–inductive thematic analysis of the data, followed by member checking with study participants and other key interest holders. Key facilitators of the CBO–health system partnership included the vital role of leaders in prioritizing the partnership; health system willingness to incorporate new information from the CBO to improve care; and health system utilization of resources to institutionalize changes that emerged from this partnership. Challenges to the CBO–health system partnership included CBO resource limitations; fragmented referral processes and information sharing; and the persistence required to nurture the relationship without formalized roles. This study contributes to the literature by offering staff perspectives on how a CBO–health system partnership formed, successes, early lessons learned, and practical suggestions for how to develop stronger alignment to provide culturally responsive patient-centered care to Black families. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article