Search Results (251)

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. 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: Cancer is one of the leading causes of morbidity and mortality worldwide and in Spain. Individuals with cancer are at a higher risk of suicide compared to the general population due to both general and disease-specific risk factors. Objective: To update knowledge on nursing care measures to address the risk of suicide in cancer patients. Methods: A narrative review was conducted by searching PubMed, WOS, Scopus, and CINAHL during February and March 2025. The inclusion criteria comprised original qualitative, quantitative, and/or mixed-methods studies related to the topic of the review. Results: Of the 289 identified studies, 23 were selected. Twelve studies of cancer patients, ten studies of healthcare professionals, and one study of caregivers and survivors were included. Regarding suicide risk factors, eight studies addressed demographic aspects, fifteen socio-economic factors, twenty-one psycho-emotional factors, and seventeen physical factors. Key risk factors included male sex, advanced age, social isolation, lack of social support, hopelessness, and physical deterioration. Seventeen studies highlighted the need for continuous and comprehensive nursing care using validated tools for systematic assessment of suicide risk. Eight emphasised the importance of ongoing training in suicide prevention, which is essential for developing communication skills and improving therapeutic relationships. Five studies underscored the relevance of a holistic approach that addresses the physical, emotional, social, and spiritual dimensions of patient care. Six extended this approach to include family members and caregivers. Conclusions: Suicide risk in cancer patients is associated with multiple risk factors. Emotional support and a comprehensive, continuous nursing approach—based on systematic assessments, specialised training, and a holistic focus—are key to effective suicide prevention. Full article

Introduction: Hospitalization of children creates significant emotional and psychological stress for parents, highlighting the importance of addressing their needs in pediatric care settings. Aims: This study examines the perceptions of both parents and pediatric nurses regarding the needs of hospitalized children. Method: A cross-sectional survey using the validated Needs of Parents of Hospitalized Children (NPQ) was administered to 218 parents and 218 pediatric nurses in four hospitals in Jeddah, Saudi Arabia. Key domains assessed included trust, information, and support. Group differences were evaluated using non-parametric statistical analyses. Results: Trust was prioritized more by parents (83.9%) than nurses (72.4%) (p < 0.05). Both groups deemed information important, but parents (87.2%) rated it as more necessary than nurses (74.1%) (p = 0.02). Parents (79.8%) expressed a greater need for support compared to nurses (67.3%) (p = 0.03). Conclusions: This study identified perceptual differences between parents and nurses regarding trust, communication, and support. Some differences were statistically significant at the p < 0.01 level, while others were suggestive (p-value between 0.01 and 0.05) and require further investigation. These disparities suggest a need to foster mutual understanding and improve communication practices to better align healthcare delivery with family expectations and strengthen family-centered care. 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

Background and Objectives: One of the challenges of modern healthcare systems, in terms of economic and organizational sustainability and the impact on patients’ quality of life, is the progressive increase in chronicity and care complexity. In this scenario, hospital–community integration models represent possible strategies to ensure the continuity of care, reduce readmission rates, and improve clinical outcomes. This study aims to map integrated care models for patients with chronic diseases, with active involvement of the family and community nurse, describing their functions and associated clinical, organizational, and economic outcomes, as well as barriers and facilitators to their implementation. Materials and Methods: The review was conducted using the JBI methodology and the PRISMA-ScR protocol and identified 26 studies with a publication range from 2000 to 2025. Results: The emerging results highlight the use of integrated and personalized organizational models in the post-discharge phases, with a leading role for the family and community nurse in the assessment, planning, and coordination of various steps. Conclusions: The interventions are associated with an increase in patient and caregiver satisfaction, a reduction in outcomes such as the rehospitalization rate, and greater continuity of care. Full article

Introduction: Nonbinary individuals who do not identify as exclusively male or female often face unique emotional challenges due to societal cisheteronormativity and limited recognition of their identities. While existing research has primarily focused on anxiety, depression, and pathways to parenthood among nonbinary people, little attention has been paid to their comprehensive emotional experiences as parents. This study aims to explore the emotional universe of two nonbinary parents from Spain and the United States. Design: Hermeneutic study. Materials and Methods: We implemented purposive sampling, conducted semi-structured virtual interviews, and followed Ricoeur’s theory of interpretation for data analysis. We used the Universe of Emotions affective taxonomy as a starting category in this analysis. Our sample consisted of a 32-year-old white Spanish nurse (she/they/them), assigned female at birth and parent of two one-year-old toddlers, and a 34-year-old white North American physiotherapist (he/they/them) assigned female at birth and parent of a ten-year-old child. Results: Through its four themes (A story of misunderstanding: “What are you, a combat helicopter?”; Clearly, you don’t fit, so…; But (a new) family is there; No monster here: I’m, at the core, a human being), this study reveals the complex emotional journey experienced by two nonbinary parents. Conclusions: Central to this journey are three key emotions: strangeness, belonging, and acceptance. The participants describe an initial stage marked by body and social dysphoria, confusion, and rejection, followed by a transformative process in which parenthood becomes a catalyst for emotional and identity integration. This transition—from alienation to connection—reflects a broader movement from dehumanization to humanization, where the experience of parenting fosters emotional resilience, social recognition, and a renewed sense of self. Implications for the profession and/or patient care: Analyzing their emotions (both negative and positive ones), we obtained robust insights into these parents’ personal and social contexts. Therefore, we can facilitate understanding of the emotional complexity of nonbinary parents by the trans and cisgender communities. Through this understanding, nurses and the organizations they work for can improve their competence in their holistic care. Acceptance from nonbinary parents’ social contexts, of which nursing is a part, is a critical factor in their health and emotional wellbeing. Full article

Background/Objectives: To examine shifts and challenges in transitional care practices during COVID-19 and the adaptive strategies developed by Transitional Care Nurses (TCNs) in response. Methods: A qualitative descriptive study was conducted using semi-structured interviews with 15 TCNs from acute care hospitals in Japan. Data were collected from October 2021 to October 2022 and analyzed using qualitative thematic analysis. The study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Three main themes emerged: (1) disrupted connections in transitional care with patients and families, among hospital staff, and with community services; (2) professional pressures in pandemic care, including the mental and physical burden on TCNs and navigating unexpected changes to transitional care plans; and (3) adaptive strategies through digital solutions and community partnerships. TCNs implemented hybrid approaches combining selective face-to-face interactions for complex procedures and strategic use of digital tools for routine communication. Conclusions: This study provides the first detailed examination of how TCNs in Japan adapted to transitional care during COVID-19. TCNs maintained essential care principles while implementing digital tools and strengthening community partnerships using hybrid approaches. These findings offer practical guidance for healthcare organizations to enhance transitional care practices during future healthcare crises. Full article

Background: Early rehabilitation is crucial for predicting post-stroke outcomes. In rural Thailand, previous works identified limited access to prompt rehabilitation services, discontinuity of home visits, and a lack of interdisciplinary management, hindering comprehensive resolution. Objective: This participatory action research-based pilot quasi-experimental study investigated the effects of personalized intermediate care (IMC) programs led by physical therapists on clinical outcomes in post-ischemic stroke older adults living in rural areas. Methods: Participatory stakeholders (two physical therapists, a physician, a nurse, and a nutritionist) convened to coordinate with relevant stakeholders (community leaders, village health volunteers (VHVs), and family caregivers (CGs)). Thirty-four acute post-stroke patients were included in the study. The interventions consisted of three action research cycles (planning, action, observation, and reflection) of home-based neurorehabilitation and comprehensive treatments by a healthcare professional network for six months and another six-month follow-up. The primary outcome was the Barthel index for activities of daily living (BI-ADL). The modified Rankin scale (mRS) was a secondary outcome for assessing disability levels. Results: Results showed that the BI-ADL gradually and significantly increased from a baseline median (IQR) of 55 (15) to 100 (20) after 6 months (p < 0.05). This improvement of the BI-ADL was maintained after 12 months (100 (15)). Furthermore, the mRS at 6 months post-discharge reduced considerably from the first month of rehabilitation (p < 0.05). Conclusions: In conclusion, the early and continuous personalized IMC rehabilitation program effectively enhanced ADL and reduced disability levels and should be disseminated to the community. Full article

Background/Objectives: Organ transplantation is a vital treatment for individuals with advanced chronic-degenerative diseases. However, the global shortage of donated organs remains a significant challenge. Improving knowledge and attitudes could positively impact this issue. This study assessed the knowledge and attitudes of nursing students regarding organ donation and transplantation. Methods: A cross-sectional study was conducted using a previously validated questionnaire administered to 235 second- and third-year undergraduate nursing students from two Italian universities. Results: The response rate was 67.3%. Only 40.4% of students felt adequately informed about transplants and brain death, while 12.8% would not authorise organ transplantation for a family member. Willingness to authorise organ procurement from family members in a brain-dead state was positively associated with being atheist or agnostic (χ² = 7.235; p = 0.022), being in the third year of study (χ² = 4.282; p = 0.039) and having positive self-assessed knowledge (χ² = 8.061; p = 0.005). Conclusions: Nursing students exhibited suboptimal knowledge and positive attitudes toward organ and tissue donation. However, there is a need for health policymakers to implement strategies to raise awareness of the importance of organ donation through school and community programmes and public education campaigns. Full article

Background/Objectives: The REACtion project was developed to provide nursing care to older adults at home within the primary care setting. The COVID-19 pandemic posed significant challenges to its implementation, acting both as a barrier and an opportunity. Although several studies have explored healthcare innovation during emergencies, there remains a need for strategic insights to guide real-world implementation efforts. This study aims to explore how the COVID-19 pandemic influenced the implementation of the REACtion project and identify the strategies adopted to ensure continuity and effectiveness in achieving its goals despite the challenges posed by the health emergency. Methods: A qualitative descriptive study was conducted. Semi-structured interviews were carried out with nine project stakeholders, including nurses and researchers, between April and May 2023. The interviews were transcribed verbatim, read in-depth, and analyzed using content analysis to identify perceived barriers, facilitators, and strategies adopted during the project. Results: The pandemic shifted priorities from routine care to emergency health activities. Barriers to project implementation included social distancing, disruptions in the decision-making processes, and a general decline in community welfare. Despite these obstacles, the COVID-19 context underscored the central role of Family and Community Nurses in proactive primary care. Stakeholders adopted relationship-based strategies, addressed workforce shortages, and implemented measures to mitigate personal fatigue. Conclusions: The implementation of innovative nursing interventions during emergencies requires adaptability, collaboration, and context-sensitive approaches. Strengthening stakeholder engagement and leveraging professional roles within the community are essential to overcoming barriers and seizing opportunities in crisis contexts. Full article

Background: The quality of palliative care (PC) services is closely linked to the effectiveness of interdisciplinary collaboration. A coordinated approach among professionals from different fields fosters holistic, person-centered care, ensuring comprehensive support for patients with complex conditions and their families. In hospital settings, In-Hospital Palliative Care Support Teams (EIHSCPs) play a key role in delivering specialized care, enhancing interdepartmental communication, training other healthcare professionals, and optimizing resources. Strong leadership by PC specialists, combined with effective team management, contributes to symptom relief, improved quality of life, and cost reduction. However, interdisciplinary collaboration presents challenges, including competing priorities, resource constraints, and communication barriers. Despite its recognized benefits, research on its implementation in PC, particularly in Portugal, remains scarce. Objective: This study explores the perspectives and practices of professionals within an EIHSCP, examining team dynamics, interprofessional collaboration, and key facilitators and barriers. Methods: Twelve semi-structured interviews were conducted with physicians, nurses, psychologists, and social workers from the EIHSCP in the Médio Tejo region. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: The interview findings were organized into three themes: (1) Social Representations and Interdisciplinary Practice; (2) Competencies for Interdisciplinary Practice; and (3) Challenges in Interdisciplinary Practice. Participants consistently highlighted that interdisciplinary collaboration enhances communication between services and improves care quality. While teamwork is central, patient- and family-centered care remains the priority. Key competencies include empathy, ethics, active listening, and cultural sensitivity, alongside structural and procedural elements such as team meetings, integrated communication, and clear referral criteria. Continuous education and professional development are essential. Challenges primarily stem from limited human and material resources, staff workload and stress, communication gaps between hospital and community teams, and insufficient institutional recognition. Suggested improvements focus on investing in ongoing training, strengthening communication and inter-institutional collaboration, and revising the organizational model of PC within Portugal’s National Health Service. Conclusions: Interdisciplinary collaboration in PC is fundamental for holistic, patient-centered care but is hindered by structural and organizational barriers. Full article