Search Results (577)

Background: Peristomal leakage is one of the most troublesome complications of living with a stoma, affecting skin integrity, quality of life, and healthcare costs. However, definitions, measurement methods, and prevalence estimates remain heterogeneous. This scoping review aimed to (i) map the international prevalence of peristomal leakage across stoma subtypes; (ii) identify associated or correlated factors; and (iii) describe the tools used to assess leakage. Methods: A scoping review was performed following the Joanna Briggs Institute (JBI) guidelines. MEDLINE, CINAHL, Scopus, Embase, and the Cochrane Library were searched, with publication language restricted to English and Italian. Primary studies and evidence syntheses addressing peristomal leakage were included. Results: Twenty-seven studies were included, most of which were primary observational studies conducted in Europe, North America, and the Nordic countries. Ileostomy was the most frequently investigated stoma type, followed by colostomy and urostomy. Across settings, peristomal leakage was highly prevalent, with most period or lifetime prevalence estimates exceeding 50%. Reported determinants clustered into anatomical, surgical, device-related, behavioral, care-related and psychosocial factors. Multiple tools were used, including leakage-specific and broader stoma questionnaires, but definitions and leakage grading were inconsistent. Conclusions: Peristomal leakage is a common, multifactorial, and largely preventable complication with substantial clinical, psychosocial and economic consequences. Clinical practice should prioritize early detection, validated assessment tools, patient education, specialized stoma nursing and structured follow-up. Future research should establish consensus definitions, robustly validate leakage-specific instruments, include under-represented regions and conduct high-quality economic evaluations to guide equitable, cost-effective care models. Full article

Background/Objectives: The Thriving at Work model proposes that organisations have a responsibility to provide supportive work environments that identify individual health outcomes, which organisations can use to determine where workforce support is needed. The aims of this study are to (1) identify and compare the predictors of early-career nurses’ thriving at work in New Zealand and Australia and (2) provide innovative and theory-informed recommendations to improve organisational support of early-career nurses to increase retention in the profession. Design: A multinational cross-sectional study design was followed. Methods: The methods include a sub-study of an international action research programme to support the thriving of early-career nurses, which evaluates and compares results from surveys of nurses at approximately three months post-registration in 2024 and 2025. A theory-informed survey assesses predictors and outcomes of thriving at work. Results: Early-career nurses (N = 320) from New Zealand (n = 277) and Australia (n = 43) completed the survey. New Zealand early-career nurses experience greater quality of care and authenticity at work; however, they also report greater burnout. For Australian early-career nurses, authenticity at work is the greatest predictor of thriving. In New Zealand, thriving is linked to burnout and colleague support. Conclusions: New Zealand must focus on reducing burnout and fostering workplaces that value social connection if it wants to mitigate early-career nurse attrition to Australia for better working conditions. In Australia, the value of authenticity at work highlights the importance of organisational cultures that enable nurses to express their true selves and professional identity. The findings highlight the need for tailored approaches in each country to strengthen workforce sustainability and improve nurse wellbeing. Implications for the Profession: In New Zealand, additional funding to bolster the recruitment and retention of the nursing workforce is crucial to improve patient ratios and reduce workloads. The remuneration of nurses must also remain competitive with Australia. Additionally, workplaces should incorporate Māori values and practices into workplace policies to strengthen social connections. Australian organisations should include authentic management training, psychological safety initiatives, and policies that value diversity and encourage open communication. Full article

Background: Intimate partner violence (IPV) represents a major public health problem in Europe, with significant physical, psychological, and social consequences. Nurses are often the first professionals capable of detecting early signs of IPV, yet they lack validated instruments to assess their clinical competency in detection, evaluation, documentation, and intervention. This study aimed to develop and validate the Intimate Partner Violence Nursing Competency Scale (IPVNCS), aligned with the Nursing Intervention Classification (NIC 6403). Methods: A cross-sectional psychometric study was conducted among registered nurses in the Community of Madrid. A 30-item Likert-type self-administered instrument (1–5 scale) was developed based on NANDA, NIC 6403, and NOC frameworks. A total of 202 nurses participated. Reliability was assessed through Cronbach’s alpha. Construct validity was examined using exploratory factor analysis (EFA) with Promax rotation and confirmatory factor analysis (CFA) using AMOS 26. Ethical approval was obtained (CEU San Pablo, code 843/24/104). Results: After item refinement, 26 items remained across four dimensions: (1) Intervention and Referral, (2) Detection and Assessment, (3) Documentation and Recording-keeping, (4) Psychosocial Support. The instrument showed excellent reliability ($\alpha$ = 0.97). KMO was 0.947 and Bartlett’s test was significant (p < 0.001). CFA demonstrated satisfactory fit: ${\chi }^2$/df = 2.066, RMSEA = 0.073, CFI = 0.92, TLI = 0.91, NFI = 0.86. The final model adequately represented the latent structure. After debugging, its psychometric properties were significantly improved. Four redundant items were eliminated, achieving internal consistency ($\alpha$ = 0.97), a KMO value of 0.947 and a significant Bartlett’s test of sphericity. It showed a better fit, according to ${\chi }^2$/df = (2.066); Parsimony = (720.736); RMR (0.0529; RMSEA (0.073); NFI (0.860); TLI (0.910) and CFI (0.920). The final model provides an adequate representation of the latent structure of the data. This study provides initial evidence of construct validity and internal consistency reliability of the IPVNCS. Conclusions: The IPVNCS is a valid and reliable tool to assess nursing competencies for clinical management of IPV. It supports structured evaluation across four core nursing domains, enabling improved educational planning, clinical decision-making, and quality of care for victims. The scale fills a gap in clinical nursing assessment tools and can support protocol development in emergency, primary care, and hospital settings. Full article

This article presents a case study from a Social and Health Care School in Denmark, where a rooftop garden was designed to promote student health and support nature-based teaching across subject areas. A novel aspect of the project is the formal integration of the garden into teaching, implying that its long-term impact may extend beyond the students to the end-users they will later encounter in nursing homes and hospitals nationwide. This study applies the Evidence-Based Health Design in Landscape Architecture (EBHDL) process model, encompassing evidence collection, programming, and concept design, with the University of Copenhagen acting in a consultancy role. A co-design process with students and teachers was included as a novel source of case-specific evidence. Methodologically, this is a participatory practice-based case study focusing on the full design and construction processes, combining continuous documentation with reflective analysis of ‘process insights,’ generating lessons learned from the application of the EBHDL process model. This study identifies two categories of lessons learned. First, general insights emerged concerning governance, stakeholder roles, and the critical importance of site selection, procurement, and continuity of design responsibility. Second, specific insights were gained regarding the application of the EBHDL model, including its alignment with Danish and international standardised construction phases. These insights are particularly relevant for project managers in nature-based initiatives. The results also show how the EBHDL model aligns with Danish and international standardised construction phases, offering a bridge between health design methods and established building practice. The case focuses on the EBHDL process rather than verified outcomes and demonstrates how evidence-based and participatory approaches can help structure complex design processes, facilitate stakeholder engagement, and support decision-making in institutional projects. Full article

Background: Teamwork and effective communication are widely recognized as essential pillars for the safety and quality of healthcare. However, in Portugal, no validated instrument had previously been available to assess healthcare professionals’ attitudes toward teamwork. This study aimed to translate, culturally adapt, and validate the TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) for the Portuguese context, resulting in the Portuguese version of the instrument. Methods: A methodological study with a quantitative approach was developed. The translation and cultural adaptation process followed internationally recognized guidelines. The sample consisted of 162 healthcare professionals (136 nurses and 26 physicians) from a hospital in Lisbon. Exploratory and confirmatory factor analysis techniques were used to assess construct validity. The internal consistency of the scale was analyzed using Cronbach’s alpha coefficient. Results: The Portuguese version comprises 30 items distributed across five dimensions: Effective Leadership Support, Team Functional Performance, Teamwork Coordination, Willingness to Engage in Teamwork, and Team Functioning Supervision. The scale demonstrated a total explained variance of 53.9% and an overall internal consistency coefficient (α) of 0.86, indicating good reliability. Confirmatory factor analysis supported the five-factor structure of the scale (χ²/df = 1.461; CFI = 0.900; GFI = 0.821; RMSEA = 0.054; MECVI = 4.731). Conclusions: The T-TAQ-PT proved to be a valid, reliable, and robust instrument for assessing healthcare professionals’ individual attitudes toward teamwork, contributing to the development of research and clinical practice in the Portuguese context. Full article

Objectives: The study aims to assess the strategies used to estimate antimicrobial consumption (AMC) and the barriers encountered in data collection. It also addresses the perception about AMC based on the World Health Organization (WHO) definition. Methodology: The qualitative study adhered to the standard consolidated criteria for reporting qualitative studies (COREQ) guidelines. It involved stakeholders from diverse sectors, i.e., regulatory bodies, the pharmaceutical industry, international health organizations, policy experts, medical professionals, veterinary doctors, and academia (nursing, medicine, and pharmacy). A total of 37 in-depth interviews were conducted using a semi-structured interview schema. The interviews were recorded and transcribed verbatim. Codes were generated afterward and organized into themes. Results: Data analysis yielded five themes consisting of (i) Perception about Antimicrobial Consumption, AWaRe (Access, Watch, Reserve) classification and related terms, (ii) Antimicrobial Consumption: Policy Design, (iii) Data management and record keeping for the Estimation of Antimicrobial Consumption, (iv) Levels of Estimation for Antimicrobial consumption and Organizations, and (v) Challenges and suggested solutions in estimation of AMC: One health approach is the way forward. Conclusions: The study concluded that AMC and AMR are two sides of the same coin. The solution to AMR and excessive AMC is to re-evaluate the policy and implement legislation strictly. Efforts focused on irrational prescribing and unsupervised OTC sales of antimicrobials. This will help in reducing the consumption of broad-spectrum antimicrobials. Full article

Objective. The aim of this study was to define a structured competence model for nurses working in gastrointestinal endoscopy in Italy and to assess nurses’ perceptions of the number of procedural repetitions required to acquire and maintain competence across different endoscopic procedures. Methods. A cross-sectional online survey targeted registered nurses working in Italian gastrointestinal endoscopy units. The questionnaire, developed from guidelines and expert consensus, covered demographics, organizational context, and perceived repetition thresholds for 30 procedures. Partial Credit Models (PCMs) estimated acquisition and maintenance thresholds; Differential Item Functioning (DIF) tested differences by self-reported experience level. Results. A total of 332 nurses participated (68.4% female; mean age 47.1 years; mean endoscopy experience 10.1 years). For competence acquisition, most procedures were placed in the 11–30 or 31–50 repetition range, with higher values for complex techniques. Competence maintenance generally required fewer repetitions, but thresholds varied by procedure. Advanced or infrequently performed techniques were perceived as more demanding. More experienced nurses reported higher thresholds, reflecting stricter internal standards. Conclusions. Acquisition and maintenance of gastrointestinal endoscopy competences differ in intensity and frequency requirements, supporting the need for tailored, modular training pathways. Findings highlight the importance of national competence standards, adaptive learning technologies, and structured mentorship to enhance skill development, reduce variability, and promote consistent, high-quality patient care across Italy. Full article

Background/Objectives: The aim of this study was to evaluate the research competencies of pediatric nurses and to assess the psychometric properties of the Research Competencies Assessment Instrument for Nurses (RCAIN) in Greece. Methods: A cross-sectional study was conducted in December 2023 via a convenience population-based sample of 106 registered pediatric nurses. Eligible participants owned a diploma, bachelor’s, or graduate degree in nursing and had completed at least two years of professional service. Research competencies were estimated through the RCAIN, a standardized instrument previously validated in the Greek language. Results: The findings revealed moderate levels of research-related knowledge (mean score: 26.92/40), skills (mean score: 22.17/30), and application of research in clinical practice (mean score: 14.89/25). Higher educational attainment and participation in scientific activities were positively associated with research competency scores. The RCAIN showed high internal consistency across subscales (Cronbach’s α: knowledge = 0.914, skills = 0.905, application = 0.935), supporting its reliability in this population. Conclusions: Pediatric nurses showed moderate research competencies, underscoring the need for direct educational and institutional strategies to foster research capacity and evidence-based practice in pediatric nursing settings. Full article

Background and Objectives: The growing number of patients seeking medical care in the internal medicine departments over the past decades has been accompanied by an increase in the bed occupancy rate. This is associated with a heavier work burden among the professional staff members, which may lead to a lower quality of care. Therefore, this study aimed to evaluate the association between the bed occupancy rate and staff compliance with hand hygiene regulations. Materials and Methods: This ecological study included 9 internal medicine departments (~300 beds) in a single medical center between 01/2017 and 12/2019. Routine hand hygiene performance was evaluated randomly, and the association between the bed occupancy rate and the staff’s compliance with the hospital regulations was studied. Univariate and multivariable analyses were performed by the generalized estimating equation model. Results: The study included 12,736 episodes that warranted hand hygiene practices (“opportunities”). The overall hand hygiene performance rate was 78.3% (physicians 76.2%, nurses 80.7%, and healthcare assistants 76.9%). There was an approximately 2% decline in staff compliance for each 10% increase in bed occupancy rate (adjusted IRR 0.98, 95%CI 0.97–0.99, p < 0.001). Stratification by staff members showed a significant decline in routine hand hygiene practices among physicians (adjusted IRR 0.97, 95%CI 0.95–0.99, p < 0.001) and healthcare assistants (adjusted IRR 0.97, 95%CI 0.96–0.99, p < 0.001) but not among nurses (adjusted IRR 0.99, 95%CI 0.98–1.01, p = 0.392). Conclusions: An increase in bed occupancy rate is associated with a decrease in the hospital staff’s compliance with hand hygiene and therefore may lead to a lower quality of care. Full article

Burnout results from chronic workplace stress and is most effectively addressed through workplace interventions. Successful implementation of interventions may, however, be constrained by factors within the work environment. This study aimed to evaluate a new tool, the Veterinary Nurse Burnout Prevention Survey (VNBPS). The 35-item, cross-sectional mixed methods survey aimed to identify the presence of burnout risk factors for veterinary nurses (VNs), and support selection of tailored interventions within the clinic. The VNBPS was conducted within VN teams (N = 67) across six Australian veterinary clinics between August and September 2025. After delivery and analysis of the survey, a summary of results and tailored recommendations was provided to each clinic. A subsequent evaluation questionnaire measured perceived ease of participation, accuracy of findings, and practicality of recommendations. The majority of the 17 respondents who completed the evaluation questionnaire (71%, n = 10) found the survey very easy to complete, and the findings to be accurate (79%, n = 11), or very accurate (21%, n = 3). Recommended interventions were perceived to be practical (50%, n = 7) or very practical (29%, n = 4). Internal reliability of the VNBPS was good. Participants reported that the survey held additional value in initiating conversations about burnout. This confirms the VNBPS as a useful tool to assist veterinary workplaces in the prevention of VN burnout and provide practical support for leaders to improve the wellbeing and professional sustainability of VN teams. Full article

Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive care units play a key role in decisions about restraint application, but there is a global lack of validated tools to assess their knowledge, attitudes, and practices, particularly in non-English-speaking contexts. Aim of this study was to develop and validate a questionnaire for assessing knowledge, attitudes, and practices (KAP) of ICU nurses regarding restraint use in adult and pediatric settings. Materials and Methods: A multi-method psychometric validation study was conducted across both adult and pediatric ICU settings at two hospitals in northern Italy. Questionnaire development included literature review, expert consultation, and iterative content and face validity assessments. Reliability was tested using test–retest methods, and construct validity was explored through exploratory factor analysis. The study followed COSMIN guidelines. Results: The final CON-Ti-IT questionnaire comprised 29 items across three subscales: Practices, Attitudes, and Knowledge. It demonstrated strong content validity (CVI = 0.96) and good internal consistency for the Practices subscale (Cronbach’s α = 0.89). Internal consistency for the Attitudes (α = 0.51) and Knowledge (α = 0.47) subscales was lower, reflecting the broader conceptual variability of these domains. Exploratory factor analysis confirmed the structural validity of the tool and led to the removal of three items with low factor loadings. Conclusions: This study presents the first validated tool specifically designed to evaluate ICU nurses’ KAP on restraint in adult and pediatric settings. While developed and validated in Italy, it could undergo cross-cultural adaptation and translation for use in other languages and healthcare systems. Its strong psychometric properties support its application in future research, and the data collected through its use can serve both to improve patient care and to provide a foundation for targeted educational initiatives. Full article

In an era of global health crises, rising misinformation, and increasing scrutiny of expert sources, journalists face a critical challenge: producing health coverage that is accurate and socially relevant. Yet despite their central role in healthcare and their consistently high public trust, nurses remain significantly underrepresented in media coverage worldwide. This paper examines the structural, cultural, and professional reasons behind this absence and explores the journalistic opportunity in changing it. Drawing from international literature, media studies, and trust metrics, the article situates nurses within journalism’s responsibility to reflect diverse, credible, and frontline voices. It outlines the unique value nurses bring to reporting—translational expertise, on-the-ground insights, and community-based perspectives—and the barriers that have historically kept them out of the news cycle, including newsroom routines, institutional hierarchies, and gendered assumptions. As nurses increasingly receive media training and prepare to engage publicly, journalists have an opportunity—and a responsibility—to reimagine their sourcing strategies. Including nurses not only deepens the quality of health stories but also reinforces journalism’s public service mission. This paper offers a framework for integrating nurses into health coverage and encourages a global shift in sourcing norms. Full article

Background: In recent years, interest has grown in the study of the role of the maximization trait in situations of high uncertainty and high stakes. However, although up to 13 different scales have been proposed for its measurement, none of them have been translated and validated in the Spanish language. This study addresses this gap by adapting and validating the Spanish version of the 7-item Maximization Tendency Scale, a concise instrument designed to assess the tendency to maximize, which may offer practical advantages in terms of brevity and ease of administration compared to longer scales. Objectives: We aimed to adapt and evaluate the psychometric properties of the Spanish version of the MTS-7, examining its internal consistency and factor structure when applied to a Spanish sample. Methods: A sample of 213 active nurses from the province of Cádiz (Spain) (83.5% female) completed the translated version of the MTS-7 and completed the retest two weeks later. Results: Both Exploratory and Confirmatory Factor Analyses confirmed the unidimensional nature of the scale. Cronbach’s alpha coefficient was 0.78; the 2-week test–retest reliability Pearson correlation coefficient was 0.89; ICC was 0.78. Conclusions: The Spanish version of the MTS-7 possesses satisfactory psychometric properties and proves to have adequate reliability and validity. This scale may serve as a useful tool for studying decision-making under uncertainty among Spanish-speaking nurses. Full article

Introduction: Promoting healthy habits in childhood is fundamental for fostering long-term well-being. This study aimed to develop and psychometrically validate an app-integrated instrument to assess knowledge, habits, and attitudes related to health in children aged 8–11, within the context of the MHealth intervention Healthy Jeart. Methods: A quantitative, cross-sectional design was used. An initial item pool underwent expert content validation before being administered to a sample of 623 children from primary education centers in Andalusia, Spain. Construct validity was examined through exploratory and confirmatory factor analyses. Results: The analyses supported a coherent four-factor structure comprising 21 items: (1) Use of technologies, (2) diet and growth, (3) psychological well-being, and (4) physical activity and well-being. The instrument demonstrated satisfactory model fit and internal consistency, providing a multidimensional assessment of children’s health-related behaviors. The sample was recruited from primary schools in Andalusia (Spain), which may limit the generalizability of the findings to other regions and cultural contexts. Conclusions: The validated instrument offers a reliable and efficient means of evaluating healthy habits in children aged 8–11, particularly when embedded within digital interventions such as Healthy Jeart. It represents a valuable tool for educators and pediatric nursing professionals working in school settings, enabling early identification of gaps in health literacy and supporting targeted interventions that promote holistic child well-being. Full article

This pilot exploratory qualitative study used the Modified Grounded Theory Approach (M-GTA) and the Realist Evaluation (RE) framework to clarify the interrelationships between nursing support and Peer Support (PS) in the creation and utilization of Crisis Plans (CPs) in Japan. Findings revealed that nursing support, constrained by psychiatric ward institutions, struggled with internal conflict while seeking to bridge risk and recovery. In contrast, PS support, rooted in lived experience, reframes crisis and risk, actively fostering patient self-determination and growth, and transforming. We propose an exploratory Context–Mechanism–Outcome (CMO) model that maps the distinctive contributions and interactions of nursing and PS support. This model provides provisional insights to inform the development of more robust, recovery-oriented CP support systems. Full article