Search Results (161)

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Background/Objectives: End-of-life care is a vital part of nursing education that has been overlooked until recent years. Advance care planning should be incorporated into the prelicensure nursing curriculum to build student nurses’ confidence in aiding patients and families with their preferred future care plans. Advance care planning tools, such as the Advance Health Care Directive (AHCD) and Five Wishes, provide experiential learning opportunities that bridge theoretical knowledge with real-world patient advocacy. In this study, students were asked to complete either the AHCD or Five Wishes document as though planning for their own end-of-life care, encouraging personal reflection and professional insight. Embedding these assignments into nursing education strengthens students’ confidence in facilitating end-of-life discussions. This study applied Kolb’s experiential learning theory, including concrete experience, reflective observation, abstract conceptualization, and active experimentation, to explore student nurses’ perspectives on the Advance Health Care Directive and Five Wishes assignments, as well as their understanding of end-of-life care. Methods: This study used an exploratory–descriptive qualitative design featuring one open-ended question to collect students’ views on the assignments. Results: The final sample comprised 67 prelicensure student nurses from Bachelor of Science and Entry-Level Master’s programs. The Advance Health Care Directive and/or Five Wishes assignment enhanced students’ understanding of end-of-life decision-making. Conclusions: It is essential to complete the assignment and immerse oneself in an end-of-life situation to grasp patients’ perspectives and concerns regarding when to engage in difficult conversations with their patients. Full article

The quality of living environments for older adults represents a critical component of social sustainability in an ageing society. Among various housing options, nursing homes are the most institutionalised form of elderly care and demand special attention regarding architectural design. This paper explores the impact of architectural and open space features on social sustainability in living environments for older adults. A comparative analysis of three Slovenian nursing homes is presented. The first two, built in the post-war period, were based on elevated architectural criteria inspired by Swedish human-centred housing design. The third was completed in 2021 in the post-COVID-19 era, which revealed the vulnerability of such housing typologies. An integrated methodological framework was developed by applying two complementary assessment tools: the Safe and Connected, developed by the authors to evaluate the spatial, health, and social resilience of nursing home environments, and the Well-being and Integration, addressing the role of open space with a particular emphasis on the identification of older adults with their environment and the facilitation of social resilience. Both tools evaluate indicators linked to the social dimension of quality of life for older adults. The results show a gradual improvement in architectural quality from the 1960s to the 1980s, followed by a partial decline in the contemporary case. The Swedish example scored highest across both tools. In contrast, the newest Slovenian facility scored surprisingly low in social integration, highlighting critical gaps in current nursing home design. This study demonstrates the value of applying interdisciplinary, tool-based evaluations in identifying design strategies that foster resilient and inclusive LTC environments, and the proposed framework may serve as a decision-making aid for architects, planners, and policymakers. This research highlights the importance of reintroducing human-oriented design principles to support socially sustainable nursing home environments. Full article

Background: Breakthrough infections (BTIs) continue to occur among healthcare workers (HCWs) despite full COVID-19 vaccination, raising concerns about ongoing vulnerability in this high-risk group. In addition to initial BTIs, breakthrough reinfections (BTRs) have emerged as a challenge, with some HCWs experiencing multiple episodes of infection after vaccination. This study investigated the factors influencing breakthrough infection and reinfection rates among HCWs between January 2021 and December 2022 in Davao City, Philippines. Methods: This retrospective cohort study was conducted using secondary data from the Davao City Epidemiological Surveillance Unit, approved by the Department of Health. This study included 1011 fully vaccinated HCWs from various congressional districts. Results: BTI was observed in all HCWs included in the study. However, BTRs varied across occupational groups: medical technologists showed the highest reinfection rate (22.37%), followed by physicians (13.48%), and nurses/nurse aides (10.14%). Booster vaccination significantly reduced BTRs (5.83% vs. 11.18%, p = 0.0267). Occupation and institutional type were significant factors, with higher rates reported by physicians and in public hospitals (p = 0.0002 and p = 0.0041, respectively). The vaccine manufacturer, sex, age, and booster type showed no significant differences. Conclusion: These findings highlight the importance of targeted interventions for high-risk HCWs and emphasize the effectiveness of the booster vaccination. Full article

Background: Spiritual care is vital for the holistic well-being of hospitalized cancer patients, addressing their emotional, psychological, and spiritual needs. This study addresses gaps in the relevant literature by evaluating spiritual perspectives among Peruvian oncology patients, offering culturally grounded insights that can inform nursing practice and healthcare management. The main objective of this research was to measure the overall level of Spiritual Perspective among hospitalized oncology patients using the Spiritual Perspective Scale (SPS) developed by Pamela Reed in 1987, which reflects early aspects of spirituality later integrated into her broader Spiritual Perspective theory. Materials and methods: This study aimed to evaluate the perceived levels of Spiritual Perspective among oncology patients in a hospital setting. Adopting a quantitative, descriptive, cross-sectional design, data were gathered from 137 patients at a national hospital in Lima, Peru. Results: The majority of participants were older adults, with a high school education, and predominantly single. Findings revealed that most patients experienced moderate levels of Spiritual Perspective, spiritual practices, and beliefs. Patients commonly practiced prayer, meditation, and spiritual reading. Beliefs centered on a higher power and forgiveness. Essential support networks also provided emotional aid, complementing spiritual care. Conclusions: This study highlights the importance of spiritual care in nursing for oncology patients. Findings advance understanding of spirituality in illness and support interventions to improve patient outcomes. Full article

Background: As artificial intelligence (AI) continues to advance in healthcare, limited research has explored how nursing professionals perceive its integration into clinical practice and education—particularly among those directly involved in AI-driven initiatives. This qualitative study aimed to investigate the perceptions, experiences, and expectations of nursing educators and clinical practitioners regarding the application of AI in nursing and to provide insights for the advancement of AI-driven nursing science. Methods: A descriptive qualitative design was employed. Between September and December 2024, semi-structured interviews were conducted with 12 nursing professionals from universities and hospitals in Shanghai, Suzhou, and Chengdu, China. Participants were selected using maximum variation sampling, and data were analyzed using content analysis. Results: Three major themes and eleven sub-themes were identified: (1) The potential of multi-perspective development of AI-driven nursing science and practice, including aiding in decision-making, assisting with writing nursing documents, helping in care practices with high exposure risks and heavy physical exertion, and supporting the development of nursing activities. (2) A multi-dimensional response to the wave of intelligent nursing research and practice: education and scientific research come first, then we fully explore the application scenarios, and then conduct deep interdisciplinary integration. (3) Obstacles for intelligent nursing research and practice: interaction factors of “human–technology–machine” for application, transformation, and promotion; financial support and continuous investment; the controversy behind the intelligent maturity level; and application risk and fault tolerance. Conclusions: Participants emphasized the importance of evidence-based, cautious, and context-sensitive application of AI technologies to ensure that intelligent nursing evolves in alignment with clinical realities. The findings suggest a need for strengthened policy, education, and resource allocation to support the sustainable integration of AI in nursing. Full article

Background/Objectives: Technological advancements are revolutionizing nursing education by improving precision, patient outcomes, and learning experiences. There is an urgent need for systematic frameworks to help nurse educators effectively integrate advanced technologies into their teaching methods. This manuscript introduces the Artificial Intelligence-Driven Technology Adoption in Nursing Education (AID-TANE) framework and operationalizes its use through a pilot study with undergraduate nursing students. Methods: The framework was tested through a convergent mixed-methods pre/post-test study design involving 160 senior-level community health nursing students who participated in an AI-driven educational intervention. Quantitative data were collected using the Facts on Aging quiz, while qualitative data were gathered from a reflective survey. Statistical analyses included paired-sample t-tests and a qualitative content analysis. Results: The study revealed a statistically significant increase in learners’ knowledge about older adults, with mean scores improving from 33.29 (SD = 5.33) to 36.04 (SD = 6.76) post-intervention (t = 5.05, p < 0.001). The qualitative analysis identified four key themes: communication and understanding, patience and empathy, respect for independence, and challenging stereotypes. Conclusions: This study found that AI-driven educational tools significantly improved nursing students’ knowledge about older adults and positively influenced their learning experiences. The findings highlight the need for targeted frameworks like AID-TANE to effectively integrate AI into nursing education, ensuring that students are ready for a technologically advanced practice setting. Full article

Background/Objectives: Mental health literacy (MHL) plays a crucial role in transitional processes, influencing, for example, students’ adaptation to higher education and, later, their transition into the workforce. This study assesses MHL about depression among first- and fourth-year nursing students and identifies which MHL components and related variables are associated with a higher likelihood of being in either academic year. Methods: A cross-sectional descriptive correlational study was conducted with 478 nursing students (59.4% first-year students; 40.6% fourth-year students), predominantly female (82.2%), with a mean age of 20.41 years (SD = 4.71) and a median age of 19.0 years. Results: The results revealed a low level of recognition of depression and knowledge of mental health first aid (MHFA) strategies, including health literacy. Students tended not to hold beliefs based on myths and stereotypes about mental illness and individuals with mental illness and did not have highly stigmatizing views. MHL varied by year of study, with fourth-year students having more adequate MHL levels. Conclusions: These findings highlight the need to integrate MHL as a key element of academic success. Health education initiatives that promote mental health, prevention, and MHFA training may serve as effective strategies to enhance MHL among nursing students. Full article

Background: Person-centered care (PCC) approaches are widely recognized for improving the quality of life of residents living with dementia in long-term care (LTC). However, residents are only one part of the care dyad, and it remains unclear whether PCC also impacts nursing care aides in similarly adventitious ways. Care aides in this context experience significant care strain, which refers to the physical, emotional, and psychological burden experienced by caregivers. While PCC approaches are promoted as the best approach for supporting residents living with dementia, there is limited research on whether their implementation also impacts care aides. This study examined potential associations between organization-level PCC indicators and care strain among nursing care aides who work with residents living with dementia in LTC homes in New Brunswick, Canada. Methods: A cross-sectional survey design was used to explore the relationship between PCC approaches and care strain. Care strain was measured using the strain in dementia care scale, including the daily emotions subscale. A modified version of the Dementia Policy Questionnaire assessed the extent to which PCC approaches were implemented in participants’ workplaces. Descriptive statistics characterized the sample, and multivariable regression analyses examined associations between PCC indicators and care strain, adjusting for demographic factors. Results: Twenty-eight participants completed both measures. Overall, participants reported high levels of care strain but also high levels of positive daily emotions. Findings partially supported the hypothesis that PCC indicators were associated with lower care strain and more positive daily emotions. Certain PCC indicators, such as structured education and ethical support, appeared particularly beneficial. Implications for Practice: Strengthening PCC practices—especially through hands-on training and ethical support—may help reduce care strain and enhance care aides’ emotional well-being. LTC facilities that prioritize these strategies over policy implementation alone may improve both staff well-being and quality of care for residents. Full article

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, with transarterial chemoembolisation (TACE) being a primary treatment for intermediate-stage disease. However, post-procedural pain remains a significant challenge due to inconsistent management practices and a lack of standardised protocols. This scoping review synthesises current evidence on pain management strategies in HCC patients undergoing TACE, evaluates their effectiveness, identifies practice gaps, and proposes optimisation strategies. Methods: A comprehensive database search according to the methodological approach given by Arksey and O’Malley with the aid of the PRISMA-ScR guidelines across Cochrane Library, Web of Science, CINAHL, PubMed, and Scopus was performed. The terms associated with pain, TACE, and liver cancer were included in the search strategy. Two independent researchers systematically screened study titles, abstracts, and full texts and extracted key study characteristics and approaches to pain management. Results: Of 1515 identified studies, 29 met the inclusion criteria. Most (72.7%) focused on pharmacological interventions, with dexamethasone and lidocaine being the most frequently investigated agents. Non-pharmacological approaches, including psychological interventions, physical therapies, music therapy, health education, and comprehensive nursing, were also reported. Pain was primarily assessed using the visual analogue scale (VAS) and numeric rating scale (NRS). Conclusions: Pharmacological interventions, particularly dexamethasone and lidocaine, remain the cornerstone of pain management in TACE, yet consensus on their optimal use is lacking. Non-pharmacological strategies provide complementary benefits. standardised, evidence-based pain management protocols integrating both approaches are needed. Future large-scale, multicentre trials are essential to establish the most effective strategies for optimising patient outcomes. Full article

Background/Objectives: This study mapped antibody dynamics across three COVID-19 vaccination rounds (primary course, first, and second booster with BNT162b2) in Belgian nursing home residents (NHRs). Methods: Within a national SARS-CoV-2 serosurveillance study (February 2021–September 2022) across Belgian nursing homes, dried blood spots were collected, on which anti-spike SARS-CoV-2 IgG antibodies were quantified by ELISA in international units/mL (IU/mL). Sociodemographic data were collected at the study start and infection history and vaccination data at each sampling round. Results: Infection-naïve NHRs had low antibody levels after primary course vaccination (geometric mean concentration (GMC) 292 IU/mL, 95% confidence interval (95% CI): 197–432), but increased tenfold after first booster (GMC 2168 IU/mL, 95% CI: 1554–3027). While antibodies among NHRs significantly declined within six months after primary vaccination (p < 0.0001), they remained stable for nine months post-booster (p > 0.05). Among primary vaccine non-responders, 92% (95% CI: 82–97%) developed antibodies after the first booster (GMC 594 IU/mL, 95% CI: 416–849), though tenfold lower than initial responders (GMC 4642 IU/mL, 95% CI: 3577–6022). Conclusions: These findings demonstrate that NHRs require tailored vaccination, prioritizing repeated immunization to improve serological outcomes in poor responders such as infection-naive NHRs. Regular immune monitoring could aid in implementing evidence-based vaccine strategies, ensuring optimal protection for vulnerable populations against SARS-CoV-2 and other infectious threats. Full article

Background: Stroke has high mortality. Challenges in providing end-of-life care include uncertainty among healthcare professionals about when to start care. While generic tools and guidelines exist, which outline components of quality end-of life care, they may not fully address stroke’s unpredictable trajectories, complicating care planning. Objective: To enhance understanding of end-of-life care post-stroke. Methods: We undertook an explanatory sequential mixed methods approach, including a cross-sectional survey and semi-structured interviews. All 286 United Kingdom (UK) National Health Service (NHS) hospitals providing inpatient stroke care were approached for participation in an on-line cross-sectional survey. The survey of healthcare professionals from UK stroke units was used to map current stroke end-of-life care and models of care. Fourteen staff who completed the survey and agreed to a future interview were purposively selected. The semi-structured interviews with healthcare professionals involved in delivering end-of-life care post-stroke were conducted and interpreted using the Theoretical Domains Framework. We aimed to enhance our understanding of the experiences, expectations, challenges and barriers in providing end-of-life care post-stroke, including effective clinical decision-making. Results: Across 108 responding survey sites, 317 responses were received. Results showed a lack of structured tools and approaches, an absence of stroke-specific guidance and variable delivery of end-of-life care post-stroke. Thirteen staff (nurses, occupational therapists, medical stroke consultants, and a speech and language therapist) agreed to be interviewed. The data provided a fuller understanding of the context within which end-of-life care post-stroke is delivered. The varied challenges faced include: uncertain prognosis, complex decision-making process, varying skill levels, staffing levels, the hospital environment, emotional strain on both families and staff, inequitable access to specialist palliative care, and difficulties associated with different models of care (stroke service structures and cultural context). Conclusions: Provision of end-of-life care post-stroke is complex, challenging, uncertain, and inconsistent. There is limited evidence or guidance to support healthcare professionals. There is a need for implementation support, which includes education, to better enable quality and more consistent end-of-life care post-stroke. Further research is required to assess interventions that can support end-of-life care post-stroke to aid clinicians in providing quality palliative care for stroke patients. Full article

Background: Establishing safe and efficient oral feeds for preterm infants is one of the last milestones to be achieved prior to discharge home. However, this process commonly elicits stress and anxiety in both care providers, such as nurses and the entire healthcare team in the Neonatal Intensive Care Unit (NICU), as well as parents. These feelings of uncertainty are exacerbated by the non-linear progression of oral feeding development and the absence of a systematized approach to initiate and advance feedings. Methods: In this 48-bed tertiary perinatal centre, staff surveys and a needs assessment showed dissatisfaction and increasing stress and anxiety due to the inconsistencies in initiating and advancing oral feeds. This paper describes the formation of a multidisciplinary feeding committee which reviewed various oral feeding training materials and the ultimate creation of two innovative oral feeding algorithms and their corresponding education materials. Results: The Sunnybrook Feeding Committee has developed two evidence-based algorithms, one for initiating oral feeds and another for monitoring progress with objective decision-making points during common oral feeding challenges. To complement and support these algorithms, educational materials and a comprehensive documentation process were also created. These resources included detailed instructions, visual aids, and step-by-step guides to help staff understand and apply the algorithms effectively. Additionally, the educational materials aimed to standardize training and ensure consistency across the NICU, further promoting a systematic approach to preterm oral feeding. Implementation of these algorithms also aimed to provide evidence-based, expert-guided guidelines for assessing readiness, initiating feeds, monitoring progress, and making necessary adjustments. Conclusions: This structured approach lays the foundation for a unit-wide language and systematic process for oral feeding. The next steps in this quality improvement project involve educating and piloting the implementation of the developed oral feeding algorithms, gathering staff feedback, and refining the tools accordingly. The goal is to enhance overall care quality, reduce stress for both care providers and parents, and ensure the best possible start for vulnerable preterm infants, ultimately supporting a smooth and successful transition to home. Full article

Background/Objectives: The aging population presents significant challenges to healthcare systems, with conditions like dementia severely affecting the quality of life for older adults, especially those in long-term care. Gamification has the potential to motivate older adults to engage in exercise by transforming physical activities into enjoyable experiences. Incorporating gaming elements in cycling exercises can foster a sense of interest and achievement, potentially improving health outcomes. This pilot study aims to explore interdisciplinary staff perspectives on using a digital game to motivate cycling exercise among residents living with dementia in long-term care (LTC). Methods: This study applied a qualitative description design. Using an interpretive description approach, we conducted focus groups with 29 staff members, including recreational therapists, rehabilitation therapists, nurses, care aides, and leadership in an LTC home. The consolidated framework for implementation research (CFIR) guided the data analysis to identify barriers and facilitators to adopting the digital game. Results: Engaging LTC residents living with dementia presents various challenges. Identified potential barriers to implementing the cycling game include cognitive and physical limitations, resistance to change, and intervention complexity. Frontline staff strategies include flexible invitations, social groups, making it fun, and building rapport. Success relies heavily on its cultural and individual relevance, along with strong support from leadership, peers, and family. Conclusions: This pilot study explored staff perspectives on the potential integration of a gamified cycling intervention for older adults with dementia in long-term care settings. Staff emphasized that successful implementation would depend on addressing key barriers and identifying enabling strategies. Based on these findings, practice implications were provided to support effective integration. Further research, including resident input and long-term evaluations, is needed to assess the feasibility, acceptance, and effectiveness of gamification in promoting health outcomes for this population. This study adhered to the COREQ Checklist. Full article

Background: Sleep difficulty is common in the current society. Poor sleep has a significant influence on health, social interactions and even mortality; therefore, maintaining good sleep is of prime importance. Cannabidiol (CBD), a cannabis-derived compound, is known for its medical significance with many positive effects in humans, including decreasing anxiety and improving sleep for those with sleep disorders. Objective: However, whether CBD skin absorption results in similar effects is unknown. Therefore, examining CBD-coated fabric as a pillow cover to improve sleep quality in duty shift nurses is the purpose of this paper. Methods: This study recruited 55 duty shift nurses as participants to evaluate sleep patterns and quality using the Pittsburgh Sleep Quality Index (PSQI) and a consumer-grade tracker (Fitbit Charge 3). Data were collected over three phases: a one-week baseline period, a two-week intervention period using a CBD-coated pillow cover and a one-week follow-up period, referred to as the post-intervention phase, during which the use of CBD-coated pillow cover was continued. Results: Of the 55 participants, 10 were men (18.2%) and 45 were women (81.8%). At baseline, all participants exhibited poor sleep quality (PSQI ≥ 5). However, after three weeks of using CBD-coated pillow covers, subjective sleep quality significantly improved, with 7.3% of participants achieving PSQI scores <5. Additionally, slight changes in sleep patterns were observed, with increases in both light sleep and deep sleep durations. Light sleep duration increased from a baseline of 196.21 ± 65.28 to 206.57 ± 59.15 min two weeks after intervention (p = 0.337). Similarly, deep sleep duration showed a modest increase from 61.97 ± 21.01 min to 64.35 ± 22.19 min (p = 0.288). Furthermore, a significant reduction in anxiety levels was reported (p < 0.005). Conclusions: Using a CBD-coated pillow cover was found to enhance sleep duration in healthy individuals experiencing poor sleep. Consequently, for adults struggling with sleep difficulties, incorporating a CBD-coated pillow cover may serve as an effective aid in improving sleep quality. Full article