Search Results (1,286)

Rapid population aging in developing countries has intensified demand for accessible nursing home services, yet spatial disparities in service distribution remain insufficiently examined in secondary cities. This study investigates spatial distribution and multi-dimensional accessibility of nursing homes in Kunming, China, using comprehensive spatial analytical methods to inform sustainable urban development. We analyzed 205 nursing homes with 47,600 beds, evaluating spatial distribution patterns, economic accessibility, and spatial accessibility across different transportation modes. Our analysis reveals a pronounced monocentric pattern with nursing resources concentrated within central urban districts, creating a “primary core-multiple satellite” structure and spatial mismatch between service supply and older adult population needs. A distinct institutional dichotomy exists between publicly and privately operated facilities, establishing a dual-track system with different accessibility implications for social equity. Economic accessibility analysis demonstrates significant barriers in central urban and tourism-oriented districts dominated by higher-priced private facilities, where minimum prices frequently exceed average monthly pension. Spatial accessibility remains inadequate across all transportation modes, with only 24.3% of communities achieving normal or higher accessibility via private car, 21.5% via public bus, and merely 13.9% via walking. These limitations primarily stem from insufficient service capacity (34 beds per 1000 older adults) relative to demographic needs rather than transportation constraints. We recommend three sustainable interventions: implementing demand-based planning mechanisms, establishing progressive pricing policies, and developing older adult-friendly transportation networks. This framework supports sustainable urbanization by promoting spatial equity and efficient resource allocation, providing valuable insights for secondary cities pursuing sustainable development goals. Full article

Humor plays a vital role in human well-being and communication and is increasingly recognized as a beneficial resource in healthcare contexts. While prior studies have explored humor in general university populations, limited research has focused on nursing students, who face distinct interpersonal and emotional demands during their training. This pilot study aimed to describe multidimensional sense of humor among first-year nursing students in Spain using the validated Spanish version of the Multidimensional Sense of Humor Scale (MSHS), which includes a three-dimension model: humor competence, humor as a coping mechanism, and social attitudes toward humor. A total of 78 students completed the MSHS questionnaire via an online survey. The overall mean score was 66.8 (SD = 13.1) out of 96, with the highest mean observed in the dimension of humor as a coping mechanism (mean = 22.2, SD = 4.0). Individual item analysis revealed strong agreement with positively worded statements such as “I like a good joke” (mean = 3.36, SD = 0.82) and “Humor is a lousy coping mechanism” (reverse scored; mean = 3.69, SD = 0.67). These findings suggest that humor is a relevant personal and interpersonal resource among future healthcare professionals. Incorporating humor-related competencies in nursing education may support student resilience and enhance patient-centered care. Further research is needed to examine humor’s longitudinal development and its role in clinical practice. Full article

Background/Objectives: This study conducted a secondary and integrative analysis of qualitative data on adolescents and young adults (AYAs) with biliary atresia who survive with their native livers. These individuals struggle with independence and self-care due to prolonged parental involvement. Prior studies have insufficiently clarified how AYAs and parents jointly navigate daily responsibility transitions during this period. Therefore, we aimed to elucidate this process and develop a practical model to support nursing care. Methods: Semi-structured interview data from eight adolescent–parent dyads (one male and seven females, aged 17–25; one father and seven mothers, aged 40–60) were reanalyzed using the modified grounded theory approach. By reframing the analytical focus on dyadic interactions, four transition phases were identified, which were then integrated with the findings of two prior studies to construct an integrative process model. Results: The transition comprised four phases: (1) parent-led recuperation, (2) a vicious cycle of control and rebellion, (3) passing the axis of responsibility, and (4) aligning the parent–child rhythm to create a patient-centered life. The transition processes were shaped by changes in cognition and behavior. The model illustrates mutual adaptation through communication, negotiation, and reflection, identifying opportunities for nursing intervention. Conclusions: This process model offers a practical framework for nurses to assess readiness for care transitions, support transitional role shifts, and co-develop care strategies. The model provides insights into relationship-based communication and shared decision-making in transitional care by capturing the relational dynamics between AYAs and their parents. Full article

Background: Simulation-based education (SBE) is a key component of nursing training. It enables students to apply theoretical knowledge in practice, expand their clinical understanding, develop critical thinking, improve communication skills, and build self-confidence. Increasing the number of simulation hours in nursing curricula may enhance students’ ability to manage stress in clinical settings. Methods: This was a cross-sectional comparative study involving 113 nursing students during a practical exam. Participants graduated in three consecutive years: 2020, 2021, and 2022. SBE was introduced into the curriculum in 2020, resulting in varying levels of simulation experience. Stress and anxiety markers were measured during the exam and compared across groups. Results: Greater simulation experience was associated with lower heart rate (p = 0.007), lower diastolic blood pressure (p < 0.001), and lower cortisol levels (p < 0.001). Students with two years of simulation training reported the lowest perceived stress (p = 0.031). However, anxiety levels remained high across all groups and did not differ significantly. Conclusions: The study showed that OSCEs are associated with elevated stress in nursing students. Students with greater exposure to simulation-based education had significantly lower stress and anxiety indicators. SBE appears to reduce stress and improve students’ preparedness for clinical assessments. Full article

Handover of patient care is the most common form of communication across hospitals. Enabling effective handover has been identified as a key priority for patient safety. This Human Factors Ergonomics socio-technical systems study aims to understand the current system of handover within departments, across departments, and at the interface of provider services, and then use this knowledge to co-design recommendations to enable resilience in clinical handover. The Systems Engineering Initiative for Patient Safety 3.0 (SEIPS3.0) framework is used to take a systems approach to observing clinical handover. Over 26 h of handover, involving 218 healthcare professionals handing over patient care across an acute hospital setting and at the interface of two external ambulance service systems, was observed. From these observations of clinical handovers, we co-designed—with the input of 41 medical, nursing, health, and social care professionals, quality and safety professionals, and patient partners—70 recommendations for enabling resilience in handover using two socio-technical systems analysis frameworks: SEIPS3.0 and the Cube. These 70 recommendations were inductively coded, and ten emergent properties that can support resilience in handover were identified, including person-centred care, multi-disciplinary team working, culture, communication, evidence-based practice, operations management, education, digitally enabled care, evidence-based design, and understanding context. This study contributes important knowledge for healthcare professionals and Human Factors Ergonomics practitioners on the systemic enablers of resilience in clinical handover in acute hospital settings. Full article

Background: As global populations age, the demand for effective and compassionate geriatric care has intensified. Humanized nursing emphasizes empathy and person-centered care, while community-based nursing builds on local resources and networks to support health and well-being. Together, these approaches offer promising strategies for improving care for older adults. This integrative review explores the evolution, clinical contributions, and implementation barriers of these models. Methods: A comprehensive literature search was performed using PubMed, CINAHL, Scopus, and Web of Science, targeting peer-reviewed studies, including qualitative and quantitative studies published between 2010 and 2025, that involved adults aged 60 years and older. Inclusion criteria emphasized humanized and community-based nursing interventions while excluding non-nursing and pediatric-focused studies. Quality appraisal was performed using CASP and JBI checklists, and data were thematically synthesized. Results: Evidence indicates that these care models significantly improve functional independence and psychosocial well-being and reduce hospital readmissions. For instance, community-based care in Taiwan improved activities of daily living in dementia patients by 15%, while U.S.-based programs reduced depressive symptoms by 30% among Latino older adults. Interdisciplinary, nurse-led interventions in South Korea and Puerto Rico showed a 22% reduction in readmissions and an 85% increase in care access. Despite these benefits, numerous barriers hinder widespread implementation, including workforce shortages, inadequate funding, fragmented healthcare systems, cultural resistance, digital literacy challenges, and policy constraints, particularly in low-resource settings such as the Philippines and Nepal. Conclusions: These findings underscore the transformative potential of humanized and community-based nursing while highlighting the need for targeted strategies such as task-shifting, inclusive technologies, and policy reform to advance equitable, sustainable geriatric care globally. Full article

By 2040, more than 80 million Americans will be aged ≥65, yet contemporary senior living communities still operate on a hospitality-first model developed for healthier cohorts three decades ago. This commentary argues that the next generation of senior living must pivot from hotel-style amenities to person-centric health platforms that proactively coordinate medical, functional, and social support. We outline four mutually reinforcing pillars. (1) Data infrastructure that stitches together clinical, functional, and social determinants of health enables continuous risk stratification and early intervention. (2) Ambient and conversational artificial-intelligence tools can extend sparse caregiving workforces while preserving resident autonomy. (3) Value-based contractual arrangements—for example, Medicare Advantage special-needs plans embedded within senior living sites—can realign financial incentives toward prevention rather than occupancy. (4) Targeted policy levers, including low-income housing tax credits for the “forgotten middle” and outcomes-based regulatory frameworks, can catalyze adoption at scale. Ultimately, re-architecting senior living around integrated technology, value-based financing and supportive regulation can transform these communities into preventive-care hubs that delay nursing home entry, improve quality of life, and reduce total cost of care. Full article

Background/Objectives: Hypodermoclysis has gained increasing recognition as a safe, effective, and minimally invasive method for administering medication and fluids in palliative care. Despite its advantages, its adoption remains limited, primarily due to a lack of structured training resources for healthcare professionals. This study aimed to develop and validate an educational tool for training clinical nurses in hypodermoclysis administration in palliative care. Methods: This is a methodological study with a multi-methods approach. Study development involved a needs assessment with 48 professionals, a literature review, and the creation of a manual enriched with visual aids. Results: The material was validated by expert judges, technical reviewers, and the target audience. Organized into 21 chapters, the manual comprehensively addresses technical, theoretical, and ethical dimensions of the practice. Content validation by 14 experts yielded an outstanding global Content Validity Index (CVI) of 0.95. An independent evaluation of visual design by four communication specialists produced consistently high scores (91–96%), classifying the material as “superior” in quality. Feedback from target users (12 nurses) highlighted the manual’s clarity, applicability, and relevance. All constructive suggestions were incorporated into the final version. Conclusions: The resulting manual demonstrates strong validity as an educational resource, with significant potential to standardize and enhance hypodermoclysis training in palliative nursing, promoting both safety and humanized care. Full article

This study aims to explore the effectiveness of a problem-solving method, grounded in Pólya’s methodological proposal and complemented by a STEM electronic educational kit, in strengthening the research competences of newly admitted nursing students at a public university in Peru. The research followed a quantitative approach using a quasi-experimental design with pre- and post-test measurements applied to a group of students who addressed real community health issues in their local context. The intervention was structured into four phases: understanding the problem, planning activities, execution, and reviewing the solution. The results showed significant improvements across all phases, particularly in problem analysis, autonomous planning, technological application, and critical thinking. The Wilcoxon test yielded p-values < 0.05 in all evaluated dimensions, allowing the rejection of the null hypothesis and confirming the effectiveness of the intervention. It is concluded that the problem-solving method, when integrated with relevant technological tools, is an effective strategy to promote formative research in vulnerable educational contexts. Moreover, it aligns with the Sustainable Development Goals—specifically SDG 4 (Quality Education) and SDG 10 (Reduced Inequalities)—by fostering inclusive, equitable, and contextually relevant education through socially and technologically meaningful innovation. Full article

Pain is a fundamental yet complex biological and psychosocial phenomenon. While acute pain serves as a defense mechanism, alerting the body to potential tissue damage, chronic pain loses this protective function and becomes a persistent, independent condition. Chronic pain in the elderly is particularly significant due to age-related changes in pain perception, a higher prevalence of comorbidities, and an increased susceptibility to pharmacological side effects. Diagnosing pain in older adults presents unique challenges owing to cognitive decline, multimorbidity, and impaired communication. This narrative review aims to summarize the current knowledge on chronic pain in the elderly, with a particular emphasis on diagnostic difficulties, therapeutic strategies, and the essential role of nurses in multidisciplinary management. Both objective scales and subjective assessment tools are essential for an accurate evaluation. Effective management requires a multidisciplinary approach that integrates individualized pharmacological and non-pharmacological therapies. Analgesic use must be tailored to account for altered pharmacokinetics and risks such as sedation or falls. Non-drug interventions, including physiotherapy and psychological techniques, are especially valuable in geriatric care. Nurses play a pivotal role in the recognition, assessment, and ongoing management of pain in this population. Developing age-appropriate, personalized strategies is essential for improving the quality of life in older adults living with chronic pain. Full article

Background: Genomic information is becoming integral to nursing practice, yet undergraduate curricula often provide limited opportunities to apply this knowledge in realistic settings. Objective: To evaluate the impact of a clinical simulation-based intervention on nursing students’ learning of genetic counseling, with a focus on knowledge acquisition, communication skills, and student satisfaction. Methods: A sequential mixed-methods study was conducted with 30 third-year nursing students enrolled in the elective Genetics Applied to Health Sciences. Quantitative data comprised (i) pre-/post-simulation knowledge tests, (ii) a satisfaction questionnaire, and (iii) final course grades, which were compared with grades of a cohort from the previous academic year that had no simulation component (n = 28). Qualitative insights were gathered through field notes and semi-structured interviews with six purposively selected participants. During the intervention each student rotated through the roles of genetic-counseling nurse, patient, and observer, followed by a facilitated debriefing. Results: Post-simulation knowledge scores and final course grades were significantly higher than both baseline values and the historical comparison cohort. Students reported very high satisfaction, highlighting the authenticity of the scenarios and the usefulness of immediate feedback. Qualitative analysis showed that role rotation fostered deeper understanding of counseling complexities, improved empathic communication, and bolstered self-confidence when discussing hereditary risk. Conclusions: Embedding standardized-patient simulation into undergraduate genetics courses measurably improves students’ knowledge, communication proficiency, and satisfaction. These findings support incorporating similar simulation-based learning activities to bridge the gap between theoretical genetics content and real-world nursing practice. Full article

Background/Objectives: Capnography monitoring in the Post-Anesthesia Care Unit (PACU) plays a crucial role in the early detection of respiratory complications, being fundamental for patient safety. It provides objective and continuous data on ventilation, enabling timely interventions to optimize health outcomes. This scoping review aims to map the available evidence regarding barriers and facilitators to the use of capnography for respiratory monitoring by nurses in the Phase I PACU. Methods: A scoping review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI). The search was performed in the MEDLINE and CINAHL Complete databases and the Portuguese Open Access Scientific Repository (RCAAP). Studies in Portuguese, English, and Spanish were included, with no time restrictions. The search strategy combined indexing terms and natural language, adapted to each database. Results: Seven studies were included in the sample. The main identified barriers were a high workload, perceived lack of patient adherence, and lack of knowledge. Key facilitators included the alarm sound, patient education, anticipating patient clinical instability, increased nurse confidence, perception of enhanced safety, targeted training for nurses, continuous improvement in care delivery, effective communication and feedback, promotion of sustainable care practices, and prior knowledge and exposure. Conclusions: The use of capnography in the PACU allows for respiratory function assessment and the early detection of clinical events. Its implementation should be based on current scientific evidence, promoting a culture of safety and quality improvement in patient care. Full article

Background/Objectives: The World Health Organization’s Surgical Safety Checklist (WHO SSC) is known to reduce surgical complications and mortality, yet its implementation remains inconsistent across institutions. This study evaluated compliance with a modified SSC and assessed the impact of structured interventions to improve adherence at the University Hospital of Split, Croatia. Methods: A before-and-after study analyzed a sample of 1437 completed SSCs over four time points between April 2024 and May 2025: the baseline and after three successive interventions (an official letter from the hospital director emphasizing mandatory SSC use, individual meetings with department heads and head nurses reinforcing its importance, and a quality audit review of SSC completeness with leadership). Checklist completeness was assessed across five SSC sections: General Information, Sign In, Time Out, Sign Out, and Staff Info. Results: Overall checklist completeness increased from 78.3 ± 8.5% at baseline to 86.3 ± 2.5%, 92.0 ± 3.8%, and 94.7 ± 4.8% after the first, second, and third interventions, respectively (p < 0.001). All checklist sections improved significantly: General Info rose from 91.1 ± 6.0% to 98.6 ± 2.6% (p < 0.001); Sign In from 85.0 ± 11.4% to 97.0 ± 3.5% (p = 0.002); Time Out from 79.0 ± 14.6% to 96.4 ± 6.5% (p < 0.001); Sign Out from 70.2 ± 11.2% to 87.7 ± 11.0% (p = 0.003); and Staff Info from 70.7 ± 12.9% to 100.0 ± 0.0% (p < 0.001). Post hoc testing confirmed significant gains versus baseline for all three interventions (Dunnett’s test), with a further significant improvement between the first and third interventions (Tukey’s HSD, p = 0.011). Conclusions: Structured, low-cost interventions emphasizing administrative support, education, and communication significantly improved SSC adherence across a large tertiary hospital. This initiative represents a pioneering effort in Croatia and offers a scalable model for similar public healthcare systems aiming to enhance patient safety. Full article

Introduction: Pain represents a significant threat to the physical and psychological well-being of children, negatively affecting their quality of life during hospitalization. Pain is considered the fifth vital sign and must be regularly assessed and managed, as also emphasized by the nursing code of ethics. The interdisciplinary approach to pediatric pain management includes both pharmacological treatments and non-pharmacological techniques (NPTs), taking into account the child’s age and specific needs. NPTs comprise a broad set of methods, ranging from simple to complex, that can be applied to children to help them manage pain. The main objective of this study was to explore and analyze which non-pharmacological methods are adopted by nurses in their clinical practice to relieve pain in school-aged children (6–12 years) undergoing surgery. Materials and Methods: This observational study involved nursing staff from pediatric wards in the Italian provinces of Ravenna, Forlì-Cesena, and Rimini, and used a validated online questionnaire. The study focused on school-aged children (6–12 years) who had undergone surgical procedures. The questionnaire included items on which NPTs nurses used to relieve pain in pediatric patients. Participants responded using a Likert scale from 1 (never) to 5 (always), and anonymity and voluntary participation were guaranteed. Data were collected between February and October 2024, involving the pediatric units of three hospitals in the provinces of Ravenna, Forlì-Cesena, and Rimini. Statistical analyses included t-tests, ANOVA, and Kruskal–Wallis tests to identify significant differences. Results: A total of 46 nurses completed the questionnaire. No significant differences were found between nurses’ backgrounds and the use of NPTs. Overall, nurses did report using NPTs, although there was limited use of such techniques in the preoperative phase. The study also highlighted a discrepancy in the information provided to children versus parents, with nurses tending to give more information to parents during the preoperative period. Notably, nurses who reported effective multidisciplinary collaboration were also those who better prepared children using NPTs. Conclusions: This study emphasizes the importance of NPTs in pediatric pain management and highlights the need to improve direct communication with children. Adopting an effective multidisciplinary approach is essential to ensuring a less traumatic surgical experience for young patients. Full article

In recent years, Italy has experienced a significant increase in violence against healthcare workers, mirroring a global trend. Manifesting as verbal, physical, psychological, and material aggression, this phenomenon endangers both personnel safety and the foundational principles of the National Health Service (SSN) as outlined in Article 32 of the Italian Constitution. The escalation—most acute in emergency departments, psychiatric units, inpatient wards, and community services—affects a broad spectrum of professionals, compromising care quality and institutional integrity. Data from the FNOMCeO-CENSIS Report 2023–2024 reveal over 18,000 reported incidents in 2024, with verbal assaults disproportionately affecting female nursing staff. The COVID-19 pandemic further exacerbated systemic vulnerabilities, heightening user dissatisfaction and psychological strain among healthcare providers. In response, legislative actions—such as Law No. 113/2020 and Decree-Law No. 137/2024—aim to strengthen prevention, monitoring, and penal measures. This article examines legal, institutional, and organizational responses, including on-the-ground and hospital-based strategies to mitigate violence. Adopting a multidisciplinary perspective, it analyzes recent policy developments, regional dynamics, and victim-perpetrator profiles, arguing that safeguarding healthcare environments is both a public security priority and an ethical imperative essential to preserving the dignity of care work and the resilience of the health system. Full article