This study aims to examine how the activation of nursing roles and professional identification as a nurse can influence moral judgments in terms of deontological and utilitarian inclinations. In Study 1, a priming technique was used to assess the impact of activating the nursing concept on moral reasoning. Participants were randomly assigned to either a nursing prime or neutral prime condition. By using a scrambled-sentences task, participants were prompted to think about nursing-related or neutral thoughts. Following the priming task, participants were asked to respond to 20 moral dilemmas. The process dissociation approach was employed to measure the degree of deontological and utilitarian tendencies in their moral reasoning. In Study 2, participants completed the nursing profession identification scale and the moral orientation scale before engaging in moral judgments similar to those in Study 1. The findings revealed that priming the concept of nursing roles resulted in an increase in deontological clinical inclinations, while having no significant effect on utilitarian inclinations. Additionally, a positive correlation was observed between identification with the nursing profession and deontological clinical inclinations, whereas a negative correlation was found with utilitarian inclinations. Deliberation orientation acted as a complete mediator in the relationship between nursing professional identification and deontological tendencies, and as a partial mediator for utilitarian tendencies.

Abstract: Women bear the biological responsibilities of reproduction to ensure human population sustainability, yet women continue to face discriminatory treatments when they become either pregnant or nursing mothers. The question is, how do we legally reconcile women’s natural child-bearing roles and support their professional endeavors? Against this backdrop, the Pregnant Workers Fairness Act (PWFA) and the Providing Urgent Maternal Protections (PUMP) were passed by the US government to address workplace biases and discrimination against women and help women during pregnancy and after childbirth. The paper is a commentary highlighting the strengths and weaknesses of these laws. We submit that while these laws mean a breakthrough for women in these categories, there are inherent flaws and areas for improvement. A limitation of the act is that the PWFA and PUMP laws do not protect pregnant women in an all-encompassing manner, with some pregnant women excluded. Pregnant and Nursing mothers should be protected by their employers regardless of the size of the organizations. We conclude that the PUMP and PWFA laws are not enough and there is a critical need for the government to address some of the critical barriers to the laws and provide an encompassing support for women.

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.

The coronaviral pandemic has led to a shift in traditional teaching methods to more innovative approaches, such as high-fidelity patient simulation (HFPS), which can improve students’ clinical judgement and decision-making for quality patient care. A modified guideline was introduced to enhance students’ satisfaction and self-confidence in learning through HFPS. The study involved 189 baccalaureate nursing students, with 92 in the intervention group and 97 in the control group. The intervention group received the modified HFPS guideline, while the control group received standard treatment with basic instruction. After the HFPS debriefing session, students provided narrative feedback on their learning experience. The quantitative results showed that students in the intervention group reported a significant improvement in satisfaction and self-confidence in learning compared to the control group. The modified HFPS guideline provided clear guidance for students to learn and apply knowledge and skills more effectively, leading to increased engagement during interactive simulation sessions. The results suggest that the HFPS guideline should be added to the curriculum to enhance students’ satisfaction and self-confidence in learning, even in junior students. Innovative teaching methods, such as HFPS, can be necessary and beneficial for healthcare professional training, after the pandemic.

Background Tuberculosis is a type of infectious disease that can cause death if treatment is not completed. the duration of tuberculosis treatment can reach 6 to 8 months so it really requires discipline when doing treatment. This makes tuberculosis patients in dire need of health information and social support which is very helpful in providing motivation, health information, and monitoring treatment from nurses. Aim of this literature review is to provide an overview of the The Role Of Nurses In Providing Social Support In Tuberculosis Treatment: Literature Review. Method is a literature review research, this study uses electronic database searches using keywords according to research questions from the online library PubMed, Content Science, and Science Direct. Result it was found that the role of nurses in the aspect of social support, namely in providing motivation, supervision, comfort, empathy, and information. this is very necessary for patients with tuberculosis at the time of treatment. Conclution social support is needed by tuberculosis patients who are currently undergoing treatment to provide motivation, health information, and as a nurse's supervision of patient adherence to tuberculosis treatment.

This study aimed to know the conditioning factors of the transition process to the self-care of women diagnosed with HIV/AIDS. This qualitative study was carried out from June to September 2015 with seven seropositive women, users of a specialized service in sexually transmitted diseases in the municipality of Imperatriz, Maranhão State, Brazil. For the data collection, an individual interview was used, and data analysis was performed by content analysis delineated by Hsieh and Shannon (2005). The resources that influence the self-care in the transition process of women with HIV/AIDS are represented by personal conditioning factors, such as the meaning they attribute to the living with the disease, personal attitudes and cultural beliefs, socioeconomic status, preparation and knowledge about the disease, and by conditioning factors found in the community and society. The transition theory can provide important insights about the resources present in the adaptation process of women diagnosed with HIV so that they can perform their self-care satisfactorily.

Escape room’s games are educational gamification technologies that consist of introducing a team of players into a physical or digital space to solve a mystery or a problem in search of clues to solve puzzles, riddles, or enigmas. This study aims to determine the effectiveness of escape room’s games on the training of nurses and nursing students. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms: "Education, Nursing" and "Educational Technology", and the free term "Escape room", combining with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n=15 interventional studies were included (n=2 Randomized Clinical Trials and n=12 quasi-experimental). Escape rooms are a recent and booming educational methodology, which is increasingly used in academia and training of nurses and nursing students; however, it is necessary to expand their use to more countries, as well as the number and quality of interventional studies, being necessary to homogenize and standardize criteria and to use validated instruments to evaluate the effectiveness of escape rooms in the field of nursing.

Introduction: This study aimed to identify factors associated with late diagnosis and clinically monitor newly diagnosed HIV/AIDS patients. Method: Retrospective longitudinal study, based on secondary data from a specialized unit at a tertiary hospital. Data collection included sociodemographic, behavioral, clinical, and laboratory data of newly diagnosed HIV patients between 2015-2019. Data analysis adopted inferential statistical tests using the SPSS program, considering α ≤ 0.05. Results: 314 individuals were newly diagnosed with HIV/AIDS. 70.3% (208) had a late diagnosis, and 57.1% (169) were diagnosed very late. There was an association of the very late diagnosis with the variables sex and education and with origin, entry, occurrence of opportunistic diseases, use of ARV therapy, and death, associated with late and very late diagnosis, respectively. The results of the regression model indicate that males had 2.28 [95% CI 1.11 - 4.46] higher chances of having a late diagnosis compared to females. Conclusions: This study evidenced a high prevalence of late and very late diagnoses in newly diagnosed male HIV patients who presented with opportunistic diseases, requiring hospitalization, and having a significant risk of progressing to death.

Background: Nursing home residents (NHRs) have special needs and may experience reduced functionality, higher sedentary behavior time (SBT) and decreased physical activity (PA). This study aimed to characterize NHRs based on SBT, PA, and functional performance (FP), and to identify associations between these factors. Methods: Cross-sectional study with 65 NHRs aged ≥60, evaluated by accelerometer (SBT, PA) and the following tests: Timed Up and Go (TUG), Short Physical Performance Battery (SPPB), Barthel Index (BI), and Mini-Mental State Examina-tion (MMSE). Health-related variables and anthropometry were assessed. The FP (TUG, SPPB, BI), SBT, PA intensities were used for K-means clustering analysis. Results: The cluster analysis identified: C1 – better FP, shorter SBT, and longer time in PA intensities; C2 - lower FP, longer SBT, and shorter time in PA. In addition, C2 were older, with lower MMSE, lower body mass index, and walking aids use. The SBT showed a negative weak correlation with BI. The moderate PA (MPA) was moderately correlated with the SPPB and strongly correlated with the TUG and BI. Conclusions: MPA is strongly associated with better FP and independence. NHRs have dif-ferent physical and cognitive profiles, which indicates the need for personalized strategies to prevent disability and increase PA.

Introduction: Emotional intelligence plays a critical role in nursing leadership, influencing organizational dynamics and patient care. However, there is limited understanding of the impact of Emotional Intelligence on leadership in Primary Health Care in the Greek context. Methods: A longitudinal experimental design assessed the effects of an educational intervention on EI and leadership among Greek Primary Health Care nurses. Questionnaires, including the Wong and Law Emotional Intelligence Scale (WLEIS) and Multifactor Leadership Questionnaire - form 5x (MLQ), were administered pre- and post-intervention. Results: The intervention group exhibited significant improvements in Emotional Intelligence and adoption of transformational leadership styles compared to the control group. Tables highlighted nuanced changes in leadership dynamics post-intervention. Conclusions: Educational interventions effectively enhance nurses' Emotional Intelligence and influence leadership styles, emphasizing the need for tailored professional development programs in nursing education.

ABSTRACT: Psychological vulnerability (PV) and low mental health literacy correlate negatively with higher education students' positive mental health and health behaviours. Levels of mental health literacy limit self-help, adaptative coping strategies and academic success. However, few studies examine the significant differences between students' PV, mental health literacy, positive mental health (PMH) and modifiable behaviours variables. Identifying modifiable vulnerability factors is essential when seeking and providing professional help. Method: A cross-sectional descriptive study was conducted to investigate the differences between modifiable behaviours and PV, mental health literacy, and PMH in higher education students. A sample of 3,600 undergraduate students was recruited, mostly female (78.8%), with an average age of 23 years (SD = 6.68). Results: The majority were women, did not exercise, were dissatisfied with sleep quality time per night (62.1% sleep less than 7 hours per night) and did not engage in leisure activities. Also, most respondents had PV and low literacy levels, particularly at F1, and 67.9% scored in the flourishing group. Results showed significant differences (p<0.001) between gender, age, sleep, exercise, diet, leisure activities and PV, and PMH and literacy. Conclusions: The results identified modifiable vulnerability factors that underpin the design of intervention-targeted programmes to promote literacy and PMH in higher education campuses in Portugal to foster students’ well-being and self-help strategies.

AI (Artificial Intelligence) chatbots has been widely applied. AI (Artificial Intelligence) chatbots has been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills, facilitate students' understanding of complex concepts in healthcare education: (1) Background: There is currently less emphasis on its application in nursing education. The application of ChatGPT in nursing education needs to be verified; (2) Methods: A descriptive study is used to analyze the scores of ChatGPT on the registered nurse license exam(RNLE) and compare to the pass rate of candidates in Taiwan; (3) Results: The average score of four exams were around 51.6 to 63.75 by ChatGPT, and pass the RNLE in 2022 1st and 2023 2nd. However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucinations; (4) Conclusions: ChatGPT may have potentially to assist with nursing education. Although AI can simulate human behavior in context, it still cannot replace human creativity, critical thinking, and clinical reasoning.

One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence negatively altered satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This cross-sectional report is part of a before/after intervention study using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study we present the results of the first audit including 719 UTI cases, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on management of UTIs, to mitigate indiscriminate antibiotic use in asymptomatic cases.

Knowing the symbolizations constructed in people's consciousness, based on lived experiences, is crucial to understanding how they structure their lives. Palliative Sedation (PS) integrates treatment in terminal palliative care, with the purpose of offering support and relief of refractory symptoms that may occur at the end of life. This study aimed at interpreting psychic fantasies that permeate thoughts, as reported by a sample of nurses when administering palliative sedation to patients in the final stage of life. This is a clinical-qualitative study conducted in a large hospital in the city of São Paulo (state of São Paulo, Brazil), a national reference in oncology. The study included 11 nurses working in the care of cancer patients. For data collection, we used the technique of SDIOQD – Semi-Directed Interview with Open-ended Questions in-Depth. The treatment by CQCA - Clinical-Qualitative Content Analysis is grounded on psychodynamic concepts. The interpretation of the meaning cores found in the interviews, complemented by observation of the para-verbal and nonverbal manifestations of the interviewees, led to the construction of three categories: (1) to symbolically serve death on a tray; (2) the act of sedation and its unfortunate coincidences; (3) palliative sedation as an agent of mercy death. This study suggests that nurses face dilemmatic situations, going through periods of self-questioning and moments of the ambivalence of feelings of beneficence and maleficence. When sedating a patient, the nurses envision to be offering dignity in death. Euthanasia fantasies in the process of administering sedation are latent in consciousness.

Background: Chronic disease is the leading cause of death and disability in children. Various complex stressors faced by children due to illness and a series of treatments can negatively impact children's welfare, which can negatively affect children's quality of life.Objectives: This literature aims to study the philosophy of spiritual-based care interventions to improve the quality of life of children with chronic diseases viewed from three philosophical perspectives, namely ontology, epistemology, and axiology.Methods: A literature search was performed on five databases, namely SCOPUS, PubMed, ProQuest, ScienceDirect, and SAGEPub. Population limitations and diagnoses in this literature of children with chronic disease. This research is a quantitative study focusing on publications between 2017-2021.Results: The philosophy of spiritual care intervention is humanistic, pragmatic, and religious intervention. Humanistic interventions are interventions in which nurses are actively involved in spiritual care. Pragmatic intervention is the activeness of a nurse in assessing the spiritual needs of patients. Meanwhile, religious intervention is an intervention that is directly related to the practice or ritual of a specific belief system. Spiritual care is an essential part of holistic care, which is considered an indicator of improving the quality of care. It will ultimately affect the optimal quality of life of children.Conclusion: Spiritual-based care interventions are essential to improve the quality of life of children with chronic diseases. Spiritual care given to children with chronic illnesses must consider all aspects such as developmental stage, life experience, and socio-cultural of the child.

Background: It is clear that breastfeeding is the gold standard of infant feeding because of the many advantages it offers to both the child and the mother. Objective: to identity the main reasons for cessation breastfeeding declares by the mother themselves during the first year. Design: A prospective cohort study was conducted, recruiting 969 newborns in a third level hospital in Spain. The main maternal variables studied were: maternal age, parity, educational level, work occupation, smoking habit, gestational age, birth, weigh, feeding type, and duration of breastfeeding. All the participants were followed for a year to determinate the duration of breastfeeding and to know the reason of the abandonment. Results: At 6 months, the percentage of maternal lactation was cut in half and only 24.6% of these mothers maintain. Mainly 15.80% of the mothers decide to give up the exclusive maternal lactation of their own free desire, and 15.41% because they suspect hypogalactia. The work cause is the third reason of abandonment in both cases. Conclusions: Our results show the need to improve the health policies of promotion, protection and support the initiation of breastfeeding. In particular, our results show the importance of the work factor with particular emphasis on improving conciliation measures.

There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions of how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. Twenty patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size suggesting, each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) (https://osf.io/9np8v/) prior to recruiting the first participant.

Introduction. The outbreak of the COVID pandemic was a period of uncer-tainty and tension for healthcare managers, resulting from the lack of knowledge, i.e. about the transmission of the virus, but also from the lack of uniform organisational and treatment procedures. It was the period where the ability to prepare to a crisis situation, to adapt to the existing conditions and to draw conclusion from the situa-tion were critical to keep ICUs operating. The aim of this study was to show the prep-aration of an ICU in Poland to ensure resilience, and also the methods of reacting dur-ing the COVID-19 pandemic on both central and local level. Methods. Based on the EC and WHO guidelines on resilience a matrix of 6 elements and 13 standards as-signed to them was created, with a series of questions from a survey questionnaire. Results. Good management in resilient systems is free access to any resource. A free and transparent flow of information and also well motivated human resources in an appropriate number. Conclusion. Appropriate preparation, adaptation to the existing situation and effective management of crisis situations is an important element of ICU resilience.

This study was undertaken to investigate and analyze noise pollution in a large Chinese governmental hospital’s medical intensive care unit and compare to the WHO guidelines.This cross-sectional study was conducted in a MICU at a public governmental teaching hospital in Fujian province between July and August of 2017. A WENSN® WS1361 Integrated Sound Level Meter (China) was used for continuous every five seconds one week noise levels recording. After this measurement, the decibel meter was used for recording different location of isolation rooms and open bays, including occupied and unoccupied patient, and recording sound events occurs in the ICU to identify sources of noise. Peak and average noise levels were obtained from the meter, and data were downloaded from the WS1361 into a laptop computer. The measured mean equivalent sound pressure levels (L) and standard Aeq deviation over one week period were 66.64±7.57 dB(A), with acute spikes reaching 119.7 dB(A), the average sound level for a 24 hour period in a work day was 68.03±5.07 dB(A). These are higher than the current daytime environmental noise limit of 40-45 decibels in China and WHO. Mean work day noise was significantly louder than weekend time, there was a significant difference in work days and weekend (t=16.85;P=0.000).There was a statistical difference between the day time and night time shifts (t=34.67;P=0.000). The isolation rooms were significantly quieter than the open-bay rooms(t=46.15; p=0.00), sound levels in the occupied and unoccupied rooms also had significant difference(t=17.26; P=0.000).Two types of noise resources, including twenty kinds sources were identified and measured, mean noise levels ranged from of 61.33 to 79.21 dB(A). This study shows noise levels in intensive care units were exceeded the recommended. The study of the influence of noise on patient and staff is needed, and noise reduction strategies must be conduct in ICU.

The interactions between work and personal life are important for ensuring well-being especially during COVID-19 where the lines between work and home are blurred. Work-life interference/imbalance can result in work-related burnout, which has been shown to have negative effects on faculty members’ physical and psychological health. Although our understanding of burnout has advanced considerably in recent years, little is known about the effects of burnout on nursing faculty turnover intentions and career satisfaction. Thus, this study aimed to test a hypothesized model examining the effects of work-life inference on nursing faculty burnout (emotional exhaustion and cynicism), turnover intentions and ultimately, career satisfaction. A predictive cross-sectional design was used. An online national survey of nursing faculty members was administered throughout Canada in Summer 2021. Nursing faculty who held full-time or part-time positions in Canadian academic settings were invited via email to participate in the study. Data was collected from an anonymous survey housed on Qualtrics. Descriptive statistics and reliability estimates were computed. The hypothesized model was tested using structural equation modeling. Data suggest that work-life interference significantly increase burnout which contribute to both higher turnover intentions and lower career satisfaction. Turnover intentions in turn was negatively associated with career satisfaction. The findings add to the growing body of literature linking burnout to turnover and dissatisfaction, highlighting key antecedents and/or drivers of burnout among nurse academics. These results provide suggestions for suitable areas for the development of interventions and policies within the organizational structure to reduce the risk of burnout during and post-COVID-19 and improve faculty retention.

Colonoscopy, essential for diagnosing and treating colorectal cancer, relies on effective bowel preparation to inspect the colonic mucosa fully. Traditional education methods include printed instructions and verbal explanations, but these may not ensure clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. Using the outpatient’s Android mobile device, the mobile health care model is provided as a nursing guide to assist in bowel preparation for colonoscopy. This single-blinded, randomized trial en-rolled patients for colonoscopy at a Northern Taiwan gastroenterology center. Eligible patients were physically and mentally healthy and could communicate in Chinese. The study tested the ColonClean app during bowel preparation. After the procedure, endoscopists rated the prepara-tion quality using the Aronchick Scale. Data analysis with SPSS software (version 25.0) evaluated if the app significantly improved bowel preparation compared to those who did not use it. Forty patients were recruited for both the control (conventional method) and experimental (conven-tional method plus ColonClean app) groups. In the experimental group, endoscopists assessed bowel preparation quality; all achieved at least "Fair," with 75% receiving "Excellent" or "Good" ratings. The ColonClean App enhanced bowel preparation quality more effectively than tradi-tional nursing guidance.

The article addresses the importance of nutrition in the health of the elderly population and focuses on the qualitative evaluation of menus provided by a social solidarity institution in Portugal, in order to prevent and/or treat malnutrition or the risk of malnutrition in this vulnerable population. The methodology involves the evaluation of four weekly menus, totalling 28 complete daily menus for the elderly, using the “Avaliação Qualitativa de Ementas para a População Idosa” (AQEDI) tool. The assessment grid is organized into six domains (general items, soup, protein suppliers, carbohydrate supplier side, vegetable side and dessert), each composed of various parameters. The results indicate that all menus were classified as "acceptable”, with percentages ranging from 60.73% to 68.84%, and suggests that while the menus are deemed acceptable, there is room for improvement. Recommendations include increasing the presence of eggs and including seasonal fruits daily, avoiding canned fruit. The study emphasizes the need for coordinated efforts within the institution to enhance menu planning, considering both nutritional guidelines and the sensory aspects of food. Coordination efforts within the institution are crucial for preserving positive aspects and addressing inadequacies in menu planning.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

Emotional intelligence can contribute to quality of life and as a health predictor. The aim of this study is to analyze emotional intelligence, quality of life and the correlation factors associated in patients undergoing chronic hemodialysis. A quantitative, observational, cross-sectional design was performed, and one hundred and thirty-eight multi-centers hemodialysis patients were recruited. A battery of questionnaires, including Trait Meta-Mood Scale (TMMS-24), Kidney Disease Quality of Life-Short Form (KDQOL-SF), and an ad-hoc sociodemographic questionnaire, were answered. Sex differences existed when assessing the three dimensions of emotional intelligence: ranked by order, the highest scores in males were in clarity, repair, and attention. However, in females were in repair, clarity, and attention. Males had higher scores than females in emotional role (p=0.045). Younger participants had better scores in all physical functions (p=0.001) and vitality (p=0.038) than older. Moreover, those who had a higher level of education presented better physical function (p=0.027) and higher scores in emotional wellbeing (p=0.036). Finally, in females, emotional attention (p=0.046) and repair (p<0.001) were strongly associated with general health perception. The assessment of emotional intelligence considering sex differences in patients undergoing chronic hemodialysis can be an indicator of quality of life including the use in health interventions.

Background: Misconceptions and knowledge gaps about antibiotic use contribute to inappropriate antibiotic use and antimicrobial resistance. Aim: Identifying and prioritizing misconceptions and knowledge gaps about antibiotic use from a healthcare professionals’ perspective. Methods: A modified Delphi study of two rounds with an expert meeting. A literature search was conducted to create statements about misconceptions and knowledge gaps about antibiotic use. These were rated by healthcare professionals from five EU countries representing general practice, out-of-hour services, nursing homes, and pharmacies. Consensus was achieved if ≥80% of the participants rated 4+ on a five-point Likert scale during the second Delphi round. Results. In total, 44 misconceptions were identified through the literature search within four themes: 1) antimicrobial resistance in general, 2) use of antibiotics in general, 3) use of antibiotics for respiratory tract infections, and 4) use of antibiotics for urinary tract infections. Consensus was reached for more than half of the statements within each setting. Conclusions. Experts from different settings and nationalities acknowledge that multiple misconceptions and knowledge gaps can contribute to inappropriate use of antibiotics in the community. These results provide valuable information to use in educational campaigns for patients and healthcare professionals to improve the use of antibiotics.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of professional nurses in maintaining service standards under new governance.We conducted the study at sub-district health-promoting hospitals using a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes. We collected data from 340 nurses and 400 patients using structured questionnaires. We divided the questionnaires into seven sections, which captured a range of metrics such as the personal data of nurses, hospital service activities, and leadership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality. We used paired t-tests to compare performance metrics before and after the administrative transfer, one-way ANOVA to assess variability among different service units, and binary logistic regression to identify key determinants of service quality in our statistical analysis. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited minimal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities. This could contribute to improved healthcare delivery across restructured health systems.

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

Aim: this scoping review was designed to identify studies that assess the adverse drug reactions (ADRs) for older people in Australian aged-care facilities. This review critically evaluated each published study to identify the risk of, or actual adverse drug events in older people. Inclusion criteria: This review considered any clinical studies that examined the adverse effects of medications in older people who were living in aged-care facilities. This review considered qualitative studies, analytical studies, RCTs, descriptive cross-sectional studies, and analytic observational studies that explored the use of medications and their adverse effects on older people in clinical settings (including aged care facilities). Methods: An initial search of the PubMed, OvidSP, EBSCOHost, MEDLINE, ScienceDirect, Wiley Online, SAGE, and SCOPUS databases, with full text was performed, followed by an analysis of the article’s title and abstract. Additionally, MeSH was used to describe the article. The initial round of the database search was based on inclusion criteria from studies that assessed tools or protocols aiming to identify the adverse effects of medications on the elderly population suffering chronic conditions or multiple co-morbidities. Two reviewers screened the retrieved papers for inclusion. The data presented in this review are in tabular forms and a narrative summary which aligns with the review’s objectives. Results: Seven studies were identified, and the extracted data from these studies were grouped according their characteristics and the auditing results of each study. Conclusion: There was no comprehensive or broadly adverse drug reaction assessment tool derived from Australian data that has been used on the elderly in an Australian healthcare setting.

Background: The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. Objective: Evaluate ex-ante whether the benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters with ultrasound-guided peripherally inserted central catheters and midline catheters by a vascular access specialist team outweigh their costs. Methods: Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when replacing peripherally inserted central catheters, midline catheters and peripheral venous catheters with ultrasound-guided peripherally inserted central catheters and midlines, as well as the additional resources required for their use. Results: Each ultrasound-guided peripherally inserted central catheter replacing a peripherally inserted central catheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, each ultrasound-guided midline catheter replacing a midline, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. Conclusion: The benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters by introducing a vascular access specialist team trained in the implantation of ultrasound-guided peripherally inserted central catheters and midline catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of healthcare-associated infections. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for Legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

The SARS-CoV-2 virus that causes the COVID-19 disease has wreaked havoc on the world community in terms of every imaginable parameter. The research output on COVID-19 has been nothing short of phenomenal, especially in the medical and biomedical sciences, where the search for a potential vaccine is being conducted in earnest. Much of the advanced research has been distributed in the leading medical journals, including the Journal of the American Medical Association (JAMA), where the latest research is distributed on a daily basis. The purpose of this paper is to provide some perspectives on 44 interesting and highly topical research papers that have been published in JAMA, at the time of writing, within the past two weeks. The diverse topics include public health, general medicine, internal medicine, oncology, paediatrics, geriatrics, and biostatistics.