1,721,007 research outputs found
What can we learn from retracted studies in the nursing field in the last 20 years? Findings from a scoping review
No full textBackground and aim of the work: Literature reviews have summarised the number of retracted studies and guidelines have been developed to prevent this issue. However, available data are scarce in the nursing field. Learning from other experiences may be able to increase awareness of the issue and prevent avoidable errors. Therefore, the intent of this study was to map retracted articles in the nursing field by investigating the reasons for retractions in order to elicit strategies to prevent their occurrence. Methods: A scoping review was performed by searching PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) for articles published from 2001 to 2021. Quantitative primary and secondary studies related to the nursing field and written in English, with a "retracted article" message and/or presenting a retraction notice, have been included. The main reasons for retraction have been recorded, as well as the main features of the studies retracted. Results: Out of 274 studies, we detected 26 retractions, of which eight were literature reviews and seven were experimental studies. Editors were the most frequent party requiring retraction. The retracted studies originated from 11 countries and were mostly published (n = 19) in general nursing journals. Scientific misconduct was the main cause of retraction (n = 18), while the remaining retractions were due to other types of errors. Conclusions: Most of the study retractions were issued by editors and originated mostly from high-scientific output countries. Scientific misconduct represented the principal cause of retraction; from these failures, educational strategies have been identified in order to prevent issues and to increase awareness among researchers and healthcare professionals
How do undergraduate nursing students learn to care for families and informal caregivers? A qualitative study with a grounded theory approach
No full textBackground: Nurses play a crucial role in caring for families of ill individuals in care, requiring high-quality relational and communication skills to care for them. Yet these skills remain underutilized, leading to reported issues of inadequate inclusion and communication. Education is crucial to enhance nurses' competencies in caring for families and informal caregivers. Aim: To explore the learning process of undergraduate nursing students to care for families and informal caregivers. Design: Qualitative study with a grounded theory approach. Settings: Bachelor's degree in nursing from two off-sites of a university and four local health units collaborating with the university in North Italy. Participants: 15 undergraduate nursing students, 10 nurse preceptors, and 10 nurse clinical teachers. Methods: We adopted initial and theoretical sampling and conducted semi-structured interviews from December 2023 to January 2024, lasting 16 to 62 min. The interviews were audio-recorded, transcribed verbatim, and analysed through open, selective, and theoretical coding. Results: We developed a theory of learning for undergraduate nursing students in caring for families and informal caregivers, comprising two themes, "Learning areas" and "Learning antecedents," and nine categories. Learning areas involve five stages of learning to care for families and informal caregivers and the most frequent opportunities to interact with families and informal caregivers. The five stages are "Seeing and considering families and informal caregivers", "Assessing the families' and informal caregivers' needs and resources", "Preparing for and planning intervention with families and informal caregivers", "Acting with families and informal caregivers", "Reflecting on the intervention with families and informal caregivers". Learning antecedents encompass student characteristics, interpersonal relationships, and the clinical training setting. Conclusions: In this study, we delineate a five-stage learning process for undergraduate nursing students to care for families and informal caregivers, influenced by individual, interpersonal, and contextual factors. We emphasised the importance of relational skill development, tailored learning experiences, and supportive mentorship in enhancing students' preparedness to engage with and support families in healthcare settings. The developed theory provides a foundational framework for designing educational interventions to optimise nursing students' capacities in this domain
Organisational models in primary health care to manage chronic conditions: A scoping review
Full text linkChronic diseases are increasing incessantly, and more efforts are needed in order to develop effective organisational models in primary health care, which may address the challenges posed by the consequent multimorbidity. The aim of this study was to assess and map methods, interventions and outcomes investigated over the last decade regarding the effectiveness of chronic care organisational models in primary care settings. We conducted a scoping review including systematic reviews, clinical trials, and observational studies, published from 2010 to 2020, that evaluated the effectiveness of organisational models for chronic conditions in primary care settings, including home care, community, and general practice. We included 67 international studies out of the 6,540 retrieved studies. The prevalent study design was the observational design (25 studies, 37.3%), and 62 studies (92.5%) were conducted on the adult population. Four main models emerged, called complex integrated care models. These included models grounded on the Chronic Care Model framework and similar, case or care management, and models centred on involvement of pharmacists or community health workers. Across the organisational models, self-management support and multidisciplinary teams were the most common components. Clinical outcomes have been investigated the most, while caregiver outcomes have been detected in the minority of cases. Almost one-third of the included studies reported only significant effects in the outcomes. No sufficient data were available to determine the most effective models of care. However, more complex models seem to lead to better outcomes. In conclusion, in the development of more comprehensive organisational models to manage chronic conditions in primary health care, more efforts are needed on the paediatric population, on the inclusion of caregiver outcomes in the effectiveness evaluation of organisational models and on the involvement of social community resources. As regarding the studies investigating organisational models, more detailed descriptions should be provided with regard to interventions, and the training, roles and responsibilities of health and lay figures in delivering care
Reasons to Access the Emergency Department by Patients Who Receive Palliative Home Care: A Scoping Review
No full textBackground: The progressive aging of society has increased the prevalence of chronic, incurable diseases, creating a critical need for palliative care programs. Palliative home care services are essential for patients facing severe symptoms and barriers to accessing health care facilities. Despite this, many patients receiving palliative home care services still access emergency departments (EDs). Objectives: This scoping review aimed to investigate ED visits among patients under palliative home care services, examining factors influencing access, patient characteristics, and leading reasons for ED visits. Methods: A scoping review was conducted by performing a systematic search of Scopus, PubMed, CINAHL, and PsycINFO between 2013 and 2024. Studies focusing on emergency access among adult patients older than 18 years cared for by a palliative home care service were included. Results: Eight retrospective studies across Italy, China, Canada, Australia, and Ireland were included. The studies revealed significant variability in ED visit rates, ranging from 8.6% to 69.15%, with cancer as the predominant diagnosis among patients. Dyspnea, pain, and fever were commonly cited reasons for ED visits, indicating potential gaps in symptom management at home. Discussion: The review highlights the importance of early enrollment in palliative home care services, multidisciplinary care, and better caregiver education to reduce unnecessary ED visits. The findings underscore the need for further research on predictive factors, avoidable versus unavoidable ED visits, and strategies for optimizing home-based palliative care to enhance patient outcomes and quality of life
To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review
No full textAIMS AND OBJECTIVES: To establish whether, and to what extent, tools measuring Unfinished Nursing Care (UNC) that have been validated to date have the ability to detect the discrete elements of the 'Integration of care' dimension of The Fundamentals of Care Framework (The Framework).BACKGROUND: UNC and The Framework have been established as two separate research lines, focused on (a) omitted care and related tools, and (b) on how to improve patient care, respectively. However, no attempts have been made to date to establish whether, and to what extent, tools measuring UNC have the ability to represent the discrete elements of The Framework.DESIGN: A two-step study: (a) a secondary analysis of a systematic review up to June 2018 later updated in May 2020, followed by (b) a comparative analysis.METHODS: A systematic review of studies on validated tools measuring UNC was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysesguideline. Then, researchers independently performed a comparative analysis between the extracted (a) discrete elements of The Framework and (b) items of the UNC tools retrieved.RESULTS: A total of 14 tools were analysed. The physical dimension of The Framework was the one mostly covered by UNC tools (up to 87.5% with the Perceived Implicit Rationing of Nursing Care). The Norwegian Basel Extent of Rationing of Nursing Care showed the highest level of representation (41.6%) for the psychosocial dimension. Only the Perceived Implicit Rationing of Nursing Care and the Unfinished Care tool measure the relational dimension (22.2%, respectively). By considering all elements of the 'Integration of care' dimension, the Perceived Implicit Rationing of Care had the highest percentage of convergence (41%).CONCLUSION: Not all UNC tools have the same ability to represent the discrete elements of The Framework. Moreover, physical needs are more often detected in UNC tools compared to the relational and psychological ones.RELEVANCE TO CLINICAL PRACTICE: Unfinished care tools validated to date can represent a body of knowledge on which to build The Framework metrics, especially for the physical dimensions
Effectiveness of digital health interventions for chronic conditions management in European primary care settings: Systematic review and meta-analysis
Full text linkBackground: The past decade has seen rapid digitalization of healthcare, significantly transforming healthcare delivery. However, the impact of these technologies remains unclear, with notable gaps in evidence regarding their effectiveness, especially in primary care settings. Objective: This systematic review assesses the effectiveness of digital health interventions versus interventions without digital components implemented over the last 10 years in European primary care settings for managing chronic diseases. Methods: Following Cochrane guidelines, we conducted a systematic review with meta-analysis. We searched multiple databases for randomized controlled trials. Inclusion criteria encompassed studies on digital health interventions for chronic disease management in primary care settings in Europe, evaluating outcomes such as hospitalizations, quality of life, and clinical measures. Data extraction and quality assessment were independently conducted by two authors, with discrepancies resolved by a third author. The certainty of the evidence was judged according to the Grading of Recommendations, Assessment, Development, and Evaluation approach. Results: From 9829 records, 23 studies were included, with most studies conducted in the UK and Spain. The most investigated conditions were type 2 diabetes and hypertension. Interventions mainly focused on patient monitoring, self-care education, and digital communication tools. The risk of bias was low to moderate for most studies. Meta-analyses showed no significant differences between digital health interventions and usual care for hospitalizations, depressive symptoms, anxiety, HbA1c, diastolic blood pressure, weight, or quality of life, except for a small improvement in systolic blood pressure. Conclusion: Digital health interventions have not yet demonstrated substantial benefits over traditional care for chronic disease management in European primary care. While some improvements were noted, particularly in systolic blood pressure, the impact remains limited. Further research is needed to enhance the effectiveness of digital health interventions, address current methodological limitations, and explore tailored approaches for both specific patient populations and multimorbid populations
What knowledge is available on massive open online courses in nursing and academic healthcare sciences education? A rapid review
Full text linkBACKGROUND: With the recent challenges due to the Coronavirus 2019 outbreak, distance learning has been largely introduced in healthcare sciences curricula, and universities have been called upon to share learning opportunities with each other to ensure continuity of education and delivery of new graduates to the health system. However, decisions about its introduction should be supported by up-to-date evidence capable of providing an overview of available knowledge. OBJECTIVES: To map the (a) state of research on massive open online courses in undergraduate and postgraduate health sciences education, (b) evaluation methods and tools used to measure learning outcomes, and (c) factors increasing their effectiveness as documented to date. DESIGN: A rapid review following the preferred reporting items for systematic reviews and meta-analysis guidelines. METHODS: PubMed, the Cumulative Index to Nursing and Allied Health Literature, Cochrane, Scopus, PsycInfo and Medline (via Ovid) were searched. Primary studies reporting one or more massive open online course (1) devoted to undergraduate and/or postgraduate students in nursing and healthcare sciences (2), written in English (3) with abstract available (4) and published up to February 18th, 2020 were all included. After having assessed the need for a review and the topic itself (a), the literature search was performed (b), studies were screened and selected (c), data was extracted (d), and the findings were summarised (e). RESULTS: Thirty-six studies emerged with mainly an explorative/descriptive or case study design. The courses have been developed mainly by universities alone or in collaboration with institutions mainly in US, Sweden and the UK. Their delivery has been performed at multi-national levels, mainly in English, and with a number of participants ranging from 45 to >23,000. The duration spanned from two weeks to six months on clinical topics (e.g., emergency medicine) to methods (e.g., statistics). The target audience has been mainly mixed, including students, healthcare professionals, and lay citizens. Evaluation methods and tools have been described in 28 studies, and multiple-choice questions were most frequently adopted. Factors affecting the effectiveness of massive open online courses have been identified analysing the courses themselves and the participants. CONCLUSION: Massive open online courses have recently started to be studied in healthcare sciences: these can be useful to educate students, mainly as elective courses, and to educate a massive audience, thus embodying the third mission of the university. The complexity of factors increasing effectiveness suggests the need for a multidisciplinary approach both in their design and implementation
L’integrazione degli infermieri nei team di Medicina Generale: il punto di vista dei Medici di Medicina Generale [The team-based care models in primary care: General Practitioners' perspectives on nurses' role.]
No full textRiassunto. Introduzione. Da circa un decennio in Italia si sono sviluppati vari modelli di cure primarie territoriali che prevedono l'inserimento di infermieri nei team di medici di medicina generale (MMG). Obiettivi. Indagare esperienze ed aspettative dei MMG rispetto ai livelli di autonomia e interdipendenza dell'infermiere inserito nei team di medicina generale. Metodi. Studio esplorativo in 2 fasi: 1) focus group con un campione propositivo di 12 MMG per individuare le tipologie di utenti/problemi e di attività affidabili agli infermieri; 2) costruzione di un questionario ad hoc per indagare il grado di autonomia/interdipendenza assegnato agli infermieri dai MMG per le diverse tipologie di utenti/problemi e attività. Il questionario è stato somministrato ad un campione di convenienza di 45 MMG, che sono stati poi intervistati per comprendere le motivazioni delle loro scelte. Risultati. I MMG riconoscono autonomia agli infermieri: nell'accertamento, monitoraggio e educazione sugli stili di vita, sulla prevenzione delle cadute, della malnutrizione e sulla compliance ai trattamenti; nell'esecuzione di attività tecnico-assistenziali e organizzative. Ritengono necessario garantire supervisione o fornire indicazioni agli infermieri nella gestione dei pazienti cronici, soprattutto nell'accertamento di segni e sintomi di riacutizzazione, nel monitoraggio e follow-up e in parte anche nei contenuti dei programmi educativi. Infine, ritengono di loro competenza la gestione dei pazienti pluri-patologici e instabili, ad esempio con scompenso cardiaco, in quanto quadri clinici che possono evolvere repentinamente e caratterizzati da notevole imprevedibilità. Conclusioni. I MMG esprimono un forte orientamento all'interdipendenza operativa, che viene modulata in rapporto all'instabilità e complessità clinica degli utenti.INTRODUCTION: In the last decade in Italy, different team-based primary care models have been developed that involve the collaboration of General Practitioners (GPs) with other professionals, such as nurses. AIMS: To investigate the GPs attitude towards the role and levels of autonomy of nurses in the primary care settings. METHODS: A two-phase exploratory study was performed: 1) a focus group with a purposeful sample of 12 GPs was conducted to identify the potential patients-clients/problems and activities that might be assigned to nurses; 2) a questionnaire was developed to analyze the levels of autonomy GPs assigned to nurses for different patients-clients/problems and activities. The questionnaire was administered to a convenience sample of 45 GPs, who were also interviewed to explain their choices. RESULTS: GPs recognized autonomy to nurses in the assessment, monitoring and education on lifestyles, prevention of falls, malnutrition and compliance with treatments; in performing technical and organizational activities. They believed necessary supervision or providing indications to nurses in the management of chronic patients, especially in the assessment of signs and symptoms of deterioration, in monitoring and follow-up and partly on the contents of health education. Finally, GPs felt responsible of the management of pluri-pathological and unstable patients, such as heart failure patients, due to their highly unpredictable and rapid deterioration. CONCLUSIONS: GPs expressed a positive attitude towards the role of nurses in the primary care setting, which varied depending on patients' instability and clinical complexity
Patient Education During Hospitalization From the Perspective of Nurse Managers: A Qualitative Study
No full text: The aim of this study was to explore patient education in surgical and medical wards from the perspective of nurse managers. A qualitative descriptive study was conducted with 28 nurse managers from 34 wards in two hospitals, using content analysis. Three themes were identified. The first "Characteristics of patient education" highlights the definitions, goals, and interdisciplinary nature of patient education, emphasizing its role in promoting autonomy and safe discharge. The second "Delivering patient education" focuses on the content, methods, and timing of education. While some managers supported routine care integration, others preferred dedicated sessions, highlighting a need for flexibility in approaches. The third "Evaluating and Improving Patient Education" examines assessment strategies, outcome tracking, and quality maintenance. Effective patient education was linked to reduced readmissions and fewer support calls. Documentation was seen as both essential and burdensome. The study underscores the complexity and benefits of patient education while addressing challenges like time constraints and workload. Recommended strategies include staff training, developing educational tools, structured but flexible approaches, enhanced documentation, and fostering interprofessional collaboration
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