Healthcare

Editorial

3 pages, 171 KiB

Open AccessEditorial

Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Conundrum of “Where to Start”

by Arianna Magon, Alessandro Stievano, Irene Baroni and Rosario Caruso

Healthcare 2023, 11(3), 378; https://doi.org/10.3390/healthcare11030378 - 29 Jan 2023

Cited by 2 | Viewed by 2294

Abstract

Transforming nursing practice and leadership is an ongoing effort in the nursing profession, and it involves several key components, such as research, education, workforce, and regulation [...] Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

Research

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13 pages, 547 KiB

Open AccessArticle

Job Stress and Burnout Among School Health Teachers During the COVID-19 Pandemic: The Mediating Effect of Resilience and the Moderating Effect of School Organizational Culture

by Hye Ran Jung, Mi Heui Jang and Min Jung Sun

Healthcare 2024, 12(22), 2247; https://doi.org/10.3390/healthcare12222247 - 11 Nov 2024

Viewed by 422

Abstract

Objectives: This study aims to examine the mediating effect of resilience and the moderating effect of school organizational culture on the relationship between job stress and burnout among school health teachers during COVID-19. Methods: The participants of the study were 223 school health [...] Read more.

Objectives: This study aims to examine the mediating effect of resilience and the moderating effect of school organizational culture on the relationship between job stress and burnout among school health teachers during COVID-19. Methods: The participants of the study were 223 school health teachers. The data collected included the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC), Job Stress Scale, Maslach Burnout Inventory (MBI), and School Organizational Culture Scale. Data analysis was performed using SPSS/WIN 25.0 software. Results: There was a significant positive correlation between job stress and burnout among school health teachers. Conversely, both resilience and school organizational culture were negatively correlated with burnout. The mediating effect of resilience on the relationship between job stress and burnout was significant. However, the moderating effect of school organizational culture was not significant. Conclusions: To prevent burnout in school health teachers, it is necessary to develop policy alternatives aimed at reducing job stress and to implement psychological and emotional support measures to improve resilience. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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14 pages, 242 KiB

Open AccessArticle

Unveiling the Core Competencies in Neuroscience Nursing Within the Context of Italy: A Qualitative Phenomenological Analysis

by Antonio Bonacaro, Elisa La Malfa, Michele Minari, Rachele La Sala, Giovanna Artioli and Federico Cortese

Healthcare 2024, 12(20), 2068; https://doi.org/10.3390/healthcare12202068 - 17 Oct 2024

Viewed by 647

Abstract

Background: In 2008, the European Association of Neuroscience Nursing (EANN) initiated the NeuroBlend™ project, which aimed to delineate the roles and competencies of neuroscience nurses across Europe. This project resulted in the development of the European Competence Profile (ECP), intended to standardize [...] Read more.

Background: In 2008, the European Association of Neuroscience Nursing (EANN) initiated the NeuroBlend™ project, which aimed to delineate the roles and competencies of neuroscience nurses across Europe. This project resulted in the development of the European Competence Profile (ECP), intended to standardize educational pathways and professional recognition for this specialized field. Aim: This study examines the relevance of neuroscience nursing practices to the competencies outlined in NeuroBlend™ across different Italian care settings, including multiple sclerosis, pediatric neurosurgery, pediatric neurology, Alzheimer’s disease, and substance addiction. Methods: A phenomenological approach was employed, utilizing focus groups to gather the perspectives of nurses on the competencies defined by the NeuroBlend™ model. The focus groups were conducted from May 2022 to September 2022. The data collected from the focus groups were analyzed using thematic analysis. Results: Thirty nurses participated in the focus groups. Thematic analysis revealed the core competencies, such as communication, empathy, flexibility, and reflective skills, as critical in all care settings. The main themes that emerged were relationships with patients and families, personalized care, and continuity of care. Conclusions: The competencies outlined in the NeuroBlend™ framework are vital to the role of neuroscience nurses in the settings studied and remain highly relevant in the context of Italian healthcare. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

12 pages, 741 KiB

Open AccessArticle

How Are Diagnosis-Related Groups and Staffing Allocation Systems Associated with the Complexity of Nursing Care? An Observational Study

by Diletta Fabrizi, Davide Paolo Bernasconi, Giulia Locatelli, Michela Luciani, Giorgio Beretta, Stefania Di Mauro, Paola Rebora and Davide Ausili

Healthcare 2024, 12(19), 1988; https://doi.org/10.3390/healthcare12191988 - 5 Oct 2024

Viewed by 746

Abstract

Background: In Italy, Diagnosis-Related Groups (DRGs) have been adopted for hospital services reimbursement. In some Italian regions, nurse staffing allocation is purely volume-based, with different minutes/patient/day categories determined by the type of hospital ward. The Information System of Nursing Performance (SIPI) is a [...] Read more.

Background: In Italy, Diagnosis-Related Groups (DRGs) have been adopted for hospital services reimbursement. In some Italian regions, nurse staffing allocation is purely volume-based, with different minutes/patient/day categories determined by the type of hospital ward. The Information System of Nursing Performance (SIPI) is a valid and reliable tool assessing nursing care complexity as an indicator of the actual nursing care demand. Evidence is lacking about the ability of current resource allocation methods to account for the nursing care demand. Objective: To evaluate the association between (1) DRG rates and nursing care complexity and (2) hospital ward categories of nurse staffing and nursing care complexity. Methods: All patients discharged from the medical department of an Italian hospital over a data collection period were eligible. To assess the association between nursing care complexity (SIPI) and DRGs, the distribution of the DRG rate (median and first–third quartile) was compared for cases with high or low complexity. To evaluate the association between nursing care complexity (SIPI) and nurse staffing, the frequency of high complexity within nurse staffing categories (120/180/240 min/patient/day) was compared. Because the sample was very large, methods of statistical inference were not applied, and only descriptive measures were reported. Results: 6872 hospitalizations were included. The median DRG rate for high and low complexity admissions were very similar (EUR 3536 and EUR 3285, respectively). The proportion of admissions with high complexity decreased for wards with higher staffing allocation rates. Conclusion: DRG reimbursement and the nurse staffing allocation systems were ineffective in accounting for nursing care complexity. The SIPI could help identify areas requiring more financial and staffing resources for nursing care. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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10 pages, 653 KiB

Open AccessArticle

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study

by Diletta Fabrizi, Paola Rebora, Valentina Spedale, Giulia Locatelli, Giuseppe Bellelli, Stefania Di Mauro, Davide Ausili and Michela Luciani

Healthcare 2024, 12(13), 1294; https://doi.org/10.3390/healthcare12131294 - 28 Jun 2024

Viewed by 1259

Abstract

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving [...] Read more.

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I–III quartiles: 80–88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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11 pages, 623 KiB

Open AccessArticle

Factors Associated with Evidence-Based Practice Competencies among Taiwanese Nurses: A Cross-Sectional Study

by Li-Chuan Cheng, Chia-Jung Chen, Shih-Chun Lin and Malcolm Koo

Healthcare 2024, 12(9), 906; https://doi.org/10.3390/healthcare12090906 - 26 Apr 2024

Viewed by 1024

Abstract

Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with [...] Read more.

Evidence-based practice (EBP) is an essential component of healthcare practice that ensures the delivery of high-quality care by integrating the best available evidence. This study aimed to explore factors influencing EBP among nursing professionals in Taiwan. A cross-sectional survey study was conducted with 752 registered nurses and nurse practitioners recruited from a regional teaching hospital in southern Taiwan. EBP competency was evaluated using the Taipei Evidence-Based Practice Questionnaire (TEBPQ). The results showed that participation in evidence-based courses or training within the past year had the strongest association with EBP competencies (Std. B = 0.157, p < 0.001). Holding a graduate degree (Std. B = 0.151, p < 0.001), working in gynecology or pediatrics (Std. B = 0.126, p < 0.001), searching the literature in electronic databases (Std. B = 0.072, p = 0.039), and able to read academic articles in English (Std. B = 0.088, p = 0.005) were significantly associated with higher TEBPQ scores. Younger age (Std. B = −0.105, p = 0.005) and male gender (Std. B = 0.089, p = 0.010) were also identified as factors contributing to higher EBP competencies. The study highlights the importance of ongoing professional development, including EBP training and language proficiency, in enhancing EBP competencies among nursing professionals in Taiwan. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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10 pages, 226 KiB

Open AccessArticle

The Commitment to Excellence: Understanding Nurses’ Perspectives on Continuous Professional Development

by Biljana Kurtović, Petra Gulić, Snježana Čukljek, Biserka Sedić, Martina Smrekar and Sanja Ledinski Fičko

Healthcare 2024, 12(3), 379; https://doi.org/10.3390/healthcare12030379 - 1 Feb 2024

Cited by 3 | Viewed by 4698

Abstract

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses’ attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses’ perspectives on CPD, focusing on [...] Read more.

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses’ attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses’ perspectives on CPD, focusing on their participation and motivation, in relation to their workplace, workplace function, and form of work. A cross-sectional study design was employed with 151 nurses from University Hospital Centre Split, Croatia. Data were collected using the “Professional Development of Nurses questionnaire (Q-PDN)” and analyzed using descriptive statistical methods, the Kolmogorov–Smirnov test, Pearson’s correlation, ANOVA test, and t-test. The average level of participation in CPD activities was 4.27 (±0.63), indicating a positive inclination towards CPD. The study identified a statistically significant difference in activities related to CPD (t = 2.12; p = 0.036) among employees of surgical and intensive care units compared to other departments, where a higher level of engagement was present among employees of other departments. Notably, nurses without managerial roles showed 0.16 points higher participation in CPD activities compared to their managerial counterparts, though this was not statistically significant (t = 0.92; p = 0.357). Nurses in managerial roles valued CPD for professional development more highly, with a significant difference (t = 2.77; p = 0.006). Full-time nurses demonstrated a higher perception of the importance of personal professional development compared to part-time nurses, with a significant difference (F = 2.88; p = 0.038). The study reveals a strong commitment to CPD among nurses, with variations based on workplace roles and schedules. It underscores the need for role-specific and adaptable CPD programs to meet diverse needs and enhance professional competence in the nursing workforce. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

15 pages, 265 KiB

Open AccessArticle

Prevalence of Varicose Veins and Its Risk Factors among Nurses Working at King Khalid University Hospital Riyadh, Saudi Arabia: A Cross-Sectional Study

by Leena R. Baghdadi, Ghadah F. Alshalan, Norah I. Alyahya, Hend H. Ramadan, Abrar M. Alshahrani, Jumana A. Alqahtani and Maha O. Aljarbaa

Healthcare 2023, 11(24), 3183; https://doi.org/10.3390/healthcare11243183 - 16 Dec 2023

Viewed by 3733

Abstract

This quantitative observational cross-sectional study assessed the prevalence and level of risk scores for varicose veins among nurses, and the association between varicose veins and sociodemographic, occupational, and lifestyle risk factors. Using simple random sampling, from August–December 2022, 250 nurses from different departments [...] Read more.

This quantitative observational cross-sectional study assessed the prevalence and level of risk scores for varicose veins among nurses, and the association between varicose veins and sociodemographic, occupational, and lifestyle risk factors. Using simple random sampling, from August–December 2022, 250 nurses from different departments at King Khalid University Hospital completed a validated self-administered questionnaire and underwent an observational physical examination. Most nurses (191) had low-risk scores for varicose veins, 46 nurses had moderate-risk scores, and 13 nurses had high-risk scores. From the outpatient clinics, 61.5% of nurses had significant high-risk scores for varicose veins. Those with a statistically significant association had a family history of varicose veins (p < 0.001) and other chronic medical conditions (p = 0.04). Physical activity, especially race-walking/running (p = 0.006), showed a statistically significant association with the varicose veins score. The years as a staff nurse were statistically significant among the occupational risk factors (p = 0.003). The adjusted multivariable regression model showed three significant predictors: a positive family history, running/walking, and total years as a staff nurse (p < 0.001, p = 0.02, and p < 0.001, respectively). Nurses working at outpatient clinics, positive family history, years as a staff nurse, and other chronic conditions are risk factors for varicose veins, while race-walking/running is a protective factor. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

12 pages, 740 KiB

Open AccessArticle

Performance of ChatGPT on Registered Nurse License Exam in Taiwan: A Descriptive Study

by Huiman Huang

Healthcare 2023, 11(21), 2855; https://doi.org/10.3390/healthcare11212855 - 30 Oct 2023

Cited by 6 | Viewed by 2694

Abstract

(1) Background: AI (artificial intelligence) chatbots have been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills and facilitate students’ understanding of complex concepts in healthcare education. There is currently less emphasis on its application in nursing education. The application [...] Read more.

(1) Background: AI (artificial intelligence) chatbots have been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills and facilitate students’ understanding of complex concepts in healthcare education. 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 was used to analyze the scores of ChatGPT on the registered nurse license exam (RNLE) in 2022~2023, and to explore the response and explanations of ChatGPT. The process of data measurement encompassed input sourcing, encoding methods, and statistical analysis. (3) Results: ChatGPT promptly responded within seconds. The average score of four exams was around 51.6 to 63.75 by ChatGPT, and it passed the RNLE in 2022 1st and 2023 2nd. However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucination; confusion or misunderstanding about complicated scenarios; and languages bias. (4) Conclusions: ChatGPT may have the potential to assist with nursing education because of its advantages. It is recommended to integrate ChatGPT into different nursing courses, to assess its limitations and effectiveness through a variety of tools and methods. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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12 pages, 453 KiB

Open AccessArticle

Peristomal Skin Complications: Detailed Analysis of a Web-Based Survey and Predictive Risk Factors

by Eliana Guerra, Francesco Carlo Denti, Cristina Di Pasquale, Francesca Caroppo, Luisa Angileri, Margherita Cioni, Aurora Parodi, Anna Belloni Fortina, Silvia Ferrucci and Martina Burlando

Healthcare 2023, 11(13), 1823; https://doi.org/10.3390/healthcare11131823 - 21 Jun 2023

Cited by 2 | Viewed by 2589

Abstract

Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive [...] Read more.

Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma. A questionnaire was used to collect patient characteristics, comorbidities, and stoma management data. The most frequent PSCs observed were dermatitis and pruritis/xerosis in approximately 60% of patients. Psoriasis was strongly correlated with dermatitis, while being overweight or obese increased the risk of pruritis/xerosis. Class 2 obesity and atopic dermatitis were associated with an increased risk of infections. Being underweight, completely nonautonomous, and having inflammatory bowel disease were associated with a higher risk of ulcerations, while radiotherapy was a strong risk factor for ulceration. Preventive measures such as using hydrocolloid barriers, TNT gauze cleansing, and low pH detergent were effective in preventing dermatitis. Appropriate stoma care and maintenance, including the use of protective film and careful monitoring of weight and comorbidities, are crucial in minimizing the risk of complications associated with a stoma. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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11 pages, 616 KiB

Open AccessArticle

The Nursing Work Environment, Supervisory Support, Nurse Characteristics, and Burnout as Predictors of Intent to Stay among Hospital Nurses in the Republic of Korea: A Path Analysis

by Young-Bum Kim and Seung-Hee Lee

Healthcare 2023, 11(11), 1653; https://doi.org/10.3390/healthcare11111653 - 5 Jun 2023

Cited by 4 | Viewed by 2336

Abstract

This study aimed to examine the comprehensive impact of five aspects of the nursing work environment as well as supervisory support, nurse characteristics, and burnout on intent to stay (ITS) among Korean hospital nurses. A cross-sectional questionnaire was distributed in seven general hospitals [...] Read more.

This study aimed to examine the comprehensive impact of five aspects of the nursing work environment as well as supervisory support, nurse characteristics, and burnout on intent to stay (ITS) among Korean hospital nurses. A cross-sectional questionnaire was distributed in seven general hospitals from May to July of 2019. Data were collected from a sample of 631 Korean nurses. The hypothesized model was evaluated using the STATA program for path models. Findings demonstrated that burnout played a mediating role on the relationships between the nursing work environment, supervisory support, nurse characteristics, and ITS. Burnout was the most influential predictor of ITS (β = −0.36, p < 0.001). Nurse participation in hospital affairs (β = 0.10, p = 0.044) and collegial nurse–physician relationships (β = 0.08, p = 0.038) had a direct effect on ITS. Supervisory support had a significant direct effect on ITS (β = 0.19, p < 0.001). Therefore, to increase nurses’ ITS, it is necessary to improve their participation in hospital affairs and collegial relationships, as well as strengthen support from supervisors and reduce burnout. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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15 pages, 1646 KiB

Open AccessArticle

Cultural Adaptation and Psychometric Properties of the Trust Me Scale—Italian Version: A Validation Study

by Dhurata Ivziku, Rosario Caruso, Marzia Lommi, Gianluca Conte, Arianna Magon, Alessandro Stievano, Gennaro Rocco, Ippolito Notarnicola, Maddalena De Maria, Raffaella Gualandi, Daniela Tartaglini and Anna De Benedictis

Healthcare 2023, 11(8), 1086; https://doi.org/10.3390/healthcare11081086 - 11 Apr 2023

Cited by 3 | Viewed by 1650

Abstract

Background: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust [...] Read more.

Background: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers. Methods: The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment. Results: Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability. Conclusions: The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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14 pages, 1446 KiB

Open AccessArticle

A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

by Federica Dellafiore, Greta Ghizzardi, Ercole Vellone, Arianna Magon, Gianluca Conte, Irene Baroni, Giada De Angeli, Ida Vangone, Sara Russo, Alessandro Stievano, Cristina Arrigoni and Rosario Caruso

Healthcare 2023, 11(5), 773; https://doi.org/10.3390/healthcare11050773 - 6 Mar 2023

Cited by 2 | Viewed by 3839

Abstract

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance [...] Read more.

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients–caregivers dyad (arm 2) (respectively, Cohen’s d = 0.92, p-value < 0.001; Cohen’s d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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13 pages, 601 KiB

Open AccessArticle

Nursing Profession Self-Efficacy Scale—Version 2: A Stepwise Validation with Three Cross-Sectional Data Collections

by Arianna Magon, Gianluca Conte, Federica Dellafiore, Cristina Arrigoni, Irene Baroni, Alice Silvia Brera, Jennifer Avenido, Maddalena De Maria, Alessandro Stievano, Giulia Villa and Rosario Caruso

Healthcare 2023, 11(5), 754; https://doi.org/10.3390/healthcare11050754 - 3 Mar 2023

Cited by 7 | Viewed by 3426

Abstract

Background: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which [...] Read more.

Background: The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which is a brief version of the original scale selecting items that contribute to stably detecting attributes of care delivery and professionalism as descriptors of salient aspects of the nursing profession. Methods: Three different and subsequent cross-sectional data collections were employed to reduce the number of items to generate the NPSES2 and validate its new emerging dimensionality. The first (June 2019–January 2020) involved 550 nurses and was used to reduce the number of the original scale items by using a Mokken scale analysis (MSA) to ensure the selection of items consistently with the invariant item ordering properties. The subsequent data collection was performed to conduct an exploratory factor analysis (EFA) involving 309 nurses (September 2020–January 2021), and the last data collection (n = 249) was performed to cross-validate with a confirmatory factor analysis (CFA), the most plausible dimensionality derived from the EFA (June 2021–February 2022). Results: The MSA led to the removal of twelve items and retention of seven items (Hs = 0.407, standard error = 0.023), which showed adequate reliability (rho reliability = 0.817). The EFA showed a two-factor solution as the most plausible structure (factors loading ranged from 0.673 to 0.903; explained variance = 38.2%), which was cross-validated by the CFA that showed adequate fit indices: χ² (13, N = 249) = 44.521, p < 0.001; CFI = 0.946; TLI = 0.912; RMSEA = 0.069 (90% CI = 0.048–0.084); SRMR = 0.041. The factors were labeled as care delivery (four items) and professionalism (three items). Conclusions: NPSES2 is recommended to allow researchers and educators to assess nursing self-efficacy and inform interventions and policies. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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26 pages, 793 KiB

Open AccessSystematic Review

Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review

by Daniela Berardinelli, Alessio Conti, Anis Hasnaoui, Elena Casabona, Barbara Martin, Sara Campagna and Valerio Dimonte

Healthcare 2024, 12(23), 2337; https://doi.org/10.3390/healthcare12232337 - 22 Nov 2024

Abstract

Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate [...] Read more.

Background: Poor medication adherence results in negative health outcomes and increased healthcare costs. Several healthcare professionals provide interventions to improve medication adherence, with the effectiveness of nurse-led interventions in people with chronic diseases remaining unclear. Objective: This study sought to evaluate the effectiveness of nurse-led interventions for improving medication adherence in adults with chronic conditions. Methods: Five databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, SCOPUS) were searched without applying a temporal limit. Studies evaluating the effects of nurse-led interventions on medication adherence in adults with one or multiple chronic conditions were included. Interventions only targeting a single acute disease were excluded. Results: A total of twenty-two studies with 5975 participants were included. Statistically significant improvements in adherence were reported in five out of seven studies involving face-to-face visits to patients with heart failure (n = 2), chronic myeloid leukemia (n = 1), hypertension (n = 1) and multimorbidity (n = 1) and in four out of nine studies adopting a mixed method involving face-to-face visits and telephone follow-up for patients with heart failure (n = 1), hypertension (n = 1), coronary disease (n = 1) and multimorbidity (n = 1). Remote interventions were effective in improving medication adherence in one out of six studies. No statistically significant differences were found between tablet computer-based patient education and nurse-led educational sessions. The motivational approach was found to be one of the most common strategies used to promote patient medication adherence. Conclusions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases. However, further research is needed because current methods for measuring medication adherence may not accurately capture patient behaviour and medication consumption patterns. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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10 pages, 241 KiB

Open AccessProtocol

Health Literacy and Self-Care in Patients with Chronic Illness: A Systematic Review and Meta-Analysis Protocol

by Camilla Elena Magi, Stefano Bambi, Laura Rasero, Yari Longobucco, Khadija El Aoufy, Carla Amato, Ercole Vellone, Guglielmo Bonaccorsi, Chiara Lorini and Paolo Iovino

Healthcare 2024, 12(7), 762; https://doi.org/10.3390/healthcare12070762 - 31 Mar 2024

Viewed by 5258

Abstract

Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific [...] Read more.

Self-care plays a critical role in symptom recognition, management, and risk factor modification for patients with chronic illnesses. Despite its significance, self-care levels in this population are generally poor. Health literacy (HL) is pivotal for promoting effective self-care, yet the association across specific chronic illnesses remains fragmented and conflicting. Therefore, a systematic review and meta-analysis will be conducted. Inclusion criteria encompass quantitative studies involving adult patients with at least one chronic illness reporting on the association between a measure of HL and one or more elements of self-care behaviors as outcomes. Databases to be searched include PubMed, CINAHL, APA PsycINFO, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The studies will undergo risk of bias and certainty of evidence assessment using ROBINS-E and GRADE. Extracted data will include authors, publication date, aim(s), study location, design, sample characteristics, chronic illness type, study length, HL, and self-care measures. Understanding the link between HL and self-care can aid healthcare providers in implementing strategies to enhance health-promoting behaviors, contributing valuable insights to the scientific community and fostering nuanced discussions. This protocol ensures methodological transparency, stimulates discourse, and paves the way for informed interventions to improve overall health outcomes. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing

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