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An examination of nurses' professional work and life in the context of the ongoing institutional restructuring of health care systems in seven European countries, England, Finland, Greece, Ireland, Portugal, Spain and Sweden. Professional experience and expertise is discussed from the nurses' perspective and focuses on how they deal with restructuring measures caused by changes in policy and administration.

The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.

\"This book outlines a clear map for dealing with the complex and often ambiguous situations encountered by those working in supportive services. Drawing from numerous interviews with frontline helpers and people seeking help, this resource uses stories to introduce and illustrate core ideas and practices. Examining some of the common dilemmas of working with and advocating for the people served in home and community based settings, this unique volume explores how to collaborate with traditionally trained professionals across systems and how to involve people's natural networks and communities in helping endeavors\"-- Provided by publisher.

Background Given increases in China’s aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, “Internet + Nursing Services” have received more attention. Thus, exploring the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective This study aimed to develop a scale for assessing the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” and to test the validity and reliability of the scale. Methods A preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale. Results The final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach’s α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ 2 /df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953. Conclusion The scale for assessing the barriers to and facilitators of nurses’ willingness to participate in “Internet + Nursing Services” has good reliability and validity, and provides a reference for evaluating nurses’ willingness to participate in “Internet + Nursing Services”.

BackgroundThe timely recognition and response to patients with clinical deteriorations constitute the afferent limb failure of a rapid response system (RRS). This area is a persistent problem in acute healthcare settings worldwide. In this study, we evaluated the effect of an educational programme on improving the nurses’ knowledge and performances in recognising and responding to clinical deterioration.MethodThe interactive web-based programme addressed three areas: (1) early detection of changes in vital signs; (2) performance of nursing assessment and interventions using airway, breathing, circulation, disability and expose/examine and (3) reporting clinical deterioration using identity, situation, background, assessment and recommendation. Sixty-seven registered nurses participated in the randomised control study. The experimental group underwent a 3 h programme while the control group received no intervention. Pretests and post-tests, a mannequin-based assessment and a multiple-choice knowledge questionnaire were conducted. We evaluated the participants’ performances in assessing, managing and reporting the deterioration of a patient using a validated performance tool.ResultsA significantly higher number of nurses from the experimental group than the control group monitored respiratory rates (48.2% vs 25%, p<0.05) and pulse rates (74.3% vs 37.5%, p<0.01) in the simulated environment, after the intervention. The post-test mean scores of the experimental group was significantly higher than the control group for knowledge (21.29 vs 18.28, p<0.001), performance in assessing and managing clinical deterioration (25.83 vs 19.50, p<0.001) and reporting clinical deterioration (12.83 vs 10.97, p<0.001).ConclusionsA web-based educational programme developed for hospital nurses to strengthen the afferent limb of the RRS significantly increased their knowledge and performances in assessing, managing and reporting clinical deterioration.

Background The “Internet + nursing services” model has been applied to various diseases and has been accepted by an increasing number of people, especially in the context of chronic disease management. This model has achieved some results. However, it is still less commonly used in orthopeadic patients. Objective To explore the demand for “Internet + nursing services” and its influencing factors among orthopaedic patients in developed areas of China and to provide evidence for the improvement of “Internet + nursing services”. Design Cross-sectional study. Methods A total of 314 orthopaedic patients who underwent orthopaedic surgeries at a tertiary hospital in Zhejiang Province from January to June 2024 were selected via convenience sampling. The patients were surveyed using a self-designed demographic questionnaire and the Home Care Demand Forecasting Scale for fracture patients before discharge. Univariate analysis and multiple regression analysis were adopted to identify the factors influencing the demand for “Internet + nursing services” among orthopaedic patients. Results This study investigated 314 patients who underwent orthopaedic surgeries. The results revealed that the average score of total home care demand was 7.95 ± 5.35, and the demand percentage was 92.04%. According to the univariate analysis, surgical site, age, self-care ability and “whether the current home care meets the treatment or rehabilitation needs” were significantly associated with total demand scores ( P  < 0.05). Multiple regression analysis indicated that self-care ability and surgical site were independent predictors of total demand. Specifically, self-care ability had a negative effect on total demand (β=-0.255, p  < 0.01), while surgical site had a significant positive effect on total demand (β = 0.156, p  = 0.004). Moreover, the survey revealed that the awareness rate of “Internet + nursing services” was low, at only 23.25%. The willingness to choose “Internet + nursing services” was low, as only 25.48% of orthopaedic patients were willing to choose these services. Conclusion Orthopaedic patients had a low awareness and willingness to use “Internet + nursing services”, but a high demand for home care. Patients with lower self-care ability exhibited a higher demand for these services, especially patients who underwent lower limb surgery, such as hip, femur and pelvis surgery. The results suggest that hospitals and government health care departments should provide more professional, personalized and multi-team services based on the needs of different orthopaedic patients. What is already known? • “Internet + nursing services” are popular and can provide patients with safe, homogeneous and continuous service. • The demands of orthopaedic patients constitute an important factor for the development of “Internet + nursing services” in this population. What this paper adds? • This study revealed that orthopaedic patients have a high demand for Internet + nursing services and many factors influence this demand. For example, self-care ability and surgical site are both important factors affecting the demand for home care services among orthopaedic patients. • Although the demand for Internet + nursing services is high, the awareness and willingness to use these services are relatively low among orthopaedic patients.

Background China is experiencing an aging population, leading to a significant demand for “Internet + nursing services” tailored for elderly individuals. However, there are many risk problems in the process of nurse service, which hinder the development of the service, and a scale is needed to assess the risk problems faced by nurses in “Internet + nursing services” for the elderly. Objective The purpose of this study is to develop an assessment scale for risk factors and outcomes related to nurses’ involvement in the “Internet + Nursing Service” for the elderly and to assess its reliability and validity. Methods Based on literature analysis, focus group, the Delphi method, and a presurvey, we designed an initial scale. The initial scale comprised two sections: risk factors and risk outcomes for nurses. In January and February of 2023, nurses engaged in “Internet + nursing services” for the elderly in Shanxi Province were chosen through a convenience sampling technique for a questionnaire survey. Subsequently, item analysis and exploratory factor analysis were employed to refine and develop a test version of the scale further. A follow-up questionnaire survey was carried out in March and April 2023 using a similar approach. The reliability and validity of the scale were assessed through confirmatory factor analysis, culminating in the formation of the final scale. Results The initial survey yielded 244 valid responses. The cumulative variance contributions of the two segments from the exploratory factor analysis were 84.584% and 90.089%, respectively. A subsequent survey garnered 220 valid responses. The confirmatory factor analysis results indicated: χ2/df = 2.086, comparative fit index (CFI) = 0.918, normative fit index (NLI) = 0.855, root mean square of residuals (RMR) = 0.045, and root mean square of error of approximation (RMSEA) = 0.070. These results demonstrate good structural, convergent, and discriminant validity. The content validity index at the item level (I-CVI) ranged between 0.875 and 1.000, while the content validity index at the scale level (S-CVI/Ave) was 0.941. Cronbach’s alpha coefficient for the entire scale stood at 0.970. Moreover, the scale exhibited a split-half reliability of 0.876 and a retest reliability of 0.980 ( p  < 0.01). Conclusion The risk factors and risk outcomes associated with nurses involved in “Internet + nursing services” for elderly individuals, as developed in this study, demonstrate strong reliability and validity. They are well suited to the Chinese national context.