Exploring the impact of socially assistive robots on health and wellbeing across the lifespan: An umbrella review and meta-analysis.

BACKGROUND: Socially assistive robots offer an alternate source of connection for interventions within health and social care amidst a landscape of technological advancement and reduced staff capacity. There is a need to summarise the available systematic reviews on the health and wellbeing impacts to evaluate effectiveness, explore potential moderators and mediators, and identify recommendations for future research and practice. OBJECTIVE: To explore the effect of socially assistive robots within health and social care on psychosocial, behavioural, and physiological health and wellbeing outcomes across the lifespan (PROSPERO registration number: CRD42023423862). DESIGN: An umbrella review utilising meta-analysis, narrative synthesis, and vote counting by direction of effect. METHODS: 14 databases were searched (ProQuest Health Research Premium collection, Scopus, PubMed, Web of Science, ASM Digital Library, IEEE Xplore, Cochrane Reviews, and EPISTEMONIKOS) from 2005 to May 4, 2023. Systematic reviews including the effects of socially assistive robots on health outcomes were included and a pooled meta-analysis, vote counting by direction of effect, and narrative synthesis were applied. The second version of A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) was applied to assess quality of included reviews. RESULTS: 35 reviews were identified, most focusing on older adults with or without dementia (n = 24). Pooled meta-analysis indicated no effect of socially assistive robots on quality of life (standard mean difference (SMD) = 0.43), anxiety (SMD = -0.02), or depression (SMD = 0.21), although vote counting identified significant improvements in social interaction, mood, positive affect, loneliness, stress, and pain across the lifespan, and narrative synthesis identified an improvement in anxiety in children. However, some reviews reported no significant difference between the effects of socially assistive robots and a plush toy, and there was no effect of socially assistive robots on psychiatric outcomes including agitation, neuropsychiatric symptoms, and medication use. DISCUSSION: Socially assistive robots show promise for improving non-psychiatric outcomes such as loneliness, positive affect, stress, and pain, but exert no effect on psychiatric outcomes such as depression and agitation. The main mechanism of effect within group settings appeared to be the stimulation of social interaction with other humans. Limitations include the low quality and high amount of overlap between included reviews. CONCLUSION: Socially assistive robots may help to improve loneliness, social interaction, and positive affect in older adults, decrease anxiety and distress in children, and improve mood, stress, and reduce pain across the lifespan. However, before recommendations for socially assistive robots can be made, a cost-effectiveness analysis of socially assistive robots to improve mood across the lifespan, and a quantitative analysis of the effects on pain, anxiety, and distress in children are required.

The community nurse's role on the promotion of papillomavirus vaccination among young students: A study protocol.

Vaccination is the principal strategy for primary prevention of infection by Human Papilloma Virus (HPV), which causes different pathological conditions, up to cancer, in both males and females. However, to date, knowledge among adolescents and their parents about the HPV vaccine is still low. The aim of this quasi-experimental, multicenter study is to assess the effectiveness of a digital educational intervention, conducted by a multidisciplinary health-care team including a Community Nurse, to increase adolescents' HPV vaccination uptake, their knowledge, self-efficacy, feelings and involvement in HPV vaccine decision-making, and parents' vaccination hesitancy. The study will be carried out among a population of students (and their parents), aged between 11 and 13, at secondary schools in Italy. Validated questionnaires will be administered to both students and parents at baseline (T0) and 3 months after a digital educational intervention (T1). The findings may be useful in evaluating and deepening a methodology for designing and implementing educational interventions, embedded in the school setting, that could promote the achievement of outcomes within the broader process of youth's health promotion.

Validation of a complex needs indicator for veterans in the UK using a composite indicators' method.

Objective: To construct an indicator for assessing the complexity of UK veterans' needs. Study design: Cross-sectional, secondary analysis. Methods: The study applied principal component (PCA) analysis as the method to determine the weights of different needs based on their interactions with each other, the effectiveness of the model was evaluated using bootstrapping. The dataset on UK veterans' support provided by the "Soldiers, Sailors, Airmen and Families Associations" (SSAFA) (N = 35,208) was considered. The grant applications for different categories of support were used as indicators of different needs. The dimensions of breadth (number of different needs) and depth (number of grant applications to address the need) were incorporated in the assessment of complexity. Results: The complex needs indicator for the current sample was validated. The majority of cases had a complexity score of 1 or less. Conclusions: The research suggested and tested an assessment method for the complexity of veterans' needs, that may be positively associated with higher risk of adverse health outcomes. This indicator can be used by decision-makers for risk stratification of the veteran population, thus supporting the allocation of resources in a more effective way.

The impact of rapid cycle simulation deliberate practice on nursing student's resuscitation self-efficacy: A quasi-experimental study.

BACKGROUND: Nursing students often report anxiety about the performance of resuscitation in a placement context. Rapid cycle deliberate practice which involves re-running the scenario after de-brief allowing for the correction of errors and improved practice has been widely used to develop skills in resuscitation. Few studies have examined the use of rapid cycle deliberate practice to improve resuscitation confidence and self-efficacy. OBJECTIVE: to assess if rapid cycle deliberate practice leads to improvements in resuscitation self-efficacy in pre-registration nursing students. DESIGN: Quasi-experimental pre and post-test design measuring self-efficacy using the Basic Resuscitation Skills - Self Efficacy Scale. SETTING: University, United Kingdom. PARTICIPANTS: Students were invited to participate (n = 120) and 106 consented to take part in the study. Participants were in pre-determined practical groups with 56 in the experimental group and 50 in the control group. METHODS: A pre and post-test of nursing students' self-efficacy during a resuscitation simulation scenario. The scenario will relate to a patient admitted to the emergency room with chest pain who then goes into cardiac arrest. The control group undertake the simulation exercise and then received a de-brief whereas the experimental group participated in a rerun of the scenario following the de-brief (deliberate practice). Both groups completed the Basic Resuscitation Skills Self-efficacy scale pre and post the session. Data were analysed using a paired sample t-test. RESULTS: Both groups showed improved self-efficacy as a result of the simulation session. The difference in the post-test mean scores between the control and the experimental group was marginal and not statistically significant. CONCLUSION: rapid cycle deliberate practice simulation does not lead to improved resuscitation self-efficacy amongst pre-registration nursing students when compared with a single session. ABSTRACT: Nursing students are often anxious about performing resuscitation in practice. Can rapid cycle deliberate practice improve resuscitation self-efficacy? Pre and post-test study (n=106) showed improved self-efficacy with no statistical difference between standard simulation and deliberate practice.

Nurses job satisfaction identified by personal preferences and perceived saturation divergence: a comparative cross-sectional study in Czech hospitals between 2011 and 2021.

BACKGROUND: The perception of the quality of care provided by the medical institution to patients is directly affected by the job satisfaction of nurses. The feeling of job satisfaction is caused besides other things by the subjective expectations of employees about what their work should provide them with in return. The aim of the study is to evaluate and compare job satisfaction of hospital nurses in the Czech Republic in 2011 and 2021 by identifying differences between their personal preferences and perceived saturation. METHODS: The respondents are hospital nurses in the Czech Republic in 2011 and 2021. A developed questionnaire was used to determine the job satisfaction factors. The order of factors of personal preferences, perceived saturation and differences between them was compiled. For evaluation was used the Euclidean distance model that enables to capture the order and determine the significance given by the distance in which the factors are located. RESULTS: At the top of personal preferences of hospital nurses, the factors salary and patient care are in the first two places with a similar distance. The salary factor is the most preferred by hospital nurses in both evaluated periods, and at the same time there is the greatest discrepancy between personal preferences and perceived saturation. By contrast, image of profession and working conditions were sufficiently saturated by the employer in both periods, but nurses do not significantly prefer these factors. CONCLUSIONS: The salary and patient care (i.e. the mission of the nurse's work itself) are at the top of personal preferences of hospital nurses, with an exclusive position among other factors. We consider it important that the hospital management emphasizes them in the management of hospital nurses. At the same time, the patient care is perceived by the hospital nurses as one of the most saturated factors - in contrast to salary, which is located at the complete opposite pole as the least saturated factor and therefore emerges from the mutual comparison as the factor with the greatest degree of divergence. The stated conclusions are valid for both compared periods. New method of data evaluation was successfully tested.

Workload, Job Satisfaction and Quality of Nursing Care in Italy: A Systematic Review of Native Language Articles.

Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers.

Nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings: An interview study.

AIM: To describe nurse leaders' experiences of how culturally and linguistically diverse registered nurses integrate into healthcare settings. DESIGN: A qualitative descriptive study design. PARTICIPANTS: A total of 13 nurse leaders were recruited from four primary and specialized healthcare organizations in Finland. METHODS: Data were collected through individual semi-structured interviews and analyzed using inductive content analysis. RESULTS: Nurse leaders' experiences were categorized into seven main categories as follows: leadership, which concerns a leader's roles, style, and experience; organizational strategy and culture, which includes structure, policies, and intra-organizational culture; support strategies, including workplace and outside-of-work integration strategies; relationships and interactions, which considers interpersonal relationships and interactions; nurse competence requirements and development, which concerns both organizational and ward level competence demands, and support for competence development; language competence, which concerns challenges relating to language proficiency and development of language competence; and cultural diversity, which considers the importance of competence development brought about through experiences of being in a multicultural workplace. CONCLUSIONS: Culturally and linguistically diverse nurses are important within healthcare systems. These nurses constitute additional human resources, bring diverse experiences and expertise, and add to organizational cultural capital. Nurse leaders require competencies that are suitable for leading a diverse workforce, utilizing its competencies, establishing staff members' needs, and ensuring their continuous development. Resourcing, planning, and structuring the integration process affects nurses' experiences of the organizational socialization process. IMPACT: The findings of our study can offer guidance to healthcare organizations with regard to structural integration strategies at an institutional level. Leadership and management educators can benefit from the findings towards developing a curriculum that supports leaders' diversity, equity and inclusion, knowledge management and formal leadership competencies. Finally, nurse leaders may benefit from this study through being more aware towards supporting a multicultural, cohesive, and competent workforce through strong social capital.

Grading practice as a strategy to improve proficiencies in undergraduate nurse education: Modelling key areas of competence.

BACKGROUND: In undergraduate nursing grading practice is generally avoided as it is considered educationally flawed. OBJECTIVES: To test an innovative online grading practice tool (GPT) in undergraduate nurse education. To model the determinants of the final practice grade in four areas of clinical competence and in one cohort analysis the relationship between final practice grade and each area of clinical competence and an OSCE grade. DESIGN: A cross-sectional study. PARTICIPANTS: A convenience sample of 782 nursing students from one Higher Education Institution in the North-East of England were included. The sample involved two sequential cohorts of final-year students with 391 students in each cohort. METHODS: A specifically designed online grading practice tool (GPT) composed of thirty-six objectives equally divided across four areas of clinical competence. The GPT was applied to two consecutive student cohorts on completion of their final practice learning placement. RESULTS: There was a statistically significant difference in the mean final practice grade between the two cohorts. In the overall sample, regression modelling showed that all four areas of student assessment contributed equally to the final grade. Analysis by cohort showed that in Cohort 1 clinical thinking and professionalism had the most influence on the final grade with person-centered care and patient safety most strongly impacting on the final grades of Cohort 2. In Cohort 2 there is no statistically significant correlation between final practice grade, each area of clinical competence and an OSCE grade. CONCLUSIONS: Practice learning is fundamental to how students develop professional awareness and learn to nurse. Findings from a novel grading practice tool applied in undergraduate nursing reveal how effectively the tool works. Nurse educators must be responsive to the realities of learning in practice and explore new ways of assessing clinical competence.

Increasing the use of experimental methods in nursing and midwifery education research.

AIM: To consider how more use could be made of experimental research in nursing and midwifery education. BACKGROUND: Much use has been made in nursing and midwifery educational research of pre- and post-, within-subjects research. While this has its place and has been a valuable design for testing educational interventions, there has been a distinct lack of more rigorous experimental designs. DESIGN: Discussion paper to consider the use of experimental designs in nursing and midwifery education research. METHODS: A review of within-subjects designs, between-subjects designs and new approaches to experimental research such as pragmatic designs, non-inferiority designs and the framework offered by complex interventions. RESULTS: Recommendations for implementing experimental designs in nursing and midwifery education research have been drawn. CONCLUSIONS: Within-subjects designs have dominated experimental research in nursing and midwifery education. While suitable for preliminary studies, they should be augmented by more rigorous designs based on between-subjects designs. These do not have to be strictly randomised controlled trials and there are many reasons why these are hard to implement in nursing and midwifery education research. However, a range of alternatives is available.

Implementing an electronic public health record for policy planning in the UK military sector: Validation of a secure hashing algorithm.

The digitalisation of healthcare services is a major resource to inform policy-makers. However, the availability of data and the establishment of a data flow present new issues to address, such as data anonymisation, records' reliability, and data linkage. The veterans' population in the UK presents complex needs and many organisations provide social and healthcare support, but their databases are not linked or aggregated to provide a comprehensive overview of service planning. This study aims to test the sensitivity and specificity of a Secure Hashing Algorithm to generate a unique anonymous identifier for data linkage across different organisations in the veterans' population. A Secure Hashing Algorithm was performed by considering two input variables from two different datasets. The uniqueness of the identifier was compared against the single personal key adopted as a current standard identifier. Chi-square, sensitivity, and specificity were calculated. The results demonstrated that the unique identifier generated by the Secure Hashing Algorithm detected more unique records when compared to the current gold standard. The identifier demonstrated optimal sensitivity and specificity and it allowed an enhanced data linkage between different datasets. The adoption of a Secure Hashing Algorithm improved the uniqueness of records. Moreover, it ensured data anonymity by transforming personal information into an encrypted identifier. This approach is beneficial for big data management and for creating an aggregated system for linking different organisations and, in this way, for providing a more comprehensive overview of healthcare provision and the foundation for precision public health strategies.

Nurses' knowledge and self-assessment of their clinical experiences of intraosseous access: A multicentre cross-sectional study.

BACKGROUND: Intraosseous access is an effective and safe option when difficult vascular access occurs. The knowledge, competence, and clinical experience of nurses are collectively essential for the successful implementation of this approach in clinical practice. Education and clinical learning are the main pillars supporting this new practice to ensure patient safety. The aim of this study was to identify the nurses' knowledge and clinical experience of intraosseous access and the factors associated with the adoption of this procedure. METHODS: A cross-sectional study was carried out from October to December 2020. A convenience sample of 432 nurses from four Italian hospitals were involved. A structured questionnaire was used to assess the nurses' knowledge of the intraosseous access guidelines and their clinical experience. RESULTS: Most participants were female (71.5%) with more than 10 years of experience (63.7%) working in an emergency (38.9%) and medical (37.7%) setting. Most of the participants demonstrated their knowledge of the use of a device e.g., it is used if vascular access is not rapidly achieved in a child (83.1%) and the boluses of liquids required in the intraosseous procedure (72.7%). A few participants reported having placed intraosseous access (3.5%). A higher level of educational preparation and working in emergency and paediatric settings were associated with increased knowledge. CONCLUSIONS: Our findings highlighted a sub-optimal level of knowledge of the IO procedure, little experience of this practice in clinical contexts, also associated with a lack of adequate protocols and devices available to nurses. Nurses need to develop their knowledge and practice the skill clinically to embed this practice. University and nurse educators should emphasise the relevance of this practice in nursing education and training, so as to improve the nursing care practice and level of patient safety.

Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review.

BACKGROUND: Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed. METHODS: This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students. RESULTS: A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation). CONCLUSION: The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.

Nurse educators' views of integrating culturally and linguistically diverse future registered nurses into healthcare settings: A qualitative descriptive study.

AIM: To describe nurse educators' views of how culturally and linguistically diverse future registered nurses are integrated into healthcare settings. DESIGN: A qualitative descriptive design was adopted. PARTICIPANTS: A total of 20 nurse educators were recruited from three higher education institutions in Finland. METHODS: Participants were recruited in the spring of 2021 through snowball sampling. Individual semi-structured interviews were held and recorded. The collected data were analysed using inductive content analysis. RESULTS: The performed content analysis identified a total of 534 meaning units from the data, which were categorized into 343 open codes and 29 sub-categories. Furthermore, nine categories were identified and categorized into three main categories. The first main category was pre-graduation and represented a time point during which educators experienced early integration, nurse educator support and cooperation with stakeholders. The second main category was integration strategies into healthcare settings, which included workplace strategies, language competence and individual competencies and attributes. The third main category was the post-graduation experience, during which educators reported organizational readiness, migration and efficacy of the integrational model. CONCLUSIONS: The results revealed a need for increased resources linked to how nurse educators support the integration of culturally and linguistically diverse future registered nurses. Moreover, a nurse educator's presence during the last clinical placement, early transition and integration was found to exert a significant effect on the smooth integration of culturally and linguistically diverse future nurses. IMPACT: This study establishes the need to enhance stakeholder cooperation between universities and other organizations towards supporting the integration process. Maximizing nurse educators' support during the final clinical practice, early transition and post-graduation allows for successful integration and intention to stay. REPORTING METHOD: This study was reported according to the Standards for Reporting Qualitative Research (SRQR). PATIENT OR PUBLIC PARTICIPATION: Participating educators shared their experiences of culturally and linguistically diverse future nurses' integration.

Barriers and facilitators of vaccine hesitancy for COVID-19, influenza, and pertussis during pregnancy and in mothers of infants under two years: An umbrella review.

BACKGROUND: Vaccination during pregnancy has been repeatedly demonstrated to be safe and effective in protecting against infection and associated harms for the mother, developing baby, and subsequent infant. However, maternal vaccination uptake remains low compared to the general population. OBJECTIVES: An umbrella review to explore the barriers and facilitators to Influenza, Pertussis and COVID-19 vaccination during pregnancy and within 2 years after childbirth, and to inform interventions to encourage uptake (PROSPERO registration number: CRD42022327624). METHODS: Ten databases were searched for systematic reviews published between 2009 and April 2022 exploring the predictors of vaccination or effectiveness of interventions to improve vaccination for Pertussis, Influenza, or COVD-19. Both pregnant women and mothers of infants under two years were included. Barriers and facilitators were organised using the WHO model of determinants of vaccine hesitancy through narrative synthesis, the Joanna Briggs Institute checklist assessed review quality, and the degree of overlap of primary studies was calculated. RESULTS: 19 reviews were included. Considerable overlap was found especially for intervention reviews, and the quality of the included reviews and their primary studies varied. Sociodemographic factors were specifically researched in the context of COVID-19, exerting a small but consistent effect on vaccination. Concerns around the safety of vaccination particularly for the developing baby were a main barrier. While key facilitators included recommendation from a healthcare professional, previous vaccination, knowledge around vaccination, and communication with and support from social groups. Intervention reviews indicated multi-component interventions involving human interaction to be most effective. CONCLUSION: The main barriers and facilitators for Influenza, Pertussis and COVID-19 vaccination have been identified and constitute the foundation for policy development at the international level. Ethnicity, socioeconomic status, concerns about vaccine safety and side effects, and lack of healthcare professionals' recommendations, are the most relevant factors of vaccine hesitancy. Adapting educational interventions to specific populations, person-to-person interaction, healthcare professionals' involvement, and interpersonal support are important strategies to improve uptake.

Understanding the barriers and facilitators of COVID-19 vaccine hesitancy amongst healthcare workers and healthcare students worldwide: An umbrella review protocol.

Healthcare workers (HCWs) and healthcare students are at increased risk of becoming infected with and being a vector of transmission of COVID-19. Vaccination efforts amongst this group of persons have been hampered in some countries by hesitancy to uptake the COVID-19 vaccine. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, a comprehensive overview of barriers and facilitators of COVID-19 vaccine hesitancy is greatly needed to address effective interventions in this population. Understanding and designing effective strategies to promote vaccination among HCWs is pivotal to secure an appropriate and safe healthcare provision. The current protocol describes the methodology for an Umbrella Review that explores the barriers and facilitators of COVID-19 vaccine hesitancy for HCWs and healthcare students. The databases that will be searched are CINAHL, MedLine, Cochrane Library, PubMed, ProQuest, Web of Science, Science Direct, IBSS, Google Scholar, and Epistemonikos. Studies will be eligible for inclusion if they: (i) conducted a systematic review (with or without meta-analysis); (ii) included primary sources utilizing a quantitative methodology; (iii) investigated factors related to COVID-19 vaccine hesitancy; (iv) and included a sub/population of HCWs or healthcare students aged 18-65. The screening processes and data extraction will be conducted independently by two reviewers. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses will be used to assess the methodological quality of the included reviews. The degree to which the included reviews contain the same primary studies will also be assessed and reported. The outcomes of this review will have wide-reaching implications for the research area, healthcare systems and institutions, and governments worldwide.

Immersive and Non-Immersive Virtual Reality for Pain and Anxiety Management in Pediatric Patients with Hematological or Solid Cancer: A Systematic Review.

Invasive and painful procedures, which often induce feelings of anxiety, are necessary components of pediatric cancer treatment, and adequate pain and anxiety management during these treatments is of pivotal importance. In this context, it is widely recognized that a holistic approach, including pharmacological and non-pharmacological modalities, such as distraction techniques, should be the standard of care. Recent evidence suggested the use of virtual reality (VR) as an effective non-pharmacological intervention in pediatrics. Therefore, this systematic review aims to analyze previously published studies on the effectiveness of VR for the management of pain and/or anxiety in children and adolescents with hematological or solid cancer. Medline, SCOPUS, Web of Science, ProQuest, CINAHL, and The Cochrane Central Register of Controlled Trials were used to search for relevant studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Randomized controlled trial, crossover trial, cluster randomized trial, and quasi-experimental studies were included. Thirteen studies, published between 1999 and 2022, that fulfilled the inclusion criteria were included. Regarding the primary outcomes measured, pain was considered in five studies, anxiety in three studies, and the remaining five studies analyzed the effectiveness of VR for both pain and anxiety reduction. Our findings suggested a beneficial effect of VR during painful vascular access procedures. Limited data are available on the reduction of anxiety in children with cancer.

Randomised controlled trials addressing how the clinical application of information and communication technology impacts the quality of patient care-A systematic review and meta-analysis.

BACKGROUND: The number of people with chronic and long-term conditions has increased during recent decades; this has been addressed by leveraging information and communication technology (ICT) to develop new self-care solutions. However, many of the developed technological solutions have not been tested in terms of impact(s) on patients' quality of care. OBJECTIVES: This systematic review aimed to identify the current best evidence on the types of interventions that have been developed to improve the quality of patient care through the clinical application of ICT in primary, tertiary or home care. DESIGN: A systematic review, including a meta-analysis, was conducted according to the JBI Manual for Evidence Synthesis guidelines. DATA SOURCES: Relevant data were identified from four electronic databases: CINAHL, PUBMED, SCOPUS and MEDIC. REVIEW METHODS: The eligibility criteria were formatted according to PICOS inclusion and exclusion criteria. At least two researchers performed the screening process separately, after which they agreed upon the results. The Cochrane Risk of Bias Assessment and JBI Critical Appraisal tool for randomised controlled studies (RCTs) were used to assess research quality. Data were extracted, and a meta-analysis was performed if the research met quantitative requirements. RESULTS: Of the 528 initially identified studies, 11 studies were chosen for final data synthesis. All of the interventions integrated ICT solutions into patient care to improve the quality of care. Patients across all of the RCTs were educated through direct training, the provision of information relevant to their disease or one-to-one educational coaching. The interventions included various interactions, e.g. nurse expert visits and support, and support provided by peers, groups or family members. These interactions occurred through face-to-face coaching, virtual human coaching or virtual coaching that relied on an algorithm. The performed meta-analysis included 6 of the 11 identified studies. The overall effect was nonsignificant, with three studies demonstrating a significant postintervention effect on patients' quality of care and quality of life and three studies a nonsignificant effect. CONCLUSIONS: The presented results suggest that ICT-based care should be developed in collaboration with nurses and other health care professionals, involve patients in decision-making and combine ICT solutions with human interaction and coaching. ICT education was found to be essential to the success of an intervention.

Culturally and linguistically diverse registered nurses' experiences of integration into nursing workforce - A qualitative descriptive study.

BACKGROUND: The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce. AIM: To describe culturally and linguistically diverse registered nurses' experiences of their integration into the Finnish nursing workforce. METHODS: The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories. RESULTS: According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses' competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention. CONCLUSIONS: Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses' integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses' competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention.

Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review.

AIMS: The aim of this umbrella review was to establish recent evidence on integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments. DESIGN: Umbrella review conducted according to Joanna Briggs institute guidelines. DATA SOURCES: Data were collected from CINAHL, PubMed, Medic, ProQuest and Scopus electronic databases in 2021. REVIEW METHODS: Two researchers simultaneously screened studies' eligibility by title, abstract and full text. Quality appraisal for the selected studies was assessed according to Joanna Briggs institute critical appraisal. Data were synthesized by conducting content analysis. RESULTS: Twenty-seven reviews were included in the final synthesis. Strategies and models for supporting the transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments were structured as intra-organizational, sociocultural, and professional development. Intra-organizational strategies and models were unique to a particular organization and included policies and support, diversity, collegial and peer support, employee treatment and workplace environment. Sociocultural strategies and models addressed social, cultural and group dynamics using cultural training, learning and support, social support and friendships, language and communication, and personal skills development. Professional development enhanced nursing competence, ability to practice and workplace professional development. This was supported through licensure and orientation to work, career and competence development, and workplace mentorship and preceptorship. CONCLUSION: There is a need to understand culturally and linguistically diverse nurses' needs and motivation to integrate, which is essential toward developing efficient integrational strategies and models. Strategies and models also need to support cultural and personal competence development of native nurses to aid efficient integration of culturally and linguistically diverse colleagues. Future studies can evaluate nursing workforce shortages and their implications on integration process.