System Innovation: A Holistic Approach to Disrupting With Love and Human Caring, by Julie Kennedy Oehlert and Kathleen Sitzman.

The bright vision presented by this book provides an invigorating push to bring out the inner anarchist hidden in even the most complacent of health professionals. This book renews the ongoing discussion of how theory-driven change can be used to ground and promote the integration of love and human caring into system innovation. Each chapter of this book provides concrete and realistic application strategies to front-line practice and gives intensive guidance on how to linguistically and intellectually challenge the barriers within an organization that can undermine a vision of holistic caring. For leaders of teams, this book provides invaluable tools to build a culture of caring and maintain a team that perceives caring from both leadership and the organization as a whole. For team members, this book is a reminder that an expectation of workplace culture that is positive, supportive, and fosters growth is not out of reach; it simply has yet to be implemented within their system.

Dyadic social interaction paradigm reveals selective role of ovarian estrogen in the caring behavior and socially transferred pain in female mice.

When a naïve observer meets with a familiar conspecific in pain, mice may have a myriad of social (sniffing, allolicking, allogrooming, huddling) and non-social (self-grooming) behaviors under dyadic social interaction (DSI) paradigm. Unlike male, female observers express more allolicking behavior toward injury site of a familiar female in pain, but with less body allogrooming. In current study, we investigated roles of natural estrus cycle phases and ovarian estrogen in these behaviors and results showed that: (1) there was no changes in above behaviors in terms of latency, time and bouts across different natural estrus cycle phases in intact female. (2) however, ovariectomy (OVX) changed estrus cycle phases, lowered circulating level of ovarian estrogen, reduced time and bouts of allolicking behavior and increased time of self-grooming without affecting other behaviors. Moreover, OVX in observers decreased social buffering effect of DSI on spontaneous pain-related behavior in demonstrator relative to naïve and sham controls. (3) treatment of OVX-female with ß-estradiol (E2) or progesterone (PROG) as replacement therapies, only E2 reversed impairment of allolicking behavior. (4) Additionally, socially transferred pain could be identified in intact female across all estrus cycle phases post-DSI, but disappeared in OVX-female, which could be reversed completely by E2 but not by PROG. (5) Finally, serum levels of estrogen, PROG, oxytocin, arginine vasopressin (AVP), prolactin, norepinephrine and 5-HT were examined by ELISA after E2, results showed only AVP level was significantly increased. These results suggest both injury site-targeted caring behavior and socially transferred pain are selectively dependent on ovarian estrogen.

Creating communities that care: social representation of mental health in two urban poor communities in Ghana.

Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.

Diversity-On: A Diversity-Sensitive Online Self-Help Program for Family Caregivers-A Protocol for a Mixed Methods Study.

BACKGROUND: Scientific research has consistently emphasised the high levels of stress encountered by family caregivers of individuals living with dementia. However, conventional self-help approaches remain underutilised. The 'Diversity-On' study addresses this issue. The study employs a storytelling approach to develop and evaluate an online self-help program that is participatory and diversity-sensitive, thereby ensuring congruence with diverse identities and lifeworlds. METHODS: The study uses a mixed-methods design, comprising the allocation and implementation of the intervention, the development of stories, a process evaluation (N = 20) and an outcome evaluation (quantitative: N = 130, qualitative: N = 20). The study's primary focus is its comprehensive participatory approach, integrated throughout the research process. The study is dependent on the input of a number of stakeholders, all of whom are committed to advocating for the concerns of patients. DISCUSSION: Given its participatory methodology and intersectional perspective, the 'Diversity-On' study is anticipated to yield a number of significant outcomes. The study has the potential to empower family caregivers of individuals living with dementia who are under high stress, empowering them to take part in self-help groups despite multiple barriers, thus alleviating their burden. Additionally, it has the capacity to promote the well-being of caregiving relatives who are providing care and are experiencing high levels of stress. The study's objective is to maintain home care arrangements for as long as possible, in accordance with the values and preferences of care recipients and their families. The study intends to develop and assess a customised online self-help resource that is suitable for a diverse range of users and that remains accessible beyond the study period. TRIAL REGISTRATION: The project is subsequently registered in ClinicalTrials.gov.

Provider perceptions of young people living with HIV and unhealthy alcohol use in Southwestern Uganda: a qualitative study.

BACKGROUND: Unhealthy alcohol use is a common public health problem in HIV care settings in Africa and it affects the HIV continuum of care. In Uganda and other low-income countries, HIV care providers are a key resource in caring for young people (15-24 years) living with HIV (YPLH) with unhealthy alcohol use. Caring for YPLH largely depends on care providers' perceptions of the problem. However, data that explores HIV care providers' perceptions about caring for YPLH with unhealthy drinking are lacking in Uganda. We sought to describe the perceptions of HIV care providers regarding caring for YPLH with unhealthy drinking in the Immune Suppression Syndrome (ISS) Clinic of Mbarara Regional Referral Hospital in southwestern Uganda. METHODS: We used semi-structured in-depth interviews (IDIs) to qualitatively explore HIV care providers' perceptions regarding caring for YPLH with unhealthy alcohol use. The study was conducted at the adolescent immunosuppression (ISS) clinic of Mbarara Regional Referral Hospital. Interviews were tape-recorded and transcribed verbatim. Using thematic content analysis, data from 10 interviews were analyzed. RESULTS: HIV care providers were concerned and intended to care for YPLH with unhealthy alcohol use. They understood that unhealthy drinking negatively impacts HIV care outcomes and used counseling, peer support, and referrals to routinely intervene. They however, did not apply other known interventions such as health education, medications and follow-up visits because these required family and institutional support which was largely lacking. Additional barriers that HCPs faced in caring for YPLH included; gaps in knowledge and skills required to address alcohol use in young patients, heavy workloads that hindered the provision of psychosocial interventions, late payment of and low remunerations, lack of improvement in some YPLH, and inadequate support from both their families and hospital management. CONCLUSION: HIV care providers are important stakeholders in the identification and care of YPLH with unhealthy alcohol use in Southwestern Uganda. There is a need to train and skill HCPs in unhealthy alcohol use care. Such training ought to target the attitudes, subjective norms, and perceived control of the providers.

Transforming harmful representations, investigating violence and empowering care practises in masculinities.

Stemming from a critical perspective of feminist studies on masculinities, this article proposes to explore how dominant and hegemonic masculinities are being reimagined, renegotiated and reconstructed, by understanding new patterns of violence amongst boys, on the one hand; and how care, as the opposite of violence, and a concept in construction from a feminist perspective, can be adopted, put in practise and understood. From a feminist standpoint masculinities studies need to go through a renewed problematisation of the social constructions of masculinities in a space-time context that intersects the economic crisis, health crisis and, on the other hand, implementation of legislation and initiatives for gender equality and citizenship, and is marked by social challenges that are related to the increase of gender inequality, violence indicators and extremism but also the emergence of caring masculinities that need closer attention. This feminist approach to masculinities allows us to critically challenge hegemonic models of boyhood/manhood, specifically by developing a FEMINIST THEORY OF CARING MASCULINITIES. Through a critical understanding of the new patterns and ways in which patriarchal masculinities are perpetuated in society, and placing CARE as the centrepiece and pro-active practise that opposes violence sustained models of masculinities, feminist masculinities studies can challenge dominant forms of masculinity by taking action in diverse social contexts and emphasising empathy, emotional expression, and cooperative relationships.

Turkish Validation and Cultural Adaptation of the Family Care Ability Assessment Scale for Pediatric Oncology Caregivers.

OBJECTIVES: This study aimed to investigate the psychometric properties of the Turkish version of the "Caring Ability of Family Caregivers of Patients with Cancer Scale" in parents of children with cancer". METHODS: The current study has a methodological design. The study group consisted of 493 parents of children with oncological problems who were followed in the pediatric hematology-oncology departments of three university hospitals. Data were collected between January and December 2021 through convenience sampling. The face, content construct validity, internal consistency, and scale stability were evaluated. SPSS 26.0 and LISREL 8.80 package programs were used to analyze the data. RESULTS: In the confirmatory factor analysis; root mean- mean square error of approximation, comparative fit index, normed fit index, and non-normed fit index were determined to be 0.08, 0.93, 0.91, and 0.92, respectively. Cronbach's alpha reliability coefficient obtained from the entire scale was calculated to be 0.88, the stability correlation coefficient was 0.84 (p < .005) and the item-total correlation coefficient was calculated between 0.249 and 0.716. CONCLUSIONS: The scale adapted to Turkish culture can be considered a valid and reliable tool for the assessment of the caring ability of family caregivers of patients with cancer. IMPLICATIONS FOR NURSING PRACTICE: The scale can be used to assess parents' caregiving abilities, to determine their strengths and weaknesses. In this respect, it can contribute to the creation of an education plan, the development of parents' caregiving abilities and the increase in the quality of care.

Formative Research to Design and Evaluate Caring Text Messages for American Indian and Alaska Native Youth, College Students, and Veterans.

Purpose. Caring Text Messages (CTM) is an evidence-based intervention, developed by the Northwest Portland Area Indian Health Board, modeled after the Caring Contacts (CC) intervention. CC has been shown to prevent suicide deaths, attempts, ideation, and hospitalizations in a variety of settings. Method. Three sets of CTM were developed by American Indian and Alaska Native (AI/AN) teens, college students, and veterans (tailored for each audience), which were reviewed by psychologists familiar with the intervention. To enroll in the service, participants texted a keyword to a text message short code and received two text messages per week with hopeful and encouraging messages. A robust multimedia social marketing campaign was designed to promote the service for each audience. Results. By September 2023, 387 participants enrolled in the Youth CTM intervention, 141 enrolled in the College CTM, and 31 enrolled in the Veterans CTM. Post surveys show elevated levels of user satisfaction. Conclusions. CTM can be tailored to reach populations at higher risk of suicide, including AI/AN youth, college students, and veterans, and connect them to culturally responsive peer and crisis support services. Continued monitoring and evaluation can guide next steps for marketing and outreach and will be useful to determine its impact on those who enroll.

Effectiveness of caring behaviours course on decision-making and caring behaviours in undergraduate nursing students: An experimental study.

BACKGROUND: Although caring is a core principle of the nursing profession, students often lack the knowledge, comprehension and ability to integrate care into all aspects of nursing practice. Students may have few opportunities to practise caring behaviours on patients who create the impression of providing care and elicit a feeling of receiving care. Studies of strategies to enhance caring behaviours in nursing education are limited. AIM: This experimental study aimed to examine the effect of nursing caring behaviours course based on interactive learning strategies on the caring behaviours and decision-making abilities of nursing students. METHODS: A purposive sample of 50 undergraduate students was recruited from a faculty of nursing. Students in the intervention group (n = 24) received 2 h of training per week for 14 weeks in accordance with caring behaviours course based on interactive learning strategies including discussion, brainstorming, concept mapping, reflection and simulation training. Nursing students in the control group (n = 26) received training according to other elective courses in the curriculum. Data were measured at the baseline time point, 7th week and 14th week with the Caring Behaviours Inventory and Nursing Decision-Making Instrument. Chi-square test, Mann-Whitney U-test, Friedman test and mixed repeated measures ANOVA were used to assess the data. RESULTS: No significant difference was determined in terms of baseline caring behaviours and decision-making scores between the intervention and control groups (p > 0.05). A significant difference in caring behaviours between the two groups and time effect was not found (p > 0.05). However, there was a significant interaction between time and groups (F = 3.484, p = 0.047). There was a significant increase in the decision-making in intervention groups over time (F = 9.372, p < 0.001) and interaction between time and groups (F = 4.160, p = 0.019). CONCLUSIONS: A deliberate strategy to raise students' awareness of caring behaviours and incorporate interactive learning methods into education enhances both caring behaviours and clinical decision-making.

Medical narrative ability and humanistic care ability of Chinese clinical nurses: The mediating role of empathy ability.

AIMS: To investigate the relationship between medical narrative ability and humanistic care ability among Chinese clinical nurses, examining the potential mediating role of empathy. BACKGROUND: In the context of the bio-psychosocial medical model and humanistic nursing care, understanding the core competencies of medical narrative ability, empathy and humanistic care in nursing is crucial. This study explored the mediating role of empathy between medical narrative ability and humanistic care ability. DESIGN: A cross-sectional study. METHODS: The study employed a descriptive, cross-sectional survey design, involving 741 nurses from Wuxi People's Hospital. It assessed nurses' demographic characteristics, medical narrative ability, empathy, and humanistic care ability using an online questionnaire from December 2022 to February 2023. Pearson correlation analysis evaluated variable correlations, and PROCESS v3.3 model 4 was utilised for mediation analysis. The STROBE statement was chosen as the EQUATOR checklist. RESULTS: A positive correlation was found between nurses' medical narrative ability, humanistic care ability and empathy. Empathy partially mediated the relationship between medical narrative ability and humanistic care ability. CONCLUSION: Nurses' medical narrative ability directly and indirectly (via empathy) influences their humanistic care ability. Enhancing nurses' narrative and empathic skills can improve humanistic care, nursing quality and nurse-patient relationships. RELEVANCE TO CLINICAL PRACTICE: Managers should prioritise programmes to improve nurses' storytelling and empathy skills to enhance humanistic care, improving nursing quality and patient relationships. PUBLIC CONTRIBUTION: This study involves clinical nurses as participants and does not involve patients. This study collected data from clinical nurses using an online questionnaire platform in China. The questionnaire consisted of four sections, including demographic information and scales such as Narrative Competence Scale, Caring Ability Inventory and the Jefferson Scale of Empathy-Health Professional. Clear instructions were given to participants on how to complete each scale, and measures were taken to prevent missing or duplicate responses.

Acute care nurses' decisions to recognise and respond to patient improvement: A qualitative study.

AIM: To explore and describe acute care nurses' decisions to recognise and respond to improvement in patients' clinical states as they occurred in the real-world clinical environment. DESIGN: A descriptive study. METHODS: Nine medical and eleven surgical nurses in a large Australian metropolitan hospital were individually observed during nurse-patient interactions and followed up in interview to describe their reasoning and clinical judgements behind observed decisions. Verbal description of observations and interviews were recorded and transcribed. Reflexive thematic analysis was used to analyse the data. RESULTS: The three themes constructed from the data were as follows: nurses checking in; nurses reaching judgements about improvements; and nurses deciding on the best person to respond. Acute care nurses made targeted assessment decisions based on predicted safety risks related to improvement in clinical states. Subjective and objective cues were used to assess for and make judgements about patient improvement. Acute care nurses' judgment of patient safety and a desire to promote patient centred care guided their decisions to select the appropriate person to manage improvement. CONCLUSIONS: The outcomes of this research have demonstrated that the proven safety benefits of acute care nurses' decision making in response to deterioration extend to improvement in patients' clinical states. In response to improvement, acute care nurses' decisions protect patients from harm and promote recovery. IMPLICATIONS FOR PATIENT CARE: Early recognition and response to improvement enable acute care nurses to protect patients from risks of unnecessary treatment and promote recovery. IMPACT: This study makes explicit nurses' essential safety role in recognising and responding to improvement in patients' clinical states. Healthcare policy and education must reflect the equal importance of assessment for and management of deterioration and improvement to ensure patients are protected and provided with safe care.

Perceptions and attitudes of Nursing students towards end-of-life care: a Phenomenological Study at a tertiary hospital in Uganda.

Introduction: Clinical practice is an important part of nursing education as it helps nursing students transition into competent health professionals who can provide quality services. However, research studies convey it as a significant stressor for nursing students when they are obliged to end of life during clinical practice. The perceptions of nursing students on caring for end-of-life care have not been exhaustively studied in the Ugandan context. This study was conducted to understand nursing students' perceptions of end-of-life care during clinical practice at Mulago Hospital. Methods: It was a qualitative study with a phenomenology method carried out among 15 nursing students from Makerere University who were assigned to Mulago Hospital for clinical practice. Data was gathered using an in-depth interview guide, audio was captured, and transcriptions were analyzed thematically using Atlas.ti version 6. Results: Three main themes emerged from the data; two themes on perceptions were (i) reactions when nursing students were informed about the physical process of caring for dying patients and (ii) how student ideas about the care changed during the process of caring for end-of-life. The third theme was the attitude of students towards patients when offering end of life care. participants described their reactions as chaotic, devastated and scared about their first-time encounter with caring for dying patients, the physical process also required preparation to handle the situation and understanding, and for positive personal values felt respected, appreciated, trusted and valued when informed about the physical process of caring for the end-of-life. Conclusion: In this study, nursing students held divisive attitudes on care for dying patients. However, nursing students appear to transition from unfavorable impressions of the process and encounter of caring for dying patients to positive perceptions during the actual caregiving experience. Despite their differing perspectives on caring for dying patients, students were typically empathic towards them.

Changes in ageing women's sexual subjectivity as seen from a life course perspective: security, caring, and desire.

This article explores the sexual subjectivity of women of post-reproductive age who seek partners on dating apps. The existing literature highlights the sexual subjectivity and agency of older women as contested and not sufficiently investigated. Even less research has been conducted on changes in the sexual subjectivity of women born in the USSR in the 1960s, with the liberalisation of sexual behaviour. The study is based on 45 interviews with women aged 55 years and over, who were born in the USSR and who now live in Israel, Finland and Russia. In the article, we examine sexual subjectivity as presented in the interviews from a life course perspective. We explain theoretically and empirically how changes in sexual subjectivity are expressed in the light of age and socio-cultural context constraints. Three life stories highlight the accumulation of experience and turning points, such as divorce and migration. They illustrate very different pathways in changing sexual subjectivity, yet all contain three Leitmotifs: desire, security and caring. The expression of post-reproductive female desire can be related to the need to feel secure and enjoy mutual care in sexual relationships. We show that these Leitmotifs shape and are shaped by women's identifications as both sexual objects and subjects, and explore how they relate to different sexual cultures and variations in the socio-sexual positioning of women in Israel, Finland, and Russia.

Developing care behaviors and ethical attitude in nursing education.

AIM: This study aims to determine the effect of education based on the Theory of Human Caring on nursing students' caring behaviors and ethical attitudes. BACKGROUND: It is crucial to plan nursing education holistically, addressing cognitive, psychomotor and affective domains for the comprehensive development of caring behaviors and ethical attitudes. DESIGN: This study employed a convergent mixed-methods approach with randomized pretest-posttest comparisons and qualitative analysis. METHODS: This study was conducted with third-year nursing students at a state university in Ankara, Turkey, in 2021. It comprised a total of 95 participants, with 47 students in the case group and 48 students in the video group. Theoretical education based on the Theory of Human Caring was simultaneously provided to both groups. Following this, one group received practical training using a video-supported teaching method, while the other group received it through a case analysis method. The research used the 'Descriptive Characteristics Form', 'Caring Nurse Patient Interaction Scale (CNPIS)', 'Scale for Attitudes of Ethical Principles (SAEP)' and 'Student Opinion Form on Care Behaviors Education' to collect data. Quantitative data were analyzed using t-tests, Mann-Whitney U tests, Wilcoxon paired two-sample tests and Linear Regression Analysis, with a significance level of p<0.05. Qualitative data were evaluated through document analysis. Permissions were obtained before the research. RESULTS: After the education provided, significant differences were found between the pre-test and post-test scores of both groups (p<0.05). It was determined that there was a statistically significant, positive and generally moderate relationship between the caring behaviors and ethical attitudes of the students. Additionally, participating students reported that they were satisfied with the education provided, stating that the teaching methods increased their motivation and positively influenced their perspectives on caring and its ethical dimensions. CONCLUSIONS: The research findings show significant improvements in nursing students' care behaviors and ethical attitudes following education based on the Human Care Theory, with both case analysis and video-supported teaching methods yielding notable results. Integration of care theories into the nursing undergraduate curriculum, alongside the use of holistic teaching methods, is recommended, along with further randomized controlled trials to assess teaching effectiveness.

Strengthening psychological well-being of Indonesian females with breast cancer through the religious-based caring program: A quasi-experimental study among Muslim population.

Background: Breast cancer presents significant psychological challenges along with physical health concerns, particularly in settings where cultural and spiritual values play a critical role in patient care. Objective: This study aimed to investigate the effect of a religious caring program on the psychological well-being of Indonesian females with breast cancer. Methods: This was a quasi-experimental study with a pretest and posttest control group design, conducted from January to July 2019 at a chemotherapy unit in Bandung, Indonesia. The patients with breast cancer were assigned to the experimental group (n = 55) and the control group (n = 57). Data were collected using the Psychological Well-Being Scale before and three weeks after the intervention. The data were analyzed using independent t-test and ANCOVA (Analysis of Covariance). Results: There was a significant improvement in the mean psychological well-being score in the experimental group following the intervention compared to the control group, with the experimental group showing a significantly higher mean score (Cohen's d = 1.4548, p <0.001). None of the covariates significantly affected psychological well-being among the experimental group (p >0.05). Conclusion: These results indicate that a religion-based caring program enhances psychological well-being. Thus, the program was effective and particularly well-suited for clinical nurses, suggesting that it should be recommended for Indonesian females with breast cancer to promote their recovery.

Family caregivers and the ethical relevance of moral identity.

Many people want to spend the last stages of their lives at home, in familiar surroundings, and possibly with people they know. However, this increasing desire on the part of older, ill, or even dying people also makes support from other people unavoidable, which in many cases involves family members, loved ones, or even friends. These family caregivers care for the person concerned, even though they lack the professional skills of nursing staff, for example, and have usually not been prepared for this task. This article focuses on the ethical significance of the moral identity of family caregivers. While the effects of this care constellation on the caregivers have often been discussed in the scientific literature, ethical considerations regarding moral identity have so far been neglected. In the first step, the question of what is actually meant by the term moral identity is examined. The second step shifts attention to those people who have taken on the care of a loved one. The relevance of this previously discussed identity is emphasized by using study results and work in this context, and placed in relation to family caregivers. The third step shows that (1) moral identity must be understood as a necessary prerequisite for adequate and humane care, (2) this identity can be enhanced through the caregiving relationship, and (3) the activities undertaken by family caregivers reveal their moral identity. These considerations are finally summarized, provided with ethical aspects, and awareness of this important work of family caregivers is raised.

Radiation therapist education and the changing landscape in Africa.

In the changing global landscape, education programs for radiation therapists (RTTs), also known as therapeutic radiographers or radiation therapy technologists, at higher education institutions (HEIs) are non-existent in many African countries. In countries with local RTT education programs, there is evidence of a wide variety of qualification types, including in-house training, diploma and degree offerings. However, what is consistent is the integrated curriculum approach to classroom theory and clinical work-based learning that across the continent follows the general structure of a work-integrated learning (WIL) approach, to enhance clinical competence and meet the needs of the health sector. This study used a qualitative approach with thematic analysis of publicly available documents and reflective writings followed by further analysis through application of the Cultural Historical Activity Theory (CHAT) to explore the changing landscape of oncology in Africa and the impact of this on the education of RTTs. The study was guided by the reflective research question: How can the systemic understanding of RTT training in a changing landscape enable competent and caring practice? The study extends prior research on RTT education in Africa and contributes to debates on the changing role of RTTs in a rapidly changing environment.

Development and Implementation of Postdischarge Text Messages to Adolescents With Suicidal Thoughts and Behaviors Through Caring Contacts: Implementation Study.

BACKGROUND: Youth suicide is a pressing public health concern, and transitions in care after a suicidal crisis represent a period of elevated risk. Disruptions in continuity of care and emotional support occur frequently. "Caring contacts" validating messages post discharge have the potential to enhance connections with patients and have been shown to improve outcomes. More recently, positive outcomes have been noted using caring contact text messages (SMS and MMS), which hold promise for engaging patients in a pediatric setting, but there are few studies describing the large-scale implementation of such an approach. OBJECTIVE: This study aims to describe the process of developing and implementing automated caring contacts within a quality improvement framework, using a standardized series of supportive texts and images, for adolescents discharged from high-acuity programs at a large midwestern pediatric hospital. We describe lessons learned, including challenges and factors contributing to success. METHODS: We implemented the caring contacts intervention in 3 phases. Phase 1 entailed developing supportive statements and images designed to promote hope, inclusivity, and connection in order to create 2 sets of 8 text messages and corresponding images. Phase 2 included piloting caring contacts manually in the hospital's Psychiatric Crisis Department and Inpatient Psychiatry Unit and assessing the feasibility of implementation in other services, as well as developing workflows and addressing legal considerations. Phase 3 consisted of implementing an automated process to scale within 4 participating hospital services and integrating enrollment into the hospital's electronic medical records. Process outcome measures included staff compliance with approaching and enrolling eligible patients and results from an optional posttext survey completed by participants. RESULTS: Compliance data are presented for 4062 adolescent patients eligible for caring contacts. Overall, 88.65% (3601/4062) of eligible patients were approached, of whom 52.43% (1888/3601) were enrolled. In total, 94.92% (1792/1888) of enrolled participants completed the program. Comparisons of the patients eligible, approached, enrolled, and completed are presented. Primary reasons for eligible patients declining include not having access to a mobile phone (686/1705, 40.23%) and caregivers preferring to discuss the intervention at a later time (754/1705, 44.22%). The majority of patients responding to the optional posttext survey reported that the texts made them feel moderately to very hopeful (219/264, 83%), supported (232/264, 87.9%), that peers would be helped by these texts (243/264, 92%), and that they would like to keep receiving texts given the option (227/264, 86%). CONCLUSIONS: This study describes the successful implementation of automated postdischarge caring contacts texts to scale with an innovative use of images and demonstrates how a quality improvement methodology resulted in a more effective and efficient process. This paper also highlights the potential for technology to enhance care for at-risk youth and create more accessible, inclusive, and sustainable prevention strategies.

Emergency patients' satisfaction with humanistic caring and its associated factors in Chinese hospitals: a multi-center cross-sectional study.

Purpose: Humanistic caring in clinical practice is important for quality care and patient satisfaction. This study aimed to assess patient satisfaction with humanistic care for emergency patients in China and its associated factors. Methods: From October 2023 to December 2023, a multi-center cross-sectional survey was conducted across 28 provinces and 87 hospitals in China, using a sampling method for inpatients in emergency department. Patient satisfaction with humanistic care was evaluated by a self-developed questionnaire with 32 items across 6 dimensions. Stepwise multiple linear regression was used to explore associated factors. Results: A total of 3,003 valid questionnaires were successfully collected, with an effective rate of 86.05%. The emergency patients' total mean humanistic caring satisfaction score was 4.67 ± 0.66. Age, medical insurance type, specialized emergency department visited, waiting times, whether had accompanied person, hospital level, and hospital type are correlated factors (P < 0.05) regarding humanistic caring satisfaction. The correlation analysis showed perceived value, and its three dimensions were moderately correlated with humanistic caring satisfaction. The multiple linear regression showed waiting time (ß = -0.219, P < 0.05), whether had accompanied person (ß = -0.192, P < 0.05), hospital level (ß = -0.137, P < 0.05), functional value (ß = 0.197, P < 0.05), and emotional value (ß = 0.418, P < 0.05) were strong predictors. Conclusion: Hospitals at all levels should improve patients' perceived value, shorten waiting times, and provide caregivers with improved humanistic care in the emergency department.

Linking patient safety, caring behaviours and professional self-efficacy with missed nursing care among Filipino emergency room nurses: A structural equation model study.

AIMS: To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses. DESIGN: Cross-sectional, correlational study. METHODS: Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses. RESULTS: The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care. CONCLUSION: Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks. REPORTING METHOD: STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.