Updating Factors Influencing Nurse Work Engagement in the Hospital Settings: A Systematic Review.

Background: Understanding the factors influencing work engagement among nurses is crucial for ensuring high-quality care and positive patient outcomes. Despite numerous factors associated with nurse work engagement, many were explored before the pandemic, potentially overlooking aspects relevant to the current context. Aim: To explore and update factors related to nurse work engagement in the new normal era. Design: Systematic review. Data Sources: The search was restricted to articles published from 2019 to 2024 in CINAHL, PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest, with full English text. The search was conducted from September 13th to 15th, 2023. Quantitative research articles that examined factors related to work engagement were included. Review Methods: Data extraction, quality appraisal, and data analysis were performed in all included studies. Manual content analysis method was used to classify and group the factors. Results: Sixty-one research articles were included in the final review. Five key groups of factors were generated from content analysis, including 1) individual-related factors, 2) organizational-related factors, 3) job and role-related factors, 4) work-life balance, and 5) work environment. Conclusion: Understanding and addressing these multifaceted factors holistically is essential to develop strategies to sustain optimal engagement levels among nursing staff and improve overall patient care outcomes. Further studies are needed to confirm the findings.

Family visits and depression among residential aged care residents: An integrative review.

BACKGROUND: Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population. OBJECTIVE: This literature review seeks to explore the association between family visits and depression among those living in residential aged care. METHODS: An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895). RESULTS: Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement. CONCLUSION: Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families. TWEETABLE ABSTRACT: Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial.

Effect of a telecare-based intervention on stress levels in informal caregivers of older adults: protocol for a randomized controlled trial.

Significance: Due to caregiving commitments, caregivers of older adults may not have the time to make use of the onsite community services available to them during the day. With the support of advanced technology, telecare could be a convenient and easily accessible channel for providing individualized caregiving advice to caregivers. Objective: The aim of the study is to describe a research protocol that highlights the development of a telecare-based intervention program for reducing stress levels in informal caregivers of community-dwelling older adults. Methods: It is a randomized controlled trial. The study is supported by two community centers. The study participants will be randomly assigned to either the telecare-based intervention group or the control group. The former will receive a 3-month program comprised of three components: online nurse case management supported by a health and social care team, an online resource center, and a discussion forum. The latter will receive the usual services that provided by the community centers. Data will be collected at two time points - pre-intervention (T1) and post-intervention (T2). The primary outcome is stress levels, while secondary outcomes include self-efficacy, depression levels, quality of life, and caregiving burden. Discussion: Besides taking care of one or more older adults, informal caregivers have to deal with work, chores, and take care of their children. This study will add valuable information to the knowledge gap on whether telecare-based interventions with the support of an integrated health-social team can alleviate the stress levels of informal caregivers of community-dwelling older adults. If successful, policymakers and healthcare professionals should consider incorporating telecare modalities in a primary health setting for informal caregivers to correspond with them, to relieve their caregiving stress and promote a healthy life. Clinical trial registration: https://www.clinicaltrials.gov/, NCT05636982.

What interventions and programmes are available to support older nurses in the workplace? A literature review of available evidence.

BACKGROUND: High exit rates, stalling entry rates, population ageing, and, most recently, the COVID-19 pandemic have placed significant strain on the world's nursing workforce. Both developed and developing countries face similar predicaments. Evidence-based programmes to support older nurses in the workplace are urgently needed to ensure the sustainability of a career in nursing for this group of healthcare professionals. OBJECTIVES: To scope and synthesise available evidence on evaluated programmes and interventions implemented to support the ageing nursing workforce's health, wellbeing, and retention. DESIGN: A literature review of available evidence using a systematic approach. METHOD: Medline, Scopus, PsycINFO and CINAHL were searched for relevant peer-reviewed evidence. Data from the peer-reviewed literature were extracted separately into purpose designed-extraction spreadsheets. Information relevant to study design, intervention design, outcome constructs, intervention outcomes, and barriers and enablers to intervention success were collected. The protocol for this review was registered in PROSPERO [CRD42021274491]. RESULTS: Eighteen published studies were included in this review. We identified a range of interventions and programmes that have been implemented to support older nurses, which included flexible and reduced work arrangements, mentoring programmes, exercise and lifestyle interventions, continued professional development and purpose-designed remote retreats. We found limited evidence of evaluated outcomes from workplace support interventions that addresses the actual challenges faced by ageing nurses as reported in previous literature reviews. Interventions that were designed to promote a sense of purpose at work resulted in positive outcomes and appeared to more directly address the stated needs of older nurses. Holistic programmes and interventions that could potentially promote both physical well-being and psychological well-being required a broader, whole-of-organisation approach rather than more piecemeal interventions addressing individual physical and mental health concerns. Interventions which acknowledged older nurses' clinical expertise and experience (e.g., mentoring programmes) were linked to positive outcomes. CONCLUSION: Future intervention efforts should acknowledge and balance intervention participation opportunities against existing everyday workload constraints faced by older nurses. Our review suggests the need for further intervention studies assessing specific outcomes such as psychological and emotional health, as well as interventions that more directly address the most pressing concerns that ageing nurses report at personal and organisational levels. A paradigm shift in productivity measurement in clinical nursing work is required in order to increase the value placed on the unique contribution of older nurses working clinically, particularly in sharing their acquired knowledge, skill, and expertise.

The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review.

AIMS AND OBJECTIVES: To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff. BACKGROUND: Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered. DESIGN: An integrative review of literature. METHODS: Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework. RESULTS: Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia. CONCLUSIONS: Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia. RELEVANCE TO CLINICAL PRACTICE: Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care.

Age-friendly interventions in rural and remote areas: A scoping review.

OBJECTIVES: In 2007, the World Health Organization published a guide on age-friendly cities. However, little is known about interventions that have been implemented to promote age-friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategies, and programs that have been implemented in rural and remote areas to create age-friendly communities. METHODS: This scoping review used the Joanna Briggs Institute (JBI) methodology. RESULTS: A total of 219 articles were included in this review. No intervention studies were referred to as 'age-friendly'. However, there were interventions (mostly healthcare-related) that have been implemented in rural and remote areas with older people as participants. There were also non-evaluated community programs that were published in the grey literature. This review identified the common health interventions in older people and the indirect relevance to the WHO age-friendly framework domains in rural and remote contexts. CONCLUSIONS: The eight age-friendly domains were not explicitly utilised as a guide in the development of interventions for older people in rural and remote settings. Implementation of age-friendly interventions in rural and remote areas requires a multisectoral approach that is tailored to address the specific needs of individual communities. Age-friendly interventions also need to consider socio-ecological factors to adequately and holistically address community needs and ensure long-term sustainability.

The COVID-19 pandemic: Narratives of front-line nurses from Wuhan, China.

This study aimed to explore the experiences of nurses in Wuhan Hospital as front-line workers during the COVID-19 pandemic. A descriptive qualitative study of such nurses was conducted from a tertiary hospital in Wuhan. Semi-structured individual interviews were undertaken with 8 registered nurses who were front-line health workers in one of the COVID-19 wards and 3 nursing managers from the response team. Five discrete themes were identified from the narratives of nurses' experiences during the COVID-19 outbreak in Wuhan: "content of fundamental care," "teamwork," "reciprocity," "nurses' own worries," and "lifelong learning and insights." Nurses in the front line of care during the COVID-19 pandemic can contribute important information from their hands-on experience for providing a holistic response to an infectious outbreak like COVID-19. The concerns nurses raised at both personal and professional levels have implications for nursing education and clinical practice settings, particularly in the time of a pandemic when nurses' well-being requires attention, and at the same time for considering organizational factors that enable nurses to provide care to patients with confidence. Hospital policies and nursing management need to be ready and adhere to flexible work planning systems and approaches during a pandemic.

Seeking and maintaining connections: A grounded theory study of maintaining spirituality in residential aged care facilities.

BACKGROUND: Moving to a residential aged care facility involves living far from family and a familiar environment, and leaving behind the social support system of relatives, friends, and society. The pressure to find and develop new and meaningful connections in a residential aged care facility can be significant for older adults. OBJECTIVE: To provide a theoretical explanation of how older adults seek and maintain connections in a residential aged care facility. METHODS: A grounded theory study was conducted. A total of 17 residents were recruited from two Nepalese residential aged care facilities using theoretical sampling. Face to face in-depth, semi-structured interviews and observation within interviews were conducted. Data analysis included the process of open, axial, selective coding, and constant comparative analysis as per Corbin and Strauss' variant of grounded theory. RESULTS: This study identified that the process of seeking connections in a residential aged care facility was forward-moving, and involved "identifying sources," "developing connections," and "appraising responses." By seeking connections, residents built new connections. Similarly, the study found that maintaining connections was a continuous process of "sustaining connections with co-residents," "preserving connections with nurses/caregivers," and "continuing connections with inner-self and higher being/s." Maintaining connections led residents to balance shifting connections. Furthermore, it was found that the process of seeking and maintaining connections was conditional on facility arrangement i.e. the way residents were placed, rules, regulations, co-residents' language, gender, religious affiliation, attitudes, the attitudes and practices of nurses/caregivers, decreasing physical abilities of residents, increasing illness of residents, illness or death of co-residents, and retirement or resignation of nurses/caregivers. CONCLUSION: The current study provides unique insights into the process of seeking and maintaining connections in a residential aged care facility. Facility arrangement, rules, regulations, and caregiving practices should resonate with residents' socio-cultural expectations and spiritual belief system to support their process of seeking and maintaining connections. IMPLICATIONS FOR PRACTICE: The findings can be beneficial for managers, nurses, caregivers, and spiritual advisors in developing interventions that promote the development of meaningful connections in a residential aged care facility.

"Connecting the dots" - The transfer of bioscience knowledge by new graduate nurses to the clinical setting: A qualitative study.

BACKGROUND: Little is known regarding the transfer of bioscience knowledge gained during undergraduate nursing studies into clinical practice. OBJECTIVE: To explore the experiences of new registered nurses in applying bioscience concepts in their day-to-day nursing practice. DESIGN: Descriptive qualitative design. PARTICIPANTS: Fifteen recently graduated registered nurses (RNs) who were working in acute care settings participated in the study. METHODS: Semi-structured, face-to-face individual interviews were conducted. Interview data were audio-recorded and thematically analysed. RESULTS: Four themes were identified from the qualitative interviews. The first and second themes demonstrated nurses' realisation of the relevance of theoretical bioscience knowledge learnt within the classroom to their practice and how this evidence-based knowledge translated into confidence in decisions made. The third and fourth themes revealed the impact bioscience knowledge had on RNs' relationships with patients and family members, which was viewed as providing compassionate care. CONCLUSIONS: The application of knowledge in biosciences gained during their undergraduate years, provided the basis for RNs to trust in their own clinical judgment and to speak with conviction. 'Connecting the dots' between bioscience knowledge and clinical practice provided the platform for RNs to gain and build trust with their patients. The practical utility of bioscience knowledge in everyday practice allowed RNs to contextualise their nursing care regimen and tailor holistic nursing care delivery to individual patient needs.

Effectiveness of acupoint pressure on older people with constipation in nursing homes: a double-blind quasi-experimental study.

Aims: To compare the differences between acupoint pressure, abdominal massage and laxatives in treatment of constipation for residents in two nursing homes.Background: There is lack of evidence on the utility of complementary therapies in the management of constipation among older adults.Design: Quasi-experimental.Methods: A total of 90 participants from two nursing homes in Taiwan were assigned to three groups: the control group (with laxatives only), group I (with laxatives and abdominal massage) and group II (with laxatives, acupoint pressure therapy [APT] and abdominal massage). The intervention was performed over 10 days. A double-blind technique was applied in both participants and the outcome assessors. Constipation as main outcome was evaluated and recorded for 10 days. Observation of the frequency of defecation and the consistency, particularly firmness of faeces over each 24 h' period was recorded. The Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist was utilised in reporting methods and findings.Results: Three variations were revealed as interface factors and showed significant differences in each group. The results showed a statistically significant decrease in constipation in the experimental groups I and II. The scores of defecation frequency, difficulty degree and time of defecation, stool quality and awareness of defecation were obviously improved after treatment.Conclusions: We concluded APT could be used in conjunction with laxatives and must be considered as a long-term intervention. The combination of APT, abdominal massage and laxatives is superior to both abdominal massage with laxatives and laxatives alone.Relevance to clinical practice: Acupoint pressure as an effective complementary therapy of constipation among older adults living in nursing home provides a non-pharmacological, independent nursing intervention that nurses could use. This is relevant to nursing home settings where nurses make autonomous decision on important clinical assessments and interventions.

What is known about the spirituality in older adults living in residential care facilities? An Integrative review.

AIM: To synthesize evidence regarding the spiritual needs and care of older adults living in residential care facilities from the perspectives of older adults and nurses or caregivers. DESIGN: Integrative review of literature. DATA SOURCES: Literature search was conducted using CINAHL Plus with Full Text via EBSCO, Scopus, PubMed, PsychInfo, Web of Science, and ProQuest Social Science Databases from March to December 2017. REVIEW METHODS: This integrative review utilised the Whittemore and Knafl framework and PRISMA in the selection of eligible articles. Quality of the articles was evaluated using the Mixed Method Appraisal Tool. RESULTS: Seven articles were reviewed and analysed. There is limited evidence \and no agreed definition of spiritual needs and care of older adults living in residential care facilities. Spiritual needs of older adults in residential care facilities is a psycho-social, religious and existential construct. Spiritual care in residential care facilities is linked to information gathering, religious guidance, maintaining family connections, providing companionship, discussing end of life issues, and providing counseling. Older adults highly value the role of nurses and caregivers in fulfilling their spiritual needs and providing spiritual care. However, nurses and caregivers perceived arranging a referral to a religious advisor as the main aspect of spiritual care. Therefore, nurses', caregivers', and older adults' views on spiritual care differed to some extent. CONCLUSION: The practical aspects of spiritual needs assessment and spiritual care provision requires further investigation, which is essential to improve the effectiveness of service delivery in residential care facilities.

Culturally and Linguistically Diverse Older Adults and Mainstream Long-Term Care Facilities: Integrative Review of Views and Experiences.

Older adults from culturally and linguistically diverse (CALD) backgrounds are increasingly identified within mainstream aging populations. However, few studies have focused on CALD older adults' views and experiences in long-term care facilities (LTCFs). The current integrative review aimed to achieve a contemporary understanding through synthesized evidence from studies focusing on CALD older adults in mainstream LTCFs. Two major categories were identified-Views About LTCFs, which included two subcategories: (a) the last stop and no other choice and (b) reasons for admission or transfer; and Experiences of Living in LTCFs, which also included two subcategories: (a) desire to remain connected to personal routines and (b) maintaining identity through native language. CALD older adults have differing perspectives about LTCFs, which are influenced by their cultural backgrounds and values. Future research should evaluate the effectiveness of ethno-specific LTCFs. Establishing culturally appropriate services for CALD older adults in LTCFs, particularly in mainstream facilities, should emphasize cultural accommodation among residents, health care providers, and staff. [Res Gerontol Nurs. 2018; 11(5):265-276.].

Nursing Work in Long-Term Care: An Integrative Review.

Evidence suggests that delivery of good nursing care in long-term care (LTC) facilities is reflected in nurses' descriptions of the factors and structures that affect their work. Understanding the contemporary nature of nursing work in aged care will influence policies for improving current work structures in this practice setting. The current review aims to present a contemporary perspective of RNs' work in LTC facilities. A comprehensive search and purposeful selection of the literature was conducted using CINAHL, PubMed, Medline, Scopus, and Google Scholar databases. Nine studies were eligible for review. Common themes revealed that nursing work in aged care settings is characterized by RNs providing indirect care tasks-primarily care coordination, engaging in non-nursing activities, and having an expanded and overlapping role. As care providers, aged care RNs do not always provide direct care as part of their nursing work. The scope of RN work beyond its clinical nature or performance of non-nursing tasks adds complexity in clarifying RN work roles in aged care. [Journal of Gerontological Nursing, 43(11), 41-49.].