Adaptation and Validation of the Self-Administered Foot Health Assessment Instrument for Portuguese Undergraduate Nursing Students.

Background and Purpose: To translate and adapt the Self-Administered Foot Health Assessment Instrument from English to European Portuguese and explore its reliability and validity among undergraduate nursing students in Portugal. Methods: The study was divided into two phases. First, the translation and cross-cultural adaptation followed Beaton's guidelines, with a pretesting of the final version with 30 students. The validation process used the content validity index with a minimum of 75% agreement between experts and Cronbach's alpha for internal consistency. The second step provided the results of the principal component analysis and confirmatory factor analysis, which were performed to study the overall fit of the model and item correlations. The STROBE checklist was used. Results: The Portuguese version, Instrumento de Auto-Avaliação da Saúde do Pé (IAASP), showed an overall acceptable evidence regarding content validity and internal consistency. The factor analysis results suggested removing the "Foot pain" dimension from the original scale. Conclusions: IAASP is suggested to maintain the original 22-item structure, with four domains, "Skin health," "Nail health," "Foot structure," and "Foot pain," being an initial reliable version with interest to measure the current foot health of nursing students. Future studies should contribute to IAASP's continuous improvement.

Insights on spirituality and bereavement: A systematic review of qualitative studies.

AIM: To describe a synthesis of the experience related to the spirituality of those living a bereavement journey in primary qualitative studies. DESIGN: A systematic review of qualitative studies. DATA SOURCE: A systematic review was carried out in March 2019 and was updated in January 2023. Searching was accomplished by an online database, such as CINAHL, MEDLINE, PsycINFO, MedicLatina, LILACS, SciELO and Academic Search Complete. The search strategy did not consider a timeline as an eligibility criterion. The quality of the studies was assessed, and a thematic synthesis was performed in this review. METHODS: A systematic review of qualitative studies was conducted according to Saini and Shlonsky's methodology. REPORTING METHOD: PRISMA checklist. RESULTS: The review included 33 articles. Most of the studies were phenomenological and focused on parents' and family experiences of bereavement. Seven significant categories emerged, which match unmet spiritual needs during the grieving process. Two major categories were identified regarding the role of spirituality in bereavement: Spirituality as a process and spirituality as an outcome. CONCLUSION: In clinical practice, attention to spirituality and providing spiritual care is critical to guarantee a holistic approach for those experiencing bereavement. IMPLICATIONS: The findings of our study could foster awareness that healthcare professionals should include the spiritual dimension in their clinical practice to provide holistic care to individuals, enhancing the healing process in bereavement. NO PATIENT OR PUBLIC CONTRIBUTION: This is a systematic review.

Women's fear of childbirth during pregnancy: A concept analysis.

PURPOSE: To map and analyze the concept of women's fear of childbirth (FOC) during pregnancy and to develop a new nursing diagnosis (ND). METHODS: Concept analysis based on Walker and Avant's methodology. An integrative literature search was conducted in Scopus, Web of Science, and CINAHL Complete databases, including peer-reviewed articles published in English from January 1981 to October 2022. FINDINGS: Thirty-one studies were included in the review. Women's FOC during pregnancy comprises three central categories: attributes, antecedents, and consequences. Nine main characteristics (attributes) are related to one or more of eight prior conditions (antecedents) that have the potential to exert negative or favorable impacts (consequences), depending on whether coping strategies have been a part of a fearful woman's pregnancy. These elements and relationships among them should be viewed as dynamic. CONCLUSIONS: Women's FOC during pregnancy is a subjective, multidimensional, and dynamic concept that benefits prenatal care responses. A conceptual matrix on prenatal care will consider the factors underlying women's FOC and their potential mechanisms, how fearful pregnant women respond, the aspects that shape FOC, and how it influences outcomes when supporting pregnant women with FOC. Therefore, the study findings can be used to inform ways of identifying fearful women or as a basis for interventions to manage fears and enhance the confidence of pregnant women for childbirth. IMPLICATIONS FOR NURSING PRACTICE: The results of this study help nurses, OB nursing practitioners, nurse-midwives, and midwives to identify the condition of women's FOC during pregnancy and guide nursing therapeutic interventions to decrease the negative effects on women's health and well-being. Therefore, there are valuable reasons to propose using "fear of childbirth" as a ND in the class "coping responses" within domain coping/stress tolerance, contributing to refining the NANDA-I taxonomy.

OBJETIVO: Mapear e analisar o conceito de medo do parto em mulheres durante a gravidez e desenvolver um novo diagnóstico de enfermagem. MÉTODOS: Análise de conceito com base na metodologia de Walker e Avant. Foi realizada uma pesquisa integrativa da literatura nas bases de dados Scopus, Web of Science e CINAHL Complete e incluiu artigos revistos por pares, publicados em inglês, de janeiro de 1981 a outubro de 2022. RESULTADOS: Trinta e um estudos foram incluídos na revisão. O medo do parto em mulheres durante a gravidez é composto por três categorias centrais: atributos, antecedentes e consequências. Nove características principais (atributos) estão relacionadas com uma ou mais das oito condições anteriores (antecedentes) que têm o potencial de exercer um impacto negativo ou favorável (consequências), dependendo se estratégias de coping fizeram parte da gravidez de uma mulher com medo. Estes elementos e as relações entre eles devem ser vistos como dinâmicos. CONCLUSÕES: O medo do parto em mulheres durante a gravidez é um conceito subjetivo, multidimensional e dinâmico que beneficia de respostas pelos cuidados pré-natais. Uma matriz conceptual sobre cuidados pré-natais considerará os fatores subjacentes ao medo do parto nas mulheres e os seus potenciais mecanismos, como as mulheres grávidas com medo respondem, os aspetos que moldam o medo do parto, e como influenciam os resultados quando as mulheres grávidas com medo do parto são apoiadas. Portanto, os resultados do estudo podem ser usados para identificar mulheres com medo ou desenvolver intervenções que permitam gerir os medos e aumentar a confiança das mulheres grávidas para o parto. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os resultados deste estudo ajudarão os enfermeiros de atenção à saúde materna a identificar a condição do medo do parto nas mulheres durante a gravidez e orientar intervenções terapêuticas de enfermagem, no sentido de diminuir os efeitos negativos do medo na saúde e no bem-estar das mulheres. Portanto, há razões relevantes para propor a utilização do "medo do parto" como um diagnóstico de enfermagem na classe "coping responses" do domínio "coping/stress tolerance", contribuindo para o refinamento da taxonomia NANDA-I.

Resilience in Older People: A Concept Analysis.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

Spiritual distress and religious involvement among cancer patients receiving chemotherapy: A longitudinal study.

PURPOSE: To determine the trajectories of spiritual distress and religious involvement among cancer patients during chemotherapy. METHODS: A prospective longitudinal study was conducted over 15 months with quarterly data collection, in a total of with five cut points. Data collection was applied a questionnaire that embraced sociodemographic characteristics, clinical profile, Spiritual Distress Scale, and Belief into Action Scale. Regarding, data analysis was performed univariate, bivariate, and multivariate statistics, and the study was approved by the Ethics Committee. FINDINGS: From the 322 cancer patients at the beginning, the attrition rate was 17.5% in the last time point. Most of participants were women (56.6%), with an average age of 60.3 years, and had a religious affiliation (93.7%). Statistically significant values were found of spiritual distress and religious involvement across the five cuts. At the end of 3 months after starting chemotherapy, the highest value of spiritual distress and the lowest value of religious involvement were reached. CONCLUSIONS: Cancer patients who are submitted to chemotherapy, after 3 months of treatment experience the peak of spiritual distress and the lowest value of religious involvement. This critical period for nurses' is required a massive approach regarding spiritual and religious needs. IMPLICATIONS FOR NURSING PRACTICE: Therefore, knowing the trajectories of spiritual distress and religious involvement during a certain period allows for the anticipating of planning of nursing therapeutic interventions in order to promote spiritual health and spiritual well-being outcomes in cancer patients.

Nursing diagnoses disturbed body image (00118) and situational low self-esteem (00120) in patients with head and neck cancer: Differential clinical validation using Q methodology.

PURPOSE: When submitted to mutilating surgery, patients with head and neck cancer may present profound physical and psychosocial changes, temporary or definitive, with an individual impact and family. The most frequent human responses to this health condition are subjective, particularly concerning body image and self-esteem. Differential validation emerges to provide nurses with clinical indicators for clinical reasoning and planning of effective interventions, considering the specific defining characteristics of each diagnosis. This study aimed at conducting a differential clinical validation of the nursing diagnoses of disturbed body image and low situational self-esteem in patients with head and neck cancer using Q methodology. METHOD: We performed an observational cross-sectional study using Q methodology. Thirty-eight participants were included. Data were analyzed using Q methodology procedures. The research and ethics committee approved the study. FINDINGS: Factor analysis was performed, and eight defining characteristics were identified for the diagnosis of disturbed body image and one for situational low self-esteem: avoiding looking at one's body, avoiding touching one's body, the behavior of monitoring one's body, depersonalization of body part by use of impersonal pronouns, focus on past appearance, focus on past function, negative feeling about body, and refusal at acknowledging change and helplessness. CONCLUSIONS: The use of the Q methodology in this process of differential validation allowed the study of two diagnoses of a subjective nature, disclosing the most specific defining characteristics of each and contributing to increasing the knowledge of these human responses. IMPLICATIONS FOR NURSING PRACTICE: This study contributes to a better understanding of the predominant defining characteristics of the diagnoses under study. In terms of the NANDA-I taxonomy, it helps to raise the levels of evidence for diagnoses. Using a qualitative and quantitative methodology allows for maintaining a more holistic research approach and greater rigor and acceptance of the results.

OBJETIVO: Os doentes com cancro de cabeça e pescoço, submetidos a cirurgias mutilantes, apresentam profundas alterações físicas e psicossociais, temporárias ou definitivas, com impacto no indivíduo e na família. As respostas humanas mais frequentes nestes processos de doença são de natureza subjetiva, principalmente relacionados à imagem corporal e à autoestima. A validação diferencial surge com o objetivo de fornecer aos enfermeiros indicadores clínicos para raciocínio clínico e planeamento de intervenções efetivas, considerando as características definidoras específicas de cada diagnóstico. Realizar validação clínica diferencial dos diagnósticos de enfermagem distúrbio da imagem corporal e baixa autoestima situacional em doentes com câncer de cabeça e pescoço, utilizando a metodologia Q. MÉTODO: Estudo observacional transversal com metodologia Q. Trinta e oito participantes foram incluídos. Foi usada a metodologia Q para analisar os dados. A comissão de ética e de investigação aprovou o estudo. RESULTADOS: Foi realizada análise fatorial, sendo identificadas oito características definidoras para o diagnóstico de imagem corporal perturbada e uma para baixa autoestima situacional: Evitar olhar para o seu corpo, evitar tocar no corpo, comportamento de monitorização do corpo, despersonalização da perda através do uso de pronomes impessoais, foco na aparência passada, foco em função do passado, sentimento negativo acerca do corpo, recusa em reconhecer a mudança e desamparo. CONCLUSÕES: A utilização da metodologia Q, neste processo de validação diferencial, permitiu o estudo de dois diagnósticos de natureza subjetiva numa população vulnerável, contribuindo para aumentar o conhecimento das suas necessidades. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Contribuir para uma melhor compreensão das características definidoras predominantes dos diagnósticos em estudo. Em termos da taxonomia NANDA - I, ajuda a elevar os níveis de evidência para diagnósticos. A utilização de uma metodologia qualitativa e quantitativa permite manter uma abordagem de investigação mais holística e um maior rigor e aceitação dos resultados.

The Primary Nursing Care Model and Inpatients' Nursing-Sensitive Outcomes: A Systematic Review and Narrative Synthesis of Quantitative Studies.

BACKGROUND: The delivery of quality, safe, and patient-centered care is foundational for professional practice. The primary nursing model allows nurses to have excellent knowledge about patients and families and to plan and coordinate care from admission to discharge, with better management of health situations. Nurses play a crucial role in improving patients' outcomes, namely those sensitive to nursing care. The knowledge of the relationship between the primary nursing model and the nursing-sensitive outcomes provides new scientific evidence that strengthens the relevance of this nursing care organization model in the inpatients' health outcomes. This systematic review describes the relationship between nurse-sensitive inpatients' outcomes and the primary nursing care model. METHODS: A systematic review was conducted with a narrative synthesis, and the following databases were searched: MEDLINE, CINAHL, Web of Science, Nursing & Allied Health Collection, SciELO Collections, and Cochrane. RESULTS: A total of 22 full texts were assessed, of which five were included in the study according to the selection criteria. The analysis results indicated that the primary nursing care model was related to nursing-sensitive patient safety outcomes. Patients' experience was also considered a nursing-sensitive outcome, namely in the satisfaction with nursing care. CONCLUSION: The negative outcomes are clearly related to the primary nursing care model. There is scarce research that relates primary nursing to positive outcomes, such as patients' functional status and self-care abilities, and more studies are needed.

Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review.

BACKGROUND: Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses' ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. METHODS: This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. FINDINGS: The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. CONCLUSION/APPLICATIONS TO PRACTICE:: Few studies have focused on nurses' foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses' workplaces.

Inteligencia emocional de enfermeras de cuidados críticos: scoping review / Critical care nurses’ emotional intelligence: A scoping review

Objetivo: La inteligencia emocional de enfermeras de cuidados críticos es una competencia necesaria en el desempeño laboral. Esta revisión tiene como objetivo construir un mapeo y sintetizar el conocimiento sobre la inteligencia emocional de enfermeras que trabajan en las unidades de cuidados críticos. Método: Scoping review basada en las recomendaciones indicadas por The Joanna Briggs Institute. Han sido considerados enfermeras como población, los cuidados críticos como contexto y la inteligencia emocional como concepto. Se ha realizado una búsqueda en bases de datos y en plataformas electrónicas tales como CINAHL Complete, MEDLINE complete, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive (via EBSCOhost), MedLine (via PubMed), SCOPUS y Web of Science. De un total de 40 seleccionados inicialmente, han sido incluidos 9 artículos en la revisión. Resultados: Los 9 artículos enfatizan la relevancia de la inteligencia emocional en la experiencia profesional, en el agotamiento emocional y la prevención del síndrome del agotamiento profesional (burnout), en el aumento de la cultura de seguridad del paciente, en la contribución para un comportamiento de ciudadanía organizacional, y en la resiliencia. Conclusiones: La inteligencia emocional es una competencia esencial de enfermeras de cuidados críticos, con repercusiones a nivel profesional, personal y en la organización.(AU)

Objective: Emotional intelligence is often described as the ability to know own emotions and to be aware of other emotions. The emotional intelligence of critical care nurses is a necessary competence for work performance. The aim of this review is to map the evidence on emotional intelligence of nurses working in this specific context. Methods: Scoping review based on Joanna Briggs Institute guidance. Nurses as a population, critical care as a context and emotional intelligence as a concept were considered. Search was conducted using databases and electronic platforms such as CINAHL Complete, MEDLINE complete, Cochrane Central Register of Controlled Trials, Nursing & Allied Health Collection: Comprehensive (via EBSCOhost), MedLine (via PubMed), SCOPUS and Web of Science. From a total of 40 citations, 9 articles have been included in the review. Results: The 9 articles emphasise the relevance of emotional intelligence in the professional experience, in emotional exhaustion and burnout prevention, in enhancing the safety culture of the sick, in contributing to organisational citizenship behaviour, and in resilience. Conclusion: Emotional intelligence is a core competency of critical care nurses, with professional, personal and organisational implications.(AU)

"Spiritual distress (00066)" in patients under fertility treatment: Clinical validation study.

PURPOSE: This study aimed to clinically validate the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in people under assisted reproductive technologies, and to determine the sensitivity, specificity, and predictive value of the defining characteristics. METHODS: Cross-sectional study that was conducted between September 2019 and June 2020. Recruitment happened by invitation posted in fertility-related websites. Those who accepted to participate were asked to fill the consent form and the online questionnaire. Statistical analysis was based on Rasch's model. The study was approved by the Ethics Committee. FINDINGS: The sample comprised 104 Portuguese individuals undergoing assisted reproductive techniques. The "Spiritual distress (00066)" was validated and 22 defining characteristics were confirmed as representative. No item showed differential item functioning. "Perceived suffering" was the most sensitive defining characteristic and had the highest negative predictive value. "Insufficient courage" had the highest positive predictive value, and "Anger toward power greater than self" was the most specific. CONCLUSIONS: Results validated the presence of the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in a sample going through assisted reproductive technologies, improving accuracy of this nursing diagnosis in such population. IMPLICATIONS FOR NURSING PRACTICE: This is a crucial step to raise the level of evidence of such nursing diagnosis and to increase the level of evidence on NANDA-I terminology. Furthermore, this study has contributed to raising the quality of nurse's critical judgement and clinical reasoning and allow an early spiritual and a more holistic and personalized patient-centered intervention in the reproductive field.

OBJETIVO: O presente estudo teve como objetivo analisar a validade clínica do diagnóstico de "angústia espiritual (00066)" em pessoas a realizar técnicas de reprodução assistida e determinar a sensibilidade, especificidade e valor preditivo das características definidoras. MÉTODOS: Este é um estudo transversal que decorreu entre Setembro de 2019 e Junho de 2020. O recrutamento ocorreu por meio de convite lançado em sítios afetos ao tema da fertilidade. As pessoas interessadas em participar preencheram um formulário de consentimento informado e um questionário online. A análise estatística primou pelo emprego do modelo Rasch. O estudo foi aprovado pela Comissão de Ética. RESULTADOS: A amostra final incluiu 104 portugueses submetidos a técnicas de reprodução medicamente assistida. O diagnóstico de "angústia espiritual (00066)" foi validado e 22 características definidoras foram confirmadas pelos dados. "Sofrimento percebido" foi a característica definidora mais sensível e com o maior valor negativo preditivo. "Coragem insuficiente" destacou-se no valor positivo preditivo, e "Raiva relativa a Poder Maior do que o próprio" foi a mais específica. CONCLUSÕES: Os resultados obtidos validaram a presença do diagnóstico de "angústia espiritual (00066)" em pessoas a realizar técnicas de reprodução assistida, contribuindo, desta forma para melhorar a acurácia deste diagnóstico de enfermagem nesta população. IMPLICAÇÕES PARA A PRÁTICA: Este é um passo crucial para elevar o nível de evidência deste diagnóstico de enfermagem e aumentar o corpo do conhecimento da terminologia NANDA-I. O seu contributo passa também por elevar a qualidade do julgamento crítico dos enfermeiros e o seu poder de decisão clínica permitindo uma intervenção precoce mais holística, centrada na espiritualidade e no paciente em contexto reprodutivo.

"Impaired Resilience (00210)" in patients under fertility treatment: Clinical validation study.

PURPOSE: The aim of this study was a clinical validation of the NANDA-I nursing diagnosis "Impaired Resilience (00210)" in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics. METHODS: A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee. FINDINGS: The "Impaired Resilience (00210)" had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are "decreased interest in vocational activities," "depression," "impaired health status," "ineffective coping strategies," "low self-esteem," "renewed elevation of distress," and "social isolation." No item showed differential item functioning. "Renewed elevation of distress" and "low self-esteem" were the most sensitive defining characteristics and had the highest negative predictive value. "Shame" was the most specific one. CONCLUSIONS: The nursing diagnosis "Impaired Resilience (00210)" was validated, and results may improve its accuracy in people going through fertility treatment. IMPLICATIONS FOR NURSING PRACTICE: This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses' critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.

OBJETIVO: Este estudo teve como objetivo a validação clínica do diagnóstico de enfermagem "Resiliência comprometida (00210)" em pessoas a realizar tratamento de fertilidade; e determinar a sensibilidade, especificidade e valor preditivo das características definidoras. MÉTODOS: Foi conduzido um estudo transversal entre Setembro de 2019 e Junho de 2020. 104 participantes foram recrutados através de sítios afetos ao tema da fertilidade, respondendo um questionário online após o seu consentimento informado. O modelo Rasch foi empregue na análise estatística. O estudo foi aprovado pela Comissão de Ética. RESULTADOS: A "Resiliência comprometida (00210)" teve uma prevalência de 15.4% na amostra, e 7 características definidoras foram confirmadas: "Interesse diminuído pelas atividades profissionais"; "Depressão"; "Estado de saúde comprometido"; "Estratégias de coping ineficazes"; "Isolamento social". Nenhum item apresentou funcionamento diferencial. O "Aumento renovado da angústia" e a "Baixa autoestima" foram as características mais sensíveis e com valores preditivos negativos mais altos. A "Vergonha" foi a característica mais específica. CONCLUSÕES: O diagnóstico de Enfermagem NANDA-I de "Resiliência comprometida (00210)" foi validado e os resultados possibilitaram melhorar a sua acurácia em pessoas a realizar tratamento de fertilidade. IMPLICAÇÕES PARA A PRÁTICA: Este artigo contribuiu para elevar o corpo do conhecimento da terminologia NANDA-I dos diagnósticos de enfermagem e contribuir para elevar a qualidade do julgamento crítico e poder de decisão clínica dos enfermeiros. Uma intervenção mais eficaz e preventiva permitirá apoiar as pessoas na sua habilidade para lidar com a adversidade durante o tratamento de fertilidade, sendo promotora de uma abordagem de Enfermagem baseada na resiliência em contexto reprodutivo.

Frequency of nurse-provided spiritual care: An international comparison.

AIMS AND OBJECTIVES: To compare the frequency of nurse-provided spiritual care across diverse cultures. BACKGROUND: Given an ethical imperative to respect patient spirituality and religiosity, nurses are increasingly taught and expected to provide spiritual care. Although nurses report positive attitudes toward spiritual care, they typically self-report providing it infrequently. Evidence about the reported frequency of spiritual care is constrained by substantial variation in its measurement. DESIGN: This cross-sectional, descriptive study involved secondary analysis of data collected in multiple sites globally using one quantitative instrument. METHODS: Data were collected from practicing nurses using the Nurse Spiritual Care Therapeutics Scale and analysed using descriptive statistics and a meta-analysis procedure with random-effect modelling. Datasets from 16 studies completed in Indonesia, Iran, Malaysia, Philippines, Portugal, Taiwan, Turkey and the United States contributed to a pooled sample (n = 4062). STROBE guidelines for cross-sectional observational studies were observed. RESULTS: Spiritual care varied between countries and within countries. It was slightly more frequent within Islamic cultures compared with predominantly Christian cultures. Likewise, frequency of spiritual care differed between nurses in palliative care, predominantly hospital/inpatient settings, and skilled nursing homes. Overall, "Remaining present…" was the most frequent therapeutic, whereas documenting spiritual care and making arrangements for the patient's clergy or a chaplain to visit were among the most infrequent therapeutics. CONCLUSIONS: In widely varying degrees of frequency, nurses around the world provide care that is cognisant of the spiritual and religious responses to living with health challenges. Future research should be designed to adjust for the multiple factors that may contribute to nurses providing spiritual care. RELEVANCE TO CLINICAL PRACTICE: Findings offer a benchmark and begin to inform nurse leaders about what may be normative in practice. They also encourage nurses providing direct patient care that they are not alone and inform educators about what instruction future nurses require.

Prevalence, defining characteristics, and predictors of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy: A longitudinal study.

INTRODUCTION: Cancer patients are exposed to several types of treatments, including chemotherapy. In this context, patients experience several nursing diagnoses, including spiritual distress. The definition of the diagnosis of spiritual distress is grounded in lack of meaning and purpose in life, a sense of suffering, and a feeling of disconnected. PURPOSE: The aim of this study was to determine the prevalence, sensitivity, specificity, and predictors of the nursing diagnosis of spiritual distress of cancer patients undergoing chemotherapy. DESIGNS: The study used a longitudinal questionnaire design with quarterly data collection points over a 12-month period. Participants were recruited through random sampling, in an outpatients' setting in one oncology day unit in Portugal. FINDINGS: The highest prevalence of spiritual distress was found at 3 months after patients started chemotherapy. The highest value of specificity was lack of meaning in life and express suffering, and the highest values of sensitivity concerned spiritual distress diagnosis. The predictors of spiritual distress were express suffering, alienation, questioning meaning in life, lack of serenity, questioning the meaning of suffering, hopelessness, and lack of meaning in life. CONCLUSIONS: Spiritual distress is a human response that is current in patients undergoing chemotherapy, and the highest prevalence seems to occur at 3 months after commencing chemotherapy. Express suffering and lack of meaning in life play the role not only of defining characteristics (DC) in this study, but also of predictors in the diagnosis of spiritual distress. CLINICAL RELEVANCE: The identification of the prevalence, predictors, sensitivity, and specificity of the DC of the nursing diagnosis of spiritual distress in cancer patients undergoing chemotherapy may facilitate nurses' clinical reasoning and improve the planning of nursing care in clinical practice in order to improve spiritual well-being in cancer patients.

Spiritual comfort, spiritual support, and spiritual care: A simultaneous concept analysis.

BACKGROUND: Spirituality is a dimension of life and the human being that should be included in holistic healthcare. One major barrier often described by nurses on implementing spirituality in practice relates to perceiving the concept of spirituality as subjective and sharing confounding similarities with other concepts. In this sense, the concepts of spiritual comfort, spiritual care, and spiritual support may require more distinct theoretical definitions aimed at clear and effective nursing interventions within spiritual care. AIM: To provide a definition of spiritual comfort, spiritual support, and spiritual care. METHODS: Simultaneous concept analysis (SCA) of three concepts according to Haase et al., which is grounded on Rodgers' evolutionary view. The method was based on a literature review with the search of electronic databases on May 2020. Search and analysis have been blinded conducted by two reviewers. RESULTS: One hundred thirty-six studies were included in the SCA. Findings suggest that spiritual comfort is an immediate state and an outcome. Spiritual support is related with an intimate and positive relationship with God. Spiritual care is defined as a complex and interactive process. Both spiritual support and spiritual care are grounded in a therapeutic context. CONCLUSION: This SCA allowed the attributes of each concept to be identified and provides definitions that may facilitate the understanding of these concepts and promote the implementation of spirituality in nursing practice, but which has also led to future research on this topic.

Instruments for Assessing Spiritual/Religious Coping in Multicultural Clinical Settings.

ABSTRACT: A review of literature was conducted to discover and compare various instruments that could be used in daily nursing practice to assess spiritual and religious coping in a variety of multicultural clinical settings. Fifteen spiritual and religious (S/R) instruments were identified, used in 31 studies in multiple countries. These S/R coping tools may be useful to nurses in assessment and for planning interventions.

Baropodometric Assessment of the Podiatric Profile of Nursing Students in Clinical Settings: A Study Protocol.

Introduction: Nursing students are exposed to increased risks of developing foot and ankle disorders due to prolonged standing and walking positions during clinical settings. This can lead to high dropout rates from nursing degree, thus contributing to a future shortage in nursing professionals. This protocol aims to develop a study to understand the influence of prolonged standing and walking positions on nursing students' foot health, and specifically to study the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms. Methods and Analysis: A prospective observational cohort study will be conducted with 194 nursing students. Participants will be asked to walk through a baropodometric platform before and after a 5-month clinical training session. Assessment will focus on the change in podiatric profile, namely foot posture and foot function, at 5 months, and changes in foot health at 5 months. The study will start in January 2022 and it's expected to end by June 2022. Discussion: The study aims to perform an innovative assessment of nursing students' podiatric profile, which will allow for a comprehensive description of foot/ankle changes and their relationship with prolonged standing and walking contexts. Ethics and Dissemination: The study was approved by The Ethical Committee of the Health Sciences Research Unit: Nursing (UICISA: E), of the Nursing School of Coimbra (ESEnfC), with the approval code nr. P799_07_2021. The study was also recorded in ClinicalTrials.gov on the number NCT05197166. Findings will be used to publish articles in peer-review scientific journals and oral communications and posters at scientific meetings.