Developing a nationwide registry of UK veterans seeking help from sector charities-a machine learning approach to stratification.

The assistance to veterans in the UK is provided by the National Health Service and over 1800 military charities. These charities count services using different definitions and reporting systems, so to date a national registry of service usage does not exist. The aim of the Map Of Need Aggregation ResearCH study is to build a standardized registry of service usage data for the military charity sector. Data are completely anonymized by adopting a Secure Hashing Algorithm. A unique anonymous identifier is generated allowing both privacy protection and avoiding double counts. Data are standardized and linked with an automated process to create an aggregated dataset. The dataset describes the population, using both a priori and machine learning approaches. To date a total of 42 509 veterans with 128 423 needs are included. The mean age was 60.1 years, and 90% were male. 65% were receiving other benefits, 5% were homeless and 1% were in prison. 65% of the needs recorded concerned social wellbeing. 40% of veterans received assistance in at least two different years. The k-means clustering approach returned 4 subgroups of use that were identical to those created using a priori knowledge. The dataset is the most comprehensive source of veteran charity usage data in the UK to date. Service usage is generally homogenous among subgroups, but some differences were highlighted indicating that younger, non-officer veterans may be more at risk of presenting with more complex needs. These first useful insights can help allocate resources to build an effective preventive strategy for more complex cases.

Profiling vaccine hesitancy in nursing to tailor public healthcare policies: A cross-sectional international study.

INTRODUCTION: Vaccine hesitancy is a complex issue of global concern. As nurses play a vital role in delivering patient care and shaping public opinions on vaccines, interventions to address vaccine hesitancy in nursing are imperative. As such, identifying profiles of characteristics and attitudes contributing to hesitancy may help identify specific areas of focus to target tailored global vaccination uptake campaigns. The purpose of this study was to profile the characteristics and attitudes contributing to hesitancy toward COVID-19 and Influenza vaccines in the nursing community. DESIGN: This multisite, cross-sectional study recruited 1967 registered nurses and 1230 nursing students from the United Kingdom, Finland, and Italy between March and September 2023. METHODS: Data collection involved an online survey adopting the Vaccination Attitudes Examination (VAX) Scale, the Bergen Social Media Addiction Scale, and questions pertaining to sociodemographic and occupational characteristics. A k-means cluster analysis was used to identify various clusters of hesitancy based on the VAX Scale. One-way ANOVA and chi-square tests were used to identify significant differences in sociodemographic characteristics, occupational factors, vaccination attitudes, and social media usage between the clusters. RESULTS: Three distinct clusters were identified. Profile A showed high vaccine confidence, profile B displayed slight hesitancy, and profile C reported high levels of hesitancy. In profile C, higher levels of vaccine hesitancy were identified in younger, less experienced nurses with lower educational attainment. While older nurses with higher educational attainment, who were in senior roles, were more vaccine-confident and had a consistent history of accepting the Influenza and COVID-19 vaccinations (profile A). The study found Italian nurses highly hesitant (profile C), British nurses highly confident (profile A), and Finnish nurses evenly distributed between confident, slightly hesitant, and highly hesitant (profiles A, B, and C, respectively). In addition, more frequent usage of Instagram and TikTok was associated with vaccine hesitancy (profiles B and C), and LinkedIn and X were more common among vaccine-confident individuals (profile A). CONCLUSIONS: This study has identified specific sociodemographic and occupational factors that are related to vaccine hesitancy in an international sample of nurses. Additionally, attitudes contributing to hesitancy were identified, with worries about unforeseen future effects of the vaccine being identified as a critical attitude that may undermine confidence and increase hesitancy in nursing. This study also sheds light on the influence that social media platforms have on vaccine hesitancy and, as such, indicates which platforms are effective to disseminate vaccination campaigns to global nursing communities. CLINICAL RELEVANCE: Global vaccination campaigns should focus on specific profiles and clusters to promote vaccination in the international nursing community. Empowering nurses early in their careers will help to instill positive vaccination behaviors, ensuring a sustained uptake of vaccinations throughout the individual's career and beyond, with an impact on promoting vaccination at the public health level as well.

Identifying patterns and profiles of vaccination hesitancy among nurses for tailoring healthcare policies in the UK: A cross-sectional study.

AIMS: To profile the characteristics of nurses with varying levels of vaccine hesitancy toward the COVID-19 and influenza vaccines. BACKGROUND: In many countries across the world, healthcare workers, and nurses in particular, display significant reluctance toward COVID-19 and influenza vaccines due to concerns about safety, distrust in healthcare policies, and media influences. To address this, a proposed approach involves profiling nurses to tailor vaccination campaigns and to improve acceptance rates and public health outcomes. METHODS: This cross-sectional study adopted the Vaccination Attitudes Examination scale to assess hesitancy toward COVID-19 and influenza vaccines among 294 registered nurses in the UK between March and July 2023. A K-means cluster analysis was performed. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were adopted. RESULTS: Three profiles were identified. Profile A showed low vaccination hesitancy, profile B showed average hesitancy, and profile C showed high hesitancy toward vaccines. The highest concern for all profiles was related to unforeseen future effects of vaccination. Profile C had more nurses in early career roles, whereas nurses in profiles A and B were in more senior roles. Profile A showed higher educational attainment. Nurses in profile C used Snapchat more, whereas nurses in profile A used Twitter more frequently. CONCLUSION: This study identified specific characteristics associated with higher levels of vaccination hesitancy in nursing. Unforeseen future effects of vaccination are a core aspect to consider in promoting vaccination. IMPLICATIONS FOR NURSING AND NURSING POLICY: Policies and vaccination campaigns should be targeted on early career nurses and should deliver tailored messages to dispel misinformation about unforeseen future effects of vaccination through specific social media platforms. Senior nurses should be involved as role models in promoting vaccination. These results are key for enhancing an evidence-based approach to implementing global health policies in healthcare.

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

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

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

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

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

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

A large cross-sectional survey of COVID-19 vaccination willingness amongst healthcare students and professionals: Reveals generational patterns.

AIMS: To determine coronavirus disease 2019 (COVID-19) vaccination hesitancy in healthcare professionals and healthcare students in Italy across four generations (baby boomers, generations X, Y and Z). DESIGN: A cross-sectional descriptive study was performed through an online survey conducted from May to June 2021. The STROBE guidelines were adopted for reporting. METHODS: Data were collected by initially sending a survey link to a convenience sample of healthcare professionals and students, which was followed by snowball sampling. The VAX scale was validated and adopted. An ANOVA was performed to detect differences in vaccine-hesitancy beliefs between the four generational groups. RESULTS: The survey was completed by 1226 healthcare professionals and students. Worries about unforeseen future effects accounted for the higher vaccination hesitancy factor across generations. More positive attitudes towards COVID-19 vaccination were expressed by members of generation Z than by members of generation Y and baby boomers. Members of generation X had the highest vaccination hesitancy scores in the overall scale. CONCLUSION: The results suggest that public health campaigns should take into account the generational differences in COVID-19 vaccination hesitancy to achieve higher levels of vaccine acceptance, including amongst healthcare professionals and students. IMPACT: Vaccination is the most effective strategy to tackle the COVID-19 pandemic. The advice of health professionals strongly influences vaccination willingness in the general population. A consideration of the generational patterns in the COVID-19 vaccination hesitancy of healthcare workers and students may increase vaccination uptake in these populations, which in turn may lead to greater public acceptance of the vaccine.

The ward manager role in the context of nursing and midwifery students' clinical learning: Testing a model.

AIM: To test a model of clinical learning that focuses on the role of the ward manager. BACKGROUND: The ward manager's role in supporting clinical learning indirectly focuses on the ward climate connected to students' clinical placements. In this way, the ward manager influences both nursing care and the pedagogical atmosphere in the ward. DESIGN: Cross-sectional, secondary analysis. METHODS: The sample included nursing and midwifery students (N = 5,776, n = 1,900) who had completed their clinical placement. Data were collected with the Clinical Learning Environment, Supervision and Nurse Teacher scale. Structural equation modelling was adopted to test the hypotheses. RESULTS: Estimates of the model parameters demonstrated that a ward manager's leadership style influences both the premises of nursing at the ward (0.84, p < .001) and the pedagogical atmosphere (0.93, p < .001), although the pedagogical atmosphere affects the mentoring relationship (0.87-0.86, p < .001). CONCLUSIONS: Ward managers exert a significant influence on the clinical learning environment via their support for an effective pedagogical atmosphere and, consequently, effective mentoring. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership style guides both the premises of nursing at the ward and pedagogical atmosphere. These findings recommend that ward managers should be involved in promoting a supportive learning climate, which supports the mentor-student relationship and, eventually, leads to effective clinical learning.

Effectiveness of a family nurse-led programme on accuracy of blood pressure self-measurement: A randomised controlled trial.

AIMS AND OBJECTIVES: To evaluate the effectiveness of a Family Nurse Practitioner (FNP)-led programme on the degree of adherence of current recommendations on home blood pressure self-measurement (HBPM) as compared to routine care and management. BACKGROUND: HBPM plays an important role for monitoring hypertensive patients; however, patients' adherence to current guidelines is unsatisfactory. A nurse-led training programme in the community setting could be an effective strategy to achieve high level of patients' adherence to recommendations. DESIGN: A multicentre randomised controlled trial was carried out from September 2016 to September 2017. METHODS: In total, 170 patients were randomly allocated into the intervention group (n = 83) and the usual care (n = 87). All participants received usual care (written and verbal information on HBPM recommendations); subjects in the intervention group also received 1-hour training session on how to correctly self-measure BP. Clinical trial registration was done (ClinicalTrials.gov.: NCT04681703). The CONSORT checklist for randomised controlled trials was used in this study. RESULTS: At baseline, the level of adherence to the recommendation was similar in the two groups (p < .05). After 1 month, the adherence significantly increased in the intervention group, where patients were more likely to measure BP at the same hour and from the same arm, in a quiet environment, with the back and uncovered arm supported and the legs uncrossed; recording BP more than once in each measurement session; keeping a diary of blood pressure measurements; use of the appropriate cuff and proper placement of the cuff; and resting for >5 min before performing the measurement (all p < .05). CONCLUSIONS: The FNP-led programme is effective in improving patients' adherence to guidelines on the correct technique to self-measure BP at home. RELEVANCE TO CLINICAL PRACTICE: This programme may be added to the existing interventions in the community setting or considered into specifically nurse-led hypertension management models.

Trust in Nurses Scale: validation of the core elements.

BACKGROUND: The Trust in Nurses Scale (TNS) was developed and psychometrically assessed so that patients' trust could be accurately and reliably measured. The TNS has been translated, assessed and administered to patients in Europe, Asia and North America. AIM: This descriptive, cross-sectional, correlational study aimed to assess the psychometric characteristics of the Italian version of the Trust in Nurses Scale. METHODS: An Italian version of the TNS was developed. We used a forward-backward translation methodology to establish semantic and conceptual equivalence within the Italian context. The scale was then administered to a convenience sample of 200 hospitalised patients in medical, surgical or oncology units. Internal consistency and construct validity were assessed performing Cronbach's alpha and confirmatory factor analysis (CFA). Both a 4-item and a 5-item TNS were assessed. RESULTS: The 4-item TNS demonstrated better construct validity than the 5-item version. Similarly, the internal consistency reliability was better with 4 items than 5 (0.83 and 0.79, respectively). CONCLUSION: The Italian version of the scale has acceptable reliability and validity and may be used to assess this aspect of the nurse-patient relationship. Being tested in different settings, it may be used with all patients admitted to hospital. Trust in nurses is critically important to patient outcomes; however, it is rarely measured quantitatively on a wide scale. The use of the Italian validated scale could be useful to increase evidences on this important topic, as it represents a core component of nursing care.