what is quantitative research used for in nursing

Nursing Research (NURS 3321/4325/5366)

• Introduction
• Understand What Quantitative Research Is
• Understand What Qualitative Research Is
• Sage Methods Map
• Step 1: Accessing CINAHL
• Step 2: Create a Keyword Search
• Step 3: Create a Subject Heading Search
• Step 4: Repeat Steps 1-3 for Second Concept
• Step 5: Repeat Steps 1-3 for Quantitative Terms
• Step 6: Combining All Searches
• Step 7: Adding Limiters
• Step 8: Save Your Search!
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What is Quantitative Research?

Quantitative methodology is the dominant research framework in the social sciences. it refers to a set of strategies, techniques and assumptions used to study psychological, social and economic processes through the exploration of numeric patterns . quantitative research gathers a range of numeric data. some of the numeric data is intrinsically quantitative (e.g. personal income), while in other cases the numeric structure is  imposed (e.g. ‘on a scale from 1 to 10, how depressed did you feel last week’). the collection of quantitative information allows researchers to conduct simple to extremely sophisticated statistical analyses that aggregate the data (e.g. averages, percentages), show relationships among the data (e.g. ‘students with lower grade point averages tend to score lower on a depression scale’) or compare across aggregated data (e.g. the usa has a higher gross domestic product than spain). quantitative research includes methodologies such as questionnaires, structured observations or experiments and stands in contrast to qualitative research. qualitative research involves the collection and analysis of narratives and/or open-ended observations through methodologies such as interviews, focus groups or ethnographies..

Coghlan, D., Brydon-Miller, M. (2014).  The SAGE encyclopedia of action research  (Vols. 1-2). London, : SAGE Publications Ltd doi: 10.4135/9781446294406

What is the purpose of quantitative research?

The purpose of quantitative research is to generate knowledge and create understanding about the social world. Quantitative research is used by social scientists, including communication researchers, to observe phenomena or occurrences affecting individuals. Social scientists are concerned with the study of people. Quantitative research is a way to learn about a particular group of people, known as a sample population. Using scientific inquiry, quantitative research relies on data that are observed or measured to examine questions about the sample population.

Allen, M. (2017).  The SAGE encyclopedia of communication research methods  (Vols. 1-4). Thousand Oaks, CA: SAGE Publications, Inc doi: 10.4135/9781483381411

How do I know if the study is a quantitative design?  What type of quantitative study is it?

Quantitative Research Designs: Descriptive non-experimental, Quasi-experimental or Experimental?

Studies do not always explicitly state what kind of research design is being used.  You will need to know how to decipher which design type is used.  The following video will help you determine the quantitative design type.

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• Quantitative and Qualitative Research

You can find evidence for clinical decision making in quantitative and qualitative research studies .  Quantitative research  refers to any research based on something that can be accurately and precisely measured and will include studies that have numerical data . Quantitative data are expressed numerically and analyzed statistically. The data are collected from experiments and tests, metrics, databases, and surveys. In healthcare research they  often  include studies of intervention effectiveness, satisfaction with care, the incidence, prevalence, and etiology of diseases, and the properties of measurement tools (Kolaski, 2023).

Findings in qualitative studies are not based on measurable statistics. Qualitative data are descriptive rather than numerical. Qualitative research derives data from observation, interviews, verbal interactions, or textual analyses and focuses on the meanings and interpretations of the participants. Qualitative research studies in healthcare investigate the impact of illnesses and interventions. The research explores experiences, attitudes, beliefs, and perspectives of patients, caregivers, and clinicians (Kolaski, 2023). The analysis of qualitative research is interpretative, subjective, and impressionistic.  

Kolaski, K., Logan, L. R., & Ioannidis, J. P. A. (2023). Guidance to best tools and practices for systematic reviews. Systematic Reviews , 12 (1), 96. https://doi.org/10.1186/s13643-023-02255-9

Quantitative vs Qualitative Study Types:

For more information on qualitative research:

Curtis, A. & Keeler, C. (2022). An introduction to qualitative methods for the nurse researcher.  American Journal of Nursing, 122  (8), 52-56. https://doi: 10.1097/01.NAJ.0000854992.17329.51.

Noyes, J., Booth, A., Cargo, M., Flemming, K., Harden, A., Harris, J., Garside, R., Hannes, K., Pantoja, T., & Thomas, J. (2023). Chapter 21: Qualitative evidence.  In Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., Welch, V.A. (Eds.).  Cochrane handbook for systematic reviews of interventions version 6.4.  Cochrane.  www.training.cochrane.org/handbook

Video:  UniversityNow: Quantitative vs. Qualitative Research

Appraising Quantitative and Qualitative Research

The articles below provide a step-by-step appraisal on how to critique quantitative and qualitative research articles:

• Ryan, F., Coughlan, M. & Cronin, P. (2007). Step-by-step guide to critiquing research. Part 1: quantitative research.  British Journal of Nursing, 16 (11), 658-663 .
• Ryan, F., Coughlan, M. & Cronin, P. (2007). Step-by-step guide to critiquing research. Part 2: qualitative research.  British Journal of Nursing, 16 (2), 738-744 .
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Differences between Qualitative & Quantitative Research

" Quantitative research ," also called " empirical research ," refers to any research based on something that can be accurately and precisely measured.  For example, it is possible to discover exactly how many times per second a hummingbird's wings beat and measure the corresponding effects on its physiology (heart rate, temperature, etc.).

" Qualitative research " refers to any research based on something that is impossible to accurately and precisely measure.  For example, although you certainly can conduct a survey on job satisfaction and afterwards say that such-and-such percent of your respondents were very satisfied with their jobs, it is not possible to come up with an accurate, standard numerical scale to measure the level of job satisfaction precisely.

It is so easy to confuse the words "quantitative" and "qualitative," it's best to use "empirical" and "qualitative" instead.

Hint: An excellent clue that a scholarly journal article contains empirical research is the presence of some sort of statistical analysis

See "Examples of Qualitative and Quantitative" page under "Nursing Research" for more information.

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Examples of Qualitative vs Quantitiative

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Understanding Nursing Research

• Primary Research

What is Quantitative Research?

How do i tell if my article has quantitative research, qualitative research.

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There are two kinds of research: Quantitative and Qualitative

Quantitative is research that generates numerical data. If it helps, think of the root of the word "Quantitative." The word "Quantity" is at its core, and quantity just means "amount" or "how many." Heart rates, blood cell counts, how many people fainted at the jazz festival-- these are all examples of quantitative measures.

Qualitative , on the other hand, is a more subjective measurement. Think of the root of the word again, this time it's "Quality." If someone is called a quality person or someone's selling a high quality product, they're being measured in subjective terms, rather than concrete, objective terms (like numbers.) Qualitative research includes things like interviews or focus groups.

Just like when we examine whether or not our article is an example of Primary Research, the best way to examine what kind of data your article uses is by reading the article's Abstract, Methodologies, and Results sections. That will tell you how the research was conducted and what kind of data (qualitative or quantitative) was collected.

An example of what to look for in the Abstract can be seen here:

You can see that data was evaluated (66% of students were in compliance with school immunization requirements), a strategy was implemented (letters and emails were sent to student's parents/guardians), and at the end of the study, new quantitative data is reported (99.6% of students were in compliance with vaccination requirements).

Finding qualitative research can be trickier, since it can often take more time to collect. Examples of qualitative data include things like interview transcripts, focus group feedback, and journal entries detailing people's experiences and feelings. The easiest way to search for a qualitative study is to include the word "qualitative" as a keyword in your database search along with the search terms about the topic you're interested in.

Check out the video below to see an example of searching for qualitative research in CINAHL.

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What is Quantitative Research?

Typical attributes of Quantitative Research:

• The basic element of analysis: numbers, statistical analyses (p values, chi square, t-test)
• Methods: counting, measuring, quantifying (e.g. Likert scale)
• Tests a theory

How to Find Peer-reviewed Quantitative Research Articles

In CINAHL and MEDLINE , to find Peer-reviewed Quantitative Research articles, add several of the following subject terms to your search:

CINAHL terms:

• Quantitative Studies
• Analysis of Variance 
• Chi Square Test

MEDLINE terms:

• Evaluation Studies
• Analysis of Variance
• Chi Square Distribution 

Identifying Quantitative Research Articles

Here's an example of an article that has several quantitative research terms as Minor Subjects in the CINAHL database.

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Nursing Research - Undergraduate: Quantitative vs. Qualitative

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What is the difference?

Quantitative research and qualitative research are two types of original research that you will come across when you are researching for original nursing research. 

While both contain useful data to use, you may be required to use one particular type of data for a paper or presentation. 

Definitions

Quantitative research : A traditional approach to research in which variables are identified and measured in a reliable and valid way (Houser, 2018, p. 34)

Qualitative research : A naturalistic approach to research in which the focus is on understanding the meaning of an experience from the individual's perspective (Houser, 2018, p. 35)

Houser, J. (2018). Nursing research: Reading, using, and creating evidence  (4th ed.).  Jones & Bartlett Learning. 

Quantitative Research

Think of quantitative research as a scientific experiment. You have your hypothesis, an item you want to change, an item you are comparing the change against, and then the results of your experiment.

At its core, quantitative research involves a control variable and an independent variable. Typically with nursing research, the independent variable will be the proposed change or intervention that you are looking to implement in your practice . Results of a quantitative research study should be something that can be replicated. Data results for quantitative research typically involve hard data, such as blood pressure, temperature, oxygen levels, etc. 

Types of Research Used for Evidence-Based Practice

Ovid. [OvidWoltersKluwer]. (2015, October 6). Types of research used for evidence- based practice [Video file]. YouTube.  https://youtu.be/jwOu24btBVk

Qualitative Research

Qualitative research focuses more on soft data, meaning it observes an individual's experience and cannot be replicated (Houser, 2018). Types of research studies that are qualitative include: "observations, in-depth interviews or focus-groups, case studies, and social interaction studies" (Houser, 2018). 

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Understanding Qualitative and Quantitative Research in Nursing: Quantiative Research Information

• Qualitative Research Information
• Quantiative Research Information

About Quantiative Research

Quantitative research consists of information expressed in numbers, variables, and percentages. It seeks to confirm that all problems, dilemmas, or hypotheses have clear, concrete, and objective solutions that can be expressed in a numerical format. This type of research focuses on specific, narrow questions in a double-blind study, usually with a large random group and variables. The data collected can be analyzed with the help of statistics in an unbiased manner with the objective to explain, describe, or predict.

Helpful Website Links on Quantitative Research in Nursing

• A nurses’ guide to Quantitative Research
• Understanding Quantiative Research (Article)
• Quantitative research ... This practice profile
• Quantitative vs qualitative research methods... 'What direction for mental
• Implications for quantitative and qualitative reviews.

Quantitative research consist of following elements

• a hypothesis
•  a random or specific study group with a common similarity
•  variables (any element or behavior that can affect or change the outcomes of a study, such as a medication, treatment, or nursing intervention)
•  outcomes.

Quantitative research is usually conducted in a controlled environment, such as a lab or healthcare unit. It can be categorized as follows.

3 Types of Quantitative Research

Correlational research is the methodical investigation of relationships or interactions between two or more variables without determining the cause-and-effect relationship the variables may have on each other. An example is studying two chemotherapy medications for compatibility without studying how the medications can have adverse interactions with food or other common medications.

Quasi-experimental research explores a cause-and-effect relationship among variables. It also evaluates the underlying cause of a problem and studies the effects of variables (such as a nursing intervention) to evaluate their effect on the problem.

Descriptive research offers an accurate representation of the characteristics of a particular individual, situation, or group. Descriptive research is a way of discovering new meaning, describing numerically something that currently exists, determining the frequency with which something occurs, and categorizing information.

To find articles in ERIC   click on the  advanced search  tab. Use the phrase "quantitative research"  as one of your search terms.

Related terms that may be searched:  

Bayesian statistics

Correlation

Effect size

Error of measurement

Factor analysis

Goodness of fit

Hypothesis testing

Item analysis

Least squares

Monte Carlo Methods

Maximum likelihood

Multivariate analysis

Regression (statistics)

Robustness (statistics)

Statistical analysis

Statistical inference

Statistical significance

Markov processes

Also the following may be use, but not restricted to Subject Terms

Experimental design, design of experiments, statistical design, or research design

Quantitative Research eBooks

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What is Quantitative Research?

Quantitative research , also called " empirical research ," is research based on traditional scientific methods which generate numerical data and seek to establish causal relationships between two or more variables , using statistical methods to test the strength and significance of the relationships. Observations in quantitative research are measured in numbers.

Quantitative research starts with a testable hypothesis. One of the goals of quantitative research design is others can repeat the findings of the study. Some examples of quantitative research methods include close-ended interviews, surveys, clinical trials, and lab experiments.

Adapted from Finding Quantitative or Qualitative Nursing Research Articles (Simmons University)

Types of Quantitative Research

Four main types of quantitative research design:

Descriptive Design  - Seeks to describe the current status of a variable or phenomenon. The researcher develops a hypothesis after the data is collected. Data collection is mostly observational.

Correlational Design  - Explores the relationship between variables using statistical analyses. The researcher does not look for cause and effect. Data collection is mostly observational.

Quasi-Experimental Design  - Seeks to establish a cause-effect relationship between two or more variables. The researcher does not assign groups or manipulate the independent variable. Control groups are identified and exposed to the variable. Results are compared with results from groups not exposed to the variable.

Experimental Design -  Uses the scientific method to establish cause-effect relationship among a group of variables in a research study. Researchers make an effort to control all variables except the one being manipulated (the independent variable). The effects of the independent variable on the dependent variable are collected and analyzed for a relationship.

Adapted from Quantitative Approaches - Center for Innovation in Research and Teaching  

Selected eBooks

Video Resources

An Introduction to Quantitative Research (37 mins) From Academic Videos Online, this video presented by Jaime Dyce covers seven areas: an introduction to quantitative research, quantitative data collection, experimental design, quantitative analysis, quantitative and qualitative methodologies, writing research reports, and ethics.

Quantitative Research Designs: Descriptive non-experimental, Quasi-experimental or Experimental? (YouTube) Students often have difficulty classifying quantitative research designs. In quantitative research, designs can be classified into one of three categories: descriptive non-experimental, quasi-experimental or experimental. To identify which of these designs your study is using follow the steps in this video.

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It's Not Always One or the Other!

It's important to keep in mind that research studies and articles are not always 100% qualitative or 100% quantitative. A mixed methods study involves both qualitative and quantitative approaches. If you need to find articles that are purely qualitative or purely quanititative, be sure to look carefully at the methodology sections to make sure the studies did not utilize both methods. 

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Qualitative and Quantitative Research

In general, quantitative research seeks to understand the causal or correlational relationship between variables through testing hypotheses, whereas qualitative research seeks to understand a phenomenon within a real-world context through the use of interviews and observation. Both types of research are valid, and certain research topics are better suited to one approach or the other. However, it is important to understand the differences between qualitative and quantitative research so that you will be able to conduct an informed critique and analysis of any articles that you read, because you will understand the different advantages, disadvantages, and influencing factors for each approach. 

The table below illustrates the main differences between qualitative and quantitative research. Be aware that these are generalizations, and that not every research study or article will fit neatly into these categories. 

Systematic reviews, meta-analyses, and integrative reviews are not exactly designs, but they synthesize, analyze, and compare the results from many research studies and are somewhat quantitative in nature. However, they are not truly quantitative or qualitative studies.

References:

LoBiondo-Wood, G., & Haber, J. (2010). Nursing research: Methods and critical appraisal for evidence-based practice (7 th ed.). St. Louis, MO: Mosby Elsevier

Mertens, D. M. (2010). Research and evaluation in education and psychology (3 rd ed.). Los Angeles: SAGE

Quick Overview

This 2-minute video provides a simplified overview of the primary distinctions between quantitative and qualitative research.

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Increasing Quantitative Literacy in Nursing: A Joint Nursing-Statistician Perspective

Krista schroeder.

a Assistant Professor of Nursing, Temple University College of Public Health, 3307 North Broad Street, Philadelphia PA 19140, USA

Levent DUMENCI

b Professor of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia PA 19122, USA

David B. SARWER

c Associate Dean for Research, Director - Center for Obesity Research and Education, Temple University College of Public Health, Philadelphia PA 11940, USA

David C. WHEELER

d Associate Professor, Virginia Commonwealth University School of Medicine, Department of Biostatistics, Richmond VA 23298, USA

Matthew J. HAYAT

e Professor of Biostatistics, School of Public Health & Byrdine F. Lewis College of Nursing and Health Professions at Georgia State University, Atlanta GA 30302, USA

Strong quantitative literacy is necessary to fulfill nurses’ professional responsibilities across education levels, roles, and settings. Evidence-based practice and systems improvement are not possible if nurses do not understand the statistics employed in generating evidence. Statistics is the language of science and rigorous nursing science cannot exist without a clear understanding of statistical methods. Increasing availability and complexity of medical and public health data and a growing focus on population health necessitate increasingly sophisticated quantitative literacy in nursing practice, leadership, and science ( Hayat, Kim, Schwartz, & Jiroutek, 2021 ; Hayat, Schmiege, & Cook, 2014 ). Without strong quantitative knowledge, the nursing profession will lose opportunities to lead evidence-driven, population-focused efforts for health improvement.

Serious limitations in both knowledge and application of statistics have been documented in nursing pedagogy, scholarship, and research for decades ( Anthony, 1996 ; Gaskin & Happell, 2014 ; Hayat, Higgins, Schwartz, & Staggs, 2015 ; Hayat et al., 2021 ; Hayat et al., 2014 ). Prior work calling for greater quantitative literacy in nursing has been solely or primarily statistician-led, leaving an opportunity and responsibility for nurses to contribute. Without the voice of nursing, efforts to improve quantitative literacy within the profession will lack nursing insight and perspective. In this commentary we provide guidance for nurses’ engagement with quantitative methods and offer suggestions to increase quantitative literacy in nursing across education levels, roles, and settings.

Be Aware of What You Do and Don’t Know

For nurses, awareness of one’s level of statistical knowledge can foster more effective communication with statisticians and consumers of nursing scholarship and avoid analytic errors ground in lack of statistical knowledge. Statistics is a discipline – not a toolbox; statistics is not simply about choosing the right analytic approach, but about a start-to-finish approach to project planning, data collection, appropriate analysis (including confirming underlying statistical assumptions and conducting sensitivity analyses), and accurately and comprehensively understanding and presenting results to a range of stakeholders with varying levels of statistical knowledge. Importantly, levels of required statistical knowledge varies by nursing role – BSN-prepared clinicians focus on evidence-based practice, MSN- and DNP-prepared nurse practitioners focuses on quality improvement and research translation to systems and practice, and PhD-prepared nurse scientists focus on creation of generalizable knowledge ( Hayat et al., 2014 ). Thus, while BSN-, MSN-, and DNP-prepared nurses may focus on quantitative literacy, PhD-prepared nurses may recognize larger gaps in their required knowledge and focus on gaining statistical expertise required to conduct high quality nursing research.

Know How to Find Statistical Help

Many nurses – particularly those working primarily in clinical practice, in a small organization, or in a setting without formal academic-practice partnerships – may be unsure how to find statistical assistance. Often, nurses are not taught how to collaborate with statisticians ( Hayat et al., 2015 ). A first step entails deciding from whom statistical help is needed. A graduate student in statistics, MS-prepared statistician, and PhD-prepared statistician will bring different expertise, but all may be appropriate collaborators depending on need. A nurse scientist conducting research to develop new knowledge likely requires different expertise than a hospital nursing unit manager planning a quality improvement project. Statistical collaborators are often available via academic institutions (schools of nursing but also schools of public health or medicine). Nursing-statistician collaboration typically necessitates deeper partnership than simply confirming which statistical test should be used, as statisticians can help with the entire project planning process ( Hayat et al., 2015 ). Nursing collaborators should be aware that statistical collaboration may entail cost such as hourly fees or coverage of salary/effort. Alternatively, statistical support services may be provided by a nursing school or college, such as via consulting labs, that do not require funding or provide short term consultation as needed.

When seeking a statistical collaborator, it is important to be aware that statisticians have different focuses and areas of expertise. Simply finding “a statistician” may be too broadly defined and thus an ineffective approach. For example, the statistician who helps with instrument development may not be the same statistician who helps plan a randomized controlled trial nor the same statistician who helps analyze large, multi-level data from an electronic medical record. Attention to statisticians’ areas of expertise is important to finding the right collaborator.

For PhD-prepared Nurses, Seek Challenging Learning Opportunities

Nurses should embrace challenge when learning about statistics. For PhD-prepared nurses, gaining statistical expertise through summer intensive or short courses, formal university coursework, or career development awards is often beneficial. Particularly for nurse scientists whose work entails advanced quantitative approaches, such additional training is likely a necessity. PhD-prepared nurses should also consider challenging themselves to learn analytic tools beyond menu-driven commercial software (e.g., SPSS) ( Hayat et al., 2014 ). Code-driven and free-of-charge statistical computing tools allow for replicability, transparency, and documentation of analytic work. R is a tool that may be of particular interest, given its open structure, large and active user-driven community, and availability of numerous flexible user-provided packages. R is also a useful tool for working with spatial data, which is relevant for nurses who are interested in social or environmental determinants of health, such as neighborhood poverty or greenspace access. Thus, while learning tools beyond menu-driven software may initially feel challenging, doing so can contribute meaningfully to one’s statistical skillset.

Focus on Quantitative Literacy Rather Than Statistical Expertise

For most nurses, the goal should be quantitative literacy ( Hayat et al., 2015 ; Hayat et al., 2014 ). Nurses bring important content expertise coupled with a wealth of relevant clinical experience that can bring data analytic strategies alive for a multidisciplinary audience in a presentation or manuscript. A statistician would not take one or two courses in “nursing” and expect to care for patients. Similarly, a nurse should not take one or two biostatistics courses and aim to plan, execute, and interpret one’s own data analysis. Nurses can approach statistical collaboration with respect for the content knowledge they bring as a nurse, rather than an insecurity about the statistical expertise they lack. Through effective collaboration and a focus on strong quantitative literacy, nurses can dispel negative stereotypes about nurses not being “good at” statistics.

Advance Efforts to Increase Quantitative Literacy in Nursing

Given documented gaps in nursing knowledge, strategies for increasing quantitative literacy must be considered. Quantitative and qualitative assessments of nurses’ statistical learning needs could inform translation of the robust statistics education literature into nursing training. A nursing-focused addendum to the Guidelines for Assessment and Instruction in Statistics Education could inform nursing education, as could increased guidance on nursing education statistical competencies from accrediting bodies. In addition, formalizing processes and enforcing rigorous guidelines for manuscripts’ statistical methods sections in nursing journals could increase rigor within the nursing literature ( Hayat et al., 2015 ; Hayat et al., 2021 ). Further, efforts to increase the pipeline of individuals well-prepared to serve as statisticians in schools of nursing could benefit academic nursing. Faculty who hold joint appointment in nursing and statistics and have formal education and training in both fields may be optimal, and they would have both scholarly authority in nursing and statistics and the ability to communicate effectively with nursing students. Joint graduate degree programs or minors – approaches used by many other disciplines at large research universities – can increase the pipeline of statisticians prepared in this manner and well-suited to serve in schools of nursing.

Conclusions

There is a ripe opportunity for increased nursing leadership to improve quantitative literacy in nursing. An active collaboration of nursing and statistical thought leaders can chart the path forward. When armed with appropriate statistical knowledge, nurses can play a unique role in using data to promote health and prevent disease among individuals, communities, and populations.

This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD101554; PI: Schroeder) of the National Institutes of Health (NIH). Dr. Sarwer’s work was supported by grant funding from the National Institutes of Health (National Institute for Diabetes, Digestive, and Kidney Disease R01 DK108628 and National Institute of Dental and Craniofacial Research R01 DE026603) as well as PA CURE Funds from the Commonwealth of Pennsylvania. The content is solely the responsibility of the authors and does not necessarily represent the views of the funder. The funder had no role in the development or preparation of this manuscript.

Conflict of Interest Statement: Krista Schroeder, Levent Dumenci, David C. Wheeler, and Matthew J. Hayat declare that they have no conflict of interest. David Sarwer discloses consulting relationships with Ethicon and NovoNordisk.

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"How does numerical value teach us about a population's problems?" .cls-1{fill:#fff;stroke:#79a13f;stroke-miterlimit:10;stroke-width:5px;}.cls-2{fill:#79a13f;} Numeric data collected from studies can indicate why a health problem exists, such as correlating data between environmental or genetic factors to a condition. This data can help us find appropriate interventions based on a specific cause.

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• Quantitative Research from the Dictionary of Nursing Theory and Research Although in isolation the term is not explicitly used very often, quantitative research is concerned with precise measurement, replicability, prediction, and control. It includes techniques and procedures such as standardized tests, random sampling and/or assignment, tests of statistical significance, and causal modeling. It may be preceded by descriptive pilot studies that are preliminary steps to a subsequent experimental or correlational study.
• Quantitative research design by Jacqueline Bloomfield & Murray J. Fisher "The aim of this article is to explain what is meant by research design and to discuss the four different types of research design that are commonly used in quantitative research" (Bloomfield & Fisher, 2019).
• Focusing on the fundamentals: A simplistic differentiation between qualitative and quantitative research by Shannon Rutberg & Christina D. Bouikidis This article describes qualitative, quantitative, and mixed methods research. Various classifications of each research design, including specific categories within each research method, are explored. Attributes and differentiating characteristics, such as formulating research questions and identifying a research problem, are examined, and various research method designs and reasons to select one method over another for a research project are discussed (2018, Rutberg & Bouikidis).
• What do the stats mean? Improving reporting of quantitative nursing research by Denis C. Visentin & Glenn E. Hunt An editorial is presented on the use of statistical methods to improve the report in mental health (MH) nursing research quantitatively. It expresses the view that methods which are easily understandable should be used to provide information and deliver measures. An overview of ways to improve the focus on effect size and the significance of communication between statistical analyst and clinical researcher is also presented.
• Statistics for the non-statistician by Trisha Greenhalgh It is possible to be seriously misled by taking the statistical competence (and/or the intellectual honesty) of authors for granted. Statistics can be an intimidating science, and understanding its finer points often calls for expert help. But I hope that this chapter has shown [ shows ] you that the statistics used in most medical research papers can be evaluated - at least up to a point - by the non-expert using a simple checklist such as that in Appendix 1 . In addition, you might like to check the paper you are reading (or writing) against common errors given in Box 5.1. If you're hungry for more on statistics and their misinterpretation, try this classic paper 'Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations' by Greenland and colleagues (Greenhalgh, 2020, Chapter 5, "Summary").

Bloomfield, J., & Fisher, M. J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses’ Association (JARNA) , 22 (2), 27–30. https://doi.org/10.33235/jarna.22.2.27-30

Greenhalgh, T. (2019). Statistics for the non-statistician. In How to read a Paper : The basics of evidence-based medicine and healthcare . (Sixth ed., pp. 62-78). Wiley Blackwell.

Quantitative research. (2010). In A. B. Powers, Dictionary of nursing theory and research (4th ed.). Springer Publishing Company. Credo Reference: https://ezproxy.simmons.edu/login?url=https://search.credoreference.com/content/entry/spnurthres/quantitative_research/0.embed?institutionId=5600

Rutberg, S., & Bouikidis, C. D. (2018). Focusing on the Fundamentals: A Simplistic Differentiation Between Qualitative and Quantitative Research. Nephrology Nursing Journal, 45(2), 209–213.

Visentin, D. C., & Hunt, G. E. (2017). What do the stats mean? Improving reporting of quantitative nursing research. International Journal of Mental Health Nursing , 26 (4), 311–313. https://doi.org/10.1111/inm.12352

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"Quantitative research is a systematic process used to gather and statistically analyze information that has been measured by an instrument. Instruments are used to convert information into numbers. It studies only quantifiable concepts (concepts that can be measured and turned into numbers)." It examines phenomenon through the numerical representation of observations and statistical analysis.

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• Validity and reliability in quantitative studies
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing, Laurentian University , Sudbury, Ontario , Canada
• 2 Faculty of Health and Social Care , London South Bank University , London , UK
• Correspondence to : Dr Roberta Heale, School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada P3E2C6; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2015-102129

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Evidence-based practice includes, in part, implementation of the findings of well-conducted quality research studies. So being able to critique quantitative research is an important skill for nurses. Consideration must be given not only to the results of the study but also the rigour of the research. Rigour refers to the extent to which the researchers worked to enhance the quality of the studies. In quantitative research, this is achieved through measurement of the validity and reliability. 1

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Types of validity

The first category is content validity . This category looks at whether the instrument adequately covers all the content that it should with respect to the variable. In other words, does the instrument cover the entire domain related to the variable, or construct it was designed to measure? In an undergraduate nursing course with instruction about public health, an examination with content validity would cover all the content in the course with greater emphasis on the topics that had received greater coverage or more depth. A subset of content validity is face validity , where experts are asked their opinion about whether an instrument measures the concept intended.

Construct validity refers to whether you can draw inferences about test scores related to the concept being studied. For example, if a person has a high score on a survey that measures anxiety, does this person truly have a high degree of anxiety? In another example, a test of knowledge of medications that requires dosage calculations may instead be testing maths knowledge.

There are three types of evidence that can be used to demonstrate a research instrument has construct validity:

Homogeneity—meaning that the instrument measures one construct.

Convergence—this occurs when the instrument measures concepts similar to that of other instruments. Although if there are no similar instruments available this will not be possible to do.

Theory evidence—this is evident when behaviour is similar to theoretical propositions of the construct measured in the instrument. For example, when an instrument measures anxiety, one would expect to see that participants who score high on the instrument for anxiety also demonstrate symptoms of anxiety in their day-to-day lives. 2

The final measure of validity is criterion validity . A criterion is any other instrument that measures the same variable. Correlations can be conducted to determine the extent to which the different instruments measure the same variable. Criterion validity is measured in three ways:

Convergent validity—shows that an instrument is highly correlated with instruments measuring similar variables.

Divergent validity—shows that an instrument is poorly correlated to instruments that measure different variables. In this case, for example, there should be a low correlation between an instrument that measures motivation and one that measures self-efficacy.

Predictive validity—means that the instrument should have high correlations with future criterions. 2 For example, a score of high self-efficacy related to performing a task should predict the likelihood a participant completing the task.

Reliability

Reliability relates to the consistency of a measure. A participant completing an instrument meant to measure motivation should have approximately the same responses each time the test is completed. Although it is not possible to give an exact calculation of reliability, an estimate of reliability can be achieved through different measures. The three attributes of reliability are outlined in table 2 . How each attribute is tested for is described below.

Attributes of reliability

Homogeneity (internal consistency) is assessed using item-to-total correlation, split-half reliability, Kuder-Richardson coefficient and Cronbach's α. In split-half reliability, the results of a test, or instrument, are divided in half. Correlations are calculated comparing both halves. Strong correlations indicate high reliability, while weak correlations indicate the instrument may not be reliable. The Kuder-Richardson test is a more complicated version of the split-half test. In this process the average of all possible split half combinations is determined and a correlation between 0–1 is generated. This test is more accurate than the split-half test, but can only be completed on questions with two answers (eg, yes or no, 0 or 1). 3

Cronbach's α is the most commonly used test to determine the internal consistency of an instrument. In this test, the average of all correlations in every combination of split-halves is determined. Instruments with questions that have more than two responses can be used in this test. The Cronbach's α result is a number between 0 and 1. An acceptable reliability score is one that is 0.7 and higher. 1 , 3

Stability is tested using test–retest and parallel or alternate-form reliability testing. Test–retest reliability is assessed when an instrument is given to the same participants more than once under similar circumstances. A statistical comparison is made between participant's test scores for each of the times they have completed it. This provides an indication of the reliability of the instrument. Parallel-form reliability (or alternate-form reliability) is similar to test–retest reliability except that a different form of the original instrument is given to participants in subsequent tests. The domain, or concepts being tested are the same in both versions of the instrument but the wording of items is different. 2 For an instrument to demonstrate stability there should be a high correlation between the scores each time a participant completes the test. Generally speaking, a correlation coefficient of less than 0.3 signifies a weak correlation, 0.3–0.5 is moderate and greater than 0.5 is strong. 4

Equivalence is assessed through inter-rater reliability. This test includes a process for qualitatively determining the level of agreement between two or more observers. A good example of the process used in assessing inter-rater reliability is the scores of judges for a skating competition. The level of consistency across all judges in the scores given to skating participants is the measure of inter-rater reliability. An example in research is when researchers are asked to give a score for the relevancy of each item on an instrument. Consistency in their scores relates to the level of inter-rater reliability of the instrument.

Determining how rigorously the issues of reliability and validity have been addressed in a study is an essential component in the critique of research as well as influencing the decision about whether to implement of the study findings into nursing practice. In quantitative studies, rigour is determined through an evaluation of the validity and reliability of the tools or instruments utilised in the study. A good quality research study will provide evidence of how all these factors have been addressed. This will help you to assess the validity and reliability of the research and help you decide whether or not you should apply the findings in your area of clinical practice.

• Lobiondo-Wood G ,
• Shuttleworth M
• ↵ Laerd Statistics . Determining the correlation coefficient . 2013 . https://statistics.laerd.com/premium/pc/pearson-correlation-in-spss-8.php

Twitter Follow Roberta Heale at @robertaheale and Alison Twycross at @alitwy

Competing interests None declared.

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Quantitative methods in nursing research

Affiliation.

• 1 Department of Epidemiology and Public Health, University of Leicester, England. [email protected]
• PMID: 8732530
• DOI: 10.1046/j.1365-2648.1996.09121.x

This paper considers some of the general principles that are common to much of quantitative research in nursing. In particular, the role of hypothesis testing is considered, and the use of estimation is emphasized. Confidence intervals are advocated as a means of assessing both statistical and clinical significance. These principles and methods are illustrated using examples taken from the nursing literature. Finally, more complicated situations and the role of design are discussed.

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Clinical Research Nursing

Clinical Research Nursing Landmark Documents

Domain of Practice   |  Model of Care

Background and Overview

In January 2007, Clinical Center Nursing at the National Institutes of Health launched a four-year strategic plan to lead an international effort to define the specialty practice of clinical research nursing. The goal was to take this definition to the level of detail and consensus required to create a certification process for nurses practicing in clinical research. This initiative is called Clinical Research Nursing 2010 , or CRN 2010 .

Clinical research nursing is nursing practice with a specialty focus on the care of research patients. In addition to providing and coordinating clinical care, clinical research nurses have a central role in assuring patient safety, ongoing maintenance of informed consent, integrity of protocol implementation, accuracy of data collection, data recording and follow up. Care received by research patients is driven by study requirements and the collection of research data as well as clinical indications. Study procedures may include administration of investigational drugs, performance of an experimental or investigational surgical or radiological procedure, detailed clinical assessment or phenotyping to characterize the natural history and etiology of a disease, or delivery of a psychosocial intervention. Additional nursing care may be necessitated by the response of the participant to the study intervention.

The scope of CRN 2010 included two the main roles assumed by nurses practicing in clinical research settings.

• Clinical research nurses are clinical staff nurses with a central focus on care of research patients. They support study implementation within the context of the care delivery setting and are primarily located in dedicated clinical research settings, such as the NIH Clinical Center and clinical research units located in academic medical centers across the country. These clinical nurses are part of the permanent infrastructure of the research unit and are available to any investigator accessing the facility.
• Research nurse coordinators are primarily responsible for study coordination and data management, with a central focus on managing subject recruitment and enrollment, consistency of study implementation, data management and integrity, and compliance with regulatory requirements and reporting. Research nurse coordinators are often hired by and report to a principal investigator for support of a specific study or group of studies. They may rely on clinical staff to deliver “hands on” care including administration of investigational drugs or interventions.

Developing tools to support the specialty practice of clinical research nursing included two parallel efforts:

• A careful and thorough documentation and clarification of the practice of clinical research nursing here at the Clinical Center, and
• The formal development and consensus around steps leading to possible national certification.

Both efforts used a team structure that included all leadership members of the Nursing Department Leadership as well as nursing Shared Governance chairs and co-chairs. Examination of the Clinical Center practice of clinical research nursing began with a clarification of our model of nursing care delivery, roles across the department and several key processes of clinical care such as research patient education and clinical documentation. Development of a specialty identity, which can lead to certification, began with a clarification of the domain of practice. This is similar to the steps taken by various specialty groups ranging from oncology nursing to informatics nursing. The CRN domain includes 5 dimensions and about 50 individual activities which make up the full range of practice of both clinical nurses providing research-based patient care and study coordinators managing studies.

This domain description was validated in 2008 with the assistance of a consensus panel representing Clinical Center and Institute nurses as well as nurses in clinical research from across the country.

In 2016, the American Nurses Association recognized Clinical Research Nursing as a specialty practice and published the Clinical Research Nursing: Scope and Standards of Practice.

Clinical Research Nursing Documents

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Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study

• Areej Ghalib Al-Otaibi   ORCID: orcid.org/0000-0002-3698-1248 1 ,
• Ahmad E. Aboshaiqah 2 ,
• Fatimah Ali Aburshaid 3 ,
• Anwar Nader AlKhunaizi   ORCID: orcid.org/0000-0003-4082-3530 4 &
• Sarah Abdulaziz AlAbdalhai 5  

BMC Nursing volume  23 , Article number:  649 ( 2024 ) Cite this article

Metrics details

Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It’s a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.

This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023.

The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p  < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p  < 0.000) to intent to stay if compared to resilience (β = 0.215, p  < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational.

The study’s findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates.

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Nurses and midwives are the backbones of the medical system and the most visible segment of the health sector. There are about 29 million nurses and midwives worldwide, according to the World Health Statistics Report [ 1 , 2 , 3 ]. The World Health Organization (WHO) predicts that by 2030, the world will need 9 million more nurses and midwives to meet increasing healthcare demands [ 4 , 5 ]. Nurses are in low supply in the Kingdom of Saudi Arabia (KSA) [ 6 ]. Under the KSA’s Saudi Vision 2030, midwifery is a healthcare service that will be vastly upgraded [ 7 ]. Providing high-quality midwifery, enhanced maternal health, and emotional and practical support to patients and their families are all within the purview of a midwife’s professional responsibilities [ 8 ]. The healthcare organization is constantly evolving at a fast pace. According to Johnson [ 9 ] and Altaweli et al. [ 7 ], the total number of births reported by the KSA’s Ministry of Health (MOH) hospitals in 2018 was 265,318. This represents an annual 2.43% increase in the Saudi Arabian population. Therefore, aspiring midwives require diverse characteristics and abilities to launch and sustain successful careers. This includes the traits of being able to bounce back from adversity, having confidence in one’s abilities, and having the ability to handle difficult situations at work.

However, nursing and midwifery professions requiring specialized care are susceptible to staffing gaps. According to Altaweli et al. [ 7 ], the MOH needs more than 7,000 additional midwives to care for mothers and newborns. The health transformation strategy expects more than 100,000 nursing positions to be required by 2030 to realize Saudi Vision 2030 [ 10 ]. However, whether nurses and midwives will continue working in healthcare facilities in the KSA is still being determined. In fact, the KSA has a relatively high nursing turnover rate, as with midwifery, which is higher than in other countries. For example, the KSA has a 20% higher nursing turnover rate than the United Kingdom [ 11 ]. The lack of healthcare professionals is causing problems, but it also needs to be clarified how hard and committed the present crop of nurses and midwives is. There hasn’t been a study done in KSA to investigate the factors of structure empowerment and resilience and determine whether they could help reduce nurses and midwives’ turnover in the future and encourage them to remain in their organization.

Much research has looked into the factors leading to high turnover rates in the midwifery field and nursing workforce [ 12 ]. In both healthcare professions, a lack of appreciation, stress, strenuous working responsibilities, lack of management support, poor compensation, and insufficient quality of life due to a lack of family and social life have all been recognized as contributing factors to this issue. Structural empowerment concerns social structures that facilitate the employee’s work. Structural empowerment, a term broadly used in the nursing literature, refers to successfully resolving these negative influences. It entails substantial factors that must exist in the workplace if midwives are to be effectively empowered. One such paradigm is Kanter’s structural empowerment, and its components include education, social networks, material resources, and professional development possibilities [ 13 ]. Sullivan et al. [ 14 ]. Corroborate this, finding many elements connected to a midwife’s capacity for resiliency, empowerment, and a long career. Support from superiors, easy access to information, and a sense of agency and control in carrying out one’s duties all affect longevity in one’s career.

In their studies, Hezaveh et al. [ 15 ] and Pallant et al. [ 16 ] asserted that Nurses’ and midwives’ improved professional effectiveness is related to their increased resilience after experiencing empowerment. They can better adjust to stress on the job and boost their professional health as they receive more managerial backing, professional recognition, and the appropriate skills and resources. In turn, creating a pleasant workplace and conducive settings for professional work helps to keep nurses around for the long haul. In their study, Al-Hamdan et al. [ 17 ] found that nurses are more likely to commit to an organization if they feel supported by the leadership, have access to the tools they need, and have positive relationships with their coworkers. Nurses are more likely to feel loyal to their employers and stay with the organization if they are given responsibility, respect, and encouragement to do their best work in service of the organization’s mission [ 18 ]. To the researchers’ knowledge, no previous studies have analyzed the connection between structural empowerment, resilience, and intention to stay in the context of the Saudi Arabian midwifery and nursing workforce. Consequently, the current literature about this crucial area of research lacks depth. The present study stands out from the rest of the literature because it attempts to investigate three variables that have not been thoroughly explored in previous research.

Based on the literature gap, this study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’ sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.

A convergent parallel mixed methods design including quantitative cross-sectional research design and qualitative research design was adopted, which means the collection of quantitative and qualitative data is independent, the analysis of both types of data is separate, and the two datasets are merged finally to see whether the findings converged, diverged or enhanced each other [ 19 ]. The justification for utilizing convergent mixed-methods design in this study is that the researchers would like to gain a more holistic and comprehensive understanding of the nurse’s and midwives’ perceptions towards structural empowerment, resilience, and intent to stay, which is to strengthen the findings of one component with the findings of the other component and to answer different types of questions [ 20 ]. Thus, the main aim of this study fits the five purposes of mixed-method designs: triangulation, complementarity, development, initiation, and expansion [ 21 ]. The researchers in this study used a mixed-methods approach because they believed that neither the quantitative nor the qualitative approaches taken separately would provide adequate information to accomplish their goals and answer the concerns.

Participants

Quantitative sample.

This study was conducted at the beginning of January 2023 and continued until the end of February 2023. The quantitative phase of the data collection involved gathering quantitative data from participants who met the inclusion criteria and were selected using a convenient non-probability sampling strategy. The sample size required for this study was derived based on a rigorous power analysis using G*Power 3.1™, a trusted scientific tool. A power of 95%, α = 0.05, a medium-effect size (f 2 = 0.15), and two predictors (structural empowerment and resilience) were used as the statistical basis for calculating a linear multiple regression analysis (fixed model, R2 deviation from zero). Based on the results, 107 participants from the total population ( n  = 297) were sufficient for this study.

Participants were included in the research study if they met the following selection criteria at the time of data collection–nurses and midwives who had three or more years of practical experience working in (delivery rooms, OB/GYN emergency rooms, and obstetrics departments), and were willing to participate in the research study. The participants were excluded from the research study if they were nurses and midwives newly recruited in the orientation period at the time of data collection. The careful selection of participants was a key aspect of the study’s design, ensuring the relevance and accuracy of the study’s findings and providing a solid foundation for the research.

To select the required sample, the researchers coded all eligible registered nurses employed at the three hospitals based on lists provided by the senior hospital administrators and the hospital director. The researchers then sent the research questionnaire link for all of them to participate in the research.

Qualitative sample

For qualitative study, the participants were eighteen registered nurses and midwives working in the OB/GYN departments of the three selected government hospitals located in the Eastern Province of Saudi Arabia (Al Khobar, Dammam, and Al Hasa), who had met the inclusion criteria by utilizing a purposive sampling: an OB/GYN nurse or midwife in the selected organizations, a minimum of three or more years of working experience to enhance credibility and trustworthiness of data, and willingness to cooperate with the researchers.

Each participating nurse and midwife were interviewed in a semi-structured individual interview. These interview sessions lasted 30 to 60 min and took place at the participants’ place of work. When the researchers determined that no new issues continued to emerge and the same topics would be repeated, data saturation was considered to have been attained, and data collection was terminated.

Setting of the study

The study was conducted in three maternity hospitals in the Eastern Province of Saudi Arabia. These hospitals were selected based on their capacity, which exceeds 500 beds in total, and their provision of 24/7 high-quality integrated health services in the field of Obstetrics and Gynecology. Additionally, their large staff of over 250 nurses and midwives in the Obstetrics departments, and their recognition as mother-friendly hospitals, where midwives provide high-standard and quality delivery care, were key factors in their selection.

Data collection

Structural empowerment.

The Conditions of Work Effectiveness Questionnaire (CWEQ-II) is a self-reported questionnaire developed by Spence Laschinger et al. [ 22 ]. The researchers adapted it to measure the midwives’ and nurses’ perceptions of structural empowerment.

The CWEQ-II is used in international nursing research; a questionnaire consists of 19 items based on Kanter’s structural theory of organization empowerment; these items were grouped under six dimensions: Access to opportunity, access to support, access to resources, having formal power and having informal power. Responses were measured on a five points Likert scale ranging from (1) to (5) where 1 represents ‘none’ and 5 represents ‘a lot’.

The components can vary from 6 to 30, with values between 6 and 13 meaning low level of structural empowerment, between 14 and 22 meaning moderate levels, and between 23 and 30 representing high value of structural empowerment. A high score indicated a high level of participants’ perception of structural empowerment. Cronbach’s previous studies reported alpha reliabilities for the instrument, which ranged from 0.81 to 0.87 [ 23 ].

The Connor–Davidson Resilience Scale 10-Item (CD-RISC-10) version questionnaire [ 24 ] was chosen to measure resilience in this study. This shortened version of the original 25-item questionnaire is a widely used, unidimensional self-report questionnaire. It contains ten statements, and the responses to each statement were measured on a five-point Likert scale, where 0 represents ‘not true at all’ and four means ‘true nearly all the time.’

Nurses’ and midwives’ responses to all ten statements in this section can provide insight into their organizations’ resilience perceptions. The final score on the questionnaire was the sum of the responses obtained on each item (range from 0 to 40), with values between 0 and 29 meaning the lowest level of resilience, between 30 and 32 meaning low levels, between 33 and 36 meaning moderate level, and between 37 and 40 representing the high value of resilience. The highest scores indicate the highest level of resilience. Cronbach’s alpha ranged from 0.6 to 0.7 and has a moderate reliability rating [ 24 ].

• Intent to stay

Nurses’ and midwives’ intent to stay in the organizations was measured by McCain’s Behavioral Commitment Scale (MBCS), which was developed by McCloskey and McCain [ 25 ]. The MBCS consists of 38 items; McCain extracted five items from this scale to measure nurses’ intent to stay [ 26 ]. The 5-item Subscale from McCain’s Behavioral Commitment Scale is used in the current study. This section contains five statements used to measure midwives’ and nurses’ perceptions of their intention to stay in their current organizations. The responses to each statement were measured on a five-point Likert scale, where one represents ‘strongly disagree,’ and five represents ‘strongly agree.’ The Cronbach’s alpha of McCain’s subscale of intent to stay was (0.90). The total score ranges from 5 to 25, and the scores are summed and divided by the number of statements to attain the participant’s perception mean. A higher score indicated a higher intent to stay.

Socio-demographic characteristics of the participants

The researchers developed the socio-demographic questionnaire, which was used to collect information about the participants’ socio-demographic characteristics. This information included the participants’ ages, marital status, work settings, years of experience, and educational levels. These items for the questionnaire were developed based on the reviewed literature about structural empowerment, resilience, and the intention to stay in the organization.

Qualitative phase

The research instruments were a series of semi-structured interviews, field notes, and audio recordings. These strategies were chosen to generate an in-depth exploration of the participants’ working experiences with research phenomena. A semi-structured interview guide was developed by the researchers to elicit participant data. Creswell & Creswell [ 19 ] indicated that the interview-guided questionnaire consisted of a series of open-ended questions that elicited the participants’ experiences. This type of data allowed the researchers to ask follow-up/probing questions from the participants so that they could clarify and expound their thoughts and have a deeper understanding of the facts presented [ 27 ].

The transcript files contained the raw data from the interviews, such as a detailed consecutive account of the participants, settings, and reflective notes on the research experience and methodological issues. The information likewise was obtaining the personal files, which enabled the reconstruction of conversations in context rather than simply relying on a contextual verbal recording. Information on the participants’ reflections and insights was also included. Audio recording was used during the interview to facilitate data gathering and verification of the information supplied during the interview.

Ethical considerations

Ethical approval.

Permission to carry out the study and record the interviews was obtained from the ethics bodies of King Saud University’s Institutional Review Board (Ref no: KSU-HE-22-785) and Governmental Hospitals (Ref No: EXT-MS-2022-001) -(Ref No: H-05-HS-065). To further protect participant anonymity, they were assigned color-coded numbers and pseudonyms. Before the interviews, participants signed a written consent form, demonstrating their voluntary participation and allowing the researchers to make audio recordings. We assured participants that their contributions, names, and recordings would be treated with the utmost respect and confidentiality.

Participants were also informed they could withdraw from the research or stop the recording at any time. The researchers showed the utmost care for the participants by adhering to the rigorous ethical concept of protecting the participants’ health and their right to privacy during the research, the participants’ informed consent was sought in the form of a written document that was signed during face-to-face contact. As a direct consequence of this, each participant was given a sheet of information. On the form that was sent to participants, information regarding the purpose of the study, its methods, dangers, potential benefits, and participant rights was detailed. Before providing their signed consent, the researchers made sure that the participants read and comprehended the information sheet that was provided to them.

Data analysis

Quantitative data analysis.

In preparing the data for analysis, the raw data were extracted from the Question Pro questionnaires and imported into the Statistical Package for Social Science (SPSS) Version 25. Question Pro program’s ability to accept imported information helped minimize data entry errors. Subsequently, each participant’s response was assigned a unique participant code number before coding the data. The researchers checked all the soft-copy questionnaires against the data entered in SPSS. Any data entry errors were edited to clean the data before analyzing it.

Descriptive and Inferential statistics of the quantitative data were performed. Descriptive statistics were carried out and represented by means and standard deviations using the frequency distribution tables to determine the level of each of the study variables. Frequencies and percentages of specific (socio-demographic) variables were used to clarify the characteristics of the sample population and their general information. The results were categorized and tabulated using Microsoft Office to produce tables and figures that visualized the data. Values of p  < 0.05 and 0.01 were considered statistically significant, and a p-value < 0.001 was considered highly statistically significant. Inferential statistical tests such as multiple regression analyses were used after all assumptions regarding linearity, multicollinearity, independence of error, homoscedasticity, and normality were achieved.

Qualitative data analysis

The Colaizzi method was used to analyze and interpret data [ 28 ]. After completing Colaizzi’s data analysis steps, the participants clarified their initial words and phrases, expanded on what they wanted to convey, changed misunderstood experiences, added more information, and rectified grammatical and typographical errors. The results were verified using the Consolidated Criteria for Reporting Qualitative Data [ 29 ].

Quantitative findings

A total of 200 out of 297 nurses and midwives participated in the study (67.3) percent response rate). Most participants (42.5%) worked in wards (Antenatal, Postnatal). The majority of the participants (63.0%) were aged (31–40 years). Regarding their years of experience, the majority of participants (33.0%) had (11–15 years) of experience, then (31.5%) of participants had (6–10 years), followed by (19.5%) with (< 6 years) of work experience, then (12.5%) with (16–20 years) of work experience and only (3.5%) with (> 20 years) of work experience. Most of the participants (51.0%) held a bachelor’s degree in nursing/midwifery, while (42.5%) had a diploma level, and only (6.5%) of the participants had Master’s or postgraduate qualifications. Of the 200 participants who indicated their marital status, the majority (77.0%) were married, and (23.0%) were single [ 30 ]. ( Table  1 )

Our findings revealed that the overall structural empowerment score level was 19.67, with a mean score and SD (3.28 ± 0.671). This means the overall perception of the participants about structural empowerment was moderate. About the - CWEQ-II subscales, the “Opportunity” dimension was the highly perceived dimension and ranked first with a mean score of (3.55 ± 0.956), followed by the “Information” dimension with a mean score (3.51 ± 0.903), then the “Support” dimension with a mean score (3.32 ± 0.844). The informal power dimension came fourth rank with a mean score (3.26 ± 0.784), followed by the “Resources” dimension with a mean score of (3.20 ± 0.847), while the minimally perceived dimension by the participants was “Formal Power” with a mean score of (2.83 ± 0.952) and ranked as the sixth and the last dimension among the structural empowerment dimensions. (Table  2 ).

Regarding resilience, our findings revealed that the overall resilience score level was 26.80, with a mean score and SD (2.68 ± 0.744). This means the overall perception of the participants about resilience was the lowest. Regarding the CD-RISC-10 subscales, the “Regulate Emotion” component was the most highly perceived. It ranked first with a mean score of (2.80 ± 1.058), followed by the “Self-Efficacy” component with a mean score of (2.78 ± 0.827), then the “Cognitive focus/maintaining attention under stress” component with a mean score of (2.68 ± 0.996). The “Optimism” component came fourth rank with a mean score of (2.67 ± 0.832), and lastly, the “Flexibility” component, with a mean score of (2.49 ± 0.878) came fifth rank among the resilience components. (Table  3 ).

Regarding the Intent to Stay, our findings revealed that the overall intent to stay mean score and SD was (3.29 ± 0.840). This means the overall perception of the study subjects about intent to stay was “Neutral” perception (between 2.61 and 3.40). The questions’ means ranged between (3.17–3.44) that’s ranged between (Neutral - Agree) perception; the highest mean belonged to statement five, which stated: “I plan to keep this job for at least two or three years,” with a mean score of (3.44 ± 1.255), followed by statement three “Even if this job does not meet all my expectations, I will not quit,” with a mean score of (3.34 ± 1.095), then statement one “I plan to work at my present job for as long as possible” with a mean score of (3.32 ± 1.194). Statement four came as fourth rank: “Under no circumstances would I leave my present job,” with a mean score of (3.18 ± 1.136). The second statement stated, “I will probably spend the rest of my career in this job or jobs that it leads to in this hospital,” with a mean score of (3.17 ± 1.112) coming fifth rank. (Table  4 ).

A multiple regression was used to identify the most significant predictor from the main factors that were found to influence participant’s intent to stay in the current working organization.

Table  5 presents “variables in the equation” that is, those factors that were found to be predictive of respondents’ Intent to Stay ( p  < 0.000). This multiple regression analysis showed that Structural Empowerment and Resilience were predictive of intent to stay, based on the Pearson correlation, significantly correlated level.

Likewise, Table  6 presents model one (structural empowerment, resilience) recorded a positive R  = 0.513 a correlation, R 2  = 0.263, which indicates that 26.3% of the variation in Intent to Stay (the dependent variable) can be explained by the independent variable (Structural empowerment, Resilience).

Moreover, the R 2 for the variables in the equation was used to determine the joint predictive contribution to the dependent variable (Intent to Stay) of the independent variables (Structural Empowerment and Resilience.

Thus, based on the multiple regression analysis, the best predictor of Intent to Stay from among the two variables analyzed is structural empowerment if compared to resilience.

Table  7 indicates that for the Model of the regression, the sum of squares = is 36.990 (p = < 0.000). Thus, the results of the ANOVA confirm differences of variance between the independent variables in terms of their predictive strengths, thereby supporting the finding that the independent variables structural empowerment and resilience are dominant predictors of intent to stay. (Table  7 )

Qualitative findings

Findings from the semi-structured interviews.

The qualitative findings were related to five major themes in the form of individual (nurses and midwives) dimensions from the narratives of 18 participants, including (1) physical and physiological, (2) psychological, (3) financial, (4) organizational, and (5) professional and occupational. The first major theme, nurturing physical and physiological, displays the activities of daily living (ADLs) and instrumental activities of daily living (IADLs) of an individual trying hard to adapt to situations. IADLs are activities that everyone does regularly, from personal hygiene tasks (shaving, brushing their teeth, and taking a bath) to professional and social obligations (going to work) to recreational pursuits (playing sports) to eating and drinking. The second major theme, the developing psychological, displays the affective-emotional or affective-motivational status of the individual. Psychological empowerment is a response to certain empowering conditions and an outcome of structural empowerment. It portrays the lived experiences of the nurse and midwives in pursuit of their cognitive (intellectual), affective (emotional), and psychomotor (skills) well-being. Thus, the third major theme, managing the financial, portrays the capacity to address practical requirements with financial resources and a sense of control and financial literacy. The fourth major theme, restructuring the organizational, covers the structure and general managerial mechanisms that serve as its backbone and fundamental building block. Lastly, the fifth major theme is called the enriching professional and occupational, exploring employee enrichment and satisfaction through work in their organization. Employment may fall under this category, but it might also refer to involvement in any activity, even if it is unpaid. This theme is actualized to the degree that derives satisfaction from engaging in these pursuits [ 31 ]. (Table  8 )

Synthesis and integration (mixing both result strands)

Separately and independently, each data type can be collected and evaluated using the methods that have been developed over time. This is a perfect opportunity for multidisciplinary teams to do research, with members having competence in both quantitative and qualitative methods. Furthermore, the design allows for a direct comparison between participant perspectives gleaned through open-ended questions (e.g., a semi-structured interview) and researchers’ perspectives gleaned via close-ended questioning (e.g., a survey chosen by the researchers). With this method, the researchers can reveal statistical trends while simultaneously giving participants a voice.

In our study’s quantitative findings, we observed that the perceptions of midwives/nurses working in OB/GYN departments were 19.67, which was at a moderate level of structural empowerment. During the interview, the theme clusters to the major theme of managing financial confirms that access to recourses is critical to enhancing midwives’ and nurses’ structural empowerment level in the organization. The participants discussed that they needed additional monetary compensation. As the participant stated:

“Our salary is not enough, according to what we are doing; we are dealing with mothers and babies.” (P1).

Moreover, theme clusters to the major theme of restructuring organizational confirm that access to support is essential for enhancing the midwives’ and nurses’ structural empowerment level. During the qualitative phase, participants described experiencing the need for organizational support for growth and development. As the participant stated:

“Okay, I guess the nursing office they must see as our staff developed educationally and regarding nursing practice, they need to see what’s their needs they need to ask us what you need to get developed in your career and what you need to increase our patient care quality. Yeah, this is my opinion. So, they started I told you this is my first year to take an education or something rather than work by my hand in every day”. (P4)

Furthermore, the theme clusters to the major theme of enriching professional and occupational confirm that access to opportunities to learn and grow is also an essential of enhancing midwives’ and nurses’ structural empowerment levels. The participants discussed their need to have technological skills to comply with modernization and advancements, continuous professional development to improve their skills in performing their duties and responsibilities, mentoring and coaching programs to teach and cultivate the best practices of the nurse leaders and managers in the unit, and participation in training and development.

On the other hand, some participants viewed the workplace as their bread and butter to support financial needs. Concerning restructuring organizational, midwives and nurses express their experience of having a strong support system, feeling motivated each time peers and patients recognize and appreciate their good performance, receiving constant feedback from different members in the organization, and they can freely exercise their power to speak up in their workplace. Thus, all of these dimensions discussed by the participants relate to the high structural empowerment level. Finally, participants mentioned that they have strong social support in their departments and freely exercise their power to speak up with their perspective on the unit as emerged in the major theme restructuring organizational dimension as being contradictory with the midwives and nurses are experiencing burnout as emergent in the major theme developing psychological dimension.

Regarding resilience, the quantitative result reveals that the perception level of midwives/nurses working in OB/GYN departments was 26.8, the lowest level of resilience. During the qualitative interview, participants discussed feeling stressed, having insufficient time to rest because of the long hours of duty, and developing different physiological changes due to their workplace issues. During the interview, the theme clusters to the major theme of nurturing physical and physiological confirm that employees lack energy, motivation, concentration, and interest when physically weary. Consequently, during the interview, the theme clusters to the major theme of developing psychological confirms that employee behavior and attitudes to work are heavily influenced by structural empowerment and resilience. Participants discussed that they are experiencing burnout. As the participant stated:

“Of course, I burned out already " (P15).

“I am dealing with the same kind of patient. I am dealing with the same problems with the same challenge. I need a new chapter in my professional life”. (P14)

However, with this theme finding, participants felt empowered knowing they could influence their patients, develop their self-confidence, and make their own decisions based on the organizational policies and regulations. Most participants recognized that not all midwives and nurses in their departments were pleased with resilience. Some staff needed to be more interested in challenges, responsibilities, and joint decision-making. Finally, according to the theme cluster adaptive competence, most participants discussed that they could seek ways and means to adapt, adjust, and cope with unfavorable situations; they imagine their selves as skillful and patient during tough times and are willing to share their competencies in the future generation.

Regarding intent to stay, the quantitative result reveals that the perception level of midwives/nurses working at OB/GYN departments was 3.29, which was a neutral intent to stay score in their organization. During the interview, the theme clusters to the major theme of managing financial confirms that access to resources is essential to why midwives and nurses stay in the organization. During the interview, the participants described how they experienced managing their finances accordingly. Moreover, the theme clusters to the major theme of restructuring organizational confirm that organizational benefits employees enhance the intention to stay. Participants discussed that they have strong support in their workplace, a strong support system, freely exercising their power, and a tenacious policy to follow. There were favorable perceptions and experiences about the hospital’s top management and policy; some participants felt empowerment as an obligation. The opportunities and support the organization provides may affect the midwives’ and nurses’ intention to stay in the organization. In addition, participants discussed that the availability of job resources is related to their decision to stay in the organization. As the participant stated:

“ I’m just work in Saudi Arabia to save money to support my family in India. But of course, I still want to settle down in my own country”. (P6)

Quantitatively, linear multiple regression analysis of structural empowerment, resilience, and intent to stay showed that structural empowerment and resilience are significant predictors of intent to stay in the organization. Structural empowerment gives midwives and nurses greater resilience, enhancing their decision to stay in the organization. The participants perceived that structural empowerment and resilience could influence their decisions to stay in the organization. During the interview, the theme clusters to the major theme of developing psychological and theme clusters to the major theme of restructuring organizational dimension; both confirm that midwives and nurses feel structurally empowered and know they can influence their patients. Thus, their ability to recognize, control, and express their emotions reflects their resilience in the organization. Consequently, access to opportunity, recourses, and positive challenges is a motivated dimension of why midwives and nurses stay in the organization. Two of the participants shared their experiences:

“Ok what motivates me, the everyday challenges here in the labor room, we don’t have a routine as I’ve said, every day and every situation is new for us. So, dealing with mother also the relationship with my colleagues, our teamwork, the respect here, the appreciation, if they say thank you, our mother trust, that motivates me.” (P1).

“I am empowered because of my colleagues are helping. Sometimes doctor is also more helpful for us. Sometimes the patient delivered at the same time delivery room may be not accepted for sometimes they are busy. They said they cannot accept it for this patient at that time, doctor said no, it’s already delivered this patient at that time our doctor stopped are helping for us.” (P7).

However, with this theme finding, participants discussed that they are experiencing burnout and still need organizational support for growth and development.

“I don’t have interest like before. Yes, yes, because every day we handle delivery, especially if it new, or we facing new challenge but it’s still the same, the same routine”. (P1)

We noticed that the level of structural empowerment of midwives and nurses in this study was moderate, which reflects partial access to components such as opportunities, resources, support, information, and formal and informal power in the organizations.

The triangulation and integration of quantitative and qualitative findings in this study provide a comprehensive and multifaceted analysis of the experience of nurses’ and midwives’ views on structural empowerment, resilience, and intent to stay. Therefore, this convergent parallel mixed method study assures a thorough understanding of the strength of participants’ perceptions of these factors.

The data analysis displayed key findings indicating that structural empowerment and resilience predicted intent to stay in the organization. Our study’s midwives and nurses reported moderate structural empowerment, lowest resilience, and neutral intent to stay in their organization. Previous studies have also demonstrated moderate structural empowerment among nurses [ 13 , 31 , 32 , 33 , 34 , 35 , 36 ].

According to structural empowerment, there are six organizational structures of access: opportunity, information, support, resources, formal power, and informal power. The findings of this study reveal that the participants perceived the greatest access to the opportunity component, followed by information and support. The informal power component was fourth, followed by resources and formal power. The higher perceived level of access to opportunity is significantly related to all participants having more than three years of work experience. This experience allows them more access to learning, growth, and expertise in their midwifery and OB/GYN specialties. This result aligns with a study by Gholami et al. [ 37 ], which revealed the highest score in the access to opportunity subscale and the lowest score in their perceptions of access to formal power. Similar studies have shown access to opportunity as the primary driver of structural empowerment [ 38 , 39 ]. In contrast, some structural empowerment studies have prioritized access to resources [ 18 , 40 ]. Oliver et al. [ 41 ]. showed lower-than-expected scores on the resource subscale and acceptable scores on the subscales of support, formal power, and informal power.

Our study results showed that midwives’ and nurses’ perceptions of structural empowerment were moderate. The participants discussed that they needed additional monetary compensation and a competitive housing allowance. Arslan Yürümezoğl and Kocaman [ 42 ] pointed out that structural empowerment through rewards and recognition for a well-done job could contribute to employee satisfaction. Our findings indicate that access to support is essential to enhancing midwives’ and nurses’ empowerment in the organization. This finding is in line with Hagerman et al. [ 43 ], who revealed that access to support must be through feedback, guidance, emotional support, helpful advice or hands-on assistance, and problem-solving advice, all of which can benefit nurses in their workplace.

Furthermore, our study results confirm that access to opportunities to learn and grow is also essential for enhancing midwives’ and nurses’ empowerment levels. The participants discussed their need to have technological skills to comply with modernization and advancements and continuous professional development to improve their skills in performing their duties and responsibilities. According to Kanter [ 44 ], when employees do not have access to resources, support, and opportunities, they experience powerlessness.

Our study also revealed that the participants perceived their resilience levels as the lowest in the organization. Several studies have addressed healthcare providers’ resilience, but few have examined midwives’ resilience. No study was found that measured levels of resilience about structural empowerment or intent to stay in the organization. Our study participants perceived their resilience as a process facilitated by various coping strategies, including accessing peer support and developing self-awareness and self-protection. Moreover, the participants identified the importance of the workplace environment in enhancing resilience.

In this study, it was evident that the participants suffered from feeling stressed and having insufficient time to rest. It confirmed that employees lack energy, motivation, concentration, and interest when physically weary. McGowan et al. [ 45 ] revealed that resilience is related to improved physical and mental health. According to this, midwives and nurses need resilience more than any other profession [ 46 ]. However, the participants felt empowered knowing they could influence their patients, develop their self-confidence, and make their own decisions based on organizational policies and regulations. Gover and Duxbury [ 47 ] point out that employee engagement in decision-making is essential to organizational resilience.

Most previous studies have focused on turnover intention rather than intention to stay. In the current study, the participants’ perceptions of their intent to stay were neutral. Various studies have found that nurses have moderate to low intentions to stay at their organizations [ 31 , 32 ]. The present study’s findings contrast with those of Al-Hamdan et al. [ 17 ]. and Alhadidi et al. [ 48 ], who found that the overall mean intention of nurses to stay in their organizations was high.

Furthermore, the results confirm that access to resources is essential to why midwives and nurses stay in the organization. Moreover, the participants confirm that organizational benefits employees enhance the intention to stay. Participants discussed that they have strong support in their workplace. There were favorable perceptions and experiences about the hospital’s top management and policy; some participants felt empowerment as an obligation. The opportunities and support the organization provides may affect the midwives’ and nurses’ intention to stay in the organization. Kleine et al. [ 49 ] Pointed out that leaders such as empowerment and supportive leadership relate to turnover. In addition, participants discussed that the availability of job resources is related to their decision to stay in the organization. Management and leadership are related to turnover [ 50 ].

In this research, the linear multiple regression analysis of structural empowerment, resilience, and intent to stay showed that structural empowerment and resilience are significant predictors of intent to stay in the organization. The participants perceived that structural empowerment and resilience could influence their decision to stay in the organization. The findings are similar to those of Liu et al. [ 51 ], who revealed that resilience had the strongest direct effect on the intention to stay in the organization. Likewise, Meng et al. [ 18 ] found that structural empowerment significantly positively affected nurses’ intent to stay. Cowden and Cummings [ 52 ] revealed that empowerment strongly influences a nurse’s intent to stay.

Resilience has high practical value and could significantly enhance nurses’ intent to stay [ 53 , 54 ]. Previous studies’ results support the current study’s findings [ 42 , 55 ]. In contrast, Hall [ 56 ] indicated that structural empowerment did not predict nurses’ intent to stay in their organizations. Kelly et al. [ 57 ] also found that structural empowerment was not significantly related to intent to leave.

Liu et al. [ 51 ]. Found that resilience had the strongest direct effect on the intention to stay in the organization. Interestingly, a component of structural empowerment, such as opportunity, resources, formal and informal power, and adaptive resilience competence, can be related to midwives’ and nurses’ intention to stay in the organization. Previous studies’ results support the current study’s findings [ 18 , 33 , 42 , 52 , 53 , 54 ]. However, participants discussed experiencing burnout and needing organizational support for growth and development. Along the same lines, a study conducted by Hall [ 56 ] showed that structural empowerment does not predict the intent to stay of nurses in the organization.

In particular, Hezaveh et al. [ 15 ] and Pallant et al. [ 16 ] reiterate the key points, assuring us that the relationship between resilience, structural empowerment, and professional effectiveness is well-supported in their studies. This reaffirms our confidence in the findings and their implications for midwifery and nursing. Although extant literature has reported that support from superiors, easy access to information, and a sense of agency and control in carrying out one’s duties all affect longevity and satisfaction in one’s career and are connected to a midwife’s capacity for resiliency, structural empowerment, and a long career [ 14 ].

Our mixed-method study contributes to the body of knowledge in various ways. Our results recommended that any healthcare organization enhance its staff’s intent to stay through empowering work conditions, promoting empowering behaviors, and increasing resilience. They should ensure the five empowering dimensions at the workplace to keep their staff resilient and to have a greater sense of loyalty to stay in their organization. Accordingly, it is essential to develop and implement a national staff empowerment standardizing policy to transform the healthcare and services system in Saudi Arabia. A policy of this type will save significant resources and provide insight into coping strategies to prevent adverse employee turnover outcomes and create retention strategies; as a result, policymakers can benefit from our results if they formulate a policy to increase midwives’ growth, power, resilience, and competence.

Our study limitations include the study’s cross-sectional design and reliance on self-reported survey questionnaire data, both of which prevent the researchers from drawing causal conclusions about study variables. Likewise, the sampled nurses and midwives were all located in the Eastern Province; therefore, the results cannot be generalized to the rest of the KSA. Finally, this error in the sampling process was attributable to using convenience sampling in quantitative research. It is challenging to detect variations in a population subgroup when using a convenience sample, which leads to underrepresentation of the sample; as a result, research study conclusions need to be more generalizable to the target population. Therefore, the sampling strategy used in the qualitative phase was deliberate, which raises the possibility of selection bias impacting the findings.

Conclusions

The study’s researchers are optimistic that drawing attention to the importance of cultivating a culture of empowerment and resilience would encourage nurses and midwives to remain in their current roles. It takes nurses and midwives succeeding in two fields simultaneously to have a global impact. The emergent themes underlined the physical, physiological, psychological, financial, organizational, professional, and vocational aspects of nurses and midwives, giving them agency, resilience, and determination to remain in the sector. All of these requirements must be met to avoid consequences for the rest. The outcome might be fatigue, burnout, workplace antagonism, and a general lack of enthusiasm among nurses and midwives.

Evidence from quantitative and qualitative studies suggests that healthcare organizations’ leaders and managers can do more to help nurses and midwives feel empowered and resilient at work and reduce turnover.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the study participants for their contributions, and dedication for sharing their lived experiences, which can shed light for other registered nurses and midwives in the kingdom to continue striving harder to achieve the Saudi Vision 2030.

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Conceptualization, A.G.A-O and A.E.A methodology, A.G.A-O and A.E.A; software, A.G.A-O ; validation, A.G.A-O , A.E.A.; A.N.A and S.A.A formal analysis A.G.A-O , A.E.A.; A.N.A and S.A.A.; investigation, A.G.A-O., and F.A.A; writing—original draft preparation, , A.G.A-O and A.E.A.; writing—review and editing, A.G.A-O, A.N.A and S.A.A; visualization, A.N.A supervision, A.E.A. All authors guarantee the integrity of the content and the study. All authors have read and agreed to the published version of the manuscript.

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Al-Otaibi, A.G., Aboshaiqah, A.E., Aburshaid, F.A. et al. Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study. BMC Nurs 23 , 649 (2024). https://doi.org/10.1186/s12912-024-02325-w

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Training healthcare professionals in assessment of health needs in older adults living at home: a scoping review

• Bente Hamre Larsen 1 ,
• Dagrunn Nåden Dyrstad 2 ,
• Helle K. Falkenberg 3 , 4 ,
• Peter Dieckmann 2 , 5 , 6 &
• Marianne Storm 1 , 7 , 8  

BMC Medical Education volume  24 , Article number:  1019 ( 2024 ) Cite this article

Metrics details

Interprofessional assessment and management of health needs for older adults living at home can help prioritize community service resources and enhance health, yet there is a shortage of professionals with the necessary competencies. Therefore, support and training for healthcare professionals in community settings to assess older adults’ health with the aim of for health promotion are needed.

To identify and provide an overview of published papers describing approaches for training healthcare professionals in assessing physical, mental, and social health needs in older adults living at home.

A systematic literature search of the Cinahl, Medline, Academic Search Ultimate, Scopus, Embase, and British Nursing Index databases was performed. We considered studies focusing on the training of healthcare professionals in assessing a single or multiple health needs of older adults aged 65 and above living at home. We considered studies published between 1990 – and March 2024. The review evaluated qualitative, quantitative, and mixed methods studies published in English-language peer-reviewed academic journals. A quality appraisal was conducted via the Mixed Methods Appraisal Tool (MMAT).

Twenty-three studies focused on training healthcare professionals to assess health needs and plan care for older adults living at home were included. The majority of the included studies combined teacher-driven pedagogical approaches consisting of educational sessions, written materials or e-learning, and more participant-engaging pedagogical approaches such as knowledge exchange or various forms of interactive learning. Healthcare professionals were trained to detect and manage single and multiple health needs, and some studies additionally incorporated interprofessional collaboration. Healthcare professionals were satisfied with the training content and it increased their confidence and competencies in health needs assessment and care planning for older adults. Moreover, some studies have reported that training interventions foster the implementation of new and effective ways of working and lead to positive outcomes for older adults.

Healthcare professionals were satisfied with a combination of participant-engaging and teacher-driven pedagogical approaches used to train them in assessing health needs and planning care for older adults living at home. Such training can lead to enhanced assessment skills and facilitate improvements in practice and health promotion for older adults. Future research is recommended on interprofessional simulation training for conducting structured and comprehensive health needs assessments of older adults living at home, as well as on the implementation of such assessments and health-promoting interventions.

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Introduction

The globally growing and diverse aging population will impact the sustainability of healthcare systems and the independent living of older adults. To support the health needs of older adults, the World Health Organization (WHO) underscores the necessity of effectively training the healthcare workforce [ 1 , 2 ]. However, the complexity of health needs in older adults, coupled with an increased risk of frailty and adverse health outcomes, challenges the provision of tailored care [ 3 ]. Healthcare professionals in homecare settings are well-positioned to assess the health needs of home-living older adults [ 4 , 5 ] and facilitate the interprofessional management of these needs within the community [ 5 ].

Health needs assessment should offer a comprehensive understanding of individuals’ physical, mental, and social health needs, and address the constantly changing needs with increasing age. The assessments aim to identify those who can benefit from healthcare services, such as health education, disease prevention, treatment, and rehabilitation [ 6 ]. The assessment can help set service priorities and allocate service resources effectively, guide clinical decision-making [ 7 ] and design targeted, health promoting interventions [ 4 , 7 , 8 , 9 ] to prevent or delay frailty [ 10 ], enhance overall outcomes for those with complex health needs [ 11 ] and enable them to remain at home for as long as possible [ 12 ]. Given its importance, the task of health needs assessment, is becoming increasingly crucial in homecare settings [ 13 ]. However, there is a scarcity of adequately trained professionals proficient in conducting interprofessional health needs assessments [ 4 , 5 , 9 , 14 , 15 ], including depression [ 16 ], cognitive function [ 17 ], social needs [ 18 ], sensory function (i.e. hearing and vision) [ 19 ], geriatric healthcare [ 20 , 21 ], and multidimensional frailty [ 22 , 23 ]. Frailty, as a dynamic state, affects an individual who experiences losses in one or more domains of human functioning (physical, mental, social) that are caused by the influence of a range of variables, and which increase the risk of adverse outcomes [ 24 ].

A comprehensive understanding of how to train healthcare professionals in health needs assessment of the physical, mental, and social health needs of older adults living at home is crucial. This review understands training as “planned and systematic activities designed to promote the acquisition of the knowledge, skills, and attitudes” [ 25 , p77]. Training can take place as “on-the-job training,” with practicing tasks with a mentor or receiving feedback, or through “off-the-job training,” in a classroom setting with lectures, discussions, and exercises [ 26 ]. It is essential to consistently update and expand knowledge and skills throughout healthcare professionals’ careers [ 27 ]. Mentorship and support are highly valued as pedagogical approaches [ 28 ]. Another approach is implementing interprofessional team-based training [ 29 ] focused on health needs assessment for older adults, which can be complemented by practical, supervised training with a mentor in real-world settings [ 9 ]. Interprofessional simulation training can support healthcare professionals developing communication and collaborative skills and improving patient outcomes [ 2 ]. Additionally, opportunities to share and exchange experiences and new learning with peers and seniors, along with tailored, role-focused teaching, are effective approaches training strategies in community healthcare [ 30 ]. Practical training through simulation, case studies, and role-playing influences skill development by creating experiences that promote individual understanding and learning [ 31 ] and it is based on Vygotsky’s sociocultural learning theory [ 32 ]. Tailored simulation training in use of systematic assessment tools enhanced nurses’ competencies to assess and treat complex symptoms among older adults in long-term care facilities [ 33 ].

Therefore, this scoping review aimed to identify and provide an overview of published papers describing approaches for training healthcare professionals in assessing physical, mental, and social health needs in older adults living at home. Three research questions guided the review: (1) what pedagogical approaches are used when training healthcare professionals to assess the health needs of older adults living at home, (2) what is the content and foci in the health needs assessment training provided in the studies, and (3) what are the outcomes of training reported by healthcare professionals and older adults living at home?

Scoping review design

This study followed the Joanna Briggs Institute (JBI) methodology [ 34 ] for conducting and reporting scoping reviews built on Arksey and O’Malley’s framework [ 35 ]: (1) Define and align the objectives (2) develop and align the inclusion criteria with the objectives (3) describe the planned approach to evidence searching, selection, data extraction, and presentation of the evidence (4) search for the evidence (5) select the evidence (6) extract the evidence (7) analyze the evidence (8) present the results (9) summarize the evidence in relation to the purpose of the review, draw conclusions and note the implications of the findings [ 36 ]. In addition, the PRISMA-ScR [ 37 ] was used as a checklist to report the scoping review data charting, data synthesis and presentation of the data (Additional file 1).

Selection of studies

To be eligible for inclusion in the review, the study had to focus on the training of healthcare professionals in assessing physical, mental and social health needs [ 24 ], specifically assessing frailty, physical function, depression, cognition, social health, and sensory function of older adults aged 65 and above living at home [ 38 ]. Healthcare professionals from diverse fields were included, whether engaging in one-to-one interactions where individual healthcare professionals work directly with patients or working collaboratively in interprofessional teams of members from different professional backgrounds [ 29 ]. The review included qualitative, quantitative, and mixed methods studies published in English-language peer-reviewed academic journals. The inclusion and exclusion criteria are specified in Table  1 below.

Search strategy

The authors and an experienced research librarian collaboratively developed the search strategy and search terms. The search strategy followed the recommendation of JBI [ 34 ]. In June 2022, a limited search of PubMed and CINAHL was conducted to identify relevant articles. To develop a more comprehensive search strategy, we subsequently analyzed the titles and abstracts of the retrieved papers, as well as the index terms used to describe the articles. A systematic literature search was performed on October 6, 2022, in the CINAHL (EBSCO), MEDLINE (EBSCO), Academic Search Ultimate (EBSCO), Scopus (Elsevier), Embase (OVID) and British Nursing Index (ProQuest) databases. The updated search was conducted on the 7th of March 2024. The search terms employed in the different databases to represent training healthcare professionals to assess health needs in older adults living at home are described in Table  2 . We considered studies published between 1990 – and March 2024. Ultimately, the reference lists of all included studies were reviewed to identify any additional studies aligned with the scoping review’s aim.

Identification and selection of studies

The search yielded a total of 2266 records. The study selection process is illustrated in Fig.  1 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram [ 39 ]. The search results were uploaded into the citation management system EndNote, where duplicates were removed. A total of 1722 records remained for screening. We used the web application Rayyan [ 40 ] to screen studies for inclusion or exclusion. The screening involved all the authors working in pairs, independently assessing eligibility on the basis of the inclusion and exclusion criteria. Discrepancies were resolved through discussions until consensus by all authors in arranged meetings.

All the records were independently screened by the authors (BHL, DND, HKF, PD and MS), and 1452 records were excluded. Two hundred seventy abstracts were reviewed in blinded pairs, leading to the exclusion of 212 records. Next, the full texts of 58 studies were read. This process resulted in the exclusion of 38 studies whose reasons are provided in the flow chart. The remaining 20 studies were included in this review (Fig.  1 ).

The primary reason for exclusion was the lack of content related to training in health needs assessment  ( n  = 13) or incorrect populations ( n  = 12). Eight studies were excluded because they focused on training for medical or bachelor’s degree students. Additionally, four publications were not peer-reviewed studies ( n  = 4).

BHL and MS independently screened the reference lists from the 20 included studies to identify additional eligible studies. After all the blinded titles were read, 28 titles of records were identified for abstract review. Following this, 22 titles were excluded, leaving 6 abstracts included in the full-text examination. The full-text reading further excluded four studies because they did not focus on training in health needs assessment. Finally, two studies [ 41 , 42 ] were added to this scoping review, resulting in a total of 22 included studies.

An updated search was conducted on the 7th of March 2024, including publications from 2022 to 2024, following the procedure above. After removing duplicates, 173 titles and abstracts were screened for eligibility. The full texts of nine articles were read. Six studies were excluded because they did not include training for healthcare professionals. One had incorrect population, and the others were in a language other than English. This led to the inclusion of one new study [ 43 ], bringing the total number of included studies for the scoping review to 23.

Search results, study selection and inclusion process [ 39 ]

Extraction and analysis of the data

In line with the updated JBI methodological guidelines for scoping reviews [ 34 ], we extracted and coded descriptive details from the 23 included records. The extraction table covered the publication year, country of origin, study purpose, research design, study population, context/setting, training intervention content and assessment tools, pedagogical approaches and training duration, and outcomes for healthcare professionals and older adults. A test was conducted to ensure that the coauthors were aligned in their understanding of what type of data to extract for the table. Feedback from the test guided essential refinements to the extraction table before the authors collaborated to extract and organize pertinent information. We applied a basic thematic analysis to code the data and identify, analyze, and interpret patterns, ultimately deriving themes that addressed our research questions [ 44 , 45 ]. The analysis utilized NVivo 12 Pro software [ 46 ].

Quality appraisal

We performed a quality evaluation of the included studies via the Mixed Methods Appraisal Tool (MMAT) in blinded pairs. This tool is designed for a structured and standardized evaluation of methodological quality and risk of bias in systematic reviews that include qualitative, quantitative, and mixed methods studies [ 47 ]. Although quality evaluation is optional in a scoping review, it can provide valuable insights [ 48 ] and enhance the interpretability of the included studies [ 49 ].

All studies were evaluated according to five quality criteria specific to each research design (qualitative, quantitative descriptive, nonrandomized, randomized, and mixed methods studies). Each criterion received a response score of either “Yes,” indicating that the study met the quality criteria, or “No,” indicating that it did not meet the quality criteria or that it was unclear (see Table  4 ). It is discouraged to calculate an overall score. Any disagreements in scoring were resolved through discussion. The quality scores were not used to exclude articles from the review; instead, they were reported and discussed [ 49 ].

In accordance with the JBI scoping review guidance [ 44 ], the extracted data are presented in a table format (Tables  3 and 5 ) and a narrative summary is provided to respond to the three research questions. Table  3 provides a description of the study characteristics, while Table  5 outlines overarching categories along with relevant extracted information [ 44 ].

Characteristics of the included studies

Table  3 shows that the 23 studies were published between 1990- and 2023. Eight studies were conducted in the United States [ 16 , 42 , 43 , 50 , 51 , 52 , 53 , 54 ], three in Canada [ 55 , 56 , 57 ], three in Australia [ 58 , 59 , 60 ], three in the United Kingdom [ 41 , 61 , 62 ], and one each in Ireland [ 63 ], Italy [ 64 ], Brazil [ 65 ], France [ 66 ], Singapore [ 67 ], and Belgium [ 68 ].

Ten studies meticulously examined training interventions tailored for primary nurses [ 43 , 50 , 51 , 54 , 55 , 60 , 61 , 63 , 66 , 68 ], one study specifically targeted the training of community health workers [ 65 ] and another presented an educational session tailored for case managers and agency supervisors [ 42 ]. The remaining studies indicated that training was provided to interprofessional teams or various distinct professions, such as nurses, physical therapists, occupational therapists, general practitioners, social workers and psychologists [ 16 , 41 , 52 , 53 , 56 , 57 , 58 , 59 , 62 , 64 , 67 ]. The study participants were in home healthcare or primary/community care [ 16 , 41 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 68 ], community and social services [ 42 , 64 ], mental health care [ 61 ], eldercare centers/daycare [ 67 ], residential settings [ 58 , 59 , 64 ], hospitals [ 53 , 56 ], rehabilitation [ 56 ] and acute care [ 61 ].

Quality evaluation results

The quality appraisal procedure revealed variations in the quality of the 23 included studies. The detailed quality evaluation results for each study are presented in Table  4 , and an overview of the methodological quality criteria is presented in Additional file 3.

Each study was evaluated on five criteria appropriate to its study design category. Overall, only one study, which was a mixed methods study, met al.l five quality criteria in the MMAT [ 62 ]. Additionally, one mixed methods study met four criteria [ 61 ], and another met three criteria [ 65 ]. The most common criterion that mixed methods studies failed to meet was 5.2: whether the different components of the study were effectively integrated to answer the research question. Among the quantitative randomized studies, one study met four quality criteria [ 50 ], whereas the other was of low quality, meeting only one criterion [ 59 ]. None of these studies met the quality criterion for proper randomization. In the quantitative nonrandomized studies, six met four criteria [ 41 , 55 , 56 , 58 , 64 , 68 ], one met three [ 63 ], and one met only one criterion [ 16 ], indicating low quality. All studies met the criterion regarding whether the intervention was administered as intended. The most common criteria they failed to meet were 3.3: whether there were complete data and 3.4: whether confounders were accounted for in the study design and analysis. Among the descriptive studies, seven met four criteria [ 42 , 43 , 54 , 57 , 60 , 66 , 67 ], one met three criteria [ 53 ], and two met only one criterion [ 51 , 52 ], demonstrating low quality.

The majority of these studies met the criterion regarding whether the measurements were appropriate. However, the criterion most studies did not meet (only one out of ten) was whether the risk of nonresponse bias was low. Notably, no qualitative methods studies were included in our scoping review.

Training interventions in assessment of older adults living at home

The next section presents a narrative overview of three major themes related to the three research questions. The themes concerned the training provided for healthcare professionals in assessing the physical, mental, and social health needs of older adults living at home: pedagogical approaches, content and foci of health needs assessment training for healthcare professionals and outcomes and evaluation of health needs assessment training for healthcare professionals and older adults living at home. The findings are summarized in Table  5 [ 44 ].

Pedagogical approaches

The included studies employed diverse pedagogical approaches to train healthcare professionals in assessing the health needs of older adults living at home. The spectrum of pedagogical approaches observed in the studies was categorized into teacher-driven and participant-engaging pedagogical approaches. Twenty-one studies [ 16 , 42 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 ] combined teacher-driven and participant-engaging pedagogical approaches, reflecting a multifaceted training strategy. Mayall et al. [ 41 ] opted for a more singular pedagogical approach, exclusively relying on lecture-based education, whereas the training method used in the Piau et al. [ 66 ] study remained unspecified. The training interventions varied in duration, from one-hour sessions [ 68 ] to an ongoing training program spanning 21 months [ 57 ]. In two studies, the specific duration of the training interventions was not specified [ 53 , 57 ]. The most common duration for training was 4–8 h [ 16 , 43 , 50 , 52 , 54 , 56 , 58 , 59 , 62 , 67 ].

Teacher-driven pedagogical approaches

Almost all studies utilized teacher-driven pedagogical approaches, including educational sessions, written materials or e-learning [ 16 , 41 , 42 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 ]. Educational sessions were evident in 14 studies [ 16 , 41 , 42 , 50 , 51 , 52 , 53 , 56 , 57 , 58 , 59 , 62 , 64 , 65 ], providing healthcare professionals with information about relevant topics through lectures [ 16 , 41 , 42 , 51 , 62 , 64 , 65 ], slides [ 16 , 64 ] and instructions [ 50 , 52 , 53 ], as well as demonstrations of the use of assessment tools [ 41 , 42 , 51 , 56 , 58 , 59 ]. Additionally, Abbasi et al. [ 57 ] and Quijano et al. [ 42 ] offered ongoing sessions during the post training implementation period.

Written materials were provided to the participants in nine studies [ 16 , 42 , 50 , 52 , 54 , 58 , 59 , 63 , 64 ]. This included training manuals containing examples and case studies [ 58 , 59 ], written documents about the training pack and the assessment forms [ 63 ], course textbooks and instruction manuals [ 64 ], educational materials including the program manual and articles [ 42 ], a CD-ROM (a data-disc for computer) containing written educational material [ 52 ] and toolkits derived from the educational material [ 16 , 50 , 54 ]. Brown et al. [ 54 ] reported that toolkits included key intervention components for seamless application of learned concepts [ 54 ]. Furthermore, some described follow-up emails to provide participants with information post training [ 50 , 54 ].

E-learning as a preplaying online module or videoclip appeared in nine studies [ 16 , 42 , 43 , 50 , 53 , 54 , 61 , 64 , 68 ]. Naughton et al. [ 61 ] delivered prerecorded lectures [ 61 ], Landi et al. [ 64 ] used video recordings presenting real cases to test participants’ assessments- and decision-making skills, and Quinlan and Ryer [ 43 ] offered online modules on aging epidemiology, fall risk factors, and age-friendly health systems [ 43 ]. Participants watched video recordings portraying late-life depression [ 42 , 53 , 54 ], and patient interactions illustrating approaches to depression assessment [ 50 , 54 , 68 ] via standardized questions and follow-up questions [ 16 ]. Professional actors were used in three studies [ 16 , 53 , 68 ].

Participant-engaging pedagogical approaches

The majority of the included studies utilized participant-engaging pedagogical approaches involving knowledge exchange or various forms of interactive learning [ 16 , 42 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 ].

Sixteen studies employed various forms of knowledge exchange such as discussion, questioning and coaching, between training participants and teachers [ 43 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 63 , 64 , 65 , 67 , 68 ]. Peer-to-peer learning and dialog facilitated the exchange of knowledge and insights [ 65 ], which enriched the overall learning experience [ 61 ]. The participants were included in discussions following lectures [ 55 ], after watching scripted videos [ 53 ], and during patient case reviews [ 56 , 67 ]. Additionally, three studies included both discussions and allowed participants questions [ 52 , 54 , 68 ]. Discussions allowed participants to delve into case management techniques [ 51 ], explore experiences related to assessing the health of older adults [ 54 , 60 , 64 ] and solve problems and discuss alternative strategies regarding depression screening [ 54 ]. A few studies have provided ongoing coaching in the post training phase to support healthcare professionals in applying newly acquired skills [ 42 , 55 , 57 ]. This included three months of feedback and support [ 42 ], mentorship for skill integration [ 57 ], and a six-month collaborative approach between resource staff and case managers involving home visits and clinical consultations [ 55 ].

Interactive training was employed in fifteen studies through skills training, role-playing, simulations, and hands-on training in real-world settings [ 16 , 42 , 43 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 ]. Skill training allows nurses to practice patient interviews and assessments and receive instructor feedback [ 54 ]. The participants practiced by assessing their colleagues’ health and responding to assessment [ 16 , 51 ], with faculty staff offering assistance, encouragement, and feedback throughout [ 51 ]. Landi et al. [ 64 ] provided practice exercises followed by presentations, and Quinlan and Ryer [ 43 ] provided a virtual training session in motivational interviewing technique and assessment. Roleplay as a teaching strategy was used to address practical aspects of administering depression screening [ 50 , 52 , 60 ], and Butler and Quayle [ 63 ] incorporated case scenarios, roleplay, and practical skills training for assessing depression in older adults [ 63 ]. Simulation training was used to immerse participants in the experience of living with sight and hearing impairments performing everyday tasks such as filling out forms or managing medications using sight impairment spectacles. Training was followed by a debriefing session [ 62 ]. Hands-on training in the assessment of older adults’ health in real-world settings was conducted in ten studies [ 42 , 51 , 54 , 55 , 57 , 58 , 59 , 60 , 64 , 65 ]. Healthcare professionals gained clinical experience through assessments of home dwelling older adults [ 55 , 58 , 59 , 60 , 64 , 65 ] and through participation in a rotational preceptorship for community health nurses. This enabled them to practice newly acquired assessment skills and collaborate in a real-life setting [ 51 ]. Additionally, two other studies emphasized practical training in communication with other professionals in real-world settings [ 58 , 59 ], while Brown et al. [ 54 ] encouraged participants to practice assessments in a real-world setting between educational sessions.

Content and foci of health needs assessment training for health care professionals

All the included studies offered insights into the content and foci of health neesd assessment training interventions for healthcare professionals. The studies were divided into those aimed at training healthcare professionals to understand and assess either single or multiple physical, mental, and social health needs in older adults living at home. Additionally, some training sessions focused on interprofessional collaboration.

Single health need assessment training

The focus of twelve studies involved enhancing the skills of healthcare professionals in assessing, planning and conducting interventions for a specific, single health need in older adults, with each addressing either the assessment of mental or physical health [ 16 , 41 , 43 , 52 , 53 , 54 , 58 , 59 , 60 , 62 , 63 , 68 ]. Two of these studies [ 43 , 62 ] focused solely on physical health factor training. Smith et al. [ 62 ] emphasized training in assessing and detecting sight and hearing impairments without specifying whether any assessment tools were used [ 62 ]. Quinlan and Ryer [ 43 ] provided fall risk assessment training, which included the use of assessment tools to evaluate the physical function of older adults and to assess their home environments. The other ten studies [ 16 , 41 , 52 , 53 , 54 , 58 , 59 , 60 , 63 , 68 ] focused on training to assess depression in older adults living at home. The training encompassed understanding and detecting the condition, and all of them included the use of assessment tools. Van Daele et al. [ 68 ] included skills such as actively listening to patients and motivating them to seek expert assistance when needed. Delaney et al. [ 16 ] incorporated skills in asking follow-up questions, and Mellor et al. [ 59 ] offered training in appropriate communication with older adults to identify masked, early signs of depression.

Multiple health needs assessment training

Eleven studies [ 42 , 50 , 51 , 55 , 56 , 57 , 61 , 64 , 65 , 66 , 67 ] described training interventions for healthcare professionals aimed at assessing, planning, and conducting interventions for multiple health needs in older adults living at home. The training content ranged from learning to performing a holistic health assessment of older adults encompassing physical, mental, cognitive, and social factors [ 42 , 51 , 55 , 56 , 57 , 61 , 64 , 66 ] to a more nuanced assessment of two or three of these factors [ 50 , 65 , 67 ]. All studies described the use of assessment tools or checklists. A holistic assessment and understanding of older adults’ health context and needs enables interventions to be tailored to their health and care needs, priorities, and levels of frailty [ 57 ]. Within the realm of holistic assessment, only two of these studies addressed alcohol and medication usage [ 55 , 56 ], whereas two other studies focused on evaluating sensory status [ 57 , 66 ]. For studies with more nuanced assessment training, three studies [ 42 , 50 , 67 ] primarily tailored their training to focus on depression assessment and intervention in older adults, but Quijano et al. [ 42 ] also included training in assessing general physical health status, social function, and cognitive function. Sin et al. [ 67 ] included dementia assessment and Bruce et al. [ 50 ] addressed factors that commonly complicate depression in homecare patients, such as health conditions, disability in activities of daily living, and cognitive function. The training included how to ask follow-up questions and observe nonverbal language [ 50 ]. Neto et al. [ 65 ] provided training for healthcare professionals in rural areas to screen for geriatric risk factors such as caregiver overburden, general health, social health, risk of falling, or difficulties in activities of daily living.

Interprofessional collaboration and communication skills in health needs assessment training

Beyond the focus on training for assessing the health needs of older adults, sixteen studies [ 42 , 50 , 51 , 52 , 53 , 54 , 55 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 68 ] have incorporated training elements to increase interprofessional collaboration and communication skills among healthcare professionals. Health needs assessment training for interprofessional teams was evident in eight of the included studies [ 51 , 55 , 57 , 58 , 59 , 61 , 64 , 65 ]. Two studies [ 58 , 59 ] outlined an advanced session to teach skills for interacting with other healthcare providers, including general practitioners and mental health specialists, whereas Couser et al. [ 51 ] stressed the importance of effectively communicating the assessment results to physicians and other healthcare providers. Training in writing referrals was emphasized in ten studies [ 42 , 50 , 52 , 53 , 54 , 58 , 59 , 60 , 62 , 68 ]. In addition, Stolee et al. [ 55 ] trained healthcare professionals in writing reports and making recommendations to the referring case manager. Only two studies [ 61 , 65 ] included collaboration with family in their training programs. Naughton et al. [ 61 ] designed training programs to support healthcare professionals in navigating the complexities of collaboration with multidisciplinary teams, older adults, and their families. They also developed a network among nurses to facilitate the exchange of expertise, experience, and innovative ideas [ 61 ]. Neto et al. [ 65 ] aimed to increase the capacity of care workers to effectively collaborate with family caregivers and social services for dependent older adults in rural areas. Stolee et al. [ 55 ] provided training for case managers to extend this knowledge to their teams and strengthen connections with specialized geriatric services. Similarly, Abbasi et al. [ 57 ] emphasized team-based care delivery training, with active and holistic discussions among patients, caregivers, and interprofessional teams. Diverse skill sets within teams can effectively meet the holistic care needs of patients. In parallel, Piau et al. [ 66 ] focused on training nurses to collaborate with general practitioners to develop comprehensive care plans. Landi et al. [ 64 ] trained case managers who collaborated in supervised teams to assess older adults and present care plans. They watched videos of simulated team discussions to enhance their understanding of the assessment process and teamwork [ 64 ].

Evaluation and outcomes of health needs assessment training for healthcare professionals and older adults

All of the studies provided insight into the experiences or outcomes of healthcare professionals participating in the training interventions. This included their satisfaction and experiences with health needs assessment training, improved confidence and competencies in health assessment and care planning and shifts in work practices. Additionally, some studies have reported outcomes for older adults following health needs assessment training, such as appropriate referrals, tailored interventions, fall prevention, symptom reduction, and improved overall function. The evaluation of these outcomes relied to a small extent on models or frameworks, with only three studies incorporating them [ 43 , 61 , 62 ]. Smith et al. [ 62 ] utilized Kirkpatrick’s four-level training evaluation model to assess the relevance and impact of educational intervention. Naughton et al. [ 61 ] adopted Alvarez et al.’s (2004) framework of an integral model of training evaluation and effectiveness. Quinlan and Ryer [ 43 ] presented their findings following the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE) framework.

Healthcare professionals’ satisfaction and experiences with assessment training

Ten studies provided insights into healthcare professionals’ experiences with participating in training interventions [ 16 , 41 , 43 , 54 , 55 , 56 , 60 , 61 , 62 , 65 ], where most of the participants expressed satisfaction with both the content and format of the courses. The participants in Brymer, Cormack and Spezowka [ 56 ] expressed a high level of satisfaction with the presenter’s content, pacing, and format, and in Mayall et al. [ 41 ], the training met the participants’ needs and expectations. The participants in Naughton et al. [ 61 ] particularly valued the peer-to-peer learning aspect, whereas Smith et al. [ 62 ] emphasized the effectiveness of simulations. Neto et al. [ 65 ] rated classroom sessions and supervised home visits very positively and found them useful. Furthermore, participants in four of the studies [ 16 , 60 , 61 , 65 ] offered suggestions to enhance the number of educational sessions. They suggested allocating more time for training [ 16 , 65 ], a greater focus on skills training [ 60 , 61 ], additional training in managing complex and technically challenging issues [ 65 ] and incorporating more time for case studies and discussions [ 16 ].

Improved confidence and competence in health assessment and care planning

Improvements in assessment competencies following training interventions among healthcare professionals were reported in nineteen studies [ 16 , 41 , 42 , 51 , 52 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Among these, nine studies explicitly reported increased confidence among healthcare professionals in assessing older adults’ health needs [ 16 , 41 , 54 , 55 , 58 , 59 , 63 , 67 , 68 ]. The health need sassessment and use of assessment tools or checklists led to the identification of health needs. Quinlan and Ryer [ 43 ] noted that without screening in a fall prevention program, the identification of fall risk among older adults would be missed. Piau et al. [ 66 ] noted that a high proportion of assessments effectively identified frailty and suggested interventions and referrals. One comment was that they “were previously skirting around the problem, now asked about mental health directly” [ 61 , p. 33]. Naughton et al. [ 61 ] reported that performing a comprehensive geriatric assessment helped when raising issues with general practitioners because they were talking about their language. Nunn, Annells and Sims [ 60 ] acknowledged the use of Geriatric Depression Screening (GDS) tool raised awareness of depression. A total of 62.5% felt that the GDS helped identify depression that might otherwise be overlooked, but some questioned its universal usefulness [ 60 ]. Abbasi et al. [ 57 ] reported that having an evaluation framework helped healthcare professionals guide meaningful measures [ 57 ]. Conversely, some participants also expressed that they relied more on observation than direct questions when assessing depression [ 54 ]. According to Landi et al. [ 64 ], careful assessments is deemed essential for effective care planning, and Stolee et al. [ 55 ] emphasize the critical role of assessment training in identifying health needs and equitably distributing community service resources. Two studies reported one year of retention of knowledge and skills without the inclusion of a refresher course [ 54 , 62 ].

Twenty studies documented a better understanding of appropriate interventions and referrals [ 16 , 41 , 42 , 50 , 51 , 52 , 53 , 55 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. According to Delaney et al. [ 16 ], 50% of the participants noted that a key aspect they learned was understanding the significance of the assessment results and the corresponding interventions [ 16 ]. The participants in the study by Neto et al. [ 65 ] demonstrated significantly improved capacity in responding to the health and care needs of older adults. The participant reported increased confidence in making referrals and consulting resources [ 51 ], increased knowledge about managing depression, making referrals, and accessing available local services [ 41 ] and enhanced self-efficacy in providing care for older adults [ 16 , 58 ]. Nunn, Annells and Sims [ 60 ] reported that 50% of participants felt prepared to address older adults’ depression after training. Smith et al. [ 62 ] observed increased referral practices and improved ability to advise patients about sensory services, whereas Mellor et al. [ 59 ] noted a slight increase over time in specialist referrals, and senior staff reported increased confidence in interacting with health specialists.

Shift in healthcare professionals’ work practices after assessment training

The training intervention resulted in either a change or potential for change in work practices in ten studies [ 16 , 42 , 43 , 52 , 53 , 55 , 57 , 62 , 63 , 64 ]. Butler and Quayle [ 63 ] reported that prior to receiving training, nurses did not utilize any formal assessment measures to screen for depression in older adults. However, following training, some nurses continue to use screening measures for depression in their clinical practice [ 63 ]. Similarly, case managers in Stolee et al. [ 55 ] stated that the major change in their assessment practice was greater consistency in the use of assessment tools. Smith et al. [ 62 ] reported a shift in practice toward incorporating more detailed information about patients’ impairments and implementing supportive strategies, and in Marcus et al. [ 53 ], communication of depression screening results to patients, physicians, or mental health specialists became a standard protocol.

Landi et al. [ 64 ] reported that training was proven feasible and may be implemented on a broader scale, and Luptak et al. [ 52 ] outlined an implementation period of the ADAPT—Assuring Depression Assessment and Proactive Treatment protocol for depression care in rural healthcare—with the potential to achieve the outlined goals in various clinical settings [ 52 ]. Delaney et al. [ 16 ] reported that project participants were interested in implementing the program in their homecare setting and developed a train-the-trainer model. Abbasi et al. [ 57 ] provided results and experiences regarding the Seniors Community Hub (SCH) through the ADKAR (awareness, desire, knowledge, ability, reinforcement) evaluation framework to assist others interested in implementing a similar integrated care model [ 57 ]. Quinlan and Ryer [ 43 ] stated that fall assessment practices are currently implemented and continuous; similarly, Quijano et al. [ 42 ] reported that depression interventions continue to be offered by participating agency offices. On the other hand, Butler and Quayle [ 63 ] noted the challenge of implementing assessment tools due to competing demands such as holidays, working part-time or being too busy, and Sin et al. [ 67 ] outlined one participant with difficulties in applying new knowledge owing to manpower shortages and constraints in time and space.

Outcomes for older adults following the health needs assessment training

Seven studies [ 42 , 43 , 50 , 53 , 57 , 66 , 68 ] detailed outcomes for older adults following health needs assessment training for healthcare professionals. These outcomes included appropriate referrals, tailored interventions, fall prevention, symptom reduction, and improved overall function. Bruce et al. [ 50 ] highlighted that depressed older adults in the intervention group were more likely to receive appropriate referrals for mental health evaluation [ 50 ], aligning with findings where a minimal intervention significantly increased the detection of depression and further referrals to general practitioners [ 68 ]. The findings in two studies demonstrated that patients were referred to tailored resources designed to address their identified problems [ 53 , 57 ]. Furthermore, Quijano et al. [ 42 ] revealed that older adults’ awareness of seeking help and the significance of physical activity for maintaining health improved. Quinlan and Ryer [ 43 ] stated that after providing care plans to 83 older adults, most implemented fall prevention strategies during a two-week follow-up call with 29 older adults, with only one fall reported. Piau et al. [ 66 ] identified the main causes of frailty and reported effective intervention recommendations and referrals [ 66 ]. Most physicians in Stolee et al. [ 55 ] reported better general function for older adults due to comprehensive geriatric assessment. Findings in two studies [ 42 , 57 ] documented reductions in depression severity at the follow-up assessment due to appropriate referrals and interventions [ 42 , 57 ], and significantly more older adults felt better and experienced pain reduction, followed by increased activity [ 42 ]. Additionally, Abbasi et al. [ 57 ] reported a slight improvement in health-related quality of life, including mobility, usual activities, pain/discomfort, and anxiety and depression, suggesting enhanced function [ 57 ].

This scoping review provides insights into training interventions for healthcare professionals assessing the physical, mental, and social health needs of older adults living at home. The analysis of 23 studies revealed that nearly all training interventions used a multifaceted training strategy combining teacher-driven and participant-engaging pedagogical approaches to teach healthcare professionals theoretical and practical knowledge. Health needs assessment training focuses on the skills needed to conduct single or multiple health needs assessments in older adults. Interprofessional collaboration was an essential part of most training interventions. Multiple studies noted that participants were satisfied with the training content and had increased confidence and competencies in health needs assessment and care planning. Studies have also reported a shift in work practices for health care professionals and some included results have shown improved health outcomes for older adults.

Our study revealed that most of the included studies blended the use of teacher-driven and participant-engaging pedagogical approaches [ 16 , 42 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 67 , 68 ]. These approaches provide participants with confidence and competencies in health needs assessment [ 16 , 41 , 42 , 51 , 52 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Skilled healthcare professionals are crucial in facilitating the implementation of health assessments for older adults [ 69 ]. Lectures can be highly effective for learning, especially when they stimulate thinking and active engagement. Their effectiveness depends on the lecturer’s skill and can be improved by incorporating learner feedback, performance results, self-reflection, and peer feedback [ 70 ]. Another way to improve lecture quality is by including interactive elements such as practical skill training, following John Dewey’s “learning by doing” philosophy [ 32 ]. In our review, we identified fifteen studies that utilized participant-engaging approaches such as skills training, role-playing, simulations, hands-on training in real-world settings [ 16 , 42 , 43 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 ], and sixteen studies employed discussion, questioning and coaching [ 43 , 51 , 52 , 53 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 63 , 64 , 65 , 67 , 68 ]. The integration of teacher-driven sessions, interactive training, and knowledge exchange resembles simulation training, which typically includes briefing, simulation exercises, and debriefing phases. These phases allow participants to reflect, enhance their learning, and deepen their educational experience [ 71 ]. Debriefing is a valuable tool for reflecting on and discussing experiences in training and real-world settings. This helps individuals and teams identify strengths, areas for improvement, and lessons learned, thereby enhancing learning and future performance [ 72 ]. However, effective debriefing relies on facilitators with strong skills to maximize learning outcomes [ 73 ].

The WHO advocates interprofessional simulation training to enhance healthcare professionals’ competencies and improve patient outcomes [ 2 ]. Even if several studies combined teacher-driven approaches, interactive training and knowledge exchange, our review included only one study utilizing simulation training [ 62 ]. Health needs assessment training for interprofessional teams was evident in eight of the studies included in our review [ 51 , 55 , 57 , 58 , 59 , 61 , 64 , 65 ]. Such training has been proven to provide valuable insights into the health of older adults, leading to improved care delivery [ 74 , 75 ], improved patient outcomes [ 76 ] and reduced hospitalization [ 74 ]. It can improve conflict management skills and team functioning [ 76 ] and play a critical role in equitably distributing community service resources [ 55 ]. Interprofessional simulation training is an engaging method for training clinical skills, procedures, teamwork, and communication in a safe, realistic environment [ 77 ]. It promotes critical thinking, reflection [ 78 ], and effective learning [ 79 ] enhancing the application of knowledge in clinical practice [ 80 ]. The use of participant engaging pedagogical approaches aligns with the sociocultural view of training, which emphasizes active engagement and collaboration in the learning process. It enables knowledge exchange and reflection, and participants can integrate their experiences with new information, internalize it, and construct new knowledge [ 32 , 81 ]. Practical training such as simulations, can push participants out of their comfort zones, foster collaborative learning and enrich the educational experience [ 82 ]. However, to achieve optimal learning, it is crucial to balance skill development with an appropriate level of challenge as learners acquire new concepts. At the same time, temporary support from more experienced learners should be available. This balance is known as the zone of proximal development, which represents the space between a learner’s current skill level and their potential skill level with guidance. Tasks within this zone promote growth [ 83 ].

Our review reports a distinction in training content with a focus on assessing single versus multiple health needs in older adults. Ten studies [ 16 , 41 , 52 , 53 , 54 , 58 , 59 , 60 , 63 , 68 ] focused solely on assessing depression. There is a strong correlation between late-life depression and reduced quality of life, as well as comorbidities such as physical illness, disability [ 58 , 84 ] and physical frailty [ 85 , 86 ]. However, single health need assessment training may inadvertently lead to the overlooking of broader health needs among older adults. A multiple health assessment of older adults is recommended [ 7 ], as it can serve as the foundation for developing holistic interventions to enhance overall health [ 10 , 12 , 87 , 88 , 89 ], promote health [ 90 ], foster positive health behaviors [ 91 ], and reduce frailty [ 92 , 93 ]. Our review included eight studies [ 42 , 51 , 55 , 56 , 57 , 61 , 64 , 66 ] providing training in physical, cognitive, mental, and social health needs assessment, alongside care planning on the basis of these assessments. Research indicates that both healthcare professionals and frail older adults participating in an interdisciplinary care approach were satisfied with the improved structure of care and appreciated the emphasis on health promotion [ 94 ]. On the other hand, a comprehensive health needs assessment is a multifaceted and complex intervention, with uncertainties surrounding its effectiveness and underlying mechanisms [ 95 ]. Some research findings indicate that there is no conclusive evidence that it reduces disability, prevents functional decline [ 96 ], impacts mortality, or supports independent living in older adults [ 97 ]. These results underscore the complexity and challenges in conducting and implementing comprehensive health needs assessments and tailoring interventions to promote health in older adults.

Our review revealed that almost all [ 16 , 41 , 42 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 63 , 64 , 65 , 66 , 67 , 68 ] health needs assessment training programs included the use of assessment tools or checklists, leading to the identification of health needs. Only one of these studies reported that participants relied more on observation than on direct questioning when assessing depression [ 54 ]. Additionally, another study found that healthcare professionals using assessment tools felt that this approach led to asking overly personal and intrusive questions without first establishing trust or explaining the purpose of the assessment [ 98 ]. On the other hand, some older adults reported that using assessment tools made it difficult to discuss issues outside the predefined domains of the comprehensive health needs assessment [ 99 ]. Research indicates that current assessment practices heavily rely on professional judgment and intuition, and healthcare professionals in community settings often lack adequate knowledge and training regarding the health needs assessment of older adults [ 22 , 100 ]. This can be seen as problematic because these professionals are ideally positioned to assess older adults early in their health trajectories [ 105 ]. Proper assessment in these settings can facilitate the early recognition of functional decline [ 101 , 102 ] and vulnerability, enable timely intervention to mitigate frailty’s adverse effects [ 105 ], and support effective care planning [ 64 ]. Even if several healthcare professionals have endorsed the integration of frailty assessment tools into primary care [ 22 ], they need a simple, efficient assessment tool [ 105 ] that empowers them to identify older adults’ health needs [ 9 , 88 , 103 , 104 ]. This is particularly critical due to the essential role that assessments play in equitably distributing community service resources [ 105 ]. As such, this review underscores the importance of educating healthcare professionals in community care to effectively assess the physical, mental, and social health needs of older adults. Furthermore, understanding the learning process of healthcare professionals [ 78 ], evaluating the effects of training [ 106 ], and establishing evidence-based standards for skills training are crucial for high-quality teaching [ 107 ]. Additionally, further research is necessary to assess the feasibility, effectiveness, and acceptability of interprofessional interventions targeting multiple health needs aimed at health promotion [ 90 ] and experiences using comprehensive health assessment tools [ 108 ].

Methodological considerations

This review included studies employing various methods to obtain comprehensive insights into training healthcare professionals in assessing the health needs of older adults living at home [ 47 ]. We utilized a validated mixed-methods appraisal tool to assess the quality of the included studies [ 47 , 49 ]. We did not include reporting on screening questions regarding the clarity of the research question or whether the collected data addressed the research questions, as our review focused exclusively on empirical studies. Additionally, we chose not to calculate an overall score from the ratings of each criterion, as this practice is discouraged. We provide an overview of each study’s quality by presenting the ratings of each criterion [ 49 ]. Our findings revealed that only one study met all the quality criteria, fifteen studies met four criteria, three studies met three criteria, and four studies met only one criterion. High-quality studies employ rigorous and robust methods, leading to reliable and valid findings [ 109 ]. While most studies met 3–4 quality criteria, they provide a relatively strong evidence base and offer valuable insights, although some concerns remain. Several studies did not meet the quality criteria for nonresponse bias or complete outcome data. It is crucial to describe and evaluate a low response rate for its potential impact, as this can limit the generalizability of findings [ 110 ]. Many studies also failed to account for confounders in their design and analysis. Confounding factors may bias results by distorting the interpretation of findings [ 49 ], masking actual associations or creating false associations, potentially leading to incorrect conclusions [ 111 ]. The randomization of study subjects and rigorous statistical analyses can mitigate the impact of confounding variables [ 112 ]. Nonetheless, conducting a quality assessment increases awareness of these biases and limitations, thereby enhancing our confidence in the study findings.

Strengths and limitations

Our scoping review has several limitations. Initially, our search strategy involved the use of six databases and various relevant search terms related to training healthcare professionals in assessing the health needs of older adults. We excluded gray literature to focus on mapping existing published research and identifying any research gaps. The search was conducted by an experienced librarian. Despite our efforts to comprehensively map the research literature, we may have overlooked some studies. Second, our exclusion criteria, which encompassed, for example, general practitioners, students, and institutional settings, restricted the scope of the study. Additionally, we focused on health needs assessment, excluding studies that assessed the environment, an important factor in enabling older adults to stay at home as long as possible. However, based on the findings and limitations of the included studies, we believe our review provides valuable insights into the research context. These findings can inform future research, practice, policymaking, and the development of training programs for healthcare professionals in community settings to assess older adults’ health needs.

Healthcare professionals require training in assessing physical, mental, and social health needs in older adults living at home to ensure tailored interventions that enhance their health and independence. Our study revealed that healthcare professionals were satisfied with the combination of participant-engaging and teacher-driven pedagogical approaches when training in physical, mental, and social health needs assessment. Such training is beneficial and strengthens healthcare professionals’ confidence and competency in assessment and care planning for older adults living at home. Additionally, some studies reported that following health needs assessment training, there was a shift in work practices and improved health outcomes for older adults. We suggest that health needs assessment training programs are valuable for improving health and care for older adults living at home and contribute to increased sustainability in healthcare.

Furthermore, we propose additional research on interprofessional simulation training for the structured assessment of multiple health needs in older adults, ensuring comprehensive coverage of all significant health issues in these assessments. We also recommend research on the implementation of such assessments and health promoting interventions.

Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors express gratitude to librarian Kari Hølland, Division of Research, Stavanger University Library for performing the systematic literature searches.

This article stems from the research project “More good days at home - Advancing health promoting practices in municipal healthcare services for older recipients of homecare” (HEIME), specifically related to Work Package 3, “Simulation and training for health needs assessment in home-living older adults”. HEIME is funded by the Research Council of Norway (grant 320622), University of Southeastern-Norway, University of Stavanger, Stavanger, Horten, Porsgrunn and Nome municipality (2021–2025). Dr. Grethe Eilertsen is the project director. Drs. Siri Tønnessen, Anette Hansen and Professor Marianne Storm are the principal researchers and work package leaders.

Open access funding provided by University of Stavanger & Stavanger University Hospital

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Faculty of Health Sciences, Department of Public Health, University of Stavanger, Postbox 8600, Stavanger, 4036, Norway

Bente Hamre Larsen & Marianne Storm

Faculty of Health Sciences, Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway

Dagrunn Nåden Dyrstad & Peter Dieckmann

National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway

Helle K. Falkenberg

USN Research Group of Older Peoples’ Health, University of South-Eastern Norway, Drammen, Norway

Center for Human Resources and Education, Copenhagen Academy for Medical Education and Simulation (CAMES), Capital Region of Denmark, Copenhagen, Denmark

Peter Dieckmann

Department of Public Health, Copenhagen University, Copenhagen, Denmark

Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway

Marianne Storm

Research Department, Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway

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All authors (BHL, DND, HKF, PD and MS) contributed to the design and development of the study, research questions, and literature search. BHL conducted the literature search in collaboration with MS and research librarian. All authors participated in the screening and quality assessment processes. Data analysis and manuscript writing and preparation was led by BHL in collaboration with MS. All authors were involved in reading, commenting and reviewing the text, and approving the final manuscript.

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Correspondence to Bente Hamre Larsen .

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Larsen, B.H., Dyrstad, D.N., Falkenberg, H.K. et al. Training healthcare professionals in assessment of health needs in older adults living at home: a scoping review. BMC Med Educ 24 , 1019 (2024). https://doi.org/10.1186/s12909-024-06014-9

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Received : 28 June 2024

Accepted : 11 September 2024

Published : 17 September 2024

DOI : https://doi.org/10.1186/s12909-024-06014-9

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