Aim: To identify and synthesise evidence on the measurement properties and clinical utility of multidimensional patient reported pain assessment instruments used in adults during acute postoperative recovery following general surgery.Background: Postoperative pain assessment commonly relies on unidimensional measures of pain intensity, which may inadequately capture movement-evoked pain and pain-related functional interference during recovery. Multidimensional instruments assess pain alongside broader dimensions of the pain experience, yet many were developed for chronic pain populations and evidence supporting their measurement properties and clinical utility in acute postoperative surgical settings remains unclear.Design/Methods: A systematic review of outcome measurement instruments will be conducted using established methodology for systematic reviews of measurement properties and reported in accordance with PRISMA-COSMIN for Outcome Measurement Instruments. MEDLINE, CINAHL, PsycINFO, Embase, and CENTRAL will be searched for English-language studies published between November 2015 and September 2026. Two independent reviewers will screen studies, extract data and assess methodological quality using the COSMIN Risk of Bias checklist, applying the relevant domain according to the measurement property being investigated. Results for each measurement property will be evaluated using COSMIN criteria for good measurement properties, and certainty of evidence assessed using a modified GRADE approach. Clinical utility, including feasibility, acceptability, and interpretability relevant to acute postoperative practice will be synthesised separately.Discussion: This review will establish the strength and certainty of evidence supporting the measurement properties of multidimensional patient reported pain assessment instruments acute postoperative care, and determine what is known about their clinical utility. Identifying instruments that capture clinically important aspects of postoperative pain, while considering their feasibility and acceptability in acute surgical settings, should reveal instruments with the strongest potential for further evaluation and translation into postoperative practice.

Background: The COVID-19 pandemic changed the care of older patients in hospitals, whether it was for COVID-19 or another reason for admission. Patients with delirium posed additional challenges to clinicians, particularly because they were in isolation and the family was unable to be present due to the rapidly implemented and strictly enforced infection control measures. Objectives/Aims: To explore nurses' experiences of caring for patients with delirium in an Australian acute care setting, with a focus on how infection prevention and control measures implemented in response to the COVID-19 pandemic impacted clinicians. Design: Descriptive qualitative study. Nurses from two acute aged care wards in a Sydney metropolitan tertiary hospital were invited to participate in semi-structured interviews to explore their overall experience of nursing patients with delirium. Eleven interviews were recorded and transcribed verbatim. Data were analysed qualitatively using human factors principles as an analytical lens. Experiences related to COVID-19 were extracted from the data. Findings: Participants experienced difficulties delivering patient-centred care, as the presence of family was restricted due to the public health orders and infection prevention and control policies imposed in hospitals. Enforcing isolation and excluding the family resulted in care failing to meet nurses' expected standards, with additional challenges in care provision and communication. Conclusion: Nurses described an overwhelming sense of responsibility and moral injuries. The advice to place patients with delirium in isolation was inconsistent with the national delirium clinical care standard. A deeper understanding of the complexity and barriers to managing delirium during a pandemic, where rapid and, at times, conflicting information was available, is needed. These findings will contribute to informing the implementation of controls in the event of future responses, including workforce preparation and support.

Background: Nurses' well-being at work is important for high-quality care and sustainable nursing careers. In care settings for older people, nurses face psychological, ethical, physical, and environmental demands in their early careers. However, little is known regarding how resilience, exposure to unethical conduct, physical work capacity, and the work environment are associated with early career nurses' well-being at work in this setting.Aim: To analyse early career nurses' well-being at work and associated factors in care settings for older people.Design: A cross-sectional, descriptive survey.Methods: Participants were qualified nurses (n = 262) at the national level in Finland. Inclusion criteria were graduation as a licensed practical nurse or registered nurse within the previous three years or during the data collection period and work experience in care settings for older people. Exclusion criterion was work experience that was limited to clinical placements. Data were collected electronically using the Nurses' Well-Being at Work Scale[©], the Brief Resilience Scale[©], and demographic and career questions. Associations between well-being at work and background variables were studied using linear regression models.Results: Early career nurses' self-assessed well-being at work was found to be moderate (3.39; SD 0.79; 5-point Likert scale). Univariate analyses revealed that better well-being at work was associated with having career plans in care services for older people, higher resilience, not observing unethical conduct, higher physical work capacity, and a better-fitting work environment; in multivariable analysis, never observing unethical conduct and higher physical work capacity remained significant.Conclusions: Early career nurses' well-being at work in care settings for older people was associated with psychological, ethical, physical, and environmental aspects, thus emphasising the need for educational, organisational, and political actions, and research to support sustainable nursing careers and high-quality care for aging populations.