{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:57:18Z","timestamp":1785589038061,"version":"3.56.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore ward\u2010based registered nurses' emotions, emotion\u2010driven behaviours, and the perceived impact of these emotions on caring for clinically deteriorating patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical deterioration in ward patients is frequently missed or poorly managed despite widespread implementation of Early Warning Score systems. Behavioural and systemic factors may contribute to these failures; however, emotional influences remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Descriptive interview study underpinned by Affective Events Theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Registered nurses from a United Kingdom teaching hospital with experience caring for clinically deteriorating patients were purposively sampled. Semi\u2010structured interviews were conducted using a topic guide informed by the seven Affective Events Theory constructs. Interviews were audio\u2010recorded, transcribed verbatim, and analysed using a combined inductive thematic approach and deductive mapping to theoretical constructs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five themes were identified and mapped to six of the seven Affective Events Theory constructs:\n                      <jats:italic>work environment, work events, affective reactions, work attitudes, affect\u2010driven behaviours and judgement\u2010driven behaviours<\/jats:italic>\n                      . The dispositions construct did not emerge as a distinct theme. Participants predominantly described negative emotional responses. Short\u2010term coping strategies, including emotional distancing, supported care delivery but were perceived to increase longer\u2010term burnout risk. Affect\u2010driven behaviours included heightened vigilance and increased bedside presence; however, reluctance to leave deteriorating patients conflicted with established escalation protocols. Judgement\u2010driven behaviours shaped longer\u2010term attitudes, including reduced motivation and intentions to leave nursing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emotional responses to clinical deterioration shaped immediate nursing behaviours that were both beneficial and potentially detrimental to patient care, while also influencing longer\u2010term professional attitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Contribution<\/jats:title>\n                    <jats:p>Two patient and public involvement advisors reviewed the interview topic guide before data collection and contributed to the development of questions exploring the therapeutic relationship between nurses and patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70482","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:15:28Z","timestamp":1785586528000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Ward Registered Nurses' Emotional Responses When Caring for Clinically Deteriorating Patients: An Interview Study Informed by Affective Events Theory"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3582-843X","authenticated-orcid":false,"given":"Karen","family":"Davey","sequence":"first","affiliation":[{"name":"Imperial College Healthcare NHS Trust Charing Cross Hospital  London England UK"},{"name":"Department of Interprofessional Healthcare, School of Health and Medical Sciences City St George's, University of London  London England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4290-8423","authenticated-orcid":false,"given":"Duncan","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Interprofessional Healthcare, School of Health and Medical Sciences City St George's, University of London  London England UK"},{"name":"University College London Hospitals NHS Foundation Trust  London England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2024.100799"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732319889354"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PTS.0000000000000720"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20107\u201037"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.colegn.2022.05.010"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzx149"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2022.05.005"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12721"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16843"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00140139.2024.2427859"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1754073909103595"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v10.i2.401"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102019\u2010010179"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2013.01.013"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14765"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10459\u2010014\u20109516\u20106"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41077\u2010021\u201000198\u20106"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2018.05.013"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315588501"},{"key":"e_1_2_13_23_1","unstructured":"NHS England.2023.\u201cCommissioning for quality and innovation (CQUIN): 2023\/24.\u201dhttps:\/\/www.england.nhs.uk\/wp\u2010content\/uploads\/2022\/12\/Commissioning\u2010for\u2010Quality\u2010and\u2010Innovation\u2010CQUIN\u20102023\u201024\u2010guidance\u2010version\u20101.2\u20101.pdf."},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010022\u201004247\u2010y"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160\u2010014\u20109609\u20108"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2015291"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14830"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1037\/mac0000014"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15636"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15620"},{"key":"e_1_2_13_32_1","volume-title":"Research in Organizational Behavior. Volume 18. 1996","author":"Weiss H. M.","year":"1996"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17500"},{"key":"e_1_2_13_34_1","volume-title":"State of the World's Nursing 2025: Investing in Education, Jobs, Leadership and Service Delivery","author":"World Health Organization","year":"2025"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1080\/1743727X.2023.2266375"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2023.09.007"}],"container-title":["Journal of Clinical Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.70482","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocn.70482","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocn.70482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:15:31Z","timestamp":1785586531000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocn.70482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":35,"alternative-id":["10.1111\/jocn.70482"],"URL":"https:\/\/doi.org\/10.1111\/jocn.70482","archive":["Portico"],"relation":{},"ISSN":["0962-1067","1365-2702"],"issn-type":[{"value":"0962-1067","type":"print"},{"value":"1365-2702","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"2026-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jocn.70482"}}