Human papillomavirus (HPV) remains a major global public health concern and is strongly associated with cervical and several other cancers. In Jordan, the HPV vaccine has not yet been incorporated into the national immunization program, and public awareness appears limited. We aimed to assess knowledge and attitudes regarding HPV and its vaccine among Jordanian young adults and to examine associations between HPV awareness and sociodemographic factors. A cross-sectional online survey was conducted among 441 Jordanian adults aged 18-29 years. Participants completed a 35-item questionnaire adapted from previously validated instruments assessing HPV knowledge, vaccine awareness, beliefs, and attitudes. Data were analyzed using descriptive statistics and multivariable regression analyses to identify factors associated with HPV knowledge and vaccination status. Overall HPV knowledge was limited (mean score 5.71 ± 4.57 out of 18), and nearly one-third of participants reported no prior knowledge of the virus. Misconceptions regarding transmission routes and HPV-related cancers were common. Higher educational level, affiliation with the health sector, and urban residence were independently associated with higher knowledge levels. Vaccination uptake was low (8.2%), and many participants expressed uncertainty regarding vaccine safety and effectiveness. Regression analysis showed that none of the examined variables were significant predictors of vaccination status. In conclusion, Substantial knowledge gaps and uncertainty surrounding HPV vaccination exist among young adults in Jordan. These findings suggest the need for further representative research and may inform future culturally appropriate HPV education efforts. The effectiveness of such approaches in improving HPV vaccine acceptance should be evaluated in future studies.
BACKGROUND:The Cornerstones of Public Health Nursing encompass the values and beliefs foundational to public health nursing practice. A comparison of the original Cornerstones, developed more than 20 years ago, with recent revisions of nursing ethical guidelines led to an update of the Cornerstones to enhance their global relevance. METHOD:We compared the Cornerstones with nursing ethical guidelines to identify missing concepts in the Cornerstones, surveyed members of the Global Network of Public Health Nursing (GNPHN) about suggested revisions, and consulted with two public health nurse experts involved in the original development of the Cornerstones. RESULTS:Feedback from GNPHN members and expert public health nurses led to the retention of four Cornerstones and the revision of six. Major changes included emphasizing global public health nursing practice and creating a new Cornerstone to focus on relationships with coworkers and the responsibility to self. DISCUSSION:The updated Cornerstones reflect values and beliefs predominant in nursing ethical guidelines and are more relevant to global public health nursing practice.
Climate change is an escalating threat to population health, placing increasing pressure on healthcare systems. Nurses play a pivotal role in delivering climate-resilient healthcare; however, evidence regarding their perceptions and climate-related health behaviors in Saudi Arabia remains limited. This study examined the relationship between nurses' perceptions of climate change and their climate-related health behaviors in support of the population health objectives of Saudi Vision 2030. A cross-sectional survey was conducted among 307 nurses in Saudi Arabia using the validated Perceptions and Behaviors regarding Climate Change and Health (PBCH) questionnaire, which assessed awareness, concern, and climate-related behaviors in both domestic and clinical settings. Data were analyzed using descriptive statistics, reliability testing, Pearson correlation, Ordinary Least Squares (OLS) regression, and quantile regression to examine predictors across different levels of behavioral engagement. The findings revealed moderate PBCH scores (mean percentage approximately 68%-69%) and excellent internal consistency (Cronbach's α up to 0.96). Awareness and concern demonstrated strong positive correlations with PBCH scores and consistently predicted climate-related health behaviors across OLS and all quantiles (0.25, 0.50, and 0.75), whereas demographic characteristics showed minimal predictive value. These findings suggest that strengthening nurses' awareness of and concern about the health impacts of climate change may significantly enhance sustainable nursing practices, improve population health protection, and support the achievement of Saudi Vision 2030.
BACKGROUND:Increasing HPV vaccination coverage is pivotal, necessitating effective vaccination strategies. This research assessed the impact of a message-framing (MF) video intervention on boosting vaccine confidence among mothers diagnosed with cervical intraepithelial neoplasia (CIN), targeting HPV vaccination for their daughters. METHODS:Conducted from January to June 2024, this interventional study took place at the gynecological cervical clinic of a university-affiliated hospital and targeted CIN patients from adjacent communities. Mothers with daughters aged 9-14 years, who were unvaccinated and whose mothers were diagnosed with CIN, participated. They were allocated to receive either standard health education or a targeted message-framing video intervention. Outcome data were collected by trained researchers after a 10-week intervention period, focusing on maternal knowledge, attitudes, and behaviors toward their daughters' HPV vaccination. RESULTS:A total of 101 patients were analyzed. Those exposed to the message-framing video intervention exhibited significantly improved knowledge, attitudes, and behaviors towards HPV vaccination (Z = -3.376, P = 0.001), and demonstrated lower vaccine hesitancy scores (Z = -2.924, P = 0.003) compared to their counterparts receiving standard health education. However, differences in the rates of scheduling vaccine appointments were not statistically significant between the groups (χ2 = 0.934, P = 0.334). CONCLUSIONS:The message-framing video intervention significantly enhanced vaccine confidence by improving the knowledge and willingness of CIN patients to vaccinate their daughters against HPV. Further studies are required to explore the intervention's influence on actual vaccination rates.
OBJECTIVE:To explore the effects of coronavirus-specific education and training on nursing interns' self-efficacy, stress levels, and knowledge. METHODS:74 nursing interns were randomly allocated to either an intervention group (n = 37) or a control group (n = 37). The intervention group received a 3-h training session covering: Basic knowledge of coronavirus disease, diagnostic and treatment procedures for suspected/confirmed cases, including precautions, practical skills (e.g., PPE donning/doffing), Psychological relaxation techniques. The control group independently studied the same material. Pre-intervention (T1), both groups completed questionnaires assessing: General demographics, self-efficacy, stress levels, skill levels. Post-intervention (T2), the same assessments were repeated. Paired sample t-tests compared within-group differences (T1 vs. T2). RESULTS:No significant differences (p > 0.05) were observed between groups at baseline (demographics, self-efficacy, stress, or skill levels).Post-intervention, the intervention group showed: Increased self-efficacy (p < 0.05), reduced stress levels (p < 0.05), improved skill levels (p < 0.05).No significant improvements were observed in the control group. CONCLUSION:Targeted education on coronavirus-specific enhances nursing interns' self-efficacy, knowledge, and technical skills while reducing stress, underscoring its value in pandemic preparedness training.
OBJECTIVE:The purpose of this study was to describe the healthcare experiences of individuals identifying with marginalized groups in the North Central Appalachian region of the United States. DESIGN:Qualitative descriptive using conventional content analysis. SAMPLE:Purposive sampling was used to recruit 11 participants from different marginalized groups living within the Appalachian region. MEASUREMENTS:The semi-structured interview script was developed based on a review of the literature, feedback from stakeholders and providers, and the social determinants of health framework. RESULTS:Five themes emerged from the data: (1) navigating intrapersonal and systems-related barriers to care, (2) being overlooked, invalidated, and dehumanized by others, (3) feeling judged, stereotyped, and stigmatized when receiving care, (4) assembling courage to advocate for self and others, and (5) establishing meaningful, respectful, and inclusive relationships. CONCLUSION:All participants reported experiences of healthcare discrimination, stigmatization, or judgement when interacting with healthcare providers, which underscores the importance of establishing trustful relationships through the provision of respectful and inclusive care. Findings offer implications for rural healthcare education and practice, particularly as it relates to barriers to care and the subsequent impact on health outcomes for marginalized populations.
OBJECTIVE:To examine whether adaptation to chronic disease mediates the relationship between health literacy and frailty among older adults with chronic illnesses. DESIGN:A cross-sectional design. SAMPLE:The study included 398 older adults aged 65 years and over attending routine outpatient visits at a public hospital in western Türkiye. MEASUREMENTS:Data were collected through face-to-face interviews using the Turkish Health Literacy Scale-32 (THLS-32), Adaptation to Chronic Disease Scale (ACDS), and FRAIL Scale. Correlation and mediation analyses were conducted performed with bootstrapping (5000 resamples). RESULTS:Nearly half of the participants (46.0%) had inadequate health literacy, and 53.8% were classified as frail. Health literacy was positively correlated with adaptation to chronic disease (r = 0.425, p < 0.001) and negatively correlated with frailty (r = -0.356, p < 0.001). Adaptation to chronic disease was negatively associated with frailty (r = -0.385, p < 0.001). Mediation analysis showed that adaptation to chronic disease partially mediated the relationship between health literacy and frailty (β = -0.030, 95% CI [-0.038, -0.023]). CONCLUSIONS:Adaptation to chronic disease was found to partially mediate the association between health literacy and frailty in older adults. Enhancing health literacy through nurse-led education and counseling may support adaptation and may contribute to frailty prevention among older adults.
OBJECTIVE:To analyze temporal trends in hospitalization and mortality rates due to diabetes mellitus and hypertension in the state of Paraná, Brazil. DESIGN:Population-based ecological time-series study. SAMPLE:Residents of the state of Paraná, Southern Brazil, from 2014 to 2024. MEASUREMENTS:Annual hospitalization and mortality rates per 100,000 inhabitants due to diabetes mellitus and hypertension were calculated using national health information systems and stratified by sex and age group. ANALYTIC STRATEGY:Joinpoint regression models were applied to estimate annual and average annual percent changes and identify temporal inflection points. RESULTS:Hospitalization rates declined for both conditions across most population groups, particularly among older adults. In contrast, mortality rates increased over much of the study period, especially among younger and middle-aged adults, with stabilization only in recent years. Divergent trends between hospitalizations and mortality were consistent across sex and age strata. CONCLUSIONS:Declining hospitalization rates do not necessarily indicate improved population health outcomes. The coexistence of reduced hospitalizations and increased mortality highlights gaps in early diagnosis, continuity of care, and longitudinal management of chronic conditions. These findings underscore the need for public health nursing strategies that integrate surveillance data, strengthen primary care follow-up, and address upstream determinants of chronic disease outcomes.
OBJECTIVE:Community settings, such as homes, community-based organizations, and schools, are important loci for addressing intimate partner violence (IPV). We identified and synthesized studies on the role of community health professionals in preventing IPV. More specifically, we considered the range and type of interventions used by community health professionals in community settings and whether these interventions appear to be effective in reducing IPV. DESIGN:We systematically searched four databases for empirical peer-reviewed articles based in the U.S. through August 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS:We included 45 articles published between 1999 and 2024, spanning quantitative and qualitative study designs. The community health professionals described were most commonly nurses, often delivering home-based interventions focused on perinatal women. Activities related to IPV included providing health education in schools, building community or organizational capacity, providing direct service and case management, and providing coaching and social support to empower individuals. CONCLUSIONS:Community health professionals have an important role in effectively preventing IPV. Additional research is needed to guide these professionals in promoting and implementing a range of IPV interventions in communities, particularly those focused on primary prevention of IPV.
AIM:The aim of this study was to evaluate the effects of climate change prevention education and a short animated film on pregnant women's levels of awareness and hope. BACKGROUND:Climate change poses significant risks to maternal and fetal health, and pregnancy provides a unique opportunity to raise awareness and promote preventive behaviors. DESIGN:A single-blind randomized controlled trial METHODS: This study was conducted between November 1, 2024, and July 17, 2025, at the antenatal outpatient clinics of the Obstetrics Department of Konya City Hospital in Konya/Türkiye. The intervention group received a 30-min face-to-face training session based on WHO guidelines. Two weeks later, they were shown a short animated film online. The control group received routine antenatal care only. Data collection tools included the Climate Change Awareness Scale for Pregnant Women (CCASPW), the Climate Change Hope Scale (CCHS), and Climate Change-Related Questions. Descriptive statistics, the independent samples t-test, the chi-square test, the McNemar-Bowker test, and multivariate analysis of covariance (MANCOVA) were used to analyze the data. RESULTS:In the intervention group, significant increases were observed in the total and all subscale scores of the CCASPW, as well as in the total, personal-sphere willpower and waypower, and collective-sphere willpower and waypower subscale scores of the CCHS. No significant changes were observed in the control group. CONCLUSIONS:This study showed that climate change prevention education combined with a short animated film significantly increased awareness and hope among pregnant women. The improvements in knowledge, attitudes, and behaviors indicate that this intervention positively influenced cognitive awareness.
BACKGROUND:Environmental degradation and climate change are growing global problems that affect public health. This integrative review aims to consolidate the available evidence concerning environmental awareness, attitudes, and behaviors among healthcare professionals toward climate change and the implementation of sustainable health practices. METHODS:A systematic integrative review of the qualitative and quantitative studies was conducted. Studies were identified through searches of eight databases until October 2025. The inclusion criteria encompassed studies involving healthcare professionals that focused on environmental awareness, attitudes, and behaviors. Two reviewers independently screened the identified studies, and a third reviewer resolved any discrepancies. Data were analyzed using a thematic analysis approach. RESULTS:The review included 10 studies. Healthcare professionals recognized the link between climate change and health, but highlighted a discrepancy between growing awareness and sustainable practices. Concerns included the environmental impact of healthcare. Barriers to adopting sustainable practices included a perceived lack of institutional support. There was a dissociation between professionals' eco-friendly behaviors in their personal lives and work settings. CONCLUSIONS:There is a need for implementing interventions focused on providing education, creating supportive work environments, and involving healthcare professionals in decision-making related to sustainability.
Objective Self-perception of aging (SPA) involves individuals' subjective experiences and beliefs concerning their health and aging process. This study aims to explore the experiences of SPA and coping strategies among Chinese community-dwelling older adults based on the common-sense model (CSM).Methods The semi-structured interviews were conducted with 15 community-dwelling older adults in Chongqing. A hybrid inductive-deductive thematic analysis approach was employed for data analysis.Results: Five main themes were identified: (a) health decline and identity in aging, (b) navigating the aging timeline with personal paces, (c) negative impacts with silver linings in later life, (d) individualized emotional spectrum of aging, and (e) multiple coping strategies. These themes align with the domains of the CSM.Conclusion In this study, the researchers gained valuable insights into the SPA among Chinese community-dwelling older adults and demonstrated the applicability of the CSM in understanding SPA. Findings also provide a theoretical basis for future research on SPA and developing culturally sensitive interventions for older adults.
OBJECTIVE:This study aimed to investigate the association between residential location-urban area and urban expansion area and sociodemographic characteristics, health behaviors, and clinical-metabolic outcomes among schoolchildren aged 6 to 9 years in the municipality of Rio das Ostras, Brazil. METHODS:This was a cross-sectional study involving 420 students from public municipal schools. Sociodemographic and behavioral data were collected using validated questionnaires (QUADA-3 and QUAFDA). Anthropometric measurements, blood pressure, and biochemical analyses were conducted. Associations were assessed using Pearson's chi-square or Fisher's exact tests and logistic regression models, both crude and adjusted for age, sex, maternal and paternal education, and household income.were estimated with 95% confidence intervals (CI). FINDINGS:Children living in urban expansion areas had lower paternal education levels (p = 0.021) and were less likely to engage in active commuting to school (2.4% vs. 42.6%; p < 0.001). No significant differences were observed in excess weight, physical activity scores, or ultra-processed food consumption between the two groups. However, children from urban expansion areas showed a higher prevalence of prediabetes (OR = 0.133; 95% CI = 0.045-0.358; p < 0.001), elevated total cholesterol (OR = 0.423; p = 0.007), low HDL-c (OR = 0.324; p < 0.001), elevated LDL-c (OR = 0.304; p < 0.001), and elevated triglycerides (OR = 0.484; p = 0.029). CONCLUSIONS:Residing in urban expansion areas was associated with worse clinical-metabolic outcomes among schoolchildren, independent of nutritional status, physical activity, and ultra-processed food consumption. These findings highlight the need for intersectoral and place-based policies to promote healthier environments for children in territories undergoing urbanization.
OBJECTIVE:This study aims to explore stakeholder opinions and recommendations for the prevention of adolescent pregnancies. METHODS:This study was conducted using a qualitative case study design, employing in-depth interviews as the primary data collection technique. The study population comprised healthcare professionals, educators, and academics from both the public and private sectors, as well as parents and adolescents. The data were collected using a descriptive characteristics form and a semi-structured interview guide. Ethical approval was obtained from the relevant institutional review board, along with necessary institutional permissions. The data were analyzed using the MAXQDA qualitative research software. RESULT:Analysis of the data revealed that parents were unable to discuss sexual topics with their children, and that adolescents similarly found it difficult to communicate about these matters with their families. Academics perceived existing policies as inadequate, while teachers and adolescents found school curricula and course content insufficient. Physicians found adolescent health services inadequate and emphasized the lack of sufficient time for educational sessions in outpatient clinics. CONCLUSION:To prevent adolescent pregnancies, comprehensive sexual and reproductive health education tailored to cultural and demographic contexts should be provided. School curricula should be expanded to incorporate broader reproductive health topics. Hospitals should establish adolescent outpatient clinics or youth-friendly health units. Additionally, employing school health nurses and establishing sexual and reproductive health units within schools would facilitate regular education sessions for both adolescents and their families. TRIAL REGISTRATION:A clinical trial registration number was not obtained for this study as it was not required.
BACKGROUND:Telenursing uses digital technologies to support remote nursing care. As telehealth expands in the UAE, nursing students need adequate knowledge and skills to use these tools effectively. OBJECTIVES:This study examined nursing students' knowledge and perceptions of telenursing and their attitudes toward eHealth and technology. METHODS:A cross-sectional study was conducted among 258 undergraduate nursing students using a demographic questionnaire, the Telenursing Knowledge Scale, and the Perceptions and Attitudes Towards eHealth and Technology Scale. Data were analyzed using descriptive and inferential statistics. RESULTS:Students exhibited positive perceptions (M = 3.65 ± 0.98) and positive attitudes (M = 3.67 ± 0.84) towards telenursing and eHealth and technology, respectively. The majority of the participants (78.3%) agreed with the incorporation of telenursing in nursing curriculum at the college level, and 77.9% were willing to utilize it as another type of health service in future professional practice. Many participants knew about the benefits of telenursing, such as increased staff effectiveness (70.2%) and improved communication between patients and staff (72.1%), which gave a mean advantage score of 3.56 ± 0.82. But there were issues about technical difficulties (59.3%), lack of patient interaction (59.3%), and society's vulnerability due to excessive dependence on technology (62.4%). Most significantly, 87.6% misunderstood telenursing with the help of the definition of telemedicine, indicating their poor conceptual knowledge. Internet usage was significantly related to positive perception and attitude (p ≤ 0.05) on all the outcome variables, but academic year and clinical courses had no effect. CONCLUSION:Nursing students generally had positive views of telenursing and eHealth, but stronger practical education in digital health is needed.
Aim This study aimed to examine the factors influencing nurses' intentions to take action toward the Sustainable Development Goals (SDGs) within the framework of the theory of planned behavior (TPB) and to evaluate perceived behavioral control (PBC) in terms of future time perspective (FTP).Methods This cross sectional, descriptive, and correlational study included 651 nurses recruited using a snowball sampling method. Data were collected using a sociodemographic questionnaire, TPB-based questionnaires, and the sustainable development awareness scale. Structural equation modeling (SEM) was employed to analyze the data using SPSS 26.0 and AMOS 24.0. Sample size adequacy was assessed using G*Power 3.1.9.Results FTP, attitudes toward SDGs, and subjective norms (SN) were positively associated with nurses' intentions to take action toward the SDGs. In addition, sustainable development awareness significantly and positively predicted intention. The proposed model explained 55.1% of the variance in nurses' intention to take action toward the SDGs, with FTP emerging as the strongest predictor.Conclusions The findings support the usefulness of the TPB in explaining nurses' intentions to engage in SDG-related actions. Enhancing nurses' future-oriented perspectives and sustainable development awareness may strengthen their engagement with SDG initiatives.
Aims This study aimed to explore nurses' ecological footprint awareness and how this awareness is reflected in their professional practices. Background Healthcare services contribute significantly to environmental degradation through intensive energy consumption, the use of disposable materials, and large-scale waste production. As the largest professional group within healthcare systems, nurses play a critical role in promoting environmentally sustainable practices. Understanding nurses' perceptions and experiences related to ecological footprint awareness is essential for developing sustainable healthcare practices and policies. Design A qualitative phenomenological study. Methods The study included 18 nurses working in different hospitals located in several cities in the eastern region of Turkey. Data were collected through semi-structured in-depth interviews and analyzed using Braun and Clarke's reflexive thematic analysis. The analysis focused on identifying patterns of meaning in nurses' experiences regarding ecological footprint awareness and environmental sustainability in clinical practice. Results Although many participants demonstrated awareness of ecological footprint issues, the translation of this awareness into environmentally sustainable practices remained limited. The analysis identified four main themes: "Sustaining Care in the Face of a Depleting Nature", "Awareness Exists, Implementation is Limited", "The Quest for Sustainable Nursing" and "Ethical and Emotional Burden of the Ecological Footprint". Conclusions Nurses experience environmental sustainability as both a professional and ethical concern embedded within daily care practices. However, the translation of environmental awareness into sustainable clinical practices is often constrained by structural and organizational factors. Strengthening institutional policies, leadership support, and environmental education in nursing is essential to promote sustainable healthcare practices.
OBJECTIVE:This study aimed to determine the seroprevalence of hepatitis B, C, and D in Mardin, Türkiye, identify at-risk populations, and evaluate the effect of the hepatitis B vaccination program. METHODS:HBsAg, anti-HBs, anti-HBc IgG, anti-HCV and anti-HDV results were analysed retrospectively. RESULTS:Among the 30430 patients (60.2% female) tested, seropositivity rates were 2.1% for HBsAg, 55.2% for anti-HBs, 27.8% for anti-HBc IgG, and 0.14% for anti-HCV; of HBsAg-positive patients, 6.1% were anti-HDV positive. After adjusting for Mardin's age distribution, the age-weighted rates were 1.48%, 56.3%, 15.9%, 0.12%, and 6.2% (for anti-HDV in adults). Those born after 1998 (aged ≤ 26), when hepatitis B vaccination began nationally, had significantly lower HBsAg (0.3% vs. 2.8%) and anti-HBc IgG (2.5% vs. 36.6%) positivity, and higher anti-HBs (59.1% vs. 53.4%) positivity, than older individuals (p < 0.001). In a subgroup of 2703 with all hepatitis B markers, vaccine-induced immunity was more frequent in those aged ≤ 26 years (55.4% vs. 22.0%), while natural immunity (1.5% vs. 26.7%) and chronic infection (0.6% vs. 4.9%) were more common in those aged ≥ 27 years (p < 0.001). CONCLUSION:This large-scale survey in Mardin shows that hepatitis B vaccination reduced prevalence, highlighting the need for targeted screening and public health nursing interventions in older adults.
OBJECTIVE:This study aims to examine the impact of zero-waste training on young people's perceptions and behaviors. METHODS:It is a quasi-experimental design with repeated measures in a single group. One week after the pre-test, participants received information on waste management and the zero-waste project, including waste types, sorting, risks, and current approaches. Data were collected one month and six months after the training. RESULTS:The results indicated that the training and zero-waste posters positively impacted young people's knowledge, perceptions, and behaviors. In addition to promoting environmental sustainability, zero-waste education plays a critical role in protecting public health. Despite the six-month gap, the training led to lasting awareness of zero-waste. CONCLUSION:Zero waste training programs should be integrated into national environmental and health policies. Environmental awareness raised through education can contribute to more effective implementation of waste management strategies across the country and protect public health. The findings also highlight the important role of public health nurses in promoting environmental health awareness and sustainable waste management behaviors through community-based educational interventions.
