INTRODUCTION:Nurses are highly susceptible to musculoskeletal disorders, with psychosocial workplace factors contributing to increased risk. However, the underlying mechanisms of this association remain unclear. This study explores the mediating role of stress in the link between psychosocial factors and musculoskeletal disorders among nurses. METHOD:A survey was conducted with 155 nurses at an academic hospital in Yogyakarta, Indonesia, from December 2023 to February 2024. Data were gathered on psychosocial factors-including work demands, interpersonal relations and leadership, work-individual interface, social capital, health and well-being-alongside stress and musculoskeletal disorders. The analysis was performed using partial least squares structural equation modelling via SmartPLS software. RESULTS:Findings indicated that stress acts as a mediator in the relationship between psychosocial factors and musculoskeletal disorders. Among the five psychosocial dimensions examined, interpersonal relations and leadership had the most significant indirect effect on musculoskeletal disorders via stress. Complementary mediation suggested additional mechanisms linking psychosocial factors and musculoskeletal disorders. CONCLUSION:This study underscores the significant role of stress in shaping how psychosocial factors influence musculoskeletal disorders. Organizations should manage psychosocial factors to reduce stress and mitigate MSDs, promoting better nurse well-being and work outcomes.
AIMS:This study aimed to describe specific missed nursing care (MNC) practices among paediatric surgical unit nurses in Türkiye and to explore descriptive differences and bivariate associations according to nurses' demographic and work-related characteristics. BACKGROUND:MNC adversely affects patient safety and care quality. Although widely studied in various clinical settings, evidence from paediatric surgical units, where care is complex and specialized, remains limited. DESIGN:A descriptive cross-sectional survey was conducted. METHODS:Data were collected from a nonprobability voluntary-response sample of 242 nurses working in paediatric surgical units between April and August 2024 using a structured questionnaire consisting of a demographic form and the adapted MISSCARE Survey. Participants were recruited through a professional association's social media network. Descriptive and exploratory bivariate statistical analyses were performed. RESULTS:Most frequently missed practices included promoting neurodevelopment (82.2%), nonpharmacological anxiety management (79%) and oral care (73.6%). Primary reported reasons for MNC were nurse shortages (42.1%) and increased patient load (40.5%). The primary reported reasons for MNC were nurse shortages (42.1%) and increased patient load (40.5%). Exploratory bivariate analyses showed statistically significant differences in MNC scores according to age, professional experience (p < 0.001), overtime work and job satisfaction (p < 0.05). CONCLUSION:Organizational challenges-chiefly staffing shortages, increased workload and communication gaps-were the most prominent reported reasons for MNC; targeted organizational interventions and confirmatory research using representative samples are warranted.
BACKGROUND:Cancer-related cognitive impairment (CRCI) is a major clinical challenge faced by lung cancer patients during or after treatment. Early identification of at-risk populations by healthcare professionals is inadequate, and little is known about measures that can be taken to enhance their prevention. Existing systematic reviews and meta-analyses have summarized common risk factors for CRCI in lung cancer patients, but integrated predictive models based on holistic theoretical frameworks remain scarce. AIM:To construct a visual assessment tool for the identification of CRCI in lung cancer survivors based on the theory of unpleasant symptoms (TOUS), complementing existing predictive models with a multidimensional theoretical perspective. DESIGN:A prospective, observational, single-centre study. METHODS:The present study was conducted in a major hospital in Urumqi, China, between October 2023 and July 2024. A total of 350 lung cancer survivors participated in this survey, which was divided into a training and validation group in a 7:3 ratio. Lasso regression and logistic regression analyses were employed to identify the risk factors for CRCI, construct a nomogram prediction model and test the prediction effect in the validation set. Model performance was evaluated using the area under the curve (AUC) and goodness-of-fit statistics, and the model was internally validated. RESULTS:A total of 350 lung cancer patients, comprising 245 in the training and 105 in validation groups, were included. Of these, 117 (33.4%) experienced CRCI. The predictive model identified significant predictors, including age, pathological stage, chemotherapy, post-traumatic stress disorder (PTSD), depression and social support scores. At the 32.3% optimal cut-off, the model had AUC values of 0.863 and 0.818 in the training and validation groups. Calibration plots demonstrated a strong correlation between predicted and observed rates, and decision curve analysis revealed optimal net benefit at threshold probabilities ranging from 10% to 80%. CONCLUSIONS:The risk prediction model constructed in this study, based on TOUS, demonstrates satisfactory predictive ability superior to some existing models. It integrates physiological, psychological and environmental factors, serving as a valuable complementary tool for healthcare professionals in identifying high-risk groups, particularly in clinical settings emphasizing holistic symptom management.
AIM:This paper aims to evaluate the effects of online pelvic floor muscle training on urinary incontinence frequency, symptom severity, quality of life and adherence across defined female life stages. BACKGROUND:Urinary incontinence is a significant public health issue affecting women's physical and mental well-being. DESIGN:The paper is designed as a systematic review and meta-analysis of randomized controlled trials. REVIEW METHODS:Nine databases were searched for RCTs of online PFMT in women with UI. Outcomes included UI incidence, symptom severity, quality of life and compliance. Data extraction, risk-of-bias (RoB 2) and GRADE assessment were performed. Random-effects meta-analyses used RevMan 5.4. RESULTS:Sixteen studies were included. Online pelvic floor muscle training significantly reduced postpartum urinary incontinence incidence (RR = 0.56; 95% CI: 0.38 to 0.82) and symptom severity (SMD = -0.25; 95% CI: -0.45 to -0.05), but not in elderly patients (SMD = -0.12; 95% CI: -0.25 to 0.02). Exercise compliance improved in both subgroups. No significant difference was found in quality of life. Moderate-to-high heterogeneity was observed. CONCLUSIONS:Online pelvic floor muscle exercise may improve urinary incontinence outcomes across different life stages. In postpartum women, it reduces incontinence incidence, alleviates symptom severity and enhances training compliance, whereas in elderly patients, its benefit is limited to improved compliance.
AIMS:This overview aims to provide high-quality evidence synthesis of animal-assisted interventions (AAIs) among people living with dementia. BACKGROUND:Dementia has become the seventh leading cause of death in the world. Unfortunately, currently effective pharmacological interventions remain elusive. As a non-pharmacological treatment, AAI is gaining more attention while the effectiveness of AAI for people living with dementia remains unclear. METHODS:EMBASE, PubMed, Cochrane Library, CINAHL, CNKI, VIP, CBM and Wanfang databases were searched from inception to March 2026. The AMSTAR2 was used to assess the methodological quality of the included reviews. Meta-analysis was conducted using STATA 16 for the original studies identified from the included reviews. Evidence quality of main outcomes was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS:Sixteen systematic reviews were included in the overview. A significant improvement was found in depression among dementia patients, but not in agitation, quality of life (QOL), cognition and activities of daily living (ADL). CONCLUSIONS:There is moderate evidence that AAI has positive effects on depression for people living with dementia. Despite searches, no sufficient evidence has been found to substantiate the positive effects of AAI on other outcomes in people living with dementia. Due to the small number of studies, small sample sizes and significant heterogeneity, more randomised controlled trials with large samples are needed.
OBJECTIVE:To assess the effectiveness of various eHealth interventions on health outcomes among patients with intestinal stomas. METHODS:We searched nine databases for relevant articles from inception to 31 December 2025. Pairwise and network meta-analyses (NMA) were conducted to compare the effects of various eHealth interventions. RESULTS:Forty-eight studies, encompassing 4463 stoma patients, were included. Network meta-analysis revealed that APPs were the most effective interventions for reducing complications (SUCRA = 10.7%, OR = 0.25, 95% CI: 0.18, 0.36) and enhancing self-care ability (SUCRA = 94.2%, MD = 18.11, 95% CI: 11.79, 24.43). Web-based plus phone calls ranked highest for improving QOL (SUCRA = 100.0%, SMD = 9.76, 95% CI: 6.36, 13.16) and self-efficacy (SUCRA = 85.9%, MD = 30.32, 95% CI: 13.67, 46.97). APPs plus telemonitoring performed best in enhancing stoma adaptation (SUCRA = 82.7%, SMD = 3.10, 95% CI: -1.39, 7.59). APPs plus phone calls ranked highest for improving anxiety (SUCRA = 15.1%, SMD = -2.06, 95% CI: -4.79, 0.66), depression (SUCRA = 18.1%, SMD = -1.59, 95% CI: -3.19, 0.87) and satisfaction (SUCRA = 82.7%, OR = 7.14, 95% CI: 0.58, 88.16). CONCLUSION:eHealth interventions, particularly APPs and combined interventions, appear to improve health outcomes in stoma patients.
BACKGROUND:Depression in patients undergoing haemodialysis (HD) can cause significant physical and emotional problems. AIM:This study aimed to identify the factors affecting depressive symptoms in HD patients according to HD duration (i.e., time since first starting HD). DESIGN:A descriptive cross-sectional study. METHODS:In total, 470 HD patients in South Korea completed a questionnaire including validated measures of social support, self-efficacy, symptoms, self-management, quality of life and adaptation. The data were analysed using stepwise multiple regression to identify factors that influenced depressive symptoms in the participants according to HD duration. RESULTS:The analysis of factors influencing depressive symptoms, segmented by haemodialysis duration into periods of less than 6 months, 6-11 months and more than 12 months, yielded models with explanatory powers of 56.8% (dialysis symptom index [DSI], quality of life, self-management, age, spouse), 62.8% (DSI, quality of life, social support), and 46.5% (DSI, psychosocial adaptation, self-efficacy), respectively. CONCLUSION:The findings of this study can serve as a foundation for developing tailored depression interventions for HD patients, taking into account their HD duration.
AIM:This study aimed to evaluate the effects of preoperative chewing gum on anxiety levels and postoperative sore throat in patients undergoing breast surgery using a laryngeal mask airway. METHOD:This study was conducted in the Anaesthesia and Reanimation Department of a training and research hospital. Patients in the intervention group (n = 46) were instructed to chew gum for 2 min during the preoperative period, whereas the control group (n = 47) received standard nursing care. Anxiety levels were assessed using the Amsterdam Preoperative Anxiety and Information Scale during premedication and immediately before surgery. Post-extubation, the severity of sore throat was measured via the Visual Analogue Scale, whereas the presence of cough and hoarseness was recorded. RESULTS:There was no significant difference between the groups in terms of postoperative sore throat and cough at the second, fourth and sixth hours (p > 0.05). However, at the second postoperative hour, the incidence of hoarseness was significantly higher in the control group (p = 0.004). There was no difference between the groups in terms of hoarseness at the fourth and sixth hours after surgery (p > 0.05). Immediately before surgery, the control group exhibited significantly higher total Amsterdam Preoperative Anxiety and Information Scale scores (p = 0.047) and anxiety subscale scores (p = 0.023). There was no significant difference between groups in the information requirement subscale (p > 0.05). CONCLUSION:Preoperative chewing gum effectively reduces anxiety levels before breast surgery. Although it does not significantly alleviate postoperative sore throat, it appears to reduce hoarseness 2 h post-extubation. As a simple and non-pharmacological intervention, chewing gum is recommended for managing preoperative anxiety. TRIAL REGISTRATION:Clinicaltrials.gov: NCT06168981.
AIM:This study aimed to develop recommendations for acceptable physical and psychological clinical indicators of acute deterioration and strategies to support sustained adoption of an approach to detecting and responding to acute deterioration in long-term care. BACKGROUND:Previous studies have trialled programmes to reduce avoidable hospital transfers through early detection of acute deterioration in long-term care. However, variability in outcomes and implementation experiences highlights differences in the essential components of these approaches. DESIGN:Three-round Delphi process. METHODS:The Delphi process conducted between September 2022 and January 2023 included a 22-member Australian expert panel to elicit consensus and to generate recommendations. Delphi participants were asked to rate the potential items on a 9-point scale for level of importance (Part A), level of priority of action (Part B) and level of acceptability (Part C). The mean, standard deviation (SD) and I-CVI of each item were calculated. Clinical indicators with mean ≥ 7, I-CVI ≥ 0.78 were considered to have a good degree of agreement, appropriateness and relevance and were deemed acceptable for inclusion. RESULTS:Participants completed a two-part online survey in Round 1, and three-part surveys in Rounds 2 and 3. Round 1, Part A included 44 clinical indicators. On completion of Round 3, 36 items remained. Care pathways in response to acute deterioration (n = 20) were included in Part B. After Round 3, 17 care pathways remained. There was agreement in Part C that communication aides, education and mentor programmes were necessary as viable strategies to support sustained adoption. CONCLUSION:Detecting the early warning signs of acute deterioration will have significant outcomes for residents, staff and health care services.
BACKGROUND:Health literacy and fear of disease progression can predict quality of life, yet the underlying mechanisms among these three factors remain poorly understood. AIM:This study aimed to investigate the hypothesis that health literacy among patients with ischemic stroke is associated with fear of disease progression and both directly and indirectly influence quality of life through the mediating role of fear of disease progression. METHODS:Between December 2023 and June 2024, questionnaires were distributed to 300 in-patients with ischemic stroke selected by convenience sampling from the neurology departments of three tertiary general hospitals in the Xiangxi region of Hunan Province. Assessments were conducted using the General Information Questionnaire, the Medical Outcomes Study Short Form 36 (SF-36), Health Literacy Management Scale (HeLMS) and Fear of Progression Questionnaire-Short Form (FoP-Q-SF). Pearson correlation analysis was employed to examine the correlations between variables; AMOS 24.0 statistical analysis software was used to explore the pathways and effect sizes of fear of disease progression and health literacy on quality of life. RESULTS:Health literacy was positively correlated with quality of life (r = 0.412, p < 0.01), while fear of disease progression was negatively correlated with quality of life (r = -0.445, p < 0.01). Fear of disease progression partially mediated the relationship between health literacy and quality of life, accounting for 41.3% of the total effect. CONCLUSIONS:Findings support the development of targeted psychosocial intervention strategies aimed at enhancing patients' health literacy to effectively alleviate disease-related fear, ultimately improving quality of life and optimizing care outcomes for stroke patients.
AIM:The aim of this study was to develop a mobile application for patients with Type 2 diabetes initiating insulin therapy for the first time and to evaluate its effects on insulin knowledge, insulin injection skills, self-management of insulin therapy and attitudes towards insulin use. METHODS:This randomized controlled study included 88 participants assigned by block randomization to intervention (mobile application, n = 44) and control (standard care, n = 44) groups. The intervention group received insulin training via the mobile app, whereas the control group received standard care. Data were collected at baseline (T1), on the 14th day (T2) and on the 28th day (T3) using the Patient Information Form, Insulin Knowledge Form, Insulin Treatment Assessment Scale, Insulin Treatment Self-Management Scale and Insulin Injection Skill Observation Form. RESULTS:In the intervention group using the mobile application, a statistically significant increase over time was observed in the levels of insulin-related knowledge, self-management of insulin treatment and insulin injection skills, whereas negative attitudes and perceptions regarding insulin treatment decreased (p < 0.05). No statistically significant change was observed in the control group (p > 0.05). CONCLUSION:The results obtained in the present study indicated that the mobile application developed for patients with Type 2 diabetes using insulin for the first time is effective in disease self-management, fosters positive behavioural changes and serves as a viable educational tool for individuals with Type 2 diabetes. The application can be integrated into routine nursing-led diabetes education programmes to enhance continuity of care and support patients during insulin initiation. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT06060743.
AIM:Nurses' health anxiety and their attitudes towards cancer screenings are interrelated. While high health anxiety shapes risk perception and health behaviours, negative attitudes towards screenings may create barriers to early diagnosis and treatment. This study aimed to examine nurses' health anxiety and attitudes towards cancer screenings. METHODS:A descriptive, cross-sectional and correlational study was conducted with 310 nurses working in a university hospital. Data were collected using the Personal Information Form, Health Anxiety Inventory and Attitude Scale Towards Cancer Screenings. Multiple linear regression analysis was used to determine predictors of health anxiety. RESULTS:The mean score on the Attitude Scale Towards Cancer Screenings was 78.7 ± 13.6, and the Health Anxiety Inventory mean score was 15.8 ± 6.3. Subscale averages were 13.1 ± 5.1 for Excessive Sensitivity to Somatic Symptoms and Anxiety, and 2.6 ± 2.0 for Negative Consequences of Disease. Regression analysis indicated that the duration of employment in the current hospital and attitudes towards cancer screenings significantly predicted health anxiety (F = 8.0, p < 0.001), explaining 15.1% of the variance. CONCLUSION:Health anxiety and attitudes towards cancer screenings were significantly associated among nurses. The duration of employment and screening attitudes were identified as predictors of health anxiety.
AIM:The study aimed to evaluate the effectiveness of information and communication technology interventions on mental health literacy among young adults and adolescents. METHODS:The systematic review and meta-analysis methods were guided by the Cochrane guidelines for systematic reviews of interventions and the PRISMA guidelines. Included articles were evaluated with appraisal tools from the Joanna Briggs Institute. The authors searched nine databases to January 2026: PubMed, CINAHL, ERIC, EMBASE, ScienceDirect, Web of Science, Sociological Abstracts, PsycInfo and Scopus for relevant articles. RESULTS:A total of 55 articles were included in this review. The interventions were successful in enhancing mental health literacy (p < 0.001), recognition of mental health disorders (p < 0.001), stigma (p < 0.001), help-seeking attitudes/beliefs (p < 0.001) and intentions (p < 0.01). They were useful for improving personal stigma, social distance, self-stigmatisation of seeking help and stigmatising attitudes but not self-stigma, perceived stigma, stigmatisation by others for seeking-help, explicit attitudes and perception of dangerousness. CONCLUSION:The interventions were generally useful for improving mental health literacy. Interactive approaches such as websites, videos, and discussions were generally more effective than campaigns, games, applications, mere information or lectures.
BACKGROUND:Gastric retention is a common complication in enteral nutrition, which may lead to interruption of nutrition, malnutrition, electrolyte imbalance and other problems. Up-to-date knowledge of its incidence and influencing factors is crucial for optimal management strategies of enteral nutrition. AIM:This study aimed to conduct a systematic review and meta-analysis to quantify the incidence of retention of gastric contents in patients receiving enteral feeding and to identify significant influencing factors. DESIGN:This study is a systematic review and meta-analysis. DATA SOURCES AND REVIEW METHODS:Using established methods and searching from database inception to 18 May 2025, we searched CNKI, Wanfang Data, CBM, VIP, PubMed, Web of Science, EMBASE and The Cochrane Library. RevMan 5.4 software was used to perform the meta-analysis. RESULTS:A meta-analysis of 14 studies involving 2642 patients receiving enteral nutrition reported a 32.0% incidence of gastric retention. Nineteen factors associated with gastric retention were identified. Notably, descriptive analyses indicated that early initiation of enteral nutrition (OR = 0.37) and concomitant use of probiotics (OR = 0.22) were protective against the development of gastric retention. CONCLUSION:Findings support clinicians and nurses in more accurately identifying high-risk patients and formulating targeted intervention strategies based on the identified risk factors.
AIM:This study aimed to synthesize evidence on multilevel strategies that promote nurse well-being and resilience to support workforce sustainability. DESIGN:Integrative review was guided by Whittemore and Knafl's methodology. METHODS:Systematic searches of CINAHL, PubMed, Web of Science and MEDLINE identified 2485 records published between January 2002 and December 2025. After removing duplicates and screening titles and abstracts, 161 articles underwent full-text review. Sources addressing nurse well-being, burnout, resilience and mental health were assessed for eligibility. Study quality was appraised using the Johns Hopkins Evidence-Based Practice tool. Fifty-two primary research studies were retained for the results synthesis. RESULTS:Analysis revealed evidence organized within a three-pillar framework that integrates mental health promotion, burnout prevention and resilience building across individual, organizational and system levels. Unlike previous reviews focusing on single interventions, this framework shows that sustainable nurse well-being requires simultaneous, coordinated action across all three pillars. Evidence consistently identified adequate staffing, supportive leadership, and psychological safety as foundational enablers, with staffing adequacy showing the strongest associations with burnout reduction. CONCLUSION:Nurse well-being requires integrated, multilevel solutions that combine individual skill development with organizational reform and supportive policy environments to ensure workforce sustainability. IMPACT:This study provides actionable, evidence-based strategies for nursing leaders, educators and policymakers to foster healthy work environments that support nurse well-being, retention and quality patient care.
BACKGROUND:Urinary incontinence (UI) stigma significantly impacts older men's mental well-being, yet individual experiences vary. Current research frequently overlooks the heterogeneity of these stigma experiences. Addressing this gap, this study identifies stigma-influencing factors and uncovers distinct subgroups to inform targeted psychological strategies. METHODS:A cross-sectional study conducted from November 2023 to February 2024 included a convenience sample of 243 older men with urinary incontinence from two hospitals in Guangdong, China. Data were collected via a demographic questionnaire and the Stigma Scale for Chronic Illness. Latent profile analysis identified distinct stigma subgroups. Furthermore, Pearson correlation and multiple linear regression were utilized to evaluate demographic and clinical differences across subgroups and identify influencing factors. RESULTS:Education, UI severity and type and water/tea intake significantly influenced stigma (p < 0.05). LPA revealed the following four subgroups: (1) 'High Self-Stigma & High Perceived Stigma' (34.4%); (2) 'Internal-Sensitive & External-Resilient' (40.2%); (3) 'Moderate Stigma' (15.0%); and (4) 'Low Stigma' (10.4%). Demographic and clinical characteristics differed significantly across these profiles. CONCLUSION:Our findings suggest that older men with UI may exhibit four distinct stigma profiles. Recognizing these patterns could inform customized psychological support, potentially advancing a precision health approach aimed at improving care efficacy and quality of life.
AIM:This study aimed to compare the effect of using the Wondaleaf adhesive pouch (WLAP) barrier method on umbilical cord care to conventional antiseptic cord care. METHODS:The study was a parallel randomized controlled study that involved a total of 234 term neonates, of which 117 were randomly assigned to both the test and control groups. The WLAP barrier method was used in the test group to protect the umbilical stump of the neonates after delivery. The control group received conventional antiseptic cord care. The cord was monitored daily until the stump detached in both groups and in the test group through the transparent pouch without dressing. RESULTS:The study found no incidence of omphalitis in either the test or control group. There was no statistically significant difference in cord separation time between the groups. However, male neonates in the test group but not the control group demonstrated a statistically significant but marginal delay in cord separation time compared with female neonates. CONCLUSION:The WLAP barrier method of umbilical cord care could successfully replace conventional antiseptic cord care with daily dressings without causing any infection or significant delay in cord separation time. More importantly, it provides a safe, protective and convenient approach to umbilical cord care.
AIM:This study aimed to adapt the Reaper Oral Mucosa Pressure Injury Scale into Turkish and evaluate its reliability and validity for use by intensive care unit nurses in assessing oral mucosal membrane pressure injuries among intubated patients. METHODS:A methodological study was conducted with 165 intensive care unit nurses in a tertiary hospital. The adaptation process followed international guidelines, including translation, back-translation, expert review and pilot testing. Psychometric testing included content validity, exploratory factor analysis, internal consistency and test-retest reliability. RESULTS:Although 83% of nurses reported familiarity with mucosal membrane pressure injuries, only 38% had received formal training, underscoring a practice gap. Turkish Reaper Oral Mucosa Pressure Injury Scale demonstrated strong psychometric performance: exploratory factor analysis confirmed a unidimensional structure (Kaiser-Meyer-Olkin = 0.92; Bartlett's χ2(136) = 2185.6, p < 0.001) explaining 52.4% of variance. Internal consistency was excellent (α = 0.874; full scale α = 0.94; item-total correlations 0.42-0.80). CONCLUSIONS:Turkish Reaper Oral Mucosa Pressure Injury Scale is a valid, reliable scale for oral mucosal membrane pressure injuries assessment.
AIM:To evaluate and compare the effectiveness of visual education and distraction methods in reducing preoperative anxiety among children and their parents. DESIGN:Three-arm, parallel-group randomized controlled trial. METHODS:The study was conducted between June 2023 and September 2024 in the paediatric outpatient surgery unit of a university hospital in Türkiye. A total of 105 children aged 5-12 years and their parents were randomly assigned to one of three groups: visual education, distraction using a kaleidoscope or control. Anxiety levels were assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) for children and the State-Trait Anxiety Inventory-State (STAI-S) for parents. Data were analysed using repeated measures ANOVA, independent samples t-tests, Bonferroni post hoc tests, effect size and observed power. RESULTS:Both interventions significantly reduced preoperative anxiety compared with the control group. Repeated measures ANOVA revealed significant between-group differences for children (F = 11.937, p < 0.001, η2 = 0.190) and parents (F = 9.164, p < 0.001, η2 = 0.152). Bonferroni post hoc analyses confirmed that visual education and kaleidoscope distraction were effective in reducing anxiety in both children and parents. Although visual education produced a greater numerical reduction in anxiety, the difference between visual education and kaleidoscope distraction was not statistically significant. CONCLUSION:These results highlight the importance of integrating structured visual education and distraction strategies into routine paediatric nursing practice. Such interventions support family-centred care, enhance perioperative cooperation and may contribute to improved clinical experiences for children and parents. CLINICAL RELEVANCE:Structured visual education programs and distraction strategies can be integrated into routine paediatric nursing practice to support children and parents in the surgical process, enhance cooperation and improve perioperative care outcomes. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT05279976.
AIM:This randomized controlled trial evaluated the effectiveness of a self-efficacy-based intervention in enhancing caring self-efficacy, reducing job-related stress and decreasing perceived stigma among psychiatric nurses. METHODS:A parallel-arm RCT was conducted between July and November 2023. Seventy psychiatric nurses were randomized 1:1 to an intervention group (n = 35) receiving eight structured self-efficacy sessions or a control group (n = 35) receiving treatment as usual. Outcomes were measured using the Caring Efficacy Scale, Psychiatric Nurses Job Stress Scale and Perceived Devaluation and Discrimination Scale (stigma) at baseline, postintervention, and 3 months later. RESULTS:The intervention group showed significant improvements in caring self-efficacy, with Caring Efficacy Scale scores increasing from 69.83 ± 23.90 preintervention to 98.20 ± 27.92 postintervention (p < 0.001, effect size = 0.537), and remaining elevated 3 months later (95.06 ± 27.31, p < 0.001), while the control group scores showed no significant change. Job stress scores decreased significantly in the intervention group compared to controls across all Psychiatric Nurses Job Stress Scale subscales (p < 0.001). The proportion of participants reporting high perceived stigma dropped significantly from 71.4% preintervention to 2.9% postintervention (p < 0.001, effect size = 0.760), sustained at 3 months. CONCLUSION:Findings support integrating self-efficacy training into psychiatric nursing professional development; such an intervention may enhance nurses' psychological well-being and ultimately improve the quality of patient care in clinical settings. TRIAL REGISTRATION:The study protocol has been registered at ClinicalTrials.gov (Identifier Code: NCT05952414).
