Background Nursing documentation plays an essential role in nursing practice, which contributes to ensuring the continuity of nursing, enhancing communication among the care team, and reflecting the quality of patient care. Inadequate or inaccurate documentation may have a negative effect on patient safety and clinical decision-making. To assess the quality of nursing documentation for postoperative limb wound care based on the situation of compliance with a tool called the Surgical Wound Assessment Tool (SWAT) and identify related factors at nine hospitals in Vietnam in 2025. Methods The study used a descriptive, retrospective, cross-sectional design and was conducted at 9 general and specialized hospitals in Vietnam from May 2025 to September 2025. The sample size included 1,012 patient records related to limb wound care (systematic random sampling) and 286 nurses who directly tended wounds. The data collection instrument is a standardized checklist adapted from SWAT, including 27 clinical items. The quality of documentation is considered “Qualified” when the total score is at least 80%. Descriptive analyses were used to present the results, using Chi-square tests and logistic bivariate models ( p < 0.05). Results The quality of wound care documentation was low, with an overall qualification rate of 30.6%. A discrepancy in the documentation was observed: while the rate of qualification for administrative and surgical items was high, ranging from 85.9% to 88.8%, the key clinical parameters showed low rates, especially those related to surgical sites, sizes, and bases (0%). Regression analyses show that the quality of wound care documentation was associated with certain characteristics of patients ( i.e ., BMI, diabetes, and smoking) and nurses’ characteristics such as educational level, seniority (years of work experience), the number of patients that they tended, and the training on wound care documentation that they attended. Discussion This multi-center study highlights a significant gap between clinical guidelines and actual nursing documentation practice in postoperative wound care. The low qualification rate underscores the urgent need for standardized training programs and organizational support. In addition, the findings suggest that enhancing individual nursing competencies and streamlining documentation tools could effectively improve patient safety and the continuity of surgical care in the Vietnamese hospital context. Conclusion The quality of nursing documentation for postoperative limb wound care conducted by nurses at nine studied hospitals was poor, especially when it came to assessment of clinical characteristics of wounds. Related factors included patients’ medical conditions and nurses’ professional factors, especially professional training and workload. The standardization of forms for documentation using SWAT, enhancing training, and reducing the number of patients in need of care would contribute to improving the quality of documentation.
Introduction Numerous individuals with hypertension demonstrate non-compliance with pharmacological and non-pharmacological treatments, in addition to dietary and lifestyle modifications. Patient compliance is a crucial element in emergency scenarios, as demonstrated by multiple sources. Method A quantitative correlational study design was employed to investigate variables affecting lifestyle adherence. 138 respondents met the following criteria: outpatients at Sokaraja I and II Community Health Centers, with a minimum of elementary school education, and aged 45-65 years. Participants were selected via purposive sampling. Multivariate, univariate, and bivariate analyses were performed to identify the primary factors affecting patient adherence to hypertension treatment and quality of life. Result Bivariate analysis indicated that gender, salt intake, smoking habits, obesity, familial history of hypertension, and marital status were strongly correlated with lifestyle adherence ( p -values < 0.05). In the multivariate analysis, marriage emerged as the variable with the greatest influence on adherence, with an odds ratio of 3.347. Married individuals were 3.347 times more likely to maintain a healthy lifestyle compared to their unmarried counterparts. Discussion The findings of this study demonstrate the significance of marriage, as an individual’s lifestyle is profoundly affected by familial support. Social cognitive theory posits that behavioral modifications are affected by both internal and external variables, including familial influences. Conclusion Factors strongly associated with adherence to a healthy lifestyle include gender, salt intake, smoking, obesity, a familial history of hypertension, and marital status.
Introduction To explore latent classes and developmental trajectories of fear of falling (FOF) within 1 to 6 months after stroke onset and to examine factors associated with latent class membership. Methods Through convenience sampling, 203 stroke patients receiving rehabilitation treatment at the Neurology Department in Hebei Province were recruited between May 2023 and December 2023. Data were collected at 1, 2, 3, 4, and 6 months after stroke onset using a general questionnaire and the Falls Efficacy Scale International (FES-I). Growth Mixture Modeling (GMM) was used to explore the latent classes and corresponding development trajectories of FOF. Univariate analysis and logistic regression were used to examine factors associated with latent class membership. Results The model fit results showed that a two-class latent-basis growth mixture model (allowing non-linear change over time) was the optimal model. The Class 1 (60.0%) was characterized by a higher initial level of FOF followed by a gradual decline over time, whereas the Class 2 (40.0%) showed a relatively lower initial level of FOF with a gradual increase over time. The logistic regression analysis indicated that education level, fall history, type of stroke, and any chronic illness were independently associated with latent class membership. Discussion The two distinct trajectories of FOF suggest that FOF changes dynamically among stroke patients during recovery. Patients with elementary school education or below, prior falls, hemorrhagic stroke, and three or more chronic illnesses were more likely to belong to the lower-FOF increasing group, comprising 40% of the sample. Conclusion These findings highlight the importance of early recognition of patients who may be more likely to follow an increasing FOF trajectory and may inform more attentive and individualized rehabilitation planning.
Introduction The transition from nursing student to New Graduate Nurse (NGN) is a critical period marked by increased responsibility and professional adjustment. This transition is particularly challenging in Emergency Departments (EDs), where high-acuity care requires rapid decision-making, prioritization, and clinical confidence. This study aimed to examine the barriers and enablers influencing the transition of NGNs into ED practice in Vanuatu. Methods A mixed-methods design was employed using a survey adapted to the Vanuatu context. Data were collected from 47 NGNs working in EDs across five hospitals in Vanuatu (response rate: 94%). Quantitative data were analysed using descriptive statistics, while qualitative responses were analysed thematically to identify key barriers and enablers affecting transition. Results Barriers to transition were categorized into organizational, personal, and family/relational factors. Key challenges included inadequate orientation, high workload, insufficient supervision, stress, and lack of confidence. Enablers were grouped into organizational and personal factors and included supportive teamwork, mentorship, fair task allocation, and ongoing learning opportunities. Most NGNs reported that structured support and exposure to diverse emergency cases improved confidence and job satisfaction. Discussion The findings highlight the complex interaction between individual readiness, workplace support, and health system constraints in shaping NGNs’ transition experiences. Compared with international studies, workforce shortages and limited supervision in Vanuatu appear to intensify transition challenges, underscoring the need for context-specific support strategies. Conclusion NGNs transitioning into ED practice in Vanuatu face significant challenges alongside important enabling factors. Strengthening structured orientation, supervision, and continuous learning opportunities may improve NGN preparedness, support professional development, and enhance patient care outcomes in emergency settings.
Introduction Midwifery education combines theoretical learning with clinical practice to ensure high-quality maternal and neonatal care. However, the management of newborns with adaptation difficulties, particularly those at risk, remains a major challenge in initial training. This study aimed to evaluate the effect of procedural simulation on midwifery students’ knowledge and clinical performance in neonatal resuscitation. Methods An experimental study was conducted from April 10 to 19, 2024, at the Higher Institute of Nursing Professions and Health Techniques in Casablanca. Forty midwifery students from semesters 4 and 6 were randomly assigned to a control group receiving traditional training (n = 20) or an experimental group receiving simulation-based training (n = 20). Data were collected using pre- and post-test knowledge assessments, a clinical performance checklist, a satisfaction questionnaire, and a confidence scale. Results Pre-test knowledge scores showed no significant difference between groups ( p = 0.662). Post-test results revealed significantly higher knowledge scores and better clinical performance in the experimental group compared with the control group ( p < 0.001). Students exposed to simulation reported high satisfaction (mean = 4.10 ± 0.55) and increased confidence. Discussion These findings underscore the educational value of procedural simulation in improving both cognitive and clinical outcomes. Nevertheless, the single-center design and limited sample size are potential limitations. Conclusion Procedural simulation significantly enhances knowledge, clinical performance, and confidence among midwifery students, supporting its integration as a complementary teaching strategy in initial midwifery education.
Introduction Nursing students frequently use social media for both academic engagement and social interaction; however, limited research has explored how different patterns of use influence their life satisfaction, particularly in relation to social media addiction. This study aimed to examine the mediating role of social media addiction among nursing students in the relationship between academic, social media usage, and life satisfaction. Methods This cross-sectional study, conducted in line with STROBE guidelines, used validated self-report questionnaires to assess social media use, addiction, life satisfaction, and problematic internet entertainment use among 298 undergraduate nursing students at the University of Al-Razi over the period from April to August 2025. Descriptive statistical analyses were performed to examine patterns and relationships among the variables. Results A total of 298 nursing students participated in the study, including 128 males and 170 females, with a mean age of 21.24 ± 1.15 years. Academic use of social media was positively associated with life satisfaction and negatively associated with social media addiction, whereas social and recreational use showed the opposite pattern. Social media addiction was negatively related to life satisfaction and partially mediated the relationship between different types of social media use and life satisfaction. Notably, entertainment-related use demonstrated the strongest association with addiction and indirectly reduced life satisfaction. Discussion These results imply that social media addiction significantly mediates the relationship between nursing students' social media usage patterns and life satisfaction. While excessive recreational and entertainment use may harm life satisfaction through increased addiction, academic use seems to be beneficial for well-being. Encouraging thoughtful, balanced social media use may improve students' academic performance and psychological health. Conclusion The association between social media usage patterns and life satisfaction among nursing students is partially mediated by social media addiction. These results, which highlight the importance of encouraging balanced, academically focused social media use to promote student well-being, are more transparent and methodologically rigorous when STROBE recommendations are followed.
Introduction Chest tube drainage system is to restore intra-pleural negative pressure and to promote the re-expansion of the lungs. However, if it is not managed properly, it can lead to complications. Aim Current study aimed to assess and evaluate the nurse’s knowledge and practices regarding the management of chest tube drainage at public hospital and to improve it through demonstration-based educational sessions. Methods A quasi-experimental study design was exploited to evaluate the effectiveness of Demonstration based educational sessions on the management of chest tube drainage among nurses. A total of 58 nurses participated in the study via Simple Random Sampling technique. Results Pre-Knowledge of nurses was found to be poor; none of the participants obtained a good knowledge score. While the post-test knowledge scores were significantly improved to the good category after the demonstration based educational sessions. Conclusion The demonstration based educational session was effective for the improvement of nurse’s knowledge.
Introduction The aim of this study was to develop and evaluate a program to improve positive Psychological Capital (PsyCap) among nurses working in long-term care hospitals. Methods A nonequivalent control group pretest-posttest design was employed. The participants included 27 nurses in the experimental group and 26 in the control group. The program, designed to enhance hope, optimism, self-efficacy, and resilience, was developed based on the positive Psychological Capital Intervention (PCI) model using the ADDIE process (Analysis, Design, Development, Implementation, and Evaluation). Results The developed program focused on contemplation, sharing experiences, and identifying strengths. The intervention demonstrated significant positive effects on professional quality of life, specifically increasing compassion satisfaction and reducing burnout, as well as enhancing organizational commitment. Discussion This study delineates the development process and the effectiveness of a PsyCap improvement program tailored for long-term care nurses. The program is expected to make a meaningful contribution to improving the professional quality of life and organizational commitment within this nursing demographic. Conclusion The findings indicate that the intervention effectively fosters a positive psychological state and improves work quality among nurses. These results encourage further research into its impact on various work environment outcomes.
Introduction This study aims to develop a Conceptual-Theoretical-Empirical (C-T-E) structure for holistic nursing care, centered on delirium prevention and treatment in critically ill patients, based on the Dynamic Symptoms Model (DSM) as the theoretical framework. Methods The conceptual-theoretical-empirical structure is developed to test theories. The conceptual model or conceptual framework guides the test of the middle-range theory or theoretical framework, linking concepts and propositions. The concepts and propositions are then presented for testing through an empirical research method. Results The C-T-E structure, based on the DSM, provides an understanding of delirium as a fluctuating and multifactorial syndrome. Besides, delirium has shown strong associations with physical, psychological, social, environmental, and spiritual antecedents. Thus, nurses and the healthcare team can prevent and reduce delirium in patients by reducing pain, mechanical ventilation, and sedatives, and by managing concomitant symptoms such as anxiety, fear, and suffering, while monitoring the trajectory of delirium. In conclusion, the C-T-E structure of the DSM in the context of delirium provides a theoretical framework for nurses and the healthcare team to personalize holistic, theoretically supported interventions. Discussion The practical implications of this study allow us to understand delirium as an event in which various patient antecedents converge. For that, nurses can apply the DSM in nursing interventions to reduce delirium-causing factors in the environment and the patient's antecedents. Conclusion This study allows us to understand delirium as an event approach that integrates theory, research, and practice, contributing to delirium prevention and enhancing nursing care quality, expanding inclusive, person-centered healthcare, and reducing the gap between theory, research, and nursing practice, thereby enhancing understanding of the phenomenon.
BackgroundWith the high requirements of nursing students’ interdisciplinary competence in contemporary nursing education, the ability of nursing students to engage in deep and meaningful learning has become essential. However, the extent to which deep learning ability contributes to the development of professional identity, and whether it acts as a psychological mechanism linking professional self-efficacy and professional identity, remains unclear. ObjectivesThis study tries to explore the relationships among professional self-efficacy, deep learning ability, and professional identity of undergraduate nursing students. MethodsA descriptive, cross-sectional correlational design was employed. 276 valid questionnaires were collected from full-time undergraduate nursing students from year 2 to year 4 at two public universities in Southwest China. Statistical software of SPSS 26.0 and PROCESS Macro Model 4 were used for data analysis. ResultsParticipants showed moderate levels of professional self-efficacy, deep learning ability, and professional identity. Nursing students with higher self-efficacy reported stronger deep learning ability and a stronger sense of professional identity. The deep learning ability partially mediated the relationship between self-efficacy and professional identity. DiscussionBased on the results, deep learning ability may serve as a bridge between self-efficacy and professional identity. Students who believe in their capabilities are more likely to learn deeply. Then their professional identity becomes clearer and more stable through this deep learning process. Teaching approaches that focus on students’ deep learning may help strengthen their professional identity. ConclusionDeep learning ability is helpful in developing professional identity among nursing students. It may serve as a practical indicator in nursing education. But further research should explore the causality in this relationship. Educational interventions that promote deep learning may help students build a stronger professional identity.
IntroductionPatients with Type 2 Diabetes Mellitus (T2DM) are prone to changes in body composition, which are often characterized by excess visceral fat and metabolic aging. Long-term insulin use is known to influence weight and fat distribution, but its effect on metabolic age remains unclear.To examine the relationship between Body Mass Index (BMI), visceral fat, metabolic age, and the duration of insulin therapy among patients with T2DM using Bioelectrical Impedance Analysis (BIA). MethodsThis cross-sectional study involved 199 adults with T2DM receiving insulin therapy at the Endocrine Outpatient Polyclinic. Anthropometric data and BIA-derived parameters were analyzed. Spearman’s correlation assessed relationships among BMI, visceral fat, and metabolic age, while the Mann–Whitney U test compared body composition between short-term (<5 years) and long-term (≥5 years) insulin users. ResultsThe majority of T2DM patients were in the obese category (69.3%). BMI showed significant positive correlations with both visceral fat (ρ = 0.43, p < 0.001) and metabolic age (ρ = 0.41, p <0.001). Visceral fat was also weakly but significantly correlated with metabolic age (ρ = 0.21, p = 0.002). Patients on insulin for less than five years had slightly higher BMI than those on longer therapy (26.7 vs 25.6 kg/m2; p = 0.025), while visceral fat and metabolic age did not differ significantly. DiscussionThese findings emphasize that adiposity plays a more dominant role than insulin exposure duration in determining metabolic aging and changes in body composition. ConclusionHigher adiposity, especially visceral fat, is strongly linked with accelerated metabolic aging in insulin-treated T2DM, whereas insulin duration has minimal effect. Nurses should facilitate routine body-composition monitoring using BIA to detect early metabolic deterioration and support individualized interventions targeting weight control and metabolic health.
IntroductionExclusive breastfeeding rates among children from birth to five months are declining in Jordan. Little is known about the challenges Jordanian mothers face in implementing breastfeeding. This study examines mothers' breastfeeding knowledge, perceived barriers, and stress levels, and analyzes their relationships with one another and with demographic factors. MethodsA cross-sectional, descriptive correlational study utilizing an online survey was conducted to gather data from mothers attending a healthcare center in Jordan. The Arabic Breastfeeding Knowledge Questionnaire, the Breastfeeding Perceived Barriers scale, and Cohen's Perceived Stress Scale were used to collect data. Pearson r, independent t-test, and one-way ANOVA were used for analysis. ResultsThree hundred and fifty mothers (mean age 29.8±5.8 years) participated in the study. The mean score of BFK-A was 11.1±2.5 out of 16. Almost half of the mothers (n=185) reported poor to fair knowledge. The mean score on the BFPB scale was 57.3±10.1 out of 110, and 42.6% (n=149) of mothers scored above the mean. The mean score of PSS-10 was 19.9±2.8 out of 40, with 97.7% of mothers (n=342) reporting moderate levels of perceived stress. Perceived stress did not correlate with breastfeeding knowledge nor with barriers. DiscussionThe findings revealed significant knowledge gaps and a positive association between level of education and breastfeeding knowledge. Breastfeeding barriers concerned with body image, self-efficacy, and inadequate professional support were prominent. ConclusionCommunity and healthcare-based counseling programs are needed to enhance knowledge, address barriers, and reduce stress among breastfeeding mothers.
BackgroundIntensive care units are characterized by high levels of responsibility and exposure to psychological stress. This study aimed to explore the relationship between perceived stress, psychological resilience, and sociodemographic variables of intensive care unit registered nurses in Jordan, as well as the predictors of perceived stress. MethodsThis cross-sectional study was conducted between January 5th and February 20th, 2025, and included 200 participants (88 males and 112 females) aged 23–51, from selected public and government hospitals located in Amman and Madaba, Jordan. Nurses’ sociodemographic characteristics were obtained, and the Perceived Stress Scale-10 and Connor-Davidson Resilience Scale-10 were administered. Statistical analyses included Pearson correlation, independent t-test, one-way ANOVA, and multiple linear regression. ResultsA significant inverse relationship was observed between perceived stress and psychological resilience. Bivariate analysis indicated that nurses’ age and experience had a significant positive relationship with perceived stress. Nurses who were female, single, of other marital status, worked a 16-hour shift system, worked extra hours, had an uncomfortable work environment, and experienced equipment shortages reported significantly higher perceived stress. Multiple linear regression indicated that working extra hours, working in an uncomfortable work environment, shift work, and being single or of other marital status collectively explained 40.4% of the variance in perceived stress scores. The strongest predictor was working extra hours, which was associated with an average increase of 2.80 units and explained 8.35% of the variance. Furthermore, working in uncomfortable workplaces was associated with an average increase of 2.116 units in perceived stress scores, accounting for 4.28% of the variance. The multiple linear regression model accurately predicted perceived stress scores 95.0% of the time, with up to 85.0% sensitivity and 78.0% specificity. DiscussionThis study revealed the relationship between perceived stress and psychological resilience among nurses. Furthermore, the impact of demographic and work stressor variables on stress levels was explored. A statistically significant inverse relationship was observed between perceived stress and psychological resilience. These findings implied that the more resilient nurses became, the less they experienced stress at work. ConclusionThe findings indicate an inverse relationship between perceived stress and psychological resilience. However, workload, shift length, extra working hours, and workplace environment conditions contributed significantly to ICU nurses’ levels of stress.
IntroductionThe provision of care to patients with Diabetes and Neuropathy must be based on health education. Educational technologies are facilitating means in this context, and after their construction, the evaluation stage is essential for improvement and analysis of the educational product. To evaluate, through the judgment of specialists and the target audience, an educational technology in booklet format on Neuropathies for people with Diabetes Mellitus. MethodsThis educational technology evaluation study, focused on interface in methodological development, employed a quantitative approach and was divided into two stages: Content and Appearance Evaluation, carried out in 2024, and Semantic Evaluation, carried out in 2025. Fifteen health specialists, nine experts in the didactic-illustrative field, and eighteen patients with diabetic neuropathies from a specialty center participated. For data collection, questionnaires were used and interpreted through the Content Index, the Summative Score of the adapted Suitability Assessment of Materials (SAM) instrument, and the Semantic Index. ResultsThe overall Content Index was 0.91, and the Appearance Evaluation obtained a score higher than 10 points in SAM. The booklet was improved following the specialists’ suggestions for version II. The overall Semantic Index was 0.98. The suggestions from the target audience were used to improve the booklet for the final version. DiscussionMoreover, the management of Diabetes Mellitus is carried out daily and continuously, combining pharmacological and non-pharmacological measures such as a balanced diet, physical exercise, and periodic personalized clinical care according to the patient’s individual needs. In this way, health communication provided through educational technologies can contribute to preventing or delaying the progression of comorbidities caused by Diabetes, such as Neuropathies. ConclusionThe booklet was evaluated for use as an educational technology for individuals with diabetes mellitus.
Introduction/objectiveGastric residual volume is considered a monitoring parameter for impaired gastric emptying and enteral nutrition tolerance in ICU patients. Changing the body position to the right lateral position is regarded as an alternative approach that may accelerate gastric emptying. This study aimed to evaluate the effectiveness of enteral nutrition using the intermittent feeding method combined with the right lateral position on gastric residual volume in ICU patients. MethodsThis study was an open-label randomized controlled trial involving 52 ICU patients who were allocated to the control group (n=26) and the intervention group (n=26). The intervention group received enteral nutrition using intermittent feeding combined with the right lateral position, while the control group received standard care. The study was conducted from March 16 to June 14, 2024. Monitoring of gastric residual volume was conducted six times daily using an observation sheet, each time before the administration of enteral nutrition, for three consecutive days. The data were analyzed using statistical tests including frequency distribution, the Mann-Whitney U test, Spearman’s rank correlation, and linear regression. ResultsThe results showed no difference between enteral nutrition using the intermittent feeding method combined with the right lateral position and standard treatment in terms of gastric residual volume (Mean [SD]: 306.25 [302.94] mL vs 315.38 [342.16] mL; p = 0.927). Additionally, this study found that the administration of catecholamine drugs and blood potassium levels were significantly associated with gastric residual volume in the intervention group (p = 0.035 and p = 0.022, respectively). DiscussionPerforming the right lateral position in ICU patients during intermittent feeding may serve as a strategy to reduce gastric residual volume, as indicated by the lower volume observed compared with the semi-recumbent position. ConclusionNo statistically significant differences were found between the two groups regarding gastric residual volume. The use of catecholamines and potassium levels may be important factors to consider in determining enteral nutrition tolerance and the rate of gastric emptying. However, further studies with larger sample sizes are recommended to strengthen these findings.
IntroductionRecovery-oriented mental health services are being implemented in various countries. However, to implement recovery-oriented mental health care, it is crucial for healthcare workers to understand it first. Therefore, the aim was to assess nurses' knowledge of a recovery-oriented mental health care approach using the recovery knowledge inventory scale (RKI). MethodsThe study utilized a cross-sectional quantitative design and 152 nurses consented to participate in the study. The RKI was used to collect data from four mental health facilities across Botswana. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Cronbach's alpha was used to test the reliability of the variables used in the study. ResultsThe sample included 81 (53.3%) female and 71 (46.7%) male nurses. The RKI was valid at Cronbach’s alpha 0.6. Most respondents (97%) agreed with the nonlinearity of recovery, while 84.9% strongly agreed or agreed that recovery from mental illness could be achieved by following a set of procedures. DiscussionThe results indicated that after validity and reliability tests were conducted, and with some adjustments, the RKI was valid and reliable for assessing nurses’ knowledge of a recovery-oriented mental health care approach in Botswana. Although its reliability was average at Cronbach's alpha of 0.6, it offered insight into how respondents perceived recovery. Overall, nurses in this study lacked orientation to recovery-oriented services. ConclusionThere was a clear lack of knowledge of the recovery approach among the respondents. This study underscores the need for targeted training to improve nurses' understanding of recovery-oriented practices.
IntroductionVascular access complications are among the most common adverse events following percutaneous coronary intervention (PCI), often requiring additional recovery and management. Evidence on associated risk factors remains inconsistent, and data from the Middle East are limited. MethodsA prospective cross-sectional study was conducted in two tertiary hospitals in the United Arab Emirates, adhering to STROBE guidelines. Convenience sampling included 211 adult patients undergoing elective PCI. Access-site complications (ecchymosis, oozing, bleeding, hematoma) were assessed immediately, at 6 hours, and at 24 hours post-sheath removal. Patient characteristics (age, sex, BMI, comorbidities) and procedural factors (puncture site) were recorded. Descriptive statistics summarized incidence; associations were tested using Chi-square (α=0.05). ResultsOf 211 patients (74% male; 68% radial access), complications were significantly associated with age (p=0.021) and female sex (57.4% vs 25.5%, p<0.001). Femoral access had a higher risk for bleeding and hematoma (p<0.05). Ecchymosis was most frequent in older females, peaking at 6 hours. BMI and comorbidities showed no significant association. DiscussionFemale sex, older age, and femoral access were key predictors of early post-PCI complications. These findings align with global evidence and underscore the need for tailored monitoring and nursing interventions, particularly in older female patients. ConclusionRadial access and targeted care strategies may reduce complication risk and improve outcomes in high-risk groups.
Introduction Treatment adherence remains a major challenge in tuberculosis (TB) control, particularly in low- and middle-income countries like Indonesia. Although TB treatment is provided free of charge, many patients still experience non-adherence due to various factors. This study examined the intrapersonal, interpersonal, and extra personal factors influencing TB treatment adherence using an integrated mixed-methods approach guided by Neuman's systems model. MethodsWe employed a simultaneous mixed-methods design. Quantitative data were collected from 185 TB patients using a structured questionnaire assessing cognitive, psychosocial, and health system-related variables. Bivariate correlations and multivariate regression analyses were conducted to analyze factors influencing adherence across Neuman's domains. Qualitative data were generated through in-depth interviews with six purposively selected patients and were analyzed thematically. Findings from both approaches were integrated through joint interpretation to identify convergent and complementary patterns within the theoretical framework. ResultsIn the multivariate analysis, shame was a significant negative intrapersonal predictor of adherence, while knowledge showed a significant trend. Family and social support served as protective interpersonal factors. Extrapersonal variables, such as healthcare support, had limited effects in the regression models. Qualitative findings highlighted emotional exhaustion, stigma, family support, and systemic barriers such as long wait times and limited follow-up as key influences. Integrated analysis showed that internal emotional struggles were the most prominent barrier. Supportive relationships and responsive healthcare services were important buffers. DiscussionTB treatment adherence is shaped by cognitive and emotional processes at the intrapersonal level, reinforced by interpersonal support, and constrained by extrapersonal conditions. Integrating quantitative and qualitative evidence through Neuman's systems model clarifies how shame and forgetfulness undermine adherence, and how motivation and social support strengthen patients' adherence to treatment. Structural challenges are less evident in the statistical models but are articulated in patient narratives, highlighting the responsiveness of the system. ConclusionTB treatment adherence is an interaction between individual, relational, and systemic stressors. Neuman's systems model provides a useful framework for understanding these dynamics. Interventions that strengthen emotional resilience, increase caregiver engagement, and incorporate digital health strategies may improve adherence in similar settings.
IntroductionEvidence-based Practice (EBP) is crucial to improving patient outcomes and providing high-quality healthcare. This study aimed to investigate nurses’ knowledge, skills, attitudes, and barriers to EBP in Sudanese hospitals. MethodsThis cross-sectional study was conducted in four Sudanese hospitals, with a total of 373 nurses recruited via convenience sampling. Data were collected using the Nursing Evidence-Based Practice Survey and analyzed using SPSS (version 28). ResultsOf the 373 nurses who participated in this study, 265 (71.0%) were female, 26.8% were between 20 and 30 years old, 54.4% held a bachelor’s degree, 53.1% worked in a government hospital, 28.7% had from 1 to 5 years of clinical experience, 35.1% worked in an emergency department, and 83.6% lacked EBP training. Most nurses had poor knowledge skills (53.9%) and attitudes (57.9%) regarding EBP. DiscussionMale nurses had a higher perception of the unit culture (M = 210.42, p = 0.007), nurses between 31 and 40 years old had a significantly higher perception of the organizational culture (M = 230.77, p = 0.001), and those working in the general ward had a higher perception of the organizational culture (M = 212.56, p = 0.009). A significantly positive weak correlation (r = .349, p = 0.000) was observed between knowledge, skills, and attitude. ConclusionThe findings highlighted nurses’ low levels of knowledge, skills, attitude, and barriers to EBP in Sudanese hospitals. Health policymakers and nursing managers can use these insights to design continuous education programs for enhancing KSAs toward EBP in Sudan.
A nursing internship is a program for the transition of nursing students to practice as registered nurses, preparing them to face real life in the clinical environment. A well-structured nursing internship program could promote clinical competency, caring ability, and self-confidence in dealing with complex clinical environments. This scoping review aimed to synthesize the knowledge of existing literature on pre-registration nursing internship programs. This review was conducted following a methodological framework for a scoping review, identifying the research questions, exploring relevant studies, study selection, charting the data, and collating, summarizing, and reporting the results. Literature searches were conducted in the databases, including Medline, CINAHL, Ovid, and ScienceDirect. It was found that the caring ability, perceived level of competency, and self-efficacy of nursing interns were likely to improve after completing the internship. Nursing interns had both positive and negative experiences of undergoing internship programs. Positive aspects of a nursing internship included filling the theory and practice gap and improving self-confidence, independence, and readiness for practice. Challenges encountered were insufficient support, workload, being involved in non-nursing work, transition shock, and feeling lost. The nursing internship programs effectively bridge theoretical knowledge with practical skills, fostering professional growth, clinical competency, and communication abilities. The concerning issues, such as burnout, transition shock, and limited critical thinking development, highlight the need for improvements in support systems and curriculum design.
