Background:The Diploma in Nursing programme (Regulation R.171) in South Africa has traditionally been delivered through face-to-face classroom teaching combined with supervised clinical practice. However, the COVID-19 pandemic in 2020 necessitated a rapid transition to online learning to ensure continuity of nursing education while minimising the spread of the virus. As caring is a fundamental value underpinning the nursing profession, it was essential that this value be maintained within virtual learning environments. In this study, caring presence is conceptualised as both relational and structural, encompassing lecturers' communication, emotional support, accessibility, institutional responsiveness and digital equity. Aim:This study explored nursing students' perceptions of lecturers' caring presence during online learning at a public nursing college in Gauteng Province, South Africa, and developed recommendations to inform the design and implementation of future online and blended learning environments. Design and Methods:A qualitative, contextual research design guided by the Appreciative Inquiry approach was employed to explore nursing students' experiences of lecturers' caring presence during online learning. Data were collected through focus group interviews with third-year nursing students and analysed using thematic analysis. Participants and Setting:Twenty-three third-year nursing students enrolled in the Diploma in Nursing programme participated in four focus group interviews conducted across two nursing college campuses in South Africa. Results:Four overarching themes emerged from the data, reflecting students' perceptions of lecturers' caring presence during online learning. Participants highlighted the importance of effective communication, emotional support, lecturer accessibility, institutional responsiveness and equitable access to digital resources in fostering a caring online learning environment. Students recommended integrating caring values into the college's mission and philosophy, strengthening the development of professional attributes such as caring, compassion, resilience and empathy through blended learning approaches, incorporating digital literacy into the nursing curriculum, providing continuous professional development for lecturers in the use of learning management systems and ensuring accessible technical support for all nursing students. Conclusion:The findings demonstrate that caring presence remains a critical component of quality nursing education, regardless of the mode of delivery. Strengthening caring relationships, institutional support and digital preparedness can enhance students' learning experiences in online environments. The recommendations may inform curriculum development, educational policy and future research aimed at promoting caring-centred online nursing education.
Background:The quality of nursing work life (QNWL) is essential to maintain nurses' well-being and professional performance, particularly in the intensive care unit (ICU) where workload, stress, and ethical challenges are high. Nurse characteristics, job demands, organizational support, Beliefs, and caring behavior are considered potential determinants of QNWL, but evidence regarding their pathways and mechanisms remains scarce. Aim:To analyze the effects of nurse-related, job-related, and organizational factors on nurses' Beliefs, caring behavior, and QNWL among ICU nurses using a Carolina Care-based structural model, including the partial mediating roles of Beliefs and caring behavior. Study Design:A cross-sectional design was applied to 200 ICU nurses from four hospitals. Data were collected using validated questionnaires assessing nurse characteristics, job factors, organizational support, Beliefs, and caring behavior, and QNWL PLS-SEM was employed to evaluate convergent validity, construct reliability, and the inner model. Results:Nurse factors had a significant negative influence on Beliefs (β = -0.208; p < 0.001), whereas organizational factors strongly and positively affected both Beliefs (β = 0.534; p < 0.001) and caring behavior (β = 0.333; p < 0.001). Beliefs significantly influenced caring behavior (β = 0.242; p = 0.001), while caring behavior strongly predicted QNWL (β = 0.533; p < 0.001). Job factors did not significantly affect Beliefs (β = 0.067; p = 0.390), which was described as nonsignificant. The measurement model showed acceptable convergent validity and composite reliability for the main constructs, although the Beliefs construct was modeled using a single global indicator and the job factor construct showed Cronbach's alpha slightly below the conventional threshold. The evaluation of the structural model showed that the endogenous variable had an R 2 value of 0.284, indicating a relatively modest level of explained variance. In addition, the Q 2 value of 0.219 suggests that the model demonstrates an acceptable level of predictive relevance. Conclusions:Organizational factors were the strongest predictors of Beliefs and caring behavior, both of which significantly improved QNWL. Supportive leadership, institutional policies, and recognition systems play key roles in shaping nurses' Beliefs and behaviors. Organizational support emerges as the most powerful level for change, directly leading to the practice recommendations. Implications for clinical practice include strengthening organizational support, providing structured training, and enhancing recognition programs to improve QNWL and sustain a resilient, caring nursing workforce. Relevance to Clinical Practice:This study highlights that improving ICU nurses' QNWL depends largely on strengthening organizational support, including supportive leadership, clear policies, and meaningful recognition. By fostering nurses' Beliefs and caring behavior through structured education, mentoring, and a caring-based practice environment, hospitals can enhance QNWL and sustain a resilient, compassionate ICU nursing workforce.
Background:Lockdowns during the COVID-19 pandemic compelled universities to implement online teaching and learning methods to comply with social distancing measures. The University of Botswana transitioned from classroom face-to-face teaching to remote learning in response to the pandemic. This study aimed to explore the experiences of nursing students at the University of Botswana with online teaching and learning during the COVID-19 outbreak. The results of the study have the potential to inform policies on how nursing education could respond to future pandemics and ensure continuity of learning. Design:The study utilised an explorative descriptive qualitative design to explore the students' experiences using online teaching and learning activities during the COVID-19 pandemic. Methods:Sixteen (16) students consented to participate in the study. Data were collected from September to November 2023 using a semistructured interview guide and analysed using content analysis. Trustworthiness was accomplished through credibility, dependability, confirmability and transferability. Further, the study used COREQ to ensure quality. Results:Five main themes and 14 subthemes were identified. The main themes are opportunities for online teaching and learning, students' performances during the COVID-19 pandemic, challenges of online teaching and learning, the need to improve online teaching and learning, and nursing as a profession and online learning. Conclusion:The study offered insights into how the COVID-19 pandemic affected nursing students' teaching and learning. Further research is recommended to guide nursing education and online learning policy.
Background:The music for pain relief study tested an innovative broad hypothesis that nurses can effectively integrate the use of music as an option for pain and anxiety management among their patients. The literature supports music for pain relief as an established best practice, and implementing music listening at the bedside supports patient-centered care and autonomous nursing practice. Methods:Guided by the Practical, Robust Implementation, and Sustainability Model (PRISM), a multidisciplinary research team comprised of nurse researchers, a patient/family co-investigator, and implementation scientists engaged nurses to implement the protocol on four inpatient units-three adult and one pediatric-from July 2021 to December 2021. Implementation strategies included nurse champions, in-person training, a unit research binder, and Spotify music streaming accounts with pre-established playlists. Reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) using data from the electronic health record (EHR), a bedside form, and a pre-post survey of nurse motivation to implement was assessed. Results:EHR data showed improvement in the monthly average documented music provision from 9 sessions preintervention to 16 postintervention and 22 in the sustainment phase. Bedside forms (n = 32) revealed nurses offered recorded music to alleviate anxiety (32%), boredom (27%), pain (22%), or procedural distraction (19%). Patients averaged 78 min of music listening, most typically on provided tablets (78%). Patients selected the genre in 46% of plays. Nurse perceptions towards the intervention significantly improved with respect to having accomplished something worthwhile. Pain scores captured before and after music listening did not show statistically significant differences. Conclusions:Nurses successfully integrated the evidence-based practice of offering recorded music to their patients during routine care, potentially facilitating pain and anxiety relief. The nurse's attitudes toward offering music showed they felt it was worthwhile. Implementation during the COVID-19 pandemic may have increased data collection fatigue, which limited postimplementation data collection.
Aim:To evaluate the effectiveness of the "Three Good Things" (TGT) intervention in improving dyadic coping, mutuality, and well-being among young and middle-aged stroke survivors and their spousal caregivers. Methods:A parallel-group quasiexperimental design was used. One hundred young and middle-aged stroke survivors and their spousal caregivers were recruited and assigned to either the intervention (n = 50) or control group (n = 50). The intervention group received eight sessions of the TGT intervention plus routine care. Outcomes were assessed at baseline, immediately postintervention, and at one- and three-month follow-up. Intervention effects over time and role differences were examined using multilevel modeling. Results:The intervention group showed significantly higher overall levels of dyadic coping, mutuality, and subjective well-being than the control group (all p < 0.05). Role differences were observed in delegated dyadic coping (p < 0.001), with spouses reporting higher levels than patients. Changes over time in delegated dyadic coping differed between patients and spouses (p = 0.010), and the intervention effect on mutuality was stronger among patients than among spouses (p = 0.001). Conclusion:The TGT intervention was associated with improvements in psychological and relational outcomes in young and middle-aged stroke survivors and their spousal caregivers.
Background:Futures thinking considers multiple possible, preferred, and undesirable futures; strategic foresight applies this orientation to planning. Nursing leaders face workforce instability, digital health adoption, and recurrent disruptions that demand anticipatory action. Purpose:To map how future-framed approaches appear in nursing-indexed journal literature (1990-2025) and identify leadership, education, and policy gaps. Methods:English-language Web of Science Core Collection journal articles and reviews (searched 08 Nov 2025) were screened for a substantive future-framed purpose in nursing. Co-citation analysis mapped frequently co-cited references, and co-word analysis mapped high-frequency author-keyword patterns. Findings:The Web of Science search generated n = 4478 raw imported records. After sequential metadata-based screening, n = 3137 records were retained as the final verified eligible corpus. Co-citation and co-word analyses identified four citation-based clusters and four author-keyword themes within the screened corpus. Within the retrieved corpus, co-citation patterns were consensus-dominant, anchored in Delphi guidance, consensus measurement, and reporting standards, alongside methodological and leadership/education reform texts. Co-word themes clustered around clinical risk, outcomes, long-term care, and measurement; nursing workforce, quality, leadership, patient safety, and work environment; Delphi/consensus-based nursing management and guideline development; and nursing education, implementation, attitudes, and learning/program development. Conclusions:Within the indexed journal record, future-framed nursing scholarship is growing but is most often operationalized through consensus-oriented pathways; explicit foresight tools such as scanning, scenarios, backcasting, and futures literacy remain comparatively sparse in titles, abstracts, and keywords.
Objective:This study examined whether documented receipt of nurse-led transitional care (NTC) was associated with postdischarge rehabilitation outcomes in patients with lumbar disc herniation (LDH). Methods:We conducted a retrospective cohort study of 134 patients with LDH who received conservative treatment between February 2022 and March 2025. Patients were classified as NTC or routine care (RC) according to the documented postdischarge nursing pathway. Outcomes included VAS, ODI, SF-36, ESCA, and GS at baseline and at 1, 2, and 3 months. Longitudinal changes were evaluated using generalized estimating equations, and 3-month outcomes were examined with multivariable linear regression adjusted for age, sex, length of hospital stay, follow-up duration, and the corresponding baseline score. A propensity score-matched sensitivity analysis was also performed. Results:Baseline characteristics were comparable between groups. In unadjusted analyses, the NTC cohort showed lower VAS and ODI scores and higher SF-36, ESCA, and GS scores than the RC cohort at all follow-up points (all p < 0.01). In adjusted longitudinal analyses, group-by-time interactions were significant for VAS (p = 0.012) and for ODI, SF-36, ESCA, and GS (all p < 0.001). At 3 months, adjusted estimates remained favorable to NTC for all five outcomes (all p < 0.001). Findings remained directionally consistent after propensity score matching. Conclusion:In this retrospective cohort, documented receipt of NTC was associated with better early postdischarge rehabilitation outcomes in patients with LDH. The overall pattern remained robust in adjusted, sensitivity, and propensity score-matched analyses, although prospective studies are still needed to address residual confounding.
Background:Pressure injuries remain a major complication among stroke and other mobility-impaired populations. Digital and smart technologies are increasingly used to support early tissue-risk detection, monitoring, and prevention-related care processes. However, evidence remains dispersed across technology types, clinical functions, and care settings. Methods:This scoping review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidance. PubMed/MEDLINE, ScienceDirect, CINAHL Complete via EBSCOhost, IEEE Xplore, and Wiley Online Library were searched for English-language studies published from 1 January 2018 to 30 July 2025. Eligible studies involved digital or smart technologies used for early pressure injury detection, physiological risk monitoring, repositioning support, pressure redistribution, or prevention-related decision support in stroke or other mobility-impaired populations. Two reviewers screened records using Rayyan and charted study characteristics, technology functions, settings, and outcomes. Critical appraisal was not undertaken because the review aimed to map evidence rather than estimate effects. Results:Of 1063 identified records, 13 studies were included. Eight technology categories were mapped: subepidermal moisture scanners, pressure ulcer monitoring platform devices, comprehensive mobile assessment of pressure, artificial intelligence-enabled smartphone applications, artificial intelligence-powered smart decompression mattresses, Internet of Things-based smart bed systems, infrared thermography, and digital skin moisture monitoring. Subepidermal moisture scanners were the only technology represented by multiple studies (6/13); all other categories were represented by single studies. Reported outcomes mainly involved diagnostic support, repositioning adherence, feasibility, and workflow-related measures. Direct evidence on pressure injury incidence was limited and heterogeneous. Most studies were hospital-based, with very limited community or home-care evidence. Conclusion:Digital and smart technologies may support earlier recognition of pressure-related tissue changes and selected prevention-related care processes, particularly in hospitals. However, evidence remains heterogeneous and insufficient to support strong effectiveness claims across technology types. Implications:Future research should prioritize clear prevention outcomes, comparative and implementation studies, and community-based testing before considering meta-analysis.
Background:Patient-centered care and interprofessional collaboration are fundamental to high-quality healthcare. This study investigated nurses' perceptions of patient-centered care and interprofessional collaboration and its factors. Methods:A descriptive cross-sectional survey was conducted. A total of 320 nurses from multiple hospitals in Vietnam participated in the study. The Index of Interprofessional Team Collaboration for Expanded School Mental Health and Patient-Centered Care Scale were used to assess interprofessional collaboration and perceptions of patient-centered care. Data were analyzed using multiple linear regression and mediation analysis. Results:Nurses reported moderate perceptions of interprofessional collaboration (2.68 ± 0.41) and relatively high perceptions of patient-centered care (3.83 ± 0.57). Multiple regression analysis revealed that perceptions of interprofessional collaboration (p < 0.001), patient-centered care training (p = 0.001), work experience (p = 0.001), and living area (p = 0.001) were significant predictors of patient-centered care perception. Interprofessional collaboration significantly mediated the relationship between patient-centered care training and patient-centered care perception. Conclusion:Nurses' perceptions of interprofessional collaboration significantly influence their views on patient-centered care, and strengthening these perceptions through targeted training and organizational support could enhance care quality and consistency.
Background:Preceptorship is a cornerstone of clinical teaching in undergraduate nursing programs in several countries, including Saudi Arabia. However, the common challenges faced by both preceptors and preceptees have not been explored. Aim:To explore the preceptors' and preceptees' perceptions toward barriers faced during preceptorship program. Methods:A qualitative descriptive design using Braun and Clarke's six-step thematic analysis was adopted, and online semistructured interviews were conducted for each participant from March to June 2022. A purposive sample of 13 participants (eight preceptors and five preceptees) was recruited from hospitals in different regions of Saudi Arabia. To ensure scientific rigor, the study's credibility, confirmability, and transferability were determined. Results:Two major themes emerged: (1) challenges of the preceptorship program (i.e., language barrier, lack of readiness to practice, lack of time, and lack of role preparation and direction and (2) strategies for improving preceptorship programs (i.e., having an organized preceptorship program and having organizational support). Conclusion:Preceptorship plays a vital role in helping nursing students develop clinical knowledge, confidence, and practical skills during their transition into professional practice. This study identified key barriers affecting effective preceptorship, including language challenges, limited readiness for practice, insufficient time, and unclear role preparation for both preceptors and preceptees. Strengthening preceptorship programs through structured organization, adequate staffing, proper preceptor support, and standardized training strategies can enhance clinical learning experiences and improve educational outcomes. Reporting Method:The Consolidated Criteria for Reporting Qualitative Research checklist was followed.
Mother-infant bonding difficulties can impair the emotional connection between mother and child and affect child development. We examined the association between postpartum depressive symptoms (PPDS) and mother-infant bonding in the first year postpartum and explored sociocultural factors that may influence bonding. We employed a cross-sectional mixed-methods approach at three health facilities. Surveys included 399 mothers within 12 months postpartum. PPDS were assessed using the Patient Health Questionnaire-9 with a cut-off score > 9, and bonding was measured with the Pre- and Postnatal Bonding Scale. We used a log-normal multivariable regression model to estimate the association between PPDS and mother-infant bonding, adjusting for potential confounders. Qualitative interviews were conducted with 31 mothers (19 with depressive symptoms and 12 without) and were analysed thematically. Overall, 29% of mothers screened positive for depressive symptoms. Screening positive was associated with a small, statistically significant reduction of 3% in bonding (adjusted mean ratio 0.97; 95% confidence interval 0.95-0.99; p = 0.01), among affected mothers compared to those not affected. However, the magnitude of this association was modest and should be interpreted with caution. Qualitative findings suggested that bonding appeared to be sustained through maternal instinct; caregiving; social support and religious, cultural and societal expectations in both groups, which may help explain the modest association observed. Culturally sensitive support and strengthened social networks may help mothers maintain strong bonds during the postpartum period.
Introduction:In ICU settings, genomic information can contribute to diagnostic clarification, individualized treatment planning, medication optimization, and appropriate referral to specialized genetic services. Critically ill patients frequently present with complex multisystem conditions, inherited disorders, or unexplained clinical manifestations that may have underlying genetic components. Consequently, genomic literacy among ICU nurses is particularly important to support family history assessment, recognition of genetic risk factors, patient education, and genomics-informed clinical decision-making. However, translating genomic knowledge into effective nursing practice requires not only foundational genomic knowledge but also positive attitudes, adequate confidence, and strong clinical decision-making skills among nurses. Purpose:This study evaluates the knowledge, attitudes, receptivity, confidence, and practices related to genetics and genomics among registered nurses working in ICUs in Amman, Jordan. Methods:A cross-sectional, descriptive study was conducted with 229 ICU nurses recruited conveniently from three hospitals in Amman. Participants completed the Genetics and Genomics in Nursing Practice Survey (GGNPS). Results:The Jordanian nurses demonstrated adequate knowledge/competencies of genetics and genomics concepts, with an average score of 66.9% on the competency subscale. They had a positive attitude toward integrating genetics into their practice and exhibited high confidence in accessing and sharing genetic information. Clinical application remained limited, with 82.1% of providers rarely or never collecting a comprehensive family history. Adoption of genetics and genomics in practice was influenced by providers' intent to expand their knowledge and their perceptions of the value and relevance of family history in patient care. Most nurses expressed a desire to learn more about genetics, especially if supported by senior nurses. A significant positive correlation was found between knowledge and confidence scores (r = 0.197, p = 0.003), indicating that nurses with higher levels of genomic knowledge reported greater confidence in their ability to discuss common genetic diseases and family history. Conclusion:While nurses possessed adequate knowledge and positive attitudes, their practical application of genetic information, particularly in family history assessment, was limited. A strong desire for further, peer-supported education was observed. These findings emphasize the need for targeted training programs to bridge the gap between knowledge and practice, ultimately enhancing the quality of genetic-informed nursing care in the ICU.
Aim:To explore healthcare professionals' confidence, skills and organisational support needs in providing pregnancy loss care within gynaecological settings in Northern Ireland. Design:This is a mixed-methods, exploratory study. Methods:An anonymous online survey was completed by 18 healthcare professionals. Quantitative data were collected using the Perinatal Bereavement Care Confidence Scale and analysed with descriptive statistics. Open-ended responses were analysed through qualitative content analysis. Results:The majority (83%) of participants acknowledged that pregnancy loss is a traumatic event for women. However, only 11% of participants felt well prepared to provide bereavement support. Organisational and environmental barriers were perceived to impede compassionate practice, and the majority of participants (94%) believed continuing bereavement education is needed. Grief counselling skills were highlighted as a particular training need. Analysis of the qualitative data generated four overarching categories reflecting healthcare professionals' perspectives on pregnancy loss care within gynaecological settings: (1) creating safe and compassionate spaces, (2) systemic and structural pressures undermine care, (3) the need for skilled, confident and supported staff and (4) building organisational commitment to bereavement care. Conclusion:Healthcare professionals aspire to deliver dignified, person-centred care following pregnancy loss but face systematic and educational barriers. Increasing organisational support as well as investment in staffing levels, bereavement training and access to emotional support are essential for the provision and sustainability of high-quality bereavement care and staff wellbeing. Implications for the Profession:Embedding bereavement education, reflective practice and dedicated bereavement care environments within gynaecological services could foster confidence and consistency of bereavement care for pregnancy loss in this setting. Patient or Public Contribution:An advisory group comprising clinicians, bereavement support organisations and women with lived experience contributed to this study. Reporting Method:This study adheres to the GRAMMS checklist for mixed-methods reporting.
Aim:This study investigated the current status and key influencing factors of supportive care needs among elderly breast cancer patients, with a focus on identifying critical determinants through a survey and advanced machine learning techniques. Design:The cross-sectional study randomly interviewed 180 elderly breast cancer patients, and 157 valid observations were retained for analysis. Methods:Firstly, patients were surveyed by two questionnaires. One is for fundamental information, which includes demographics, clinical, and psychosocial variables; the other is the Chinese version of the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34). And then, the questionnaires' results were transferred into a tabular dataset, with each question from the questionnaires serving as a column in the dataset. Secondly, an Extreme Gradient Boosting (XGBoost, a supervised learning algorithm) model was trained on the dataset. Fundamental features served as input variables, and the label was the total score of SCNS-SF34. Thirdly, the Shapley Additive Explanations (SHAP) framework was applied to interpret the XGBoost model by quantifying feature importance. Results:The XGBoost model demonstrated moderate predictive efficacy (R 2 = 0.58). After adopting the SHAP method on the model, we have the following findings. Fatigue severity emerged as the most significant feature of increased care needs, followed by weight, age, and educational level. Surgical interventions and low exercise frequency were associated with heightened demands, while managed chronic conditions (e.g., hypertension) and higher socioeconomic status (e.g., pension-based income) mitigated the care needs. Psychosocial factors, such as minority ethnicity and low health literacy, exacerbated unmet needs, whereas regular family support and higher education levels buffered demands. Conclusion:This study highlights the multidimensional nature of supportive care needs in elderly breast cancer patients, emphasizing the interplay of physiological, treatment-related, and psychosocial factors. The findings suggest that targeted interventions, such as fatigue management, culturally sensitive care navigation, and structured support for low-literacy populations, are essential to address unmet needs. Future research should prioritize longitudinal designs and policy integration to enhance care delivery and promote health equity. Reporting Method:The study adhered to STROBE guidelines for cross-sectional studies to ensure transparent and comprehensive reporting of results. Patient or Public Contribution:Not applicable.
Aim:To develop and psychometrically validate an instrument to assess the competencies (knowledge, skills, and attitudes) of nurses and nursing students regarding the effects of climate change on the health of older people. Methods:Cross-sectional descriptive study of questionnaire construction and validation developed in four phases: creation and elaboration of the initial items, content validation by an expert panel, pilot test, and psychometric validation. A tool was developed consisting of a knowledge questionnaire, a skills scale, and an attitude scale. Data were collected from a convenience sample of 708 individuals (210 nurses and 498 nursing students) between January and April 2024. Content validation was carried out by consulting a panel of 13 experts and a pilot test. Psychometric validation was carried out using Item Response Theory, specifically the Rasch model for the knowledge questionnaire and Andrich's rating scale model for the skills and attitude scales. The STROBE checklist for cross-sectional studies was followed. Results:Reliability for the set of items and for individuals was excellent (0.99 and 0.90, respectively). Item separation index was above 2 in all three parts of the instrument, although somewhat more limited for people. Internal consistency was acceptable in the knowledge questionnaire (11 items, Cronbach's α 0.68) and excellent in the skills (13 items, Cronbach's α 0.91) and attitudes (11 items, Cronbach's α 0.93) scales. Conclusion:Nursing Competencies Questionnaire on Older People's Environmental Health is a useful and reliable instrument for measuring knowledge, skills, and attitudes in nurses and nursing students.
Background:Epilepsy is one of the most common neurological conditions which affects 50 million individuals worldwide and has a high prevalence rate in Saudi Arabia (0.654%). Epilepsy negatively impacts the global health and lowers the quality of life (QoL) of affected individuals. Patients with epilepsy not only deal with the symptoms of the disease but also with the adverse effects of treatment and the worry of an unexpected crisis. Objectives:This study aimed to assess the QoL in patients with epilepsy in Jeddah, Saudi Arabia. Methodology:A descriptive cross-sectional study was conducted at a governmental hospital on 101 patients who met the inclusion criteria. The QoL of patients with epilepsy was assessed using an Arabic version of the Quality of Life in Epilepsy Inventory 31 (QOLIE-31) questionnaire to examine the QoL. Data analysis of the study was carried out by using descriptive statistics (SPSS) version 23. Results:The overall score was 51.2, indicating a decline in the QoL of patients with epilepsy. This score was compared with a published global normative mean QOLIE-31 score of 59.8. The difference between the study mean and the global mean was statistically significant (one-sample t-test, t = -5.223, p < 0.001). The domains with the highest rankings were in the following order: overall QoL (61.9), energy/fatigue (52.3), cognitive function (51.9), social function (51.8), medication effects (45.9), emotional well-being (45.7), and seizure-worry (39.1). Conclusion:Epilepsy was associated with a reduced QoL among patients in Jeddah, particularly in the domains of seizure worry, emotional well-being, and medication effects. These findings highlight the need for comprehensive management strategies that address not only seizure control but also the psychosocial aspects of epilepsy care.
Undergraduate nursing students experience stress as a multidimensional construct shaped by academic, clinical, psychosocial and contextual demands throughout training, placing them at increased risk of adverse mental health outcomes. Contemporary literature suggests that stress measures vary by instrument, reflecting distinct constructs (perceived vs. symptom-based). This systematic review and meta-analysis synthesised instrument-specific pooled estimates of moderate-to-high stress among undergraduate nursing students and examined variation by training stage, country income level, geographical region, pandemic period and stress measurement approach. Electronic databases were searched for quantitative studies published between January 2010 and December 2025. Random-effects meta-analyses were conducted separately for studies using the Perceived Stress Scale (PSS), reflecting perceived stress, and the Depression Anxiety Stress Scale (DASS) stress subscale, reflecting affective stress symptoms. Subgroup, sensitivity and meta-regression analyses were undertaken to explore heterogeneity. Forty-two studies involving 19,655 students from 21 countries met the inclusion criteria, with 27 studies contributing to prevalence synthesis and 18 to pooled mean scores. Given the very high heterogeneity and the non-equivalence of instruments, an overall pooled prevalence of 49.98% was calculated only as a descriptive summary. Instrument-specific analyses indicated a substantial prevalence of perceived stress in PSS studies (74.37%) and symptom-based stress in DASS studies (30.46%), while mean scores across both scales suggested moderate stress levels. However, substantial unexplained heterogeneity persisted, indicating the influence of unmeasured contextual, psychosocial and methodological factors across studies. These findings emphasise the wide range and variability of reported stress prevalence, suggesting that a pooled estimate may not adequately capture the underlying complexity. Overall, estimates are presented according to instrument-defined constructs, and cross-instrument comparisons should be interpreted with caution, highlighting the need for measurement-aware, context-sensitive research and interventions.
Introduction:The global aging of the population highlights the urgent need to monitor and promote physical activity (PA) among older adults. A multidimensional understanding, encompassing assessment, promotion, and biopsychosocial factors associated with PA, is essential for healthy aging. Objectives:To map and synthesize the available evidence on PA assessment instruments, intervention strategies, and biopsychosocial factors associated with PA in adults aged 60 years and over. Methodology:A scoping review was conducted following the JBI methodology and PRISMA-ScR guidelines. The search included validated and nonvalidated questionnaires, PA promotion interventions, and biopsychosocial factors associated with PA (clinical, psychological, and social domains) in studies published between 2019 and 2026 across community, clinical, and residential settings. Results:A total of 51 studies were included, showing substantial heterogeneity in sample size, objectives, clinical status, and settings. Twenty different instruments were identified (e.g., PASE, IPAQ, CHAMPS, and VREM), most of them validated. The majority of studies involved populations aged ≥ 65 years and were conducted in the United States, Canada, Australia, and China. Among the biopsychosocial factors associated with PA, frailty (6.45%), cognitive decline (6.45%), and chronic conditions (6.45%) were prominent. Lifestyle-related factors such as sedentary behavior (11.8%), nutrition (5.37%), and participation in PA programs (16.13%) were also frequent. Outcomes included activities of daily living (9%), quality of life (8.6%), and levels of dependency (6.45%). Intervention-based studies were less frequently identified compared to observational and methodological studies. Conclusion:This review highlights the importance of promoting PA to improve functional capacity and quality of life in older adults. Although a wide range of validated tools is available, their application varies depending on context. The limited presence of intervention studies indicates a need for further research focused on structured, multicomponent programs tailored to individual needs within a biopsychosocial framework.
Background:During pregnancy, extensive hormonal and metabolic changes can occur. Gestational diabetes can cause maternal and neonatal complications. Follow-ups have shown that women who first develop metabolic diseases during pregnancy have an increased risk of developing other metabolic diseases, including hypothyroidism. There are contradictory results. The aim of this study is to provide an overview of the relationship between gestational diabetes and gestational thyroid dysfunctions. Methods:This study is a retrospective case-control study conducted in 2025 on 353 pregnant women in Iran; 176 were included in the case group (women with gestational diabetes) and 177 in the control group (women without gestational diabetes). The diagnosis of hypothyroidism was assessed in both groups. Descriptive statistics, chi-square test, t-test, and unconditional logistic regression were used to analyze the data. Findings:Gestational diabetes was associated with a significant increase in the risk of hypothyroidism (approximately 2.8-fold) (p = 0.03). A history of other diseases was also associated with a significantly increased risk of developing hypothyroidism (p = 0.001). In contrast, the risk of hypothyroidism was not significantly associated with age at first pregnancy (p = 0.10), number of pregnancies (p = 0.11), or breastfeeding (p = 0.35). Conclusion:Gestational diabetes and a history of other diseases significantly increased hypothyroidism risk, while age at first pregnancy, number of pregnancies, and breastfeeding showed no significant associations. Based on these findings, regular thyroid screening is suggested for pregnant women with gestational diabetes or other medical conditions, regardless of reproductive factors.
Aims:To identify diagnostic technologies for postoperative urinary retention in patients undergoing lower limb arthroplasty surgeries. Design:Integrative review. Data Sources:Searches were conducted in April 2024 in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, Web of Science, Scopus, and CINAHL. Review Methods:Studies published in the last 10 years, without language restriction, were included. The search strategy combined the terms "postoperative," "arthroplasty," "diagnosis," and "urinary retention." Study selection and analysis followed PRISMA recommendations. Data were analyzed descriptively and synthesized qualitatively. Results:A total of 34 studies were included, comprising 36,736 participants. Bladder ultrasound was recommended in 73.5% of the studies as the primary diagnostic technology. The most frequent urinary volume thresholds indicating catheterization ranged from 400 to 500 mL, with postvoid residual volumes around 150 mL also reported. Conclusion:Bladder ultrasound is the most recommended diagnostic technology for postoperative urinary retention in patients undergoing lower limb arthroplasty. However, further studies are needed to validate its use across different clinical contexts and populations. Impact:The findings support the incorporation of bladder ultrasound into clinical protocols to improve early diagnosis, reduce unnecessary catheterization, and enhance patient safety in postoperative care. This review also highlights the need for greater involvement of nursing professionals in research and clinical application of diagnostic technologies. Patient or Public Contribution:Not applicable.
