Artificial intelligence (AI) is increasingly influencing nursing practice and care delivery. This cross-sectional correlational study examined nurses' ethical awareness, attitudes, anxiety, and intention to use AI among 414 registered nurses in a large Middle Eastern healthcare organization. Participants reported moderate ethical awareness and anxiety, positive attitudes, and moderately high intention to use AI. The regression model explained 59.4% of the variance in intention; ethical awareness (β = 0.436) and positive attitudes (β = 0.366) significantly predicted intention, whereas age showed a small negative association (β = -0.111). Findings support targeted education and organizational strategies for responsible AI adoption in nursing practice.
Artificial intelligence (AI) responsiveness in nursing was conceptually analyzed to clarify its defining attributes, antecedents, consequences, and empirical referents. Guided by Walker and Avant's approach, sources on AI literacy, responsiveness, and related nursing concepts were thematically synthesized. Four defining attributes were identified: foundational understanding of AI, critical appraisal of AI outputs, ethical and accountable response, and integration with clinical judgment. Antecedents included exposure to AI-enabled tools, digital and informatics foundations, education and training, and organizational and regulatory support. AI responsiveness supports safer practice, stronger decision-making, ethical care, equity, readiness, and professional nursing accountability.
This study explored the challenges and strengths shaping Latine families' experiences of pediatric loss in the United States context. Eighteen semistructured interviews with healthcare providers (n = 7) and bereaved Latine caregivers (n = 11) were carried out using an integrated qualitative descriptive and Liberation Psychology approach. Four themes emerged that are heavily shaped by individual and contextual factors: (1) Unsupportive and hegemonic systems, (2) caregiver and provider discordance regarding end-of-life care, (3) caregiver identity transcendence in the "natural distress of grief," and (4) supportive networks and their limitations. Results highlight sociocultural realities that inform needed structural, policy, and practice changes.
Infants undergoing cardiac surgery are vulnerable to cardiac arrest and subsequent morbidity and mortality. While various risk factors for postoperative cardiac arrest have been identified, no comprehensive framework exists to explain the interrelationships among them. In this study, we first extended Selye’s General Adaptation Syndrome to illustrate the mechanisms leading to postoperative cardiac arrest in this population. We then interviewed 17 expert clinicians to explore infant stress exposure and stress response across the clinical trajectory. Using the qualitative data, we revised and evolved our initial theoretical framework. The evolved theory offers a foundation for future nursing research and clinical practice.
By integrating epigenetic science using a multidisciplinary approach, grounded in nursing theory, this concept paper offers a transformative frontier for understanding and addressing cardiometabolic health inequities experienced by Black women. Building on the legacy and insights of the Black Women’s Health Study and drawing on the Social Ecological Model, the Neuman Systems Model, and the weathering hypothesis, we present a conceptual framework that elucidates how systemic drivers of health shape cardiometabolic health outcomes through psychosocial pathways that mediate epigenetic changes. Methodological and ethical considerations, and implications for theory development, practice, and policy, are discussed.
Nurse burnout affects individual and system-level outcomes. A reevaluation of an appropriate theoretical framework to guide research on burnout among military nurses is required to advance military nursing science. Fawcett’s method for theory analysis and evaluation was used to assess the applicability of the Job Demands-Resources theory. Analysis also included potential military nurse-specific job demands and resources based upon scientific literature. Results indicate that Job Demands-Resources theory should be considered a predictive, middle-range theory with applicability to research addressing military nurse burnout, well-being, and job performance.
Equity and justice have long been positioned as moral imperatives in nursing, yet operational models of quality improvement seldom integrate these values at a theoretical level. This concept development adapts the Donabedian model to align structural competence, social mission, and equitable outcomes, offering a mid-range theory to guide nurse-led quality improvement, education, and policy: the Equity-Driven Quality Framework. This equity-driven reconfiguration relies on the familiar structure-process-outcome triad, then extends it to intentionally incorporate health equity as a defining criterion of quality. The framework advances nursing’s moral and scientific commitments to justice within contemporary health system reform.
Adolescent girls and young women (AGYW) aged 15 to 24 face disproportionate human immunodeficiency virus acquisition risk in sub-Saharan Africa, yet existing frameworks inadequately address their multilevel, gender-specific determinants. We developed INFORM-HERS (INtegrated Framework fOR assessing Multilevel determinants of human immunodeficiency virus acquisition among AGYW) using “Up and Down” theory integration of 3 established frameworks: Theory of Gender and Power, Modified Social Ecological Model, and Center for Latino Adolescent and Family Health Framework of Social Determinants of Health Mechanisms. INFORM-HERS incorporates gender inequality risk factors, social protective factors, and AGYW-specific developmental transitions, providing a theoretical foundation for multilevel interventions in sub-Saharan Africa.
This paper adapts Anderson and Griffith’s Trust-Building Process in Healthcare Organizations Framework to a nurse-led framework, illustrating how trust influences engagement in preventive health among structurally marginalized populations. Using cervical cancer screening among Appalachian women as an exemplar, the framework conceptualizes trust-building as a multilevel process operating at intrapersonal, interpersonal, and institutional levels. By situating trust as both a relational and structural construct, this adaptation underscores nurses’ essential role in cultivating trustworthiness within healthcare systems and advancing equity. The framework offers a conceptual pathway for developing trustworthy systems of care that foster sustained preventive health engagement.
The purpose of this paper is to understand processes contributing to childhood obesity by embedding internalized weight bias (IWB) within an existing psychological theory called self-discrepancy theory. We conceptualize IWB as a misalignment between adolescents’ actual self and internalized ideal and ought self-guides shaped by the social environment. This framework explicates emotional and motivational consequences of self-discrepancies, identifies modifiable clinical targets, and supports hypothesis generation and variable selection for nurse scientists. Overall, this new conceptualization of IWB and obesity can aid nursing science in dismantling systemic weight stigma in obesity treatment, ultimately improving trust and engagement between patients and providers.
Guided by Mishel theory of uncertainty in illness, this cross-sectional study examined relationships between uncertainty and psychological distress among 300 Taiwanese patients with atrial fibrillation (AF). The instruments included the Brief Illness Perception Questionnaire, Symptom Frequency Subscale of the Symptom Checklist-Frequency and Severity, Medical Outcomes Study Social Support Survey, AF Knowledge Scale, Mishel Uncertainty-in-Illness Scale, and Hospital Anxiety and Depression Scale. Path analysis examined the relationships among uncertainty, psychological distress, and related variables. Findings suggest that enhancing social support and AF knowledge through nursing interventions may help reduce uncertainty and psychological distress.
This article examines nursing professionalization in the Republic of Korea in light of two Korean laws enacted in 2024: the Nursing Act and legislation on integrated community care. Drawing on nursing professionalism and sociology of professions literature, we distinguish professionalism-the identity, knowledge, values, clinical judgment, ethics, and accountability constituting nursing practice-from professionalization, the institutional process through which nursing work gains jurisdiction, authority, legal protection, reimbursement, and social legitimacy. The Korean case shows that legal recognition creates visibility but does not by itself produce professional authority. Nursing role development in Korea is shaped by population aging, chronic illness, community-care demand, physician-delegated medical support tasks, cost-containment pressures, uneven workforce distribution, and weak reimbursement for nursing services. We argue that professionalization requires more than role expansion: it requires scope and role standards, education-credentialing alignment, legal authority and accountability, reimbursement mechanisms, nurse-led community models, and academic-practice-policy governance. The Korean case offers a theoretically useful example of the gap between statutory recognition and institutionalized professional authority.
Children undergoing surgery experience heightened relational vulnerability associated with separation, loss of control, bodily exposure, and transitions of consciousness. The Pediatric Perioperative Relational Safety Theory advances a middle-range nursing theory that conceptualizes relational safety as a dynamic, nurse-mediated process co-constructed among nurses, children, and families across perioperative phases. Five interrelated constructs - Congruent Communication, Integrated Parental Presence, Supported Child Agency, Protected Personal Integrity, and Transitional Continuity - specify modifiable relational mechanisms. Nine propositions articulate pathways linking these mechanisms to proximal perioperative responses and longer-term psychosocial trajectories. The Pediatric Perioperative Relational Safety Theory positions relational safety as a central nursing safety function, extending and integrating perioperative theory, research, and practice.
Type 2 diabetes requires sustained management of metabolic risk and psychosocial distress. This quasi-experimental pretest-post-test study evaluated a 12-week, group-based yoga intervention embedded in outpatient care. Adults with type 2 diabetes received either yoga plus routine care or routine care alone. The yoga group showed significant improvements in glycated hemoglobin ( P = .043), high-density lipoprotein cholesterol ( P = .012), and depressive symptoms; post-test depression scores were lower than in the control group ( P = .005). Group-based yoga may offer a low-equipment, relational nursing intervention for sustainable chronic illness care.
Post-sentence treatment for individuals convicted of sexual offenses requires balancing care, safety, and public protection, yet frontline staff experiences remain understudied. This qualitative study explored staff experiences in Taiwan through 4 focus groups with 21 interprofessional members. Data were analyzed using thematic analysis. Five themes emerged: entering unfamiliar care, practicing under legal oversight, negotiating gendered safety, absorbing invisible emotional labor, and navigating structural gaps. Beyond general psychiatric nursing, staff require specialized legal awareness, boundary work, and safety practices. Strengthening practice demands structured education, clear protocols, and policy recognition. Making this work visible advances forensic psychiatric nursing and sustainable care.
Poor sleep quality impacts cognition, emotions, and immunity. This study evaluated the efficacy of auricular acupressure in improving sleep conditions. Eighty-eight women aged ≥40 years with insomnia were randomly assigned to acupoint, sham, or comparison groups. Magnetic pellets were applied to heart, liver, and shenmen acupoints for the acupoint group and were offset by 1 to 2 cm for the sham group. Participants pressed pellets thrice daily for 1 month. In the acupoint and sham groups, insomnia was reduced and sleep quality improved dramatically in the acupoint group at 4 weeks. Auricular acupressure may improve sleep and support equitable, cultural patient-centered care.
This cross-sectional study examined associations among work-related characteristics, sleep problems, and metabolic syndrome in Taiwanese workers. A total of 348 workers undergoing routine occupational health examinations were analyzed using multivariate logistic regression. The prevalence of metabolic syndrome was 26.4%, higher in men (33.3%) than in women (19.3%). Among women, shift work and body mass index were associated with metabolic syndrome, whereas among men, sleep disturbances, sleep latency, and body mass index were significant predictors. These findings suggest sex-specific pathways linking occupational conditions, sleep characteristics, and metabolic risk and highlight the importance of targeted occupational health nursing interventions.
