Background: The effectiveness of change initiatives in healthcare systems is often undermined by nurses’ resistance to change, resulting in unfavorable outcomes. Despite nurses’ central role in hospital-based initiatives, multiple factors may contribute to this resistance. The existing literature remains insufficient in synthesizing comprehensive, integrative evidence on this issue. This gap highlights the need for a systematic review to inform tailored interventions that enhance the implementation and sustainability of change in healthcare.Purpose: This review provides a comprehensive overview of the factors influencing resistance to change in the nursing profession.Methods: Following the PRISMA guidelines, a systematic search was conducted in PubMed, CINAHL, Scopus, and Web of Science using terms related to “resistance to change” and “nursing.” Studies examining resistance factors among nurses, published in English between 2010 and 2024, were included. Two independent reviewers conducted data extraction and quality assessment using the Mixed-Methods Appraisal Tool. Content and thematic analyses were performed to generate a comprehensive synthesis.Results: Of the 646 records identified, 14 studies met the inclusion criteria and were included in the final review. The findings revealed significant individual, interpersonal, and organizational factors contributing to nurses’ resistance to change. Individual-level factors included low readiness for change, limited empowerment, and personality characteristics. Interpersonal factors were associated with poor communication, limited stakeholder engagement, and weak leader–member relationships. At the organizational level, the factors included ineffective leadership styles, inadequate training, and dysfunctional organizational culture.Conclusion: Resistance to change among nurses is multifaceted and context-dependent. These findings underscore the need for targeted interventions, particularly emphasizing the importance of effective communication, training, and nurse involvement in enhancing the sustainability of change initiatives in healthcare settings.
Background: Simulation-based learning (SBL) is widely used in nursing education, especially in high-risk settings such as emergency departments. However, limited qualitative research has explored how emergency nurses experience simulation in clinical practice.Purpose: This study aimed to explore emergency room nurses’ lived experiences of simulation-based learning and to understand how simulation contributes to their professional development and clinical practice.Methods: A descriptive phenomenological approach was used. Ten emergency room nurses from a public hospital under Oman’s Ministry of Health were recruited using purposive sampling. Data were collected through in-depth interviews and analyzed using Colaizzi’s seven-step phenomenological method to identify the meaning of participants’ experiences.Results: Three themes emerged from the analysis: (1) simulation as a bridge between theory and clinical practice, where simulation enabled nurses to translate theoretical knowledge into practical decision-making in realistic emergency scenarios; (2) developing professional confidence and clinical competence, where repeated simulation practice strengthened clinical skills, preparedness, and confidence; and (3) simulation as a strategy for improving nursing services, where participants perceived simulation as contributing to improved clinical performance, teamwork, and patient care quality. Participants also identified practical challenges, including scheduling constraints and workload demands, which limited participation in simulation activities.Conclusion: Simulation-based learning is experienced by emergency nurses as a meaningful experiential learning process that supports the integration of theoretical knowledge with clinical practice. In addition to improving individual competencies, simulation contributes to professional confidence, teamwork, and the quality of emergency care. Further research across diverse healthcare settings is needed to explore its long-term impact on nursing practice and patient outcomes.
Background: Emotional intelligence (EI) and critical thinking motivation (CTM) are crucial for nursing students’ development, particularly in patient care and clinical decision-making. However, empirical evidence on these constructs remains limited among nursing students in Saudi Arabia.Purpose: This study aimed to investigate the relationship between EI and CTM among nursing students and to explore demographic variations and predictors of CTM.Methods: This cross-sectional study included 215 undergraduate students from Saudi Arabia, recruited via convenience sampling. EI was assessed using the Schutte Self-Report Emotional Intelligence Test, and CTM was measured using the Critical Thinking Motivational Scale (CTMS). Data were analyzed using descriptive statistics, Chi-square tests, and multiple regression, with the significance level set at p < .05.Results: A total of 215 participants were included in the analysis. EI and CTM scores varied, with 51.6% of participants exhibiting moderate levels of both. Higher EI was significantly associated with higher CTM scores (χ² = 29.9, p < .001), with students with low EI demonstrating lower CTM and those with high EI demonstrating higher CTM. Demographic analysis showed that EI was higher among students living with their families (p = .01), while CTM scores were higher among older students (p = .019) and those in higher academic years (p < .001). Multiple regression identified EI, education level, and residence as positive predictors of CTM, while male gender was a negative predictor (R² = .29, p < .001).Conclusion: These findings indicate that EI is significantly associated with CTM, suggesting that promoting EI and fostering supportive learning environments may enhance students’ motivation to engage in critical thinking and contribute to their academic and professional development. Future research should employ longitudinal and intervention designs to examine causal relationships and explore potential mediating factors.
Background: Mental health literacy plays a significant role in addressing mental health issues. However, evidence regarding mental health literacy among women from Turkmen communities living in post-conflict settings in Iraq remains limited.Purpose: This study aimed to determine the level of mental health literacy and its associated factors among women in the context of conflict recovery in Telafer City, Iraq.Methods: This study employed a descriptive cross-sectional design involving 603 women attending a general hospital in Telafer city. The Arabic version of the Mental Health Literacy scale was used to collect data. Descriptive statistics (mean and standard deviation) were calculated to assess mental health literacy scores. Inferential analyses, including one-way ANOVA, independent-samples t-tests, and multiple linear regression at a 95% confidence level (p < .05), were conducted to assess the relationship between mental health literacy and eight sociodemographic predictors (age, educational level, employment status, marital status, residence, culture, and mental health clinical and family history).Results: The mean mental health literacy score among women was 88.06 (SD = 13.80). Bivariate Pearson’s correlation analysis indicated that age, educational level, employment status, and marital status were significantly associated with mental health literacy (p < .05). However, in the multiple linear regression analysis, only educational level remained a significant predictor (B = 1.342, SE = .456, p = .003, 95% CI [0.447, 2.237]). Conclusion: Mental health literacy among women in Telafer City was moderate. Educational level was the only significant predictor of mental health literacy among Turkmen women. These findings highlight the need for targeted interventions to improve mental health literacy among women in conflict- and war-affected settings. Additionally, the results support the development of mental health education programs tailored for women’s educational levels in Turkmen and Arab communities.
Background: People living with HIV–TB (PLHIV–TB) continue to experience persistent stigma, fear, guilt, and silence that shape their psychosocial wellbeing and social interactions. HIV–TB represents a double burden that intensifies stigma and moral judgment, particularly within sociocultural and religious contexts. However, the lived experiences of PLHIV–TB in Indonesia remain insufficiently explored, despite the country’s unique cultural and religious dynamics. Understanding these contextualized experiences is essential for strengthening holistic, culturally responsive, and stigma-sensitive HIV–TB care.Purpose: This study aimed to explore experiences of PLHIV-TB amid fear, guilt, and silence within the Indonesian sociocultural context.Methods: A descriptive phenomenological design was employed, with 20 PLHIV-TB purposively selected from Lampung, Palembang, Depok, and Yogyakarta between January and June 2025. Data were collected through in-depth, semi-structured interviews lasting 45–70 minutes and analyzed using NVivo software with Colaizzi’s method. Trustworthiness was ensured through member checking, peer debriefing, and reflexivity.Results: Six themes captured the essence of participants’ experiences: (1) living under constant fear of exposure, (2) choosing silence as protection, (3) bearing the weight of guilt and moral judgment, (4) loneliness amid social disconnection, (5) struggling with faith and moral reconciliation, and (6) searching for meaning and self-acceptance. Participants’ narratives revealed a transformation from concealment and shame toward spiritual reconciliation and dignity through emotional and faith-based resilience.Conclusion: The lived experiences of people living with HIV–TB in Indonesia are shaped by intertwined dynamics of fear, guilt, and silence within a context of pervasive stigma. At the same time, some individuals demonstrate adaptive processes that reflect a complex journey from suffering to meaning-making and self-acceptance. These findings underscore the need for stigma-sensitive, psychosocial, and spiritually informed interventions to support holistic HIV–TB care.
Background: Type 2 Diabetes Mellitus (T2DM) presents a chronic health challenge that extends beyond the patients, significantly affecting family members who assume caregiving responsibilities. Family caregivers often experience emotional, physical, and psychological burdens, particularly in low-resource settings. However, the interplay between family communication, decision-making, caregiver burden, and self-efficacy, and how these factors jointly influence caregiver quality of life, remains insufficiently explored, particularly in culturally specific and resource-limited settings.Purpose: This study aimed to examine the structural relationships among family communication, shared decision-making, caregiver burden, self-efficacy, and their influence on the quality of life of family caregivers of individuals with T2DM.Methods: A cross-sectional study was conducted involving 327 family caregivers recruited from 16 primary health centers using cluster random sampling. Data were collected using validated instruments to measure family communication, decision-making, caregiver burden, self-efficacy, and quality of life. Structural Equation Modeling (SEM) was used to analyze both direct and indirect relationships among the variables.Results: The findings revealed that family communication (β = 0.35) and decision-making (β = 0.42) had significant positive effects on self-efficacy, whereas caregiver burden (β = -0.33) had a significant negative effect. Self-efficacy, in turn, significantly improved caregivers’ quality of life (β = 0.51). Furthermore, self-efficacy mediated the indirect effects of family communication, decision-making, and caregiver burden on quality of life. The model explained 49% of the variance in self-efficacy and 64% of the variance in caregiver quality of life.Conclusion: Self-efficacy plays a central role in enhancing caregiver well-being and quality of life. Interventions that promote open family communication, shared decision-making, and burden reduction are essential. Nursing implications include the need for culturally sensitive, family-centered nursing interventions to enhance caregiver self-efficacy through communication training, psychosocial support, and empowerment in decision-making. Nurses should be equipped to assess caregiver burden and
Background: Fetal movement is an important indicator of fetal life and well-being and contributes to maternal–fetal bonding. However, evidence on pregnant women’s knowledge, attitudes, behaviors, self-efficacy, and experiences in self-monitoring fetal well-being remains limited.Purpose: This study aimed to comprehensively examine pregnant women’s knowledge, attitudes, behaviors, self-efficacy, and experiences related to fetal movement monitoring.Methods: A mixed-methods study with a concurrent triangulation design was conducted. Quantitative and qualitative data were collected simultaneously through a survey of 216 respondents from two districts and interviews with 18 participants drawn from the survey pool. Comparative analysis was used to assess differences in knowledge, attitudes, behaviors, and self-efficacy between the two districts using the Mann–Whitney test for survey data, while thematic analysis was applied to the interview data.Results: Overall, the majority of pregnant women demonstrated low knowledge (64.4%), negative self-monitoring behaviors (52.7%), and low self-efficacy (56.0%), while attitudes toward fetal movement self-observation were slightly more favorable (53.7%). Statistical analysis indicated significant differences in knowledge, attitudes, and behaviors related to fetal movement self-observation (p < .05), whereas self-efficacy was not statistically significant (p > .05). Thematic analysis identified four themes: (1) Bonding since in the womb; (2) Emotional responses; (3) Actions when sensing abnormalities; and (4) Culture and beliefs.Conclusion: The findings suggest that mothers and fetuses form a strong emotional bond from the womb, as reflected in maternal experiences and behaviors. There is a need for nursing interventions in fetal monitoring, particularly to improve pregnant women’s knowledge, attitudes, behaviors, and self-efficacy. Furthermore, this study strengthens the evidence base for maternity nursing practice, enabling nurses and midwives to design targeted educational and monitoring interventions that promote pregnant women’s autonomy in observing fetal health and responding appropriately to early warning signs.
Background: Creativity and innovation are essential competencies in nursing education, as they support problem-solving, critical thinking, and adaptability in dynamic healthcare environments. However, limited evidence exists on factors associated with creativity and innovation among undergraduate nursing students.Purpose: This study aimed to examine the association between selected sociodemographic and academic characteristics (age, gender, cumulative grade point average [CGPA], year of study, and exposure to creativity- and innovation-related courses) and creativity and innovation among undergraduate nursing students.Methods: This cross-sectional study was conducted among undergraduate nursing students at a public university in Malaysia. Using total sampling, 167 students were included. Data were collected using a structured questionnaire. Descriptive statistics were used to summarise the variables. Pearson correlation, independent t-test, and one-way ANOVA were performed to examine associations, with significance set at p < 0.05.Results: A total of 167 undergraduate nursing students were included. The mean total creativity and innovation score was 27.56 (SD = 0.79). Male students and those who had attended creativity- and innovation-related courses had significantly higher scores (p = 0.007 and p < 0.001, respectively). Creativity and innovation scores were positively correlated with CGPA (r = 0.188, p = 0.015) and negatively correlated with age (r = -0.162, p = 0.036), with no significant difference by year of study (p = 0.872).Conclusion: Creativity and innovation among undergraduate nursing students were significantly associated with gender, attendance in creativity- and innovation-related courses, CGPA, and age, but not with year of study. These findings suggest that both academic performance and educational exposure may play a role in shaping creativity and innovation competency, underscoring the importance of supportive learning experiences in nursing education.
Background: Patient safety is a fundamental aspect of healthcare in hospital settings; however, implementing it remains challenging in nursing practice due to factors such as inadequate staffing, heavy workloads, poor communication, and limited resources. While previous studies have primarily focused on these structural and organizational barriers, there is limited understanding of nurses’ experiences in implementing patient safety programs, particularly in inpatient settings.Purpose: This study aimed to explore nurses’ experiences in implementing patient safety programs in hospital inpatient settings.Methods: A descriptive qualitative study was conducted among 22 ward nurses selected using purposive sampling. The inclusion criteria were nurses with at least one year of work experience and a minimum of a bachelor’s degree in nursing or equivalent professional nursing qualifications. Data were collected through focus group discussions (FGDs) and analyzed using thematic analysis.Results: Four main themes were identified: (1) understanding patient safety principles, (2) barriers to patient safety implementation, (3) leadership and organizational support for patient safety, and (4) technology as a facilitator of patient safety. Although nurses demonstrated an understanding of patient safety principles, they continued to encounter barriers, including variations in peer awareness of safety standards, workload constraints, and a blame culture. Furthermore, nurses reported anxiety and demotivation when reporting errors, highlighting the need for stronger leadership and organizational support. Finally, participants emphasized technology’s role as a key facilitator in achieving patient safety goals.Conclusion: Nurses’ commitment, patient safety–related workplace culture, and the availability of innovative technology remain critical factors influencing the implementation of patient safety programs. Communication barriers, limited managerial support, and challenges in sustaining patient safety practices persist. Therefore, hospital leadership should strengthen systems and policies, improve resource planning, enhance support and supervision, and provide continuous training to improve patient safety programs.
Background: Effective diabetes management requires sustained commitment and heightened awareness. Individuals with diabetes often face multiple obstacles that affect daily functioning and long-term health outcomes. However, evidence describing specific obstacles among people with diabetes in Indonesia, particularly in Central Java, remains limited.Purpose: This study aimed to examine the prevalence and domains of perceived diabetes-related obstacles among adults living with diabetes and to assess their associations with sociodemographic characteristics.Methods: A cross-sectional study was conducted among individuals with diabetes attending public health centres in Semarang, Central Java, Indonesia. Participants were consecutively recruited if they were aged ≥18 years, had a confirmed diagnosis of diabetes, and had no known cognitive impairment. Individuals who were acutely ill were excluded. Data were collected using the 57-item Bahasa Indonesia version of the Diabetic Obstacle Questionnaire (DOQ), which covers eight domains of diabetes-related challenges. Independent t-tests and multiple linear regression were used to examine associations between obstacle scores and selected sociodemographic characteristics.Results: A total of 237 participants were included (mean age = 61.96 years), the majority of whom were female, with a mean diabetes duration of 8.16 ± 7.39 years. The highest perceived obstacles were observed in the diagnosis domain (−21.36 ± 33.39). Bivariate analysis showed that education level (p = .002) and diabetes duration (p = .045) were significantly associated with obstacles related to knowledge and beliefs, while random blood glucose level was associated with obstacles related to advice and support (p = .029). Multivariable analysis further identified education level, employment status, diabetes duration, and glycaemic control as significant predictors across selected domains.Conclusion: Although perceived barriers to diabetes management were generally low, challenges persist in the domains of diagnosis, knowledge, and support. These findings highlight the influence of sociodemographic and clinical factors, as well as sociocultural context, in shaping diabetes-related obstacles. Culturally responsive, person-centred interventions are needed to improve self-management and health outcomes.
Background: Nurses fulfill a critical dual role as both caregivers and health promoters; however, their own health-promoting behaviors (HPBs) frequently receive inadequate attention. These behaviors significantly influence nurses’ personal well-being, professional credibility, and willingness to advocate for healthy lifestyles among patients. In Saudi Arabia, empirical evidence regarding HPB levels and their demographic and occupational predictors among clinical nurses remains scarce, hindering the design of targeted wellness interventions.Purpose: This study evaluated the levels of HPB among clinical nurses in Saudi Arabia and identified significant demographic and occupational predictors.Methods: A cross-sectional study was conducted among 233 clinical nurses from 16 public hospitals using convenience sampling. Data were collected through an online, self-administered questionnaire that incorporated the Health-Promoting Lifestyle Profile II (HPLP-II) and items assessing perceived health status and sociodemographic characteristics. Data normality was assessed using Kolmogorov-Smirnov and Shapiro-Wilk tests. In addition to bivariate analyses (t-tests and ANOVA), multiple linear regression was performed to identify independent predictors while controlling for confounders.Results: The overall mean HPLP-II score was 2.46 ± 0.46, reflecting a moderate level of engagement in HPBs. Spiritual growth and interpersonal relations were the highest-scoring domains, whereas physical activity was the lowest. The regression model explained 24% of the variance (R² = 0.24). Multivariable analysis identified perceived health status (p < 0.001) and supervisory job titles (p = 0.046) as the only significant independent predictors of higher HPB scores. No other demographic or occupational characteristics were significant.Conclusion: Clinical nurses demonstrated a moderate level of HPBs, primarily driven by their perceived health status and occupational role. Strengthening nurses’ health perceptions through structured wellness initiatives, supported by nursing leadership, may enhance behavioral engagement and reinforce their effectiveness as health advocates.
Background: Critical care nurses play a central role in pain management; however, persistent knowledge and competency gaps continue to affect patient outcomes globally, including in Saudi Arabia. Despite the growing adoption of e-learning in nursing education, no context-specific, expert-validated module exists for critical care pain management in this context.Purpose: This study aimed to develop and content-validate a context-specific e-learning module on pain management to enhance critical-care nurses’ competency in a regional health cluster in Saudi Arabia.Methods: A three-round modified Delphi technique was employed. An initial needs assessment was conducted through a literature review and expert focus group input. It was then refined over three rounds with a panel of five multidisciplinary critical care specialists with 7 to 23 years of experience. Experts rated content relevance on a four-point scale. Content validity was assessed using the Content Validity Ratio (CVR) and the Content Validity Index (CVI), with retention thresholds set at CVR ≥ 0.99 and I-CVI ≥ 0.80.Results: The Delphi process achieved 100% of retention across all rounds. Of the 25 initial content items, 24 met the CVR and I-CVI cutoffs (CVR = 1.00, I-CVI = 1.00) and were retained. One item, “Non-pharmacological interventions” (CVR = 0.60), was excluded. The final curriculum comprised six modules totaling 2.5 hours, covering pain basics and assessment; clinical aspects of pain; pharmacological management; interdisciplinary practice; case-based application; and assessment of knowledge and skills. New items suggested by the experts and included in the final curriculum were risk stratification, complication monitoring, and documentation protocols. The final scale-level CVI was 1.00.Conclusion: This Delphi study produced an expert- and content-validated e-learning module on critical care pain management. Although strong content validity was established, the small panel size and single-region representation limit generalizability. Following pilot testing and outcome evaluation, this e-module could be used as an effective educational intervention to improve knowledge and potentially clinical practice related to pain management.
Background: Working mothers are often considered at risk for suboptimal exclusive breastfeeding (EBF) due to employment-related constraints. Early initiation of breastfeeding (EIBF) is widely recognized as a critical first step in optimal infant feeding; however, its specific contribution to sustained EBF among working mothers remains insufficiently quantified at the national level.Purpose: This study examined the role of EIBF in achieving EBF among working mothers in Indonesia.Methods: This secondary analysis used data from the 2022 Indonesian National Nutritional Status Survey, including 46,130 children aged 0−23 months born to working mothers. Exclusive breastfeeding was the outcome, with early initiation of breastfeeding as the main exposure. Seven covariates were examined: residence, maternal age, marital status, education, household wealth, antenatal care utilization, and child gender. Adjusted associations were estimated using binary logistic regression.Results: The prevalence of EBF among working mothers was 40.4%, while 59.7% practiced EIBF. Working mothers who initiated breastfeeding within the first hour after birth were significantly more likely to achieve EBF than those who did not (AOR = 1.715; 95% CI: 1.706−1.724). All covariates showed significant associations with EBF.Conclusion: EIBF emerged as the strongest determinant of EBF among working mothers in Indonesia, even after controlling for socioeconomic and health service factors. These findings provide robust national evidence supporting the integration of EIBF as a core strategy within maternal health services and workplace breastfeeding policies. However, maternal socioeconomic characteristics, health service utilization, and contextual factors also shape EBF practices, indicating the need for comprehensive multi-level strategies.
Background: Nursing students’ clinical readiness is important for a smooth transition into practical settings; however, evidence on the level of readiness and the factors that influence it remains limited. Existing studies often provide only a partial understanding of preparedness, particularly regarding demographic and psychosocial characteristics.Purpose: This study aimed to assess the level of work readiness among fourth-year nursing students and to examine its association with selected demographic and psychosocial variables.Methods: A descriptive cross-sectional study was conducted across five purposively selected colleges of nursing in Iraq. The sample consisted of 550 final-year nursing students. Data were collected using a sociodemographic questionnaire and an 18-item work readiness scale. Descriptive and inferential statistics (chi-square tests) were used for data analysis.Results: Among the 550 nursing students, 62.7% were female, 94.5% were unmarried, and 48.2% perceived their socioeconomic status as middle. Work readiness was moderate in 57.3% of students, with a mean score of 52.43 (SD = 3.999). Significant associations were found between readiness and gender (p = .001), socioeconomic status (p = .001), educational level prior to college (p = .001), support system (p = .001), and interest in nursing (p = .001).Conclusion: The study found that students are moderately to well prepared for their nursing careers. They demonstrate the ability to think critically and provide care in clinical contexts, as reflected in their problem-solving skills. These findings highlight the need for targeted educational and psychosocial support strategies to further enhance students’ readiness for professional practice.
Background: Paradoxical leadership, characterized by balancing competing yet interrelated managerial demands, such as maintaining managerial control while simultaneously allowing nurses’ professional autonomy, has emerged as a promising leadership approach in complex healthcare environments. However, empirical evidence regarding how paradoxical leadership relates to positive psychological outcomes, such as psychological empowerment and workplace thriving, remains limited in nursing research, particularly within Middle Eastern healthcare contexts.Purpose: This study examined the association between paradoxical leadership and workplace thriving among nurses and explored the potential mediating role of psychological empowerment. Methods: A cross-sectional correlational study was conducted using a convenience sample of 231 nursing staff from three tertiary hospitals. Data were collected through a web-based survey that included the Paradoxical Leadership Behavior Scale, Psychological Empowerment Scale, and Thriving at Work Scale, along with demographic information. Structural equation modeling using the partial least squares approach was applied to examine the hypothesized relationships.Results: Nurses reported moderate levels of paradoxical leadership (M = 3.12, SD = 0.44), psychological empowerment (M = 4.37, SD = 0.69), and workplace thriving (M = 3.45, SD = 0.45). Paradoxical leadership was positively associated with psychological empowerment (β = 0.720, p < .001) and workplace thriving (β = 0.553, p < .001). Psychological empowerment was also positively associated with workplace thriving (β = 0.336, p < .001). Mediation analysis indicated a significant indirect association between paradoxical leadership and workplace thriving through psychological empowerment (β = 0.241, p < .001), suggesting a partial mediation pattern consistent with the proposed model.Conclusion: Paradoxical leadership was positively associated with nurses’ workplace thriving both directly and indirectly through psychological empowerment. These findings highlight the potential relevance of leadership practices that balance competing managerial demands in supporting nurses’ positive work experiences. Leadership development initiatives that foster empowering leadership behaviors may help strengthen nurses’ engagement and thriving within healthcare organizations.
Background: Maternal adherence to complementary feeding guidelines is crucial in preventing childhood malnutrition, yet adherence remains low. Although previous studies have identified several influencing factors, evidence from Indonesia is limited and lacks a theory-based explanation of how cognitive and behavioral determinants influence maternal feeding practices.Purpose: This study applies the Integrated Change Model (I-Change Model) to examine the determinants of maternal adherence to complementary feeding guidelines.Methods: A cross-sectional design was used, involving 579 mothers of children aged 6–23 months, selected through cluster-stratified random sampling. Maternal adherence to complementary feeding guidelines was assessed using the Infant and Young Child Feeding (IYCF) indicators, while a self-developed questionnaire, along with several modified questionnaires, was used to evaluate associated factors. Multiple logistic regression analysis was applied to identify the determinants of maternal adherence to these guidelines.Results: Only 40.1% of mothers adhered to complementary feeding guidelines. Maternal adherence was significantly associated with higher education (AOR = 1.984; 95% CI: 1.053–3.739), positive attitudes (AOR = 5.752; 95% CI: 1.283–25.794), high self-efficacy in providing complementary feeding (AOR = 2.695; 95% CI: 1.426–5.091), and non-provision of formula milk (AOR = 0.568; 95% CI: 0.395–0.806).Conclusion: Maternal education, attitudes, self-efficacy, and non-provision of formula milk were identified as key determinants of adherence. These findings highlight the need for interventions focusing on enhancing maternal education, promoting positive attitudes, and improving self-efficacy. Future research should examine social support and sociocultural or economic factors through longitudinal studies to better understand their impact on adherence behaviors.
Background: Postoperative recovery following major surgery in neurosurgery, orthopedic surgery, and abdominal surgery significantly impacts the quality of life of both patients and caregivers. In Thailand, although various strategies including referral systems, postoperative care plans, home follow-up, and patient and caregiver education have been developed to support recovery and ensure continuity of care from hospital to home, challenges remain, particularly in community health service models, access to care, and the provision of welfare and benefits.Purpose: This research aimed to explore the continuity of care for postoperative patients in hospitals and community healthcare services in Thailand.Methods: This qualitative study using an ethnographic approach involved 86 informants, including 57 key informants consisting of postoperative patients (n = 7), caregivers (n = 8), healthcare providers (n = 35), and executives of relevant agencies (n = 7), and 29 general informants who contributed additional perspectives. Data were collected from April 2023 to March 2024 in southern Thailand. Participants were recruited using non-probability sampling methods, including purposive sampling followed by snowball sampling. Qualitative data were collected using participant observation, in-depth interviews, focus group discussions, field notes, and document analysis. Data were validated through triangulation and analyzed using Creswell’s thematic analysis approach.Results: Continuity of care for postoperative patients was organized into three themes: (1) organization of healthcare services, describing coordinated hospital and community systems that support rehabilitation, referral processes, discharge planning, home visits, long-term care, and emergency support; (2) support for postoperative patients, highlighting integrated mechanisms such as capacity building for patients and caregivers, shared information systems, and welfare, social, and financial assistance after discharge; and (3) management and coordination, which enabled community-based postoperative care through integrated data systems and shared governance arrangements.Conclusion: Continuity of postoperative care in Thailand is facilitated by the integration of hospital and community services, caregiver support, and coordinated management systems. Nurses play a central role in ensuring follow-up, information sharing, and patient support across care settings. Strengthening organizational integration, support mechanisms, and coordination processes can enhance continuity of care and address gaps identified in current postoperative services.
Background: Individuals affected by family violence (FV) face a range of physical, social, and psychological effects, disrupted family relationships, and mental health issues. In Nigeria, FV incidents are often kept silent due to cultural norms and social stigma, which prevent survivors from accessing essential care and support. Despite the significant impact of this problem, research on context-specific healthcare and support pathways remains limited; therefore, this study addresses this gap.Purpose: The study explored a nurse-led community-based approach to preventing and mitigating the impact of FV.Methods: The study employed an exploratory qualitative case study design using an intervention development model. Conducted in Ondo State, data were collected through semi-structured interviews (n = 18) and focus group discussions (n = 92) across three senatorial districts and were analysed using content and thematic analysis.Results: The analysis led to the development of a three-component FV intervention consisting of (1) a training manual for nurses, (2) a clinical intervention pathway, and (3) management guidelines for nurses to identify and care for survivors.Conclusion: The intervention offers a culturally appropriate and context-specific framework to strengthen nurses’ capacity in addressing FV in Nigeria and may serve as a model for integrating FV management into primary healthcare practice.
Background: Depersonalization, characterized by emotional detachment and reduced compassion, is a key dimension of burnout that threatens the well-being of nurses and patient care, especially in oncology settings where exposure to suffering is frequent. Empathy typically protects against depersonalization; however, its effect may weaken in emotionally demanding environments. Emotional preparedness, or the psychological readiness of nurses to face distressing situations, may help sustain empathy and prevent depersonalization.Purpose: This study examined whether emotional preparedness mediates the relationship between empathy and depersonalization among oncology nurses in Indonesia.Methods: A cross-sectional survey using convenience sampling was conducted with 116 oncology nurses at Dharmais National Cancer Hospital in Jakarta. Empathy, emotional preparedness, and depersonalization were measured using the Jefferson Scale of Empathy (JSE), the Expanded Nursing Stress Scale (ENSS), and the Maslach Burnout Inventory (MBI). Data were analyzed using Pearson correlation, multiple linear regression, and mediation analysis with Hayes’ PROCESS Macro (Model 4).Results: Emotional preparedness and empathy were both negatively correlated with depersonalization (r = −0.28, p < .01; r = −0.54, p < .01, respectively). Empathy significantly predicted depersonalization (β = −0.21, SE = 0.02, p < .001), and mediation testing demonstrated that emotional preparedness fully mediated this relationship (β = −0.08, SE = 0.06, 95% CI [−0.14, −0.02]).Conclusion: Emotional preparedness fully mediates the association between empathy and depersonalization among oncology nurses. Strengthening emotional preparedness through structured training and psychosocial support may help preserve empathy, reduce depersonalization, and enhance both nurse well-being and the quality of patient care.
Background: The quality of nursing care for dying patients is influenced by nurses’ understanding of the signs of dying, which in Balinese Hinduism are contextualized through the concept of Pacang Seda; a near-death phase metaphorically described as emphasizing the attainment of a peaceful final moment. Empirical accounts of nurses’ experiences in caring for Pacang Seda patients remain limited, highlighting the need for more comprehensive and culturally informed insights.Purpose: To explore the experiences of Hindu nurses in providing end-of-life care for Pacang Seda patients using a descriptive phenomenological approach.Methods: The study utilized a qualitative research design with a descriptive phenomenological approach. Purposeful sampling was conducted by interviewing Hindu nurses (n = 10) with specific experience caring for Pacang Seda patients. The interviews took place in their homes without any third party present to avoid bias. Data analysis followed the steps outlined in the Colaizzi method, and data validation was conducted through follow-up discussions.Results: The analysis revealed four main themes derived from the experiences of Hindu nurses: (a) emotional responses, (b) the relationship between medical treatment and Pacang Seda, (c) strengthening families, and (d) the integration of spiritual aspects into nursing practice. Nurses displayed emotional responses and facilitated connections between medical treatment and Pacang Seda. They actively contributed to providing information to strengthen patients’ families and engaged in Pacang Seda care to facilitate a peaceful journey toward death.Conclusion: The study’s outcomes provide valuable insights into the experiences of Hindu nurses delivering end-of-life care in Bali. The identified themes underscore the significance of emotional responses, the interconnection between medical treatment and Pacang Seda, the pivotal role of nurses in supporting families, and the specific practices associated with Pacang Seda care. These findings contribute to a broader understanding of cultural influences on nursing care, emphasizing the need for tailored approaches in end-of-life care.
