AIMS:Newly graduated paediatric surgery nurses must be able to identify and handle potential risks to ensure patient safety. It is necessary to reinforce their understanding of their roles and responsibilities to achieve this goal. However, the limitations of traditional classroom-based teaching hinder the exploration of learners' potential. This study aimed to evaluate the effectiveness of the Jeffries simulation framework in improving the core competence of new graduate nurses in paediatric surgery. DESIGN:A quasi-experimental study, descriptive design following STROBE checklist. METHODS:A quasi-experimental methodology with a pretest/posttest design was used. The study involved 60 new graduate paediatric nurses who work in the paediatric surgery department of a level A tertiary hospital in Southwest China. Clinical scenario simulation cases, which were designed based on the Jeffries simulation framework, were used to improve clinical competence. Before and after the training, teachers assessed each nurse's core competency and clinical decision-making ability by the Chinese Registered Nurse Core Competency Scale (CIRN) and the Clinical Decision-Making in Nursing Scale (CDMNS). In addition, participants provided self-reported reflective feedback during the debriefing sessions following each simulation scenario. RESULTS:Across all 60 newly graduated paediatric surgical nurses, significant improvements in clinical competence were observed following the simulation-based training (p < 0.001). The total score of core competence increased significantly from 118.48 ± 8.84 pre-training to 142.56 ± 6.11 post-training, with a mean difference of 24.08 ± 9.51 points. Similarly, the total score of clinical decision-making ability showed a marked improvement, rising from 83.92 ± 2.43 to 91.15 ± 3.24, representing a mean increase of 7.23 ± 4.17 points. Moreover, the dimensions of 'clinical nursing', 'critical thinking/scientific' and 'clear goals and values' also showed significant improvements. CONCLUSION:Training new graduate paediatric nurses via the Jeffries simulation framework can enhance their clinical competence by helping them internalize knowledge and skills and improve their core competencies and clinical decision-making abilities. PATIENT OR PUBLIC CONTRIBUTION:The study analysed the core competency levels of newly graduated paediatric surgery nurses, providing a valuable reference for the management, training and evaluation of these nurses as well as establishing qualification criteria for paediatric specialist nurses. Identifying the factors that influence core competitiveness is crucial for developing standardized training programmes and enhancing the construction of nursing safety and paediatric nursing talent. TRIAL REGISTRATION:Clinical Trial Registry registration number: ChiCTR2400082003.
OBJECTIVE:To explore patients' experiences and perceptions of using digital health technologies, and their ethical evaluations regarding the processing of personal health data in healthcare digital environments. METHODS:An interpretive phenomenological qualitative study reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. Thirteen outpatients admitted to units at a university hospital were involved through purposive sampling. Face-to-face interviews were conducted using a semi-structured guide. Data were analysed using a thematic analysis approach. RESULTS:Patients' experiences with digital technologies are multidimensional, with convenience and limitations coexisting. Privacy protection, autonomy over health data, trust in the system and healthcare professionals, data security, and procedural fairness are experienced as compromised. These ethical breaches were associated with patients' perceptions of negative emotional responses and power loss. Participants described themselves as passive users of the systems, particularly due to a lack of transparency in data access and limited opportunities to correct, delete, or restrict the sharing of their data. Strengthening informed consent processes and digital literacy initiatives that enable patients to make informed use of digital systems are fundamental components of ethical protection. CONCLUSIONS:While digital health technologies offer functional conveniences for patients, they present significant ethical vulnerabilities. Privacy violations, weakening of data autonomy, and erosion of trust fundamentally affect data security and the relationship patients have with digital health systems and the wider healthcare system. The rejection of being passive victims in these processes clearly reveals the need for patient-centred digital health governance that prioritises transparent, traceable, and accountable systems, along with data controllability. IMPLICATIONS FOR NURSING PRACTICE:This study shows that nurses are essential in promoting patients' ethical and informed use of digital health systems. Nurses should foster patients' digital health literacy, inform them of their rights related to personal health data and consent, identify and report ethical concerns in digital health systems, and encourage patients' active involvement in decisions about their health data. These practices help empower patient autonomy, build trust in digital health systems, and support the delivery of ethical digital health services. PATIENT OR PUBLIC CONTRIBUTION:Patients who utilised digital health systems participated in this study exclusively as research subjects. To enhance the credibility of the findings, member checking was conducted with two participants, and their feedback on the emerging themes was obtained. Neither patients nor members of the public were involved in the study's design, conduct, data analysis, interpretation of results, or dissemination planning.
AIMS:To capture nurse anaesthetists' opinions on the use of depth of anaesthesia assessment methods and describe when and how nurse anaesthetists find such technical devices useful in their clinical practice. DESIGN:Cross-sectional. METHODS:Exploratory web-based survey among (n = 79) nurse anaesthetists who were members of the Swedish National Association for Anaesthesia and Intensive Care. RESULTS:In total, 25 nurse anaesthetists estimated that they used anaesthesia depth monitoring in up to every fourth case, whereas 20 reported applying monitoring in up to every second patient. Situations in which nurse anaesthetists would use depth of anaesthesia monitoring were during total intravenous anaesthesia, and in previous instances of awareness. There was a divergence of opinion among the nurse anaesthetists regarding whether judgement of clinical signs was equivalent or superior to the use of anaesthesia depth monitoring. CONCLUSION:Based on the survey results, there are indications that knowledge regarding depth of anaesthesia assessment methods needs to be enhanced. IMPLICATIONS FOR THE PROFESSION:Anaesthesia depth monitoring is regarded as important in specific clinical situations, rather than as a routine component of all general anaesthesia. Variations in nurse anaesthetists' opinions on the value of clinical signs compared with technological monitoring indicate that these approaches may be best understood as complementary rather than mutually exclusive methods of assessing anaesthetic depth. Furthermore, the findings highlight the need for ongoing professional education and discussion regarding the appropriate indications, interpretation, and application of anaesthesia depth monitoring in nurse anaesthesia practice. IMPACT:The findings suggest that anaesthesia depth monitoring is not routinely used by responding nurse anaesthetists. The results further indicate that nurse anaesthetists' opinion and experiences toward this technology vary, highlighting the importance of considering these factors when developing structured guidelines for clinical practice. REPORTING METHOD:Strobe guidelines were followed. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.
AIM:To compare the effectiveness of simulation-based education (alone or in combination with patient-based clinical teaching) in undergraduate nursing students, when measured using objectively assessed outcomes. DESIGN:Systematic review with meta-analyses. REVIEW METHODS:Comparative studies in undergraduate nurses where outcomes of externally verified exams, proficiencies or competencies for both groups were included. Citation-checking, data-extraction and quality-assessment (using CASP checklists) were by two reviewers independently, and Revman (5.4) was used for meta-analysis, using standardised mean differences (SMD). DATA SOURCES:Ten databases (platforms) were searched from January 2000 to January 2024: MEDLINE (OVID), Embase (OVID), Maternity and Childcare (OVID), CINAHL (EBSCO), PsycINFO (EBSCO), Central (Cochrane Library), Scopus, Science Citation Index (Web of Science), ERIC (EBSCO) and Assia (ProQuest). RESULTS:Forty-two studies (5336 participants) were included: 19 randomised controlled trials, two randomised crossover trials, three cohort and 18 case-control studies. Twenty-eight studies compared simulation-based education to clinical teaching, 11 compared simulation-based education plus clinical teaching to clinical teaching only, and three compared more versus less simulation-based education in courses. Comparison 1: 21 studies (n = 2329 participants) could be meta-analysed, giving SMD = 0.96 (95% confidence intervals = 0.63-1.30). Comparison 2: 11 studies (n = 918 participants) gave SMD = 0.82 (95% confidence intervals = 0.49-1.15). All included studies reported as good or better results for simulation education. CONCLUSIONS:Simulation-based education, alone or in combination, may be as good as patient-based clinical teaching only to teach care skills to nursing students. Future simulation-based education versus patient-based clinical teaching evaluations should also measure clinical and patient-based outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:More simulation-based education of nursing students may result in fewer patients used for teaching. IMPACT:Increased simulation-based education may enhance undergraduate teaching, as more can be taught patient-based clinical skills in an educational setting without apparently reducing educational performance. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution as this is a systematic review. TRIAL REGISTRATION:PROSPERO (https://www.crd.york.ac.uk/prospero): CRD42022363205.
AIM:To assess digital fatigue and multidimensional cognitive load, and to examine their associated factors among nursing students engaged in online learning in Jordanian universities. DESIGN:A cross-sectional study. METHODS:An Internet-based questionnaire was distributed to undergraduate nursing students from governmental and private universities in Jordan between March and April 2025. Digital fatigue was measured using the Zoom Exhaustion and Fatigue scale, and cognitive load was measured using Leppink's Cognitive Load Scale. Associations were examined using bivariate tests, and a multiple linear regression analysis with bootstrapping was conducted to identify factors independently associated with extrinsic cognitive load. RESULTS:A total of 537 nursing students participated. Students reported relatively high levels of digital fatigue and cognitive load, with extrinsic cognitive load showing the pronounced ceiling effect. Digital fatigue was independently associated with extrinsic cognitive load after adjusting for demographic and academic characteristics. Academic year, type of university, and daily digital device use were also independently associated with extrinsic cognitive load, while age, sex, grade point average, device type, and Internet quality showed no significant associations. CONCLUSION:Digital fatigue was independently associated with extrinsic cognitive load among nursing students, highlighting the role of instructional design in shaping students' cognitive experiences. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Nurse educators should prioritise instructional strategies that reduce unnecessary cognitive demands in online learning environments, such as simplified navigation, reduced task-switching, and structured pacing, to support nursing students' cognitive wellbeing. IMPACT:Digital fatigue and cognitive load remain underexamined among nursing students in resource-limited settings. This study identifies extrinsic cognitive load as a modifiable, instructional-design-related factor, offering nurse educators a concrete target for improving online nursing education. REPORTING METHOD:This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.
AIM:To identify peer recovery coaches' activities from a care perspective to help determine the essential care elements for substance use disorders in Korea. DESIGN:Descriptive qualitative study. METHODS:Using purposive sampling, data were collected through one-on-one interviews conducted from November 2023 to May 2024. The transcripts were analysed using deductive content analysis, with the findings structured according to the middle-range theory of caring framework. RESULTS:Peer recovery coaches' program participation experiences were categorized as follows: 'being a helper with objective insight', 'being a companion to move forward together', 'being a navigator based on experience', 'being a facilitator of recovery who promotes growth', and 'being a caregiver with positive values and attitude'. CONCLUSION:Peer recovery coaches facilitate recovery and foster mutual growth within the caring process. For substance use disorder programmes to succeed, nurses must play a pivotal role in designing and implementing these interventions in collaboration with peer recovery coaches. IMPLICATIONS FOR NURSING PRACTICE:The findings lay a foundation for developing nurse-led interventions that integrate peer recovery coaches into substance use disorder programmes. Specifically, the study offers insights into how nursing professionals can support peer recovery coaches in maintaining personal recovery, accessing institutional support and enhancing their clinical competencies. IMPACT:This study examines the emerging role of peer recovery coaches within South Korean's substance use disorder recovery landscape through the lens of caring theory. The findings offer significant clinical insights for nursing-a field where patient-centred and team-based practice is essential-by demonstrating how the lived experiences of peer recovery coaches can integrate with nursing expertise to deliver highly personalized care. REPORTING METHOD:The COREQ guidelines were followed. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.
AIM:Premature infants require interventions supporting comfort in the NICU and development after discharge. Therefore, this study examined the effects of maternal affectionate touch and lullaby singing on early comfort and of a developmental support programme on subsequent development. DESIGN:This randomized controlled experimental study included 57 premature infants in a neonatal intensive care unit: 27 in the intervention group and 30 in the control group. METHODS:Mothers in the intervention group provided lullaby singing and affectionate touch three times weekly for at least six 10-min sessions. From 40 weeks' gestation, they implemented the developmental support programme, and infant development was assessed monthly for 3 months. The Premature Infant Comfort Scale and Developmental Support Programme Evaluation Form were used. RESULTS:Sex distribution was 8/19 girls/boys (29.6%/70.4%) in the intervention group and 16/14 (53.3%/46.7%) in the control group. Post-intervention PICS scores were significantly lower in the intervention group in weeks 1, 2, and 4 (p = 0.032, p < 0.001, and p = 0.047, respectively). At 1 month, social-emotional development (p = 0.028), receptive language (p = 0.005-0.009), productive language (p = 0.002), and cognitive skills (p = 0.004) were significantly higher in the intervention group. Receptive language at 2 months (p = 0.028) and cognitive development at 3 months (p = 0.033) also favoured the intervention group. In the BH-FDR sensitivity analysis, only the Week 2 post-intervention PICS difference (adjusted p = 0.012) and the first-month PLS-4 language finding (adjusted p = 0.040) remained statistically significant; the first-month RLS-3 finding was at the threshold of statistical significance (adjusted p = 0.050). RECOMMENDATIONS:Maternal lullaby singing, affectionate touch, and developmental support may support comfort and early developmental follow-up in premature infants; however, findings should be confirmed in larger studies with longer follow-up. PATIENT OR PUBLIC CONTRIBUTION:Mothers participated voluntarily and devoted sufficient time to each stage of the study. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT06191757.
AIM:This study aimed to determine whether midwifery students' awareness of global climate change is associated with their attitudes and behaviours toward medical waste management. DESIGN:This study employed a descriptive cross-sectional design. METHODS:The study was conducted during the 2025-2026 academic year at Atatürk University. The sample consisted of volunteer midwifery students enrolled across all academic years. Data were collected using a sociodemographic questionnaire, the Global Climate Change Awareness Scale and the Medical Waste Attitude and Behaviour Scale. Data were analysed using descriptive statistics, independent samples t-tests, one-way ANOVA with Bonferroni post hoc tests and Pearson correlation analysis. RESULTS:Participants demonstrated high levels of climate change awareness (74.60 ± 8.21) and generally positive attitudes toward medical waste management (96.91 ± 12.10). Fourth-year students had significantly higher awareness scores than students in lower academic years (p < 0.05). Students who perceived climate change as a professional responsibility and believed that it affected health had significantly higher climate change awareness scores. A moderate positive correlation was identified between climate change awareness and medical waste attitudes (r = 0.392, p < 0.001). IMPLICATIONS FOR NURSING PRACTICE:Nurse educators should integrate climate change, environmental sustainability and medical waste management into undergraduate nursing and midwifery curricula using evidence-based educational strategies. Strengthening students' environmental competencies may promote sustainable healthcare practices, improve waste management behaviours and prepare future healthcare professionals to address the environmental challenges associated with climate change. NO PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.
AIM:To explore nurse managers' perceptions of how leadership practices contribute to the work environment within selected healthcare facilities in Ghana. DESIGN:An exploratory descriptive qualitative design was employed to gain an in-depth understanding of nurse managers' leadership experiences. METHODS:Nineteen nurse managers with at least 2 years of managerial experience from three healthcare facilities in the Kumasi Metropolitan Area were purposively selected to participate in the study. Data were collected through semi-structured in-depth interviews and were analysed using thematic analysis. RESULTS:Findings revealed that nurse managers commonly adopted a mixed (situational) leadership approach, adapting their leadership behaviours to meet varying workplace demands. Other leadership styles, including transformational, transactional, democratic, and laissez-faire, were also reported. Effective communication, staff mentorship, and participatory decision-making and supportive supervision emerged as key leadership practices that fostered a healthy work environment. Participants also identified organisational support, adequate staffing, and professional development opportunities as important enablers of effective leadership. CONCLUSION:Nurse managers described flexible, context-responsive leadership practices involving supervision, communication, mentorship, participatory decision-making, motivation, and adaptation to organisational demands. Participants perceived these practices as relevant to the nursing work environment, while staffing constraints, workload, resource limitations, and organisational structures were described as contextual challenges. Because the study reflects nurse managers' perceptions, the findings do not establish causal effects on staff retention, job satisfaction, workforce performance, or patient outcomes. IMPLICATIONS FOR NURSING PRACTICE:Leadership education, structured mentorship, adequate staffing, and supportive organisational systems may be considered as potential areas for intervention and should be evaluated for feasibility and effectiveness in future implementation studies. NO PATIENT OR PUBLIC CONTRIBUTION:No patient or public involvement in this study.
AIM:To examine whether recovery experiences and need for recovery mediate the association between psychological capital and perceived stress in nurses. DESIGN:Cross-sectional online survey. METHODS:A total of 184 nurses currently practicing in France completed an anonymous online questionnaire administered in January 2023. Participants completed the French versions of the Psychological Capital Questionnaire, the Recovery Experience Scale, the Need for Recovery Scale, and the Perceived Stress Scale. Two mediation models were estimated using ordinary least squares regression with percentile bootstrap inference for the indirect effects. RESULTS:Psychological capital was positively associated with recovery experiences and negatively associated with need for recovery. Need for recovery was strongly and positively associated with perceived stress, while psychological capital showed no direct association with perceived stress. The indirect effect of psychological capital on perceived stress through need for recovery was statistically detectable, whereas a complementary indirect effect through recovery experiences was in the expected direction but did not meet the bootstrap criterion for statistical significance. CONCLUSION:In this cross-sectional sample, psychological capital was associated with lower perceived stress primarily through its association with reduced need for recovery rather than through a direct association with stress. Interventions intended to protect nurse well-being should therefore be conceived as combining individual resource-building with organizational architectures that enable effective recovery. IMPLICATION FOR NURSING PRACTICE:Psychological capital should be seen as one element in integrated interventions rather than a stand-alone solution to nursing stress. Brief recovery-focused interventions for nurses need to be combined with scheduling practices and organizational policies that protect rest and make recovery feasible, a configuration that appears more promising than psychological capital training alone. REPORTING METHOD:The study followed the STROBE Statement for the reporting of cross-sectional studies. NO PATIENT OR PUBLIC CONTRIBUTION:This study focused on nurses as study participants. No patient or public stakeholder was involved in the design, conduct, or interpretation of the research, since the research question concerns occupational psychological resources rather than clinical practice or care delivery.
AIMS:To examine the associations among illness perception, resignation coping, social support, and self-regulatory fatigue (SRF) in patients with Type 2 diabetes mellitus. The study specifically explores whether resignation coping and social support exhibit indirect associations with SRF in the context of illness perception. DESIGN:A cross-sectional study. METHODS:From November 2024 to October 2025, a convenience sample of 302 adult patients with T2DM was recruited from a tertiary general hospital in China. Participants completed validated instruments with established psychometric properties, namely the Brief Illness Perception Questionnaire, the Medical Coping Modes Questionnaire, the Perceived Social Support Scale, and the Self-Regulatory Fatigue Scale. Statistical analyses included Spearman correlation and serial mediation analysis using the PROCESS Macro (Model 6) with bias-corrected bootstrapping. RESULTS:SRF was positively correlated with negative illness perception (r = 0.579, p < 0.01) and resignation coping (r = 0.612, p < 0.01), and negatively correlated with social support (r = -0.598, p < 0.01). Serial mediation analysis revealed that illness perception was associated with SRF through indirect pathways involving resignation coping and social support. Resignation coping and social support mediated the association between illness perception and self-regulatory fatigue, both individually and sequentially. CONCLUSIONS:Negative illness perception correlates with higher SRF. This observed correlation is additionally linked to indirect pathways involving resignation coping and lower social support. Collectively, these findings highlight a pattern of interrelated cognitive (illness perception), behavioural (resignation coping), and resource (social support) factors that are associated with self-regulatory fatigue in this cross-sectional study. IMPLICATIONS FOR THE PROFESSION:The findings offer a clear, evidence-based framework for nursing practice. They highlight the potential value of integrated assessment and intervention that simultaneously addresses patients' illness beliefs, maladaptive coping strategies, and social support systems, which are associated with lower SRF and better diabetes self-management. REPORTING METHOD:This study adheres to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION:Patients participated solely as research participants by providing survey data. They were not involved in the study design, implementation, data analysis, interpretation, or manuscript preparation. All patients provided written informed consent prior to questionnaire completion.
AIM:This study aims to explore the experiences, strengths, challenges, and potential improvements for professionals in managing the complex needs of vulnerable migrants (VM) in an Italian rural reception centre. METHODS:A qualitative study using semi-structured interviews was conducted in April 2024. Data were analysed using the Automatic Analysis of Textual Data, based on Fraire's seven-step model for Exploratory Multidimensional Data Analysis. DATA SOURCES:Data were collected from 16 professionals working in a rural reception centre in southern Italy. Interviews were conducted and analysed using AATD in April 2024. FINDINGS:The analysis identified two main dimensions of professionals' roles: balancing systemic responsibilities with personal engagement and managing immediate needs versus long-term integration goals. Professionals face significant challenges, such as resource scarcity, bureaucratic inefficiencies, and emotional fatigue, which impact their well-being and the quality of care provided to migrants. Resilience, adaptability, and multidisciplinary collaboration were identified as key strengths. CONCLUSION:The study highlights the dual nature of professionals' work in reception centres, requiring them to balance operational tasks with emotional involvement in migrant care. Targeted interventions and systemic reforms are necessary to support professionals and enhance the quality of care for vulnerable migrants, particularly in resource-constrained rural settings. IMPLICATIONS FOR PRACTICE AND/OR PATIENT CARE:This study underscores the importance of providing targeted support to professionals working in reception centres, including training in intercultural competence, stress management, and coping strategies. Policies should address systemic challenges and provide resources to enhance healthcare delivery and social integration programs. REPORTING METHOD:This study adhered to the EQUATOR guidelines for reporting qualitative research (COREQ). The findings were reported in compliance with these guidelines, ensuring methodological rigour and transparency. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:This study highlights the critical need for targeted support and training for professionals working in reception centres, particularly in rural settings. To improve care for vulnerable migrants, professionals should receive training in intercultural competence, stress management, and coping strategies to better navigate the complex challenges they face. Furthermore, systemic changes are necessary to alleviate the pressures on reception centres, such as streamlining bureaucratic processes and enhancing healthcare infrastructure, particularly in rural areas where resources are limited. By addressing these needs, we can improve the well-being of both the professionals and the migrants they serve, fostering more effective support systems and better care outcomes. Additionally, fostering multidisciplinary collaboration and community engagement can contribute to more comprehensive and sustainable care models. PROTOCOL REGISTRATION:The Ethics Committee of the University of Rome Tor Vergata approved this study on 07/07/2021 (protocol registration number 160.21).
AIM:To investigate the symptom burden associated with MPNs and its impact on patients' psychophysical well-being and quality of life through a structured PROM-based nurse-led visit. DESIGN:Observational study. METHODS:We included MPN patients followed at the haematology outpatient clinic of a large university-affiliated hospital in Italy. Data were collected from September 2024 to March 2025 on 102 patients who underwent a structured PROM-based nurse-led visit supported by a dedicated symptom diary. RESULTS:Symptom burden was substantial (85% were symptomatic) across all disease subtypes, with fatigue emerging as the most prominent symptom, affecting 72% of patients and accompanied by marked psychological distress (42% and 44% with anxious and depressive symptoms, respectively). Overall health-related quality of life was predominantly moderate (mean score: 70.7 ± 21.3). Nearly all moderate-to-severe symptoms, including fatigue, inactivity, pain, itching, and abdominal discomfort, were strongly associated with impaired global health. 43% of patients need support in becoming more proactive in managing their disease, and satisfaction with the visit was very high (mean score 9.3 ± 1.3/10). CONCLUSION:The impact of MPNs was significant and multifaceted, affecting patients' physical, emotional, and social well-being. Structured PROM-based nurse-led visits play a key role in detecting patients' needs and supporting symptom management across all domains of well-being, fostering motivated engagement. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE:Integrating structured PROM-based nurse-led visits into routine haematology care may improve symptom monitoring, support patient engagement, and guide timely and tailored supportive interventions. IMPACT:Patients with MPNs experience a substantial physical and psychosocial symptom burden. Symptom clusters are associated with anxiety, depression, and reduced quality of life. Structured PROM-based nurse-led visits may facilitate the early identification of unmet supportive care needs. REPORTING METHOD:Guidelines for reporting observational studies (STROBE): PATIENT CONTRIBUTION: Patients actively participated during the nurse-led visit and in data collection.
AIM:The primary duties of emergency healthcare professionals (EHPs) are to provide emergency patient care to acutely ill and injured individuals. Due to the nature of their work, EHPs operate under constant stress, often requiring rapid decision-making, swift action, and the delivery of necessary medical care in life-or-death situations, sometimes under inadequately safe conditions. Therefore, the aim of this study is to determine the validity and reliability of the Emergency Healthcare Professional Stress Factors and Symptoms (SEHP:SFMS) Scale in Turkish for identifying stress factors and symptoms in emergency medical care professionals providing emergency patient care services. DESIGN:A methodological study design was used in this study. METHODS:The study was conducted with the participation of 211 EHPs from employees working in emergency care institutions affiliated with the Muğla Provincial Health Directorate between November 2023 and June 2024. Data were collected via a face-to-face survey. Data were analysed using Lawshe content validity ratio, Kaiser-Meyer-Olkin coefficient, Bartlett test, exploratory factor analysis, principal component analysis, Varimax factor rotation method, confirmatory factor analysis, Cronbach's α internal consistency coefficient, convergent validity, discriminant validity, test-retest, and Spearman correlation coefficient tests. RESULTS:The linguistic translation and cultural adaptation of the SEHP:SFMS showed strong performance. The scope validity index of the scale is 0.83. The item-total correlation values of the scale were found to be between 0.486 and 0.794, and the factor loadings were between 0.474 and 0.816. Confirmatory factor analysis fit indices: χ2 = 248.727; df = 101; n = 211; p = 0.000; χ2/df = 2.463; RMSEA = 0.083; CFI = 0.914, SRMR = 0.052, which was found to be compatible and acceptable with the proposed 3-factor model. The Cronbach's α reliability coefficient of the scale was 0.931, and the total variance was 61.97%. CONCLUSIONS:SEHP:SFMS is a valid and reliable tool to assess stress factors and symptoms of Turkish emergency healthcare professionals. Its use improves the quality of emergency care. PATIENT OR PUBLIC CONTRIBUTION:These study findings have been used to create a tool with Turkish validity and reliability that allows for the examination of stress factors among healthcare professionals working in emergency and critical services. Identifying and reducing stress factors among healthcare professionals is crucial for the delivery of quality healthcare services. It can also be used to develop targeted interventions and ongoing strategies to facilitate improved clinical supervision and mentoring. IMPLICATION FOR NURSING PRACTICE:Nurses in emergency departments, which are among the most stressful, dynamic, intense, life-saving, and critical environments in healthcare institutions, and where life-saving treatment is administered, are at high risk of experiencing psychological trauma. Trauma experienced in the work environment is a significant problem for nursing. The consequences of trauma negatively affect nurses and institutions. Studies show that post-traumatic stress, anxiety, depression, and burnout are commonly observed in emergency department nurses. In this sense, understanding the stress and stress factors experienced by nurses can guide future interventions. The results of this study are considered important in making visible the stress and stress factors experienced by nurses in the emergency department, and also in guiding managers and nurses working in this field in terms of preventive and protective measures.
AIM:This cross-sectional study examined the associations between short video exposure, nursing students' empathy, and attitudes toward end-of-life (EOL) care, and tested whether perceived impact is statistically consistent with an indirect pathway in these relationships. DESIGN:A descriptive cross-sectional study. METHODS:In total, 534 undergraduate nursing students were included. Data were collected using a self-designed questionnaire, including the Attitudes Toward Care of the Dying Scale and the Jefferson Scale of Empathy-Health Professions Student version for empathy assessment. Statistical analysis for correlation and mediation analysis (PROCESS macro) was performed. RESULTS:85.96% of students watch short videos for more than 30 min daily, with more than 60% of them viewing EOL-related content. Students with prior caregiving experience or formal palliative care education showed significantly higher empathy and more positive attitudes (p < 0.05). Exposure to medical and EOL-related short videos was positively correlated with perceived impact, empathy, and positive EOL attitudes, with effect sizes ranging from very weak to modest (r = 0.10 to 0.27). The data were consistent with an indirect pathway between short video exposure and empathy via perceived impact (indirect effect = 0.04; 95% bootstrap CI [0.01, 0.08]). However, for EOL attitudes, short video exposure showed a direct association rather than an indirect pathway via perceived impact (direct effect = 0.09, p < 0.01). CONCLUSION:In this cross-sectional study, short video exposure was modestly associated with nursing students' empathy, with data consistent with an indirect pathway via perceived impact; the observed associations explained only approximately 1% to 7% of the variance in the outcome variables. However, reshaping EOL attitudes may require more systematic education beyond brief video exposure. These findings are hypothesis-generating and await validation through longitudinal and experimental research using standardized video content. IMPLICATIONS FOR NURSING PRACTICE:Nursing educators should consider integrating curated short video content into palliative care curricula to enhance students' empathy and perceived impact of end-of-life education. However, brief video exposure alone may be insufficient to reshape deeper end-of-life attitudes, suggesting the need for comprehensive, multi-modal educational strategies.
AIMS:To summarise and synthesise extant research studies that identify risk factors for the development of postpartum weight retention in postpartum women. DESIGN:Integrative review. REVIEW METHODS:This review was guided by Whittemore and Knafl's methodology. Eleven databases were searched for relevant original studies from database creation to November 25, 2025. Two researchers independently screened articles against the predefined inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies using the Newcastle-Ottawa Scale. Descriptive summaries and graphical representations were produced for the findings. PROSPERO registration number: CRD42024530948. RESULTS:Of 2750 retrieved sources, 26 studies were included in this review. The existing measurement approach failed to assess postpartum weight retention precisely. Overall study quality was moderate (n = 16), with seven rated as high quality and three as low quality. Risk factors for postpartum weight retention were categorised into three themes, nine subthemes, and 21 risk factors according to the Andersen model, most of which are modifiable. CONCLUSION:The accuracy of postpartum weight retention measurement approaches needs to be examined to provide reliable data. The incidence of postpartum weight retention is unsatisfactory, especially for women in upper-middle-income countries. Designing a comprehensive and evidence-based health management strategy will support minimising risk factors of postpartum weight retention, and high-quality empirical studies could be conducted to refine the theoretical framework for postpartum weight retention. IMPLICATIONS FOR NURSING PRACTICE:This study suggests that nursing managers should strengthen education and training for nurses, midwives, and postpartum care providers regarding postpartum weight management and regularly assess their ability to evaluate postpartum weight and identify risk factors for postpartum weight retention. These findings may also serve as a reference for nursing researchers in developing risk assessment instruments for postpartum weight retention and optimising predictive models. REPORTING METHOD:This review was conducted by following the PRISMA 2020 guidelines for reporting systematic reviews. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution.
ABSTRACT Aim To synthesise ocular outcomes, assessment methods and associated factors among critically ill adults exposed to prone positioning ventilation. Design Systematic review with narrative synthesis. Review Methods Two reviewers independently completed study selection, data extraction and methodological appraisal. Findings were synthesised narratively because heterogeneity precluded meta‐analysis. Data Sources PubMed, Embase, CINAHL, Web of Science and the Cochrane Library were searched from inception to November 2025, with backward citation searching. Results Seven studies involving 722 critically ill adults were included. Reported findings included chemosis, exposure keratopathy, conjunctival abnormalities and increased intraocular pressure. Chemosis and exposure keratopathy were the most frequent ocular surface manifestations. Two studies evaluated physiological increases in intraocular pressure rather than clinical complications, and several mixed intensive care cohorts lacked prone‐position‐specific estimates. Reported associated factors included lagophthalmos, deeper sedation, higher positive end‐expiratory pressure, prolonged or repeated prone positioning and increased ocular secretions, although multivariable evidence was limited. Conclusion Critically ill adults exposed to prone positioning may develop ocular abnormalities, but heterogeneous designs, assessment methods, and outcome reporting prevent reliable estimation of incidence. Implications for the Profession and/or Patient Care Ocular risk assessment should be integrated before, during, and after prone positioning. Preventive eye care, repeated assessment, documentation, and timely ophthalmological referral may support early identification and reduce avoidable injury. Impact This review addresses fragmented evidence on ocular safety during prone positioning, identifies common ocular findings and highlights clinically relevant associated factors. The findings are relevant to critical care nurses and prone‐positioned adults. Reporting Method The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020 statement. No Patient or Public Contribution Patients and the public were not involved because this review analysed published studies. Trial and Protocol Registration International Prospective Register of Systematic Reviews, CRD420251268507.
ABSTRACT Background Over the past decade, few studies have explored workplace violence (WPV) in nursing education in the Kingdom of Saudi Arabia. Understanding nurse educators' experiences of WPV is critical to craft effective and efficient interventions. The study explores nurse educators' experiences with WPV across multiple nursing educational settings in Saudi Arabia. Methods Twenty‐five nurse educators were interviewed using a semi‐structured interview guide at various nursing schools (colleges and universities) in the Eastern Province of Saudi Arabia. The COREQ criteria were followed to report the qualitative findings of participants' narratives. Result Three themes were generated based on educators' experiences of WPV: (1) the workplace violence aggression; (2) the keys to successful adaptation; and (3) the recommendations for the future. A lack of awareness about the nature of WPV is the primary reason for its presence in academic settings. Awareness campaigns are needed to promote active engagement and sustainable actions to combat and prevent it in nursing education facilities in Saudi Arabia. Implications for the Profession and/or Patient Care The findings of this research would serve as a catalyst for nursing advocates, experts, and academic leaders to develop innovative approaches to eliminating or reducing WPV recurrence, such as strong preventive policies and responsive actions, confidential reporting, clear anti‐WPV protocols, simulation‐based training, leadership accountability, improved peer and mental health support, and ongoing monitoring systems. Patient or Public Contribution No patient or public contribution. Nurse educators participated as interviewees.
ABSTRACT Aims To evaluate sleep quality in patients receiving maintenance haemodialysis and to identify the association between lifestyle factors and sleep quality. Design A cross‐sectional study design was employed. Methods In this study, 286 haemodialysis patients from two hospitals were selected. Logistic regression analysis was used to identify the association between lifestyle factors and sleep quality. Results The mean Pittsburgh Sleep Quality Index was (7.89 ± 4.68). 73.4% of patients had poor sleep quality. In multivariate logistic analyses, age, maintenance haemodialysis duration, depression (psychological factor) and self‐management (as a behavioural lifestyle domain) were major factors associated with sleep quality. Patient or Public Contribution No patients or members of the public were involved in the design, conduct, interpretation, or dissemination of this study. Participants were involved solely as respondents in the data collection process. Implications for Nursing Practice This study found that depression and self‐management were the key factors associated with sleep quality in patients undergoing maintenance haemodialysis. Based on these findings, we recommend the following nursing practices: First, nurses should integrate brief sleep‐quality screening and depression screening into routine dialysis care to facilitate early identification of at‐risk patients. Second, nursing interventions should strengthen patients' self‐management skills, including dietary adherence, fluid restriction and medication compliance, as these may contribute to better sleep outcomes. Third, dialysis teams should adopt a holistic approach that addresses both psychological well‐being and behavioural self‐management, recognizing their combined influence on patients' sleep quality. Fourth, nurses should provide individualized lifestyle counselling tailored to each patient's dietary and fluid needs, recognizing that active participation in treatment plans may improve sleep quality.
