Introduction People living with chronic illness constitute a heterogeneous and often multimorbid population whose needs evolve over time and across care settings. Person-centered care is central to achieving meaningful outcomes, increasingly supported by digital health technologies, but their integration must be adaptive to different phases of illness trajectories, responsive to the person’s goals and capacities, supporting clinical workflows and relationships, and attentive to equity, safety, and sustainability. Purpose The purpose of this practice update is to explore how digital health solutions can be integrated across chronic illness trajectories to support person-centered nursing care within specialized healthcare services. Through the authors’ extensive clinical and empirical experience with chronic care and digital health, fictional cases representing the concepts of personal, illness, and care trajectories were developed using iterative refinement and discussion upon the finalization of the cases. Then, the cases are the core of the articles’ examination of how digital solutions shape contemporary care practices, coordination work, and relationships over time. The cases illustrate the potential of digital technologies to support person-centered nursing and the risks of disruption when technologies are poorly aligned with the person’s goals, capacities, and everyday contexts. This clarifies how nurses are significant in ensuring person-centeredness in the development and implementation of digital health technologies. Conclusion Digital health technologies can strengthen person-centered nursing care across chronic illness trajectories when they are grounded in person-centered ethics, support shared narratives and partnerships, and are embedded in coherent workflows and governance structures. The philosophy of person-centered care must be explicitly integrated into the design, implementation, and use of digital solutions. Nursing leadership can shape digital practices that sustain continuity, dignity, and meaningful care over time. A practical step is nursing’s stewardship of patient narratives and digital tools can enable documentation of a concise “what matters” note for handoffs, updated at transitions.
Introduction Corley’s model posits that individual and organizational factors, particularly organizational justice, play an important role in the development of moral distress and its consequences for nurses’ well-being. Objective Guided by this theoretical framework, this study aimed to examine whether organizational justice mediates the relationship between moral distress and emotional exhaustion among nurses. Methods A multicenter, cross-sectional survey was conducted among 521 nurses employed at three medical universities in Fars Province, southern Iran. Data were collected using validated instruments, including the Moral Distress Scale–Revised (MDS-R), the Emotional Exhaustion Questionnaire, and the Organizational Justice Questionnaire. Mediation analysis was conducted using Hayes’s PROCESS macro (Model 4) in SPSS, version 27. Results Moral distress was significantly and negatively associated with organizational justice (β = −0.74, p <0.001), whereas higher organizational justice was associated with lower emotional exhaustion (β = −0.63, p < 0.001). The total effect of moral distress on emotional exhaustion was significant (β=0.75, p <0.001), while the direct effect was substantially attenuated after organizational justice was included in the model (β = 0.28, p < 0.001). Organizational justice also showed a significant indirect effect in the association between moral distress and emotional exhaustion (β = 0.47, 95% CI: 0.42–0.51), with this indirect pathway accounting for 62.3% of the total effect and thereby supporting a partial mediating role of organizational justice. Conclusion The findings provide empirical support for the relevance of Corley’s model to the relationship between moral distress and emotional exhaustion. Although Corley conceptualized organizational factors as important antecedents and contextual determinants of moral distress and its consequences, the present findings further indicate that organizational justice may function as a mechanism linking moral distress with emotional exhaustion.
Introduction The implementation of routine infection prevention and control (IPAC) practices can protect both the health care workers and patients. Unfortunately, nursing students may not have the knowledge or the skills to implement IPAC practices effectively in hospital settings. IPAC education that utilize multiple modes of learning may be an effective way to provide knowledge and practice skills that can be used in the clinical setting. Therefore, this study evaluated changes in knowledge and practice intentions following a multi-modal educational session that included didactic education intermingled with hands-on practice, and video scenarios on IPAC knowledge, attitudes, and self-reported compliance. Methods This quasi-experimental study used a pre-test post-test design. Nursing students participated in an educational intervention in class at the University. The education intervention included didactic, kinesthetic, and videos depicting correct and incorrect IPAC practices. The WHO Hand Hygiene Knowledge Questionnaire, the Declarative Intention of Hand Hygiene Behavior, and the Knowledge and Attitudes Regarding Hand Hygiene and Environmental Cleaning/Disinfecting questionnaires, were completed before and after the educational intervention. Data was analysed using descriptive statistics. An effect size was calculated for the WHO Hand Hygiene Knowledge Questionnaire, and changes in knowledge were evaluated using a Wilcoxon Signed Rank Test. Results There was improvement in nursing students’ (n = 64) hand hygiene knowledge (pre median score = 20.0, post median score = 21.5, p < 0.01, medium effect size r = 0.41). There was also an improvement in intentions to complete hand hygiene and environmental cleaning and disinfection. Participants were able to identify correct and incorrect IPAC practices after watching the videos. Conclusion This study highlights the importance of multiple methods of providing IPAC education to improve knowledge. Continuous education and hands-on experience are essential to improve clinical knowledge.
Introduction Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can cause life-threatening symptoms that impede individuals’ ability to perform their daily activities. Identifying factors associated with functional status may help inform interventions to improve functional status among individuals with AECOPD. Objectives This study assessed the extent and patterns of functional status among individuals with AECOPD and identified its associated factors. Methods This cross-sectional study included 132 individuals aged 40 years or older with post-bronchodilator FEV1/FVC < 0.70 who experienced acute exacerbations within the past six months. The study was conducted at three tertiary hospitals in the central region of Thailand with high AECOPD caseload. Functional status was assessed using the Short-Form Pulmonary Functional Status Scale (PFSS-11 © ). Data were collected in outpatient departments during scheduled clinical appointments using questionnaires and medical chart reviews. Multiple linear regression was used to evaluate the associations. Findings are reported according to the STROBE checklist. Results Functional status during acute exacerbations was moderately impaired (Mean = 3.45, SD = 1.03). Physical and emotional functioning were also moderately impaired (Mean 3.42, SD 1.03; Mean 3.54, SD 1.02, respectively). The multiple regression model was statistically significant (F= 68.682, p < .001) and explained 76.7% of the variance in functional status (R 2 = .767, Adjusted R 2 = .756). Symptom distress (β = −.380, p < .001), age (β = −.203, p < .001), social support (β = .189, p < .001), three or more episodes of exacerbation (β = −.179, p = .006), symptom management attempts (β = −.153, p = .025), and two episodes of exacerbation (β = −.150, p = .004) were significantly associated with functional status. Conclusion AECOPD moderately impaired functional status. Interventions properly addressing symptom distress, age, social support, symptom management attempts, and exacerbation frequency may help support functional status.
Introduction Heart failure is a chronic condition with increasing global prevalence and substantial impacts on patients, families, and health systems. Self-care is central to heart failure management. The purpose of this scoping review was to map reported psychoeducational interventions and information needs for self-care among adults with heart failure across the care continuum, using self-care as a conceptual lens. Methods A scoping review was conducted using ( Arksey & O’Malley, 2005 )’s framework and reported in accordance with PRISMA-ScR. Seven databases were searched on 15 September 2025: PubMed, Scopus, Web of Science, CINAHL, Embase, MEDLINE, and PsycInfo. Eligible studies included English-language intervention and non-intervention studies published between 2015 and 2025 that addressed psychoeducational interventions, information needs, literacy-related needs, or self-care support among adults with heart failure. Two reviewers independently screened studies, extracted data, and synthesized findings descriptively. Results From 6,392 records, 28 studies were included after duplicate removal, title and abstract screening, and full-text assessment. The most frequently reported intervention characteristics were nurse-led structured programs and multimodal delivery approaches. Telehealth or mHealth support, printed or audiovisual materials, teach-back, group-based education, coaching, motivational interviewing, and palliative or prognostic modules were also reported. Psychoeducational interventions were most frequently initiated during hospitalization, before discharge, or at discharge, with several studies continuing support through hospital-to-home booster contacts. Across studies, improvements were commonly reported in self-care, knowledge, and self-efficacy, whereas findings for readmission and quality of life were mixed. Conclusion The literature most commonly reports psychoeducation for adults with heart failure as structured, nurse-led, and multimodal, combining teach-back, printed or audiovisual materials, telehealth or mHealth support, and scheduled booster contacts. Reported initiation points cluster around hospitalization, pre-discharge preparation, and early post-discharge transition. These findings provide a descriptive map to inform future nursing-led, literacy-sensitive, family-inclusive, and transition-focused psychoeducational interventions.
