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Abstract Background Prostate cancer is a worldwide health issue, and current prostate cancer care extends to the patient‒caregiver dyadic setting, where individuals are interdependent and interact with each other as well as possible negative psychological and behavioural outcomes. However, the impact of dyadic care interventions on health outcome indicators for prostate cancer patients and their informal caregivers has yet to be examined. Aim To describe the characteristics of dyadic interventions involving patients with prostate cancer and their informal caregivers and investigate their effects on psychosocial health, sexual health, and dyadic relationships. Methods Ten electronic databases (Web of Science, Cochrane Library, PsycINFO, PubMed, Embase, CINAHL, CNKI, Wanfang, VIP, and SinoMed) were thoroughly searched for related publications published between the database’s founding and April 2024. The risk of bias for the included studies was evaluated using the Cochrane risk-of-bias tool, and a meta-analysis was performed using RevMan 5.4. Results This study identified and evaluated 19 RCTs reporting 22 different interventions, as well as outcome indicators for the three aspects of psychosocial health, sexual health, and dyadic relationships in prostate cancer patients and informal caregivers. A meta-analysis of pooled data revealed that for prostate cancer patients, the intervention improved dyadic coping (SMD95% CI [95% CI] = 0.22 [0.01;0.42], p = 0.04), and for informal caregivers the dyadic care intervention reduced anxiety (SMD95% CI [95% CI] = -0.35 [-0.65;-0.06], p = 0.02), enhanced self-efficacy (SMD [95% CI] = 0.22 [0.01;0.43], p = 0.04), and improved sexual functioning (SMD [95% CI] = 0.29 [0.05;0.54], p = 0.02). No statistically significant overall effects were observed for the other outcome indicators. Conclusion The results of this review indicate that dyadic care interventions benefit prostate cancer patients and informal caregivers. However, given features such as research quality and sample size, further randomized controlled trials with excellent study designs are needed in the future to evaluate and validate the efficacy of dyadic care treatments for patients with prostate cancer. Trial registration The protocol for this study is registered in PROSPERO with registration number (CRD42024567542).

Abstract Background Working as a pregnant clinical nurse might experience a range of challenges, such as significant anatomical and physiological changes as well as emotional and cognitive changes. That might be particularly obvious under the historical background of coronavirus disease-2019 (COVID-19) pandemic. However, a dearth of studies has explored the experiences of working as a pregnant nurse during this special period. This study aimed to explore the experiences of working as a clinical nurse while pregnant during the COVID-19 pandemic. Methods A descriptive qualitative design was selected. Purposive sampling, combined with maximum variation strategy and snowball sampling, were utilized to identify and select participants from tertiary-teaching hospitals, specialized hospitals, and community hospitals in Zhejiang Province, southeastern China. Online semi-structured individual interviews were used to collect data, and conventional content analysis was used to analyze the data. Results Eleven Chinese nurses with a mean age of 31.8 years, ranging from 26 to 40 years, participated in this study. Four themes and twelve subthemes emerged: (1) still adhering to work as a clinical nurse despite being pregnant during the pandemic; (2) working during pregnancy under pandemic is still an ordinary nurse; (3) still staying in the special life phase as a pregnant mother; and (4) growth and gains as pregnant mother. Conclusion The pregnant clinical nurses suffered from various changes and difficulties during the pandemic. Managers, occupational health and other health system leaders, and policymakers should be aware of the importance of establishing a work environment that guarantees safe continued pregnancy. Future studies should focus on the establishment of specific guidelines and manuals regarding how pregnant nurses worked, as well as the development of self-protection interventions during pregnancy. Moreover, research on moral stigma and bullying in nursing during pregnancy deserves further exploration. Clinical trial number Not applicable.

Abstract Background Registered nurses are the largest single professional group working in the field of cancer care and support one of the most vulnerable patient cohorts in the healthcare system. Cancer nurses are known to experience high rates of burnout, but there are significant limitations to current research on the unique stressors experienced by this group of nurses, particularly since the emergence of COVID-19. Methods This study employs the Job Demands Resource Model (JD-R model) to better understand the experiences of Victorian cancer nurses’ work and describe factors which ameliorate burnout and work-related stress. A multiple case study research design was used in this study, with two groups of cancer nurses making up a total of 30 participants, allocated to separate cases bounded by geographical location. A two-phase study of Victorian cancer nurses in metropolitan and regional healthcare services was conducted from 2019 to 2021. Data included field notes and in-depth interviews. Data analysis used a process of elaborative coding, with a pre-conceived coding framework based on the JD-R model. A combination of thematic analysis and storyline analysis was employed to analyse the data. Results A cross-case analysis of similarities and differences identified the job demands affecting cancer nurses, and conversely, any positive job resources which may buffer these demands. Job demands identified in both cases appeared to have similar causes but were more explicitly linked to poor resourcing in the regional case. Job resources identified in both cases were similar, but it was noted how few job resources were available to buffer the many demands inherent in cancer nurses’ work. This multiple case study found that the work of cancer nurses is high in demands and low in resources. Conclusions Despite challenging work conditions, findings identified a highly engaged workforce. The job resources identified in this study suggest there are modifiable strategies to cultivate a supportive work environment for cancer nurses.

Abstract Background The healthcare system is under increasing pressure to improve service quality and patient outcomes, with nurses playing a crucial role. They are responsible for about 80% of healthcare services in hospitals, and their proficiency directly influences care quality, patient satisfaction, and complication rates. The work environment also significantly impacts nurses’ ability to perform these competencies, highlighting the need for a comprehensive understanding of these factors in healthcare delivery. This study aims to assess the relationship between nursing process competency and the work environment among clinical nurses. Methods This study utilized a cross-sectional correlational design involving 321 clinical nurses from five teaching hospitals in Ardabil, Iran. Data were collected from April to June 2024 using the Competency of Nursing Process Questionnaire (CNPQ) and a work environment questionnaire. Data analysis was conducted using SPSS version 14, employing descriptive statistics and analytical methods, including Independent sample t-tests, ANOVA, and Pearson correlation, to examine relationships between variables. Results The findings revealed significant relationships between overall competency of nursing process and supportive work conditions, particularly fairness in evaluation (r = 0.388, p

Abstract Background Lower back pain (LBP) is the main cause of workplace impairment and a significant contributor to absenteeism. Implementing relaxation techniques in the workplace can be considered an investment because it can eventually lower the incidence of chronic LBP (chronic lower back pain). Aim The purpose of the current study was to evaluate the effect of relaxation techniques on the quality of working life, pain and disability level, with nurse-led interventions among occupational workers with chronic lower back pain (CLBP). Method A quasi-experimental design with a pre- and post-test method was used. Setting The study took place at a yarn and textile factory in Kafr El-Sheikh City, Kafr El-Sheikh Governorate, Egypt. Sample A purposive sample of 100 industrial workers with persistent LBP was chosen. The participants were matched and sorted into two equal groups: the study group and the control group. Instruments The study used a structured interview questionnaire, the Visual Analogue Scale (VAS), the Quality of Working Life Scale (QWL), and the Oswestry Disability Index. Results Participants’ average age was 41.4 ± 8.7 years in the study group and 40.5 ± 7.8 years in the control group. Following the relaxation technique intervention, the study group’s pain intensity, frequency, and duration were significantly lower than in the control group. Following the intervention, the study group’s overall quality of working life improved statistically significantly, with the mean score rising from 72% in the pretest to 93.3% in the post-test. The research group’s daily activities and the overall quality of working life improved dramatically when compared to the control group. Furthermore, after the intervention, the study group’s disability levels decreased significantly, with only 46% having a disability compared to 86% before the intervention. Conclusions The implementation of relaxation techniques greatly improved the quality of working life in the study group when compared to the control group. There was a notable and statistically significant difference in pain intensity between the study group and the controls. Following the intervention, industrial workers’ daily living activities improved, despite persistent LBP. Recommendation Health education and awareness programs should be conducted to improve the quality of life for industrial workers with LBP. Additionally, occupational health nurses’ roles in the early detection and referral of LBP patients in diverse industrial settings should be strengthened.

Abstract Background The COVID-19 pandemic has posed enormous challenges for healthcare systems worldwide. The strain on nursing staff working in special COVID-19 wards during the pandemic increased dramatically. To support nursing staff more effectively in similar situations in the future, it is important to identify specific stress factors to design effective support measures. Objective To collect the experiences and lessons learned from nursing staff who have been affected by COVID-19 pandemic on a special COVID-19 ward that were perceived as stressful. The findings should contribute to the development of specific support measures for healthcare professionals. Design Qualitative interview study. Setting We interviewed 14 members of nursing staff who worked on COVID-19 wards at two University Hospitals about their working experiences during the pandemic. Results We were able to identify 10 key stress factors. These included an increased workload, communication deficits, a difficult personnel situation, subjective pressure, the establishment of a new ward, a shortage of material resources, inadequate hygiene conditions, a lack of opportunities to cope with the situation, the absence of relatives and decision making. Conclusion The identification of various stress factors highlights the urgent need for comprehensive support measures. These measures could include concepts for dealing with physical and psychosocial stress, the provision of resources and sufficient personnel support. It remains crucial to proactively take preventive and supportive measures to reduce the burden and moral distress of nursing staff and protect their health in the long term. Despite the pandemic, the implications of our findings remain relevant for the future.

Abstract Background Spiritual leadership emphasizes that nurses encounter situations that require compassion, empathy, and a deep understanding of the human experience. Passion can drive nurses' motivation, engagement, and commitment to patient care. Altruism is a core value in nursing that involves selfless concern for the well-being of others. Spiritual leadership might be an essential organizational resource in enhancing followers’ inspiring vision, compassion for others, and passion for their work. Aim of the study To investigate the role of spiritual leadership in the relationship between altruism and passion for work among nurse colleagues. Subjects & method A multicenter descriptive, cross-sectional research study was conducted at six Nursing Egyptian faculties affiliated with Alexandria, Port-Said, Fayoum, Damanhur, Assiut, and Sohag Universities, with 391 nurse colleagues. Data collection tools Personal and Job-related Data Questionnaire, Spiritual Leadership Questionnaire (SLQ), Passion Scale, and 9- Self-Report Altruism Scale (9- SRA) were utilized to collect data. Results The current study verified that nurse colleagues had high levels of perceived spiritual leadership, passion, and altruism (50.9, 47.6, and 40.2, respectively). The results revealed noteworthy positive correlations between spiritual leadership, passion, and altruism (r = 0.644, 0.519, & 0.509). Furthermore, mediation analysis highlighted that spiritual leadership could mediate the effect of altruism on the passion level. Conclusion This study delivers valued insights into the crucial role of spiritual leadership in augmenting nurse colleagues’ altruistic tendencies and passion. Recommendations Cultivating workplace spirituality on a daily agenda is a key component of management that requires spiritual competencies from nurse leaders. These competencies ultimately enhance passion for work, performance, and altruistic behaviors.

Abstract Background Although previous studies have linked emotional intelligence to nurses’ job performance, research lacks how moral intelligence and occupational stress mediate this relationship. Addressing this gap is essential for improving nursing care outcomes. This study aims to determine the mediating effect of moral intelligence and occupational stress in this relationship among Iranian nurses. Methods This descriptive cross-sectional correlational study was conducted in Urmia Teaching Hospital from February to April 2022. Six hundred and twenty-one nurses were recruited using quota sampling. Data were collected using a demographic questionnaire, Lenik and Kiel’s Moral Intelligence Questionnaire (LK-MIQ), Siberia Schering’s Emotional Intelligence Questionnaire (SS-EISQ), Patterson’s Job Performance Questionnaire (P-JPQ), and the Nursing Stress Scale (NSS). Data were analyzed using IBM SPSS ver. 23 and Smart-PLS ver. 3.0. Results The effect of emotional intelligence on job performance was positive, direct, and weak (β = 0.099, t-value = 2.285, p = 0.023). Emotional intelligence had a negative, direct, and weak effect on moral intelligence (β = − 0.257, t-value = 4.754, p = 0.000) and a negative, direct, and moderate effect on occupational stress (β = − 0.316, t-value = 6.482, p = 0.000). Moral intelligence mediates the relationship between emotional intelligence and occupational stress (β = 0.0842, 95% CI: 0.0532, 0.1194). However, the mediating role of occupational stress between emotional intelligence and job performance was not supported (β = 0.003, 95% CI: − 0.0139, 0.0184). Conclusion Moral and emotional intelligence should be key criteria for selecting nursing staff and managers to create a safe, low-stress environment that boosts nurses’ job performance. Healthcare managers should promote nurses’ emotional intelligence by offering practical courses for enhancing nurses’ self-awareness, self-management, social awareness, and relationship management skills. It is essential to support moral intelligence by organizing educational classes that improve their integrity, responsibility, compassion, and forgiveness.

Abstract Background Nursing Faculty’s readiness to teach online has been recognized as a critical prerequisite for effective online teaching. Aim To examine the Nursing Faculty’s level of readiness to teach online among a sample of nursing educators from Saudi Arabia and the UK. Methods A convenient sample of 152 (46%) Nursing Faculty from five universities across Saudi Arabia and the UK completed Part 2 of The Faculty Readiness to Teach Online (FRTO)’ survey between February – June 2021. Mann-Whitney U and Kruskal-Wallis One-Way Analysis of Variance tests were used to examine the differences in the average median scores of the participants’ responses across selected independent variables. Results Nursing Faculty from Saudi Arabia universities have scored significantly higher Median score than their British counterparts on the Course Design subscale (z=-2.6, p = 0.01) and Time Management subscale (z=-4.403, p = 0.001), and Nursing Faculty who completed a training course before they can teach online have also scored significantly higher median score than those who didn’t on the same two subscales respectively (X 2 = 6.15, df = 2, p = 0.05), (X2 = 12, df = 2, p = 0.002). Female Nursing Faculty scored significantly higher median score than male Nursing Faculty on the Course Communication subscale (z=-2.73,p = 0.006). Moreover, Nursing Faculty who mostly used asynchronous online teaching significantly scored the highest median score on the technical subscale (X 2 = 8.64, df = 3, p = 0.03). The number of years of teaching online emerged as a key factor for defining the Nursing Faculty’s level of readiness to teach online. For example, those Nursing Faculty with 6 years and longer of online teaching experience have scored significantly higher median scores on in Course Communication (X 2 = 23.4, df = 4, p = 0.00), Time Management (X 2 = 13.2, df = 4, p = 0.01) and Technical (X 2 = 10.13, df = 4, p = 0.008) subscales compared with those with less than 6 year of online teaching experience. Nursing Faculty across Saudi and British universities who teach on MSc program have scored significantly higher median scores than those who teach on other programs on all four subscales. Conclusion The Nursing Faculty expressed a high level of competency in teaching online, with significant variations based on socio-demographic parameters. Future research needs to examine the factors that shape the Nursing Faculty’s readiness to teach online.

Abstract Background The nursing profession plays a vital role in the provision of healthcare services. The sustainable and high-quality development of nursing work is inseparable from the nurses' proactive voice behavior. However, in China, comprehensive nationwide survey data on nurse voice behavior remains limited. The present study utilized latent profile analysis to examine the potential profiles, current status, and determinants of nurses' voice behavior on a national scale, with the aim of formulating targeted intervention strategies to enhance nurses' capacity for constructive feedback. Methods This study employed a cross-sectional survey design and recruited nurses from medical institutions in China as research participants between November 2023 and January 2024. The survey encompassed three dimensions: individual, environment, and behavior. General demographic questionnaires and voice behavior questionnaires were administered via the questionnaire star platform to collect data for statistical analysis. Results A total of 3528 questionnaires from 552 s-class and three-class hospitals hospitals located in 22 provinces, 4 municipalities, 3 autonomous prefectures and 2 special administrative regions throughout China were collected in this study. By analyzing the potential profile of nurses' voice behavior, three potential categories were formed: low voice behavior group(C1, 21.1% of the total population), medium voice behavior group(C2, 60.9% of the total population), and high voice behavior group(C3, 18.0% of the total population). Factors including night shift work, workload intensity, monthly income, years of nursing experience, professional title, position, health status, personality traits, organizational justice perception, and self-efficacy were found to significantly influence nurses' expression of their opinions. Conclusion The voice behavior of nurses in China exhibits a moderate level. Heterogeneity was observed in the voice behavior of nurses, suggesting variations among individuals. The focus of nurse managers should be on nurses belonging to the C1 and C2 group, enabling them to implement early targeted prevention and care based on the distinctive characteristics and influencing factors associated with each latent profile.

Abstract Background The role of nurses in shared decision-making (SDM) within the healthcare decision-making process has increasingly gained attention The ability of nurses to engage in effective SDM can significantly impact patient outcomes and satisfaction with care. Given the palliative care continues to evolve, this study aimed to investigate the level of SDM competency and explore associated factors among palliative care nurses in China. Methods A cross-sectional study was conducted between June and July 2024. The convenience sample was recruited from five online Chinese palliative care nurse groups. Anonymous data were collected through a self-designed sociodemographic questionnaire, the Shared Decision-Making Competency Scale (SDMCS) and the Empathy Ability Scale (EAS). Multivariate linear regression was performed to explore the factors associated with SDM competency. Results A total of 429 palliative care nurses from 30 provinces or municipalities across China participated in this study. The Chinese palliative care nurses had a high level of SDM competency (mean total SDMCS 211.72 ± 25.75) and high empathic ability (EA), (mean total EAS 132.63 ± 20.30). There was a positive correlation between EA and SDM competency (r = 0.704, P

Abstract Background Sentinel events, involving serious injury or death, reveal critical vulnerabilities in clinical practices. Nurses play a key role in identifying errors and contributing factors in such events. However, evidence on the effectiveness of nurse-guided RCA in improving compliance and corrective actions is limited. Objective The aim of our research is to deeply explore the experiences, roles, challenges, and strategies of nurses in guiding RCA. By concentrating on nurses’ guidance, we can provide in-depth insights into their unique contributions in the RCA process. Methods Twelve participants from a tertiary hospital in southeastern mainland China were selected for the study. A constructivist qualitative research method was used to collect views and opinions from the participants' perspectives through semi-structured face-to-face interviews, and content analysis was applied, the data was further interpreted using thematic analysis. Results A total of 12 RCAdirectors were included in this study. Analyses revealed four main themes and 11 sub-themes. The main themes were: (1) success in a demanding field requires exceptional skills and abilities (having comprehensive knowledge, empowering capabilities, demonstrating interest and engagement), (2) building strong interpersonal relationships between guides and team leaders (selecting mature and experienced team leaders, building trust and cooperation with team leaders, exerting the guiding role of team leaders in projects), (3) tailored communication strategies in nursing for effective leadership and safety enhancement (navigating complex hierarchies through tailored communication, fostering collaboration through targeted communication strategies, empowering teams through clear and adapted communication) (4) investing effort and overcoming obstacles are key to successful nursing-guided project implementation (investing time and effort in project implementation, addressing obstacles during project advancement). Conclusion We provide new evidence on the critical role of the care coach in RCA programmes, highlighting the importance of competence, communication, trust and collaboration in enhancing team dynamics and improving quality of care and safety outcomes.

Abstract Background and aim Nurse staffing levels are associated with patient mortality, but little is known regarding the association between nurse turnover rate and patient mortality. This study investigated the combined effect of the bed-to-nurse ratio and the nurse turnover rate on in-hospital mortality in patients admitted to Korean acute care hospitals using national administrative data. Methods This study analyzed data from the National Health Insurance Service (NHIS) on 459,113 admitted patients and 111,342 employed nurses in 403 hospitals in South Korea from January to December 2016. Differences in in-hospital mortality and nurse turnover among hospital characteristics, including the bed-to-nurse ratio, were explored using the chi-square test. Multilevel, multivariate GEE logistic regression analyses were used to examine the combined effect of the bed-to-nurse ratio and the nurse turnover rate on in-hospital mortality. Results During the study period, 13,675 (3.0%) patients died during hospitalization, and 13,349 (12.0%) nurses left their jobs. The risk of death among patients admitted to hospitals with a bed-to-nurse ratio of

Abstract Background Nurse retention is critical for healthcare systems worldwide, as high turnover rates adversely affect patient care and organizational stability. Aim Examines the impact of transformational leadership, career growth opportunities, work well-being, and work-life balance on nurse retention. Methods A cross-sectional study was conducted with 297 nurses employed in inpatient wards at Mansoura University Hospital. The study measured variables using the Nursing Retention Index, Global Transformational Leadership Scale, Career Growth Scale, Work Well-Being Scale, and Work-Life Balance Scale. Results A linear regression analysis identified significant predictors of nurse retention. Work-life balance was found to be a strong predictor, with an unstandardized coefficient (B) of 0.255 (p

Abstract Background Workplace violence in healthcare has become a global concern, and nursing interns are not immune to it in clinical settings. It is critical to understand the impact of workplace violence on the psychological and work status of nursing interns. Methods Between April and May 2024, a total of 2213 nursing interns from 12 hospitals in China participated in the study. Data were collected with questionnaires on basic information, the Workplace Violence Scale, the Caregiver Occupational Deviant Behavior Scale, and the DSM-5 Level 1 Cross-Cutting Symptom Measure. The basic analysis was performed using SPSS 24.0 software, and the network structure analysis was constructed using R software to calculate the relationship between the nodes and the centrality index. Results In nursing interns, the items with the highest prevalence of workplace violence were verbal assault (32.038%) and threats (10.303%); in psychopathological symptoms, the items with the highest prevalence were anxiety (38.500%), anger (35.337%), and depression (33.439%). The strongest edge within the cluster is “Verbal sexual harassment-Physical sexual harassment,” and the strongest edge between clusters is “Verbal assault-Depression.” The node with the highest strength, expected influence, and betweenness indices is “Anxiety,” and the node with the highest closeness index is “Depression.” Conclusions The results demonstrate the effectiveness of the network perspective in elucidating the complex relationships and interconnections between different symptoms. We identified the strongest relationships between nodes, “Depression” and “Anxiety” as the most important symptom. These findings may provide more precise targets for developing interventions for nursing interns.

Abstract Background Nurses are the cornerstone of healthcare delivery, playing a pivotal role in ensuring safe, high-quality, and patient-centered care. However, the significant demands on their time and resources often lead to the rationing or omission of essential nursing care activities, undermining patient outcomes. As frontline caregivers, nurses’ ability to collaborate effectively within teams is critical to overcoming these challenges. The Big Five Teamwork Model, which emphasizes trust, communication, and leadership, offers a transformative approach to strengthening teamwork and addressing barriers to comprehensive nursing care. Aim This study aimed to assess the impact of the Big Five Teamwork Awareness Sessions (Big 5TWAS) on the rationing of nursing care and patient-centered care. Methods A quasi-experimental pre-post-test design was conducted in critical care units at an Egyptian university hospital. A convenience sample of 60 nurses and 31 admitted patients participated in the study. Big 5TWAS interventions were implemented for nurses, and study variables were measured using nursing teamwork surveys, the Rationing of Nursing Care Observational Checklist (RONCO), and patient-centered care questionnaires before and after the intervention. Data were analyzed using descriptive and inferential statistics. Results The Big 5 Teamwork Awareness Sessions (Big 5TWAS) demonstrated a significant impact on the study variables. Post-sessions, there was a significant decrease in rationing of nursing care scores and significant increases in nursing teamwork and patient-centered care scores (p ≤ 0.001). In addition to the significant correlation values, regression analysis revealed that overall teamwork accounted for approximately 22% of the variance in rationing of nursing care (R² = 0.224, p = 0.015), with trust as the significant predictor. Furthermore, teamwork explained approximately 80% of the variance in patient-centered care (R² = 0.801, p

Abstract Background Midwifery is one of the key professions in maintaining community health and is important in providing maternal and child healthcare. As a high-risk profession, it involves numerous occupational hazards and challenges that can affect the quality of work life. This study investigated the occupational hazards and factors related to midwives’ quality of work life. Method This cross-sectional study was conducted in 2023 in Iran, involving midwives working in hospitals (teaching and non-teaching) and health centers. Sampling was done in multiple stages in two large cities, Tabriz and Ahvaz. All midwifery staff meeting the inclusion criteria participated in the study. Data were collected using demographic and social information, occupational stress, work-related quality of life, Minnesota job satisfaction, and occupational hazards questionnaires. The analysis was performed using an independent t-test, ANOVA, Pearson’s correlation, and linear regression test by SPSS version 24. P-values

Abstract Introduction Nurses play a crucial role in the primary prevention of phenylketonuria (PKU) within national screening programs for newborns. This is achieved through consult with the child’s provider promptly to arrange a PKU test, accurate collection of blood samples at maternal and child health centers, enable early detection of potential cases. Aim This study aimed to assess the level of primary health care nurses’ knowledge and neonatal screening performance for phenylketonuria in Alexandria Methods A descriptive research design was used. The study included all nurses (50 nurses) who are responsible for obtaining newborn screening test from 5 primary health care centers in Alexandria. Two tools were used to collect the necessary data: nurses’ knowledge regarding phenylketonuria disease assessment sheet and nurses’ performance about newborn screening for phenylketonuria observational checklist. Results It was found that the mean age of participant was 42.94 ± 5.0 and 52% of them had completed their technical level of education and the means years of experience was 17.64 ± 4.84. The total mean score of nurses’ knowledge regarding phenylketonuria screening was 16.24 ± 1.99 with the mean percent score of 72.72 ± 8.27. It was also found the total score of nurses’ screening performance was 11.0 ± 0.97 with the mean percent score of 64.71 ± 5.70. A significant positive correlation was found between nurses’ knowledge and their screening performance with P =

Abstract Background This article aimed to assess the impact of nursing decision interventions based on the nursing process on the clinical outcomes and quality of life (QoL) of patients with ST-segment elevation myocardial infarction (STEMI). The main research question was whether nursing decision-making interventions can improve clinical outcomes in patients with acute STEMI (ASTEMI), including time management, cardiac function recovery, and QoL. It was hypothesized that patients receiving nursing process-based interventions would demonstrate significant improvements in clinical outcomes, recovery time, incidence of adverse cardiac events, and QoL compared to those receiving standard care. Methods A retrospective analysis was conducted, including 205 patients with ASTEMI as the study sample, 125 cases in the intervention group (IG) and 80 cases in the control group (CG). Data on time management indicators, major cardiac adverse events, QoL scores, left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and cardiac troponin I (cTnI) levels were collected. Results Through intervention, the IG suggested visibly shorter rescue time, vein opening time, intervention procedure time, and hospital stay compared to the CG; the probability of heart failure (HF), cardiac arrest, and death in the IG was visibly lower than in the CG; the physical health, mental health, social relationships, and environmental scores in the IG were visibly higher than in the CG. Further comparison of post-intervention outcomes between the IG and CG showed no statistically significant differences in serum BNP and cardiac troponin I levels (P > 0.05), with the confidence intervals (CIs) indicating that the changes between the two groups were comparable. However, when comparing post-intervention LVEF between the groups, the IG showed a significantly higher LVEF than the CG (P

Abstract Background Nurses’ work engagement is critical for improving quality care, facilitating positive patient outcomes, and solving considering the nursing shortage. This study aimed to identify the mediating effect of job crafting on the relationship between positive psychological capital and work engagement in registered nurses. Methods A total of 132 hospital nurses with clinical experience of more than one year, excluding nurse administrators, participated. The participants were recruited from three hospitals in South Korea from August to September 2021. The SPSS 27.0 and PROCESS macro were used for data analysis. Results Positive psychological capital had a significant association with job crafting (β = 0.74, 95% CI = 0.71 to 0.95), and job crafting had a positive association with work engagement (β = 0.51, 95% CI = 0.29 to 0.56). In the mediating effect analysis, the mediating role of job crafting on the relationships between positive psychological capital and work engagement was statistically significant (β = 0.35, 95% CI = 0.24 to 0.48). Conclusions Based on our findings that positive psychological capital and job crafting could improve the work engagement of registered nurses, strengths coaching-based programs for increasing positive psychological capital and job crafting exercises for helping nurses make their job more engaging need to be developed.

Abstract Aim This study carried out to examine the effects of nursing care given to coronary intensive care patients according to their circadian rhythms on sleep quality, pain, anxiety, and delirium. Study Design This study was designed as a randomised controlled, clinical investigation. The study population consisted of patients treated in the coronary care unit of a training and research hospital between September 2022 and February 2023. Total of 44 participants were included. The included participants were followed up for 3 days in the coronary intensive care unit. Data were collected using “Patient Information Form, Sleep Quality Scale in Coronary Intensive Care Patients (SQ-CC), Visual Analogue Scale (VAS), Morningness-Eveningness Questionnaire (MEQ), Hospital Anxiety and Depression Scale (HADS), Intensive Care Delirium Screening Checklist (ICDSC).” In addition, melatonin and cortisol measurements were made, and sleep data were taken with a smartwatch. Patients with intermediate chronotype, delirium, on ventilator support, or using sedative drugs were excluded. The chronotypes of the participants were determined, and the patients in the intervention group were given nursing care by their circadian rhythms. No intervention was made to the control group, and their routine care was continued in accordance with intensive care unit functioning. Frequency distribution, dependent and independent sample t-test, Wilcoxon test, repeated measures analysis of variance, Mann Whitney U, and chi-square analysis were used to evaluate the data. The study has been registered in ClinicalTrials.gov (Identifiers: NCT04934436). During statistical analysis, the groups were coded as Group A and Group B, ensuring blinding for the statistician. Results The intervention group’s sleep quality increased compared to the control group (post-test SQ-CC total scores: intervention group 22.41 ± 6.67 vs. control group 50.45 ± 10.63, p 0.05). Considering the sound levels in the environment, the first-night decibel mean was significantly higher in the intervention group than in the control group (first-night decibel mean: intervention group 56.58 ± 2.43 dB vs. control group 54.51 ± 2.41 dB, p

Abstract Background Cystic Fibrosis (CF) significantly affects the respiratory system, often requiring lung transplantation in advanced stages. This life-saving procedure presents substantial challenges and uncertainties. While there is existing research on support and information needs post-lung transplant from various perspectives, this study aims to specifically address the unique experiences and challenges faced by individuals with CF during both the pre-transplant and post-transplant periods. Methods Twenty-three lung-transplanted individuals with CF participated in this exploratory qualitative study. Data was collected through individual semi-structured interviews and analyzed using inductive content analysis. Results Participants faced physical and mental challenges, including fatigue, depression, and anxiety. The waiting period involved isolation, dependence on family, and guilt. Post-transplant, they dealt with relief but also severe pain and adjusted to a new identity. Participants highlighted the importance of taking immunosuppressive medications as prescribed, even though the regimen was complicated and these medications had side effects. Participants stressed the need for earlier and more open dialogue with healthcare professionals and better emotional preparation for the transplant process, including preparedness for pain and previously inadequately addressed concerns such as depression and anxiety. Conclusions This study underscores the significant physical and emotional challenges individuals with CF face during lung transplantation, highlighting the need for comprehensive, person-centered care. Psychological support, effective post-transplant pain management, and early palliative care may be beneficial approaches to improve the patient experience. Nurses can play a pivotal role in this process by ensuring clear communication, managing pain, educating patients on immunosuppressive regimens, and advocating for holistic care.

Abstract Introduction The persistent attrition of nurses from the profession is a significant challenge for both healthcare policymakers and administrative bodies within numerous low-income countries. In Ethiopia, various cross-sectional studies have been conducted regarding nurses’ intention to stay in the nursing profession; however, the results have demonstrated inconsistency. Hence, this study aims to pool the level of nurses’ intention to persist in the nursing profession. Methods In our systematic review and meta-analysis, targeted findings were searched from a variety of electronic databases; including Pub Med, Google Scholar, African Journal Online, the Cochran Library, and Science Direct. To determine the pooled prevalence and associated factors of intent to stay in nursing profession among nurse in Ethiopia, all the necessary data was extracted by using a standardized data extraction format. We analyzed the data by using Stata 17 statistical software. Heterogeneity between the primary studies was assessed by I-square tests. A random-effect model was applied to estimate the pooled intention of nurses to continue within the nursing profession. Result We included a total of 12 full-text studies in our analysis. The findings of this meta-analysis revealed that the pooled prevalence of nurses' intention to stay in nursing profession among Ethiopian nurses was 45.57% (95% CI; 38.43, 52.72). The subgroup analysis data revealed that the highest pooled prevalence of intention to stay was reported in the Tigray region which is 56.1% (95% CI 52.24, 59.96). In contrast the lowest prevalence was documented in Addis Ababa city administration which was 19.4% (95% CI 15.56, 23.24). Factors such as job satisfaction (OR = 2.69, 95% CI = 1.11 – 6.53), professional development (OR = 2.49, 95%CI = 1.27- 4.9), level of education (OR = 2.7, 95% CI = 1.92–3.8), payment and benefit (OR = 1.9, 95%CI = 1.15- 3.19) all were the significant determinants of nurses’ intention to continue in the nursing profession. Conclusion The results of our investigation suggested that the degree of intention to continue in the nursing profession among Ethiopian nurses was inadequate. The nurses' intention to depart from the nursing profession is an alarming. Therefore, it’s imperative for healthcare policymakers and stakeholders to prioritize on retention strategies encompassing job satisfaction, recognition, incentives, career opportunities, professional support, and autonomy were necessary.

Abstract Background Nurses lack skills to analyse ethical problems, and some feel powerless and frustrated when encountering and having to deal with ethical dilemmas in clinical practice. The lack of ethical competence among nurses might somewhat be related to the neglect and side-lining of ethics in the education system. For those nurse educators who are facilitating ethics within their curriculum, their strategies and practices are inefficient due to lack of resources. Lack of efficient strategies to facilitate ethical competence create threats to ethical values in healthcare with a potential to jeopardise patients’ health outcomes. Methods This was a qualitative, descriptive, exploratory, and contextual research that was done in one higher education institution among 9 nurse educators and clinical nurse preceptors. Online semi-structured interviews were conducted, data were transcribed and analysed following Giorgi’s thematic analysis method. Results Two themes with 5 related subthemes emerged from the data. The theme of barriers that hinder the facilitation of ethical skills for nursing students indicated how Covid-19 pandemic lead to constraints that lead to facilitators focusing on clinical skills and procedures and side lining ethics education. While the theme transformative approaches to fostering ethical competency through simulation– based learning indicated some strategies that facilitators could adopt to ensure efficient ethics education for nursing students. Conclusion Barriers related to insufficient human resources and infrastructure made it almost impossible to facilitate ethics education among nursing students, especially during Covid-19 pandemic. This research offers some transformative solutions that could be adopted by higher education institutions to ensure that ethical competence is effectively facilitated.

Abstract Background Patients undergoing surgery and anaesthesia are in a vulnerable situation, requiring advanced treatment and care. Nurse anaesthetists are specially trained to meet their needs when administering and monitoring anaesthesia, ensuring patient safety and comfort throughout the entire perioperative care. However, there is a growing concern that efficiency requirements might take precedence over humanistic care when having to prioritize. Most people have a limited understanding of the extended role of nurse anaesthetists in maintaining quality and safety in anaesthesia services. This study aimed to explore how nurse anaesthetists describe their practice as being nursing when caring for surgical patients. Methods We applied a qualitative inductive design. Twenty nurse anaesthetists working in small or large hospitals in different regions of Norway were recruited. Semi-structured individual interviews were carried out. Data were analysed using qualitative content analysis. This study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist. Results We identified three categories and eight subcategories. The category Continuously attending to physical and psychological needs involved reading the patient and responding accordingly and the ethical and moral obligation to maintain patients’ well-being and dignity. The category Providing a concerned presence involved the importance of the nursing process and nurse anaesthetists’ self-confidence in their professional abilities and readiness to act when caring for the surgical patient. The category Aspiring towards excellence involved expectations towards nurse anaesthetists as professionals who display professional courage and undertake professional development through continuous learning. Conclusion Nurse anaesthetists experience themselves as being highly qualified to address the needs of surgical patients. Their nursing background and extensive training have prepared them to know how and argue why. Knowledge from this study could be expected to add to the field of describing and understanding nurse anaesthetists’ practice in the perioperative context and support supervision in postgraduate education.

Abstract Background The long peripheral intravenous catheter (long PIVC), a type of PIVC, has an indwelling time of 5–14 days and is one of the options for antibacterial therapy. However, there is no consensus regarding the impact of insertion site selection on the complications associated with long PIVCs. Methods This randomized controlled trial included 90 participants randomly assigned to either the control or experimental group, with 45 patients in each group. In the control group, long PIVCs were placed in the forearm, while in the experimental group, they were inserted in the upper arm. The primary outcome was catheter-related complications, while secondary outcomes included the first-attempt insertion success rate, total procedure time, and indwelling catheter duration. Results The incidence of catheter-related complication rates was significantly lower in the experimental group (25.0%) compared to the control group (66.7%) (χ2 = 14.528, P 0.05). Conclusions Selecting the upper arm as the insertion site for long PIVCs reduced the incidence of thrombophlebitis and extended indwelling catheter duration during antimicrobial therapy. Trial registration ClinicalTrials.gov identifier: NCT06455228 (Initial Release: 05/30/2024).

Abstract Background Neonatal hyperbilirubinemia is a potentially fatal condition that has toxic effects on the brain and may have negative effects. Humanized care is a comprehensive approach that focuses on the nutritional, therapeutic and hygienic needs of neonates, which helps in the resolution of hyperbilirubinemia. Method A quasi-experimental design was utilized in this study to evaluate the effect of humanized nursing care application on the clinical outcomes of neonates with hyperbilirubinemia. It was carried out at the Neonatal Intensive Care Unit at Tanta Main University Hospital. A total of 120 neonates with hyperbilirubinemia who fit the inclusion criteria were randomly assigned to both the study and control groups. The data were collected using the biosocial-demographic characteristics of the studied neonates and neonatal clinical outcome measures for humanized care. Results On the seventh day after receiving humanized care, total bilirubin levels in the study group decreased to 4.03 ± 1.48 compared to 10.21 ± 2.08 in the control group; there was also a decline in the time of jaundice regression with a mean of 3.966 ± 1.09 in the study group compared to 4.66 ± 1.29. in the control group. The mean days of phototherapy were 1.83 ± 0.73 in the study group and 2.41 ± 1.01 in the control group. Additionally, oxygen saturation increased significantly on the 7th day in the study group compared to the control group; the mean amount of daily milk intake was 752.8 ± 262.9 ml in the study group compared with 600.76 ± 290.31 ml in the control group. Conclusion Applying humanized care improved neonatal clinical outcomes, including O2 saturation, jaundice regression, enhanced newborn feeding and decreased duration of phototherapy.

Abstract Background Young nurses are the backbone of the intensive care unit nursing team. Their turnover intentions not only directly impact the physiological health and life outcomes of critically ill patients but also significantly affect the efficient operation of the healthcare system. Previous research has noted the association between nurse emotional exhaustion and turnover intentions. However, few studies have examined how both external and internal resources simultaneously moderate this relationship, especially among young intensive care unit nurses. This study explore the potential mechanisms by which emotional exhaustion affects turnover intentions among young intensive care unit nurses. On this basis, it investigates how organizational justice and organizational-based self-esteem, as critical work resources, moderate the relationship between emotional exhaustion and turnover intentions. Methods A cross-sectional survey design was adopted. A total of 490 questionnaires were distributed, with a final valid response rate of 91.2%. SPSS 27.0 was utilized for descriptive analysis and Pearson correlation analysis. AMOS 25.0 was employed to construct the Structural Equation Model and the Bootstrap test. Results Emotional exhaustion among young intensive care unit nurses positively predicts turnover intention, with job performance playing a mediating role. The indirect effect of job performance accounts for 3.24% of the total effect. Organizational justice and organizational-based self-esteem respectively moderated the relationship between emotional exhaustion and turnover intention. The combined indirect effects accounted for 17.18% and 12.76% of the total effect, respectively. Organizational justice and organizational-based self-esteem, as well as organizational justice, organizational-based self-esteem, and job performance, respectively played a chain mediating role between emotional exhaustion and turnover intention. The indirect effect accounted for 3.82% and 3.63% of the total effect, respectively. Conclusion Emotional exhaustion has a positive predictive effect on turnover intention among young intensive care unit nurses, with job performance playing a mediating role. Organizational justice and organizational-based self-esteem, as key work resources, moderated this relationship, mitigating the impact of emotional exhaustion on turnover intention. Clinical trial number Not applicable.

Abstract Background In recent years, health needs have become more complex and serious in Japan, and technologies that enhance local strengths to solve problems are essential. It is essential to develop a learning programme for public health nurses to acquire public health nursing skills that enhance community strengths and a self-assessment scale for achievement. Aim This study developed a self-assessment scale for the Public Health Nursing Art to Enhance “Strength of Community” (PASC). Design This study was designed as confirmatory. Methods A draft of the scale was developed using the framework of Public Health Nursing Art to Enhance “Strength of Community,” and a self-administered questionnaire was mailed to full-time public health nurses working at 1245 sites, including the government offices of the prefectures and ordinance-designated cities/designated mid-level cities across Japan. Subsequently, item, confirmatory factor, and correlation analyses were conducted to verify the scale’s reliability and validity. Findings Content, construct, and criterion-related validities and reliability were confirmed. Conclusions This scale can measure public health nursing art to enhance public health nurses’ “strength of community.” Furthermore, reflecting on their daily activities will improve public health nurses’ skills, contributing to the community's optimal health outcomes. Clinical evidence This study developed a self-assessment scale of Public Health Nursing Art to enhance “Strength of Community.” Regarding reliability, no significant bias in the data distribution or correlations was observed and confirmed internal consistency. Regarding construct validity, the GFI, AGFI, and CFI were considered statistically acceptable.

Abstract Background Nurses who work during the global pandemic are known to experience physical and psychological exhaustion, as well as severe anxiety and depression symptoms. This study aimed to explore the relationships between sleep duration, sleep quality, and depression symptoms among nurses during the outbreak of the Omicron variant. Methods A cross-sectional study was conducted between August 2022 and September 2022. Participants (N = 2140) were evaluated for depression symptoms via the Hospital Anxiety and Depression Scale (HADS), and sleep was evaluated via the Pittsburgh Sleep Quality Index (PSQI), and "short sleep duration" was defined as ≤ 5 h per day. Demographic information was also collected. Binary and multivariate logistic regression was performed to assess the relationships between sleep duration, sleep quality, and depression symptoms. Results In total, 2140 nurses were included in this study; 1481 (69.2%) had poor sleep quality, while 866 (40.4%) had depression symptom scores > 7 according to the HADS criteria. Both duration and quality of sleep were significantly correlated with depression symptoms among nurses (P

Abstract Objective This study investigated the application of and research on 5G mobile nursing stations in clinical settings. Methods A randomized sample of 300 nurses from one hospital was selected. The control group was established from December 2021 to September 2022 as the nurses used the computerized hospital information system (HIS) for nursing documentation and performed routine manual verification of the treatment and patient information. The observation group was established from October 2022 to August 2023 as the nurses used portable digital assistants (PDAs) from the 5G mobile nursing stations for nursing documentation and scanned quick response (QR) codes to verify treatment and patient information. This study compared the time taken by nurses in both scenarios to verify oral medicine dispensing and intravenous (IV) infusions against medical orders, as well as the time taken by nurses to input vital signs and complete nursing documentation. Results In the observation group, the average time for verifying IV infusions against medical orders was 52.34 ± 2.61 s, that for verifying oral medicine dispensing against medical orders was 29.32 ± 1.71 s, that for inputting vital signs was 46.82 ± 3.64 s, and that for completing nursing documentation was 86.81 ± 5.62 s. These times were significantly different from those of the control group, which were 59.84 ± 5.76 s, 35.30 ± 2.31 s, 58.58 ± 3.59 s, and 128.51 ± 6.19 s, respectively (P

Abstract Background Increasing quality and efficiency in health services can directly relate to nurses’ innovative work behaviors. The happiness levels of nurses at the workplace can positively affect their innovative work behaviors and their willingness to make a positive difference in patient care. In this context, the study aims to examine the serial mediation role of these factors by associating the effect of nurse happiness on innovative work behaviors with transformational leadership and perception of artificial intelligence use. Methods Nurses working in two medium-sized public hospitals in the Eastern Black Sea region of Turkey were selected as the study sample. Data were collected from 458 nurses by convenience sampling method. In this cross-sectional study, scales whose validity and reliability were supported by other studies were used. Results When the findings of the study were evaluated, a significant positive relationship was found between nurses’ happiness and innovative work behavior. In addition, it was found that transformational leadership and perception of AI usage had a mediating role separately in the relationship between nurses’ happiness and innovative work behavior. Finally, when the research model was tested, it was also determined that transformational leadership and perception of AI use have a serial mediating role in the relationship between nurses’ happiness and innovative work behavior. Conclusions This study revealed that nurse happiness has a significant and positive effect on innovative work behaviors, and transformational leadership and perception of artificial intelligence use have a serial mediating role in this relationship. Ultimately, this research offers some theoretical and practical implications for practitioners by emphasizing the strategic importance of transformational leadership practices and the integration of artificial intelligence technologies, as well as increasing the happiness levels of nurses to promote innovation in healthcare services.

Abstract Background Nurses play a critical role in the implementation of child-friendly healthcare, ensuring that pediatric patients receive comprehensive and compassionate services. However, there is a global scarcity of research evaluating nurses’ practices in delivering child-friendly healthcare. Therefore, this study focuses on exploring the assessment of child-friendly healthcare practices from the perspective of nurses themselves. Method This descriptive qualitative study employed purposive and snowball sampling methods to recruit 14 pediatric nurses from six hospitals in Zhejiang province, Southeast China. Individual semi-structured interviews were conducted face-to-face between January and June 2024. Data were analyzed through the qualitative content analysis approach. Results We identified 415 unique meaning units in the interview data, 332 of which were related to child-friendly healthcare practice assessment. These units were classified into 58 codes across 4 categories and 17 subcategories. The four categories were identified: services designed for children’s interests, tailoring the environment adapted for children, facilitating social interactions, and promoting childhood development. Conclusion The findings from this study were derived from the perspectives of Chinese nurses on child-friendly healthcare practice assessment, offering a comprehensive and multidimensional view of this field. The results reflect the current state and future direction of child-friendly healthcare in China, which will aid in sustaining the development of a child-friendly healthcare evaluation system.

Abstract Objective This study aimed to investigate the perspectives of nurses and patients on the misplacement of supportive care information for type 2 diabetes mellitus (T2DM). Methods A descriptive qualitative study was conducted using purposive sampling to recruit elderly individuals diagnosed with T2DM and nurses from a geriatric hospital in the central region of China. Semi-structured interviews were carried out between June and October 2024. Findings A total of 21 patients and 12 nurses participated in this study. Five themes were generated: (1) consistent value identity, (2) inadequate information carriers, (3) conflicting subject needs, (4) loose information links, and (5) strong willingness to improve. Conclusion It was essential for patients and nurses to enhance access to information and establish a robust information support framework. In addition to improving the information support capabilities of nurses, it was equally important to enhance patients’ ability to provide feedback on the information they receive.

Background: Breast cancer remains one of the leading causes of cancer-related mortality among women globally. Early detection through screening is crucial for improving outcomes. However, knowledge gaps, misconceptions, and poor practices around screening timing persist among young women. This study explores the knowledge, perceptions, and practices related to breast cancer screening among female students at the University of Zimbabwe. It aims to inform nursing practice by highlighting the critical role nurses play in addressing these gaps through education, awareness, and guidance on screening timing. Methods: This analytical cross-sectional study employed random sampling to recruit participants at the University of Zimbabwe from March 4 to April 8. A structured questionnaire with three sections, consisting of closed-ended questions, was used to assess demographic characteristics, as well as knowledge, perceptions, and practices related to breast cancer screening. Data were analyzed using STATA 15, with descriptive statistics presented in tables and figures. Associations between variables were tested using Chi-square, Fisher’s exact tests, and binary logistic regression. Results: Of the 139 participants, 85% were aged 20-25, single, and undergraduates. Among all age groups, 54% did not perform breast self-examinations. Participants aged 36-40 had significantly higher odds of late screening (OR=17.8, p=0.014) and married participants also had higher odds of later screening (OR=4.42, p=0.009) compared to single participants. Participants who perceived that a healthy diet reduces breast cancer risk had lower odds of late screening (OR=0.32, p=0.021). Participants who knew the recommended age of Breast Self-Examination had higher odds of late screening (OR=2.5, p=0.027). Participants with religious and cultural beliefs influencing their decision-making were significantly more likely to present late (OR = 3.21, p = 0.030). Conclusion: Socio-demographic factors and health-seeking behaviors significantly influenced breast cancer screening timing. Nurses are pivotal in promoting early screening through tailored health promotion strategies, including raising awareness, addressing misconceptions, and encouraging self-examination practices.

Background: The assessment of learners is a fundamental element in medical science curricula. The Direct Observation of Procedural Skills (DOPS) exam is a valuable way to assess clinical skills. The present study aimed to assess the clinical skills of operating room students of Neyshabur University of Medical Sciences, Iran, using the DOPS exam, and determine the effect of the exam on the learning and satisfaction of the learners. Materials and Methods: The current study was a semi-experimental study that used a single-group posttest study design. The statistical sample included 30 operating room students. The 5 skills were selected for assessment and the assessment checklist was designed by the researcher and approved by the expert panel. Moreover, 3 researcher-made questionnaires were used to examine the students’ skills and opinions regarding facilitating learning and their satisfaction with the DOPS examination. Mann-Whitney, Kruskal-Wallis, and Wilcoxon tests were used to analyze the data. Results: The results showed that there was a significant difference between the scores of the students in the first and second examinations (z = -4.243, p < 0.001), and the students› scores increased significantly on the second examination. The learners were satisfied with the way the DOPS exam was conducted, and their satisfaction score of this exam was 90.7 out of 120. Furthermore, students agreed that this exam affected learning facilitation. Their score on the effectiveness of this exam was 93.9/120. Conclusions: Although the DOPS examination is one of the clinical assessment methods for learners, it can be used as an instructional tool in the learning process.

Background: The workplace and the context in which oncology nurses work are unique due to the complex and dynamic nature of cancer care. Nurses who care for cancer patients are exposed to varying degrees of psychological pressure. The present study was conducted to explore oncology nurses’ perceptions regarding mental health in the workplace. Materials and Methods: This study was conducted in 2018–2019. The participants were recruited through purposive sampling from eight educational specialty cancer treatment centers in Iran. Data were collected through individual semistructured interviews and analyzed using the conventional qualitative content analysis method. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used to document the report of the study. Results: The extracted concepts were classified into three main categories and 17 subcategories. The main categories included attention to nurses’ occupational stress-provoking factors, attention to emotional/psychological responses in the workplace, and healthy mental atmosphere in the workplace. Conclusions: The findings indicate that oncology nurses need to be supported to enhance their mental health in the workplace. The findings of this study could help policymakers and nurse managers to understand the importance of improving the mental health of nurses in cancer care. In this regard, it is essential to make the necessary plans and scientific decisions to design and provide strategies to alleviate workplace problems and improve nurses’ mental health.

Background: Despite progress made in antiemetic control, most cancer patients still experience chemotherapy-induced nausea and vomiting. In oncology departments, nurses can evaluate the effects of complementary therapies such as use of essential oil on reducing nausea and vomiting of patients undergoing chemotherapy. Therefore, this study was conducted to explore the effect of cinnamon essential oil on the chemotherapy-induced nausea and vomiting of cancer patients. Materials and Methods: This is a two-group experimental study with a pretest-posttest design that was conducted between January 20 and March 15 of the year 2020. Through convenience sampling, 70 patients experiencing chemotherapy-induced nausea and vomiting were recruited to participate in this study. The participants were randomly allocated to two control and intervention groups. A pad moistened with 2 ml of isotonic saline and 0.2 ml of cinnamon essential oil was first placed inside a plastic bag, and then patients in the intervention group were asked to take three deep breaths while their face was towards the bag for two times at five-minute intervals. Patients in the control group used a placebo (a pad moistened with 2 ml of isotonic saline) instead of cinnamon essential oil during the intervention period. Participants in the two groups received routine antiemetic treatment. Using Visual Analog Scale (VAS), the severity of nausea and vomiting was measured in both groups before the intervention. For this reason, the severity of nausea and vomiting was measured after the first three breaths, and then after the second three breaths. Data were analyzed by SPSS software, using independent t-test, Chi-squared test, and Fisher’s exact test. Repeated measures ANOVA were also used to evaluate nausea and vomiting between the two groups across times. The significant level of 0.05 was considered for all tests. Results: There were no significant differences between the two groups in terms of demographic characteristics and the severity of chemotherapy-induced nausea and vomiting before the intervention. The severity of chemotherapy-induced nausea and vomiting was significantly lower in the cinnamon group than the control group after the first 3.08 (0.55), (F2 = 13.27, p < 0.001) and second breaths 1.91 (0.33) (F2 = 11.39, p < 0.001). Conclusions: Nurses can educate patients and their families to use of cinnamon essential oil. Nursing managers can also emphasize on the use of cinnamon essential oil, which is one of the non-pharmacological, low-cost, and effective methods of reducing chemotherapy-induced nausea and vomiting, by holding in-service training classes.

Background: Middle age serves as a crucial transitional phase between youth and old age in women’s health, making it a critical period for women. Accordingly, this study aimed to explore the experiences of life changes among middle-aged women. Materials and Methods: This study was conducted using qualitative content analysis from September to December 2022 in Zahedan. The participants included 10 middle-aged women selected via purposive sampling. Data were collected through individual face-to-face interviews, and all interviews were subsequently transcribed and analyzed. Categories representing the beginning, middle, and end of the narratives were extracted. First, thematic similarities were identified, leading to the emergence of subcategories. Then, the related subcategories were reviewed and placed into the same category. Results: At the beginning of the narratives, the identified subcategories included perception of middle age, gaining experience, and behavior change. In the middle of the narratives, understanding the developmental stages and gaining experience in managing life were extracted as the subcategories. At the end of the narratives, maturity was identified as the main category. Conclusions: The findings from this study revealed that development occurs through the accumulation of experience. Although this study did not explore development in contextual terms, addressing and identifying the challenges of middle age in their context may facilitate quicker development. Furthermore, recognizing and investigating physical problems associated with middle age could lead to more timely treatment.

Background: Currently, fertility and childbearing rates in Iran are below the replacement level (1.2 children), and Iranian families have a low propensity to have children. The COVID-19 pandemic will also have a negative impact on the decision of couples to have children. The present study was conducted with the aim of investigating the effectiveness of an educational program on women’s childbearing intention under the conditions of the COVID-19 pandemic. Materials and Methods: This study was a clinical trial with a pretest–posttest design, conducted on 80 women (control group = 40 and intervention group = 40) in comprehensive health centers in 2019. The educational program was delivered to the intervention group in 3 sessions. The data collection tools included the Attitudes to Fertility and Childbearing Scale (AFCS), Demographic Information Questionnaire, and researcher-made fertility intention questionnaire. Data were analyzed using t-test, Mann–Whitney, Chi-square test, ANOVA, Bonferroni post hoc test, and Wilcoxon test. Results: The women in the intervention group were in the age range of 18 to 44 years and in the control group were in the age range of 19 to 44 years. The results showed that the mean scores of attitude toward fertility and intention to have children after training were significantly different between the two groups. However, after the training, it was significantly higher in the intervention group than in the control group (F1,67 = 1037, p < 0.001). Conclusions: It seems that the implementation of the use of theoretical models can be effective in the informed decision of families, especially women, for childbearing.

Background: Gestational Weight Gain (GWG) is an important indicator affecting pregnancy outcome, and thyroid hormones are also weight regulators. Researchers showed that thyroid hormones were correlated to prepregnancy Body Mass Index (BMI) and GWG. However, the normal ranges of thyroid parameters and GWG depend on the trimester of measurement. Therefore, we systematically reviewed the current knowledge on the association between thyroid function tests and prepregnancy BMI and GWG. Materials and Methods: This review was finally conducted on nine articles, while Google Scholar and databases such as Scopus, Medline, Cochrane Library, ISI Web of Science, Science Direct, and ProQuest were searched to find English articles from October 2022 to June 2023. Results: Thyroid-Stimulating Hormone (TSH) was positively correlated with prepregnancy BMI, while Free Thyroxine (FT4) was inversely correlated. TSH was positively related to weight gain and BMI in the first trimester, while the relationship was negative for FT4. Free Triiodothyronine (FT3) had a positive relationship with BMI in the first trimester (p = 0.004). Furthermore, TSH level was not associated with GWG in the second and third trimesters, while FT4 was inversely correlated with GWG. FT3 also increased with BMI in the second trimester and not in the third trimester (p < 0.001). Finally, there was a positive correlation between thyroid peroxidase autoantibodies values and prepregnancy BMI as well as maternal BMI, but the data were inconsistent. Conclusions: Determining the relationship between thyroid hormone levels and prepregnancy BMI and/or GWG may help researchers and clinicians manage weight gain and/or thyroid function in pregnancy.

Background: Pain experienced by intubated patients is caused by several extrinsic sources, including nursing care procedures such as endotracheal suctioning. Several nonpharmacological therapies, including listening to Quran recitation, have never been tested for their pain relief effects among intubated patients, despite these therapies being cost-effective, easy to implement, and free of adverse effects. This study aimed to examine the pain-relieving effect of listening to Quran recitation during pain-inducing procedures in patients receiving mechanical ventilation support. Materials and Methods: This pilot study used an experimental design with 32 intubated patients at King Abdullah University Hospital in Irbid, Jordan. The Behavioral Pain Scale and Ramsay Sedation Scale were used to assess pain levels and sedation, and physiologic parameters were monitored before and during endotracheal suctioning. Results: The findings showed significant differences in Behavioral Pain Scale (BPS) scores and heart rate measures between the intervention and control groups after controlling for the level of sedation. The patients in the intervention group scored lower pain and HR measures than those in the control group (F5,26 = 11.47, p < 0.001). Conclusions: The findings showed significant improvement in the levels of pain and heart rate measures among intubated patients who are exposed to Quran recitation. Complementary medicine is essential to the healthcare plans of critically ill patients and their families. Holy Quran recitation has been reported to be a useful nonpharmacological intervention for critically ill Muslim patients.

Background: Despite the prevalence of unintended pregnancies, little is known about the connections between psychosocial and sociodemographic characteristics. This study explored the predictors of fetal attachment, worry, anxiety, and stress in unintended pregnancies. Materials and Methods: This descriptive, cross-sectional study was conducted on 229 father and mother pairs from two primary healthcare centers in Fars province in southern Iran. Data were collected in a face-to-face survey using the Parents Fetal Attachment Scale, Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), Perceived Stress Scale (PSS), and Parental Worry Scale. The participants were selected using the two-stage random cluster sampling method from November 2022 to February 2023. Data were analyzed in SPSS software using binary logistic and multiple linear regression tests. Results: According to the findings, education level and previous parenting experience were found to have a statistically significant effect on the attachment levels of mothers (F4,224 = 5.14; p < 0.05). However, there was no statistically significant difference between the perceived stress of mothers and fathers (p > 0.05). Previous parenting experience significantly affected mothers’ anxiety (odd ratio: 3.20; p < 0.05). The age variable had a significant relationship with the mothers’ perceived stress (p < 0.05). Conclusions: According to the results, unwanted pregnancy had a significant relationship with fetal attachment, anxiety, stress, and worry. It is recommended that to enhance the mental health of couples who have experienced unintended pregnancy, a platform should be provided for the development of their psychosocial environment.

Background: In Indonesia, several hospitals have designed various forms of discharge planning in line with the guidelines provided by the Indonesian Endocrinology Association. These initiatives were implemented to enhance the quality of healthcare service. Despite the efforts made by the government, the rate of non-compliance (9%) and readmission (20%) has continued to increase. This indicates that there is a need to reevaluate the existing discharge planning module. Therefore, this study aims to validate the contents of the diabetes mellitus discharge planning module, which was incorporated into the summary of diabetes self-care activity. The effectiveness of the intervention in improving the compliance of patients with self-care activity was also evaluated. Materials and Methods: This study used a mixed methodological approach, which combined an evaluation method and an experimental quantitative design. The content validity of the module used was carried out using professional judgment, involving competent experts in the bahteramas hospital in southeast Sulawesi, Indonesia. The sample population consisted of sixty-five randomly selected respondents, who participated in the validation of the summary of Diabetes Self-Care Activities (SDSCA) questionnaire, which had three phases, namely pre-test, during, fieldwork, and post-test. Results: The content validity of the module was tested using Aiken’s v, and the results ranged from 0.82 to 0.88 for each session, indicating that it was valid. Furthermore, the internal consistency (Cronbach’s alpha) obtained in this study was acceptable, with values ranging from 0.60 to 0.92. Conclusions: The results showed that the diabetes mellitus discharge planning module could be used to improve self-care among patients.

Background: Effective pain assessment in neonatal care is crucial for ensuring the well-being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by Neonatal Intensive Care Units (NICUs) nurses. Materials and Methods: This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data. Results: Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes. Conclusions: This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well-being of newborns.

Background: Uterine cervicitis in women requires careful selection of a suitable and straightforward treatment. This study aimed to examine the effect of Nika vaginal cream on the symptoms of uterine cervicitis in women. Materials and Methods: This double-blind, randomized, controlled clinical study was conducted on 66 women who where reffered to Hamadan health centers in 2021(33 people in each group). The participants in the intervention group were instructed to use Nika vaginal cream every night for 14 nights, along with a single dose of one gram of azithromycin, 400 mg of cefixime, and 500 mg of metronidazole twice a day for both the patient and her husband. The control group received a placebo cream and the same drugs as the intervention group. After the 14-day treatment period, clinical signs were assessed through examinations, and participants completed questionnaires again. Results: The study found that participants in the Nika user group experienced a 69.70% improvement in symptoms related to uterine cervicitis. This improvement was significantly higher than the control group, which only showed a 45.50% improvement. Although the Risk Ratio (RR) between the two groups was 53% higher in the intervention group, this difference was not statistically significant (p=0.06). However, the Risk Difference (RD) of 0.24 between the groups was found to be statistically significant (p=0.04). Additionally, participants in the intervention group reported a 76.00% reduction in dyspareunia (p=0.03) and an 84.00% reduction in urinary frequency (p=0.05). Conclusions: According to the result of RD, Nika vaginal cream had a significant effect on the improvement of cervicitis symptoms.

Background: Nurses working in Intensive Care Unit (ICU) for COVID-19 are more at risk as they interact more with infected patients. Therefore, this study aimed to explore the experience of Indonesian nurses who work in ICU for COVID-19 patients. Materials and Methods: A qualitative hermeneutic phenomenological approach was used. A total of 20 nurses working in the respective ICUs of eight COVID-19 referral tertiary hospitals in Indonesia were recruited using purposive sampling. Semistructured individual video call interviews were conducted in June–September 2021; then, Diekelmann’s hermeneutic phenomenological approach was used to analyze and interpret the data. Results: Thirteen subthemes describing the following four themes, namely, the pleasing and bad feelings, new challenges of working, nursing professional growth, and nurse resource management for COVID-19 . Conclusions: This study describes nurses’ experiences working in ICUs during the COVID-19 crisis, such as their feelings, perceived challenges, and received support. Nurse leaders play a significant role in providing adequate Personal Protective Equipment (PPE), flexible work shifts, and a caring and healing work environment. However, being aware of the limit of pressure that an individual can manage and providing adequate allowance as rewards for work in risky areas are essential to avoid burnout.

Background: Clinical deterioration occurs due to changes in vital signs, which can be identified early to prevent negative outcomes. We used the NEWS2 system to assess the potential for early clinical deterioration in adult inpatient units at a public university hospital in southeastern Brazil. Materials and Methods: This was an exploratory study conducted at a public hospital in southeastern Brazil, following the guidelines of the Reporting of Strengthening Observational Studies in Epidemiology (STROBE) initiative. Data was collected from January to April 2021, involving 251 inpatients. A questionnaire was used to gather sociodemographic and clinical data, and the Brazilian version of NEWS2 was used to assess the risk of clinical deterioration. Data analysis included descriptive analyses, linear correlation tests, and comparative tests. Results: The average NEWS2 score was 2.9 points among 251 patients, indicating a moderate level of care complexity and recommending assessment by a registered nurse every 4–6 hours. There was no significant correlation between age and NEWS2 score, but the NEWS2 score was significantly higher for men. Conclusions: This study highlights the necessity of using robust assessment tools to evaluate the risk of early clinical deterioration, enabling clinicians to manage patient conditions effectively.

Background: The decision and experience of high-risk pregnant women to undergo amniocentesis can depend on their setting, context, social structures, and significant others, including cultural values and beliefs. What is less understood is women’s experience with decision-making, which may contribute to their anxiety during and after amniocentesis. This study aimed to explore the decision-making experiences of Thai pregnant women undergoing amniocentesis. Materials and Methods: A qualitative content analysis approach was employed to collect and analyze data. Purposive sampling and in-depth interviews were conducted between July and October 2021 with 15 Thai high-risk pregnant women after undergoing amniocentesis. Data analysis involved multiple readings of transcriptions to discern themes and understanding of the women’s stories. Results: Four themes of decision-making experiences were identified: (1) “Shocked, worried, and questioned why the risk was high”; (2) “Does my baby have Down syndrome? I want to know”; (3) “Worried”; and (4) “Relief from anxiety.” Conclusions: Women’s experiences with amniocentesis involved uncertain positive and negative feelings through the journey of undergoing, waiting, and receiving the test results. The nurses and nurse-midwives played an important role in counseling Thai pregnant women about whether to undergo amniocentesis.

Background: Nurses are exposed to higher stress, anxiety, and depression due to the nature of their work. Considering the differences between specialized and general hospital units, this article focuses on comparing the levels of stress, anxiety, and depression among nurses in these two types of units. Materials and Methods: This descriptive-analytical study was conducted in 2023 on 135 nurses in specialized units and 219 nurses in general units selected through stratified random sampling out of 1681 nurses. For this study, 6 public hospitals in the West Azerbaijan province of Iran were selected. Data were collected through a demographic questionnaire and the Depression, Anxiety, Stress Scales-21 (DASS-21) and analyzed using SPSS software. A significance level of 0.05 was considered for this study. Results: This study reported that stress, anxiety, and depression affected 72.04%, 46.33%, and 53.68% of nurses, respectively, with mild to extremely-severe intensity levels. No significant differences were observed in stress, anxiety, and depression between specialized and general units (p > 0.05). Among specialized units (ICU, CCU, and dialysis ward), dialysis unit nurses had significantly lower depression scores (p < 0.05). Additionally, a significant correlation existed between demographic variables and DASS-21 constructs (p > 0.05). Conclusions: The similarities among nurses in specialized and general units outweigh the observed differences. Given the high prevalence of stress, anxiety, and depression among nurses and the negative correlation with job satisfaction, managers should improve job satisfaction to support nurses’ mental health.