Nurs. Rep., Volume 15, Issue 10 (October 2025) – 28 articles

Objective: The purpose of this study was to explore the impact of disability on dyadic quality of life (QoL) among stroke survivors and to examine the mediating role of social support in this process. Methods: Outcome measures were collected at four time points: baseline, 1 month, 3 months, and 6 months post-discharge. The Actor–Partner Interdependence Mediation Model was used to analyze the dyadic data. Results: A significant association was observed between a higher degree of disability and more severe depressive symptoms in stroke survivors (β = 0.626) and their spouses (β = 0.426). Survivors’ disability had a negative impact on their own physical health (β = −3.731) and indirectly affected the physical health of the spouse caregiver through the spouse caregiver’s depression (β = −0.198). In addition, disability affects the survivor’s own mental health through depression and social support (β = −0.231) and indirectly through the spouse caregiver’s depression and their own social support (β = −0.156). Conclusions: Survivor disability has a major impact on depression and QoL in couples with stroke. It is recommended that healthcare providers should identify disability early in stroke survivors and then target interventions to improve the QoL of couples affected by stroke who are at high risk of negative emotions. Full article

Background: Patient education (PE) is an essential component of quality healthcare and chronic disease management. However, effective implementation often faces patient-, nurse-, and organization-related barriers. This is particularly relevant in multicultural healthcare settings such as Saudi Arabia, where a highly diverse nursing workforce may influence PE practices. Aim: To examine the barriers and facilitators influencing patient education practices among nurses working in multiple hospitals in Saudi Arabia. Methods: A descriptive cross-sectional study was conducted among 289 registered nurses recruited through convenience sampling from various hospitals in Saudi Arabia. Data were collected using a validated self-administered questionnaire consisting of demographic items and structured scales assessing PE barriers and facilitators. Descriptive statistics were used to analyze the data. Results: Language differences (64.3%) and cultural barriers (59.2%) were the most commonly reported patient-related obstacles. Among nurse-related barriers, staff shortages (72.4%), heavy workload (72.0%), and time constraints (59.9%) were prominent. Organizational barriers included limited educational resources (39.4%) and unsupportive environments (35.6%). Key facilitators identified by nurses included availability of policies and procedures (63.6%), provision of PE training (63.7%), and integration of PE into clinical workflow and nurse appraisals. Conclusions: Despite strong professional support for PE, multiple barriers hinder its implementation in Saudi hospitals. Addressing these challenges requires institutional strategies such as workforce reinforcement, policy integration, and resource allocation. Future efforts should also include integrating patient perspectives, developing culturally tailored education resources, and evaluating the impact of targeted interventions to strengthen PE delivery in diverse hospital settings. Full article

Background/Objectives: One of the most important self-management behaviors is following agreed-upon treatment recommendations. In chronic disease, which affects over one-third of adults, a critical behavior is taking prescribed medication. However, approximately half of patients with chronic conditions fail to adhere to medication recommendations. Research into medication adherence is complicated by the diversity of measurement methods and definitions, resulting in inconsistent outcomes. Accurate measurement is essential for clinical decision making and identifying effective interventions. This state-of-the-art review aimed to map the current landscape of adherence measurement in chronic disease management and provide evidence-based recommendations for future research and practice. Methods: Using a state-of-the-art review approach, we examined objective and subjective adherence measures in studies where medication adherence was a primary outcome, published from August 2019 to July 2024. The frequencies of each method type were calculated. In studies using more than one method within a sample, adherence outcomes were compared to assess their comparability. Results: Of 1036 screened records, 314 met the inclusion criteria. Self-report questionnaires were most frequently used (72% of studies), followed by pharmacy refill measures (22%), electronic monitoring (2.5%), and biologic assays (1.3%). Subjective measures were more frequently used due to their convenience and lower cost but they reduce the level of precision. Objective measures offered greater precision but at a higher cost and logistical complexity. Conclusions: Our findings suggest a dominant reliance on subjective measures. Standardizing definitions, thresholds, and reporting, and adopting multimodal measurement strategies, will improve the validity, comparability, and clinical utility of adherence research. Full article

Background/Objective: Clinical handover of patient information is a key component of patient care in hospitals. Nurses use a structured framework to minimise communication errors. Electronic Medical Record (EMR) systems can support patient safety and clinical handover with contemporaneous documentation. The aim of this study was to evaluate nurses’ adoption, perceived usability, and satisfaction with an updated handover page within the EMR. Methods: A pre-post mixed-methods study across a large Australian tertiary healthcare organisation examined handover page adoption using data from the EMR, and perceived usability and satisfaction were measured using a survey (handover page updated in EMR on 23 September 2024). Descriptive and inferential statistical analyses were conducted for quantitative data, and content analysis was used for qualitative data. Results: Adoption of the handover page was not statistically significant post-update (Wilcoxon signed-rank test z = −1.376, p = 0.169). Improved usability of the updated handover page post-update was demonstrated by a statistically significant decrease in the need to navigate away from the page to find relevant clinical information during handover (Fisher’s Exact Test p = 0.042). Nurses’ satisfaction increased, indicated by statistically significant increases in two items of the End User Computing Satisfaction Scale (precise information (Mann–Whitney U = 963.50, p = 0.040); and sufficient information (Mann–Whitney U = 927.50, p = 0.034)). Free-text comments indicated adoption and acceptability of the updated handover page by nurses, although a gap remains in the practice process. Conclusions: A co-designed solution to update the handover page within the EMR had good usability and satisfaction among nurses. Updates or implementations to digital health technologies must be continuously evaluated by specialist informatics teams to ensure appropriate adoption, usability and satisfaction by nurses, and positive repercussions for patient safety. Full article

Maternal healthcare guidelines (MHCGs) are documents with detailed information on how to manage maternal and perinatal conditions step by step and accordingly to reduce preventable maternal and perinatal deaths. The National Maternity Guidelines Committee in the Department of Health, guided by the WHO, developed the (MHCGs) to ensure that every primary healthcare facility (PHC) has one or two midwives at their disposal to use, but its implementation remains a huge problem in South Africa. The purpose of this study is to evaluate the knowledge, practices, and attitudes of midwives during the implementation of MHCGs in a selected district, Limpopo province, South Africa. A quantitative methodology will be employed; cross-sectional descriptive research design will be used. The population of this research study will be midwives working in the PHCs of a selected district, Limpopo province, South Africa. The convenient sampling approach will be used; whereby self-developed semi-structured questionnaires will be used as a data collection instrument. The collected data will be analyzed using the Statistical Package for Social Sciences (SPSS), version 29, with the help of a statistician. The results will be available after data collection. The conclusion and recommendations will be based on the findings of the study. Full article

Background: Transition from clinical to academia requires newly appointed nurse educators to deploy certain coping strategies to thrive in their newly assumed roles. This is because this period is often coupled with high teaching expectations, research, increased workloads, and a lack of proficiency with work–life balance, resulting in a lack of coping. Therefore, this study aimed to explore and describe the coping strategies used by newly appointed nurse educators in a South African university. Methods: A qualitative, explorative, and descriptive research design was used. Data were gathered from 12 newly appointed nurse educators using online semi-structured individual interviews. Nurse educators who joined academia from clinical practice within the last six months to five years were included in this study. Data were analysed using Cresswell and Cresswell’s five steps for data analysis. Findings: Four categories emerged from the data: newly appointed nurse educators’ experiences of problem-focused coping, emotion-focused coping, meaning-focused coping, and coping through support from others during the transition from clinical practice to academia. Among the many coping strategies, the participants expressed that they apply clinical experience, self-assertiveness, conflict management, and setting boundaries to cope with the transition to academia. Conclusions: The findings of this study suggest that the transition from clinical practice to academia remains challenging for newly appointed nurse educators. This study further suggests that there is a need to have support measures in place for newly appointed nurse educators during their transition to academia to improve their ability to cope. Full article

Background/Objectives: Legacy planning should respect te care preferences of people facing serious illness and integrate palliative care (PC). Legacy creation with the guidance of health professionals in PC assumes a therapeutic nature and aims to respond to the psychospiritual needs of patients and their families. To date, research on professional experiences to create legacy in PC remains scarce. Therefore, this study sought to explore the experiences of PC professionals in legacy creation with the ill person and their family during EoL care. Methods: A descriptive qualitative study was performed through in-person semi-structured interviews with PC professionals from Portugal. Data collection was conducted from February to May 2025. Transcripts from the interviews were thematically analyzed with qualitative data management software WebQDA. The study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Results: Sixteen PC professionals participated in the study. Most participants were nurses (n = 8), followed by six physicians and two psychologists. The mean age of participants was 44.93 ± 10.46 years. Data analysis yielded three themes: (1) the worth of legacy in EoL; (2) enablers of legacy-building process; and (3) challenges of legacy-building process. Conclusions: Legacy is a meaningful resource that gives professionals the opportunity to connect with patients and their families, and to enact value-concordant person-centered care. By providing a greater grasp of legacy construction, our findings may help healthcare providers better understand how to provide dying patients and their families with dignity-conserving care. Full article

Background: Surgery is often accompanied by fear and anxiety, which can adversely affect recovery and patient’s well-being. Understanding the relationship between surgical fear and anxiety and satisfaction with nursing care can help nurses target interventions that improve perioperative outcomes. Aim: We aimed to investigate surgical fear, preoperative anxiety, and satisfaction with nursing care among hospitalized surgical patients and identify clinical and experiential predictors of surgical fear. Methods: A descriptive cross-sectional study of 100 adult surgical patients was conducted using the Surgical Fear Questionnaire (SFQ), State–Trait Anxiety Inventory (STAI), and a validated Patient Satisfaction with Nursing Care Questionnaire. Descriptive and multivariable regression analyses were performed using IBM SPSS Statistics version 29.0 to explore the associations. Results: Patients reported high overall satisfaction with nursing care but notable preoperative anxiety and moderate surgical fear. Previous surgery, prior anesthesia exposure, longer hospital stay, and limited knowledge of the illness independently predicted greater surgical fear. Conclusions: Despite overall high satisfaction with nursing care, surgical patients experience considerable fear and anxiety. Nurses can reduce the perioperative psychological burden by delivering structured, nurse-led preoperative education, improving communication, and offering emotional support. Integrating such interventions into routine surgical pathways could reduce fear and anxiety and improve the patient experience. Full article

Background/Objectives: Limited access to mental health services contributes to poorer outcomes among individuals with mental health conditions, including major depressive disorder (MDD). Nurse-led interventions serve as a strategic model of care to improve mental health service delivery and enhance patient outcomes. This project aims to co-design a nurse-led telehealth family psychoeducation (FPE) for MDD and primarily assess its feasibility by evaluating the recruitment and retention rates. Methods: A multi-methods study encompassing a co-design phase (Study Phase 1) and a feasibility study (Study Phase 2). Study Phase 1 will involve semi-structured interviews with individuals with MDD and their families or significant others, as well as surveys and focus groups with mental health professionals to develop telehealth FPE for MDD. Study Phase 2 will evaluate the feasibility and acceptability of the intervention, which comprises three biweekly FPE sessions and a six-week follow-up with patient–family dyads using a single-group pre-post design. The primary outcomes comprise the feasibility and acceptability of intervention. Exploratory secondary outcomes include personal recovery, medication necessity beliefs and concerns, antidepressant adherence, and depression severity, measured at baseline, immediately post-intervention, and at 6-week follow-up using validated measures. Data analysis will primarily involve descriptive statistics and thematic analysis. The TIDieR checklist will be followed in reporting the intervention development. Conclusions: Findings from the proposed study will inform the design and protocol for a future randomised trial of telehealth FPE for improving clinical and non-clinical outcomes in MDD. The feasibility study was prospectively registered with the ClinicalTrial.gov on 8 June 2025 (NCT07014241). Full article

Background: As the United States population becomes increasingly diverse, the representation of minorities in health professions is critical to addressing health disparities. Few investigations have been conducted among students enrolled in the first semester of the nursing program, a vulnerable and adjustment period for most nursing majors. Thus, this study examined the association between reading comprehension and science aptitude on student retention and standardized test scores. Method: A cross-sectional repeated measures study was conducted to investigate the outcomes from a compendium of programmatic interventions implemented among n = 80 nursing students enrolled in the first semester of a pre-licensure baccalaureate nursing program in one Hispanic-serving institution. These interventions included the Weaver™ reading online program, case studies, NCLEX-type practice tests, test-taking skills, and peer-mentoring. Data collection was conducted in Spring 2024. Multivariate statistical analysis was used to determine predictors associated with student retention and standardized test scores. An independent t-test was used to examine any significant difference in the reading comprehension level among the cohort’s participants. A qualitative investigation using thematic analysis was conducted to understand students’ experiences with the programmatic interventions. Results: Students’ baseline reding comprehension level was significantly associated with failure in the first semester of the nursing program (β = −0.815; SE = 0.349; Wald = 5.444; p < 0.05). End-of-term reading comprehension level was significantly associated with end-of-course HESI score in the Foundations in Nursing course (β = 26.768; SE = 10.049; Beta = 0.445; p < 0.05) while science GPA was significantly associated with end-of-course HESI score for Health Assessment (β = 3.022; SE = 1.315; Beta = 0.434; p < 0.05. Cohort retention was 75%. The independent t-test result indicated a significant difference in reading level was found between those who dropped out from the cohort (M = 4.23, SE = 0.173 and those who did not (M = 5.15, SE = 0.188), t (68) = −3.037, p < 0.01. A reading level of grade 10 and above was associated with student progression to the next semester (M = 10.16, SE = 0.375, t (70) = −0.560, p < 0.05. Although the participants found the reading comprehension modules tedious, test-taking strategies, applying the nursing process in case studies, and the expertise of a nurse educator, who understood the learning needs of first-semester students, were perceived as critical to academic success. Conclusions: Reading comprehension and science aptitude are essential to students’ early success in the nursing program. Addressing gaps in reading comprehension and science aptitude before admission to a nursing program would increase chances of success in the early stages of a nursing major. Full article

Background: Authentic leadership is characterized by the authenticity and self-awareness of the leader, who acts with transparency and promotes positive outcomes in clinical practice and team management. In Portugal, there isn’t a tool available to assess nurses’ perceptions of authentic leadership in nursing. This study aimed to translate and cross-culturally adapt the Authentic Nurse Leadership Questionnaire (ANLQ) for the Portuguese context and to evaluate its psychometric properties. This instrument assesses nurses’ perceptions of the authentic leadership exercised by their leader. Methods: A methodological, descriptive, cross-sectional study with a quantitative approach was conducted. The translation and cross-cultural adaptation process followed the recommendations of internationally recognized guidelines. The Authentic Nurse Leadership Scale—Portuguese version (ANLS-PT) was administered to a sample of 406 nurses from various functional units in three primary healthcare centers. Exploratory and confirmatory factor analysis techniques were used. Reliability was established through a test–retest administration to 22 nurses at two different times, with a two-week interval. The internal consistency of the scale was assessed using Cronbach’s Alpha. Results: An instrument with 29 items and 3 dimensions was obtained, explaining 68.3% of the total variance. The identified dimensions were Caring and Decision-Making, Self-Awareness, and Relational Integrity and Ethics. The overall instrument showed an internal consistency of 0.97. Conclusions: The ANLS-PT proved to be a valid, reliable, and robust tool for assessing authentic leadership in the Portuguese cultural context and can be used in various nursing practice contexts. Full article

Background: Inclusion of under-represented rare-disease communities in research remains limited, threatening representativeness and equity. Methods: To assess equality, equity, diversity, and inclusion in research and identify barriers to participation faced by the rare disease community, utilising a mixed-methods online survey of a convenience sample of community advocates using Likert scales and free response options. Results: The findings from seventeen stakeholders in the rare disease community showed unanimous agreement that anxiety, fear, safety concerns, and lack of trust hinder participation in research. A total of 82% agreed or strongly agreed that additional financial resources are needed, and 76% agreed or strongly agreed that research grant applications often lack sufficient funds. The free-text responses demonstrate that the rare disease communities are keen to be involved in research but faces barriers to inclusion. Rare disease communities are willing to participate in research, but those responsible for research need to address the challenges related to language, misconceptions and fear. Conclusions: Key legislation in the United Kingdom, specifically the Proposed Patient and Public Involvement Strategy 2020–2025, emphasises the importance of involving patients and the public in health and social care. This survey marks the first step toward gaining valuable insights into the challenges faced by this community in participating in healthcare research, which is crucial for developing a solid evidence base for their treatment and care. Involving stakeholders is essential in health and social care policy and practice, rooted in advocacy and social justice. Full article

Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults with MCCs in these settings. Aim: The aim of this study was to examine the associations between caregivers’ and patients’ socio-demographic characteristics and patients’ clinical variables and the CC to patient self-care behaviors in adults with MCCs in an LMIC context. Methods: This multicenter, cross-sectional study included patient–caregiver dyads recruited from outpatient and community settings across Albania, between August 2020 and April 2021. CC was assessed using the Caregiver Contribution to Self-Care of Chronic Illness Inventory scale (CC-SCCII). Three multivariable linear regression models were used to explore associations with the three dimensions of CC to self-care maintenance, monitoring, and management. Results: Caregivers were mostly female, children, or spouses with a high level of education and employed. Patients were primarily female and had low education. Hypertension and diabetes were the most prevalent. Older and employed caregivers contributed less to CC to self-care maintenance, while higher education and caregiving experience increased it. Living with the patient and being a spouse reduced CC to self-care monitoring, whereas more caregiving hours and experience improved it. CC to self-care management was negatively influenced by cohabitation, presence of a second caregiver, and being a spouse, but improved with more caregiving hours. Conclusions: Socio-demographic and caregiving factors differently influence CC to self-care dimensions in older adults with MCCs in an LMIC. Tailored caregiver support programs are essential to enhance caregiver involvement and improve MCC patient outcomes in LMICs. Full article

Background/Objectives: This narrative review addresses ongoing controversies and advancements concerning ultrasound-guided peripheral intravenous (IV) catheter insertion, and the impact of ultrasound guidance on success rate, procedural time, patient and staff experience, complications and costs, as well as requirements for its use. Methods: A literature review was conducted. Results: Growing evidence suggests that ultrasound-guided insertion of peripheral IV catheter represents a superior technique across various patient populations, particularly those presenting with difficult IV access (DIVA). Key findings highlight significant improvements in first-attempt success rates, reduction of procedural complications, and enhanced patient comfort. Ultrasound-guided insertion is also associated with an increase in catheter dwell time, a reduction in repeat procedures and in central line placements, leading to improved resource utilization and the potential for substantial long-term cost-effectiveness, despite the cost of initial investment and training. However, obtaining these improvements involves a critical importance for standardized training, adherence to rigorous aseptic techniques, and generalization of the transformative impact of ongoing technological advancements in ultrasound devices. Conclusions: The collective body of evidence supports the widespread adoption of ultrasound-guided peripheral IV cannulation as an evidence-based best practice in modern healthcare. Full article

Background/Objectives: End-of-life (EoL) experiences are critically important for everyone involved, giving rise to a set of needs that extend far beyond bio-physiological aspects, to encompass the spiritual dimension as the core of human beings. Understanding the processes of spiritual awakening (SA) assists palliative care professionals in enhancing the quality of care provided to individuals with life-threatening illnesses, as well as to their families. SA is a fundamental occurrence linked to the fulfilment of our spiritual needs when facing an existential crisis, such as the proximity of death. However, its conceptual boundaries need to be clarified to provide qualified and humanized palliative care. Therefore, this study aims to identify the key attributes, antecedents, consequents, and empirical referents of SA at EoL, as well as to clarify the concept’s existing ambiguities. Methods: Walker and Avant’s eight-step concept analysis was used. A literature search was conducted in May 2025 across three databases (PubMed, CINAHL and Scopus). Results: Following the review, 21 articles were included for analysis. The concept analysis revealed four main attribute domains: (1) sensory–perceptual domain; (2) affective/cognitive domain; (3) relational domain; and (4) transcendental domain. Moreover, spiritual consciousness and the existential matrix were antecedents to this concept; revaluation of beliefs, finding spiritual serenity and inner freedom, fostering spiritual growth, and the desire to leave a legacy were its consequences. Conclusions: The concept of SA at the EoL reveals itself to be a complex and multifactorial phenomenon, with a profound impact on a person’s confrontation with finitude. Recognizing and integrating SA into palliative care allows for a more comprehensive understanding of human consciousness. To deal with SA experiences in healthcare settings, a multifaceted approach is needed. This encompasses acknowledging spirituality as a determinant of health, including spiritual care in standard practice, and offering education and training on spiritual care competence for healthcare practitioners. Further transdisciplinary research should be undertaken to explore SA phenomenological variations, guide clinical interventions, and evaluate SA impacts on spiritual well-being and spiritual growth. Full article

Background/Problem: Sarcopenic obesity (SO) is characterized by significant muscle loss combined with obesity, and it is mostly prevalent among older adults. Consequences include a heightened incidence of falls and a greater susceptibility to non-communicable diseases. Thailand currently lacks a care model for SO in older adults. Objective/Purpose: This study utilizes participatory-action research (PAR) to develop a care model for sarcopenic obesity in Thailand. Design and Methodology: In-depth interviews with 25 older adults with SO and focus group discussions with 12 stakeholders were conducted to develop a preliminary care model. An action research spiral process was utilized with 15 older adults with SO over 16 weeks. Findings: We developed a culturally sensitive care model for SO in older adults. This study demonstrates that a participatory-action research (PAR) method for behavior transformation, highlighting health awareness and SO literacy, is crucial for behavior change. Conclusions and Implications: The behavior change process using transformative behaviors facilitated internal changes. This approach helps individuals to understand interconnected factors through personal experiences, leading to profound understanding and readiness for deep, continuous, and meaningful behavioral changes. Full article

Background and Purpose: There remains a need for effective and accessible education methods to support recovery after total hip replacement. To evaluate the effects of video-based education on daily living activities and wound healing of patients undergoing total hip replacement surgery. Methods: A randomised controlled trial was used. Eligible participants were those aged 18 years and over who had undergone total hip replacement surgery in a training and research hospital. The intervention group received video-based training, while the control group received only routine care. Results: Patients in the video-based training group showed significantly greater improvement in daily living activities, hip function, and wound healing on postoperative days 5 and 30 compared to the control group (p < 0.01). Conclusions: Video-based education significantly improved daily living activities, hip function, and wound healing in patients undergoing total hip replacement. Clinicaltrials ID: NCT06523829 Full article

Background/Objectives: Despite the increasing recognition of person-centered care (PCC), existing evaluation tools often have profession-specific limitations, lacking broad applicability across interdisciplinary contexts. This study aimed to develop and validate the Person-Centered Care Instrument (PCCI), designed to assess the competence of healthcare providers from diverse professions. Methods: Using a two-round modified Delphi technique, ten experts validated an initial pool of 63 items. The process assessed both face validity (overall appropriateness) and content validity using a 9-point Likert scale and the Item-level Content Validity Index (I-CVI). Items with a median rating of 6 or higher and an I-CVI of ≥0.70 were retained. Results: The final PCCI consists of 37 items, with a scale-level content validity index of 0.65. Three items achieved universal agreement among the experts (I-CVI = 1.0). For the final 37-item PCCI, the Scale-level Content Validity Index (S-CVI) was 0.65, and the index based on universal agreement was 0.22. Conclusions: The developed PCCI demonstrated good face and content validity, making it a valid and broadly applicable tool for assessing competence in delivering PCC. This instrument can support quality improvement initiatives and help promote a culture of empathy and respect in healthcare. Full article

Background/Objective: Chronic constipation is a common gastrointestinal disorder that can be caused by a variety of factors, such as demographic, lifestyle, and medical disorders like hypothyroidism. Its prevalence varies worldwide, affecting quality of life and leading to specialized management strategies. To explore hypothyroidism patients’ knowledge and practice regarding constipation and evaluate the perceived effectiveness of pharmacological and non-pharmacological management approaches. Methods: A descriptive, cross-sectional design was used to collect the data from a private hospital in the eastern region of Saudi Arabia from January to May 2025. A convenient sample of 300 individuals with hypothyroidism completed the Bowel Habits Questionnaire. Results: Most participants knew that hypothyroidism could cause constipation, but they reported that they did not have more knowledge about it. Both pharmacological and non-pharmacological interventions, especially increase water intake, fiber intake, and exercise, were commonly used by the participants, and they perceived these approaches to be effective. There were strong correlations between constipation frequency and age, disease duration, and the use of constipation management methods. A strong association was found between constipation management strategies and treatment effectiveness. Conclusion: Age, disease duration, and constipation management strategies significantly affect constipation in hypothyroidism patients. Drinking plenty of water and eating more fiber are two very effective non-pharmacological strategies. It is recommended that nurses who integrate routine bowel health education and lifestyle guidance into care plans consider the gap in patient knowledge regarding the relationship between hypothyroidism and constipation, to enhance patients’ self-management and contribute to better health outcomes. Full article

Background: Chemsex, the intentional use of psychoactive substances to enhance sexual experiences, is an emerging public health issue in Brazil, associated with increased risks of sexually transmitted infections and complex psychosocial vulnerabilities. Despite the universal coverage provided by the Unified Health System (SUS), individuals who practice chemsex often encounter barriers to healthcare, including stigma, discrimination, and a lack of specialized services. To date, no comprehensive reviews appear to synthesize evidence on how this population accesses healthcare in the Brazilian context; existing knowledge remains fragmented across individual studies. Objectives: The aim is to map and synthesize the available evidence regarding access to health services among people who engage in chemsex in Brazil, identifying health needs, professional demands, barriers, and facilitators. Methods: The protocol follows the Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. A systematic search will be conducted in MEDLINE (PubMed), Embase, Scopus, SciELO, and LILACS for studies published between 2014 and 2024 in Portuguese, English, or Spanish. Data will be summarized using descriptive and narrative synthesis, presented in tables and thematic categories. Studies will be included if they address chemsex or sexualized drug use in Brazil and report on healthcare access, regardless of gender identity, sexual orientation, or drug type. Studies that do not address chemsex, focus on drug use outside a sexual context, or are unrelated to Brazil will be excluded. Expected results: The review is expected to identify key barriers and facilitators to healthcare access, highlight knowledge gaps for underrepresented groups, and support recommendations for research, policy, and practice to improve care for people engaging in chemsex in Brazil. By focusing on an underexplored intersection of drug use, sexuality, and healthcare access in Latin America, this study aims to provide an innovative contribution to public health literature. Full article

Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive basic life support (assisted transition), and an even smaller but clinically significant number require advanced life support (resuscitation). Within the context of family-centered care, the presence of parents during resuscitation has emerged as a factor with potential implications for emotional adjustment, communication with healthcare providers, and early parent–infant bonding. However, the presence of family members during neonatal resuscitation remains a subject of ongoing debate among healthcare professionals (HCPs). Despite increasing recognition of its potential benefits, HCPs’ views on parental presence during such critical procedures have not been extensively investigated in Greece. This study aims at developing and validating a tool to assess healthcare professionals’ views on parental presence during neonatal resuscitation. Methods: A preliminary questionnaire was developed based on the principles of family-centered care and adapted to the Greek population. The first phase included expert assessment of validity, clarity, and relevance using a modified Delphi method. Item Content Validity Index (I-CVI) and Scale CVI (S-CVI) were calculated. Pilot testing was conducted to assess test–retest reliability. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and Bland–Altman analyses. The study followed the principles of the Declaration of Helsinki, ensuring anonymity, informed consent, and confidentiality. Results: The questionnaire includes 37–50 items allocated in four sections. It demonstrated excellent content validity (CVI = 1.00) and good test–retest reliability (ICC = 0.86). Qualitative feedback indicated that the tool is user-friendly and comprehensive. Interestingly, participants expressed genuine concerns regarding the implementation of parental presence in neonatal resuscitation. Conclusions: The questionnaire development process led to a comprehensive tool, ready for large-scale testing in order to further establish its validity and internal consistency. Full article

Background: We present a multidisciplinary training experience based on simulation techniques and critical resource management implemented in the emergency department. Methods: Simulation courses/workshops were conducted with a multidisciplinary team from the Hospital Emergency Department. The timeline for their development includes a preliminary analysis of needs, objectives, and scenario design, development of the simulation course, and finally, areas of implementation. In this last phase, the teaching team prepares a document and/or report/summary of the activity in which, among other things, the aspects with the greatest capacity for improvement or the areas for implementation of safety measures are determined. A total of 112 healthcare professionals (doctors, nurses, and care assistants) participated in this training program. Its design consisted of the following stages: a preliminary analysis of training needs, the establishment of objectives and scenario design, the development of the simulation workshop, and finally, a report on areas for improvement in patient safety identified during the workshop learning process. Results: The workshops enabled us to identify areas for improvement and develop local protocols/recommendations aimed at improving patient safety in the emergency department, such as standardizing a protocol to guide us in managing resources in crisis situations, a protocol for airway management, a protocol for massive transfusion, and a review of the triage process. In addition, we added value by incorporating cognitive aids and visual tools into the standardization of processes. Conclusions: For resource management in this type of crisis in the hospital emergency setting, it is essential to use a debriefing process guided by experienced instructors after a specific experiential learning experience through simulation scenarios. This helps to contextualize and analyze the advantages and disadvantages of general recommendations. Full article

Background: The European Doctoral Conference in Nursing Science provides a unique platform for doctoral students in nursing and health sciences to present their research in a supportive environment. Celebrating its 20th anniversary, the 2024 conference embraced the motto “looking back and looking forward,” offering an opportunity to reflect on the development of nursing science and future challenges. Results: Held at the Medical University of Graz, Austria, the conference hosted 90 participants from 13 countries. It featured two keynote lectures, three workshops, 48 presentations, and a science slam. Abstract submissions underwent peer review to ensure the quality of presentations. The presentations highlighted key challenges and opportunities across nursing practice, healthcare work environments, education and digitalization in nursing, and health perspectives. Topics included, for example, workforce retention, artificial intelligence in nursing practice, leadership in error management, and culturally sensitive care. The keynotes emphasized the importance of patient and public involvement in research and the benefits of survey data in nursing science. Workshops imparted knowledge and skills regarding funding acquisition, guideline development, and effective research presentation. A science slam introduced innovative and creative ways to present research. Conclusions: The conference showcased the evolving landscape of nursing science, emphasizing the importance of evidence-based practice, supportive working conditions, and constructive collaboration. It demonstrated the enthusiasm and readiness of a new generation of researchers to advance nursing science in a rapidly changing healthcare environment. Full article

There has been a significant increase in scientific publications in recent years, and the nursing field has been no exception. Consequently, the number of publications containing errors that lead to document retractions has also increased. It is essential to understand and delve into this phenomenon within nursing research. Objective: This study aims to identify and analyze the retractions of scientific publications in nursing research worldwide between 2000 and 2024. Methodology: This is a descriptive and cross-sectional study with a bibliometric approach. Data were collected using the Retraction Watch database, from which 408 retracted documents related to nursing research were extracted. Results: Over the last 25 years (2000–2024), a total of 408 documents in the nursing field have been retracted, with the majority concentrated in the 2020–2024 period, accounting for 84.8%. Ethical misconduct was the cause of retraction in 87.3% of the cases. Of the 408 retracted documents, 42.6% involved human participants in research or control groups, totaling 21,369 patients who were part of flawed studies. Conclusions: It is crucial that nursing research remains rigorous and adheres to bioethical standards, as these guide evidence-based nursing practice. Flawed literature can have significant consequences for patient health and care. Full article

Background: Depression is a significant public health concern, with working mothers at greater risk due to combined biological and psychosocial stressors. Recent evidence suggests that inner strength may play a mediating role in the link between biological risks and depression. Objectives: The primary objective was to determine whether inner strength mediates the relationship between biological risk factors (hormonal fluctuations, smoking, alcohol use, family psychiatric history, and physical diseases) and depressive symptoms among Chinese working mothers. A secondary objective was to assess the prevalence of depressive symptoms in this population, measured with the OI-Depression subscale (Outcome Inventory-21). Methods: A cross-sectional online survey was conducted with 330 Chinese working mothers aged 30–45 years, using validated instruments to measure depression, inner strength, and parental stress. Mediation analysis evaluated the indirect effect of inner strength, while covariate-adjusted regression analyses explored associated factors. Results: Biological risk factors showed a significant direct effect (β = 0.584, p < 0.001) and an indirect effect through inner strength (indirect effect = 0.623, 95% CI [0.294, 0.962]. The Sobel test indicated that the indirect effect of biological risk factors on depressive symptoms through inner strength was statistically significant (z = 3.67, p < 0.001). The prevalence of clinically significant depressive symptoms was 38.2%. Conclusions: Biological factors significantly contribute to depressive symptoms, but inner strength partially mediates this relationship, suggesting that interventions to enhance inner strength may help reduce depression risk in working mothers. Further research should investigate strategies to build inner resilience in this population. Full article

Background: The nursing licensure examination is the final assessment of the university curriculum, certifying that students have acquired the competencies necessary for practicing the profession. Understanding the meaning and usefulness attributed to this test can contribute to the international debate on its value and potential continuation. In Italy, most studies in this field involve Directors of Degree Courses, while research on the lived experience of newly graduated nurses in facing the examination is lacking. Objective: The objective of this study is to explore the lived experience of newly graduated nurses during the licensure examination. Methods: A qualitative phenomenological study was conducted. Video–audio-recorded interviews were conducted and analyzed using Giorgi’s descriptive method, inspired by Husserl’s philosophy. Results: Fifteen nurses participated. The thematic analysis of the interviews revealed four significant areas: preparation and support received, ambivalent experience of the exam, emotions experienced during the exam, and the symbolic value ascribed to the exam itself. Each thematic area was further articulated into subthemes, for a total of ten analytical subdimensions. The licensure examination holds multiple meanings for new graduates: an opportunity for verification, a rite of passage, but also an emotionally charged event. While it represents a fundamental moment for constructing a professional identity, it also requires critical reflection on assessment methods, the fairness of the system, and the true educational value of the examination. Conclusions: Understanding the elements that influence the examination experience can help educators improve student preparation and promote a smoother transition to the professional role. Full article

Background/Objectives: Japan has the most rapidly aging population worldwide, with older adults expected to reach 38.7% by 2070. Furthermore, individuals ≥ 60 years old desire to spend their final days at home. Following the establishment of the Long-Term Care Insurance System in 2000, care managers at home care support facilities continually assist most older adults receiving home care. Moreover, home-based end-of-life care is expected to increase. Therefore, the care manager’s role will be crucial in providing end-of-life care support and offering grief care to bereaved families following a patient’s passing. In this study, we aimed to clarify the perceptions of care managers regarding grief care for older bereaved individuals following the loss of their spouse and living alone. Methods: Seventeen care managers with prior experience in grief care for older bereaved individuals who became independent after the death of their spouse were interviewed. The 17 care managers comprised 2 men and 15 women, aged between their late 30s and early 60s. Qualitative data analysis was performed. Results: The following five categories were generated regarding the perceptions of care managers: necessity of supporting older bereaved individuals, ambivalent feelings towards grief care, death considerations, need for reflection, and challenges in implementing grief care. Conclusions: Care managers recognized the importance of maintaining a continued relationship before death, including the need for assessing older bereaved individuals, and collaborating with multiple professions in grief care. Full article

Background/Objectives: In Japan, evidence on catecholamine syringe exchange methods is limited, with practices varying across facilities and individuals. In this study, we aimed to determine the effect of the catecholamine syringe exchange method on blood pressure variability in intensive care unit patients. Methods: We retrospectively analyzed 119 patients (308 syringe exchanges) who underwent catecholamine syringe exchange between 1 April 2020 and 31 March 2022. Patient characteristics for the double-pumping changeover (DPC) and quick syringe changeover (QC) groups were matched and compared using propensity scores. A sub-analysis focused on patients with severe shock with systolic blood pressures ≤ 90 mmHg. Logistic regression analysis was used to examine factors influencing blood pressure variability during the catecholamine syringe changeover. Results: Neither propensity score matching nor the sub-analysis for patients with shock revealed significant differences in the coefficient of variation or absolute systolic/diastolic/mean blood pressure within 15 min of syringe exchange in the two groups. Logistic regression revealed that age was the sole risk factor affecting blood pressure variability during syringe changeover (odds ratio: 1.018, 95% confidence interval: 1.001–1.036), while syringe changeover methods did not contribute to circulating variability (odds ratio: 1.186, 95% confidence interval: 0.672–2.092). Conclusions: Differences between the DPC and QC methods did not significantly affect blood pressure variability during catecholamine syringe changeovers. However, in older adult patients, catecholamine syringe changeover may be more likely to cause blood pressure variability. Full article