Nurs. Rep., Volume 16, Issue 2 (February 2026) – 40 articles

Background: Venous catheters are standard devices in clinical practice. However, their use is not exempt from possible errors and complications. In addition, using them effectively is key to avoiding complications such as infection or phlebitis. Objectives: To determine the frequency of appropriate venous catheters chosen based on the drug and treatment duration in hospitalized patients in a region with 154,000 inhabitants. Methods: A cross-sectional design was carried out between 14 and 28 February 2020, in patients with a peripheral or central intravenous catheter admitted to the acute care unit. Variables collected were related to the catheters, patients, and nurses. Results: One hundred and eighty-eight patients were included, with 319 catheters inserted by 68 nurses. Seventeen patients (8.8%) were ruled out due to the lack of data on the medication administered. Finally, data from 171 patients were included in the final analysis, with 297 catheters inserted. Of them, 246 catheters (82.8%) were inadequate. Discussion: In this point-prevalence study, catheter inadequacy affected more than four out of five catheters and was mainly linked to the use of peripheral catheters for high-risk IV medications and/or for treatments extending 7 days or more. Conclusion: The selection of venous catheters in acute care units is not usually adequate since many peripheral catheters are placed in patients who require intravenous medication during a prolonged period or who are receiving risk medication. Full article

Background/Objectives: We aim to codesign and test a nurse-led, large language model-empowered agent to increase hepatitis B screening and vaccination for inclusion health populations. Methods: This study employs a double diamond model-guided codesign methodology. It includes four phases: (i) Discover: To identify intervention targets, a systematic review was undertaken that synthesized 51 factors influencing hepatitis B screening and vaccination among inclusion health populations. A qualitative study will later be conducted to further elucidate specific cultural barriers in the Chinese context. (ii) Define: To delineate effective intervention designs, two systematic reviews were performed, informing the integration of nurse-led intervention components (e.g., counseling, case management, and care coordination) and adaptation of a large language model to address identified intervention targets. (iii) Develop: To codesign an agent, hepatitis B prevention datasets will be constructed with subsequent model adaptations through fine-tuning and retrieval-augmented generation, as well as collaborations among diverse stakeholders. It will facilitate human–agent interactive consultation, intelligent case management, and care coordination, as well as collaborate with a nurse-led multidisciplinary team to manage hepatitis B screening, vaccination, and care linkage. (iv) Deliver: To evaluate and refine the agent, a mixed-methodology will be adopted, encompassing quantitative evaluation of model response, as well as qualitative evaluation of user experience, technical barriers, and potential benefits. Discussion: This intervention is expected to improve hepatitis B screening and vaccination rates among inclusion health populations, thereby enhancing diagnosis, immunity, and care linkage. It will establish a codesign framework for nursing-specific large language models, broadening the impact of nurses on preventive health equity. Full article

Background/Objectives: The aim of this study was to determine the relationship between self-efficacy and caregiving competence in family caregivers of patients with chronic kidney disease receiving renal replacement therapy. Methods: This was a quantitative, observational, descriptive, and correlational study, in which a sample of 275 caregivers was obtained through non-probabilistic convenience sampling. Information on the participants was collected using a sociodemographic characterization form, the Revised Caregiver Self-Efficacy Scale, and the Caregiver Competence for Care instrument, short version. Results: Most of the caregivers, with a median age of 50, were women, homemakers, cohabiting in a common-law relationship, with complete or incomplete high school education, in socioeconomic stratum 1, from urban areas, affiliated with the subsidized healthcare system, Catholic, wives of the person they care for, and receiving family support. A high linear correlation (Spearman’s Rho = 0.771) was found, which was statistically significant (p < 0.01): the greater the self-efficacy (confidence of the caregiver in performing their work), the greater the competence in caregiving. Conclusions: A positive and significant correlation between self-efficacy and caregiving competence was identified among the participating caregivers. Likewise, variables such as age, length of time as a caregiver, and number of hours per day devoted to caregiving were associated with higher levels of caregiving competence. Full article

Background/Objectives: Sexual health is a crucial yet often overlooked aspect of nursing care, and nursing students often lack the communication skills needed to discuss it. Although several instruments are available to evaluate students’ attitudes and barriers, evidence on culturally adapted tools for Serbian nursing students remains limited. Therefore, the study aimed to assess the psychometric properties of the Serbian version of the SA-SH-Ext and to explore nursing students’ attitudes and barriers to sexual health communication. Methods: A sequential mixed-methods design was used. A total of 180 nursing students completed the SA-SH-Ext and SABS scales, followed by psychometric analysis including exploratory and confirmatory factor analyses and reliability testing. Semi-structured interviews with 20 students were thematically analysed to explore experiences and communication challenges. Results: Factor analysis yielded a four-factor model with the factors Being Comfortable, Communication with People with Disabilities, Future Patient and Working Relations, and Education and Competence, which explained 60.6% of the variance. The scale demonstrated strong internal consistency. Male and younger students reported higher comfort levels. Qualitative findings revealed discomfort, limited training, and fear of patient reactions, especially when discussing sexual health with older, disabled, or terminally ill patients. Conclusions: The Serbian SA-SH-Ext is a valid and reliable tool for assessing readiness to address sexual health. Despite positive attitudes, students face significant barriers. Integrating structured education into nursing curricula is essential to building competence and reducing stigma around sexual health in clinical practice. Full article

Background: In disaster-prone countries like Japan, disaster prevention education (DPE) is considered essential for vulnerable populations, including pregnant women. This pilot study aimed to clarify the status of DPE and the use of the Maternal and Child Health Handbook (MCHH) in medical institutions during disasters. Methods: This cross-sectional pilot study was conducted in 2020. An anonymous self-administered questionnaire was distributed to administrators at 101 medical facilities across three Japanese prefectures. Descriptive statistics and Fisher’s exact test were used to analyze the implementation of DPE and associated factors, focusing on MCHH guidance (medical history, identification, and carrying the handbook). Results: Of the 28 facilities with valid responses, 9 (32.1%) implemented DPE. There was a tendency for guidance on MCHH usage during disasters to be provided in facilities that were General or Regional Perinatal Medical Centers (n = 5, 83.3%; p = 0.007). Despite limited sample sizes in some categories, the results suggested that specific institutional characteristics influence the provision of disaster preparedness information. Conclusions: While perinatal medical centers are multifaceted and busy, they play an essential role in emphasizing the importance of the MCHH during disasters. Facilities already providing DPE should integrate broader preparedness measures alongside specific MCHH guidance to improve maternal and child safety. Full article

Background/objectives: Emotional intelligence (EI) plays an important role in nursing education by supporting competencies such as communication, leadership, resilience, and clinical performance. In contemporary nursing education, students face increasing academic, clinical, and emotional demands, highlighting the need to identify modifiable factors that may be associated with EI and can inform student support strategies. Despite extensive EI research, evidence remains limited and inconsistent regarding how specific health-promoting lifestyle domains and sleep quality relate to EI among prelicensure nursing students. This study aimed to examine factors associated with EI and its relationship with health behaviors among prelicensure nursing students. Methods: A cross-sectional quantitative design was used. A convenience sample of 287 prelicensure nursing students from a local nursing school completed self-report questionnaires: the Schutte Self-report Emotional Intelligence Scale (SSEIS), the Health-Promoting Lifestyle Profile II (HPLP-II), and the Pittsburgh Sleep Quality Index (PSQI). Results: In structured multiphase regression, HPLP-II interpersonal relations (B = 4.42, 95% CI = 1.44 to 7.50, p = 0.004) and spiritual growth (B = 6.59, 95% CI = 3.81 to 9.37, p < 0.001) were positively associated with EI. Poor sleep quality (PSQI > 5) was negatively associated with EI (B = −1.95, 95% CI = −3.88 to −0.01, p = 0.049). Conclusions: Interpersonal relations, spiritual growth, and sleep quality were associated with EI among prelicensure nursing students. These factors may be relevant to consider when designing student support and EI-related educational initiatives; however, longitudinal and intervention studies are needed to clarify directionality and causality. Full article

Background: Missed nursing care, defined as essential patient care that is omitted or delayed, is a growing source of concern due to its effects on healthcare quality and patient safety. Our aims in this study were twofold: first, we examined the extent and types of missed nursing care, and second, we analyzed the relationship between the care missed by hospital nurses and the staffing and resource adequacy in an academic medical center. Methods: A descriptive cross-sectional study was conducted during the period between November 2022 and July 2023. Data were collected using a self-administered questionnaire that comprised items on socio-demographic and work-related characteristics, items on staffing and resource availability, and items from the ‘MISSCARE’ Survey. Results: The most frequently missed nursing care involved pressure-relieving interventions (Mean = 2.39) and ambulation/mobilization (Mean = 2.27), while medication administration (Mean = 1.60) and glucose monitoring (Mean = 1.56) were missed the least. Labor resource inadequacy (β = 0.315, p < 0.001) and communication and teamwork deficits (β = 0.285, p < 0.001) were positively associated with missed nursing care, whereas staffing and resource adequacy showed an inverse association (β = −0.164, p = 0.006). The model explained 49.8% of the variance in missed nursing care (R² = 0.498). Conclusions: These findings highlight that missed nursing care is a system-level issue primarily associated with staffing and resource constraints rather than individual characteristics. Improving staffing adequacy, resource availability, and interprofessional collaboration may reduce care omissions and enhance patient safety in Saudi Arabian academic medical centers. Full article

Background/Objectives: Limited health literacy among older adults with noncommunicable diseases (NCDs) remains a major challenge in community and primary-care settings. This action research aimed to develop and evaluate a community-based health literacy training model for volunteer caregivers for the elderly (VCEs) to support the prevention and control of diabetes and hypertension among older adults in the community. Materials and Methods: This study was conducted in a primary care-based community setting and comprised two phases: Phase 1 (model development) and Phase 2 (implementation and evaluation). The primary analytic sample consisted of 38 volunteer caregivers for the elderly, each providing home-based health education to one older adult (n = 38). The intervention combined structured health literacy education based on the K-shape framework (Knowledge, Comprehension, Thoughtful Inquiry, Decision-making, and Implementation) with SKT meditation/exercise. The program was delivered weekly over 8 weeks. Outcomes included health literacy (20-item scale) and disease prevention and control behaviors (12-item scale), assessed at baseline, immediately post-intervention, and 1 month after program completion. Results: Among VCEs, mean health literacy scores increased significantly from baseline to post-intervention and were further improved at 1-month follow-up (p < 0.001), indicating sustained gains in health literacy. Preventive behavior scores also increased significantly from baseline to post-intervention (p < 0.001); however, no additional improvement was observed at 1 month compared with immediately after the program (p > 0.05). The magnitude of improvement suggested a meaningful effect of the intervention on health literacy, while behavioral changes appeared to plateau after program completion. Conclusions: The community-based training model effectively and sustainably improved health literacy among volunteer caregivers for the elderly. Although preventive health behaviors improved immediately after the intervention, no further gains were observed at 1 month, suggesting that ongoing reinforcement may be required to sustain behavioral change. This model supports the role of community participation in primary care-based NCD prevention among older adults. Full article

Background: Pediatric Interhospital Transport demands highly specialized, coordinated care to ensure safety and continuity across settings. The SCOPETAS scale, recently adapted into Spanish from the Pediatric Transport Triage Tool, has been validated for physicians but not for nurses. Objective: To validate the SCOPETAS scale for use by nursing professionals in Pediatric Interhospital Transport. Methods: A cross-sectional inter-rater reliability study using clinical vignettes was conducted between December 2024 and February 2025 with nurses from eight hospitals within a Spanish autonomous community. Participants applied the SCOPETAS scale to two simulated pediatric transport scenarios. Agreement with physicians’ decisions (gold standard) was analyzed using weighted kappa statistics, logistic regression, and ROC curve analysis. Results: A total of 128 nurses participated (91% female; mean age, 39.5 years). Correct team composition decisions were achieved in 91.4% of severe cases and 73.9% of mild cases. Overall concordance with physicians was high. Possession of a Master’s degree was inversely associated with decision accuracy. Conclusions: When applied by nurses, the SCOPETAS scale demonstrated strong agreement with physicians’ decisions, particularly in severe scenarios. Its implementation may enhance patient safety, optimize resource allocation, and promote nursing autonomy in Pediatric Interhospital Transport, supporting its integration into clinical practice as a validated, evidence-based decision-support tool for pediatric transport triage. Full article

Background/Objectives: The diagnosis of a rare disease such as Sturge–Weber syndrome (SWS) has a profound emotional impact on parents, who must adapt to an unexpected and complex caregiving role. This study aimed to analyse the sense of caregiving among parents of children with SWS and to identify the coping strategies they adopt. Methods: A cross-sectional descriptive study was conducted with 28 parents of children with SWS in Spain. Data were collected using the Brief COPE inventory and the Finding Meaning Through Caregiving Scale (FMTCS). Descriptive statistics and non-parametric bivariate analyses were performed. Results: Acceptance (mean = 5.14; SD = 0.85) and active coping (mean = 5.07; SD = 1.12) were the most frequently used coping strategies. Higher provisional meaning in caregiving was positively associated with active coping (ρ = 0.423; p = 0.025), acceptance (ρ = 0.562; p = 0.002), and humor (ρ = 0.557; p = 0.002). As children aged, parents reported a greater sense of caregiving meaning (ρ = 0.294; p = 0.049). Conclusions: Parents of children with SWS tend to adopt active and adaptive coping strategies over time, finding increasing meaning in their caregiving role. These findings highlight the importance of nursing-led interventions aimed at supporting parental coping, meaning-making, and emotional well-being in families affected by rare diseases. Full article

Background: Adults on maintenance hemodialysis experience multiple physical and psychological symptoms that can affect confidence in self-management and perception of care received from healthcare providers. Understanding the interplay between symptom burden, self-management self-efficacy, and perceptions about care received is essential to inform patient-centered nephrology nursing. Aim: This cross-sectional study aimed to describe dialysis symptom burden, self-efficacy to manage chronic disease, and satisfaction with nursing care, and to examine associations among these variables in adults undergoing maintenance hemodialysis in Oman. Methods: A cross-sectional study using consecutive sampling was conducted among 232 adults on maintenance hemodialysis at two dialysis units in Muscat, Oman. Data were collected using the Dialysis Symptom Index, the nursing care satisfaction questionnaire, and the self-efficacy scale. Descriptive, correlation, and multivariable linear regression analysis were used to summarize the findings. Results: The mean age was 55.9 years and the most common comorbidities were diabetes (58.2%) and hypertension (74.1%). Symptom burden was substantial, with over half reporting muscle soreness, anxiety, sleep disturbance, dry mouth, pruritus, appetite loss, and dyspnea, although severity was generally mild–moderate (1.1–1.6/4). Satisfaction with nursing care was high (90.2%), while self-efficacy was moderate (mean 30.52/44). Patient satisfaction correlated positively with self-efficacy (r = 0.25, p < 0.001), but not with symptom burden (r = 0.08, p = 0.24); Self-efficacy showed a small positive correlation with dialysis symptom burden (r = 0.14, p = 0.03), suggesting that patients who were more aware of and reported more symptoms also perceived themselves as more actively engaged in managing their illness. In multivariable analysis, higher satisfaction and more favorable laboratory indicators independently predicted higher self-efficacy. Conclusions: Adults on hemodialysis reported high satisfaction with nursing care but continued to experience multiple physical and psychological symptoms and had only moderate self-efficacy to manage their condition. There is a need to integrate structured symptom assessment and targeted, nurse-led self-management support intervention into routine dialysis care to reduce symptom burden and enhance patients’ confidence in managing their illness. Full article

Background: Frailty markedly increases risk of unplanned readmission, 30-day mortality, and discontinuity of care during the transition from hospital to home. Although this transition represents a critical period for patient safety and recovery, the specific needs perceived by individuals with frailty and their caregivers at the time of discharge remain insufficiently understood. Aim: The aim of this study was to explore and synthesize qualitative evidence of perceived needs by individuals with frailty and their caregivers during the transition from hospital to home. Methods: A qualitative systematic review will be conducted following the Joanna Briggs Institute (JBI) methodological guidance. Systematic searches will be performed in PubMed, CINAHL, Web of Science (WoS), Biblioteca Virtual de Salud (BVS), Scopus, and Google Scholar. All primary qualitative and mixed-methods studies with a qualitative component, published in any language and without date restrictions, will be eligible. Methodological quality will be appraised using the JBI Critical Appraisal Checklist for Qualitative Research. A meta-aggregative approach will be applied to extract and synthesize findings using JBI SUMARI software. Confidence in the synthesized findings will be assessed using the ConQual approach. Expected results: The results will describe the perceived needs of this population and their caregivers and will support the development of practical recommendations for transitional care. Conclusions: The findings are expected to inform person-centered transitional care practices and support the development of clinical strategies to improve continuity of care. Full article

Background: Burnout and job satisfaction are widely studied phenomena within the field of occupational health, particularly among nursing professionals exposed to high work demands. Work engagement has been identified as a potential mediator that may buffer the negative effects of burnout on job satisfaction. However, in the Peruvian context, empirical evidence on this relational dynamic remains limited. Objective: The objective of this study is to examine the mediating role of work engagement in the relationship between burnout and job satisfaction among Peruvian nurses using a structural equation modeling (SEM) approach. Methods: An explanatory study was conducted with a sample of 230 Peruvian nurses (M = 41.22, SD = 11.65). Data were analyzed using structural equation modeling. Results: Burnout showed significant negative correlations with work engagement (r = −0.47, p < 0.01) and job satisfaction (r = −0.41, p < 0.01), while work engagement was positively associated with job satisfaction (r = 0.79, p < 0.01). The structural model demonstrated a good fit (CFI = 0.96, TLI = 0.95, RMSEA = 0.06, and SRMR = 0.04). The model also indicated solid overall fit and revealed a significant indirect effect of burnout on job satisfaction through engagement, accounting for approximately 24% of the variance in engagement and 80% of the variance in job satisfaction. Conclusions: The findings confirm that work engagement fully mediates the relationship between burnout and job satisfaction among Peruvian nurses, serving as a key protective psychosocial resource. These results reinforce the Job Demands–Resources (JD-R) model and highlight the importance of implementing organizational interventions aimed at strengthening work engagement as a strategy to improve satisfaction and well-being in demanding healthcare settings. Full article

Background: The humanization of care is increasingly recognized as a core component of healthcare quality; however, its meaning remains complex and strongly shaped by organizational, professional, and educational contexts. Nursing students, as future healthcare professionals, play a crucial role in the development and transmission of humanized care values, making their representations of the humanized hospital particularly relevant for understanding how these values are constructed during professional education. Aim: To explore how undergraduate nursing students conceptualize the humanized hospital. Methods: A qualitative exploratory study was conducted involving 742 undergraduate nursing students enrolled in a Bachelor of Science in Nursing program in Italy. Data were collected through a single open-ended written question inviting students to describe how they imagine a humanized hospital. Textual data were analyzed using Automatic Analysis of Textual Data within an Exploratory Multidimensional Data Analysis framework, enabling the identification of shared lexical patterns, discursive clusters, and latent semantic dimensions within a large textual corpus. Findings: Students articulated the humanized hospital as an integrated and system-oriented care environment in which relational, organizational, professional, and holistic dimensions are deeply interconnected. Humanization was associated not only with empathy, respect, and emotional engagement, but also with organizational functioning, teamwork, adequate resources, and professional competence. Two latent dimensions structured these representations: the first highlighted organizational systems as enabling conditions for person-centered care, while the second framed professional operability and technical competence as foundations for a holistic understanding of patients’ physical, psychological, and social well-being. Conclusions: Undergraduate nursing students’ discourse revealed an articulated and multidimensional representation of hospital humanization, conceptualizing it as an emergent property of healthcare environments rather than as a function of individual attitudes alone. These findings underscore the importance of addressing hospital humanization simultaneously at relational, educational, and organizational levels and highlight the need for nursing education programs and healthcare institutions to foster structural and professional conditions that sustainably support humanized care in clinical practice. Full article

Background: Trauma-informed education (TIE) has become commonplace in nursing education; however, little is known about students’ experience of this and its impact on their practice. Aim: This study aimed to evaluate and explore mental health nursing students’ perspectives on TIE, and its impact on their practice, to contribute to the knowledge and evidence base that informs nursing and broader healthcare education. Methods: This qualitative, phenomenological study used a conversation café approach to focus group interviews (n = 3) with final year mental health nursing students (n = 11), reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Analysis: The data generated was analysed using reflective thematic analysis. Findings: Three themes were identified: 1. a compass for practice; 2. mental health nursing: between paradigms; and 3. supporting personal development and wellbeing. Integrating TIE within nursing education can support students to adopt the principles of trauma-informed care (TIC) both personally and in their practice. Improved self-awareness, recognition of trauma and adopting self-care strategies were valuable in supporting personal resilience and wellbeing and in managing the challenges of mental health practice. Conclusions/Recommendations: TIE has the potential to have a positive impact on wellbeing; therefore, its integration should be considered for all healthcare programmes. Further interprofessional research is needed to establish the longer-term impact of TIE as students progress into their nursing careers. Full article

Background/Objectives: Domestic violence against women is a widespread global health issue profoundly affecting victims, their families, and society. This study aimed to assess the prevalence, patterns, risk factors, and health sequelae of domestic violence among females during reproductive age in Sharkia governorate, Egypt. Methods: A cross-sectional descriptive study was conducted from April to December 2024. A total of 379 females of reproductive age (15–49 years) were recruited using simple random sampling from secondary schools and Maternal and Child Health centers affiliated with the Ministry of Health. Data were collected using a structured interview questionnaire covering sociodemographic characteristics, violence exposure (physical, psychological, economic, and sexual), risk factors, causes, severity, perpetrators, and consequences. Results: The overall prevalence of domestic violence was 88%. Psychological violence was the most common form (78%), followed by physical violence (63%), and economic violence (43%). Insults were the predominant form of verbal abuse, while slapping and beating were the most common manifestations of physical violence. Husbands were identified as the primary perpetrators across all violence types. Major risk factors included cigarette use by the abuser (47%), alcohol and drug use (14%), and psychological problems (11%). The most frequently reported consequences were anxiety, fear, and depression (82%), followed by insomnia (55%) and seeking separation (49%). Conclusions: Domestic violence against women of reproductive age is highly prevalent in the study setting, with significant physical and psychological consequences. Comprehensive interventions, including awareness campaigns, legal enforcement, women empowerment programs, and healthcare provider training, are urgently needed to address this critical public health issue. Full article

Background/Objectives: Workplace violence (WPV) is a major occupational concern in psychiatric settings, where mental health nurses (MHNs) are consistently identified as a high-risk professional group. Within this context, sexual violence (SV) remains understudied as a distinct phenomenon and is often embedded within aggregated measures of WPV. This systematic review aimed to synthesize the available evidence on SV against MHNs working in inpatient settings by: (1) describing its prevalence, forms, and characteristics; (2) examining psychological, occupational, and physical outcomes; and (3) identifying associated risk factors. Methods: This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251103606). A literature search was performed across PubMed, CINAHL, Scopus, Web of Science, and PsycInfo, supplemented by reference list checking and citation tracking. Peer-reviewed quantitative and qualitative studies published in English or Italian were eligible if they involved MHNs working in inpatient settings and addressed SV. Study selection, data extraction, and risk-of-bias assessment were conducted independently by two reviewers. A narrative synthesis following SWiM guidance was undertaken, and the certainty of evidence for statistically significant outcomes was assessed using the GRADE approach. Results: Twenty-five studies published between 2003 and 2025 were included. Definitions of SV varied substantially. Reported prevalence ranged from 0% to 68%, with verbal sexual harassment ranging from 19.5% to 53.4%, physical sexual harassment ranging from 14% to 42.9%, and sexual assault up to 18.6%. Evidence indicated associations between SV exposure and poorer quality of life, burnout, and days lost from work. The main risk factors included gender, age, education, work experience, employment type, acute psychiatric settings, night shifts, normalization of violence, and history of physical and sexual violence. Conclusions: SV against MHNs represents a relevant issue in psychiatric settings. Findings suggest significant psychological and occupational consequences. Standardized definitions and measurement, longitudinal research, and intervention studies are needed to inform effective prevention strategies and organizational responses. Full article

Background/Objectives: The global nursing workforce shortage has heightened concerns about burnout, workload, and nurse retention, with an increasing intention to leave the profession and the unit, especially in the post-pandemic context. Although intention to leave has been widely studied, limited attention has been paid to nurses who continue to provide high-quality care and persist despite expressing a desire to leave. This study aimed to explore the reasons for persistence among nurses who intend to leave the organization and the profession. Methods: A descriptive qualitative study was conducted involving frontline nurses and nurse managers working in a large university healthcare trust in Northern Italy. Data were collected through three focus groups, using a semi-structured interview, until data saturation was achieved. Data were analyzed using inductive content analysis. Findings were reported in accordance with COnsolidated criteria for REporting Qualitative research guidelines. Results: Thirty-two participants were included. Overall, two main themes emerged: ‘Reasons that are inside of me’ and ‘Reasons that are outside of me but influence my decisions to stay’, with eight and six subthemes respectively. Internal reasons included professional passion, commitment, autonomy, perceived usefulness, and supportive collegial relationships. External reasons included organizational flexibility, opportunities for internal mobility and professional development, responsiveness to nurses’ expectations, and, in some cases, limited external employment alternatives. Conclusions: Persistence represents a distinct and underexplored dimension within the intention-to-leave continuum. While internal reasons reflect deeply rooted professional identity, external organizational reasons are modifiable and play a critical role in promoting retention. Organizational strategies aligned with nurses’ values, expectations, and professional development needs may enhance workforce stability and inform more targeted retention interventions. Full article

Background. Virtual reality (VR) is emerging as a non-pharmacological tool to support rehabilitation and self-management. Evidence of its effectiveness, however, remains fragmented. This umbrella review synthesized systematic reviews and meta-analyses on VR interventions in chronic conditions. Methods. Following the Joanna Briggs Institute Manual for Evidence Synthesis, comprehensive searches were conducted in MEDLINE, CINAHL, Cochrane Database, Web of Science, and Scopus. Eligible studies were systematic reviews and meta-analyses assessing VR interventions. Two reviewers independently performed screening, quality appraisal, and data extraction. Results. Seventeen reviews, including 229 primary studies, were analyzed. Stroke and chronic obstructive pulmonary disease were most frequently investigated. VR tools ranged from web- and smartphone-based systems to wearable devices and interactive games. Significant improvements were reported in respiratory outcomes, functional mobility, balance, and psychological symptoms. Cognitive effects were mixed. Reported adverse events, mainly cybersickness and dizziness, were mild. Conclusions. VR may improve physical, respiratory, psychological, and selected cognitive outcomes in chronic conditions. Despite study heterogeneity, evidence supports its integration into chronic care. Future work should standardize protocols, assess long-term effects, broaden target populations, and address equity and ethical issues to fully realize VR’s potential as a person-centered tool. Full article

Background: Narration of care (NOC) refers to a nurse’s ability to explain the purposes, goals, and objectives of nursing tasks. In this project, narration of care (NOC) refers to real-time verbal explanation of nursing tasks and should not be confused with the Nursing Outcomes Classification, which uses the same acronym. Although NOC is recognized as a critical skill, little research exists on how to teach it or evaluate its use. A companion article describes the development of a NOC framework. This article focuses on implementation and observed changes during rollout. Objective: We aimed to describe the implementation of a discussion-based course designed to teach nurses and patient care assistants (PCAs)—collectively referred to as nursing staff—how to effectively narrate care, and to assess changes observed during the implementation period. Methods: We used a mixed-methods, pre- and post-implementation design across seven hospitals over six months (February–August 2023). Quantitative data included pre–post comparisons of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores (baseline: 2022; follow-up: 2024) and structured observations of nurse–patient interactions. Qualitative data from free-text course evaluations were thematically analyzed to contextualize quantitative findings. Integration occurred by comparing themes with observed practice gaps and patient experience trends. Results: Course Evaluations: In total, 7341 staff completed the course; 4185 evaluations were submitted. Ninety-five percent reported increased knowledge and rated the course highly. Common strategies cited included teach-back, reducing anxiety through NOC, active listening, and building personal connections. HCAHPS Comparisons: Five domains improved significantly post-implementation: care transitions (4.6, p = 0.001), cleanliness (3.9, p = 0.024), communication about medications (2.3, p = 0.042), discharge communication (2.7, p = 0.002), and restfulness (2.5, p = 0.015). Practice Observations: In total, 1281 observations were conducted. Observations indicated frequent use of several NOC-aligned behaviors and opportunities to improve narration of the environment and resolution of patient concerns. Conclusions: Improvements in patient experience measures and observed practices coincided with the course rollout. However, given the pre–post, uncontrolled design, causality cannot be inferred. Full article

The rise in ICU survival rates has introduced new challenges related to the long-term effects of intensive care, known as Post-Intensive Care Syndrome (PICS). Nurses play a key role in these clinics; however, the nature and outcomes of their interventions remain insufficiently understood. Objectives: This review aims to identify nursing interventions for PICS in follow-up clinics. Methods: Using the JBI scoping review methodology, we searched PubMed, Web of Science and CINAHL (via EBSCOhost) in March 2025, and examined grey literature in RCAAP and Open Dissertations (through B-ON). Inclusion criteria, based on JBI’s PCC (Population, Concept, Context), focused on nursing interventions for PICS for patients and families in follow-up. Studies involving children, adolescents, pregnant women, and those receiving end-of-life care were excluded. Results: Encompassing studies from 2005 to 2022 across multiple countries, this review highlights nursing interventions for post-ICU recovery. A total of 394 articles that met our search criteria were found, resulting from searches in the mentioned databases. These were initially exported to Rayyan, and 115 duplicates were removed. The 21 articles that met our inclusion criteria were fully analyzed, and those that effectively answered our questions and met our inclusion criteria were selected. In the end, 9 articles were selected, to which, after an individual analysis of their bibliographic references, 3 more were added, totaling 12 articles submitted to the final analysis. Conclusions: For patients, interventions ranged from debriefing, PICS symptom evaluation, ICU re-visits, health education, cognitive–behavioral therapy and support groups, complemented by home-based physical rehabilitation and virtual reality. Family-focused interventions centered on appointment involvement, educational sessions, patient diary review, and emotional support. These assessments and interventions address the consequences of ICU admission, with the goal of facilitating physical, mental, and emotional rehabilitation of ICU survivors. This review emphasizes the critical role of follow-up consultations in the recovery of both patients and families. A comprehensive assessment using PICS scales and the integration of families into care plans are crucial for optimizing intervention outcomes. Implications for Clinical Practice: The development of evidence-based guidelines for implementation of follow-up clinics for SPICI appointments is necessary. Full article

Background/Objectives: Hyperbaric Oxygen Therapy (HBOT) involves breathing oxygen at pressures greater than atmospheric levels and is used to treat diverse clinical conditions. However, little is known about the lived experiences and perceived needs of patients undergoing scheduled treatment in multiplace hyperbaric chambers, where nurses play a key role in support, safety, and communication. This study aimed to explore the perceptions, expectations, and needs of patients receiving scheduled HBOT sessions in a multiplace chamber in a hospital setting. Methods: A qualitative phenomenological design was used. Participants were recruited consecutively among adults who had completed at least 10 HBOT sessions and demonstrated adequate cognitive function. Individual semi-structured interviews were conducted between January and March 2023 in locations chosen by participants. Interviews were audio-recorded, transcribed, and validated by participants. Results: Twelve participants (eight men, four women; aged 25–84 years) were included. Four thematic areas emerged: (1) Biopsychosocial lived experiences, including initial uncertainty, physical discomfort such as ear pressure or mask-related issues, and progressive recognition of therapeutic benefits. (2) Interpersonal relationships, highlighting trust, security, and emotional support provided mainly by nurses. (3) Communication experiences, with participants expressing satisfaction but requesting clearer, earlier information on procedures, risks, and expected sensations. (4) Structural and organizational factors, where transportation logistics and treatment scheduling were significant sources of fatigue and discomfort. Conclusions: Patients valued HBOT and perceived notable health improvements, while identifying specific unmet informational and organizational needs. These findings suggest the importance of nurse-led educational interventions to enhance preparation, reduce anxiety, and optimize patient experience during HBOT. Full article

Background/Objectives: Challenging behaviour post-stroke can complicate care and disrupt rehabilitation, yet its presentation and management are underreported. This study explored how such behaviours were documented in clinical records and managed in stroke settings, and how care delivery and discharge outcomes were documented in this context. Methods: A retrospective chart review was conducted across two NHS stroke units, covering all admissions between March and April 2022. Patient records were reviewed to capture demographic, clinical, and behavioural information, together with details relating to management and discharge. Challenging behaviour was identified retrospectively from clinical documentation during routine care. Descriptive statistics were used to summarise the data. Results: Forty-eight stroke admissions were examined, with challenging behaviour documented in thirteen patients (27%). Eleven had ischaemic stroke, with moderate severity common (n = 6), while inattention/neglect (n = 5) and infection (n = 4) were also documented. Behaviours were commonly recorded as confusion or agitation, and predominantly by nursing staff. Challenges to care delivery were documented in six of these patients, and additional professional input was provided for seven. Discharge delays were documented in patients with challenging behaviour, and the median length of stay was notably longer for this group (19 days compared with 7). Documentation of cognitive or delirium screening was uncommon. Conclusions: Challenging behaviour was documented in over a quarter of acute stroke admissions and was documented alongside greater care complexity and longer hospital stays. These preliminary descriptive findings from a small sample indicate a need for further exploration to better characterise challenging behaviour following stroke and its implications for care. Full article

Background: Health literacy and eHealth literacy are core competencies for nursing students, yet their distribution across training pathways remains insufficiently explored. Objective: This study aimed to examine HL and eHL levels among nursing students across different years of the educational programme and identify distinct subgroups of students. Methods: A cross-sectional study was conducted among undergraduate nursing students enrolled in all years of a single Italian university programme. Literacy profiles were assessed using validated questionnaires. A Two-Step Cluster Analysis was applied to identify homogeneous literacy profiles. Group differences were examined using appropriate statistical tests. Results: Four distinct clusters were identified, showing heterogeneous patterns of literacy profiles across the training course. Significant differences emerged in demographic and educational variables across clusters. Conclusions: The findings highlight the coexistence of diverse literacy profiles among nursing students and suggest the need for tailored educational strategies. Due to the cross-sectional design, causal inferences cannot be drawn. Full article

Background/Objectives: This study examined the reasons and sociodemographic drivers behind delays in seeking medical care among participants in the All of Us Research Program. Methods: A cross-sectional study was conducted using data collected between 2018 and 2024. The primary outcome was the prevalence of reasons for delayed medical care (DMC). Descriptive statistics were used to calculate the prevalence of the various reported reasons for delayed medical care. Binary logistic regression was applied to examine the association between sociodemographic characteristics and each reported reason for delayed medical care. Results: Out of a total of 633,000 All of Us participants, 300,820 participants had complete data on the healthcare utilization and access survey and were eligible for final analysis. The most common reported reasons for DMC were out-of-pocket expenses (16.68%), nervousness about seeing a provider (14.18%), and inability to get time off work (11.04%). Females had significantly higher odds of DMC due to out-of-pocket costs (OR = 1.31, 95% CI: 1.28–1.33). Black (OR = 0.81, 95% CI: 0.78–0.84) and Asian (OR = 0.94, 95% CI: 0.89–0.99) individuals had lower odds of DMC due to out-of-pocket costs. Married individuals had more than twice the odds of DMC due to childcare responsibilities (OR = 2.45, 95% CI: 2.33–2.56). Conclusions: A significant proportion of participants reported DMC due to various reasons, with financial, medical visit anxiety, and work-related reasons being the most common. These findings highlight actionable intervention targets, including nurse-led cost navigation and financial counseling, flexible scheduling/telehealth to reduce work-related delays, and patient-centered communication and outreach strategies to reduce visit-related anxiety and support caregiving and transportation needs. Full article

Background: Individuals with mental health conditions frequently experience stigmatization and discrimination. Among the primary objectives in the fight against stigma is to examine groups that play a crucial role in addressing it, such as healthcare professionals. Although research has examined stigma among healthcare professionals, few studies have specifically addressed how nurses perceive and contribute to the stigmatization of individuals with mental health conditions. Objective: The aim of this review was to compile and compare the scientific literature addressing nurses’ stigma toward individuals with mental health conditions. Methods: Following the methodological guidelines of the Joanna Briggs Institute and in accordance with the PRISMA 2020 guidelines, an integrative review was conducted of MEDLINE (PubMed), EMBASE, APA PsycInfo (EBSCO), and CINAHL Complete (EBSCO). Database-specific indexing terms were combined with the Boolean operators AND/OR. Studies with quantitative or qualitative methodologies, published in Spanish or English and without restrictions by year of publication, were included. Two independent reviewers selected the studies and performed the critical appraisal. Results: The search retrieved 4256 records, of which 32 articles were finally included. A content analysis of the selected studies was conducted. Most studies used validated questionnaires to assess stigma and its associations with various variables, while only a limited number employed qualitative designs. Across the 32 studies (n = 6283 nurses from 29 countries), stigma was observed across settings but tended to be lower among mental health specialists. Insufficient training and limited contact were consistently associated with higher levels of stigma, whereas specialization and positive contact were linked to lower levels. Associative stigma emerged as a recurrent theme with implications for psychiatric nursing identity. Conclusions: Nurses working in mental health settings generally demonstrate more positive attitudes toward individuals with mental health conditions compared with those in other clinical areas; however, stigma persists across all settings. Associative stigma may be influencing the development and advancement of psychiatric nursing. Specific academic training, capacity building, and specialization in mental health are essential to counteract stigma. Further qualitative research is required to achieve a deeper understanding of this phenomenon. Full article

Background: The nursing profession is currently facing a critical challenge with a noticeable decline in interest among young people to pursue nursing as a career. Objectives: This study examined academics’ perceptions of factors driving low enrollment in Greek baccalaureate nursing programs and explored incentives that could motivate young people to pursue nursing careers. Methods: We performed a cross-sectional study. We collected our data during October 2025 through an anonymous questionnaire. Source population included all academics in the nine nursing departments in Greece. Response rate was 54.2% (90 out of 166). Results: We classified the factors contributing to the low interest in baccalaureate nursing education programs into four groups: (a) poor working conditions, (b) negative social and cultural perceptions, (c) educational constraints, and (d) impact of the COVID-19 pandemic. Academics identified negative social and cultural perceptions of nursing and poor working conditions as the primary drivers of low interest in baccalaureate nursing programs. The COVID-19 pandemic was viewed as having a moderate influence on young people’s career choices, while educational constraints were considered least important overall. Academics in nursing departments based in Greece’s capital perceived the pandemic’s impact as more substantial than colleagues outside the capital and attributed greater importance to educational constraints. Respondents without prior clinical nursing experience emphasized educational barriers more strongly. To attract students, academics prioritized improving working conditions, increasing salaries, and expanding scholarships and support. Conclusions: Academics reported that unfavorable nursing work environments, intensified during COVID-19, influence students’ career choices, underscoring the need for urgent policy and organizational actions informed by this study and existing evidence. Full article

Objective: This study aimed to examine the association between family cohesion and disease identity in adolescents and young adults (AYAs) with type 1 diabetes mellitus (T1DM) and to test the mediating role of perceived social support in this relationship. Methods: From January 2025 to June 2025, a total of 222 AYA patients with T1DM were recruited from the Department of Endocrinology and Department of Pediatrics of four tertiary-level hospitals in Zhengzhou, Henan Province, China. The Disease Identity Questionnaire for AYA patients with T1DM, Family Cohesion Scale, and Perceived Social Support Scale were used. Results: Family cohesion was positively correlated with perceived social support and disease identity, and perceived social support was positively correlated with disease identity. Perceived social support played a partial mediating role in the association between family cohesion and disease identity (β = 0.391, p < 0.001), accounting for 63.6% of the total effect. Conclusions: Family cohesion is positively associated with perceived social support and disease identity in AYA patients with T1DM, with perceived social support playing a partial mediating role. This indicates that family cohesion shows both direct and indirect associations with patients’ disease identity. The study suggests that interventions aimed at enhancing family cohesion and perceived social support may inform strategies to improve patients’ disease identity, thereby potentially facilitating their psychosocial adaptation. Full article

Background/Objectives: The 2024 Noto Peninsula earthquake in Japan severely affected community care for persons with psychiatric disabilities. This study analyzed the difficulties and adaptive coping strategies of psychiatric visiting nurses (PVN) to inform disaster mental health practice. Methods: A qualitative, descriptive design was used. Semi-structured interviews were conducted with six PVN, and the data were analyzed thematically. Results: Key findings indicated two main challenges: a system-level paralysis of care owing to infrastructure collapse and the ethical dilemmas experienced by the role of PVN as “dual victims.” In response, nurses leveraged pre-existing therapeutic relationships to ensure care continuity and acted as essential liaisons to external teams. The study also documented substantial and unexpected patient resilience. Conclusions: Based on the findings, this study’s primary contribution is a recommendation to reframe disaster policy by shifting focus from merely deploying external aid to empowering existing, trusted community care networks and adopting a strengths-based model for mental health support. Full article