Nurs. Rep., Volume 16, Issue 3 (March 2026) – 27 articles

Background/Objectives: Head and neck cancer survivors experience many late toxicities following radiation therapy. This study aims to identify symptom clusters of late toxicities and their related factors in head and neck cancer survivors. Methods: A cross-sectional study was conducted with 83 survivors (pharyngeal or laryngeal cancer) who had received radiation therapy at least one year earlier. Nine late toxicities were assessed using the Japanese version of the Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) and a custom questionnaire. Quality of life (QoL) and related factors were evaluated with the European Organization for Research and Treatment of Cancer (EORTC QLQ-C 30), Hospital Anxiety and Depression Scale (HADS), UCLA Loneliness Scale, and Liebowitz Social Anxiety Scale (LSAS). Exploratory factor analyses and multiple regression analyses were performed. Results: All participants reported at least one symptom. Dry mouth (90.4%) and difficulty swallowing (72.3%) were particularly prevalent. Exploratory factor analysis (EFA) identified two symptom clusters (SCs): an oropharyngeal dysfunction cluster (pain, trismus, taste changes, difficulty swallowing, hoarseness) and a dry mouth cluster (dry mouth, sticky saliva). Regression analysis indicated that higher scores in both clusters were significantly associated with lower global QoL (oropharyngeal dysfunction SC: β = −0.427, p < 0.001; dry mouth SC: β = −0.268, p = 0.009). Chemoradiotherapy (CRT) was also significantly associated with higher cluster scores (oropharyngeal dysfunction SC: β = 0.233, p = 0.020; dry mouth SC: β = 0.343, p = 0.001). Conclusions: Late toxicities following radiation therapy include two clusters: oropharyngeal dysfunction cluster and dry mouth cluster. Head and neck cancer survivors with higher SC scores had lower global QoL scores and had undergone CRT. These findings may aid in the assessment and self-management support of head and neck cancer survivors after radiation therapy. Full article

Background/Objectives: Secondary traumatic stress (STS) affects healthcare professionals indirectly exposed to patients’ trauma, and emergency personnel may be particularly vulnerable. Evidence from Romania is limited. Methods: We conducted a cross-sectional survey (July–August 2025) among emergency medical professionals working across the integrated emergency care system in Timisoara, Romania (prehospital ambulance/SMURD services and hospital Emergency Department). Secondary Traumatic Stress (STS) symptoms were measured using the 17-item Secondary Traumatic Stress Scale (STSS; item coding 1–5). We summarized STSS total/subscale scores and reliability, classified total scores into severity categories (0–68 metric), compared scores by workplace, sex, and professional role, and examined associations with age and years of experience. Results: The analytic sample included 145 participants (49.0% women), with a median age of 44 years [33–50] and median professional experience of 10 years [5–15]. Mean total STSS was 36.4 (SD 11.9; range 17–66) and internal consistency was high (Cronbach’s alpha = 0.92). Most participants were classified as little/no STS (77.2%), followed by mild (12.4%), moderate (5.5%), high (4.1%), and severe (0.7%). STSS scores did not differ significantly between ambulance service and ED/UPU staff. Women reported higher total STSS than men (39.0 vs. 33.9; p = 0.010), with significant differences for intrusion (p = 0.035) and arousal (p = 0.004). Role differences were significant for total STSS, intrusion, and arousal (p ≤ 0.031), with nurses scoring higher than ambulance drivers/attendants in post hoc comparisons. Years of experience showed small positive correlations with total STSS (r = 0.18, p = 0.032) and intrusion (r = 0.21, p = 0.010); age was associated with intrusion only (r = 0.22, p = 0.008). Conclusions: In this Romanian emergency care cohort, most participants reported low STS severity, but a clinically relevant minority had moderate-to-severe symptoms. Higher symptom burden among women and nurses suggests groups that may benefit from targeted monitoring and support within the integrated emergency system. Full article

Background/Objectives: Research that systematically identifies the components of a psychosocial workplace environment tailored to people with mental illness is limited. This scoping review aimed to map the existing literature and clarify the key concepts of a desirable workplace environment from a psychosocial perspective that enables sustainable employment for people with mental illness. Methods: A scoping review was conducted using the Joanna Briggs Institute methodology. Five databases, including PubMed and Scopus, were searched to extract original English-language, peer-reviewed research articles published between 2003 and 2025 on workplace environments for individuals with mental illness. Two independent reviewers screened the records and selected 16 studies using the population, concept, and context framework. Following data extraction, qualitative inductive analysis was conducted for category development. Results: Five categories and 17 subcategories were identified as psychosocial workplace environments promoting sustained employment: (1) Growth-supportive environments that leverage individual strengths and promote self-actualization; (2) recognition-affirmative environments that respect individual characteristics and are based on fair evaluation and acceptance of diversity; (3) a low-psychological-strain environment featuring predictability and autonomy; (4) a multilayered support network; and (5) a support environment based on interprofessional collaboration and system utilization. Conclusions: Workplace environments supporting the sustained employment of individuals with mental illness appear to involve a multilayered structure integrating self-actualization, predictable and autonomous job design, and comprehensive interprofessional support. The findings provide a preliminary concept map; however, gaps remain in the types and quality of evidence. Future primary research and formal concept analysis are required to validate these components and address existing methodological and contextual gaps. Full article

Background/Objectives: Oral mucositis (OM) is a common complication in onco-hematological patients undergoing chemotherapy and hematopoietic stem cell transplantation, negatively affecting comfort, nutrition, and quality of life. Despite existing assessment tools and recommendations, OM management—particularly non-pharmacological approaches—remains inconsistent, and evidence on nurses’ perspectives and contextual factors is limited. This study explored nurses’ perceptions and experiences regarding non-pharmacological treatments for OM, including educational needs and barriers and facilitators to implementation in clinical practice. Methods: A qualitative descriptive study using inductive content analysis was conducted. Semi-structured interviews were carried out with nurses working in onco-hematological settings in Italy. Data were analysed according to the Elo and Kyngäs framework. Results: Twelve nurses with extensive experience in onco-hematology and transplant care participated in the study. Five main themes emerged: (1) education and training pathways; (2) approaches to mucositis management; (3) nursing competence in OM care; (4) interprofessional collaboration; and (5) governance of practice, including protocols and guidelines. Findings highlighted strong experiential competence, high levels of nursing autonomy in assessment and patient education, and effective interprofessional collaboration, particularly in specialised settings. However, training pathways were predominantly informal, and the availability and use of protocols varied widely across clinical contexts. Conclusions: Non-pharmacological management of OM appears to be sustained primarily by advanced nursing competence and a specialised clinical culture rather than by structured education and standardised governance. Addressing educational gaps and promoting shared protocols may enhance the consistency, quality, and equity of supportive care while ensuring that the findings are clearly reflective of nurses’ experiences. Full article

Background: Australia’s increasingly multicultural landscape has seen a rise in culturally and linguistically diverse populations, many of whom face subtle and systemic forms of discrimination known as “new racism”. Objective: Underpinned by a person-centred and holistic framework, which recognises individuals as experts in their own lived experiences and emphasises strength-based, culturally situated understandings of well-being, this paper reports on a study that explores how culturally and racially marginalised diverse people in Australia cope with the mental health impacts of new racism. Design: A qualitative descriptive approach was employed in this study. Participants: Thirty participants from ten culturally and linguistically diverse communities participated in eight focus groups, providing rich insights into their lived experiences. Methods: Data were collected through semi-structured focus-group interviews conducted between March and June 2025. Data were analysed using Braun and Clarke’ method of thematic analysis. Results: Thematic analysis revealed four key coping strategies: (1) acceptance of immutable identity traits to foster resilience, (2) emotional ventilation within culturally safe spaces, (3) self-growth and empowerment through reflection and adaptive practices, and (4) assertive responses to racism when necessary. While some participants reported psychological distress, many demonstrated resilience and resourcefulness, challenging deficit-based assumptions often found in the existing literature. Findings underscore the importance of culturally responsive mental healthcare, including peer support, emotional safe spaces, and strength-based interventions. Conclusions: This study offers a holistic understanding of how culturally and racially marginalised people cope with new racism and its mental health impacts. The findings highlight the critical need for person-centred, culturally responsive, and equity-focused mental health support, providing actionable guidance for nursing practice and policy development. Full article

Objectives: This study aims to identify factors associated with medication errors among home care nurses in Italy, focusing on the relationships between knowledge, attitudes, and behaviors, and assessing how sociodemographic and professional characteristics influence these dimensions. Methods: A nationwide cross-sectional survey was conducted using the Italian validated version of the Knowledge, Attitudes, and Behaviors in Medication Error in the Home Care setting questionnaire, previously developed and validated for home care settings. Multivariate logistic regression analyses were performed to explore associations among knowledge, attitudes, behaviors, and selected sociodemographic variables because the survey was disseminated through open online channels, and the response rate could not be calculated. Results: A total of 320 nurses participated. Younger age and holding a non-university degree were significantly associated with higher knowledge levels. Internet access at the workplace emerged as the only significant factor associated with medication error prevention for both positive attitudes [OR = 0.412, 95% CI: 0.197–0.861; p = 0.018] and correct behaviors [OR = 0.456, 95% CI: 0.216–0.962; p = 0.039]. Furthermore, attitudes positively predicted knowledge [OR = 2.226, 95% CI: 1.291–3.962, p = 0.004], and both knowledge and attitudes significantly influenced behaviors. Conclusions: The study highlights the interdependence of knowledge, attitudes, and behaviors in preventing medication errors in home care. While internet access and formal education are associated with differences in knowledge, attitudes, and behaviors, the relationships observed warrant further investigation. These findings underscore the potential value of targeted educational strategies and resource availability to support nurses in promoting safe practices. Full article

Background/Objectives: While caregiver burden in Inflammatory Bowel Disease (IBD) is well documented, the association between informal support and patient-reported outcomes (PROs), particularly health-related quality of life (QoL) and psychological well-being, remains underexplored. This systematic review synthesizes evidence on the association of informal caregiving on patient-reported QoL and psychosocial outcomes and maps the available evidence on clinical outcomes. Methods: Following international reporting guidelines and prospective protocol registration, a systematic search was conducted across five electronic databases between May and October 2025. Observational studies in adults with IBD assessing informal support and patient-reported or psychosocial outcomes were included. Owing to substantial heterogeneity in constructs and outcome measures, results were synthesised using a structured Synthesis Without Meta-analysis (SWiM) approach. Methodological quality was assessed using standardised critical appraisal checklists. Results: Six cross-sectional studies involving 1036 patients and 417 informal caregivers met the inclusion criteria. All studies reported a positive direction of association between higher levels or better quality of informal caregiver support and improved patient-reported QoL. Several studies identified psychological and relational factors, such as lower patient psychological distress and caregiver-related positive feelings and caring ability, as mechanisms statistically associated with this relationship. Conclusions: Available cross-sectional evidence suggests a positive association between informal support and patient-reported QoL/psychological outcomes in IBD, but causality cannot be inferred. Priorities include longitudinal dyadic studies and caregiver-inclusive interventions, alongside standardised definitions and measures of support. Full article

Background: Professional identity and ethical integrity are foundational to nursing practice and are shaped in part by educational experiences. This study evaluated an online Holocaust and genocide educational seminar delivered to fourth-year Bachelor of Science in Nursing (BSN) students and explored how students linked seminar content to professional identity formation, ethical vigilance, and patient advocacy. Methods: We conducted a descriptive mixed-methods educational evaluation. Students completed an anonymous pre-seminar survey (demographics, motivations for studying nursing, self-identified desirable professional qualities, and self-rated knowledge of the Holocaust and other genocides) and an anonymous post-seminar feedback survey with four open-ended questions. Quantitative items were summarized descriptively; qualitative data were analyzed using inductive qualitative content analysis. Results: Of the 205 students who attended the seminar, 133 completed the pre-seminar survey, and 110 completed the post-seminar survey. Students reported high baseline knowledge of the Holocaust but limited knowledge of the Armenian and Rwandan genocides. The five themes that emerged are as follows: (1) ethical judgment and the influence of nurses; (2) patient advocacy and social justice; (3) the effect of historical and contemporary trauma on students’ learning experience; (4) genocide awareness and prevention; and (5) approaches to education and content presentation. Conclusions: Carefully facilitated Holocaust and genocide education, delivered through interactive online pedagogy and structured debriefing, may support late-stage nursing students’ reflection on ethical integrity and professional identity during the transition to professional practice. Full article

Patients with end-stage liver disease (ESLD) and their caregivers experience extensive physical, psychological, and social burdens and needs for resources. However, empirical evidence on patients’ and caregivers’ specific reported use of resources to help manage ESLD is lacking. Understanding the type and helpfulness of resources used could strengthen clinical care to address individual needs for resources. Aim: To examine and compare resources patients and caregivers identified as being most helpful in managing ESLD in relation to resources they felt would be helpful. Methods: Patients with ESLD and their caregivers responded in writing to two open-ended questions as part of a survey: (1) What resources have you found most helpful in dealing with patient’s liver disease? and (2) What resources would be helpful in dealing with patient’s liver disease? Conventional content analysis was used to identify resource categories. Results: A total of 192 patients and 198 caregivers completed surveys. We identified two major resource domains—medical and non-medical—and five categories within each. Analysis revealed participant group- and disease severity-based differences in helpful resources. Conclusions: Proactively engaging patients and caregivers early in the course of illness to identify relevant resources that might facilitate ability to manage ESLD. An interprofessional care approach would facilitate efforts supporting financial, social, spiritual, emotional, and mental health needs. Future longitudinal research of unique resource needs along the disease trajectory may help to develop effective interventions. Full article

Background: Fatigue is a multidimensional and subjective experience, and it is one of the most common symptoms of multiple sclerosis (MS), affecting up to 80% of patients and acting as a major driver of work disability. Despite its clinical significance, existing assessment tools often lack conceptual clarity or remain too lengthy for routine clinical use. Objective: To develop and evaluate a new patient-reported outcome instrument designed to assess multidimensional fatigue domains in patients with multiple sclerosis (MS) for use in clinical practice. Methods: This study was carried out in three research stages. Stage 1 (Concept Elicitation) involved qualitative interviews (n = 19) to identify core fatigue domains based on patient experience. Stage 2 (Cognitive Interviews) consisted of interviews with 50 patients to ensure the relevance and clarity of the items. Stage 3 (Exploratory Factor Analysis) and internal consistency testing (Cronbach’s alpha) were performed on the same sample of 50 patients to examine the preliminary factor structure and reliability. Results: Concept elicitation identified lack of energy and persistent exhaustion as core symptoms. The resulting 14-item instrument covers three subdomains: Psychosocial, Physical, and Cognitive. Exploratory factor analysis supported a three-factor solution explaining 75% of the total variance (Factor 1: 28%; Factor 2: 27%; Factor 3: 20%). Internal consistency was high across all factors: Psychosocial (α = 0.923), Physical (α = 0.895), and Cognitive (α = 0.844). Conclusions: This new instrument is a conceptually robust tool that captures the interconnected nature of fatigue in multiple sclerosis (MS). These initial findings support its internal structure and conceptual foundation, providing a practical tool for symptom monitoring in neurological consultations. Full article

Background/Objectives: Pain is a common symptom for hospitalised older adults. Pain is not always adequately assessed, which can lead to inadequate pain management and adverse patient outcomes. Thus, new technology-driven pain assessment tools have been developed; however, little is known about patients’ and families’ experiences of nurses using them in acute care. This study aimed to explore the perspectives of older adult inpatients and their families’ regarding nurses’ use of the digital technology-driven pain assessment application PainChek^® Universal. Methods: A survey was undertaken as part of a stakeholder evaluation of a randomised control trial exploring the effectiveness of nurse-led volunteer support and technology-driven pain assessment in improving the outcomes of hospitalised older adults. The PainChek^® Universal application was implemented on two medical wards of an acute private hospital in Western Australia as part of a larger single-centre, prospective, non-blinded, cluster-randomised control trial. This stakeholder evaluation invited older adult inpatients and their family members to participate in a survey about nurses’ use of the PainChek^® Universal application for pain assessment. Results: A total of 96 inpatients and 27 family members completed the survey. Thirteen patients and nine family members provided additional feedback. Over 90% of patients and family members agreed that the use of the PainChek^® Universal application was a positive addition to pain assessments, rendered no concerns, and helped nurses complete pain assessments. A total of 84% of patients and 87% of family members felt PainChek^® Universal provided a more accurate pain assessment. Survey feedback related to PainChek^® Universal application use, integration of technology, and need for further education. Conclusions: The findings suggest that older adults and their families recognised the benefits of nurses using a digital application for pain assessments. Technology integration in healthcare must be accompanied by patient and family education. Full article

Digital health technologies are being used in healthcare more than ever, which has implications for the daily work of nurses. As the newest members of the nursing profession, new graduate nurses (NGNs) experience great change during the transition to practice experience. The experience of NGNs transitioning to practice while digital health technologies are being increasingly integrated is not well elucidated in the nursing literature. This proposed scoping review will address this gap and aims to explore and describe the literature involving NGNs and digital health technologies. This review will use the Joanna Briggs Institute (JBI) guidelines to search CINAHL, MEDLINE, Embase, and ERIC databases for keywords and subject headings related to the concepts of “digital health technology” and “new graduate nurses”, published between 2020 and 2026. Included articles will involve new graduate nurses with 0–12 months of experience, use digital health technology in the clinical context of nursing, and be peer-reviewed primary research. Articles will be screened and extracted using Covidence and described in line with JBI guidance and presented narratively. The findings of this scoping review will be key in positioning the transition to practice experience for NGNs in an age of digital revolution. Results will be instrumental in enhancing nursing curriculum, ensuring transition policies and procedures are supportive of developing digital health competence and assuring the delivery of better care to patients when using digital health technologies. The contribution of this review will be unique and novel in exploring NGNs and digital health, providing context for the modern experience of transition to practice. Full article

Background/Objectives: Disasters have a substantial impact on health systems and populations worldwide, with increasing frequency, mortality, and economic losses associated with natural hazards. The United Nations emphasises that disasters result from the interaction between hazards, exposure, and vulnerability, requiring integrated, people-centred health responses aligned with the 2030 Agenda. However, empirical evidence describing specific nursing interventions, particularly during response and recovery phases, is limited. This study aims to analyse the fundamental nursing care interventions provided to disaster victims in the Autonomous Region of Azores, Portugal. Methods: A qualitative multiple case study was conducted using documentary analysis of the nursing records from two disaster survivors with different clinical trajectories. Data were collected between August 2023 and May 2024 through complete transcription of nursing documentation contained in the clinical files. Data analysis followed Yin’s case study methodology and was theoretically supported by the Fundamentals of Care Framework. Results: The findings indicated a predominance of interventions addressing physiological needs during the acute phase, which progressively evolved to maintenance, psychosocial support, and adaptation needs during prolonged hospitalizations. Nursing care integrates advanced technical skills with relational and person-centred interventions, including emotional support, therapeutic communication, and promotion of patient autonomy. Conclusions: Nursing practice in disaster situations should be conceptualised as integrative, person-centred care grounded in international nursing frameworks. Strengthening disaster-specific nursing education, developing phase-adapted care protocols, and promoting multicentre longitudinal research appear to play a critical role for advancing nursing care models and informing health policies in disaster-prone regions. Full article

Background/Objectives: Undergraduate nursing students experience high levels of stress and depressive symptoms. This study investigated the prevalence of stress and depressive symptoms among undergraduate nursing students and analyzed the sociodemographic and interpersonal factors influencing these conditions. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, Embase, and CINAHL) were searched for studies published between 2019 and 2024. Both narrative synthesis and meta-analysis were conducted to identify contributing factors and estimate the pooled prevalence rates. Prevalence rates of stress and depressive symptoms were estimated using random-effects models. Subgroup analyses were performed based on the severity of symptoms, study location, country income group, and measurement tool. Effect size, 95% confidence intervals, and p-values were reported. Results: The review included 54 studies. The prevalence of depressive symptoms and stress was 48% and 55%, respectively. Depressive symptoms were most prevalent in studies conducted in lower–middle-income countries and those using the Beck Depression Inventory II. Stress prevalence was highest in studies from upper–middle-income countries and those using the Perceived Stress Scale-10. Significant associations among sociodemographic and interpersonal factors include younger age, female gender, single status, financial issues, poor perceived health, conflicts with friends, and dissatisfaction with social activities. Conclusions: Nearly half of undergraduate nursing students from diverse settings experienced significant stress and depressive symptoms, driven by multiple sociodemographic and interpersonal factors. Full article

Background/Objectives: The rapid expansion of generative artificial intelligence (AI) and large language model-based chatbots has accelerated their adoption in higher education, including nursing. This scoping review mapped the use of AI-based chatbots in nursing education, including curricular domains, pedagogical approaches, educational outcomes, and implementation challenges. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported in accordance with the PRISMA-ScR guideline. Searches were performed across major bibliographic databases and grey literature sources. Quantitative, qualitative, and mixed-methods studies addressing the use of AI chatbots in nursing education or professional training were included. Data were extracted using a standardized instrument and synthesized through descriptive statistics and qualitative content analysis. Results: Sixty-six studies (2019–2025) were included, with significant growth observed after 2023. Most studies employed quasi-experimental designs (37.9%) and were implemented in academic settings (83.3%). Application formats varied across online, hybrid, simulation-based, and classroom models. Reported benefits included improved learning performance, clinical reasoning, and student engagement. Key challenges involved the reliability of AI outputs, academic integrity, data protection, and limited institutional governance. Conclusions: AI-based chatbots represent promising tools to enhance nursing education, particularly when integrated into structured pedagogical strategies with active faculty supervision. Their use can support the development of clinical reasoning, student engagement, and personalized learning. However, methodological heterogeneity, ethical concerns, and governance gaps highlight the need for careful implementation and further rigorous research to ensure safe, effective, and pedagogically sound integration. Full article

Background/Objective: Nursing students commonly use social networking sites during clinical practicums, and excessive use may interfere with their attention, performance, and training during clinical placements. However, the relationship between problematic social networking use, perceived stress, distraction, and self-management of activities during clinical practice among nursing students has not been explored in depth. The aim of this study was to analyze the relationship between problematic use of social networking sites, perceived stress, smartphone-related distraction, and self-management among nursing students during clinical practicums. Methods: A cross-sectional design was carried out. The sample consisted of 340 nursing students. Data were collected between September and November 2025 using a sociodemographic form, the WhatsApp Negative Impact Scale, Perceived Stress Scale, Distraction Smartphone Use during Clinical Practice Scale, and Self-Control and Self-Management Scale. The data were analyzed using SPSS 28. Regression analysis was performed to define the factor of the problematic use of social networks and the relationship between the scales. The STROBE Checklist was used when preparing the manuscript. Results: A positive relationship was found between problematic social networks use and perceived stress (p < 0.001) and distraction (p < 0.001), and there was a negative relationship with self-management (p < 0.001). A negative relationship was found between perceived stress and self-management (p < 0.001). After regression analysis, more problematic social network use consisted of those who spent more time daily using the smartphone (p < 0.001), had more distraction associated with smartphone use during clinical practicum (p < 0.001), had more perceived stress (p < 0.001), those whose last place performing the practicum was the hospital (p = 0.006), and those whose sex was male (p = 0.026). Conclusions: The results obtained from this study indicated an association between problematic Social networksuse and increased perceived stress and distraction, as well as decreased self-management activities during clinical practicum. In line with these findings, perceived stress was negatively associated with self-management; nursing students reporting lower perceived stress also reported a greater capacity for self-management of clinical activities. Full article

Introduction: Currently, REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is an emerging technique for resuscitation in patients presenting severe pathology in hemodynamic shock refractory to conventional treatments. The REBOA technique consists of inserting a balloon through the femoral artery to temporarily occlude the aorta and thus control massive bleeding and improve perfusion of vital organs in critical situations such as hemorrhagic shock. Although it is not a definitive technique, its use buys time before the implementation of a definitive treatment when possible. This makes REBOA an ideal technique for the philosophy of out-of-hospital emergency services and more particularly in the HEMS (Helicopter Emergency Medical Service) environment. On the other hand, REBOA has been postulated as one of the basic pillars in the resuscitation of severe trauma patients with hemorrhagic shock and of the doctrine of damage-control resuscitation in non-compressible torso and lower limb hemorrhage. Objective: To evaluate the potential feasibility of REBOA implementation in patients attended by HEMS teams in Castilla-La Mancha, Spain. Method: A retrospective observational study was conducted analyzing medical and nursing reports from HEMS units between 1 January and 31 December 2023. A statistical study of the variables collected was carried out using statistical techniques appropriate to the pre-specified study variables. A descriptive analysis of the population was performed. Frequency results are expressed in absolute terms, as percentages and confidence intervals. Continuous variables are expressed as mean (SD) and median (range) according to normality test (Kolmogorov–Smirnov test). For the study of the relationship between the different variables, Chi-square or Analysis of Variance is used if they are parametric. Descriptive and inferential statistics were performed using SPSS v24. Results: A total of 103 patients (72.81% men, mean age 57.7 years) were identified as potential REBOA candidates. On arrival of the emergency services the mean SI (shock index) of the patients was 1.36 (SD +/− 0.380). On arrival at the hospital, the mean SI was 1.25 (SD +/− 0.601). Of the series, 57 (55.33%) patients suffered cardiorespiratory arrest (CRA) at some point during pre-hospital care. Of the total number of patients, 38 were patients presenting severe trauma criteria (characterized by life-threatening injuries, with RTS score ≤ 11, shock index > 0.9, or ISS ≥ 16, indicating severe physiological or anatomical alterations), of which 26 (68.4%) did not go into CRA, while 12 (31.6%) did. Of the total number of patients, 65 (63.1%) did not meet severe trauma criteria, but did present medical criteria for REBOA placement, of which 55 (53.4%) were patients who at some point during attendance presented CRA. Although the shock index showed a slight decrease after healthcare without statistical significance or relevant correlation, a highly significant association was observed between severe trauma and cardiorespiratory arrest (p < 0.001). Conclusions: It could be affirmed that it may have been feasible to implement REBOA in 4.47% (103) of the patients attended by the HEMS healthcare team of Castilla-La Mancha. This could help to reduce the morbimortality and mortality of critical patients in medical helicopters. More studies are needed to corroborate this assertion. Full article

Background/Objectives: To identify existing evidence on strategies for standardising nursing handovers in paediatric hospital settings, given their impact on communication, safety, and quality of care. International bodies such as the WHO and The Joint Commission recommend standardisation as a key measure to reduce patient safety incidents. Methods: A scoping review was conducted in December 2022 using Medline, Cochrane Library, Scopus, and CINAHL databases. The search strategy included documents published between 2012 and 2022, in Spanish, English, Catalan, French, and/or Portuguese. We screened according to inclusion criteria (professional nurses and hospitalisation) and exclusion criteria (intensive care and medical professionals) and tabulated the results according to concurrent themes. The PRISMA-ScR guidelines were followed. Results: A total of 308 records were identified. After screening, 25 full-text articles were assessed for eligibility. Following quality appraisal, six were excluded for not meeting predefined criteria, resulting in 19 studies included in the final synthesis. The evidence mapped shows that most structured communication tools have been developed or validated in adult or medical contexts, with limited evaluation in paediatric nurse-to-nurse inpatient settings. Standardised structured communication tools used in hospital settings include SBAR, I-PASS, and Flex 11, while assessment instruments such as the Handoff CEX Scale and Handover Evaluation Scale have been applied to evaluate handover quality. Conclusions: Structured communication tools may contribute to improving information transfer and perceived quality of handover; however, paediatric nurse-specific evidence remains limited and frequently derives from non-nursing or adult contexts. Further adaptation and validation in paediatric inpatient nursing settings are required. Full article

Background/Objectives: Evaluation of students in practicums is essential in their training process. Mobile technologies enable formative assessments in training, enhance feedback, and improve students’ clinical competence and self-efficacy. Nevertheless, in the absence of previous evidence, their effects on clinical learning must be evaluated with rigor and caution. We aimed to evaluate the improvement in nursing students’ clinical competence and self-efficacy during their clinical practicums using the Evaluation Nursing Student (EVENS) application. Methods: A quasi-experimental design with non-equivalent control and intervention groups was adopted. Participants were not randomly assigned. The inclusion criterion was enrolment for the Supervised Practicum II course in the Nursing degree course at University X. Students agreeing to use the EVENS application during their Supervised Practicum II were assigned to the intervention group. The primary outcomes were student competence and self-efficacy, and the secondary outcome was the usability of the application. The analysis included a comparison of the pre- and post-intervention means of the intervention and control groups using Student’s t-tests. Results: One hundred and forty-nine mostly female (n = 137, 91.9%) students participated in the study. Forty-eight were assigned to the intervention group and 101 to the control group. No statistically significant differences regarding clinical competence or self-efficacy were found between the groups. Tutors rated the application’s usability with an average of 3.8 out of 5. Conclusions: The use of the EVENS application did not improve the primary outcomes. Although it was positively received by tutors as supportive of their role in training students engaged in clinical practicums. Full article

Background/Objectives: This study aimed to analyze the perceptions and experiences of health professionals regarding teamwork as an interprofessional competency within the context of Intensive Care Units (ICUs) in a Brazilian public teaching hospital. Methods: This was a qualitative, exploratory study guided by a constructivist–interpretative perspective. The scenario consisted of Intensive Care Units of a public teaching hospital, which is a reference for emergency care, located in Brazil. Sampling was intentional and involved 29 professionals, most of whom, 25 (86.20%), were females, including nurses, nursing technicians, physicians, physiotherapists, and others. In order to collect data, individual semi-structured face-to-face interviews were conducted in 2025, which were audio-recorded and fully transcribed. The criterion for determining the number of participants was theoretical saturation. Data analysis followed the steps of Braun and Clarke’s thematic analysis, conducted inductively, with peer validation and the use of illustrative quotations to ensure credibility. Results: Five main categories emerged: “Understanding teamwork as an interprofessional competency,” “Factors that facilitate interprofessional teamwork,” “Factors that hinder teamwork,” “Tools used in the ICU to develop interprofessional teamwork” and “Individual actions to develop interprofessional teamwork.” The analysis revealed a central tension: although professionals discursively value interprofessional teamwork, its practical implementation is constrained by organizational and hierarchical barriers. Communication was identified as a transversal axis, functioning at times as a facilitator and at other times as a barrier. Conclusions: This study demonstrates that interprofessionality in Brazilian ICUs cannot be sustained solely through individual initiatives, but requires structured institutional strategies, such as formal collaboration protocols, interprofessional education programs, and a revision of hospital organizational culture. Furthermore, although health professionals value interprofessional teamwork, their practice still faces significant barriers. These findings may support managers’ reflection on the need to implement in-service teaching and learning strategies that facilitate interprofessional teamwork, especially those in high-technology units, thus enhancing collaborative practice in health. Full article

Background/Objectives: Evidence on postmortem grief care for family caregivers after home-based end-of-life care is limited. This scoping review aimed to map the content and effects of such interventions for adult family caregivers after home deaths. Methods: Following the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines, we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Library, and Ichushi-Web from database inception to 31 March 2024. We included English- or Japanese-language intervention studies performed in home and community settings. “Early” grief care was defined as (i) support initiated within 6 months after the death of a loved one and (ii) interventions initiated during caregiving that assessed bereavement outcomes within 6 months after the death of a loved one. Data were charted and descriptively summarized. Results: From 4766 records, six studies were selected for the review (five randomized controlled trials and one ongoing registry trial). Interventions varied from dyadic psychological sessions integrated into specialist palliative home care (DOMUS) to brief psychoeducation, structured family-physician consultations, general-practice bereavement management with screening and stepped care, remote monitoring with nurse coaching during home hospice care, with bereavement outcomes assessed at 6 months (SCH), and an online self-help program for widowed older adults. The effects were mixed. DOMUS showed a small but significant reduction in caregiver anxiety; SCH reduced caregiver burden during caregiving and improved bereavement adjustment at 6 months. Other interventions did not demonstrate a clear advantage in outcomes over usual care. Conclusions: Early grief care after home-based end-of-life care is heterogeneous. Need-responsive multicomponent models embedded in existing home and community care pathways warrant further theory-informed evaluation. Full article

Background/Objectives: Pressure injuries and falls are frequent hospital adverse events. Identifying high-risk periods may help guide preventive strategies. In this exploratory study, we aimed to estimate the time from hospital admission to the occurrence of pressure injuries and/or falls and analyze its relationship with the nursing assessment at admission. Methods: A longitudinal observational study was conducted with a systematic sample of 314 adult patients admitted between January and May 2024. Nursing assessment at admission was performed using the VALENF Instrument, which integrates functional capacity, pressure injury risk, and fall risk. Survival analysis was performed to describe the temporal distribution of adverse events and compare their occurrence across nursing assessment variables using the log-rank test. Poisson Generalized Linear Models were applied to explore associated factors. Results: Nineteen adverse events were recorded (15 pressure injuries and 4 falls). Twelve of the 19 total events (63%) occurred within the first five days of admission. Patients with lower functional capacity (log-rank p < 0.001) and high-pressure injury risk (log-rank p < 0.001) according to the VALENF Instrument, showed an earlier occurrence of new pressure injuries in the Kaplan–Meier analysis. Similarly, fall risk scores (log-rank p = 0.037) obtained with the same instrument were associated with falls. Patients classified as high risk for pressure injuries showed an approximately nine-fold higher incidence rate of developing new injuries (Wald χ², p < 0.001), while urgent admission further increased this risk more than six-fold (Wald χ², p = 0.015). Conclusions: In this exploratory study with a limited number of events, most adverse events occurred early during hospitalization. The findings suggest that early nursing assessment using the VALENF Instrument may help stratify patients for closer monitoring early in admission, pending confirmation in larger studies. Full article

Background: Teamwork promotes the quality and safety of care. The TeamSTEPPS^® program enhances communication and teamwork among healthcare professionals and students, as well as the associated benefits. Currently, there are no studies that comprehensively explore the benefits achieved through the implementation of TeamSTEPPS^® across different contexts (educational and clinical practice). Objective: This scoping review aimed to map the existing evidence on the benefits of implementing TeamSTEPPS^® in educational and professional settings, emphasizing its contribution to sustainable teamwork, patient safety, and organizational learning. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guidelines. Searches were performed in CINAHL Ultimate, Medline Ultimate, Scopus, the Portuguese Open Access Scientific Repository, Web of Science and Psychology and Behavioral Sciences Collection, with no time restrictions. Studies were selected based on the PCC framework, focusing on healthcare students and professionals (Population), TeamSTEPPS^® implementation (Concept), and academic or clinical settings (Context). A descriptive and thematic analysis was used, enabling the identification of emerging categories and recurring patterns among the included studies. Results: Twenty-eight articles published between 2009 and 2025, predominantly from the United States of America and conducted in hospital settings, were found. The included studies comprised quantitative (n = 11), qualitative (n = 4) and quasi-experimental study (n = 13) designs. From the analysis, four thematic categories emerged: academic education, interprofessional education and simulation; professional transition and professional development; clinical implementation of the TeamSTEPPS^® program in real-world settings; and patient safety culture as a central focus. Conclusions: The available evidence suggests that the TeamSTEPPS^® program may strengthen teamwork and promote safe and high-quality care in both educational and clinical settings. While short-term training leads to immediate improvements in team dynamics, continuous training demonstrates greater long-term effectiveness. The consolidation of the TeamSTEPPS^® methodology relies on organizational commitment, leadership engagement, and the integration of interprofessional training from the academic level onward. Full article

Background/Objectives: Nutritional management is central to the care of patients with end-stage renal disease (ESRD), yet malnutrition often remains under-recognized due to gaps in nursing knowledge and competencies. This study aimed to develop and validate the Nursing Education and Competencies in Nutrition for Patients with CKD in ESRD (NECN-ESRD) questionnaire, designed to assess nephrology nurses’ competencies, attitudes, and practices in nutritional care. Methods: A methodological and cross-sectional design was adopted, following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for instrument development. The process comprised five phases: construct definition and item generation, expert consultation and revision, quantitative content validity analysis, pilot testing, and psychometric testing. Data were collected between August and September 2025 from 405 nephrology nurses across Italy. Exploratory Factor Analyses (EFAs) and Confirmatory Factor Analyses (CFAs) were conducted on split samples (60/40), and key psychometric properties were evaluated. Results: EFA identified a four-factor structure—Recommendations, Attitudes, Practice, and Advanced Competencies—which was confirmed through CFA with good fit indices [Comparative Fit Index (CFI) = 0.995, Tucker–Lewis Index (TLI) = 0.994, Root Mean Square Error of Approximation (RMSEA) = 0.07]. A higher-order model further improved fit (CFI = 0.994, RMSEA = 0.029), explaining 68.2% of variance. Internal consistency was excellent (ω = 0.89–0.96), test–retest reliability showed perfect agreement [Intraclass Correlation Coefficient (ICC) = 1.00], and invariance testing supported equivalence across educational and experience levels. Conclusions: The NECN-ESRD demonstrated strong validity, reliability, and stability, providing a robust and context-specific tool to assess and enhance nurses’ competencies in nutritional care for ESRD patients. Its application can support targeted educational interventions, improve clinical practice, and contribute to enhancing the quality of nutritional care for patients with ESRD within healthcare systems. Full article

Background/Objectives: Integrating technology with caring is essential in modern healthcare, yet the clinical applicability of nursing theories remains underexplored. Locsin’s Technological Competency as Caring in Nursing (TCCN) theory emphasizes the competent use of technology to address patients holistically, rather than focusing solely on health concerns. Here, we explored the interpretive clarity of the TCCN Instrument–Revised for Practice (TCCNI-RePract) items and identified the conceptual barriers encountered by psychiatric nurses when engaging with its theoretical constructs. Methods: This concurrent mixed-methods study surveyed 291 psychiatric nurses across five large hospitals in the Kansai region of Japan. Quantitative data on the TCCNI-RePract perception dimension were examined using descriptive statistics and normality testing. Qualitative open-ended responses were analyzed using reflexive thematic analysis. To ensure rigor and integration, a joint display was utilized to bridge both data strands. Results: Quantitative findings indicated that nurses strongly endorsed core values of caring (high agreement) but perceived theoretical constructs (wholeness and technological knowing) as significantly more difficult to interpret than concrete, behavior-oriented items. Qualitative analysis revealed four major themes: (1) fragmented understanding of “technology and caring,” (2) struggles with abstract and philosophical language, (3) moral and emotional tensions in caring relationships, and (4) contextual barriers to integrating caring and technology. We found a “semantic gap,” where the professional endorsement of caring values was not automatically translated into the mastery of theoretical lexicon. Conclusions: While psychiatric nurses identify with the moral core of TCCN, a substantial gap exists between abstract theory and clinical practice. For effectiveness, middle-range theories require “clinical translation” that resonates with the moral, emotional, and organizational realities of psychiatric settings. Full article