Nurs. Rep., Volume 16, Issue 7 (July 2026) – 47 articles

Background/Objectives: Advancing clinical competence within contemporary healthcare systems requires innovative educational approaches that bridge professional silos. While Interprofessional Education (IPE) is globally recognized as a mechanism to enhance teamwork, its implementation within resource-constrained public health systems marked by historical and structural inequalities remains poorly understood. This study explored the perspectives and experiences of healthcare professionals and clinical educators regarding how interprofessional education (IPE) may contribute to clinical competence in selected South African public hospitals. Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with 22 purposively selected healthcare professionals and clinical educators from nursing, medicine, physiotherapy, occupational therapy, pharmacy, and social work. Interviews were conducted at selected hospitals following approval from hospital Chief Executive Officers. Data were collected by the researcher and co-researcher who is not part of this manuscript, audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Ethical clearance and institutional permissions were obtained, and informed consent was secured from all participants. Trustworthiness was ensured through credibility, dependability, confirmability, and transferability. Findings: The thematic analysis yielded two primary patterns: (1) the perceived capacity of IPE to enhance clinical decision-making, communication, and collaborative practices; (2) systemic and structural constraints, including rigid professional hierarchies, severe time constraints, and a lack of formally institutionalized opportunities. Conclusions: IPE is perceived as an important contributor to collaborative clinical competence, but its sustainability depends on explicit institutional mandates. These findings imply that hospital managers and curriculum developers must transition from ad hoc interactions to structured, short-duration interdisciplinary platforms to overcome operational bottlenecks. Full article

Background/Objectives: Dependency-related skin injuries (DRSIs) are a significant health issue that exacerbates in critically ill patients, as their clinical condition (immobility, hemodynamic instability, use of diagnostic and therapeutic devices, malnutrition, and pharmacotherapy) promotes their occurrence. The objective of this study was to analyze the incidence and characteristics of DRSIs in critically ill patients at a tertiary care hospital. Methods: An observational, descriptive, longitudinal, and prospective study was conducted in the Intensive Care Units of the Hospital Clínico Universitario de Valencia. Data were analyzed using R software (v.4.2.2). The study was approved by the institutional ethics committee, and informed consent was obtained from each patient or family member. Results: The final sample included 139 patients. The incidence of DRSIs was 33.1% (n = 46), with a total of 82 lesions recorded. The mean time to DRSI onset was 9.2 days. Pressure ulcers accounted for 76.8% (n = 63) of the injuries, of which 47.6% (n = 30) were category I. Approximately 40% of the DRSIs were associated with the use of medical devices, primarily endotracheal tubes, non-invasive ventilation, and respiratory support devices. The most frequent locations were the heels, sacrum, and nose. Conclusions: One-third of the patients admitted to the studied critical care units developed one or more DRSIs. The use of clinical devices and high-risk scores on risk assessment scales (EVARUCI and/or Braden) is associated with a greater predisposition to developing these skin injuries. Full article

Purpose: Breast cancer has been recognised as a chronic condition, with survivors experiencing long-term physical and psychosocial effects following treatment. Supporting breast cancer survivors to self-manage their health can optimise health-related quality of life and reduce symptom burden. Self-management education (SME) has been advocated at the policy and programme level in Australian primary care, but its uptake is often limited. This study explores healthcare professionals’ (HCPs) experiences and perceptions of SME in primary care, aiming to identify factors influencing its implementation and to support survivorship care for breast cancer survivors in Australia. Methods: A qualitative descriptive approach was adopted involving in-depth semi-structured interviews. Convenience sampling was used to recruit HCPs across the three primary care clinics in the Greater Brisbane area. The interviews were conducted based on an interview guide. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyse the data. Results: Fourteen participants were interviewed across three primary care settings, including five general practitioners and nine registered nurses. Three categories were synthesised from the data: (1) Meaning and role of SM/SME; (2) Suboptimal SME in current practice; (3) Perceived factors impacting SME delivery in practice. Each category had two to six subcategories for the participants. Conclusions: The findings highlighted the importance and perceived benefits of SME for breast cancer survivors and HCPs in Australian primary care. However, the integration of SME into primary care remained suboptimal due to a combination of systemic, organisational, and healthcare provider factors. Evidence-based resources, particularly guidelines and training, are essential to equip HCPs to effectively integrate SME into routine care for breast cancer survivors. Full article

Background/Objectives: Self-management intervention strategies are recommended to address the needs of breast cancer survivors (BCSs) who have cardiovascular diseases (CVDs). Despite the benefits, these strategies are often suboptimally implemented, resulting in inadequate cardiovascular management among BCS with CVDs. The project aims to develop a nurse-led and GP-supported self-management (NGPS) intervention to reduce cardiovascular risks in BCS with CVDs and evaluate its feasibility and potential effects in primary care settings using the double diamond co-design process and the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions. Methods: The study will be conducted in two phases. In phase I, an evidence-based and co-designed NGPS protocol with end-users will be preliminarily developed based on the identified research evidence, relevant theories, practice guidelines and the current practice standards in Australia. The co-design workshop(s) will involve healthcare professionals and BCSs with CVDs to further refine and validate the developed preliminary protocol. In phase II, a one-group pre-post pilot study will evaluate the feasibility of the intervention and study procedures, such as recruitment, retention, adherence, acceptability, and safety as primary outcomes. The study will also preliminarily explore the effectiveness of the intervention such as physiological measures as secondary outcomes to inform a future large-scale trial. Phase II also involves follow-up qualitative interviews to explore participants’ experiences of the pre-post pilot study. The participants will be recruited from primary medical centres in Victoria. Conclusions: The findings will provide a co-designed evidence-based intervention for primary care nurses and General Practitioners (GPs) to promote long-term health outcomes for patients with both breast cancer (BC) and CVDs. Clinical registration: ClinicalTrial.gov (registration No. NCTO7313397). Full article

Background: Postoperative pain is a significant continuous clinical problem for patients in surgical units. This study aimed to examine surgical nurses’ attitudes toward the use of non-pharmacological techniques in postoperative pain management and to identify factors associated with these attitudes. Methods: This descriptive and cross-sectional study was conducted between October 2025 and February 2026 with 200 nurses working in the surgical clinics of a private hospital in Türkiye. Data were collected through digital forms by using the Socio-Demographic Data Form and the Attitude Scale Toward Non-Pharmacological Techniques in Postoperative Pain Management. Descriptive statistics, independent samples t-test, and one-way ANOVA were used for data analysis (p < 0.05). Results: Approximately 59% of the nurses were aged 20–29 years, and 65.5% were female. 68% of the nurses used both pharmacological and non-pharmacological techniques in postoperative pain management, and 80% of them believed that non-pharmacological methods were effective. The mean total score obtained from the scale was 48.42 ± 9.70, indicating that nurses had a positive attitude toward the use of non-pharmacological techniques. Mean scores related to non-pharmacological techniques differed significantly according to gender, marital status, educational level, professional experience, and department (p < 0.05). Conclusions: Surgical nurses demonstrated positive attitudes toward non-pharmacological postoperative pain management. Non-pharmacological techniques should be integrated into clinical practice by nurses in pain management. Full article

Background/Objective: Social media platforms have become increasingly integrated into nursing students’ academic and daily lives, influencing how health-related information is accessed, evaluated, and shared. At the same time, eHealth literacy has emerged as an important competency for nursing students within contemporary digital healthcare environments. This study aimed to examine the relationship between multidimensional social networking engagement and perceived eHealth literacy among undergraduate nursing students. Methods: A cross-sectional descriptive correlational design was used among undergraduate nursing students (N = 146). Data were collected using an electronic survey that included demographic characteristics, the Social Networking Usage Questionnaire, and the Revised eHealth Literacy Scale. Descriptive statistics, Pearson’s correlation, and linear regression analyses were performed using SPSS version 26. Results: Participants reported moderate-to-high social networking engagement and generally favorable perceived eHealth literacy. A strong positive correlation was identified between SNUQ and eHEALS-R scores (r = 0.75, p < 0.001), with academic use showing the strongest dimension-level association with perceived eHealth literacy. In the adjusted regression model, social networking engagement remained independently associated with perceived eHealth literacy, whereas demographic variables and daily social media use showed no significant associations. Conclusions: The findings suggest that how nursing students engage with digital platforms is associated with their confidence in accessing, evaluating, and applying online health information. Strengthening purposeful and critical digital engagement within nursing education may help prepare students for contemporary digital healthcare environments. Full article

Background/Objectives: The assessment of clinical competencies in nursing education requires valid and reliable instruments, especially for essential procedures such as the placement of a cervical collar in the care of polytrauma patients. The objective of this study was to analyse the psychometric properties of a rubric designed to assess the placement of cervical collars in nursing students in a low-fidelity clinical simulation environment. Methods: A quasi-experimental, cross-sectional study was conducted with 186 undergraduate nursing students, organised into 61 groups, over three academic years (2021–2024). An eight-item rubric was applied, with a four-level Likert scale (1–4). Interrater reliability was analysed using Cohen’s Kappa index (0.418–0.796), internal consistency using Cronbach’s alpha (alpha = 0.753), and the internal structure of the instrument using exploratory factor analysis, applying Varimax orthogonal rotation. Results: Inter-rater reliability showed values ranging from moderate to substantial, with greater agreement observed in items related to the selection of the collar and the position of the medical team, and moderate agreement in those related to technical manoeuvres and immobilisation. The rubric showed adequate overall internal consistency (α = 0.76), with good to very good consistency values in six of the eight items. Exploratory factor analysis identified a two-dimensional structure with a dominant procedural factor (four items) and a second factor associated with clinical judgement (four items). Conclusions: The validated rubric has adequate levels of reliability and internal consistency for evaluating the placement of cervical collars by nursing students. Its application can promote more objective and structured evaluation processes in clinical simulation for nursing students, contributing to the development of essential skills in the care of polytrauma patients. Full article

Elder abuse is internationally recognized as a growing problem of the 21st century that requires urgent intervention and action. This review aimed to synthesize evidence on the prevalence and risk factors of elder abuse between 2010 and 2022. A total of 2875 articles were identified through database searches, of which 28 met the inclusion criteria and were included in the final analysis (24 cross-sectional studies, 3 prospective studies, and 1 descriptive study). Reported prevalence rates of elder abuse ranged from 2.2% to 81.2% overall, while studies conducted during the COVID-19 pandemic reported rates ranging from 1.6% to 44.7%. Psychological abuse was the most frequently reported form of violence. The most commonly identified risk factors included low income, low educational level, gender, disability, depression, and—during the COVID-19 pandemic—social isolation. Across most studies, individuals with lower education and women were statistically more likely to experience abuse. The findings indicate substantial variability in the prevalence of elder abuse both before and during the pandemic, with consistently high rates observed. These results highlight the urgent need for improved screening, education, and targeted interventions by healthcare and social service professionals. Full article

Background/Objectives: Adolescent pregnancy remains a global public health challenge associated with adverse outcomes for both mothers and newborns. This study aimed to use two instruments and several multivariate techniques to identify a minimal set of variables that reproduces the instrument-based classification of adolescent pregnancy risk, while remaining parsimonious with the original instruments. Methods: A cross-sectional, quantitative methodological study was conducted among Colombian schoolgirls, comprising 160 adolescents in the face-validity phase and 319 in the risk-estimation and modeling phase. The IRENE and REND instruments, originally developed to assess the risk of adolescent pregnancy, underwent cultural adaptation, face validity and content validity. Subsequently, the instruments were administered to estimate the risk. Finally, Factor Analysis and Categorical Principal Component Analysis were applied as exploratory dimensionality reduction techniques to identify the most relevant variables for retention, thereby preserving the parsimony of the original versions. Results: Overall, 80.3% of participants were classified as not at risk, while the remainder were classified as at risk by one or both instruments. The results suggest that variables such as who the adolescent lives with, the age at which the adolescent had their first complete sexual intercourse, and how the adolescent would respond to an unplanned pregnancy are factors associated with the instrument-based risk classification. Subsequently, dimensionality reduction and logistic regression analyses identified a small subset of variables that can be used to reproduce the instrument-based classification of adolescent pregnancy risk. Conclusions: The reduced set of variables reproduced the instrument-based risk classification with high internal accuracy. Because the predictors and the outcome derive from the same instruments, these findings reflect internal reproduction of the instrument classification rather than prediction of an observed pregnancy, and they require external validation. Overall, the reduced and optimized set of variables from the IRENE and REND instruments offers a parsimonious approach that reproduces the instrument-based risk classification and that may support rapid screening once validated in independent adolescent samples. The main limitations are the use of a single institution, the non-probabilistic convenience sample, and the absence of an observed pregnancy outcome. Full article

Background/Objectives: In rural settings, work, family, and environmental conditions are closely intertwined, requiring Primary Health Care to recognize care needs arising from productive work and everyday family responsibilities. This study aimed to analyze overall and domain-specific levels of perceived workload related to agriculture/fishing and family involvement in the household among rural and small-scale fishing workers, examine associated factors, and discuss analytical implications for nursing care organization in Primary Health Care. Methods: This cross-sectional study was conducted in three island territories in Rio Grande, southern Brazil, following the STROBE guidelines. Data were collected using a structured questionnaire on sociodemographic, family, and occupational characteristics and the NASA Task Load Index (NASA-TLX), applied separately to assess workload related to agriculture/fishing and family involvement in the household. Results: The sample included 146 rural and small-scale fishing workers. Perceived workload could suggest high in both dimensions, with higher levels in agriculture/fishing (mean 84.0 ± 16.5; 89.7% high/very high) than in family involvement in the household (mean 76.1 ± 24.5; 75.4% high/very high). Agriculture/fishing workload perceived could suggest highest scores for overall effort level, temporal demand, and physical demand, whereas family involvement could suggest highest scores for performance-related workload and overall effort level. In the adjusted model, agriculture/fishing perceived workload may be associated with longer daily working time (b = 1.69; 95% CI: 0.82 to 2.56; p < 0.001) and shorter rest time during work (b = −0.05; 95% CI: −0.08 to −0.01; p = 0.011). Perceived workload related to family involvement in the household may be associated with monthly income up to two minimum wages (b = 19.90; 95% CI: 7.78 to 32.10; p = 0.001). The adjusted R² values were 17.3% and 6.7%, respectively. Conclusions: Perceived workload appears to be related to high levels in both productive and family household contexts. The findings might contribute to providing analytical support for future discussions on nursing care organization in Primary Health Care, potentially by considering working conditions, family responsibilities, and territorial context when discussing care needs among rural and small-scale fishing workers. Full article

Background/Objectives: Human trafficking is the use of force, fraud, or coercion to compel a person to provide labor or sex and has become a public health crisis. This scoping review aimed to identify known risk factors for trafficking among North American Indigenous women and to synthesize the complexities of trafficking and its related health outcomes. Methods: Following the PRISMA-ScR checklist, a comprehensive literature search of seven electronic databases (CINAHL, Embase, PubMed, SCOPUS, PsycINFO, Cochrane Library, and Google Scholar) was conducted in March 2022 and updated in September 2023. English language research reports, literature reviews, dissertations and theses, commentaries, and government reports that focused on human trafficking in North American Indigenous women aged 18 years and older from the United States and Canada were identified using key terms. Results: Fifteen articles were included, revealing three themes: structurally produced vulnerabilities and other contributors to human trafficking, the long-term effects of human trafficking, and the need for collaboration of key stakeholders to mitigate human trafficking. Risk factors of human trafficking for Indigenous women include personal factors, historical trauma, and inadequate systems to identify and support victims. The needs of this population are complex. However, a multidisciplinary approach can be effective in combatting human trafficking. Conclusions: This review substantiates key risk factors and complexities unique to the trafficking experienced by North American Indigenous women, while also revealing a persistent gap in the research. These findings advance nursing knowledge by informing culturally responsive, trauma-informed care approaches while supporting targeted educational and research initiatives to improve health outcomes among these women. Full article

Pain is highly prevalent during hospitalization, and inadequate assessment contributes to avoidable suffering, prolonged length of stay, and increased resource use. Nurses play a central role in pain assessment, timely analgesic administration, patient education, and escalation of care. Background/Objectives: This study assessed nurses’ knowledge and attitudes regarding pain assessment and management and examined perceived causes of delayed pain treatment and perceived barriers to timely pain control at a tertiary hospital in Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in inpatient and outpatient departments at King Abdulaziz Medical City, Jeddah, Saudi Arabia (August–December 2023). Registered nurses providing direct patient care were recruited via convenience sampling. Data were collected using a demographic and clinical practice questionnaire, the Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKASRP), and an adopted instrument assessing perceived causes of delayed pain treatment and perceived barriers. Data were analyzed using descriptive statistics, two-tailed t-tests, one-way ANOVA with assumption checks and post hoc testing, Pearson correlations, and multiple linear regression. Results: A total of 125 nurses participated; 95.2% were female and 80.8% held a bachelor’s degree. The mean NKASRP composite score was 46.69% (SD = 9.90), indicating a suboptimal knowledge-and-attitudes profile. Age group was significantly associated with NKASRP scores (F = 5.136, p = 0.007), and age remained the only significant independent predictor in the multivariable model (b = 0.055, p = 0.006). The most frequently perceived delay was contacting a physician for opioid prescription (58.4%), followed by obtaining opioids from the pharmacy (46.4%). Major perceived barriers included insufficient staff–patient communication (60.0%), insufficient patient knowledge of pain control (52.8%), and inadequate staffing (49.6%). Conclusions: Nurses demonstrated a low composite knowledge-and-attitudes score and reported communication, workflow, and system-related barriers relevant to timely analgesia. These findings support further prospective evaluation of targeted educational and system-level strategies in similar settings. Full article

Background/Objectives: Climate change is a major global health challenge with direct implications for public health. As frontline health professionals and agents of change, nurses must develop competencies to address climate-related health issues and implement sustainable practices. This study aimed to translate and culturally adapt the Climate, Health, and Nursing Tool (CHANT) into French and to assess its content validity using item-level and scale-level content validity indices (I-CVI and S-CVI, respectively). The CHANT evaluates nurses’ awareness, motivations, concerns and self-reported behaviours related to climate change. A secondary objective was to examine potential associations between experts’ sociodemographic and professional characteristics and their CVI ratings. Methods: A descriptive international study using a three-round modified e-Delphi approach was conducted between January and June 2025 in French-speaking regions of Switzerland, France and Belgium. A multidisciplinary panel of experts in nursing, planetary health and environmental sciences evaluated the relevance, clarity and comprehensiveness of each item and response option, enabling iterative refinement. Results: The original 12-item CHANT was evaluated by 17 experts in Round 1. Following expert recommendations, one additional item was incorporated, resulting in a 13-item version, which was subsequently evaluated by 15 experts in Round 2 and 25 experts in Round 3. Across the three Delphi rounds, 57 completed expert evaluations contributed to the iterative refinement of the instrument. Round 1 I-CVI ranged from 0.79 to 1.0, and S-CVI reached 0.935, with full consensus. Round 2 I-CVI ranged from 0.71 to 1.0, and S-CVI was 0.91 (92% consensus), with one item not meeting the predefined threshold. Round 3 I-CVI ranged from 0.82 to 1.0, and S-CVI returned to 0.935, confirming consensus. A final linguistic, semantic and cultural review conducted by the research team ensured the conceptual consistency and cultural appropriateness of the translated instrument. Conclusions: The French-language version of the CHANT demonstrated satisfactory content validity and provides a culturally adapted instrument to assess climate-related competencies and eco-literacy in nursing education and practice. Further psychometric evaluation is warranted. Full article

Background/Objectives: Sexual health is frequently under-addressed after stroke, despite its relevance to intimacy, identity, relationships, and rehabilitation. This convergent mixed-methods study integrated sex-specific screening with descriptive narrative material to examine sexual functioning and patient-reported concerns in clinical rehabilitation. Methods: Twenty-six adults were assessed: ten with the Female Sexual Function Index (FSFI), sixteen with an International Index of Erectile Function six-item field (IIEF-6), and ten with analyzable semi-structured interview responses. The sex-specific measures were analyzed separately. Continuous variables were summarized by median and interquartile range; nonparametric correlations and group comparisons underwent Benjamini–Hochberg false discovery rate correction. Quantitative and qualitative findings were integrated in a participant-level joint display. This integration yielded case-level meta-inferences rather than inferential mixed-methods testing in this sample. Results: Nine of ten FSFI profiles and nine of sixteen IIEF-6 profiles met the respective exploratory threshold for possible dysfunction. No association or group comparison remained statistically significant after correction. Six of eighteen threshold-positive profiles had analyzable interviews, twelve represented narrative silence, and four interviewed participants were threshold-negative. Narratives documented fear, embarrassment, reduced desire or sexual frequency, relational or communication change, support needs, clinical sequelae, and positive or neutral adaptation. Screening and narratives showed convergence, complementarity, and divergence: low scores did not establish personal distress, whereas concerns could occur above a threshold. Conclusions: Responsive sexual rehabilitation should combine confidential, permission-based, patient-led screening and narrative inquiry with individualized information, optional support, appropriate referral, and reassessment according to readiness. These preliminary, hypothesis-generating findings do not validate an intervention or support confirmatory inference. Full article

Background: Bronchiectasis is a chronic respiratory condition characterised by irreversible airway dilation and recurrent infections, resulting in significant symptom burden and frequent healthcare utilisation. Although nurses are central to chronic respiratory disease management, their specific roles and responsibilities in outpatient bronchiectasis care remain poorly defined. Understanding these roles is imperative to support workforce planning, optimise multi-disciplinary collaboration, and improve patient outcomes. Aim: This scoping review aimed to map and synthesise existing evidence on the roles and responsibilities of nurses involved in the outpatient management of adults with non-cystic fibrosis bronchiectasis. Methods: A scoping review was conducted. Six databases were systematically searched (MEDLINE, CINAHL Complete, Central, Web of Science, and ProQuest Dissertations and Theses Citation Index). Records describing nursing roles, responsibilities, or models of care within outpatient bronchiectasis settings were included (any design). Data was analysed descriptively and thematically. Results: Five studies and two international clinical practice guidelines published between 2002 and 2025 were included. Nurses were shown to play roles across five key domains: 1. clinical assessment and monitoring, 2. self-management support and patient education, 3. care co-ordination and multi-disciplinary collaboration, 4. patient advocacy and communication, and 5. leadership and service development. Evidence on measurable outcomes and standardised role definitions remains limited. Conclusions: This review mapped five domains within which nurses may contribute to outpatient bronchiectasis care; however, most identified roles and responsibilities were derived from multi-disciplinary recommendations rather than explicit descriptions of nursing practice. Further research is required to better define nursing roles and responsibilities and evaluate nurse-led models of care in bronchiectasis outpatient care settings. Full article

Background/Objectives: The employment of migrant nurses requires structured support from local nursing staff. However, multiple challenges persist in facilitating effective collaboration. We aimed to clarify the efforts made by Japanese nurses and identify their support needs when working alongside migrant nurses in Japan. Methods: We adopted a qualitative descriptive design. Eighteen Japanese nurses with experience working alongside migrant nurses were recruited through hospitals employing migrant nurses. Semistructured interviews were conducted, and data were analyzed using qualitative descriptive analysis. We classified the codes derived from the participants’ narratives and inductively generated categories. Results: Japanese nurses’ efforts in working alongside migrant nurses were classified into five categories: “Overcoming language barriers,” “Respecting the nursing practices and cultural backgrounds of migrant nurses,” “Encouraging migrant nurses to gain self-confidence,” “Engaging Japanese staff in establishing support systems for migrant nurses,” and “Addressing the personal challenges faced by migrant nurses working abroad.” Three categories of support needs were identified: “Learning about nursing practices and cultural backgrounds of migrant nurses,” “Information exchange on how to support migrant nurses,” and “Support systems for enhancing migrant nurses’ competencies in Japan.” Conclusions: Japanese nurses demonstrated active efforts to address differences in language, culture, and nursing practices, while collaboratively establishing support systems involving other staff members. They also extended support to aspects of migrant nurses’ personal lives. However, additional institutional and external support is required. Structured opportunities should be developed to enhance their understanding of migrant nurses’ backgrounds, alongside continuing education initiatives to support migrant nurses’ integration into the Japanese healthcare system. Full article

Background: Moral distress is a significant concern in nursing, particularly among newly graduated registered nurses transitioning into professional practice. Limited experience, high workloads, and exposure to ethically challenging situations may negatively affect well-being and contribute to early-career attrition. Evidence on how NGRNs experience and manage moral distress globally and in Saudi Arabia remains limited, and the role of healthcare organisational factors in shaping this phenomenon is not yet well understood. Aim: This study aims to examine the experiences of NGRNs regarding moral distress in adult tertiary care hospitals in Saudi Arabia, focusing on contributing factors, coping strategies, and organisational influences. Methods: A mixed-methods sequential explanatory design will be used. In the quantitative phase, NGRNs will complete the Measure of Moral Distress—Healthcare Professionals (MMD-HP) and a demographic questionnaire. Data will be analysed using descriptive and inferential statistics to assess levels of moral distress and associations with intention to leave. The qualitative phase will involve semi-structured interviews with NGRNs and focus groups with nursing managers, which will be analysed using reflexive thematic analysis. Integration will occur at the data collection and interpretation stages. The study is guided by Bronfenbrenner’s Ecological Systems Theory. Ethical approval has been obtained from Queen’s University Belfast and the Najran Health Cluster. Expected Impact: The study is expected to provide a comprehensive understanding of moral distress among NGRNs and inform the development of targeted organisational strategies to support Registered Nurse wellbeing, retention, and quality of care. Full article

Background/Objectives: This study aimed to assess technostress and burnout levels among healthcare practitioners, explore the relationships between technostress, perceived organizational support (POS), and burnout, and examine whether POS mediates this relationship using a suppression approach. The rapid proliferation of digital health technologies has increased technology-related job demands in healthcare settings. Technostress has become a major psychological risk factor associated with burnout, but evidence for its direct effects is inconsistent. Although organizational resources, especially perceived organizational support, might moderate this relationship, the underlying mechanism is not well understood, particularly in the context of rapidly digitalizing healthcare systems like Saudi Arabia’s. Methods: This was a cross-sectional, multicenter, descriptive-correlational study with a sample of 150 healthcare professionals conveniently selected from clinical settings in Saudi Arabia. Technostress Creators Scale, Copenhagen Burnout Inventory and Perceived Organizational Support Scale were used for data collection. Statistical analyses included Pearson correlations, multiple regression, bootstrap mediation analyses, and structural equation modeling. Results: Moderate levels of technostress were observed across all dimensions (M = 2.87–3.42). POS was positively related to technostress (r = +0.36, p < 0.001) and negatively related to burnout (r = −0.54, p < 0.001). The bivariate relationship between technostress and burnout was nonsignificant (r = −0.06, p = 0.437). Mediation analysis showed a significant negative indirect effect through POS (β = −0.19, p = 0.002) and a significant positive direct effect (β = +0.14, p = 0.019), indicating an inconsistent mediation (suppression effect). Structural equation modelling demonstrated excellent model fit consistent with a just-identified model. Conclusions: The findings suggest that the observed statistical associations are consistent with a suppression mediation model in which technostress was positively associated with burnout while also being associated with higher perceived organizational support, which in turn was negatively associated with burnout. POS plays a critical protective role but does not fully offset the harmful associations of technostress. Healthcare organizations should implement proactive support strategies, including continuous technical support, structured digital training, and active managerial engagement, to manage technostress and reduce burnout risk. Full article

Background/Objectives: Sexualized drug use (SDU) and chemsex have emerged as a growing public health concern globally, reflecting complex intersections between sexual practices, psychoactive substance use, and structural vulnerabilities. In Brazil, however, evidence on healthcare access among individuals who engage in SDU/chemsex remains limited and fragmented. This scoping review aimed to map and analyze the available literature on healthcare access in this population, identifying barriers, facilitators, and gaps in care. Methods: The review followed the Arksey and O’Malley framework and Joanna Briggs Institute recommendations, with searches conducted in six databases (MEDLINE/PubMed, Embase, Scopus, SciELO, LILACS, and PsycINFO) for studies published between 2014 and 2025. Results: Eleven studies met the inclusion criteria, predominantly quantitative and concentrated in large urban centers. Findings indicate that healthcare access is shaped by persistent structural and symbolic barriers, including stigma, discrimination, fear of disclosure, and limited professional preparedness. Care remains largely centered on human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) services, with insufficient integration of primary care, mental health, and substance use services, contributing to fragmented care. Significant gaps were identified, including the underrepresentation of women, transgender, and non-binary populations, and the absence of studies focusing on healthcare professionals. Conclusions: Substance use patterns reflect both global trends and local specificities, particularly the prominence of alcohol and cocaine in Brazil. This review provides the first synthesis of Brazilian evidence on chemsex from a healthcare access perspective. The findings highlight critical inequities and support the need for integrated, stigma-free, and context-sensitive care within the Brazilian Unified Health System. Based on these findings, the VIP-SDU/Chemsex Model is proposed as a multilevel framework to explain how structural, symbolic, and programmatic factors shape access and health outcomes. Full article

Background/Objectives: Nursing is characterised by demanding working conditions, including long working hours and staffing shortages. Although Decent Work (DW) has been proposed as a framework for improving labour conditions, existing measures do not adequately capture how these conditions are experienced in practice. This study aimed to develop and validate the Decent Work Scale for Hospital Nurses (DWS-N), conceptualising DW as the experiential realisation of structural labour conditions. Methods: A multi-phase methodological design was employed. In Phase 1, 184 items were generated through concept analysis and refined to 142 items via expert review. In Phase 2, exploratory and confirmatory factor analyses were conducted to examine structural validity and reliability. In Phase 3, cross-validation and criterion-related validity were assessed using an independent sample. Results: A five-factor structure comprising 22 items was identified: Meaningful and Fulfilling Work, Protection of Workers’ Rights, Supportive and Safe Working Environment, Appropriate Working Time and Work–Life Balance, and Adequate Compensation. The scale demonstrated good internal consistency (Cronbach’s α = 0.896) and acceptable fit (CFI = 0.969, RMSEA = 0.037). Cross-validation supported model stability (CFI = 0.917, RMSEA = 0.070). DW was positively associated with work engagement and negatively associated with burnout. Different dimensions of DW showed distinct patterns of association with occupational outcomes. Conclusions: The DWS-N is a valid and reliable instrument for assessing Decent Work in nursing. By capturing the experiential realisation of structural labour conditions, the scale offers a context-specific approach to understanding nurses’ working environments, with potential applications in workforce management and organisational policy. Full article

Background/Objectives: As the frequency and impact of global disasters intensify, the role of nursing in disaster management has become increasingly vital. Analyzing the evolution of disaster nursing research can inform preparedness strategies and enhance clinical responses. The aim of the study was to explore and visualize trends in research on disaster, disaster management, disaster nursing, and disaster preparedness from 1980 to 2024. Methods: A scientific mapping and performance analysis were conducted using Biblioshiny, VOSviewer, and Excel. The search strategy included the keywords ‘disaster’, ‘disaster management’, ‘disaster nursing’, ‘disaster preparedness’, ‘disaster training’, and ‘disaster care,’ searched across all fields in the Web of Science Core Collection database. A total of 1331 publications from a dataset of 21,703 articles were included in the analysis. Results: The most common keywords were “disaster”, “nursing”, “COVID-19”, and “emergency preparedness”. The USA led in research output, followed by Sichuan University as the top institution. Thearticle, “Disaster preparedness among nurses: a systematic review of literature”, was the most cited, with 216 citations. English was the predominant language, and most publications were articles. Conclusions: Research in disaster nursing, management, and preparedness has grown significantly, particularly since 2005, emphasizing the critical need for improved disaster education and response strategies. This study was not registered. Full article

Background: Simulation-based education (SBE) is increasingly integrated into medical curricula to enhance clinical reasoning, reflective practice, and experiential learning in safe educational environments. Evaluating learners’ satisfaction is essential to assess the educational impact of simulation activities. Although the Satisfaction with Simulation Experience Scale (SSE) has been internationally validated, no robust psychometric validation has been conducted among Italian medical students. This study aimed to evaluate the psychometric properties of the Italian version of the SSE (SSE-It). Methods: A cross-sectional psychometric validation study was conducted with 408 third-year medical students enrolled at a Northern Italian university after participation in a mandatory simulation internship on introductory ultrasound. Participants completed the Italian adaptation of the 18-item SSE, rated on a 5-point Likert scale and organized into three domains: Debriefing and Reflection, Clinical Reasoning, and Clinical Learning. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Confirmatory factor analysis (CFA) was performed to examine the factorial structure of the scale. Results: CFA supported the original three-factor structure of the SSE-ITA, showing good fit indices: χ²(132) = 410.67 (WLSMV-scaled), CFI = 0.98, TLI = 0.97, RMSEA = 0.07, and SRMR = 0.05. Internal consistency was high for the total scale (α = 0.94; ω = 0.95) and satisfactory across subscales (α ranging from 0.84 to 0.92; ω ranging from 0.86 to 0.93). Conclusions: The SSE-It demonstrated satisfactory reliability and construct validity in this task-trainer-based, introductory ultrasound simulation context, supporting its use as a reliable instrument to assess satisfaction with this type of simulation-based education among Italian medical students. Generalizability to high-fidelity, immersive simulation modalities remains to be established. Full article

Background: The transition to motherhood represents a critical life phase marked by profound biological, psychological and social changes. During this period, women’s nutritional practices are shaped not only by physiological needs but also by shifting identities, caregiving responsibilities and social expectations. Although nutrition during pregnancy and the postpartum period has been widely studied from a biomedical perspective, less attention has been paid to how women experience, negotiate and attribute meaning to food during the transition to motherhood. Objective: This systematic qualitative review aimed to synthesise existing qualitative evidence on women’s experiences of nutritional practices during the transition to motherhood, with particular attention to food as self-care, control, autonomy, identity formation and mental well-being. Methods: A systematic search of electronic databases was conducted to identify qualitative studies exploring women’s experiences of nutrition during pregnancy and early motherhood. Eligible studies employed qualitative methodologies such as interviews, focus groups or ethnographic approaches. Study selection followed PRISMA guidelines. Methodological quality was appraised using established qualitative appraisal tools. A thematic synthesis approach was used to integrate findings across studies. Results: The synthesis identified several interrelated themes: nutrition as a form of self-care and emotional regulation; loss of autonomy and heightened moral surveillance around food choices; food practices as a means of performing and negotiating “good motherhood”; and the emotional burden of dietary expectations in relation to mental health and identity. Women described navigating competing demands between their own nutritional needs and those of their infants, often within contexts of social judgement and limited support. Conclusions: Nutritional practices during the transition to motherhood extend beyond health behaviours and are deeply embedded in issues of identity, autonomy and care. Recognising the social and emotional dimensions of maternal nutrition may inform more holistic, woman-centred approaches to nutritional guidance and maternal health support. Full article

Background/Objectives: Attitudes toward end-of-life care (EOLC) are a key component of nursing practice. This study aimed to assess nursing students’ attitudes toward EOLC and their perceived preparedness to manage end-of-life situations. Methods: A cross-sectional descriptive study was conducted with 593 undergraduate nursing students from a public Spanish university. Data were collected using an online questionnaire, including the validated Spanish version of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-S). Descriptive and inferential analyses were performed. Results: The median reverse-coded FATCOD-S total score was 125.0 (IQR 119.0–131.0), and 99.7% of students were classified as having positive or very positive attitudes when the descriptive cut-offs were applied. In the exploratory adjusted model, fourth-year status and previous EOLC training were associated with higher FATCOD-S total scores. However, 59.5% of respondents reported feeling unprepared to provide EOLC, and 59.0% perceived EOLC as a significant source of stress for nurses. Additionally, 62.0% of students with positive attitudes reported not feeling prepared to provide such care. Responses related to emotional involvement, communication about death, and ethical aspects showed greater variability. Conclusions: Although most nursing students display favorable attitudes toward EOLC, these coexist with a low perceived level of preparedness, with more than half of students reporting that they do not feel prepared to provide EOLC. Positive attitudes alone may not ensure confidence in clinical practice. Strengthening undergraduate education—particularly in emotional preparation, communication skills, and coping strategies—is essential to better prepare future nurses for the complexities of EOLC. These findings should be interpreted in light of the study’s cross-sectional design and single-university setting. Full article

Background: In-hospital falls are common adverse events associated with injuries, functional decline, prolonged length of stay, and increased healthcare costs, which require effective and sustained nursing interventions. Objective: To identify, through a Systematic Literature Review, which nursing care interventions are effective in reducing the incidence/rate of falls among inpatients in hospital settings. Methods: A systematic literature review was conducted using the JBI methodology. The review was guided by the PICO framework (P: inpatients; I: nursing care interventions; C: usual care; O: incidence of accidental falls). A comprehensive search was performed in the MEDLINE, CINAHL, and Scopus databases. Studies were included if they evaluated nursing-led or nursing-related interventions aimed at fall prevention and reported fall-related results. Eligible study designs included randomized controlled trials, quasi-experimental studies, observational studies, and quality improvement initiatives. Study selection, data extraction, and critical appraisal were conducted according to JBI recommendations. Results: Six studies were included (quasi-experimental, cohort, prospective/observational, and quality improvement projects). Two main themes emerged: (1) structured multifactorial and educational interventions and (2) technology-based interventions. Multifactorial approaches that combine risk assessment, education, communication, and environmental measures have been shown to improve adherence and reduce falls. Technology-based interventions, especially video monitoring, showed the most consistent reductions in fall rates, including fewer nighttime falls and decreased need for one-to-one observation. The included studies were methodologically heterogeneous in design, clinical setting, and outcome definitions, which precluded statistical pooling and warrants caution in the interpretation of the findings. Conclusions: Structured, standardized, multifactorial, and nursing-led approaches can contribute to reducing inpatient falls. However, more robust and comparable studies are required to consolidate practice-relevant recommendations. Full article

Objective: To map the scientific evidence and identify knowledge gaps regarding the health of Black and Sexual and Gender Minority populations within the global context of health education. Introduction: Health education curricula should explicitly recognize, define, and address the specific needs and health disparities affecting Black and Sexual and Gender Minority populations to ensure that healthcare provision is comprehensive and inclusive in diverse settings. Eligibility criteria: Studies related to professional health training at undergraduate and graduate levels, as well as other educational modalities addressing healthcare provision for Black and Sexual and Gender Minority populations, were included. Methods: This scoping review was conducted following the JBI methodology. Studies were retrieved from Scopus, Web of Science, PubMed, Embase, MEDLINE, Virtual Health Library, CINAHL, ERIC, Cochrane Library, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations & Theses Global, EBSCO databases, and the Networked Digital Library of Theses and Dissertations, without language or time restrictions. Two independent reviewers screened the studies and extracted data using a standardized form developed for this review. Concepts, definitions, structures, results, and applications of professional health education for the care of Black and Sexual and Gender Minority populations were systematically synthesized. The results were organized and presented in tabular and graphical formats, accompanied by a narrative summary. Results: A total of 104 studies were included. The evidence was predominantly concentrated in North America, particularly in the United States, with limited representation from other regions. Most studies were published after 2020, indicating a recent expansion of research interest. The methodological profile was characterized by a predominance of quantitative and descriptive designs, alongside qualitative and mixed-methods approaches. Thematic analysis revealed a concentration of studies addressing gender-affirming care, workforce diversity, social determinants of health, and discrimination, while intersectional approaches and long-term educational outcomes remained less explored. Conclusions: The available evidence indicates that health education has increasingly incorporated themes related to equity and diversity; however, the integration of structured and mandatory curricular approaches addressing the intersectional health needs of Black and Sexual and Gender Minority populations remains limited. The findings highlight the need for broader geographic representation, stronger methodological designs, and the development of comprehensive educational strategies capable of addressing structural inequalities within health training contexts. Full article

Background/Objectives: Norway’s ageing population includes many older adults living alone who receive home care and are at increased risk of loneliness. Loneliness is the subjective sense of unmet or imbalanced social needs, shaped by culture and living conditions, and can be social (lack of contact) or emotional (absence of close, trusting relationships). In older people, it often follows partner or role loss or reduced mobility or participation and is associated with emotional pain, lowered self-worth and poorer health and quality of life. This study aimed to explore patients’ experiences of loneliness while living alone and receiving home care. Methods: Twelve older patients (aged 74–98 years) participated in in-depth interviews, which were analysed using phenomenological-hermeneutical analysis in line with Lindseth and Norberg’s recommendations. Results: The results are presented under the following themes: (I) An overwhelming and painful feeling, (II) A presence without connection, and (III) Experiencing a sense of alienation. Conclusions: This study describes complex feelings of loneliness for the majority of participants, often worsened by poor mobility and shrinking social networks. From the patient perspective, good home care goes beyond practical and medical tasks: patients need to be treated as whole persons, with respect and understanding, to alleviate loneliness. Staffing stability, predictable visiting times, time for conversation, and small acts of kindness are central to well-being and the prevention of loneliness. Municipal healthcare should prioritize relationship-building, communication skills, and organizational solutions that enable continuity and flexibility. Focusing on the patient perspective in planning and evaluation will create better targeted interventions and support dignified ageing. Full article

Background/Objective: Colleges and universities worldwide are experiencing an increase in students from diverse cultural and linguistic backgrounds. Nursing students who study in a second language face both theoretical and practical challenges within their study programs. If these challenges are unaddressed, they may have implications for third parties such as employers, patients, and colleagues. The bachelor’s thesis challenges students’ understanding of a chosen subject within nursing, in addition to research skills and academic writing abilities. Effective student learning and final thesis results often rely on supervisors who are interested in and motivated by the students’ success. Thus, the aim of this study was to explore supervisors’ experiences and perceptions of supervising undergraduate second-language (L2) nursing students in their bachelor’s thesis work. Methods: A qualitative research approach was employed to collect and analyze data. Components of Systematic Text Condensation were used for sorting and coding, and Interpretive Description was applied in the interpretive analysis. Results: Four prominent conceptual themes were agreed upon by the researchers: (1) uncertainty and cultural barriers, (2) cultural considerations, (3) teaching strategies, and (4) supervisor integrity. The conceptualized themes were found to align with the five identified attributes of cultural humility; openness, self-awareness, egolessness, supportive interaction, self-reflection and critique. Conclusions: This study suggests useful insights and practical guidance to supervisors on central issues to consider and reflect upon when guiding nursing students who are writing their bachelor’s theses in a second language. The theory of cultural humility, including the identified attributes, appears to be a useful framework for supervisors when guiding L2 nursing students. Full article

Background/Objectives: Health systems across Europe are increasingly challenged by population ageing, multimorbidity, and persistent inequities in access to care. Community Nursing has emerged as a promising approach to strengthening preventive, community-based services, yet evidence on stakeholder-perceived needs during early implementation remains limited. This study aimed to explore how different types of needs are perceived and articulated during the early implementation of Community Nursing in Austria. Methods: An interpretive descriptive qualitative study was conducted as part of an Austrian Community Nursing pilot project. Semi-structured interviews were carried out with eleven stakeholders, including informal caregivers, network partners (e.g., local healthcare providers), and local political decision-makers. Data were analyzed using qualitative content analysis, guided deductively by Bradshaw’s Taxonomy of Needs and complemented by inductive sub-category development. Interviews were conducted via telephone or video call (Zoom) and ranged from approximately 30 min to an hour. Results: Normative needs reflected expectations for preventive services, continuity of care, advocacy, and sustainable organizational structures. Felt needs centered on trust, emotional security, and relational continuity. Expressed needs became visible through active use of Community Nursing services, including preventive programs, transitional care support, and administrative navigation. Comparative needs highlighted geographic inequities and differences between municipalities with and without access to Community Nursing. Across stakeholder groups, concerns regarding long-term financing and sustainability were prominent. Conclusions: The findings suggest that Community Nursing addresses multiple stakeholder-perceived needs simultaneously, particularly by providing relational, accessible, and preventive support. However, sustained impact depends on stable funding and systemic integration beyond pilot phases. These results offer transferable insights for the development and scaling of community-based nursing models in ageing societies. Full article

Background: Chemsex, or sexualized drug use, exists along a continuum ranging from non-problematic, consensual recreational practice across diverse populations to problematic behaviors linked with clinical vulnerabilities, substance dependence, or compulsive disorders. Within nursing practice, understanding this spectrum is essential to mitigate healthcare-related stigma. Objective: To map and synthesize evidence on stigma and attitudes among nurses regarding chemsex, identifying implications for practice and research. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were performed across PubMed/MEDLINE, Scopus, Web of Science, CINAHL, EMBASE, and LILACS. Studies involving nurses or healthcare teams focused on stigma, attitudes, or related constructs in chemsex care were included. Data underwent descriptive and thematic synthesis. Results: Six studies met the inclusion criteria, showing substantial heterogeneity. Only one focused exclusively on nurses. Stigma and attitudes were rarely assessed explicitly, emerging instead as underlying factors influencing clinical practice, communication, and patient engagement. Key themes included the necessity for non-judgmental care, significant gaps in knowledge and training, variability in clinical practice, and the impact of organizational barriers. A schematic representation was developed to illustrate the interrelationships between stigma, knowledge, professional attitudes, and structural factors influencing healthcare practice. Conclusions: This review positions stigma as a central mechanism influencing nursing care in chemsex contexts. The findings underscore critical gaps in nursing-specific evidence and emphasize the need for targeted training, validated measurement tools, and integrated care models. Strengthening stigma-informed, patient-centered approaches is essential to improve care delivery and health outcomes for this population. Full article