Nursing Reports

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

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

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

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