Nursing Reports

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

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

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

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

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

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

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

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

Background: Peristomal leakage is one of the most troublesome complications of living with a stoma, affecting skin integrity, quality of life, and healthcare costs. However, definitions, measurement methods, and prevalence estimates remain heterogeneous. This scoping review aimed to (i) map the international prevalence of peristomal leakage across stoma subtypes; (ii) identify associated or correlated factors; and (iii) describe the tools used to assess leakage. Methods: A scoping review was performed following the Joanna Briggs Institute (JBI) guidelines. MEDLINE, CINAHL, Scopus, Embase, and the Cochrane Library were searched, with publication language restricted to English and Italian. Primary studies and evidence syntheses addressing peristomal leakage were included. Results: Twenty-seven studies were included, most of which were primary observational studies conducted in Europe, North America, and the Nordic countries. Ileostomy was the most frequently investigated stoma type, followed by colostomy and urostomy. Across settings, peristomal leakage was highly prevalent, with most period or lifetime prevalence estimates exceeding 50%. Reported determinants clustered into anatomical, surgical, device-related, behavioral, care-related and psychosocial factors. Multiple tools were used, including leakage-specific and broader stoma questionnaires, but definitions and leakage grading were inconsistent. Conclusions: Peristomal leakage is a common, multifactorial, and largely preventable complication with substantial clinical, psychosocial and economic consequences. Clinical practice should prioritize early detection, validated assessment tools, patient education, specialized stoma nursing and structured follow-up. Future research should establish consensus definitions, robustly validate leakage-specific instruments, include under-represented regions and conduct high-quality economic evaluations to guide equitable, cost-effective care models. Full article

Background: This study aimed to examine correlation between nurses’ assessments of health literacy in older adults, communication skills, and ageism, as well as whether these factors could be key predictors of nurse burnout. Methods: To determine which factors predict burnout among clinical nurses, a structured questionnaire was distributed to 269 clinical nurses. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression analysis. Results: Elderly patients’ health literacy assessed by nurses showed significant correlations with communication skills, ageism, and burnout. Communication skills were negatively correlated with ageism and burnout, whereas ageism showed a strong positive correlation with burnout. Multiple regression analysis revealed that ageism (β = 0.287), communication skills (β = −0.251), female gender (β = 0.139), and aging anxiety (β = −0.181)were significant predictors of burnout, collectively explaining 29.3% of the variance in burnout. Conclusions: Ageism was the strongest predictor of burnout among clinical nurses, followed by communication skills. Strategies reducing ageism and enhancing communication competencies are essential for mitigating burnout in geriatric nursing practice. These findings highlight the need for systematic educational interventions related to the elderly tailored for both nursing students and clinical nurses. Full article

Background: Traditional, complementary, and alternative medicine (TCAM) is a promising and increasingly popular approach in managing chronic neck and shoulder pain. Despite recognized benefits for pain relief and well-being, how TCAM facilitates self-care practices is poorly understood. This scoping review maps the existing evidence on TCAM-based self-care strategies for adults with chronic neck and shoulder pain to identify which domains of self-care are addressed and which are overlooked. Methods: We searched five academic databases, including PubMed, Scopus, Embase, Cinahl Complete (EBSCOhost), and Public Health Database (ProQuest). Articles published over a 20-year period that examined the use of TCAM for adults with chronic neck and shoulder pain were included. An analytical framework based on Riegel’s three core components of self-care (maintenance, monitoring, and management) was used to structure and synthesize the findings from included studies. Results: Thirty-three studies met the inclusion criteria. Most research focused on just one or two self-care components, primarily self-care maintenance (e.g., physical activities and treatment adherence) and self-care management (e.g., pain control). However, critical dimensions, such as psychological well-being, social support, work–life balance, and cultural context, were frequently overlooked. Conclusions: To enhance the quality of life for adults with chronic neck and shoulder pain, future TCAM research must adopt a more holistic self-care approach that extends beyond physical symptoms. Our findings highlight the need for integrated research, policy, and clinical services that address the full spectrum of self-care in chronic pain management. Full article

Background/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is highly prevalent among individuals residing in care homes, where effective disease management can enhance quality of life by slowing disease progression. Care home staff are central to COPD management in these settings, and their capacity to deliver optimal care may be strengthened through targeted education and training interventions. This scoping review aimed to synthesise existing evidence on education and training intended to enhance COPD care delivery by care home staff. Methods: A scoping review was conducted in accordance with Joanna Briggs Institute (JBI) guidelines and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. Four electronic databases (CINAHL, EMBASE, MEDLINE, and PsycINFO) were systematically searched for studies evaluating educational or training interventions regarding COPD for care home staff. Results: Only one study met the eligibility criteria for inclusion. This mixed methods study encompassed both a randomised control trial and semi-structured interviews, evaluating the effects of a COPD education programme for healthcare professionals working in a care home setting. This education intervention led to increased COPD-related knowledge and improved support for staff managing residents with COPD. Conclusions: Evidence for educational interventions for care home staff caring for individuals with COPD is extremely limited. While the included study shows potential for educational programmes, substantial gaps persist. Further research is needed to develop, implement, and rigorously assess education and training interventions to support high-quality COPD care in care homes. Full article

Introduction: Nursing informatics aims to improve patient care through rapid access to patient data, systematic assessment, a reduction in clinical errors, evidence-based practice, cost-effectiveness, and improved patient outcomes and safety. Background: Despite being the largest workforce in healthcare, nurses are not being adequately prepared to use nursing informatics, and this has been attributed to poor digital literacy, limited professional development, and a lack of undergraduate informatics education. Objectives: This scoping review aims to review contemporary published literature on the benefits, barriers, and enablers for embedding nursing informatics into undergraduate nursing education with a focus on the Australian healthcare context. Methods: A scoping review was conducted using the PRISMA-ScR checklist and the JBI Manual for evidence synthesis in adherence with an a priori scoping review protocol. A comprehensive search of JBI, Cochrane, CINAHL, Ovid, ProQuest, PubMed, and Scopus databases was performed. Two reviewers independently screened the results via Covidence, with discrepancies resolved via a third reviewer. Results: Two searches were conducted for this scoping review. In the first search, a total of 3227 articles were identified through database searches, with an additional 76 articles identified through bibliographic and grey literature searches. Following duplicate removal and screening, 46 articles met the inclusion criteria. In the second search, a total of 1555 articles were identified, and after duplicate removal and screening, 16 articles met the inclusion criteria. Duplicate removal during the second search round included those articles identified in the first search. The combined searches resulted in a total of 62 sources for this review. Conclusions: Despite the early adoption of nursing informatics in Australia in the 1980s, barriers remain to effective nursing informatics engagement and proficiency, including a lack of understanding of nursing informatics, limited infrastructure and resources, inadequate digital literacy of students and faculty, and the evolving nature of nursing informatics. Definitions of nursing informatics and associated fields, development of university faculty competency, access to digital health technologies, competency standards, digital literacy of the student cohort, faculty digital proficiency, and leadership from professional nursing bodies are all viewed as integral foundations for the development of student competency in nursing informatics. Full article

Background: Nurses’ teaching skills in the clinical setting are crucial to ensuring that students receive high-quality training. Despite the growing importance of competency frameworks, there is little research on the relationship between nurses’ teaching competence and sociodemographic, professional, training, and research variables. Methods: This was a cross-sectional, descriptive, and correlational study conducted at nine hospitals linked to the clinical placement subjects of the Bachelor of Nursing of the University of Barcelona. The study population comprised all nurses directly involved in clinical teaching. Participants’ level of self-reported teaching competence was evaluated using the Spanish version of the Capabilities of Nurse Educators (S-CONE) questionnaire, and the sociodemographic, professional, and academic variables were collected in an ad hoc questionnaire. Descriptive statistics, non-parametric tests, and linear and logistic regression models were used to analyse the associations between the S-CONE total score and the variables collected. Results: The mean age of the participants (n = 596) was 41.9 years (standard deviation: 8.82), and 85.6% of them were women (n = 510). The overall mean S-CONE score was 3.81 (SD: 0.73). Higher scores were observed in those with advanced academic degrees, formal teacher training, and participation in academic activities. Professionals with mixed roles (clinical mentor and academic tutor) self-reported significantly higher competence levels. Multivariate analyses identified participation in conferences, tutoring of undergraduate theses, and involvement in research or development projects as the main predictors of higher teaching competence as measured by the S-CONE questionnaire. The lowest-scoring factor was research and evidence, which points to a potential area for improvement. No significant associations were found with age, sex, or years of clinical experience. Conclusions: Participants had a high self-reported level of teaching competence and rated themselves as competent overall, especially in professional practice and curriculum design. However, we identified areas for improvement related to pedagogical innovation and the use of evidence. The findings reinforce the importance of professional development and academic involvement to strengthen teacher competence. Full article

Background/Objectives: Missed Nursing Care is a global concern that affects nurses’ well-being and patients’ safety. Despite global recognition of Missed Nursing Care, there is limited synthesized evidence that determines its characteristics in a Middle Eastern context. The purpose of the study is to synthesize the existing evidence about the prevalence of Missed Nursing Care among nurses in hospitals, the types of care missed, and reasons for Missed Nursing Care in the Middle East. Methods: A systematic literature review is conducted by using a comprehensive search in CINAHL, Scopus, and ScienceDirect databases for studies published between 2020 and 2025 and utilizing the MISSCARE Survey. Results: 25 studies met the inclusion criteria. The reported prevalence of Missed Nursing Care ranged between 1.06 and 2.9 out of five, indicating a low to moderate level. Frequent missed care activities included ambulation, hygiene, mouth care, and patient teaching. Contributing factors were staffing shortages, heavy workload, resource limitations, and communication issues. Missed Nursing Care critically affected patients’ outcomes, reduced job satisfaction, and caused moral distress and a higher intent to leave the profession. Conclusions: Missed Nursing Care remains a significant, complex challenge in the Middle East. Therefore, understanding this phenomenon in the region is needed. Collaborative efforts among policymakers, administrators, and nursing leaders are essential to implement targeted interventions, supportive policies, and ongoing research to minimize Missed Nursing Care across the Middle East. Full article

Background/Objectives: Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination, inflammation, and autoimmunity, leading to progressive physical and psychological impairments. Anxiety and depression are among the most prevalent neuropsychiatric comorbidities in MS, significantly impacting patients’ quality of life (QoL). This study aimed to assess the evolution of anxiety and depression in individuals with relapsing-remitting multiple sclerosis (RRMS) over a six-month follow-up period, identify associated factors, and explore potential predictors of these psychological conditions. Methods: A prospective observational study was conducted with 35 RRMS patients diagnosed at the Lucus Augusti University Hospital between January 2023 and March 2025. Psychological symptoms were assessed at baseline, after 3 months, and after 6 months using the Goldberg Anxiety and Depression Scale (GADS), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Data were analyzed using non-parametric tests to account for the small sample size and non-normal distribution of variables. Results: Anxiety and depression were prevalent and persistent in the study population, with no significant changes in mean scores over time (p > 0.05). However, specific symptoms, such as pessimism and loss of pleasure, showed worsening trends, while sadness and guilt remained stable. Sociodemographic factors, including lower income and employment status, were significantly associated with higher anxiety and depression scores (p < 0.05). Additionally, clinical factors such as autoimmune comorbidities and a history of mononucleosis were linked to higher depressive symptoms. Baseline anxiety and depression scores emerged as strong predictors of future levels (p < 0.01), emphasizing the importance of early assessments. Conclusions: Anxiety and depression are prevalent and persistent in RRMS patients, with specific symptoms fluctuating over time. Sociodemographic and clinical factors play a significant role in psychological outcomes, highlighting the need for integrated care models that address both physical and psychosocial aspects of MS. Early psychological assessments and targeted interventions are critical for improving QoL and mitigating the long-term burden of mental health challenges in RRMS. Full article

Background/Objectives: Urine drug testing (UDT) is a core component of nursing interventions within the treatment of substance use disorder (SUD). Beyond the detection of psychoactive substance use and medication adherence, UDT also provides opportunities for therapeutic dialogue, patient support, and recovery monitoring. Despite its routine use, little is known about how patients experience UDT and its potential as a therapeutic nursing tool within recovery-oriented care. This study aimed to explore patients’ lived experiences with UDT to understand its role in recovery-oriented addiction treatment. Methods: A phenomenological study with in-depth, semi-structured interviews was conducted among 12 residents of a supervised living facility at Addiction Care North Netherlands. Data were analyzed using Colaizzi’s seven-step method. Results: Four main themes were constructed in relation to trust within the therapeutic relationship—empowerment, accountability, and autonomy. Patients stated that their perception of UDTs as either supportive or punitive depended strongly on the level of trust within the therapeutic relationship. When trust was present, UDTs were experienced as supportive nursing tools that fostered empowerment and positive self-image, reinforced accountability for recovery goals, and upheld autonomy in decision-making. Conversely, in the absence of trust, UDTs were often perceived as punitive, coercive measures that undermined self-confidence and diminished accountability, ultimately hindering recovery progress. Nursing practices that emphasized nonjudgmental interpretation of results, collaborative decision-making, and patient-centered support contributed to positive experiences. Conclusions: Patients’ experiences indicate that the therapeutic value of UDT is highly dependent on the quality of the patient–nurse relationship. Nurses play a key role in ensuring that UDT is used as a supportive intervention rather than merely a control measure. Integrating UDT into holistic, recovery-oriented care can foster engagement, empowerment, and a sense of accountability. Future research should investigate nursing-led strategies to optimize UDT implementation tailored to treatment phase and patient needs. Full article

Background: Globally, stroke is a significant health problem and is considered one of the leading causes of mortality and permanent disability worldwide. Nurses are key stakeholders and integral members of the stroke care team, contributing to every stage of care. Objective: This study aimed to assess the effects of a nurse-led stroke training program on the knowledge, attitudes, and practices of registered nurses working in Berea primary health care facilities, Lesotho, before and after an educational intervention. Methods: To evaluate the effectiveness of the nurse-led intervention, this study used a pre-experimental one-group pretest–posttest design. Participants completed a structured questionnaire before the intervention to assess their baseline knowledge, attitudes, and practices related to stroke. Following the intervention, which consisted of educational sessions led by trained nurses, the same questionnaire was administered again to measure changes in participants’ knowledge, attitudes, and practices. Paired t-tests compared results. Results: A total of 34 registered nurses from 18 primary healthcare facilities participated in this pre- and post-intervention questionnaire study. When comparing knowledge, attitudes, and practices related to stroke before and after the educational intervention, the increase in correct response rates was statistically significant (p < 0.001). The training evaluation received positive feedback from the participants. Conclusions: Structured nurse-led educational interventions enhance nurses’ knowledge, attitudes, and practices in stroke care, leading to improved patient outcomes and stronger community-based prevention. These findings highlight the need to integrate continuous stroke education into nursing policies and primary health care practice. Full article

Background/Objectives: Nurses are at high risk for burnout. Identification of biomarkers associated with early manifestations of distress is essential to support effective intervention efforts. Methods: Fifty nurses from a large hospital system participated in a 30-day study of biopsychosocial factors that may contribute to burnout. Nurses wore an Oura ring that collected behavioral data and they completed a self-report burnout questionnaire at baseline and the end of the study period. Machine learning models were developed to evaluate whether objective measures could predict burnout states and changes at the end of the study period. Analyses were exploratory and hypothesis-generating for future work. Results: Data for 45 participants were included in the analyses. Participants with burnout had significantly higher sleep variability. Sleep measures provided 75.75% accuracy in ability to discriminate between burnout states. Heart rate-based measures better modeled changes in symptomatic components of burnout (Emotional Exhaustion, Depersonalization) over time. Heart rate-based measures provided a R-squared value of 0.13 (p < 0.05) (RMSE of 7.41) in a regression model of changes in Emotional Exhaustion evaluated in a leave-one-participant-out cross-validation. Conclusions: Sleep measures’ association with a state of burnout may reflect the longer-term manifestations of chronic exposure to workplace stress. Short-term changes in burnout symptoms are associated with disturbances in heart rate measures. Wearable technology may support monitoring/early identification of those at risk for burnout. Full article