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Nursing Reports

Nursing Reports is an international, peer-reviewed, open access journal on nursing sciences published monthly online by MDPI.

Indexed in PubMed | Quartile Ranking JCR - Q2 (Nursing)

All Articles (1,150)

  • Study Protocol
  • Open Access

Co-Design and Evaluation of a Gamified E-Resource About Healthcare Decarbonisation: A Study Protocol

  • Nuala McLaughlin-Borlace,
  • Stephanie Craig and
  • Nuala Flood
  • + 12 authors

Climate change poses a major global health threat, with healthcare systems contributing substantially to global greenhouse gas emissions. Health professionals and students play an essential role in advancing sustainable practice, yet many lack the knowledge, skills, and confidence needed to address the environmental impacts of healthcare. This study aims to co-design and evaluate a gamified e-resource that enhances pre-registration health profession students’ knowledge, self-efficacy, and attitudes towards healthcare decarbonisation, while encouraging sustainable behaviour change. A sequential explanatory design will be employed in three phases: (1) a scoping review of the literature; (2) four co-design workshops with students (n = 20) followed by post-workshop focus groups using focused ethnography to explore co-design experiences; and (3) pre- and post-test questionnaires (n = 200) assessing knowledge, attitudes, self-efficacy, behaviours, willingness to act, and usability, followed by focus groups (n = 30) exploring behavioural changes after using the e-resource. The study will generate evidence on how a co-designed, gamified e-resources influence student learning and engagement with healthcare decarbonisation. Findings will inform the integration of sustainability and decarbonisation principles within education and support efforts to equip future health professionals with the competencies required for a low-carbon healthcare system.

13 December 2025

Study design graphic.

Background/Objectives: Sex trafficking is a form of modern-day slavery still present in our societies. Health professionals are in a key position to identify and support victims, but adequate training is required. The aim of this study was to analyze the impact of a structured educational intervention on knowledge, perceived professional role, and attitudes toward sex trafficking of women among undergraduate nursing students at the University of Seville, Spain. Methods: A cluster randomized pilot educational trial with a pre-test–post-test control group design and one-year follow-up was conducted. A two-hour educational session addressed key concepts related to sex trafficking, health professionals’ responsibilities, and survivor support. Knowledge and attitudes were assessed at baseline, immediately after the intervention, and at one-year follow-up. Results: 199 students participated. Significant post-intervention improvements were observed in knowledge and attitudes, with sustained impact after one year despite some knowledge decay. Conclusions: This pilot educational intervention appears to improve knowledge and attitudes toward sex trafficking among undergraduate nursing students and may represent a useful strategy for sensitizing and training future health professionals in this area.

15 December 2025

Background/Objectives: Low-income compared to high-income women have a higher incidence of and mortality from cervical cancer (CC) due to lower screening rates (under/never-screened). Home-based screening for CC via mailed “self-collection” for human papillomavirus (HPV) testing is an alternative to traditional, provider-collected screening that may be more acceptable to low-income women. Theoretically, adoption of a recent technology, in this case, mailed return of self-collection, is related to the Diffusion of Innovations concepts of advantages and complexity. The purpose of this study was to develop and psychometrically test scales to measure advantages and complexity of self-collection in a low-income, under/never-screened population. Methods: Low-income women (n = 168) were recruited in person from food pantries and online using Facebook in the Midwest U.S. After a baseline survey, women were mailed a self-collection kit. We assessed reliability with item analysis and Cronbach’s α and evaluated validity with exploratory factor analysis and t-tests, using mailed kit return as the independent variable. Results: Two scales were developed: (1) advantages (Cronbach’s α = 0.84), item–total correlation = 0.51 to 0.69, and (2) complexity (Cronbach’s α = 0.82), item–total correlation = 0.45 to 0.64. Exploratory factor analysis supported items factoring on their respective scales, and t-tests supported a relationship between each scale and mailed return of kits. Conclusions: Both the advantages and complexity scales demonstrated reliability and validity among low-income women. Future studies should evaluate these scales in a larger, more diverse population. Nurses could use these scales to assess preferences and difficulties associated with self-collection and aid patients with CC screening decision-making.

15 December 2025

Background: Nurses have unique insights into health systems yet remain underrepresented in policy processes. Strengthening political competence is widely regarded as important for evidence-informed nursing leadership. Objectives: To assess self-perceived political competence and policy participation among nurses and nursing students in Croatia. Methods: We conducted a cross-sectional online survey using open, non-probability recruitment. Of 447 individuals who opened the survey link, 440 provided responses and 390 completed all 19 competence items measuring political competence across three domains (attitudes, knowledge/evidence, and skills). Open recruitment precluded calculation of a conventional response rate. A 19-item self-report questionnaire measured political competence across three domains (attitudes, knowledge/evidence and skills); internal consistency was α = 0.91, although the Croatian version has not been fully validated. Data were analyzed using descriptive statistics, binomial tests and ordinal logistic regression on the complete-case sample. Results: Most respondents endorsed nurses’ policy involvement, the importance of scientific evidence and nursing’s holistic perspective. Conclusions: Nurses and nursing students reported strong conceptual support for a policy role but only moderate confidence in influencing policy. These cross-sectional findings highlight a gap between conceptual support and personal confidence that may be addressable through structured educational and institutional support; the impact of such initiatives on policy influence should be examined in future longitudinal or interventional studies.

14 December 2025

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Nurs. Rep. - ISSN 2039-4403