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Virtual Reality Education Increases Neurologic Immersion and Empathy in Nursing Students
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Identifying Risk Factors for Delirium Through Comprehensive Geriatric Assessment in Older Adults Receiving Palliative Cancer Care
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Beyond Care: A Scoping Review on the Work Environment of Oncology Nurses
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Factors Contributing to Non-Adherence to Treatment Among Adult Patients with Long-Term Haemodialysis: An Integrative Review
Journal Description
Nursing Reports
Nursing Reports
is an international, peer-reviewed, open access journal on nursing sciences published monthly online by MDPI (from Volume 10 Issue 1 - 2020).
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, ESCI (Web of Science), PMC, PubMed, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 27.5 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the first half of 2025).
- Journal Rank: JCR - Q2 (Nursing) / CiteScore - Q2 (General Nursing)
- Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
- Journal Cluster of Healthcare Sciences and Services: Geriatrics, Journal of Ageing and Longevity, Healthcare, Hospitals, Hygiene, International Journal of Environmental Research and Public Health and Nursing Reports.
Impact Factor:
2.0 (2024);
5-Year Impact Factor:
2.5 (2024)
Latest Articles
Barriers and Facilitators to Patient Education Among Nurses in Multicultural Hospital Settings: A Cross-Sectional Study
Nurs. Rep. 2025, 15(10), 371; https://doi.org/10.3390/nursrep15100371 - 17 Oct 2025
Abstract
Background: Patient education (PE) is an essential component of quality healthcare and chronic disease management. However, effective implementation often faces patient-, nurse-, and organization-related barriers. This is particularly relevant in multicultural healthcare settings such as Saudi Arabia, where a highly diverse nursing workforce
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Background: Patient education (PE) is an essential component of quality healthcare and chronic disease management. However, effective implementation often faces patient-, nurse-, and organization-related barriers. This is particularly relevant in multicultural healthcare settings such as Saudi Arabia, where a highly diverse nursing workforce may influence PE practices. Aim: To examine the barriers and facilitators influencing patient education practices among nurses working in multiple hospitals in Saudi Arabia. Methods: A descriptive cross-sectional study was conducted among 289 registered nurses recruited through convenience sampling from various hospitals in Saudi Arabia. Data were collected using a validated self-administered questionnaire consisting of demographic items and structured scales assessing PE barriers and facilitators. Descriptive statistics were used to analyze the data. Results: Language differences (64.3%) and cultural barriers (59.2%) were the most commonly reported patient-related obstacles. Among nurse-related barriers, staff shortages (72.4%), heavy workload (72.0%), and time constraints (59.9%) were prominent. Organizational barriers included limited educational resources (39.4%) and unsupportive environments (35.6%). Key facilitators identified by nurses included availability of policies and procedures (63.6%), provision of PE training (63.7%), and integration of PE into clinical workflow and nurse appraisals. Conclusions: Despite strong professional support for PE, multiple barriers hinder its implementation in Saudi hospitals. Addressing these challenges requires institutional strategies such as workforce reinforcement, policy integration, and resource allocation. Future efforts should also include integrating patient perspectives, developing culturally tailored education resources, and evaluating the impact of targeted interventions to strengthen PE delivery in diverse hospital settings.
Full article
Open AccessReview
Medication Adherence Measurement in Chronic Diseases: A State-of-the-Art Review of the Literature
by
Jacqueline Dunbar-Jacob and Jian Zhao
Nurs. Rep. 2025, 15(10), 370; https://doi.org/10.3390/nursrep15100370 - 16 Oct 2025
Abstract
Background/Objectives: One of the most important self-management behaviors is following agreed-upon treatment recommendations. In chronic disease, which affects over one-third of adults, a critical behavior is taking prescribed medication. However, approximately half of patients with chronic conditions fail to adhere to medication recommendations.
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Background/Objectives: One of the most important self-management behaviors is following agreed-upon treatment recommendations. In chronic disease, which affects over one-third of adults, a critical behavior is taking prescribed medication. However, approximately half of patients with chronic conditions fail to adhere to medication recommendations. Research into medication adherence is complicated by the diversity of measurement methods and definitions, resulting in inconsistent outcomes. Accurate measurement is essential for clinical decision making and identifying effective interventions. This state-of-the-art review aimed to map the current landscape of adherence measurement in chronic disease management and provide evidence-based recommendations for future research and practice. Methods: Using a state-of-the-art review approach, we examined objective and subjective adherence measures in studies where medication adherence was a primary outcome, published from August 2019 to July 2024. The frequencies of each method type were calculated. In studies using more than one method within a sample, adherence outcomes were compared to assess their comparability. Results: Of 1036 screened records, 314 met the inclusion criteria. Self-report questionnaires were most frequently used (72% of studies), followed by pharmacy refill measures (22%), electronic monitoring (2.5%), and biologic assays (1.3%). Subjective measures were more frequently used due to their convenience and lower cost but they reduce the level of precision. Objective measures offered greater precision but at a higher cost and logistical complexity. Conclusions: Our findings suggest a dominant reliance on subjective measures. Standardizing definitions, thresholds, and reporting, and adopting multimodal measurement strategies, will improve the validity, comparability, and clinical utility of adherence research.
Full article
(This article belongs to the Special Issue Self-Management of Chronic Disease)
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Open AccessArticle
Nurses’ Adoption, Perceived Usability, and Satisfaction with an Updated Electronic Handover Page Within the Electronic Medical Record: A Mixed-Methods Study
by
Rebecca Miriam Jedwab, Anthony T. Pham, Yixin Qu, Rebecca Brook, Joanne Foster, James-Norbert Garduce, Siwen Li, Jane M. Smith and Naomi Dobroff
Nurs. Rep. 2025, 15(10), 369; https://doi.org/10.3390/nursrep15100369 - 15 Oct 2025
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Background/Objective: Clinical handover of patient information is a key component of patient care in hospitals. Nurses use a structured framework to minimise communication errors. Electronic Medical Record (EMR) systems can support patient safety and clinical handover with contemporaneous documentation. The aim of this
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Background/Objective: Clinical handover of patient information is a key component of patient care in hospitals. Nurses use a structured framework to minimise communication errors. Electronic Medical Record (EMR) systems can support patient safety and clinical handover with contemporaneous documentation. The aim of this study was to evaluate nurses’ adoption, perceived usability, and satisfaction with an updated handover page within the EMR. Methods: A pre-post mixed-methods study across a large Australian tertiary healthcare organisation examined handover page adoption using data from the EMR, and perceived usability and satisfaction were measured using a survey (handover page updated in EMR on 23 September 2024). Descriptive and inferential statistical analyses were conducted for quantitative data, and content analysis was used for qualitative data. Results: Adoption of the handover page was not statistically significant post-update (Wilcoxon signed-rank test z = −1.376, p = 0.169). Improved usability of the updated handover page post-update was demonstrated by a statistically significant decrease in the need to navigate away from the page to find relevant clinical information during handover (Fisher’s Exact Test p = 0.042). Nurses’ satisfaction increased, indicated by statistically significant increases in two items of the End User Computing Satisfaction Scale (precise information (Mann–Whitney U = 963.50, p = 0.040); and sufficient information (Mann–Whitney U = 927.50, p = 0.034)). Free-text comments indicated adoption and acceptability of the updated handover page by nurses, although a gap remains in the practice process. Conclusions: A co-designed solution to update the handover page within the EMR had good usability and satisfaction among nurses. Updates or implementations to digital health technologies must be continuously evaluated by specialist informatics teams to ensure appropriate adoption, usability and satisfaction by nurses, and positive repercussions for patient safety.
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Open AccessProtocol
Protocol to Assess the Knowledge, Attitude, and Practices of Midwives in the Implementation of Maternal Healthcare Guidelines in a Selected District, Limpopo Province, South Africa
by
Mantsha Sarah Maeko, Thifhelimbilu Irene Ramavhoya, Tebogo Maria Mothiba, Mamoeng Nancy Kgatla and Nonkululeko Peaceful Ntshayintshayi
Nurs. Rep. 2025, 15(10), 368; https://doi.org/10.3390/nursrep15100368 - 15 Oct 2025
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Maternal healthcare guidelines (MHCGs) are documents with detailed information on how to manage maternal and perinatal conditions step by step and accordingly to reduce preventable maternal and perinatal deaths. The National Maternity Guidelines Committee in the Department of Health, guided by the WHO,
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Maternal healthcare guidelines (MHCGs) are documents with detailed information on how to manage maternal and perinatal conditions step by step and accordingly to reduce preventable maternal and perinatal deaths. The National Maternity Guidelines Committee in the Department of Health, guided by the WHO, developed the (MHCGs) to ensure that every primary healthcare facility (PHC) has one or two midwives at their disposal to use, but its implementation remains a huge problem in South Africa. The purpose of this study is to evaluate the knowledge, practices, and attitudes of midwives during the implementation of MHCGs in a selected district, Limpopo province, South Africa. A quantitative methodology will be employed; cross-sectional descriptive research design will be used. The population of this research study will be midwives working in the PHCs of a selected district, Limpopo province, South Africa. The convenient sampling approach will be used; whereby self-developed semi-structured questionnaires will be used as a data collection instrument. The collected data will be analyzed using the Statistical Package for Social Sciences (SPSS), version 29, with the help of a statistician. The results will be available after data collection. The conclusion and recommendations will be based on the findings of the study.
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Open AccessArticle
Coping Strategies Used by Newly Appointed Nurse Educators During Transition from Clinical Practice to Academia: A Qualitative Study
by
Tumelo Dintwe, Gopolang Gause and Leepile Alfred Sehularo
Nurs. Rep. 2025, 15(10), 367; https://doi.org/10.3390/nursrep15100367 - 15 Oct 2025
Abstract
Background: Transition from clinical to academia requires newly appointed nurse educators to deploy certain coping strategies to thrive in their newly assumed roles. This is because this period is often coupled with high teaching expectations, research, increased workloads, and a lack of proficiency
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Background: Transition from clinical to academia requires newly appointed nurse educators to deploy certain coping strategies to thrive in their newly assumed roles. This is because this period is often coupled with high teaching expectations, research, increased workloads, and a lack of proficiency with work–life balance, resulting in a lack of coping. Therefore, this study aimed to explore and describe the coping strategies used by newly appointed nurse educators in a South African university. Methods: A qualitative, explorative, and descriptive research design was used. Data were gathered from 12 newly appointed nurse educators using online semi-structured individual interviews. Nurse educators who joined academia from clinical practice within the last six months to five years were included in this study. Data were analysed using Cresswell and Cresswell’s five steps for data analysis. Findings: Four categories emerged from the data: newly appointed nurse educators’ experiences of problem-focused coping, emotion-focused coping, meaning-focused coping, and coping through support from others during the transition from clinical practice to academia. Among the many coping strategies, the participants expressed that they apply clinical experience, self-assertiveness, conflict management, and setting boundaries to cope with the transition to academia. Conclusions: The findings of this study suggest that the transition from clinical practice to academia remains challenging for newly appointed nurse educators. This study further suggests that there is a need to have support measures in place for newly appointed nurse educators during their transition to academia to improve their ability to cope.
Full article
Open AccessArticle
Legacy Building from the Perspective of Palliative Care Professionals in Portugal: A Qualitative Thematic Analysis
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Carlos Laranjeira, Andréa Marques, Ana Fátima Fernandes, Maria Aparecida Domingos and Isabel Borges Moreira
Nurs. Rep. 2025, 15(10), 366; https://doi.org/10.3390/nursrep15100366 - 15 Oct 2025
Abstract
Background/Objectives: Legacy planning should respect te care preferences of people facing serious illness and integrate palliative care (PC). Legacy creation with the guidance of health professionals in PC assumes a therapeutic nature and aims to respond to the psychospiritual needs of patients
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Background/Objectives: Legacy planning should respect te care preferences of people facing serious illness and integrate palliative care (PC). Legacy creation with the guidance of health professionals in PC assumes a therapeutic nature and aims to respond to the psychospiritual needs of patients and their families. To date, research on professional experiences to create legacy in PC remains scarce. Therefore, this study sought to explore the experiences of PC professionals in legacy creation with the ill person and their family during EoL care. Methods: A descriptive qualitative study was performed through in-person semi-structured interviews with PC professionals from Portugal. Data collection was conducted from February to May 2025. Transcripts from the interviews were thematically analyzed with qualitative data management software WebQDA. The study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines. Results: Sixteen PC professionals participated in the study. Most participants were nurses (n = 8), followed by six physicians and two psychologists. The mean age of participants was 44.93 ± 10.46 years. Data analysis yielded three themes: (1) the worth of legacy in EoL; (2) enablers of legacy-building process; and (3) challenges of legacy-building process. Conclusions: Legacy is a meaningful resource that gives professionals the opportunity to connect with patients and their families, and to enact value-concordant person-centered care. By providing a greater grasp of legacy construction, our findings may help healthcare providers better understand how to provide dying patients and their families with dignity-conserving care.
Full article
Open AccessArticle
Surgical Fear, Anxiety, and Satisfaction with Nursing Care: A Cross-Sectional Study of Hospitalized Surgical Patients
by
Ioanna Dimitriadou, Aikaterini Kaperda, Aikaterini Toska, Evangelos C. Fradelos, Kyriakos Souliotis, Ioanna V. Papathanasiou, Pavlos Sarafis and Maria Saridi
Nurs. Rep. 2025, 15(10), 365; https://doi.org/10.3390/nursrep15100365 - 13 Oct 2025
Abstract
Background: Surgery is often accompanied by fear and anxiety, which can adversely affect recovery and patient’s well-being. Understanding the relationship between surgical fear and anxiety and satisfaction with nursing care can help nurses target interventions that improve perioperative outcomes. Aim: We aimed to
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Background: Surgery is often accompanied by fear and anxiety, which can adversely affect recovery and patient’s well-being. Understanding the relationship between surgical fear and anxiety and satisfaction with nursing care can help nurses target interventions that improve perioperative outcomes. Aim: We aimed to investigate surgical fear, preoperative anxiety, and satisfaction with nursing care among hospitalized surgical patients and identify clinical and experiential predictors of surgical fear. Methods: A descriptive cross-sectional study of 100 adult surgical patients was conducted using the Surgical Fear Questionnaire (SFQ), State–Trait Anxiety Inventory (STAI), and a validated Patient Satisfaction with Nursing Care Questionnaire. Descriptive and multivariable regression analyses were performed using IBM SPSS Statistics version 29.0 to explore the associations. Results: Patients reported high overall satisfaction with nursing care but notable preoperative anxiety and moderate surgical fear. Previous surgery, prior anesthesia exposure, longer hospital stay, and limited knowledge of the illness independently predicted greater surgical fear. Conclusions: Despite overall high satisfaction with nursing care, surgical patients experience considerable fear and anxiety. Nurses can reduce the perioperative psychological burden by delivering structured, nurse-led preoperative education, improving communication, and offering emotional support. Integrating such interventions into routine surgical pathways could reduce fear and anxiety and improve the patient experience.
Full article
Open AccessStudy Protocol
Telehealth Family Psychoeducation for Major Depressive Disorder: A Protocol for Intervention Co-Design and Feasibility Study
by
Obumneke Obieche, Jing-Yu (Benjamin) Tan, Sita Sharma, Daniel Bressington and Tao Wang
Nurs. Rep. 2025, 15(10), 364; https://doi.org/10.3390/nursrep15100364 - 11 Oct 2025
Abstract
Background/Objectives: Limited access to mental health services contributes to poorer outcomes among individuals with mental health conditions, including major depressive disorder (MDD). Nurse-led interventions serve as a strategic model of care to improve mental health service delivery and enhance patient outcomes. This project
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Background/Objectives: Limited access to mental health services contributes to poorer outcomes among individuals with mental health conditions, including major depressive disorder (MDD). Nurse-led interventions serve as a strategic model of care to improve mental health service delivery and enhance patient outcomes. This project aims to co-design a nurse-led telehealth family psychoeducation (FPE) for MDD and primarily assess its feasibility by evaluating the recruitment and retention rates. Methods: A multi-methods study encompassing a co-design phase (Study Phase 1) and a feasibility study (Study Phase 2). Study Phase 1 will involve semi-structured interviews with individuals with MDD and their families or significant others, as well as surveys and focus groups with mental health professionals to develop telehealth FPE for MDD. Study Phase 2 will evaluate the feasibility and acceptability of the intervention, which comprises three biweekly FPE sessions and a six-week follow-up with patient–family dyads using a single-group pre-post design. The primary outcomes comprise the feasibility and acceptability of intervention. Exploratory secondary outcomes include personal recovery, medication necessity beliefs and concerns, antidepressant adherence, and depression severity, measured at baseline, immediately post-intervention, and at 6-week follow-up using validated measures. Data analysis will primarily involve descriptive statistics and thematic analysis. The TIDieR checklist will be followed in reporting the intervention development. Conclusions: Findings from the proposed study will inform the design and protocol for a future randomised trial of telehealth FPE for improving clinical and non-clinical outcomes in MDD. The feasibility study was prospectively registered with the ClinicalTrial.gov on 8 June 2025 (NCT07014241).
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(This article belongs to the Section Mental Health Nursing)
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Association of Reading Comprehension and Science Aptitude with Early Success in a First-Semester BSN Cohort: A Cross-Sectional Study
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Marivic B. Torregosa and Orlando Patricio
Nurs. Rep. 2025, 15(10), 363; https://doi.org/10.3390/nursrep15100363 - 10 Oct 2025
Abstract
Background: As the United States population becomes increasingly diverse, the representation of minorities in health professions is critical to addressing health disparities. Few investigations have been conducted among students enrolled in the first semester of the nursing program, a vulnerable and adjustment
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Background: As the United States population becomes increasingly diverse, the representation of minorities in health professions is critical to addressing health disparities. Few investigations have been conducted among students enrolled in the first semester of the nursing program, a vulnerable and adjustment period for most nursing majors. Thus, this study examined the association between reading comprehension and science aptitude on student retention and standardized test scores. Method: A cross-sectional repeated measures study was conducted to investigate the outcomes from a compendium of programmatic interventions implemented among n = 80 nursing students enrolled in the first semester of a pre-licensure baccalaureate nursing program in one Hispanic-serving institution. These interventions included the Weaver™ reading online program, case studies, NCLEX-type practice tests, test-taking skills, and peer-mentoring. Data collection was conducted in Spring 2024. Multivariate statistical analysis was used to determine predictors associated with student retention and standardized test scores. An independent t-test was used to examine any significant difference in the reading comprehension level among the cohort’s participants. A qualitative investigation using thematic analysis was conducted to understand students’ experiences with the programmatic interventions. Results: Students’ baseline reding comprehension level was significantly associated with failure in the first semester of the nursing program (β = −0.815; SE = 0.349; Wald = 5.444; p < 0.05). End-of-term reading comprehension level was significantly associated with end-of-course HESI score in the Foundations in Nursing course (β = 26.768; SE = 10.049; Beta = 0.445; p < 0.05) while science GPA was significantly associated with end-of-course HESI score for Health Assessment (β = 3.022; SE = 1.315; Beta = 0.434; p < 0.05. Cohort retention was 75%. The independent t-test result indicated a significant difference in reading level was found between those who dropped out from the cohort (M = 4.23, SE = 0.173 and those who did not (M = 5.15, SE = 0.188), t (68) = −3.037, p < 0.01. A reading level of grade 10 and above was associated with student progression to the next semester (M = 10.16, SE = 0.375, t (70) = −0.560, p < 0.05. Although the participants found the reading comprehension modules tedious, test-taking strategies, applying the nursing process in case studies, and the expertise of a nurse educator, who understood the learning needs of first-semester students, were perceived as critical to academic success. Conclusions: Reading comprehension and science aptitude are essential to students’ early success in the nursing program. Addressing gaps in reading comprehension and science aptitude before admission to a nursing program would increase chances of success in the early stages of a nursing major.
Full article
Open AccessArticle
Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Authentic Nurse Leadership Questionnaire for the Portuguese Context: A Methodological Study
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Pedro Lucas, Ana Gaspar, Paulo Cruchinho, Mafalda Inácio, Ana Rita Figueiredo, Luísa Dias, Paula Agostinho, João Oliveira, Marie Giordano-Mulligan, Elisabete Nunes and Patrícia Costa
Nurs. Rep. 2025, 15(10), 362; https://doi.org/10.3390/nursrep15100362 - 9 Oct 2025
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Background: Authentic leadership is characterized by the authenticity and self-awareness of the leader, who acts with transparency and promotes positive outcomes in clinical practice and team management. In Portugal, there isn’t a tool available to assess nurses’ perceptions of authentic leadership in
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Background: Authentic leadership is characterized by the authenticity and self-awareness of the leader, who acts with transparency and promotes positive outcomes in clinical practice and team management. In Portugal, there isn’t a tool available to assess nurses’ perceptions of authentic leadership in nursing. This study aimed to translate and cross-culturally adapt the Authentic Nurse Leadership Questionnaire (ANLQ) for the Portuguese context and to evaluate its psychometric properties. This instrument assesses nurses’ perceptions of the authentic leadership exercised by their leader. Methods: A methodological, descriptive, cross-sectional study with a quantitative approach was conducted. The translation and cross-cultural adaptation process followed the recommendations of internationally recognized guidelines. The Authentic Nurse Leadership Scale—Portuguese version (ANLS-PT) was administered to a sample of 406 nurses from various functional units in three primary healthcare centers. Exploratory and confirmatory factor analysis techniques were used. Reliability was established through a test–retest administration to 22 nurses at two different times, with a two-week interval. The internal consistency of the scale was assessed using Cronbach’s Alpha. Results: An instrument with 29 items and 3 dimensions was obtained, explaining 68.3% of the total variance. The identified dimensions were Caring and Decision-Making, Self-Awareness, and Relational Integrity and Ethics. The overall instrument showed an internal consistency of 0.97. Conclusions: The ANLS-PT proved to be a valid, reliable, and robust tool for assessing authentic leadership in the Portuguese cultural context and can be used in various nursing practice contexts.
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Enhancing Equality, Equity, Diversity and Inclusion in Rare Disease Research in the United Kingdom
by
Andrew E. P. Mitchell and Sondra Butterworth
Nurs. Rep. 2025, 15(10), 361; https://doi.org/10.3390/nursrep15100361 - 9 Oct 2025
Abstract
Background: Inclusion of under-represented rare-disease communities in research remains limited, threatening representativeness and equity. Methods: To assess equality, equity, diversity, and inclusion in research and identify barriers to participation faced by the rare disease community, utilising a mixed-methods online survey of
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Background: Inclusion of under-represented rare-disease communities in research remains limited, threatening representativeness and equity. Methods: To assess equality, equity, diversity, and inclusion in research and identify barriers to participation faced by the rare disease community, utilising a mixed-methods online survey of a convenience sample of community advocates using Likert scales and free response options. Results: The findings from seventeen stakeholders in the rare disease community showed unanimous agreement that anxiety, fear, safety concerns, and lack of trust hinder participation in research. A total of 82% agreed or strongly agreed that additional financial resources are needed, and 76% agreed or strongly agreed that research grant applications often lack sufficient funds. The free-text responses demonstrate that the rare disease communities are keen to be involved in research but faces barriers to inclusion. Rare disease communities are willing to participate in research, but those responsible for research need to address the challenges related to language, misconceptions and fear. Conclusions: Key legislation in the United Kingdom, specifically the Proposed Patient and Public Involvement Strategy 2020–2025, emphasises the importance of involving patients and the public in health and social care. This survey marks the first step toward gaining valuable insights into the challenges faced by this community in participating in healthcare research, which is crucial for developing a solid evidence base for their treatment and care. Involving stakeholders is essential in health and social care policy and practice, rooted in advocacy and social justice.
Full article
Open AccessArticle
Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study
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Sajmira Adëraj, Manuela Saurini, Rocco Mazzotta, Edona Gara, Dasilva Taçi, Alta Arapi, Vicente Bernalte-Martí, Alessandro Stievano, Ercole Vellone, Gennaro Rocco and Maddalena De Maria
Nurs. Rep. 2025, 15(10), 360; https://doi.org/10.3390/nursrep15100360 - 8 Oct 2025
Abstract
Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults
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Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults with MCCs in these settings. Aim: The aim of this study was to examine the associations between caregivers’ and patients’ socio-demographic characteristics and patients’ clinical variables and the CC to patient self-care behaviors in adults with MCCs in an LMIC context. Methods: This multicenter, cross-sectional study included patient–caregiver dyads recruited from outpatient and community settings across Albania, between August 2020 and April 2021. CC was assessed using the Caregiver Contribution to Self-Care of Chronic Illness Inventory scale (CC-SCCII). Three multivariable linear regression models were used to explore associations with the three dimensions of CC to self-care maintenance, monitoring, and management. Results: Caregivers were mostly female, children, or spouses with a high level of education and employed. Patients were primarily female and had low education. Hypertension and diabetes were the most prevalent. Older and employed caregivers contributed less to CC to self-care maintenance, while higher education and caregiving experience increased it. Living with the patient and being a spouse reduced CC to self-care monitoring, whereas more caregiving hours and experience improved it. CC to self-care management was negatively influenced by cohabitation, presence of a second caregiver, and being a spouse, but improved with more caregiving hours. Conclusions: Socio-demographic and caregiving factors differently influence CC to self-care dimensions in older adults with MCCs in an LMIC. Tailored caregiver support programs are essential to enhance caregiver involvement and improve MCC patient outcomes in LMICs.
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(This article belongs to the Special Issue Self-Management of Chronic Disease)
Open AccessReview
Recent Advances in Ultrasound-Guided Peripheral Intravenous Catheter Insertion
by
Amélie Bruant and Laure Normand
Nurs. Rep. 2025, 15(10), 359; https://doi.org/10.3390/nursrep15100359 - 8 Oct 2025
Abstract
Background/Objectives: This narrative review addresses ongoing controversies and advancements concerning ultrasound-guided peripheral intravenous (IV) catheter insertion, and the impact of ultrasound guidance on success rate, procedural time, patient and staff experience, complications and costs, as well as requirements for its use. Methods: A
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Background/Objectives: This narrative review addresses ongoing controversies and advancements concerning ultrasound-guided peripheral intravenous (IV) catheter insertion, and the impact of ultrasound guidance on success rate, procedural time, patient and staff experience, complications and costs, as well as requirements for its use. Methods: A literature review was conducted. Results: Growing evidence suggests that ultrasound-guided insertion of peripheral IV catheter represents a superior technique across various patient populations, particularly those presenting with difficult IV access (DIVA). Key findings highlight significant improvements in first-attempt success rates, reduction of procedural complications, and enhanced patient comfort. Ultrasound-guided insertion is also associated with an increase in catheter dwell time, a reduction in repeat procedures and in central line placements, leading to improved resource utilization and the potential for substantial long-term cost-effectiveness, despite the cost of initial investment and training. However, obtaining these improvements involves a critical importance for standardized training, adherence to rigorous aseptic techniques, and generalization of the transformative impact of ongoing technological advancements in ultrasound devices. Conclusions: The collective body of evidence supports the widespread adoption of ultrasound-guided peripheral IV cannulation as an evidence-based best practice in modern healthcare.
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(This article belongs to the Section Nursing Education and Leadership)
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Open AccessArticle
Seeking Something Beyond Themselves: A Concept Analysis of Spiritual Awakening Experiences at the End of Life
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Manuela Monteiro, Joel Vitorino, Marina G. Salvetti and Carlos Laranjeira
Nurs. Rep. 2025, 15(10), 358; https://doi.org/10.3390/nursrep15100358 - 8 Oct 2025
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Background/Objectives: End-of-life (EoL) experiences are critically important for everyone involved, giving rise to a set of needs that extend far beyond bio-physiological aspects, to encompass the spiritual dimension as the core of human beings. Understanding the processes of spiritual awakening (SA) assists palliative
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Background/Objectives: End-of-life (EoL) experiences are critically important for everyone involved, giving rise to a set of needs that extend far beyond bio-physiological aspects, to encompass the spiritual dimension as the core of human beings. Understanding the processes of spiritual awakening (SA) assists palliative care professionals in enhancing the quality of care provided to individuals with life-threatening illnesses, as well as to their families. SA is a fundamental occurrence linked to the fulfilment of our spiritual needs when facing an existential crisis, such as the proximity of death. However, its conceptual boundaries need to be clarified to provide qualified and humanized palliative care. Therefore, this study aims to identify the key attributes, antecedents, consequents, and empirical referents of SA at EoL, as well as to clarify the concept’s existing ambiguities. Methods: Walker and Avant’s eight-step concept analysis was used. A literature search was conducted in May 2025 across three databases (PubMed, CINAHL and Scopus). Results: Following the review, 21 articles were included for analysis. The concept analysis revealed four main attribute domains: (1) sensory–perceptual domain; (2) affective/cognitive domain; (3) relational domain; and (4) transcendental domain. Moreover, spiritual consciousness and the existential matrix were antecedents to this concept; revaluation of beliefs, finding spiritual serenity and inner freedom, fostering spiritual growth, and the desire to leave a legacy were its consequences. Conclusions: The concept of SA at the EoL reveals itself to be a complex and multifactorial phenomenon, with a profound impact on a person’s confrontation with finitude. Recognizing and integrating SA into palliative care allows for a more comprehensive understanding of human consciousness. To deal with SA experiences in healthcare settings, a multifaceted approach is needed. This encompasses acknowledging spirituality as a determinant of health, including spiritual care in standard practice, and offering education and training on spiritual care competence for healthcare practitioners. Further transdisciplinary research should be undertaken to explore SA phenomenological variations, guide clinical interventions, and evaluate SA impacts on spiritual well-being and spiritual growth.
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Open AccessArticle
The Development of a Care Model for Sarcopenic Obesity in Older Adults: Participatory Action Research
by
Nuchthida Samaisong, Chomchuen Somprasert and Lisa Pawloski
Nurs. Rep. 2025, 15(10), 357; https://doi.org/10.3390/nursrep15100357 - 5 Oct 2025
Abstract
Background/Problem: Sarcopenic obesity (SO) is characterized by significant muscle loss combined with obesity, and it is mostly prevalent among older adults. Consequences include a heightened incidence of falls and a greater susceptibility to non-communicable diseases. Thailand currently lacks a care model for SO
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Background/Problem: Sarcopenic obesity (SO) is characterized by significant muscle loss combined with obesity, and it is mostly prevalent among older adults. Consequences include a heightened incidence of falls and a greater susceptibility to non-communicable diseases. Thailand currently lacks a care model for SO in older adults. Objective/Purpose: This study utilizes participatory-action research (PAR) to develop a care model for sarcopenic obesity in Thailand. Design and Methodology: In-depth interviews with 25 older adults with SO and focus group discussions with 12 stakeholders were conducted to develop a preliminary care model. An action research spiral process was utilized with 15 older adults with SO over 16 weeks. Findings: We developed a culturally sensitive care model for SO in older adults. This study demonstrates that a participatory-action research (PAR) method for behavior transformation, highlighting health awareness and SO literacy, is crucial for behavior change. Conclusions and Implications: The behavior change process using transformative behaviors facilitated internal changes. This approach helps individuals to understand interconnected factors through personal experiences, leading to profound understanding and readiness for deep, continuous, and meaningful behavioral changes.
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(This article belongs to the Topic Healthy, Safe and Active Aging, 2nd Edition)
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Open AccessArticle
The Effect of Video-Based Education on Activities of Daily Living and Wound Healing of Patients with Total Hip Replacement: Randomised Controlled Trials
by
Ayse Sinem Tas and Ismet Eser
Nurs. Rep. 2025, 15(10), 356; https://doi.org/10.3390/nursrep15100356 - 4 Oct 2025
Abstract
Background and Purpose: There remains a need for effective and accessible education methods to support recovery after total hip replacement. To evaluate the effects of video-based education on daily living activities and wound healing of patients undergoing total hip replacement surgery. Methods: A
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Background and Purpose: There remains a need for effective and accessible education methods to support recovery after total hip replacement. To evaluate the effects of video-based education on daily living activities and wound healing of patients undergoing total hip replacement surgery. Methods: A randomised controlled trial was used. Eligible participants were those aged 18 years and over who had undergone total hip replacement surgery in a training and research hospital. The intervention group received video-based training, while the control group received only routine care. Results: Patients in the video-based training group showed significantly greater improvement in daily living activities, hip function, and wound healing on postoperative days 5 and 30 compared to the control group (p < 0.01). Conclusions: Video-based education significantly improved daily living activities, hip function, and wound healing in patients undergoing total hip replacement. Clinicaltrials ID: NCT06523829
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(This article belongs to the Special Issue Nursing Interventions to Improve Healthcare for Older Adults)
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Open AccessArticle
Development and Content Validation of a Person-Centered Care Instrument for Healthcare Providers
by
Krishan Soriano, Sora Nakatani, Kaito Onishi, Hirokazu Ito, Youko Nakano, Yoshiyuki Takashima, Yueren Zhao, Allan Paulo Blaquera, Ryuichi Tanioka, Feni Betriana, Gil Platon Soriano, Yuko Yasahura, Kyoko Osaka, Matsuko Kataoka, Misao Miyagawa, Masashi Akaike, Minoru Irahara and Tetsuya Tanioka
Nurs. Rep. 2025, 15(10), 355; https://doi.org/10.3390/nursrep15100355 - 2 Oct 2025
Abstract
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Background/Objectives: Despite the increasing recognition of person-centered care (PCC), existing evaluation tools often have profession-specific limitations, lacking broad applicability across interdisciplinary contexts. This study aimed to develop and validate the Person-Centered Care Instrument (PCCI), designed to assess the competence of healthcare providers
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Background/Objectives: Despite the increasing recognition of person-centered care (PCC), existing evaluation tools often have profession-specific limitations, lacking broad applicability across interdisciplinary contexts. This study aimed to develop and validate the Person-Centered Care Instrument (PCCI), designed to assess the competence of healthcare providers from diverse professions. Methods: Using a two-round modified Delphi technique, ten experts validated an initial pool of 63 items. The process assessed both face validity (overall appropriateness) and content validity using a 9-point Likert scale and the Item-level Content Validity Index (I-CVI). Items with a median rating of 6 or higher and an I-CVI of ≥0.70 were retained. Results: The final PCCI consists of 37 items, with a scale-level content validity index of 0.65. Three items achieved universal agreement among the experts (I-CVI = 1.0). For the final 37-item PCCI, the Scale-level Content Validity Index (S-CVI) was 0.65, and the index based on universal agreement was 0.22. Conclusions: The developed PCCI demonstrated good face and content validity, making it a valid and broadly applicable tool for assessing competence in delivering PCC. This instrument can support quality improvement initiatives and help promote a culture of empathy and respect in healthcare.
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Open AccessArticle
Integrated Management of Constipation in Hypothyroidism: Evaluating Pharmacological and Non-Pharmacological Interventions
by
Eman M. Gaber Hassan, Sharell Lewis, Sajedah Fawzi Alsadiq, Salha Ali Almarhoon, Hanan Mufareh Alsubeh, Sana Mohammad Alboori, Khulood Abdulghafour Al Marzooq, Fatimah Saleh Al Awami and Mohammad Daud Ali
Nurs. Rep. 2025, 15(10), 354; https://doi.org/10.3390/nursrep15100354 - 29 Sep 2025
Abstract
Background/Objective: Chronic constipation is a common gastrointestinal disorder that can be caused by a variety of factors, such as demographic, lifestyle, and medical disorders like hypothyroidism. Its prevalence varies worldwide, affecting quality of life and leading to specialized management strategies. To explore hypothyroidism
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Background/Objective: Chronic constipation is a common gastrointestinal disorder that can be caused by a variety of factors, such as demographic, lifestyle, and medical disorders like hypothyroidism. Its prevalence varies worldwide, affecting quality of life and leading to specialized management strategies. To explore hypothyroidism patients’ knowledge and practice regarding constipation and evaluate the perceived effectiveness of pharmacological and non-pharmacological management approaches. Methods: A descriptive, cross-sectional design was used to collect the data from a private hospital in the eastern region of Saudi Arabia from January to May 2025. A convenient sample of 300 individuals with hypothyroidism completed the Bowel Habits Questionnaire. Results: Most participants knew that hypothyroidism could cause constipation, but they reported that they did not have more knowledge about it. Both pharmacological and non-pharmacological interventions, especially increase water intake, fiber intake, and exercise, were commonly used by the participants, and they perceived these approaches to be effective. There were strong correlations between constipation frequency and age, disease duration, and the use of constipation management methods. A strong association was found between constipation management strategies and treatment effectiveness. Conclusion: Age, disease duration, and constipation management strategies significantly affect constipation in hypothyroidism patients. Drinking plenty of water and eating more fiber are two very effective non-pharmacological strategies. It is recommended that nurses who integrate routine bowel health education and lifestyle guidance into care plans consider the gap in patient knowledge regarding the relationship between hypothyroidism and constipation, to enhance patients’ self-management and contribute to better health outcomes.
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(This article belongs to the Special Issue Clinical and Rehabilitative Nursing in Chronicity)
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Open AccessProtocol
Healthcare Access Among Individuals Who Practice Chemsex in Brazil: A Scoping Review Protocol
by
Isadora Silva de Carvalho, Lariane Angel Cepas, Álvaro Francisco Lopes de Sousa, Talita Morais Fernandes, Talia Gomes Luz, Jean Carlos Soares da Silva, Augusto da Silva Marques, Caíque Jordan Nunes Ribeiro, Shirley Veronica Melo Almeida Lima, Anderson Reis de Sousa, Carlos Arterio Sorgi, Ricardo Nakamura and Ana Paula Morais Fernandes
Nurs. Rep. 2025, 15(10), 353; https://doi.org/10.3390/nursrep15100353 - 27 Sep 2025
Abstract
Background: Chemsex, the intentional use of psychoactive substances to enhance sexual experiences, is an emerging public health issue in Brazil, associated with increased risks of sexually transmitted infections and complex psychosocial vulnerabilities. Despite the universal coverage provided by the Unified Health System (SUS),
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Background: Chemsex, the intentional use of psychoactive substances to enhance sexual experiences, is an emerging public health issue in Brazil, associated with increased risks of sexually transmitted infections and complex psychosocial vulnerabilities. Despite the universal coverage provided by the Unified Health System (SUS), individuals who practice chemsex often encounter barriers to healthcare, including stigma, discrimination, and a lack of specialized services. To date, no comprehensive reviews appear to synthesize evidence on how this population accesses healthcare in the Brazilian context; existing knowledge remains fragmented across individual studies. Objectives: The aim is to map and synthesize the available evidence regarding access to health services among people who engage in chemsex in Brazil, identifying health needs, professional demands, barriers, and facilitators. Methods: The protocol follows the Joanna Briggs Institute methodology for scoping reviews and PRISMA-ScR guidelines. A systematic search will be conducted in MEDLINE (PubMed), Embase, Scopus, SciELO, and LILACS for studies published between 2014 and 2024 in Portuguese, English, or Spanish. Data will be summarized using descriptive and narrative synthesis, presented in tables and thematic categories. Studies will be included if they address chemsex or sexualized drug use in Brazil and report on healthcare access, regardless of gender identity, sexual orientation, or drug type. Studies that do not address chemsex, focus on drug use outside a sexual context, or are unrelated to Brazil will be excluded. Expected results: The review is expected to identify key barriers and facilitators to healthcare access, highlight knowledge gaps for underrepresented groups, and support recommendations for research, policy, and practice to improve care for people engaging in chemsex in Brazil. By focusing on an underexplored intersection of drug use, sexuality, and healthcare access in Latin America, this study aims to provide an innovative contribution to public health literature.
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Development and Validation of a Tool to Assess Healthcare Professionals’ Views on Parental Presence During Neonatal Resuscitation
by
Paraskevi Volaki, Rozeta Sokou, Abraham Pouliakis, Nikoleta Aikaterini Xixi, Zoi Iliodromiti, Styliani Paliatsiou, Georgios Kafalidis, Theodora Boutsikou, Theodoros Xanthos and Nicoletta Iacovidou
Nurs. Rep. 2025, 15(10), 352; https://doi.org/10.3390/nursrep15100352 - 26 Sep 2025
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Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive
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Background/Objectives: Childbirth is a natural and joyfully anticipated life event for parents and relatives. Yet, in some cases, it can be a medical emergency requiring immediate intervention, i.e., neonatal resuscitation. The majority of newborns breathe spontaneously; a small number, though, may receive basic life support (assisted transition), and an even smaller but clinically significant number require advanced life support (resuscitation). Within the context of family-centered care, the presence of parents during resuscitation has emerged as a factor with potential implications for emotional adjustment, communication with healthcare providers, and early parent–infant bonding. However, the presence of family members during neonatal resuscitation remains a subject of ongoing debate among healthcare professionals (HCPs). Despite increasing recognition of its potential benefits, HCPs’ views on parental presence during such critical procedures have not been extensively investigated in Greece. This study aims at developing and validating a tool to assess healthcare professionals’ views on parental presence during neonatal resuscitation. Methods: A preliminary questionnaire was developed based on the principles of family-centered care and adapted to the Greek population. The first phase included expert assessment of validity, clarity, and relevance using a modified Delphi method. Item Content Validity Index (I-CVI) and Scale CVI (S-CVI) were calculated. Pilot testing was conducted to assess test–retest reliability. Reliability was assessed using the Intraclass Correlation Coefficient (ICC) and Bland–Altman analyses. The study followed the principles of the Declaration of Helsinki, ensuring anonymity, informed consent, and confidentiality. Results: The questionnaire includes 37–50 items allocated in four sections. It demonstrated excellent content validity (CVI = 1.00) and good test–retest reliability (ICC = 0.86). Qualitative feedback indicated that the tool is user-friendly and comprehensive. Interestingly, participants expressed genuine concerns regarding the implementation of parental presence in neonatal resuscitation. Conclusions: The questionnaire development process led to a comprehensive tool, ready for large-scale testing in order to further establish its validity and internal consistency.
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