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29 pages, 1150 KiB  
Review
What Helps or Hinders Annual Wellness Visits for Detection and Management of Cognitive Impairment Among Older Adults? A Scoping Review Guided by the Consolidated Framework for Implementation Research
by Udoka Okpalauwaekwe, Hannah Franks, Yong-Fang Kuo, Mukaila A. Raji, Elise Passy and Huey-Ming Tzeng
Nurs. Rep. 2025, 15(8), 295; https://doi.org/10.3390/nursrep15080295 - 12 Aug 2025
Abstract
Background: The U.S. Medicare Annual Wellness Visit (AWV) offers a structured opportunity for cognitive screening and personalized prevention planning among older adults. Yet, implementation of AWVs, particularly for individuals with cognitive impairment, remains inconsistent across primary care or other diverse care settings. Methods: [...] Read more.
Background: The U.S. Medicare Annual Wellness Visit (AWV) offers a structured opportunity for cognitive screening and personalized prevention planning among older adults. Yet, implementation of AWVs, particularly for individuals with cognitive impairment, remains inconsistent across primary care or other diverse care settings. Methods: We conducted a scoping review using the Consolidated Framework for Implementation Research (CFIR) to explore multilevel factors influencing the implementation of the Medicare AWV’s cognitive screening component, with a focus on how these processes support the detection and management of cognitive impairment among older adults. We searched four databases and screened peer-reviewed studies published between 2011 and March 2025. Searches were conducted in Ovid MEDLINE, PubMed, EBSCOhost, and CINAHL databases. The initial search was completed on 3 January 2024 and updated monthly through 30 March 2025. All retrieved citations were imported into EndNote 21, where duplicates were removed. We screened titles and abstracts for relevance using the predefined inclusion criteria. Full-text articles were then reviewed and scored as either relevant (1) or not relevant (0). Discrepancies were resolved through consensus discussions. To assess the methodological quality of the included studies, we used the Joanna Briggs Institute critical appraisal tools appropriate to each study design. These tools evaluate rigor, trustworthiness, relevance, and risk of bias. We extracted the following data from each included study: Author(s), year, title, and journal; Study type and design; Data collection methods and setting; Sample size and population characteristics; Outcome measures; Intervention details (AWV delivery context); and Reported facilitators, barriers, and outcomes related to AWV implementation. The first two authors independently coded and synthesized all relevant data using a table created in Microsoft Excel. The CFIR guided our data analysis, thematizing our findings into facilitators and barriers across its five domains, viz: (1) Intervention Characteristics, (2) Outer Setting, (3) Inner Setting, (4) Characteristics of Individuals, and (5) Implementation Process. Results: Among 19 included studies, most used quantitative designs and secondary data. Our CFIR-based synthesis revealed that AWV implementation is shaped by interdependent factors across five domains. Key facilitators included AWV adaptability, Electronic Health Record (EHR) integration, team-based workflows, policy alignment (e.g., Accountable Care Organization participation), and provider confidence. Barriers included vague Centers for Medicare and Medicaid Services (CMS) guidance, limited reimbursement, staffing shortages, workflow misalignment, and provider discomfort with cognitive screening. Implementation strategies were often poorly defined or inconsistently applied. Conclusions: Effective AWV delivery for older adults with cognitive impairment requires more than sound policy and intervention design; it demands organizational readiness, structured implementation, and engaged providers. Tailored training, leadership support, and integrated infrastructure are essential. These insights are relevant not only for U.S. Medicare but also for global efforts to integrate dementia-sensitive care into primary health systems. Our study has a few limitations that should be acknowledged. First, our scoping review synthesized findings predominantly from quantitative studies, with only two mixed-method studies and no studies using strictly qualitative methodologies. Second, few studies disaggregated findings by race, ethnicity, or geography, reducing our ability to assess equity-related outcomes. Moreover, few studies provided sufficient detail on the specific cognitive screening instruments used or on the scope and delivery of educational materials for patients and caregivers, limiting generalizability and implementation insights. Third, grey literature and non-peer-reviewed sources were not included. Fourth, although CFIR provided a comprehensive analytic structure, some studies did not explicitly fit in with our implementation frameworks, which required subjective mapping of findings to CFIR domains and may have introduced classification bias. Additionally, although our review did not quantitatively stratify findings by year, we observed that studies from more recent years were more likely to emphasize implementation facilitators (e.g., use of templates, workflow integration), whereas earlier studies often highlighted systemic barriers such as time constraints and provider unfamiliarity with AWV components. Finally, while our review focused specifically on AWV implementation in the United States, we recognize the value of comparative analysis with international contexts. This work was supported by a grant from the National Institute on Aging, National Institutes of Health (Grant No. 1R01AG083102-01; PIs: Tzeng, Kuo, & Raji). Full article
(This article belongs to the Section Nursing Care for Older People)
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14 pages, 344 KiB  
Article
The Experience of Patients with Type 1 Diabetes Mellitus with the Use of Glucose Monitoring Systems: A Qualitative Study
by Anxela Soto-Rodriguez, Ana Fernández-Conde, Raquel Leirós-Rodríguez, Álvaro Toubes Opazo and Nuria Martinez-Blanco
Nurs. Rep. 2025, 15(8), 294; https://doi.org/10.3390/nursrep15080294 - 12 Aug 2025
Abstract
Aim: The purpose of this study was to explore the broad experience of continuous glucose monitoring from the perspective of patients diagnosed with type 1 diabetes mellitus, including not only their emotions and feelings but also the lifestyle changes, perceptions, and social aspects [...] Read more.
Aim: The purpose of this study was to explore the broad experience of continuous glucose monitoring from the perspective of patients diagnosed with type 1 diabetes mellitus, including not only their emotions and feelings but also the lifestyle changes, perceptions, and social aspects associated with its use. Design: This is a phenomenological qualitative study. Patient or Public Contribution: The sample consisted of 10 adult patients diagnosed with type 1 diabetes who had been using the continuous glucose monitoring system for at least 6 months and were patients of the Endocrinology and Nutrition Service of the University Hospital Complex of Ourense. Methods: The recorded interviews were conducted in November 2024. The conversations were audio-recorded with the participants’ consent, and then transcribed for thematic analysis. Results: Three main categories were identified: “experience prior to continuous glucose monitoring” (accessibility, prior knowledge, and expectations), “experience with the use of continuous glucose monitoring” (perception of healthcare support, concerns, strengths, and alarm management), and “experience regarding the disease” (self-management of the disease and safety). Despite the fact that diabetes mellitus is a complex chronic disease, all participants provided a positive assessment of their progress and improved control through continuous glucose monitoring. Conclusions: All participants felt more secure and protected with continuous glucose monitoring, improving their quality of life. The main concern among the subjects was the possibility of the sensor failing. They positively valued the alarm system in case of hypoglycemia. The CGM is a highly effective tool for the management and self-control of diabetes and promotes the relationship between patients and professional health. Impact: The findings of this study have important implications for clinical care, highlighting the need for more training and more health education at the first level of health care, such as health centers. Full article
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18 pages, 812 KiB  
Review
Mapping Care Practices and Service Delivery Models for Refugee and Displaced Families in Private Hosting Arrangements: A Scoping Review
by Areej Al-Hamad, Yasin M. Yasin, Lujain Yasin and Andy Zhang
Nurs. Rep. 2025, 15(8), 293; https://doi.org/10.3390/nursrep15080293 - 11 Aug 2025
Abstract
Private hosting arrangements have emerged as community-driven alternatives to institutional refugee housing, offering personalized support and opportunities for enhanced social integration. However, clarity around care practices and service delivery models remains underdeveloped. This paper presents the findings of a scoping review aimed at [...] Read more.
Private hosting arrangements have emerged as community-driven alternatives to institutional refugee housing, offering personalized support and opportunities for enhanced social integration. However, clarity around care practices and service delivery models remains underdeveloped. This paper presents the findings of a scoping review aimed at mapping evidence on service delivery and care practices in private hosting contexts for refugee families. Following an overview of the background and methodology, we present key themes, propose a conceptual model, and conclude with implications for policy, practice, and future research. This scoping review maps existing literature on care practices; it does not assess the effectiveness of interventions or establish best practices. The review synthesizes empirical and gray literature on service delivery and care practices supporting refugee and displaced families in private hosting contexts. Following the Joanna Briggs Institute (JBI) methodology, six academic databases and multiple gray literature sources were systematically searched, resulting in the inclusion of 28 studies. The analysis identified four conceptual dimensions of care described in the literature: relational care and trust-building, program structure and policy integration, holistic integration pathways, and embedded equity and protection. While private hosting facilitates emotional connection and psychosocial integration, the review highlights key challenges, including variability in host preparedness, emotional labor disparities, and limited formal oversight. The findings underscore the need for evidence-informed guidelines, standardized host training, trauma-informed approaches, and coordinated policy frameworks. The resulting model offers a foundation to inform future research, guide policy development, and strengthen private hosting practices to ensure equitable, inclusive, and sustainable outcomes for refugee and displaced families. Full article
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18 pages, 538 KiB  
Review
Barriers and Facilitators to the Use of Capnography for Respiratory Monitoring by Nurses in Phase I Post-Anesthesia Care Unit: A Scoping Review
by Adriana Sofia Lucas Assunção and Lara Daniela Matos Cunha
Nurs. Rep. 2025, 15(8), 292; https://doi.org/10.3390/nursrep15080292 - 11 Aug 2025
Abstract
Background/Objectives: Capnography monitoring in the Post-Anesthesia Care Unit (PACU) plays a crucial role in the early detection of respiratory complications, being fundamental for patient safety. It provides objective and continuous data on ventilation, enabling timely interventions to optimize health outcomes. This scoping [...] Read more.
Background/Objectives: Capnography monitoring in the Post-Anesthesia Care Unit (PACU) plays a crucial role in the early detection of respiratory complications, being fundamental for patient safety. It provides objective and continuous data on ventilation, enabling timely interventions to optimize health outcomes. This scoping review aims to map the available evidence regarding barriers and facilitators to the use of capnography for respiratory monitoring by nurses in the Phase I PACU. Methods: A scoping review was conducted following the methodology proposed by the Joanna Briggs Institute (JBI). The search was performed in the MEDLINE and CINAHL Complete databases and the Portuguese Open Access Scientific Repository (RCAAP). Studies in Portuguese, English, and Spanish were included, with no time restrictions. The search strategy combined indexing terms and natural language, adapted to each database. Results: Seven studies were included in the sample. The main identified barriers were a high workload, perceived lack of patient adherence, and lack of knowledge. Key facilitators included the alarm sound, patient education, anticipating patient clinical instability, increased nurse confidence, perception of enhanced safety, targeted training for nurses, continuous improvement in care delivery, effective communication and feedback, promotion of sustainable care practices, and prior knowledge and exposure. Conclusions: The use of capnography in the PACU allows for respiratory function assessment and the early detection of clinical events. Its implementation should be based on current scientific evidence, promoting a culture of safety and quality improvement in patient care. Full article
(This article belongs to the Special Issue Breakthroughs in Nursing: Clinical Reasoning and Decision-Making)
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10 pages, 220 KiB  
Article
The Role of Nurse Practitioners in Surgical Settings Across the Perioperative Trajectory: A Comparative Study on Patient-Centered Outcomes
by Limor Chen, Ziv Gil, Nasra Idilbi, Dafna Zontag and Efrat Shadmi
Nurs. Rep. 2025, 15(8), 291; https://doi.org/10.3390/nursrep15080291 - 9 Aug 2025
Viewed by 149
Abstract
Nurse practitioners (NPs) are increasingly integrated into surgical care teams, complementing traditional surgical roles. However, the relationship between their involvement and patient-reported outcome measures (PROMs), such as pain and anxiety, remains understudied. Purpose: To examine the types of care from NPs in [...] Read more.
Nurse practitioners (NPs) are increasingly integrated into surgical care teams, complementing traditional surgical roles. However, the relationship between their involvement and patient-reported outcome measures (PROMs), such as pain and anxiety, remains understudied. Purpose: To examine the types of care from NPs in surgical units during the perioperative period and evaluate their association with length of stay, pain, and anxiety. Methods: Our prospective comparative study in two surgical units at a tertiary medical center included 315 patients: 156 received care from NPs, and 159 received usual care. Data were collected at three time points: post-operative day one (T0), during hospitalization (T1), and 14 days post-discharge (T2). Measures included the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, and an intervention checklist completed by the NPs. Findings: NPs performed primarily in-hospital interventions including care coordination (40%) and medication management (44%). Patients treated by NPs reported significantly lower in-hospital anxiety compared to usual care (p = 0.001). The length of stay and pain levels were not significantly associated with NP care. Discussion: NPs in surgical settings provide patient-centered care associated with lower in-hospital anxiety. Further research is recommended to validate these findings in diverse settings. Full article
16 pages, 266 KiB  
Article
Pediatric Pain Management: An Observational Study on Nurses’ Knowledge of Non-Pharmacological Techniques
by Lum Jusufi, Enrico Cocchi, Rita Blaco, Valeria Cremonini, Claudia Cadas, Elsa Vitale, Roberto Lupo, Giorgio De Nunzio, Donato Cascio, Gianandrea Pasquinelli, Luana Conte and Ivan Rubbi
Nurs. Rep. 2025, 15(8), 290; https://doi.org/10.3390/nursrep15080290 - 9 Aug 2025
Viewed by 127
Abstract
Introduction: Pain represents a significant threat to the physical and psychological well-being of children, negatively affecting their quality of life during hospitalization. Pain is considered the fifth vital sign and must be regularly assessed and managed, as also emphasized by the nursing [...] Read more.
Introduction: Pain represents a significant threat to the physical and psychological well-being of children, negatively affecting their quality of life during hospitalization. Pain is considered the fifth vital sign and must be regularly assessed and managed, as also emphasized by the nursing code of ethics. The interdisciplinary approach to pediatric pain management includes both pharmacological treatments and non-pharmacological techniques (NPTs), taking into account the child’s age and specific needs. NPTs comprise a broad set of methods, ranging from simple to complex, that can be applied to children to help them manage pain. The main objective of this study was to explore and analyze which non-pharmacological methods are adopted by nurses in their clinical practice to relieve pain in school-aged children (6–12 years) undergoing surgery. Materials and Methods: This observational study involved nursing staff from pediatric wards in the Italian provinces of Ravenna, Forlì-Cesena, and Rimini, and used a validated online questionnaire. The study focused on school-aged children (6–12 years) who had undergone surgical procedures. The questionnaire included items on which NPTs nurses used to relieve pain in pediatric patients. Participants responded using a Likert scale from 1 (never) to 5 (always), and anonymity and voluntary participation were guaranteed. Data were collected between February and October 2024, involving the pediatric units of three hospitals in the provinces of Ravenna, Forlì-Cesena, and Rimini. Statistical analyses included t-tests, ANOVA, and Kruskal–Wallis tests to identify significant differences. Results: A total of 46 nurses completed the questionnaire. No significant differences were found between nurses’ backgrounds and the use of NPTs. Overall, nurses did report using NPTs, although there was limited use of such techniques in the preoperative phase. The study also highlighted a discrepancy in the information provided to children versus parents, with nurses tending to give more information to parents during the preoperative period. Notably, nurses who reported effective multidisciplinary collaboration were also those who better prepared children using NPTs. Conclusions: This study emphasizes the importance of NPTs in pediatric pain management and highlights the need to improve direct communication with children. Adopting an effective multidisciplinary approach is essential to ensuring a less traumatic surgical experience for young patients. Full article
19 pages, 1578 KiB  
Review
Augmented Reality in Health Education: Transforming Nursing, Healthcare, and Medical Education and Training
by Georgios Lampropoulos, Pablo Fernández-Arias, Antonio del Bosque and Diego Vergara
Nurs. Rep. 2025, 15(8), 289; https://doi.org/10.3390/nursrep15080289 - 8 Aug 2025
Viewed by 273
Abstract
Background: In health sciences education and particularly, in healthcare education, nursing education, and medical education, augmented reality is being increasingly used due to the changes and benefits to teaching and learning approaches it can yield. However, as the field advances, it is [...] Read more.
Background: In health sciences education and particularly, in healthcare education, nursing education, and medical education, augmented reality is being increasingly used due to the changes and benefits to teaching and learning approaches it can yield. However, as the field advances, it is important to systematically map the current literature and provide an overview of the field. Aim: By analyzing the current literature, this study focuses on examining the use of augmented reality in healthcare, nursing, and medical education and training. Method: The study adopts a systematic mapping review approach and analyzes 156 studies that were published during 2010–2025. Results: The results revealed that augmented reality is an effective educational tool that can support teaching and learning of diverse subjects in the context of health education, as it enables learners to combine their theoretical knowledge with practical applications within interactive and immersive learning environments and simulations without risking patient safety. Increased learning outcomes, including hands-on acquisition of practical skills and clinical competencies, engagement, performance, knowledge gain and retention, as well as their critical thinking and decision-making were observed. The potential of augmented reality to offer realistic and interactive visual representations, to support procedural training, to provide cost-effective solutions, to enhance collaborative learning, and to increase accessibility to education, even in resource-limited settings, was highlighted. Education stakeholders expressed positive attitudes and perspectives toward the adoption and integration of augmented reality into health sciences education. Discussion: The results emphasize the role of augmented reality in supporting and improving health education. Additionally, the study revealed six main topics, identified current research gaps, and provided future research directions. Conclusions: When appropriately applied, augmented reality has the potential to effectively support and enrich nursing, healthcare, and medical education and training. Full article
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13 pages, 267 KiB  
Article
Sense of Coherence and Perceived Academic Stress Among Nursing Students: A Multicenter Cross-Sectional Study
by David Ballester-Ferrando, Esther Cáceres-Malagelada, Carolina Rascón-Hernán, Teresa Botigué, Ana Lavedán, Olga Masot, Dolors Burjalés, Luis González-Osorio, Ximena Osorio-Spuler, Eva Serrat-Graboleda and Concepció Fuentes-Pumarola
Nurs. Rep. 2025, 15(8), 288; https://doi.org/10.3390/nursrep15080288 - 8 Aug 2025
Viewed by 184
Abstract
Background: Nursing students often face high academic and emotional demands, which can negatively affect both their mental health and academic performance. From a salutogenic perspective, the sense of coherence (SOC) is considered a key protective factor in managing stress and fostering resilience. Objectives [...] Read more.
Background: Nursing students often face high academic and emotional demands, which can negatively affect both their mental health and academic performance. From a salutogenic perspective, the sense of coherence (SOC) is considered a key protective factor in managing stress and fostering resilience. Objectives: This study aimed to explore the SOC levels among nursing students and examine their associations with perceived academic stress and sociodemographic variables. Methods: A multicenter, cross-sectional, exploratory study was conducted in a sample of 1301 undergraduate nursing students from four universities in Spain and Chile. Participants completed the Orientation to Life Questionnaire, a validated instrument assessing SOC and its three dimensions: comprehensibility, manageability, and meaningfulness. Sociodemographic data and students’ perceived stress in relation to key academic activities were also collected. Descriptive and inferential statistical analyses were performed, including t-tests and ANOVA. Results: The mean SOC score was 62.65 (SD = 12.36), with no significant differences between universities. Significant associations (p < 0.05) were found between SOC scores and age, marital status, academic year, work status, and university entry path, but not with gender or caregiving responsibilities. Students aged ≥29 years and those who were married or working had higher SOC scores. Higher levels of perceived stress in lectures, seminars, clinical practice, group work, and written assignments were significantly associated with lower SOC scores. Conclusions: This study’s findings suggest that a stronger SOC is associated with lower perceived academic stress and certain sociodemographic characteristics. Integrating salutogenic approaches into nursing curricula could strengthen students’ SOC, promoting their mental well-being and academic resilience. Full article
19 pages, 272 KiB  
Article
Legacy of Strength and Future Opportunities: A Qualitative Interpretive Inquiry Regarding Australian Men in Mental Health Nursing
by Natasha Reedy, Trish Luyke, Brendon Robinson, Rhonda Dawson and Daniel Terry
Nurs. Rep. 2025, 15(8), 287; https://doi.org/10.3390/nursrep15080287 - 7 Aug 2025
Viewed by 156
Abstract
Background/Objectives: Men have historically contributed significantly to mental health nursing, particularly in inpatient settings, where their presence has supported patient recovery and safety. Despite this legacy, men remain under-represented in the nursing workforce, and addressing this imbalance is critical to workforce sustainability. This [...] Read more.
Background/Objectives: Men have historically contributed significantly to mental health nursing, particularly in inpatient settings, where their presence has supported patient recovery and safety. Despite this legacy, men remain under-represented in the nursing workforce, and addressing this imbalance is critical to workforce sustainability. This study offers a novel contribution by exploring the lived experiences, motivations, and professional identities of men in mental health nursing, an area that has received limited empirical attention. The aim of the study is to examine the characteristics, qualities, and attributes of mental health nurses who are male, which contributes to their attraction to and retention within the profession. Methods: A qualitative interpretive inquiry was conducted among nurses who were male and either currently or previously employed in mental health settings. Two focus groups were conducted using semi-structured questions to explore their career pathways, motivations, professional identities, and perceived contributions. Thematic analysis was used to identify key themes and patterns in their narratives. Results: Seven participants, with 10–30 years of experience, participated. They had entered the profession through diverse pathways, expressing strong alignment between personal values and professional roles. Five themes emerged and centred on mental health being the heart of health, personal and professional fulfillment, camaraderie and teamwork, a profound respect for individuals and compassion, and overcoming and enjoying the challenge. Conclusions: Mental health nurses who are male bring unique contributions to the profession, embodying compassion, resilience, and ethical advocacy. Their experiences challenge traditional gender norms and redefine masculinity in health care. Fostering inclusive environments, mentorship, and leadership opportunities is essential to support their growth. These insights inform strategies to strengthen recruitment, retention, and the future of mental health nursing. Full article
(This article belongs to the Section Mental Health Nursing)
17 pages, 962 KiB  
Article
Impact of COVID-19 on Mental Health in Nursing Students and Non-Nursing Students: A Cross-Sectional Study
by Verena Dresen, Liliane Sigmund, Siegmund Staggl, Bernhard Holzner, Gerhard Rumpold, Laura R. Fischer-Jbali, Markus Canazei and Elisabeth Weiss
Nurs. Rep. 2025, 15(8), 286; https://doi.org/10.3390/nursrep15080286 - 6 Aug 2025
Viewed by 238
Abstract
Background/Objective: Nursing and non-nursing students experience high stress levels, making them susceptible to mental health issues. This study compared stress, anxiety, and depression between these two groups after 2 years of the COVID-19 pandemic. Additionally, it explored the relationship between perceived helplessness, [...] Read more.
Background/Objective: Nursing and non-nursing students experience high stress levels, making them susceptible to mental health issues. This study compared stress, anxiety, and depression between these two groups after 2 years of the COVID-19 pandemic. Additionally, it explored the relationship between perceived helplessness, self-efficacy, and symptoms of mental stress and strain resulting from challenging internship conditions for nursing students. Methods: This cross-sectional study included 154 nursing students (mean age = 22.43 years) and 291 non-nursing students (mean age = 27.7 years). Data were collected using the Depression Anxiety Stress Scales (DASS-21), Perceived Stress Scale-10 (PSS-10), and a questionnaire on mental stress and strain. Results: Nursing students reported significantly higher scores in the DASS-21 subscales depression (ηp2 = 0.016) and anxiety (ηp2 = 0.037), and global stress (PSS-10; ηp2 = 0.029) compared to non-nursing students, but no significant difference on the DASS-21 Stress subscale. The observed group differences in the present study may be partially attributed to group differences in demographic factors. Helplessness correlated strongly with nearly all scales of mental stress and strain during internships (all p’s < 0.001), while self-efficacy showed a strong negative correlation with non-occupational difficulties, health impairment, and emotional problems (all p’s < 0.001). Conclusions: Nursing students experience elevated depression, anxiety, and perceived stress levels compared to non-nursing students. Stronger feelings of helplessness and lower confidence in their ability to overcome challenges were strongly correlated with mental stress and strain during clinical training. Targeted interventions such as cognitive behavioral training and stress management should be integrated into nursing curricula to enhance resilience and coping strategies. Full article
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23 pages, 3890 KiB  
Article
Evaluating Nursing and Midwifery Students’ Self-Assessment of Clinical Skills Following a Flipped Classroom Intervention with Innovative Digital Technologies in Bulgaria
by Galya Georgieva-Tsaneva, Ivanichka Serbezova and Milka Serbezova-Velikova
Nurs. Rep. 2025, 15(8), 285; https://doi.org/10.3390/nursrep15080285 - 6 Aug 2025
Viewed by 315
Abstract
Background/Objectives: The transformation of nursing and midwifery education through digital technologies has gained momentum worldwide, with algorithm-based video instruction and virtual reality (VR) emerging as promising tools for improving clinical learning. This quasi-experimental study explores the impact of an enhanced flipped classroom [...] Read more.
Background/Objectives: The transformation of nursing and midwifery education through digital technologies has gained momentum worldwide, with algorithm-based video instruction and virtual reality (VR) emerging as promising tools for improving clinical learning. This quasi-experimental study explores the impact of an enhanced flipped classroom model on Bulgarian nursing and midwifery students’ self-perceived competence. Methods: A total of 228 participants were divided into a control group receiving traditional instruction (lectures and simulations with manikins) and an experimental group engaged in a digitally enhanced preparatory phase. The latter included pre-class video algorithms, VR, and clinical problem-solving tasks for learning and improving nursing skills. A 25-item self-report questionnaire was administered before and after the intervention to measure perceived competence in injection techniques, hygiene care, midwifery skills, and digital readiness. Results: Statistical analysis using Welch’s t-test revealed significant improvements in the experimental group in all domains (p < 0.001). Qualitative data from focus group interviews further confirmed increased student engagement, motivation, and receptiveness to digital learning tools. Conclusions: The findings highlight the pedagogical value of integrating structured video learning, VR components, and case-based learning within flipped classrooms. The study advocates for the wider adoption of blended learning models to foster clinical confidence and digital competence in healthcare education. The results of the study may be useful for curriculum developers aiming to improve clinical readiness through technology-enhanced learning. Full article
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16 pages, 506 KiB  
Article
The Transition to Caregiver in Advanced Alzheimer’s Disease: From Emotional Connection to Care Responsibility—A Grounded Theory Approach
by Federica Dellafiore, Orejeta Diamanti, Luca Guardamagna, Gloria Modena, Pierpaolo Servi, Donato Antonio Rotondo, Tiziana Nania, Andreina Saba and Giovanna Artioli
Nurs. Rep. 2025, 15(8), 284; https://doi.org/10.3390/nursrep15080284 - 4 Aug 2025
Viewed by 292
Abstract
Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in [...] Read more.
Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in its deeper processual dimensions. This study aims to explore and theorize the transition experienced by a family member becoming the primary informal caregiver for a person with advanced AD. Methods: A qualitative study based on the Constructivist Grounded Theory according to Charmaz’s approach (2006) was conducted. In-depth interviews were carried out with 10 participants who had become informal caregivers for a loved one with advanced AD. Data were analyzed using initial coding, focused coding, the constant comparative method, and theoretical coding. Results: Ten caregivers (mean age 39 years, range 35–54; nine females) of patients with advanced AD participated in the study. The analysis revealed a complex, emotionally intense caregiving experience marked by sacrifice, feelings of powerlessness, identity loss, and the necessity of sharing caregiving responsibilities. A core category emerged: A Silent and Certain Willingness to Care, representing the caregivers’ deep, often unconscious commitment to prioritize the care of their loved ones above their own needs. Four interconnected phases characterized the caregiving process: (1) The Changing Daily Life—involving significant sacrifices in personal and social life; (2) Feeling Powerless—confronting the inevitable decline without means to alter the course; (3) Losing Oneself—experiencing physical and psychological exhaustion and a sense of identity loss; and (4) Sharing with Others—seeking external support to sustain caregiving. These findings highlight the evolving nature of becoming a caregiver and the enduring dedication that sustains this role despite the challenges. Conclusions: The progression of AD deeply transforms the lives of caregivers, who become co-sufferers and active participants in the disease’s management. The results underscore the urgency of designing integrative care strategies—including psychological, social, and potentially technological support—that can enhance both patient outcomes and caregiver resilience. Grounded in real-world experiences, this study contributes to the broader neurodegeneration discourse by emphasizing caregiving as a critical factor in long-term disease management and therapeutic success. Full article
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15 pages, 317 KiB  
Review
The Contribution of Artificial Intelligence in Nursing Education: A Scoping Review of the Literature
by Federico Cucci, Dario Marasciulo, Mattia Romani, Giovanni Soldano, Donato Cascio, Giorgio De Nunzio, Cosimo Caldararo, Ivan Rubbi, Elsa Vitale, Roberto Lupo and Luana Conte
Nurs. Rep. 2025, 15(8), 283; https://doi.org/10.3390/nursrep15080283 - 1 Aug 2025
Viewed by 601
Abstract
Background and Aim: Artificial intelligence (AI) is among the most promising innovations for transforming nursing education, making it more interactive, personalized, and competency-based. However, its integration also raises significant ethical and practical concerns. This scoping review aims to analyze and summarize key studies [...] Read more.
Background and Aim: Artificial intelligence (AI) is among the most promising innovations for transforming nursing education, making it more interactive, personalized, and competency-based. However, its integration also raises significant ethical and practical concerns. This scoping review aims to analyze and summarize key studies on the application of AI in university-level nursing education, focusing on its benefits, challenges, and future prospects. Methods: A scoping review was conducted using the Population, Concept, and Context (PCC) framework, targeting nursing students and educators in academic settings. A comprehensive search was carried out across the PubMed, Scopus, and Web of Science databases. Only peer-reviewed original studies published in English were included. Two researchers independently screened the studies, resolving any disagreements through team discussion. Data were synthesized narratively. Results: Of the 569 articles initially identified, 11 original studies met the inclusion criteria. The findings indicate that AI-based tools—such as virtual simulators and ChatGPT—can enhance students’ learning experiences, communication skills, and clinical preparedness. Nonetheless, several challenges were identified, including increased simulation-related anxiety, potential misuse, and ethical concerns related to data quality, privacy, and academic integrity. Conclusions: AI offers significant opportunities to enhance nursing education; however, its implementation must be approached with critical awareness and responsibility. It is essential that students develop both digital competencies and ethical sensitivity to fully leverage AI’s potential while ensuring high-quality education and responsible nursing practice. Full article
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17 pages, 501 KiB  
Article
Nurse-Led Binaural Beat Intervention for Anxiety Reduction in Pterygium Surgery: A Randomized Controlled Trial
by Punchiga Ratanalerdnawee, Mart Maiprasert, Jakkrit Klaphajone, Pongsiri Khunngam and Phawit Norchai
Nurs. Rep. 2025, 15(8), 282; https://doi.org/10.3390/nursrep15080282 - 31 Jul 2025
Viewed by 356
Abstract
Background/Objectives: Anxiety before ophthalmic surgery under local anesthesia may hinder patient cooperation and surgical outcomes. Nurse-led auditory interventions offer a promising non-pharmacological approach to perioperative anxiety management. This study evaluated the effectiveness of superimposed binaural beats (SBBs)—classical music layered with frequency differentials—in [...] Read more.
Background/Objectives: Anxiety before ophthalmic surgery under local anesthesia may hinder patient cooperation and surgical outcomes. Nurse-led auditory interventions offer a promising non-pharmacological approach to perioperative anxiety management. This study evaluated the effectiveness of superimposed binaural beats (SBBs)—classical music layered with frequency differentials—in reducing anxiety during pterygium surgery with conjunctival autografting. Methods: In this randomized controlled trial, 111 adult patients scheduled for elective pterygium excision with conjunctival autografting under local anesthesia were allocated to one of three groups: SBBs, plain music (PM), or silence (control). A trained perioperative nurse administered all auditory interventions. The patients’ anxiety was assessed using the State–Trait Anxiety Inventory—State (STAI-S), and physiological parameters (blood pressure, heart rate, respiratory rate, and oxygen saturation) were recorded before and after surgery. Results: The SBB group showed significantly greater reductions in their STAI-S scores (p < 0.001), systolic blood pressure (p = 0.011), heart rate (p = 0.003), and respiratory rate (p = 0.009) compared to the PM and control groups. No adverse events occurred. Conclusions: SBBs are a safe, nurse-delivered auditory intervention that significantly reduces perioperative anxiety and supports physiological stability. Their integration into routine nursing care for minor ophthalmic surgeries is both feasible and beneficial. Trial Registration: This study was registered with the Thai Clinical Trials Registry (TCTR) under registration number TCTR20250125002 on 25 January 2025. Full article
(This article belongs to the Section Mental Health Nursing)
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24 pages, 624 KiB  
Review
Integrating Artificial Intelligence into Perinatal Care Pathways: A Scoping Review of Reviews of Applications, Outcomes, and Equity
by Rabie Adel El Arab, Omayma Abdulaziz Al Moosa, Zahraa Albahrani, Israa Alkhalil, Joel Somerville and Fuad Abuadas
Nurs. Rep. 2025, 15(8), 281; https://doi.org/10.3390/nursrep15080281 - 31 Jul 2025
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Abstract
Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping [...] Read more.
Background: Artificial intelligence (AI) and machine learning (ML) have been reshaping maternal, fetal, neonatal, and reproductive healthcare by enhancing risk prediction, diagnostic accuracy, and operational efficiency across the perinatal continuum. However, no comprehensive synthesis has yet been published. Objective: To conduct a scoping review of reviews of AI/ML applications spanning reproductive, prenatal, postpartum, neonatal, and early child-development care. Methods: We searched PubMed, Embase, the Cochrane Library, Web of Science, and Scopus through April 2025. Two reviewers independently screened records, extracted data, and assessed methodological quality using AMSTAR 2 for systematic reviews, ROBIS for bias assessment, SANRA for narrative reviews, and JBI guidance for scoping reviews. Results: Thirty-nine reviews met our inclusion criteria. In preconception and fertility treatment, convolutional neural network-based platforms can identify viable embryos and key sperm parameters with over 90 percent accuracy, and machine-learning models can personalize follicle-stimulating hormone regimens to boost mature oocyte yield while reducing overall medication use. Digital sexual-health chatbots have enhanced patient education, pre-exposure prophylaxis adherence, and safer sexual behaviors, although data-privacy safeguards and bias mitigation remain priorities. During pregnancy, advanced deep-learning models can segment fetal anatomy on ultrasound images with more than 90 percent overlap compared to expert annotations and can detect anomalies with sensitivity exceeding 93 percent. Predictive biometric tools can estimate gestational age within one week with accuracy and fetal weight within approximately 190 g. In the postpartum period, AI-driven decision-support systems and conversational agents can facilitate early screening for depression and can guide follow-up care. Wearable sensors enable remote monitoring of maternal blood pressure and heart rate to support timely clinical intervention. Within neonatal care, the Heart Rate Observation (HeRO) system has reduced mortality among very low-birth-weight infants by roughly 20 percent, and additional AI models can predict neonatal sepsis, retinopathy of prematurity, and necrotizing enterocolitis with area-under-the-curve values above 0.80. From an operational standpoint, automated ultrasound workflows deliver biometric measurements at about 14 milliseconds per frame, and dynamic scheduling in IVF laboratories lowers staff workload and per-cycle costs. Home-monitoring platforms for pregnant women are associated with 7–11 percent reductions in maternal mortality and preeclampsia incidence. Despite these advances, most evidence derives from retrospective, single-center studies with limited external validation. Low-resource settings, especially in Sub-Saharan Africa, remain under-represented, and few AI solutions are fully embedded in electronic health records. Conclusions: AI holds transformative promise for perinatal care but will require prospective multicenter validation, equity-centered design, robust governance, transparent fairness audits, and seamless electronic health record integration to translate these innovations into routine practice and improve maternal and neonatal outcomes. Full article
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