Search Results (1,893)

Cancer center infusion departments are often challenged with scheduling a large number of patients while having a limited number of nurses available to administer the infusions. Cancer patients have different acuity levels depending on many factors, such as treatment plans, drug side effects, and health status. Thus, several factors need to be considered when assigning patients to nurses, as unbalanced nurse-to-patient assignments affect patient flow and nurse workload. This study introduces a mixed-integer programming model for nurse–patient assignments that minimizes patient wait times while ensuring workload balance among oncology nurses, while addressing the limited attention in existing studies to jointly modeling patient acuity and nurse continuity. The model also explores the effects of maintaining nurse continuity for patients desiring the same nurse throughout their treatments. Because the mixed-integer programming model can become difficult to solve when there are many cancer patients, an alternative nurse–patient assignment heuristic is proposed and evaluated. Numerical examples based on data from a regional cancer center compare the effectiveness and performance of the exact and heuristic methods. The results show that patient wait time and workload variation among nurses increase when there is a stronger requirement to maintain nurse continuity, which could negatively affect both patient and nurse satisfaction. This study provides valuable insights into the nurse–patient assignment problem and helps cancer infusion centers determine the impacts of maintaining different levels of nurse continuity in their settings. Full article

Background/Objectives: The success of cardiopulmonary resuscitation relies on both technical and non-technical skills. Cognitive aids, such as checklists, have been shown to enhance technical performance in emergencies. The aim of this study was to evaluate the capabilities of a cognitive aid app (CA-App) in improving non-technical skills. Methods: In this single-centre randomised controlled trial, 62 teams, each consisting of an experienced physician and a specialised nurse, were randomised either to CA-App or control (No-App) groups performing cardiopulmonary resuscitation. The study was registered with the German Clinical Trials Register (DRKS) on 4 November 2025 (DRKS00038336). The primary outcome was the team leader’s performance in non-technical skills, assessed via the validated Team Emergency Assessment Measure (TEAM™) questionnaire by two raters. Secondary analyses examined TEAM™ subdomains (leadership, teamwork, task management) and the correlation between app usage duration and performance. Results: 62 out of 67 teams were finally randomised, with 31 teams in each group. The CA-App group demonstrated a marginally elevated median TEAM™ total score (83.33%) in comparison to the control group (79.33%), although this difference was not statistically significant (p = 0.190). The leadership subgroup score was significantly higher in the app group (p = 0.006). There was no significant correlation between the time spent using the app and improved team performance (r = 0.260, p = 0.166). Conclusions: The CA-App demonstrated potential for improving leadership skills, a critical component of non-technical skills in emergency scenarios. These findings highlight the potential capability of cognitive aids to improve non-technical skills and the need for further research to explore their optimal design and integration into clinical practice to enhance team performance and patient safety. Full article

Background: Job satisfaction among nursing staff is a key determinant of workforce stability, quality of care, and healthcare system sustainability. Nurses are increasingly exposed to high workload, staffing shortages, and complex organizational demands, which may adversely affect satisfaction and retention. The aim of this study was to examine job satisfaction among nursing staff working across different levels of healthcare in Slovenia and to identify organisational and sociodemographic factors associated with job satisfaction. Methods: A cross-sectional quantitative study was conducted among nursing staff employed in Slovenian healthcare settings. Data were collected using an online questionnaire that included the Job Satisfaction Survey (JSS) and sociodemographic, occupational, and organizational variables. Differences in job satisfaction across professional groups were examined using non-parametric tests. Associations between job satisfaction dimensions and explanatory variables were analysed using Spearman’s correlation coefficients, and multiple linear regression analyses were performed to identify independent predictors of job satisfaction. Results: Organizational and workload-related factors emerged as the most consistent determinants of job satisfaction across all JSS dimensions and total satisfaction. Unclear job task definitions, high workload, insufficient staffing, continuous healthcare provision, unfavourable work schedules, and limited opportunities for rest were associated with lower job satisfaction. In contrast, financially compensated overtime, supportive supervision, higher perceived employer quality, longer tenure in the current position were associated with higher satisfaction in several domains. Sociodemographic variables showed weaker and less consistent effects after adjustment for organizational characteristics. Intentions to change jobs within or outside the healthcare system were strongly associated with lower satisfaction across nearly all dimensions. Conclusions: Job satisfaction among nursing staff is shaped predominantly by modifiable organizational factors rather than demographic characteristics. Interventions aimed at improving task clarity, staffing adequacy, work organization, leadership practices, and recovery opportunities may enhance job satisfaction and contribute to a more sustainable nursing workforce. Full article

Objectives: As artificial intelligence (AI) technologies become increasingly integrated into healthcare systems, understanding healthcare professionals’ psychological responses—particularly AI-related anxiety—has become increasingly important for the safe and effective implementation of these technologies in clinical practice. This study aimed to examine the relationships between oncology nurses’ readiness for artificial intelligence, their attitudes toward artificial intelligence, and their levels of AI-related anxiety. Design: A descriptive, cross-sectional study. Setting: An oncology hospital within a state hospital in Istanbul, Turkey. Participants: A total of 207 oncology nurses working full-time in clinical settings. Methods: Data were collected using an online survey consisting of a demographic information form, the Medical Artificial Intelligence Readiness Scale (MAIRS-MS), the Artificial Intelligence Anxiety Scale (AIAS), and the General Attitudes toward Artificial Intelligence Scale (GAAIS). Spearman correlation analysis, general linear modeling, and conditional mediation analysis were performed using JAMOVI (v2.6.17). A p-value of <0.05 was considered statistically significant. Results: AI-related anxiety was significantly and negatively correlated with both readiness and attitudes toward AI. General linear modeling showed that attitudes toward AI significantly predicted anxiety (β = −0.327, p < 0.001), whereas readiness did not have a direct significant effect. Conditional mediation analysis demonstrated that attitudes fully mediated the relationship between readiness and AI anxiety. The indirect effect of readiness on anxiety through attitudes was stronger among nurses who had received prior AI-related education. While the indirect effect remained significant among untrained nurses, its magnitude was considerably smaller. The total effect of readiness on anxiety was significant only in the untrained group, suggesting that structured education redirects the impact of readiness primarily through attitudes. Conclusions: Attitudes toward artificial intelligence represent the key psychological mechanism linking readiness to AI-related anxiety among oncology nurses. Prior AI education appears to strengthen this relationship by enhancing the association between readiness and attitudes and by being associated with lower anxiety levels. Educational and implementation strategies that emphasize ethical awareness and the development of positive, informed attitudes—rather than focusing solely on technical competence—are likely to be more effective in reducing anxiety and promoting the safe and ethical integration of AI into oncology nursing practice. Full article

Background/Objectives: Alcohol and tobacco use in adolescence are major public health concerns that shape long-term health trajectories and undermine healthy behaviour development. Schools are key settings for health promotion, offering structured environments to foster self-regulation, social skills, and protective behaviours. This scoping review mapped recent school-based educational strategies designed to prevent alcohol and tobacco use among adolescents and to examine whether the included studies reported any involvement of school nurses. Methods: Review followed Arksey and O’Malley’s framework and adhered to JBI guidance and PRISMA-ScR. Searches were conducted in PubMed and Web of Science (2019–2024) to identify school-based educational interventions targeting alcohol and/or tobacco use among primary or secondary school children. The primary search targeted prevention strategies, complemented by nursing-related terms to identify nurse involvement. A standardised charting form captured study characteristics, intervention formats, theoretical foundations, implementation factors, and any reported participation of health professionals. Data extraction was performed independently by two reviewers. Results: Eleven studies met the inclusion criteria. Most were randomised controlled trials (81.8%). Educational strategies included online (45.5%), hybrid (27.3%), and face-to-face (27.3%) formats. Programs focused on social skills, self-regulation, harm reduction, or resilience. Digital formats were cost-effective but showed challenges in engagement and sustained participation, while face-to-face or hybrid approaches offered relational support but were vulnerable to implementation drift. No study reported nurse involvement. Conclusions: School-based prevention strategies can contribute to healthier behaviours related to substance use by reinforcing socioemotional competencies and reducing early exposure to substances. However, persistent barriers such as low engagement, inconsistent delivery, and the absence of health professionals limit their impact. The role of school nurses could be considered in future school-based prevention programmes. Full article

Background: Peripheral nerve stimulation (PNS) is increasingly used in selected patients with neuropathic pain, and many individuals seek supplemental online information to clarify procedural expectations and postoperative care. Large language models such as ChatGPT may provide scalable patient education; however, their performance for PNS-related questions has not been evaluated. This study assessed the reliability, accuracy, and comprehensibility of ChatGPT-5.0 responses to common PNS patient questions. Methods: We conducted a cross-sectional evaluation of ChatGPT-5.0 responses to 21 standardized questions derived through expert consensus, spanning pre-implantation, implantation, and post-implantation domains. Sixteen board-certified interventional pain specialists and a nurse educator independently rated each response using validated scales for reliability (1–6), accuracy (1–3), and comprehensibility (1–3). Descriptive statistics were calculated, and domain-level patterns were examined. Results: Clinician ratings demonstrated generally strong performance across all domains. Mean reliability was 4.7 ± 1.4, mean accuracy 2.6 ± 0.6, and mean comprehensibility 2.8 ± 0.5. Foundational questions addressing mechanisms, expectations, and postoperative care received the highest ratings. Lower ratings were observed for implantation-focused items requiring procedural nuance. No response fell below predefined acceptability thresholds, and sensitivity analyses confirmed that including one partial evaluator did not alter the observed trends. Conclusions: ChatGPT-5.0 generated responses to PNS-related patient questions that clinicians rated as generally reliable, accurate, and understandable, particularly for foundational and postoperative topics. Performance was more variable for procedural questions, underscoring the need for clinician oversight and verification. These findings provide a benchmark of current LLM capabilities and highlight the importance of ongoing evaluation as models evolve and as patients access versions with differing functionalities. Full article

Background: Nurse coaching can reduce stress throughout the complex psychosocial process associated with the cancer journey, which affects numerous spheres, such as neurological, psychological, physical, and emotional ones. The purpose of this paper is to review the literature to assess the extent of stress reduction among cancer care adopting nurse coaching interventions. Methods: This systematic review and meta-analysis was registered in PROSPERO with id no. CRD420261290368 and performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The search approach was performed by mixing keywords with Boolean operators like “coaching intervention”, “oncology nursing” and “stress” throughout the CINAHL, Embase, PubMed, Scopus and Web of Science databases. We assessed stress levels alongside the nurse coaching interventions using the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Results: A total of three studies were included, comprising 112 participants. Heterogeneity among studies was very high and statistically significant (p < 0.001; τ² = 1.02; I² = 96.2%, with a 95% CI: [85.89; 99.90]); thus, a random-effects model (REML) was applied. A small, non-significant reduction in stress levels following the nurse coaching intervention, with an overall SMD of −0.35 (SE = 0.60; 95% CI: [−1.52, 0.82]; p = 0.556), was recorded. Conclusions: Attention to standardization of core coaching components, while preserving flexibility and personalization, will be critical to advancing implementation in routine oncology care. Overall, nurse coaching represents a promising adjunct to comprehensive cancer care, with the potential to support psychological well-being, empower patients and caregivers, and address the broader determinants of stress throughout the cancer experience. Full article

Background/Objectives: Nomophobia, the irrational fear of being without a mobile phone, is increasingly prevalent among university students and has emerged as a concerning form of digital dependence. Among nursing students, this condition is particularly relevant due to the emotional demands and cognitive challenges of healthcare education. Nomophobia has been linked with adverse psychological outcomes, sleep disturbances, and impaired academic and clinical performance. However, existing evidence remains fragmented and lacks an integrated conceptual synthesis. This review aimed to synthesize current evidence on the prevalence, correlates, and outcomes of nomophobia among nursing students. Methods: An integrative review was conducted following Whittemore and Knafl’s methodology and PRISMA guidelines. A systematic search was performed in PubMed, CINAHL, PsycINFO, PsycArticles, and Medline (between 2015 and 2025), supplemented by Google Scholar. Cross-sectional studies and literature focusing on nomophobia in nursing students were included. The primary studies and selected review articles were considered when no overlap with the included primary evidence was identified. Methodological quality appraisal was assessed using validated tools (QuADS and JBI). Results: Twenty-two studies were included (19 cross-sectional and 3 reviews). Four thematic areas emerged: prevalence and severity (50–90% moderate to severe); psychological correlates (anxiety, depression, stress, insomnia, alexithymia, fear of missing out); academic and cognitive outcomes (impaired performance, procrastination, reduced decision-making); and behavioural predictors (excessive smartphone use and emotional dysregulation). The Nomophobia Questionnaire (NMP-Q) was the most frequently used instrument. Conclusions: Nomophobia represents a relevant dimension of the mind–technology relationship in nursing education, with implications for students’ mental health, academic engagement, and clinical readiness. Addressing nomophobia may support healthier learning environments and contribute to the development of emotionally competent and safe future healthcare professionals. However, significant gaps remain, particularly regarding longitudinal evidence and intervention-based approaches. Full article

Aims: To conduct an exploratory analysis the psychometric properties of the Spanish version of the Soft Skills Questionnaire for Nurses (SSQN) and examine its conceptual coherence and its preliminary empirical behavior among nursing professionals and students. The aim is to critically assess the instrument’s suitability as a tool for exploring perceptions and self-reported soft skills rather than to establish its psychometric validity. Design: Exploratory methodological study focused on analyzing the empirical performance and conceptual adequacy of the SSQN within a Spanish sample, with particular attention to the internal patterns of responses and the coherence between the instrument’s items and its proposed dimensions. Methods: The process included the translation of the questionnaire and an empirical application in a sample of nursing professionals and students. Exploratory analyses were performed, including exploratory factor analysis and reliability assessment (Cronbach’s alpha and McDonald’s omega), using Jeffreys’s Amazing Statistics Program (JASP) (version 1.18.3), in order to examine the structural performance of the instrument and detect possible conceptual and methodological limitations. Results: The SSQN showed notable inconsistencies in its empirical structure, with dimensions that did not display clear or theoretically coherent patterns. Factor inconsistencies and low internal consistency suggest that the instrument does not adequately capture the multidimensionality of interpersonal skills, reflecting weaknesses inherent in its original formulation rather than in the adaptation process. Conclusions: The Spanish version of the SSQN cannot be considered valid or reliable in its current form. The results underscore the need for a thorough revision of the questionnaire and a conceptual rethinking to develop more robust tools for assessing soft skills. Impact: This study highlights the need for a solid methodological evaluation before introducing instruments designed to measure complex and subjective competencies in the healthcare field. Full article

Background/Objectives: Simulation-based education often lacks personalization, focusing on technical competence rather than individual student profiles. This protocol describes a study designed to evaluate whether adapting gamified narratives to nursing students’ personality profiles has the potential to support academic performance in obstetrics. This study aims to validate the integration of psychometric profiling and AI as a sustainable strategy for personalized clinical training. Methods: A cluster-randomized controlled longitudinal pilot trial will be conducted at the University of Atlántico Medio. The protocol has been submitted for registration at ClinicalTrials.gov (Registration Pending). Thirty-eight second-year nursing students meeting inclusion criteria (excluding repeaters or those with prior specialized training) will be assigned by natural practice to either a control group (generic gamification) or an experimental group (gamification adapted according to Player Personality and Dynamics Scale profiles using AI-generated content). The intervention comprises four clinical simulation sessions focusing on pregnancy and childbirth, which are managed via the Wix platform. The primary outcome is academic performance, measured as “Learning Gain” (post-test scores minus pre-test scores). Secondary outcomes include student satisfaction measured via the Gameful Experience Scale. Data will be analyzed using Mann–Whitney U tests to compare overall efficacy and intragroup evolution. To minimize observer bias, knowledge assessments will utilize automated, objective scoring, and participants will be blinded to the study hypothesis. Expected Outcomes: The study aims to establish the technical and pedagogical feasibility of integrating AI-adapted narratives into nursing curricula. It is anticipated that the personalized approach will show positive trends in learning gains and engagement patterns, providing a baseline for larger multicenter trials. Conclusions: This protocol presents a framework for “Precision Education” in nursing, shifting from “one-size-fits-all” simulations to student-centered adaptive training. The use of Generative AI makes such personalization sustainable and cost-effective for health science faculties. Full article

Background/Objectives: Optimization of the frequency and depth of chest compressions is considered essential for effective cardiopulmonary resuscitation in patients with cardiac arrest. Structured debriefing performed after actual or simulated cardiac arrest may help resuscitators maintain chest compression parameters within guideline-recommended ranges. The objective of the present study was to analyze whether Plus/Delta structured debriefing after clinical simulation of cardiac arrest on the duration of chest compressions performed within guideline-recommended frequency and depth ranges. Methods: A quasi-experimental study without a control group was carried out with nursing students. Compression frequency and depth parameters were analyzed in two manikin-based tests separated by the performance of a Plus/Delta structured debriefing. Results: After the intervention, the frequency and depth of chest compressions showed a slight decrease, accompanied by a statistically significant increase in the duration of cardiopulmonary resuscitation within the ranges recommended by the guidelines, although with limited clinical relevance. Conclusions: In this simulated setting, Plus/Delta structured debriefing was associated with a modest increase in the duration during which chest compressions were maintained within guideline-recommended frequency and depth ranges. Given the absence of a control group, these findings should be interpreted as exploratory but suggest a potential educational value of structured reflective debriefing in CPR training. Full article

Ongoing health system reforms in Kazakhstan have transformed the working environment of primary health care (PHC) staff and may increase workload and psychosocial stress. This study aimed to assess perceived stress among PHC workers in Almaty and its associations with socio-demographic characteristics and health-related behaviors. A cross-sectional survey was conducted in October–November 2023 across all 36 state-funded PHC facilities in Almaty. General practitioners (GPs) and family nurses employed in these facilities were invited to participate. In total, 1484 respondents completed a standardized questionnaire in Kazakh or Russian administered electronically via Google Forms. Perceived stress was assessed using PSS-10, physical activity using IPAQ-SF, alcohol consumption using AUDIT-C, and tobacco use through items aligned with STEPS/GATS. Statistical analyses were performed using SAS. Associations between variables were evaluated using χ² and Fisher’s exact tests, and multivariable logistic regression models were applied. Statistical significance was set at p < 0.05. Higher stress levels were more common among GPs than nurses (OR = 2.58; p < 0.0001) and less common in younger workers (18–29 vs. 50–59: OR = 0.504; p = 0.017) and alcohol abstainers (OR = 0.587; p = 0.0004). Kazakh ethnicity showed a borderline protective association (OR = 0.472; p = 0.057), while physical activity was not a significant predictor. Perceived stress is highly prevalent in Almaty PHC and disproportionately affects GPs; younger age and alcohol abstinence are protective. The findings support prioritizing organizational measures to reduce role-related burden and maladaptive coping behaviors. Full article

Background: Population aging represents a major public health challenge, accompanied by an increasing prevalence of chronic diseases and age-related functional decline. Declines in lower-extremity physical function are particularly important, as they are strongly associated with mobility limitations, loss of independence, increased risk of falls, hospitalization, and mortality in older adults. Reliable and valid tools to assess physical performance are therefore essential in both clinical and research settings. The Short Physical Performance Battery (SPPB) is a widely used instrument for assessing lower-extremity physical performance in older adults and is recommended within the diagnostic algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP2) for evaluating physical performance severity. However, the SPPB has not yet been psychometrically validated in the Croatian older population. This study aimed to evaluate the reliability and validity of the SPPB in Croatian older adults. Methods: This study examined the metric properties of the SPPB in a sample of 153 older adults recruited from nursing homes and community settings. Results: The SPPB demonstrated acceptable internal consistency (Cronbach’s alpha = 0.74) and good test–retest reliability (ICC = 0.893) for the total score. Convergent and construct validity were supported by significant associations with established measures of functional mobility and muscle strength. Conclusions: The Croatian version of the SPPB is a reliable and valid instrument for assessing lower-extremity physical performance in older adults. Its use is supported in clinical practice and research settings in Croatia. Further studies should examine responsiveness and predictive validity in nationally representative samples. Full article

Background/Objectives: The incidence of cardiac arrest among critically ill patients has been increasing, with many patients experiencing clinical exacerbation prior to the event. Early detection and rapid treatment are essential to reduce the risks associated with cardiac arrest; however, difficulties such as limited ICU resources and inadequate monitoring of vital signs reduce the effectiveness of treatment. Various cardiac arrest prediction systems have been developed to overcome these issues. This study performed a summative evaluation of a Central Monitoring System with AI-based Cardiac Arrest Prediction. Methods: A summative usability evaluation was conducted in a simulated ICU environment with 22 ICU nurses experienced in using patient monitoring devices. Participants completed tasks based on the device workflow and then filled out the System Usability Scale (SUS) and satisfaction surveys, with task performance and survey responses analyzed to assess usability. Results: The usability test achieved a task success rate of 90%, with critical tasks achieving success rates ranging from 73% to 100%. The SUS score was 67.3 (“OK”), and the satisfaction survey showed an average score of 4.5, indicating generally positive user perception. Conclusions: Participants generally rated the system as acceptable, although some tasks showed lower success rates due to design issues such as poor button visibility. Further studies in clinical settings are needed to evaluate the system’s effectiveness, user experience, and contribution to the timely detection of cardiac arrest. Full article

Extended reality (XR) has increasingly been applied to nursing practicum education; however, most systems rely on controller-based interfaces that limit precise capture of continuous fine motor performance and objective assessment. This study developed and validated a sensor-integrated, controller-free XR nursing practicum system (Smart Nursing v1.0) grounded in continuous precision sensing. Based on internationally standardized intravenous injection protocols, the system integrated optical hand tracking and speech recognition to quantify hand kinematics, spatial accuracy, procedural sequencing, and verbal compliance. A three-phase validation framework was implemented. Internal technical verification confirmed stable real-time performance (≥60 FPS) and consistent action recognition. In a user-based study involving 63 undergraduate nursing students, XR-based automated scores demonstrated high agreement with expert instructor ratings (ICC = 0.932, 95% CI = 0.91–0.96, p < 0.001). XR baseline scores significantly predicted post-training performance (β = 0.632, p < 0.001) and showed significant incremental validity beyond instructor pre-training scores (ΔR² = 0.186, p < 0.001). Independent verification confirmed high recognition accuracy (100%) and system stability. These findings indicate that precision sensing enables XR environments to function as reliable performance measurement systems, supporting standardized non-face-to-face nursing practicum education. Full article