Search Results (2,597)

Introduction: With the emergence of the expert patient and the expansion of health literacy, the importance of planning and building health technologies aimed at teaching and training health professionals, especially nurses, due to their activities with patients in Primary Health Care, with the aim of meeting the real and constant demands of the expert patient, is evident. Methods: Methodological study with a quantitative approach. The course was constructed based on a scope review, scientific reference, and observational visits during the months of September 2021 and August 2022. For validation, an organized electronic form was used with general information about the research and items of the course constructed for later evaluation by the judges with the three-point Likert scale and with the application of the Delphi Technique between the months of September and October 2022; for the agreement of the judges, the Content Validation Coefficient > 0.8 was considered. Results: Based on the content selected in the scope review, the reference contribution, and the observational visits, the course was constructed. Nine judges participated in the validation stage in Delphi I with a total Content Validation Coefficient above 0.90 and with some suggestions for modifications and improvements pointed out by them. In Delphi II, six judges evaluated the course, resulting in a total Content Validation Coefficient of 0.99. Conclusions: The course developed was considered valid to support the training of Primary Health Care nurses in the formation of the expert patient, with a view to promoting patient autonomy in self-care management, optimizing Primary Health Care, and reducing unnecessary hospital admissions. Full article

Background/Objectives: The pain associated with invasive procedures is one of the most common experiences in the pediatric population. Its management remains insufficient due to gaps in healthcare training and knowledge. The aim of this study was to analyze the attitudes, beliefs, care practices, and training of healthcare professionals in relation to pediatric pain, through the development and application of the questionnaire ‘Humanisation of Pediatric Care in Pain Management with a Non-Pharmacological Approach (HUPEDCARE-Q)’. Methods: A cross-sectional, observational, and descriptive study with a quantitative approach was conducted to validate a questionnaire. The process was carried out in three phases: (1) design and initial development of the instrument; (2) evaluation of content validity through expert judgment, using the Content Validity Coefficient (CVC); (3) administration of the questionnaire to a large sample of healthcare professionals to assess its internal consistency and psychometric structure. Results: The evaluation involved five experts, and the items were assessed using the Content Validity Coefficient (CVC), with the overall CVC of the questionnaire exceeding 0.80. The average item scores given by the experts ranged from 0.88 to 0.95, indicating a high level of agreement in their evaluations. The results showed statistically significant positive correlations among most items (p < 0.001), indicating adequate internal consistency. Conclusions: The content validation and pilot study confirmed the theoretical relevance and appropriateness of the HUPEDCARE-Q questionnaire items in the Spanish context. The results support its usefulness as a valid and reliable tool to identify attitudes, beliefs, knowledge, and training needs in the humanized management of pediatric pain. Full article

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

Background/Objectives: Pressure injuries are a significant concern among older adults, particularly in community-based long-term care settings where prolonged immobility is prevalent. This study aimed to identify factors influencing sacral interface pressure in community-dwelling older adults, with an emphasis on support surface usage and clinical risk indicators. Methods: A total of 210 participants aged 65 years and older, all receiving long-term care services in South Korea, were enrolled in this study. Sacral interface pressure was measured in the supine position using a portable pressure mapping device (Palm Q7). General characteristics, Braden Scale scores, Huhn Scale scores, and mattress usage were assessed. Data were analyzed using descriptive statistics, t-tests, chi-square tests, and logistic regression. Results: Mattress non-use was identified as the strongest predictor of elevated sacral interface pressure (OR = 6.71, p < 0.001), followed by Braden Scale scores indicating moderate risk (OR = 4.8, p = 0.006). Huhn Scale scores were not significantly associated with interface pressure. These results suggest that support surface quality and skin condition have a stronger impact on interface pressure than mobility-related risk factors. Conclusions: The findings highlight the importance of providing high-quality pressure-relieving mattresses and implementing standardized nursing assessments to reduce the risk of pressure injuries. Integrating smart technologies and expanding access to advanced support surfaces may aid in developing tailored preventive strategies for vulnerable older adults. Full article

Integrating BIM curriculum into traditional construction management (CM) programs is essential to meet the increasing industry demand for BIM-ready graduates. However, academia struggles with BIM curriculum integration due to unfamiliar emerging BIM technologies, and the increased workload associated with curriculum transformation. Disciplines including nursing, health science, and medical overcame the same challenges using the ability-desire-knowledge-ability-reinforcement (ADKAR) change management model, while CM programs have not explored this model for BIM curriculum development. Thus, this research introduces the ADKAR change management lens to BIM curriculum development by proposing a practically modified and replicable ADKAR model for CM programs. Focus group interviews with 14 academics from the UK, USA, Korea, and Australia, revealed establishing a sense of urgency by appointing a BIM champion is the most critical step before the BIM curriculum development. Instant advice demystifying uncertain BIM concepts is recognised the most effective motivation among academia. Well-balanced BIM concept integrations is ‘sine qua non’ since excessively saturating BIM aspects across the program can dilute students’ essential domain knowledge. Students’ evaluation over the BIM curriculum were collected through a six-year longitudinal focus group interviews, revealing that progressive BIM learnings scaffolded from foundational concepts to advanced applications throughout their coursework is the most valuable. Full article

This study aims to understand the meaning nursing professionals attribute to their lived experiences of providing humanized care within a public hospital setting. Grounded in Jean Watson’s theory of human caring, the research adopts a qualitative, descriptive phenomenological design to capture the perceptions and emotions of nurses regarding humanized care. Data were collected through semi-structured interviews with nine experienced nurses, selected through purposive sampling. The interviews, conducted virtually between July and December 2024, were analyzed using Colaizzi’s method and supported by Atlas.ti software. Four main thematic categories emerged: institutional health policies, professional image and identity, strengths and challenges in care, and essential competencies for humanized care. The findings highlight the critical role of empathy, cultural sensitivity, ethical commitment, and emotional presence in delivering compassionate care. Participants emphasized that, beyond clinical procedures, humanized care requires relational and contextual sensitivity, often hindered by institutional limitations and excessive administrative burdens. The study concludes that nursing professionals are key agents in promoting ethical, empathetic, and culturally respectful practices that humanize health services. These insights offer valuable contributions for designing policies and training strategies aimed at strengthening humanized care as a cornerstone of quality healthcare systems. Full article

Background/Objectives: For kidney transplantation, it is very important to provide effective post-transplantation interventions to help patients achieve continuous and efficient self-management. Therefore, we review the self-management interventions applied to kidney transplant recipients and suggest the optimal approach to increase the effectiveness of future self-management interventions. Design: Systematic review. Methods: Search terms and strategies included kidney transplantation; self-management; intervention; systematic review. We searched MEDLINE via PubMed, Excerpta Media dataBASE, Cochrane Register Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and one domestic Korean database to identify studies of self-management interventions for kidney transplant recipients aged ≥ 18 years published in English or Korean until 14 May 2025. Two reviewers independently selected related studies and extracted relevant data. Identified studies were assessed for quality and bias. Results: Of 1340 studies identified, 27 with 1912 participants met the inclusion criteria. Educational interventions were the most common self-management interventions and were provided 3 months to 1 year after kidney transplantation; most interventions were administered by nurses. Outcome variables were divided into cognitive, behavioral, affective, and health outcomes. Educational interventions were effective in improving cognitive, behavioral, and affective aspects. Some differences were observed, depending on the study. Conclusions: We recommend that nurse-involved educational interventions be included when developing self-management interventions and guidelines for kidney transplant recipients in clinical and community nursing settings. Full article

Background: The rationale for strict fluid fasting for pediatric and adult patients has been questioned recently. Point-of-care tools for the evaluation of gastric content have evolved over time, often using gastric ultrasound. Usually, the gastric antral cross-sectional area (CSA) is determined. A liberal fluid fasting regimen, that is, ingestion of liquid fluids until the call for theatre, does not delay gastric emptying compared to midnight fasting, as evaluated with gastric ultrasound. Anesthesia is safe, and no adverse events result from a liberal regimen. Methods: The ethics committee of LMU Munich approved the study (21-0903). Liberal fluid fasting in a geriatric orthopedic surgery department (LFFgertrud) is a sub-study within a project investigating perioperative neurocognitive disorders (Study Registration: DRKS00026801). After obtaining informed consent from 134 geriatric patients 70 years or older, we investigated the gastric antral cross-sectional area (CSA) prior to and postimplementation of liberal fluid management, respectively. Results: After the implementation of liberal fluid fasting, fasting times for solid food and liquids decreased from 8.8 (±5.5) to 1.8 (±1.8) hours (p < 0.0001). In 39 patients where CSA was obtained, a slight increase in fluid was encountered. No critical amount of gastric content was observed, and no adverse events occurred. Conclusions: A liberal fluid fasting concept was safe even for comorbid elderly patients in orthopedic surgery. Applying a gastric ultrasound may be helpful to increase safety. According to the incidence of complications encountered in our study, it seems indispensable. Full article

Background/Objectives: Senior nurses in Taiwan shoulder layered responsibilities shaped by professional roles, gendered expectations, and family duty. Although Taiwan faces a persistent shortage of experienced clinical nurses, limited research has explored how long-serving nurses sustain identity and commitment across decades of caregiving. This study examines how senior staff nurses understand their journeys of becoming—and remaining—nurses within a culturally and emotionally complex landscape. Methods: Interviews were conducted between May 2019 and September 2023 in locations chosen by participants, with most sessions face-to-face and others undertaken via video conferencing during COVID-19. This narrative inquiry involved in-depth, multi-session interviews with five female senior staff nurses born in the 1970s to early 1980s. Each participant reflected on her life and career, supported by co-constructed “nursing life lines.” Thematic narrative analysis was conducted using McCormack’s five-lens framework and Riessman’s model, with ethical rigor ensured through reflexive journaling and participant validation. Results: Three overarching themes emerged: (1) inner strength and endurance, highlighting silent resilience and the ethical weight of caregiving; (2) support and responsibility in relationships, revealing the influence of family, faith, and relational duty; and (3) role navigation and professional identity, showing how nurses revisit meaning, self-understanding, and tensions across time. Participants described emotionally powerful moments, identity re-connection, and cultural values that shaped their paths. Conclusions: These narratives offer a relational and culturally embedded understanding of what it means to sustain a career in nursing. Narrative inquiry created space for reflection, meaning-making, and voice in a system where such voices are often unheard. Identity was not static—it was lived, reshaped, and held in story. Full article

Background/Objectives: Evidence-based nursing practice (EBNP) is essential in high-acuity settings such as intensive care units (ICUs) and emergency departments (EDs), where nurses are frequently required to make time-critical, high-stakes clinical decisions that directly influence patient safety and outcomes. Despite its recognized importance, the implementation of EBNP remains inconsistent, with frontline nurses often facing barriers to accessing and applying current evidence. Methods: This descriptive, cross-sectional study systematically mapped and prioritized clinical questions generated by ICU and ED nurses at a tertiary hospital in South Korea. Using open-ended questionnaires, 204 clinical questions were collected from 112 nurses. Each question was coded and classified according to the Nursing Interventions Classification (NIC) taxonomy (8th edition) through a structured cross-mapping methodology. Inter-rater reliability was assessed using Cohen’s kappa coefficient. Results: The majority of clinical questions (56.9%) were mapped to the Physiological: Complex domain, with infection control, ventilator management, and tissue perfusion management identified as the most frequent areas of inquiry. Patient safety was the second most common domain (21.6%). Notably, no clinical questions were mapped to the Family or Community domains, highlighting a gap in holistic and transitional care considerations. The mapping process demonstrated high inter-rater reliability (κ = 0.85, 95% CI: 0.80–0.89). Conclusions: Frontline nurses in high-acuity environments predominantly seek evidence related to complex physiological interventions and patient safety, while holistic and community-oriented care remain underrepresented in clinical inquiry. Utilizing the NIC taxonomy for systematic mapping establishes a reliable framework to identify evidence gaps and support targeted interventions in nursing practice. Regular protocol evaluation, alignment of continuing education with empirically identified priorities, and the integration of concise evidence summaries into clinical workflows are recommended to enhance EBNP implementation. Future research should expand to multicenter and interdisciplinary settings, incorporate advanced technologies such as artificial intelligence for automated mapping, and assess the long-term impact of evidence-based interventions on patient outcomes. Full article

Academic English support is crucial for English as an Additional Language (EAL) nursing students in English-medium nursing education programmes. However, empirical research on content and language integrated learning (CLIL) within this specific context remains limited. This study, informed by recent advancements in translanguaging and trans-semiotising (TL-TS) theory, investigates the patterns of teacher collaboration in nursing CLIL and its impact when employing a TL-TS pedagogical approach. Analysis of students’ pre- and post-tests and multimodal classroom interactions reveals that effective collaboration between nursing specialists and language experts in CLIL can be fostered by (1) aligning with language education principles through the incorporation of internally persuasive discourse (IPD) about language learning and TL-TS practices; (2) simulating potential professional contingencies and co-developing coping strategies using TL-TS; and (3) elucidating nursing language norms through TL-TS and IPD. We advocate for re-imagination of CLIL in English-medium nursing education through an organistic–procedural TL perspective and highlight its potential to enhance EAL nursing students’ development of language proficiency and professional competencies. Full article

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

Background/Objectives: The integration of AI chatbots in nursing education, particularly in simulation-based learning, is advancing rapidly. However, there is a lack of structured evaluation models, especially to assess AI-generated simulations. This article introduces the AI-Integrated Method for Simulation (AIMS) evaluation framework, a dual-phase evaluation framework adapted from the FAITA model, designed to evaluate both prompt design and chatbot performance in the context of nursing education. Methods: This simulation-based study explored the application of an AI chatbot in an emergency planning course. The AIMS framework was developed and applied, consisting of six prompt-level domains (Phase 1) and eight performance criteria (Phase 2). These domains were selected based on current best practices in instructional design, simulation fidelity, and emerging AI evaluation literature. To assess the chatbots educational utility, the study employed a scoring rubric for each phase and incorporated a structured feedback loop to refine both prompt design and chatbox interaction. To demonstrate the framework’s practical application, the researchers configured an AI tool referred to in this study as “Eval-Bot v1”, built using OpenAI’s GPT-4.0, to apply Phase 1 scoring criteria to a real simulation prompt. Insights from this analysis were then used to anticipate Phase 2 performance and identify areas for improvement. Participants (three individuals)—all experienced healthcare educators and advanced practice nurses with expertise in clinical decision-making and simulation-based teaching—reviewed the prompt and Eval-Bot’s score to triangulate findings. Results: Simulated evaluations revealed clear strengths in the prompt alignment with course objectives and its capacity to foster interactive learning. Participants noted that the AI chatbot supported engagement and maintained appropriate pacing, particularly in scenarios involving emergency planning decision-making. However, challenges emerged in areas related to personalization and inclusivity. While the chatbot responded consistently to general queries, it struggled to adapt tone, complexity and content to reflect diverse learner needs or cultural nuances. To support replication and refinement, a sample scoring rubric and simulation prompt template are provided. When evaluated using the Eval-Bot tool, moderate concerns were flagged regarding safety prompts and inclusive language, particularly in how the chatbot navigated sensitive decision points. These gaps were linked to predicted performance issues in Phase 2 domains such as dialog control, equity, and user reassurance. Based on these findings, revised prompt strategies were developed to improve contextual sensitivity, promote inclusivity, and strengthen ethical guidance within chatbot-led simulations. Conclusions: The AIMS evaluation framework provides a practical and replicable approach for evaluating the use of AI chatbots in simulation-based education. By offering structured criteria for both prompt design and chatbot performance, the model supports instructional designers, simulation specialists, and developers in identifying areas of strength and improvement. The findings underscore the importance of intentional design, safety monitoring, and inclusive language when integrating AI into nursing and health education. As AI tools become more embedded in learning environments, this framework offers a thoughtful starting point for ensuring they are applied ethically, effectively, and with learner diversity in mind. Full article

Introduction: Nurses are the largest group of healthcare workers, and healthcare managers should pay attention to the quality of work life and the health and working capacity of nurses in order to ensure a sufficient number of nurses and a stable workforce. Aim: The present study aimed to determine nurses’ quality of work life, work ability index and intention to leave the nursing profession and to examine the associations between nurses’ quality of work life, work ability index and intention to leave the nursing profession. Methods: An online cross-sectional study was conducted. A total of 498 nurses completed the instrument, consisting of demographic data, Brooks’ Quality of Nursing Work Life Survey (BQNWL), Work Ability Index Questionnaire (WAIQ) and questions on their intention to leave their current job or the nursing profession. Results: Most nurses had a moderate quality of work life (QWL) (73.7%) and a good work ability index (WAI) (43.78%). Men (p = 0.047), nurses who study (p = 0.021), nurses who do not have children (p = 0.000) and nurses who do not take care of their parents (p = 0.000) have a statistically significantly higher total WAIQ score. Most nurses (61.1%) had considered changing jobs in the last 12 months, and 36.9% had considered leaving the nursing profession. A statistically significant positive correlation was found between the total BQNWL and the total WAI. The study found no correlation between QWL, WAI and intention to change jobs or leave the profession, which was unexpected. Conclusions: To ensure the provision of necessary nursing care and a healthy working environment for nurses, it is necessary to regularly monitor QWL and WAI and take measures to ensure the highest quality of working life. Further longitudinal and mixed-methods research is needed to understand the relationship between QWL, WAI and intention to leave. Full article

Background: Nemaline myopathy is a rare congenital neuromuscular disease associated with progressive weakness and frequent respiratory complications. In emergency situations, families often serve as the first and only responders. The aim of this study is to explore how parents in Spain care for children with nemaline myopathy during emergency situations, focusing on the clinical responses performed at home and the organizational challenges encountered when interacting with healthcare systems. Methods: A qualitative phenomenological study was conducted with 17 parents from 10 families belonging to the Asociación Yo Nemalínica. Semi-structured interviews were performed via video calls, transcribed verbatim, and analyzed using Giorgi’s descriptive method and ATLAS.ti software (version 24). Methodological rigor was ensured through triangulation, reflexivity, and member validation. Results: Four themes were identified. First, families were described as acting under extreme pressure and in isolation during acute home emergencies, often providing cardiopulmonary resuscitation and respiratory support without professional backup. Second, families managed ambiguous signs of deterioration using clinical judgment and home monitoring tools, often preventing fatal outcomes. Third, parents frequently assumed guiding roles in emergency departments due to a lack of clinician familiarity with the disease, leading to delays or errors. Finally, the transition to the Pediatric Intensive Care Unit was marked by emotional distress and rapid decision-making, with families often participating in critical choices about invasive procedures. These findings underscore the complex, multidisciplinary nature of caregiving. Conclusions: Parents play an active clinical role during emergencies and episodes of deterioration. Their lived experience should be formally integrated into emergency protocols and the continuity of care strategies to improve safety and outcomes. Full article