Nurs. Rep., Volume 14, Issue 4 (December 2024) – 76 articles

Background/Objectives: Clinical simulation is a pivotal educational strategy in nursing, facilitating the integration of theoretical knowledge with practical skills in a safe environment. While the benefits of simulation in enhancing technical and non-technical competencies are well-documented, the transition of nursing students to the role of instructors within these simulations remains underexplored, particularly in the Spanish context. This study aims to investigate how assuming the instructor role in clinical simulations impacts the professional development of fourth-year nursing students. Methods: A qualitative study employing an interpretative phenomenological approach was conducted to deeply understand the experiences and perceptions of nursing students transitioning to instructors in clinical simulations. Nine fourth-year nursing students from the University of Vic—Central University of Catalonia (UVic-UCC) were purposively selected to ensure diverse perspectives. Data were collected through semi-structured interviews, a focus group, and non-participant observations, achieving data saturation. Thematic analysis, guided by Braun and Clarke’s methodology, was utilized to identify and organize emergent themes related to professional development and pedagogical competencies. Results: The transition to the instructor role significantly enhanced both technical and non-technical competencies among the participants. Key findings include improved leadership, decision-making, and effective communication skills. Student-led debriefing sessions were identified as crucial for fostering deeper reflection and enhancing the ability to provide and receive constructive feedback. Conclusions: Assuming the instructor role in clinical simulations offers substantial pedagogical benefits, enriching the professional development of nursing students by strengthening essential competencies. These findings underscore the value of integrating instructor roles within nursing education programs in Spain, suggesting that such practices can lead to more competent and confident healthcare professionals. This study was not registered. Full article

Background/Objectives: Patient safety is a critical component of healthcare quality, yet there remains a significant gap in understanding how patient safety knowledge progresses among nursing students throughout their educational journey. This scoping review aims to map and analyze the existing literature on the development of patient safety knowledge in undergraduate nursing education. Methods: This study will follow the Joanna Briggs Institute methodology for scoping reviews and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Scoping Reviews) guidelines. A comprehensive search strategy will be employed across multiple databases, including CINAHL (Cumulative Index to Nursing and Allied Health Literature), ERIC (Education Resources Information Center), PubMed, Embase, SCOPUS, and Web of Science. The review will include studies published from 2019 to 2024 in English, Portuguese, and Spanish. Two independent reviewers will conduct study selection and data extraction. The data will be synthesized narratively, with quantitative data summarized using descriptive statistics and qualitative data analyzed thematically. Results: The review is expected to identify key patterns in the progression of patient safety knowledge among nursing students, including critical periods for knowledge acquisition, challenges in translating theoretical knowledge into practice, and effective educational strategies. The findings will be presented in both tabular and narrative forms, providing a comprehensive overview of the current state of patient safety education in nursing programs. Conclusions: The anticipated outcomes of this review have significant implications for nursing education, healthcare policy, and clinical practice. For educators, the findings will inform curriculum development and the design of targeted interventions to enhance patient safety competencies. From a policy perspective, the results could support the standardization of patient safety education across nursing programs. In clinical practice, the study may emphasize the importance of continuous professional development in patient safety. This scoping review aims to fill a critical gap in the literature by providing a comprehensive understanding of how patient safety knowledge progresses among nursing students. The findings are expected to contribute significantly to the advancement of nursing education and patient safety, ultimately fostering a culture of safety that benefits both healthcare providers and recipients. Full article

Background: Ethics is one of the essential concepts associated with professional nursing practice, and can play a part in the development of compassion. Although a number of instruments have been developed for the measurement of ethics, most are context-specific or excessively lengthy. The Santa Clara Ethics Scale (SCES) overcomes these problems. The goal is to translate, adapt, and validate the Spanish version of the Santa Clara Ethics Scale and to study the role of ethics, as a moral resource, in the prediction of the levels of compassion of nursing students. Methods: This study is a translation, adaptation, and validation study, with a cross-sectional design. A total of 924 Spanish nursing students participated in this study. Ethics and compassion for others were measured. Analyses included a confirmatory factor analysis, reliability estimates, and a structural equation model in which ethics explained the five correlated dimensions of compassion for others. Results: The confirmatory factor analysis had an adequate fit: χ²(35) = 173.56 (p < 0.01), CFI = 0.94, TLI = 0.92, RMSEA = 0.07 [90% CI = 0.06, 0.08], and SRMR = 0.05. Internal consistency was adequate (α = 0.74; ω = 0.83). The predictive model pointed to positive and statistically significant relationships between ethics and all dimensions of compassion for others. Conclusions: The SCES can be considered a suitable instrument for the assessment of ethics in the Spanish nursing population and, thus, can be used as a tool for the measurement of key ethical competencies during the nursing degree. Moreover, the development of ethics is likely to improve the compassion levels of students. Ethics is, then, a key internal resource for both nursing students’ compassionate care skills and, consequently, must be taken into account when redefining nursing students’ curricula. Full article

Background: Numerous prognostic scores have been developed and used in intensive care; however, the applicability and effectiveness of these scores in critically ill patients with acute kidney injury may vary due to the characteristics of this population. Objective: To assess the predictive capacity of the Simplified Acute Physiology Score III (SAPS III), Sequential Sepsis-related Organ Failure Assessment (SOFA) and Nursing Activities Score (NAS) prognostic scoring systems for acute kidney injury in critically ill patients. Methods: Cohort, prospective and quantitative study with follow-up of 141 critical patients in intensive care. A questionnaire was used to collect information about the capacity of prognostic scoring systems to predict AKI. Mann–Whitney, Kruskal–Wallis and Bonferroni-corrected Mann–Whitney tests were used and the statistical significance was considered to be at two-sided p < 0.05. Results: It was revealed that 41.85% of patients developed acute kidney injury during their stay in the Intensive Care Unit and indicated greater severity assessed by the medians of prognostic scoring systems—SAPS III [55 (42–65 vs. 38 (32–52), p < 0.001], SOFA [3.3 (2.26–5.00) vs. 0.66 (0.06–2.29), p < 0.001] and NAS [90 (75–95) vs. 97 (91–103), p < 0.001]—when compared to patients without kidney damage. Conclusions: The SAPS III, SOFA and NAS prognostic scoring systems showed good predictive capacity for acute kidney injury in critically ill patients. This study was not registered. Full article

Background/Objectives: Access to palliative care is an urgent global need. Countries with the greatest palliative care needs have limited access. In Cameroon, demand for palliative care is growing due to the rising incidence of life-limiting conditions. Identifying available palliative care services and programs could provide an understanding of access gaps and inform future roadmaps for palliative care development in the country. We aim to map available palliative care services, identify gaps and inform recommendations to promote early access to palliative care in Cameroon. Methods: We undertook a literature review of articles reporting any aspects of palliative care in Cameroon. We searched Embase, MEDLINE, Scopus, PsycINFO, CINAHL, PubMed and gray literature. Data were analyzed thematically using the World Health Organization model for the assessment of palliative care development. Results: We identified 41 articles reporting 21 organizations with some form of palliative care services such as clinical services, education, advocacy and research. These were led mostly by individual health care providers or private and faith-based organizations. Major palliative care initiatives included training in the form of workshops, and adult and pediatric outpatient, in-patient and community-based palliative care. There were few reports of oral morphine production, community engagement, advocacy and palliative care research. Conclusions: Progress in palliative care development was reported in five regions of Cameroon over the last two decades. Findings suggest the need for an intersectoral approach including government, community, and health care stakeholders to achieve sustainable palliative care. This could potentially ensure equitable access to palliative care in Cameroon. Full article

Introduction: The advancement of nursing science and practice necessitates the documentation of information, which is increasingly being recorded in electronic mediums due to the progress of information technology. Various countries around the world have implemented electronic nursing records (ENRs) or are in the process of implementing them. This study aims to ascertain the significance of electronic nursing records and consolidate their primary benefits for nursing. Methods: The study utilized an established scoping review methodology (Arksey and O‘Malley protocol; JBI method; PRISMA ScR (2018)). Results: Out of 6970 initial articles extracted from four databases, 36 were included in the study. Several essential elements for structuring, introducing, and emphasizing the importance of ENRs have been recognized, including the availability of standardized terminology, enhancement of nursing care quality, advancement of research activity, integration with electronic systems, optimization of healthcare, and conditions for ENR integration. Conclusions: Electronic nursing records are indispensable and beneficial for enhancing care quality, improving patient safety, and affirming the autonomy of the nursing profession. Full article

Background/Objectives: A favorable attitude towards suicidal behavior is associated with an increased risk of suicidal behavior in youth populations. Hence, the aim of the present study was to analyze attitudinal beliefs about suicidal behavior among Mexican medical and nursing students. We also compared attitudinal beliefs about suicidal behavior according to the religious affiliation of the participants. Methods: This is a cross-sectional observational study. Attitudinal beliefs about suicidal behavior were assessed using the Attitudinal Beliefs Questionnaire about Suicide Behavior (CCCS-18). We evaluated personal and family histories of suicide using the Spanish version of the MINI International Neuropsychiatric Interview. Comparative analysis between nursing and medical students was performed, using Chi-square tests for categorical variables and Student t-tests for continuous variables. Results: A total of 195 (52.2%) medical students and 178 (47.8%) nursing students participated. Medicine students reported a higher prevalence of a family history of suicide attempts and knowing someone who had tried to die by suicide compared to nursing students (p = 0.001). Regarding attitudinal beliefs—specifically, suicide in terminal patients—medical students reported higher scores than nursing students (9.50 ± 5.91 vs. 11.23 ± 6.38, p < 0.001), while the latter exhibited higher scores in attitudinal beliefs related to suicide itself (9.55 ± 4.45 vs. 7.28 ± 4.09, p < 0.001). Both groups display similar scores when compared by religious affiliation. Conclusions: Our findings show differences in attitudinal beliefs about suicidal behavior between medical and nursing students. Medical students exhibited more positive responses toward suicide in terminal patients, while nursing students had higher values for attitudinal beliefs related to suicide itself. These results could be considered in the planning of health sciences curricula in order to positively impact future suicide prevention efforts. This study was retrospectively registered at the Universidad Juarez Autónoma de Tabasco, with the registration number 20240063 on 8 June 2024. Full article

Background: Transformational leadership fosters trusting relationships; new visions; and personal, professional, and cultural growth. Effective leaders support their team’s motivational growth and organizational goals. This study aims to underscore the importance of transformational leadership and its various dimensions, focusing on its impact on job satisfaction and personal mastery among nursing leaders in healthcare organizations. Method: A cross-sectional design with convenience sampling was used. The evaluation tools included the Multifactor Leadership Questionnaire (MLQ-6S), the Satisfaction of Employees in Health Care (SEHC) questionnaire, and the Personal Mastery Scale (PMS). Results: The findings indicate that job satisfaction is influenced by transformational leadership, emphasizing the importance of tailored leadership development strategies within healthcare organizations. The laissez-faire leadership style was the only one showing no correlation with nurses’ job satisfaction. Other leadership styles showed significant positive or negative correlations with the analyzed variables. Conclusions: Transformational leaders are essential for fostering trust and enhancing job satisfaction in healthcare settings. Positive leadership styles contribute to higher levels of job satisfaction and personal mastery among nursing leaders. Conversely, laissez-faire and autocratic leadership styles can negatively impact performance and staff satisfaction. These findings highlight the critical role of leaders in creating positive work environments and supporting employee development and well-being in healthcare. Full article

Background/Objectives: Nursing competence encompasses the integration of knowledge, skills, and attitudes essential for comprehensive and safe patient care. This study aimed to compare self-assessment and tutor evaluation of nurses’ competencies in a hospital emergency department before and after a training intervention. Methods: A quasi-experimental design was employed, involving 63 newly hired nurses who participated in a mentorship program. The intervention included theoretical and practical sessions on critical care skills. Data were collected through self-assessment questionnaires and objective evaluations by tutors using validated rubrics. Results: The results indicated significant differences between self-assessment and tutor evaluations in pre- and post-intervention phases, particularly in competencies related to orotracheal intubation and fibrinolytic therapy for ischemic stroke. Post-intervention, discrepancies between self-assessment and tutor evaluations decreased, suggesting improved self-awareness and competence among participants. Conclusions: This study highlights the importance of combining self-assessment and external evaluation to ensure accurate competency assessment and effective educational interventions, ultimately enhancing the quality of patient care. Full article

Background: Pediatric illnesses not only impose physical challenges on affected children, but also profoundly impact their emotional well-being. Understanding how parents respond to their children’s psychological distress during medical experiences is crucial for enhancing the overall support provided to these families. Aim: This study evaluated the internal structure of the Parental Response Styles Questionnaire (PRSQ), designed to differentiate parental responses to psychological distress in children with pediatric illnesses. Methods: A sample of 701 parents of children with medical issues responded to the PRSQ, reporting their different emotional expressions and responses to their children’s expressions of distress during the medical experience. Results: Factor analysis confirmed, in three of the five subsamples, an internal scale structure consisting of four factors: apathy and dysphoria, irritability and rejection, overprotectiveness, and perceived maladjustment. The invariance analyses revealed that congenital heart disease and neurological disorders are more similar in function to each other than pediatric cancer. Parents of children with neurological disorders exhibited a notably insecure pattern of parental responsiveness. Conclusions: In pediatric contexts, parental responses to their children’s emotional distress are significant factors in the process of adaptation. These responses can be measured, differentiated, and, ideally, managed by nurses and other healthcare professionals. The Parental Response Styles Questionnaire (PRSQ) is a promising tool for assessing parental reactions during their children’s treatment, and its structure appears to be particularly robust across diagnoses such as pediatric cancer, congenital heart disease, and neurological disorders. Full article

Around the world, family caregivers are an important source of support for people with intellectual disability (ID) and for those with severe mental disorder (SMD), although the level of support can be influenced by the culture and government healthcare systems in each country. However, there is little evidence about the mental health and coping mechanisms of these caregivers in low-income countries. To address this need, we aimed to elicit whether there are potential links between coping style, mental health, and perceived burden experienced by this group, using a sample from a central Asian upper middle-income country. Methods: We recruited 120 participants, of which 60 were caregivers of people with ID and 60 of people with SMD. All participants were recruited from Ulaanbaatar, the capital city of Mongolia, Central Asia, and were asked to complete of the Depression, Anxiety and Stress Scale (DASS) and the Coping Orientation to Problems Experienced inventory scale (COPE). Multiple regression analyses were used to investigate associations between these measures. Results: We found that DASS scores were significantly higher among the sample of caregivers of individuals with ID than in those of SMD. Mental and behavioral disorders were associated with higher DASS scores in the sample of caregivers of those with SMD. Good coping styles, indicated by higher scores in the COPE, were associated with increased age in caregivers of individuals with ID. Conclusion: Although overall the carers of people with SMD appeared to have better active coping skills and better acceptance of the caring role, they demonstrated comparatively high levels of stress. This study was not registered. Full article

Background/Objectives: To explore how Public Health Nurses (PHNs) in Fukushima perceived their roles and activities as necessary or inadequate from the immediate aftermath through the long-term recovery of the nuclear disaster. Methods: We conducted a qualitative study using a self-administered questionnaire with open-ended questions to capture the perceptions of PHNs across three disaster phases: peacetime; nuclear emergency; and recovery. Responses were analyzed through qualitative content analysis. Results: PHNs’ needs and perceived inadequacies varied across the disaster phases. In peacetime, the emphasis was on education for disaster preparedness for both nurses and residents. During the nuclear emergency, the focus shifted to the need for PHN deployment and radiation screening systems, highlighting a significant gap in radiation knowledge. In the recovery phase, the importance of ongoing resident support, rumor management, and trust-building was emphasized, alongside an increased need for radiation education. Conclusions: This study highlights the critical need for phase-specific support systems and educational programs to enhance PHNs’ disaster response capabilities. It underscores the importance of preparedness plans and continuous training to improve PHNs’ effectiveness in addressing public health challenges during nuclear disasters. This study was not registered. Full article

Background/Objectives: School nurses are capable of fostering safe and healthy school environments that are favorable to quality learning and social interactions. To this end, it is essential that they acquire a set of skills needed to implement bullying intervention programs. This article describes the protocol for a scoping review to identify and map the core competences for school nurses to develop anti-bullying strategies. Methods: The review will be conducted according to the JBI methodology for scoping reviews. The review will include primary, secondary, and gray literature, including theses and reports, found through comprehensive research in several databases: Scopus, WoS, APA PsycINFO, Embase, ScienceDirect, MEDLINE/PubMed, CINAHL (EBSCOhost), ERIC, LILACS, BDENF, IBECS, Cochrane Library, CAPES Dissertations and Theses Portal, RCAAP, Theses Canada, ProQuest Dissertations and Theses, and Google Scholar, as well as reference tracking. No geographical restrictions will be applied. The studies must include investigations into actions and interventions conducted by or involving nurses for the prevention of bullying in the school context. Two reviewers will act independently in screening the studies and extracting data using an extraction tool developed by the research team. Results: The results will be presented in a tabular format, supported by a narrative synthesis. The details of the scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Conclusions: We anticipate that our scoping review will to strengthen a field of nursing that is still little explored, showing the school nurses’ role in prevent bullying episodes. Full article

Background/Objectives: Higher education institutions must improve the attractiveness and retention of the nursing profession to address the widespread shortage. This pilot multimethod study aimed to preliminarily understand the relationship between motivations for enrolment and dropout among first-year undergraduate nursing students. Methods: A two-step approach was conducted among first-year nursing students from five Italian universities involving: (a) a baseline quantitative online survey collecting their characteristics and motivations for enrolment; (b) a follow-up semi-structured interview qualitative data collection among students who dropped out. Descriptive and inferential statistics were used to describe the motivations for enrolment and differences between universities. Dropout motivations emerged from inductive content analysis, with data categorisation according to Urwin’s framework. Results: A total of 759 students completed the online survey. Primary motivations for enrolment included the desire to be useful (88.8%), help suffering people (84.3%), and find employment (74.2%); 22.3% cited unsuccessful admission to another university as motivation for enrolment. Of the 141 students who discontinued, 31 were interviewed (22%). Eleven categories and three themes were identified. More than half of the participants dropped out due to interest in other courses and lack of aptitude, while a smaller number cited personal circumstances. Other motivations for dropout were related to negative learning environments or feelings and difficulties related to course characteristics. Conclusions: This study provides an initial insight into these complex phenomena that will be instrumental in understanding data from an Italian multicenter cohort study. The findings can inform recommendations and strategies to strengthen the future nursing workforce. Full article

Background: Caring for dependent people is an intense task that leads family caregivers to suffer physical or mental pathologies. Resilience is a protective factor that makes an individual more resistant to adverse events. Some characteristics of the caregiver or the care provided predispose the caregiver to be less resilient. Knowing these characteristics will allow us to detect vulnerable caregivers. Aim: The aim of this study was to explore the factors associated with caregiver resilience and establish a predictive model, including the relationship between preparedness, burden, resilience, and anxiety. Materials and Methods: The study design was descriptive, observational, and cross-sectional, with purposive sampling. The sample included 172 family caregivers of care-dependent patients in Spain. Questionnaires were administered to assess caregiver resilience, anxiety, burden, and the preparedness of care-dependent patients. Correlation, univariate, and multiple linear regression analyses were performed to identify the factors associated with resilience. Results: We found that there is a correlation between resilience, preparation, and burden. Factors related to resilience include age, the caregiver’s health status, kinship, childcare, and state aid granted. Caregiver preparedness is the factor that most predicts caregiver resilience in our model. Caregivers with high levels of resilience also demonstrated high levels of preparedness and experienced less burden than those with low levels of resilience. Conclusions: These findings emphasize the relevance of improving the preparation of family caregivers to increase their resilience and, at the same time, the quality of care provided. Full article

Background: The care of dependent people is eminently family-oriented, and often, there is a high level of dedication to this family care. Constant and continuous care leads to a series of negative psychological consequences. Social support has been related to improved mental health in family caregivers. We found heterogeneous results regarding the relationship between the types of social support received and the perceived level of support. In addition, to our knowledge, no reviews analyse this relationship among family caregivers. Objectives: Therefore, we objective to systematically synthesise the relationships between perceived and received social support in informal caregivers. Methodology: We have carried out a quantitative systematic review with a meta-analysis, registered in PROSPERO (id: CRD42023470047); the systematic search was carried out in the following databases: PubMed, CINAHL, PsycINFO, and Scopus, until November 2023. After the selection and review of the results, twelve studies were obtained, two of which were eliminated due to a high risk of classification bias. Results: Regarding the results, a medium-size positive statistical association was found (r = 0.43). The results were consistent, accurate, and robust. The Trim and Fill test showed a variation of 7%. Subgroup analysis indicated no differences in the age group of the people cared for (adults or children), selection bias, and confounding bias. Conclusions: In conclusions, perceived social support is related to more social support received by family caregivers. Full article

Background: Human papillomavirus (HPV) poses a significant health burden, yet the vaccine which successfully prevents HPV and its associated cancers remains underutilized. Nurses play a crucial role in patient education and advocacy for HPV vaccination. This study explores how knowledge, along with cultural, religious, and social beliefs, shapes the attitudes of Israeli nurses and nursing students toward the HPV vaccine and their advocacy efforts. Methods: A cross-sectional study was conducted from August 2023 to January 2024 using an anonymous online questionnaire distributed via Facebook groups targeting Israeli nurses and nursing students. The questionnaire assessed demographic data, HPV-related knowledge, and attitudes toward HPV vaccination. Results: The study included 458 participants (229 nurses and 229 nursing students). Significant knowledge gaps were found, with 52% of participants incorrectly believing that the vaccine can cure existing infections and 47% mistakenly believing that it is administered in a single dose. Logistic regression revealed that nurses working in community settings were more likely to have positive attitudes toward HPV vaccination (OR = 2.98, 95% CI: 1.84–4.85). Higher levels of HPV-related knowledge (OR = 3.35, 95% CI: 2.10–5.35) and secular or traditional religious affiliations (OR = 2.45, 95% CI: 1.52–3.97) were strongly associated with positive attitudes toward and advocacy for the vaccine. Conclusions: Targeted educational programs addressing knowledge gaps, especially those tailored to Israel’s cultural and religious diversity, are crucial for empowering nurses and nursing students as advocates for HPV vaccination. Enhancing their understanding of HPV can increase vaccine uptake, reduce the incidence of HPV-related diseases, and strengthen public health initiatives in Israel. Full article

Background/Objectives: The general health and well-being of middle-aged women have become a major public health issue worldwide. More than 80% of women experience physical or psychological symptoms during the transition to menopause. This study aims to compare the effect of menopause on quality of life (QOL) in two groups of women undergoing natural and surgical menopause. Methods: The sample consisted of 100 female patients from a Greek hospital in Athens, with an average age of 44.5 years, half of whom had natural menopause, while the remaining women had iatrogenic menopause after surgery for any reason other than malignancy. A questionnaire related to the QOL in menopause was used to collect the data. The scale used to evaluate the QOL of women is the Utian QOL Scale (UQOL), translated into Greek. Results: From the analysis of the data, it was found that there is no statistically significant difference between the QOL of women with natural and surgical menopause. Menopausal symptoms, psychosocial and sexual health, as well as the general health of the two groups, showed similar rates (OR: 63.7–66.6, p = 0.248). The only statistically significant difference found was in weight gain, with natural menopausal women having greater weight gain compared to surgically menopausal women (p = 0.041). Conclusions: Menopausal symptoms are associated with a decrease in women’s QOL. However, QOL is affected regardless of the type of menopause transition. This study was not registered. Full article

Background/Objectives: The increasing rates of nurse turnover pose significant challenges to healthcare systems, negatively impacting patient outcomes and increasing operational costs. Despite the recognized importance of retaining nursing staff, factors contributing to turnover intentions, such as job dissatisfaction and burnout, remain inadequately addressed. Developing job crafting skills among nurses can be a proactive strategy to mitigate these issues, leading to a more engaged and committed workforce. The aim of this study was to analyze nurses’ job crafting and its relationship with the intention to stay at their working hospitals or to leave the nursing profession. Methods: A cross-sectional, correlational study was conducted with a sample of 284 registered nurses using a self-reported online questionnaire with the standardized Spanish version of the Job Crafting Scale. Mann–Whitney U and Kruskal–Wallis nonparametric tests were used to determine statistically significant differences between two or more different groups for the job crafting variable, respectively. The Spearman correlation coefficient was calculated to explore the relationships between variables. Results: Mean scores obtained for the Job Crafting Scale indicated that nurses in the study had a high level of job crafting. Nurses with lower scores for the ‘Decreasing hindering job demands’ subscale had a significantly lower intention to stay at their workplace. Greater ‘Decreasing hindering job demands’ scores were significantly associated with a lower intention to leave the nursing profession. Lower nurses’ intention to leave the nursing profession was significantly associated with a greater intention to stay at hospitals. Conclusions: Improving ‘Decreasing hindering job demands’ job crafting skills to “decrease hindering job demands” through workload management, time management training, supportive supervision, resource availability, autonomy encouragement, promotion of team collaboration, and mental health support. It could lead to greater retention of nurses in their workplaces and in the nursing profession. Nursing managers and leaders should consider improving the job crafting skill “Decrease Hindering Job Demands” among nurses as a potential strategy for effective retention of nurses to address the challenges of the global nursing shortage. Full article

Background: Nursing students face unique challenges during their university education, making them vulnerable to mental health problems. Psychological resilience has been identified as a protective factor against these issues. However, previous reviews have identified gaps in the literature on resilience and mental health among nursing students. Objectives: This scoping review aims to identify and map studies on psychological resilience and mental health in undergraduate nursing students, synthesize current evidence on their relationship, identify interventions for enhancing resilience, and highlight gaps in the existing literature. Eligibility criteria: Studies published between January 2019 and April 2024 in English, Portuguese, and Spanish addressing resilience and mental health in undergraduate nursing students will be included. Primary studies, secondary studies, clinical guidelines, and grey literature will be considered. Sources of evidence: Searches will be conducted in multiple databases including EMBASE, ERIC, PubMed, Science Direct, Web of Science, DOAJ, ELSEVIER, EMERALD, and WILEY ONLINE LIBRARY. Grey literature sources will also be searched. Charting methods: Data will be extracted using a standardized form and synthesized narratively. Thematic analysis will be conducted using MAXQDA software ((Verbi GmbH, 24 version, 2023). Quantitative summaries, visual mapping, subgroup analyses, and trend analyses will be performed where appropriate. Results: As this is a protocol, results are not yet available. The review will present a comprehensive map of the current literature on psychological resilience and mental health in nursing students, including identified interventions and research gaps. Conclusions: This scoping review will provide valuable insights to guide curriculum development, support services, and policy-making in nursing education. The findings may support actions to strengthen resilience and prevent mental health problems among future nursing professionals. Full article

Background. Previous research has shown that patients with ostomy frequently exhibit a low health-related quality of life (HRQoL). Self-care is a key element that influences their HRQoL. However, the evidence regarding the relationship between these two constructs in patients with ostomy is still not clear. Materials and Methods. This was a secondary analysis of an Italian multicenter, observational, longitudinal study. Participants were recruited from seven outpatient ostomy care clinics in central and northern Italy. The Stoma-Specific Quality of Life Questionnaire (Stoma QoL) and the Ostomy Self-Care Index (OSCI) were administered to the participants. The relationship between self-care and HRQoL was analyzed using structural equation modeling. Results. A total of 521 patients were enrolled. Our results emphasized that self-care is a predictor of HRQoL among people with ostomy. Self-care maintenance and self-care monitoring had a positive effect on HRQoL (self-care maintenance: β = 0.506, p < 0.001; self-care monitoring: β = 0.303, p < 0.001). The model exhibited acceptable fit indices: χ² (151, n= 521) = 516.447, p ≤ 0.001, comparative fit index (CFI) = 0.97, Tucker–Lewis index (TLI) = 0.96, root mean square error of approximation (RMSEA) = 0.068 (90% CI, 0.062–0.075), p < 0.001, and standardized root mean square residual (SRMR) = 0.038. Conclusions. The structural equation model tested the causal relationship between self-care and HRQoL in people with a stoma, demonstrating for the first time that inadequate self-care in patients with ostomy may lead to lower HRQoL. Thus, to enhance HRQoL, interventions should be designed to improve self-care behaviors. Future research should investigate potential mediating variables in the relationship between self-care and HRQoL. Full article

Background: Nurse practitioners have been prescribing medication within a narrow scope of practice throughout the world for several decades as a means of meeting rising demand for community health services. Prominent medical bodies have alleged that the Australian government’s decision to remove the need for general practitioner collaboration in the context of a nurse practitioner prescribing medication compromises patient safety. Objectives: This study aimed to determine whether nurse practitioner prescribing increases patient risk relative to general practitioner prescribing in a large digital health service. Methods: Investigators retrospectively analyzed prescription errors from all audited consults of the Eucalyptus Australia service over a 6 month period between 1 October 2023 and 31 March 2024. Results: Of the 8359 consults, errors were observed in 911 (14.22%) of NP and 417 (21.37%) of general practitioner consults and this difference was found to be statistically significant, X² (1, N = 8359), =57.33, p ≤ 0.001. No statistically significant difference was observed in the incidence of high-risk or never events between nurse practitioners and general practitioners. Most high-risk and never events pertained to medical contraindications, insufficient side-effect counselling, and the insufficient assessment of a patient’s medical history. Conclusion: These findings suggest that nurse practitioners are capable of safely performing patient assessments and prescribing medications for a select range of conditions in digital health services. Full article

Background: Psycho-emotional aspects as a cross-cutting theme have gained relevance and scientific interest in recent years. Pregnant women diagnosed with a rare disease constitute a vulnerable population, experiencing psycho-emotional challenges due to their specific circumstances. It is essential that this group is informed and receives the proper to manage the physical, emotional, and psychological challenges linked to their condition. Objectives: The aim of this review is to understand how the diagnosis of a rare disease affects the psycho-emotional aspects of a pregnant woman. Methods: The research question posed is how does the diagnosis of a rare disease affect the psycho-emotional aspects of a pregnant woman? This systematic review has been carried out following the PRISMA model and has been registered in PROSPERO with registration number CRD42024558523. A literature search was conducted in the databases of Scopus, PubMed, Cinahl, Scielo, and the Cochrane Library. Articles were selected on the basis of the following inclusion criteria: publication in the last twenty years and all languages. Results: In the end, 28 articles were selected. The main results highlight that there is a negative impact on the psycho-emotional level in these patients, altering aspects such as anxiety, stress, social rejection, and self-stigma. Conclusion: The role of nursing in addressing this psycho-emotional dimension as a mediator between families and other branches of the health sciences environment stands out. Full article

Background: Patient center care (PCC) plays a crucial role in achieving the organizational and patient outcomes. Literature suggests that PCC enhance patient’s adherence to treatment, lower the cost of health care organization. This study aimed explore the higher and middle managers’ perceptions of patient-centered care (PCC) in an oncology setting, identify the PCC implementation challenges in the oncology setting, and understand the role of managers in facilitating PCC within the oncology context. Methods: Sampling involved the use of the purposive sampling technique on 17 middle managers and 6 upper managers who had been working in an oncology setting. The six-step thematic analysis method was used for data analysis. Results: The interviews identified six main themes and seventeen subthemes: “comprehensive care, partnership, and informed decision-making”, “infrastructure and support systems”, “leadership influence on patient-centered care”, “cultural and operational barriers”, “perceived outcomes”, and “strategies to enhance PCC in oncology”. The subthemes of comprehensive care included fostering partnerships and enabling informed decisions. The infrastructure and support systems encompassed educational empowerment and service integration. Leadership influence highlighted the role of elevating awareness, providing organizational support, and promoting comprehensive care. The cultural and operational barriers addressed the challenges faced in implementation. The perceived outcomes focused on the results of patient-centered care, while strategies to enhance PCC in oncology provided actionable insights for improvement. This provides a comprehensive understanding of the perceptions of middle and higher managers on patient-centered care (PCC) in oncology settings. It identifies key challenges in PCC implementation, highlights the critical role of managers in facilitating PCC, and offers actionable strategies for enhancing PCC. Full article

Objective: This study investigates the perceptions of Long COVID patients in Spain regarding the healthcare they receive to identify demands and areas for improvement. Methods: Using a qualitative descriptive phenomenological approach, the study included 27 participants selected through non-probabilistic convenience sampling. Data were collected via online semi-structured interviews and analyzed using thematic analysis. Results: The findings reveal three key themes: (i) health status and challenges in healthcare during the initial COVID-19 infection; (ii) perceptions about healthcare as Long COVID patients; and (iii) demand for and aspects of improving quality of healthcare. The participants, predominantly women (66.67%) with a median age of 51 years, experienced symptoms that they generally perceived as severe, although only 14.81% required hospitalization. The participants reported initial self-management of symptoms at home, which was influenced by familial responsibilities and hospital overcrowding, and the persistence of a wide range of Long COVID symptoms that significantly impacted their daily lives. Satisfaction with healthcare services varied, with frustrations over systemic inefficiencies and long waiting times. Conclusions: The study highlights the need for timely access to medical care, comprehensive and empathetic healthcare services, and specialized Long COVID units. The results emphasize the importance of patient-centered approaches and multidisciplinary care to address the complex nature of Long COVID effectively. These findings provide crucial insights for improving healthcare protocols and systems to better support Long COVID patients. This study was prospectively registered with the Ethics Committee for Research on Medicines of the Albacete Integrated Health Care Management System (registry) on 22 February 2022 with registration number 2022/001. Full article

Background/Objectives: The nursing work environment is a critical element in healthcare delivery and a strong predictor of both patient and nurse outcomes. Understanding the complexity and multifaceted nature of this environment is essential for improving nursing practices and optimizing healthcare systems. This study aimed to gain insights into the perceived characteristics of the nursing work environment, considering it as a complex and multifaceted system. Methods: A qualitative research approach was employed, involving 42 semi-structured interviews with 43 nurses and managers from academic, teaching, and general hospitals in The Netherlands. Data were collected between July 2020 and August 2021 through convenience sampling. Thematic coding was conducted to identify key patterns and themes. Results: The findings revealed that nurses demonstrated flexibility and a strong commitment to high-quality care, despite grappling with rigorous organizational tasks and processes. Four key themes emerged: (1) direct patient care as a standard feature of nursing work; (2) nurses’ flexibility for hospital productivity; (3) interdependencies, which decrease autonomous nursing practices; and (4) organizational structures that determine how nurses can shape their work. Nurses found it difficult to balance direct care with broader tasks due to organizational rigidity, revealing a gap between ideal nursing practices and daily reality. Conclusions: This study highlighted the challenges within the nursing work environment, particularly in balancing direct care with organizational demands. Addressing this gap between ideal nursing practice and reality requires a systems approach. This includes autonomous practices, supportive management, and flexible structures, allowing nurses to shape their work and enhance job satisfaction and care quality. Full article

Background/Objectives: It is well known that there are differences in the academic and employment preferences of nursing students once they have completed their undergraduate studies in nursing. These preferences are largely influenced by students’ affinity for certain thematic areas over others. Therefore, the objective of this study was to identify the employment and academic preferences of third- and fourth-year Nursing Degree students at the University of Las Palmas de Gran Canaria (ULPGC). Methods: A cross-sectional, descriptive observational study was conducted among nursing students across three campuses of the ULPGC (Canary Islands, Spain). An online questionnaire was used to collect various sociodemographic and academic variables, as well as preferences across ten thematic areas. Descriptive and bivariate inferential analyses were performed, along with a correlation analysis among the areas. Results: The areas of highest preference were “Emergency Nursing”, “General Nursing”, and “Family and Community Nursing”. The areas of lowest preference were “Other Areas (teaching, management, research)”, “Mental Health and Psychiatric Nursing”, and “Geriatric Nursing”. Three clusters of closely correlated areas were identified: cluster 1 (Intensive and Critical Care Nursing, Emergency and Emergency Nursing and Operating Theatre and Anaesthesia Nursing), cluster 2 (Obstetric-Gynaecological Nursing–Midwifery, Paediatric Nursing and Mental Health and Psychiatric Nursing) and cluster 3 (remaining areas). A significant proportion of students expressed intentions to pursue postgraduate studies. Conclusions: Strategies should be implemented to enhance students’ preferences in the areas of “Mental Health and Psychiatric Nursing” and “Geriatric Nursing”, which are areas where there is a high demand for nurses. It is also necessary to increase their interest in research, management, and teaching. This study was not registered. Full article

Background: The number of foreign-born patients with tuberculosis (TB) has been increasing in Japan, and the number of Vietnamese patients was the highest in 2019. Tuberculosis (TB) is the second leading cause of death from infectious diseases after coronavirus disease-2019 (COVID-19). As the prevalence of TB varies widely globally, measures must be tailored to local characteristics. The Directly Observed Treatment (DOTS) short-course was introduced by the World Health Organization as a global strategy to overcome these challenges. The purpose of this study is to develop an original risk assessment for treatment interruption for Vietnamese patients with TB to be used in Directly Observed Treatment (DOTS), a tuberculosis control measure. Methods: The researchers adopted the Delphi method. Public health nurses of mid-career or above (n = 15) who had conducted DOTS for several Vietnamese patients with TB were selected and surveyed about the content and surface validities of the draft risk assessment items for treatment interruption. The survey was conducted three times. The quantification of content validity and the review and modification of responses regarding each item were analyzed by the researchers. Results: The results identified the following risk categories: “physical characteristics”, “background of life during residence”, “treatment environment”, “understanding tuberculosis and disease acceptance”, and “cultural and value trends”. Conclusions: The results suggest the need to provide support for tuberculosis recovery from various perspectives, including the living environment of Vietnamese patients with TB, their social environment in Japan, and the culture and values of their country of birth and upbringing. Full article

Objective: This study describes the epidemiological changes in pressure ulcers (PUs) in a Portuguese intensive care unit (ICU) from January 2017 to June 2023, characterizes critically ill patients with PUs, identifies specific risk factors, and assesses the effectiveness of implemented preventive measures. Materials and Methods: A retrospective observational cohort study was conducted, analyzing records of ICU patients with PUs during the specified period. Data were extracted from the institution’s Global Risk Management application and the ICU’s electronic PU registry. The study included patients with ICU stays longer than 24 h and excluded those with ineligible clinical records or incomplete characterization data. Results: Among 3816 evaluated patients, 257 developed a total of 345 PUs, averaging 1.4 PUs per patient. The average PU prevalence rate was 6.81%, with the highest prevalence in 2020 (11.0%) and the lowest in 2022 (3.48%). The average incidence rate was 3.76%, peaking at 5.71% in 2020 and declining to 2.54% in 2023. The sacrum and heels were the most commonly affected areas, with Category 2 PUs being the most frequent. Key intrinsic risk factors included systemic diseases and sensory deficits, with pressure identified as a significant extrinsic factor. Preventive measures focused on risk assessment and pressure control. Conclusions: The study reveals a PU prevalence of 6.81% and an average incidence of 3.76%, underscoring the need for enhanced preventive strategies, especially in anatomical areas like the sacrum and heels. It emphasizes the importance of personalized assessments, continuous education for nursing staff, and a multidisciplinary approach to improve patient outcomes and care quality in the ICU. Full article

Background/Objectives: Inborn errors of immunity (IEI) encompass various congenital disorders, resulting in immunity defects and recurrent infections. Home-based subcutaneous immunoglobulin replacement therapy (scIgRT) is the best treatment option for those with primary antibody deficiency (PAD). However, the lack of standardized procedures in patient training remains a challenge. Our study investigates nurses’ practice and perspectives, aiming to identify areas for improvement in at-home scIgRT practice. Methods: We prepared a structured survey regarding scIgRT, including needle choice experience and perception of adverse events, and distributed it among qualified nurses involved in patient training and scIgRT supervising. Results: We included 56 nurses with a median age of 50 years. Among them, 67.9% represented adult care providers, while 32.1% supervised IgRT in children. Most respondents (83.9%) used the classic or assisted with hyaluronidase scIgRT preparations. Single-channel needles were administered most commonly (85.7%). The needle length was mostly chosen solely by a nurse (57.1%) or in cooperation with the patient (23.2%). Next, 9 mm and 12 mm needles were used most often (92.9% and 78.6%, respectively). As expected, the 6 mm needle was more frequently applied for children compared to adults (n = 16, 88.9% vs. n = 11, 28.9%, p < 0.001), while 12 mm was primarily used in adults (n = 35, 92.1% vs. n = 9, 50.0%, p < 0.001). Visual skin fold assessment was the basis for the needle selection (58.9%), followed by the injection site rule (26.8%) or a choice between two available needle types for thinner or thicker patients (25.0%). Results of this survey indicate that, according to nurses’ opinions presented in this survey, the needle length could be associated with local scIgRT adverse events, such as side needle leakage or local burning. Yet, it was likely unrelated to general adverse signs, such as headaches or dizziness. Most respondents (66.1%) indicated that, even if local adverse events occur, patients are reluctant to change scIgRT preparation or needle length. Most participants (69.6%) reported that the optimal administration technique needs to be discussed with the patient before and during scIgRT. Conclusions: This study sheds light on scIgRT practice in Poland, emphasizing deficiency in needle selection technique. Future research should focus on standardized training and advanced needle selection procedures on patient outcomes, investigating the correlation between needle strategies and adverse events, as well as the effectiveness of scIgRT. Full article