Aims: To compare traditional versus dry wipes hygiene in hospitalized, bedridden patients with regard to economic and environmental impact and patient and professional satisfaction. Background: Evidence shows that dry hygiene with disposable wipes can reduce the risk of infection compared to traditional hygiene with soap and water. However, there is a need to compare the costs and environmental impact (waste) between the two methods. Design: Environmental impact and patient and user satisfaction were assessed through an ad hoc survey and cost minimization analysis in accordance with the Consolidated Health Economic Evaluation Reporting Standards. Methods: The environmental impact and costs associated with traditional versus dry hygiene were compared in an observational analysis. A single-center, randomized controlled trial was performed in a tertiary hospital to assess patient and professional satisfaction in patients with a urinary catheter recovering from heart surgery between January 2019 and February 2020. Results: Direct hygiene costs were similar using traditional (€15.82) and dry (€14.35) methods. However, the analysis of indirect costs, including those related to the probability of contracting catheter-associated urinary tract infections, showed that the total cost per hygiene session was €1345 higher with the traditional method. When using a high-efficiency energy system from a guaranteed renewable source, dry hygiene does not lead to a higher environmental impact (220.07 g CO2 traditional vs. 215.17g CO2 dry). However, emissions from conventional energy systems are 840.14 g CO2 higher when using traditional hygiene. Both patients and professionals express greater satisfaction with the dry method. Conclusion: Dry hygiene is not inferior to traditional hygiene in terms of satisfaction, and it can provide environmental benefits at a significantly lower cost. Implications for the profession and/or patient care: This study provides evidence supporting the introduction of the dry hygiene method, with is associated with higher user and professional satisfaction, lower economic cost, and similar or lower environmental impact compared to soap and water.

Objective: Clostridioides difficile, a Gram-positive, spore-forming bacillus, has emerged as a leading cause of healthcare-associated infections, significantly contributing to infectious diarrhea and increasing healthcare costs. Materials and Methods: This cross-sectional, observational study polled Saudi Arabian nursing staff from July 2023 till December 2023 to evaluate their knowledge, attitudes, and habits regarding C. difficile infection (CDI). They were evaluated using a pre-tested, standardized questionnaire. Results: A total of 358 nurses in Saudi Arabia were surveyed, and 66% reported having knowledge of C. difficile procedures. However, only 30.5% of respondents correctly classified C. difficile as an anaerobic bacillus, while 42% were aware of the organism’s common occurrence in healthy adult volunteers. Additionally. 56% of respondents were aware of risk factors, and 49% could name typical medicines that might cause illness. Merely 24% acknowledged the cytotoxin test as the gold standard for detection. Of those who responded, 27% identified hand washing your hands was the greatest preventive approach and 36% thought that oral metronidazole was the best course of action. Conclusions: These findings highlight the global challenge that nurses are adequately knowledgeable on C. difficile. They stress the necessity of continuing education and training to enhance CDI management and patient outcomes, regardless of geographical variances.

Nursing, a profession known for its compassion and dedication to providing exceptional patient care, relies heavily on the cultivation of caring attributes to uphold the highest standards of practice. Despite the common use of small group work in nursing education, there is a gap in understanding how these caring attributes are developed through this approach. This qualitative study sought to explore the emergence of caring attributes in small group settings as perceived by nursing students and educators. Thirteen nursing students and ten educators participated in semi-structured group interviews at a professional educational institution. The study identified four key sets of caring attributes nurtured through small group work: interpersonal communication with respect, compassion, and empathy; competence and confidence; and accountability to commitment. These findings underscore the essential role of caring in nursing, emphasizing how collaborative group work can facilitate the development of crucial attributes through interpersonal interactions. The cultivation of respectful communication skills among students is highlighted as pivotal for enhancing interactions with healthcare professionals, patients, and families, ultimately improving the quality of care provided. By providing opportunities for interactive learning and ongoing practice, students can effectively embody these caring attributes, fostering their nursing professionalism throughout their careers.

Background: Breastfeeding self-efficacy is a critical factor influencing the initiation and continuation of breastfeeding among mothers. Low self-efficacy affects mothers’ ability to sustain breastfeeding. Several studies have investigated the factors influencing breastfeeding self-efficacy, but none have interconnected maternal, infant, and social support factors. Aims: This study aimed to measure the correlation between maternal and infant factors, social support, and breastfeeding self-efficacy. Methods: A cross-sectional approach was employed in Jember, Indonesia, among 200 breastfeeding mothers. The study population consisted of mothers 17-42 years old who were breastfeeding and who met the following inclusion criteria: mothers who have babies aged 1-6 months, term pregnancy history, wanted pregnancy, and baby weight born ≥ 2500 grams. Maternal and infant factors and social support were determined through interviews and questionnaires. Breastfeeding self-efficacy was examined using The Breastfeeding Self-efficacy Scale Short. The multiple logistic analysis was used for multivariate analysis. Results: Of a total of 200 breastfeeding mothers, 63% had low breastfeeding self-efficacy, and 59.5% of mothers did not exclusively breastfeed. The multiple logistic regression indicated that 74.2% of the factors included in the model influenced breastfeeding self-efficacy. Positive correlations were observed between breastfeeding self-efficacy and feeding type (OR=6.603), breastfeeding frequency (OR=6.220), breastfeeding intention (OR=4.993), and family type (OR=4.001). Conclusion: feeding type, breastfeeding frequency, and family support were the important factors that support breastfeeding self-efficacy.

Background/Objectives: In response to the impact of the COVID-19 pandemic, the authors implemented an innovative and alternative approach to practice learning for a Cohort of Year One Adult and Mental Health student nurses. The evaluation aimed to explore the effectiveness of virtual practice learning as a viable alternative to traditional practice placements and the impact on the student practice learning experience. Methods: All year one student nurses attending the four Simulated Practice Learning Experience (SPLE) weeks were invited to participate and complete a generated questionnaire within the virtual environment on their final day of each week. The evaluation employed a mixed methods approach to evaluate the effectiveness of the SPLE on student satisfaction and their overall practice learning experience. Results: A mean total of 205 student nurses completed the questionnaire, achieving a response rate of 98-100%. Students reported an overall satisfaction score of 88%, highlighting their preparedness and positive feedback on the organisation, delivery, and content of the SPLE. Qualitative analysis revealed key themes, including the development of transferable skills and personal growth, the value of peer learning, the benefits of a virtual environment, and appreciation of service user and healthcare professional input. Students reported significant personal growth, improved communication skills, and a deeper understanding of holistic care through interactive and collaborative learning experiences. Conclusions: This evaluation underscores the innovative potential of virtual practice learning to enhance nursing education, emphasising the importance of integrating emerging technologies and diverse pedagogical approaches. The findings suggest that SPLEs can effectively prepare nursing students for the complexities of clinical practice while addressing the evolving demands of healthcare education. Future research should focus on longitudinal studies to assess the sustained impact of virtual learning on clinical experiences and professional development.

Adolescent eating disorders pose a significant public health challenge, deeply affecting both physical and emotional well-being. Early diagnosis is important for improving treatment outcomes, though it remains complex due to multiple influencing factors. The family perspective is essential in this process, as it provides valuable insights into changes in adolescents’ habits and emotional health. Methods: A descriptive qualitative study was conducted in Madrid, Spain, between January and February 2023, using a phenomenological approach to explore the experiences and perspectives of family members of adolescents with eating disorders. Results: Four thematic blocks with their categories were identified: (T1) Diagnosis, (T2) Family (T3) Resources, and (T4) Treatment. Participants emphasized the need for early intervention and a multidisciplinary approach to the treatment of eating disorders. Family therapy was recognized as vital in treatment, and common dissatisfaction in the public health structure underscored the need for greater investment in research and access to specialists. Mental health nurse practitioners have an important role in providing comprehensive care and support as well as mental health literacy. Conclusions: A holistic patient-centered approach, including family involvement and appropriate support systems, is key to improving outcomes and quality of life of adolescents undergoing treatment for eating disorders. Improving healthcare resources and addressing the challenges faced by families is essential. In addition, mental health literacy is critical, as it enables families to understand the disease better, make informed decisions, and actively participate in the recovery process, contributing to improved therapeutic outcomes and quality of life for patients.

Background: Malnutrition is a widespread issue among old people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. This study examines the influence of continuing education on healthcare workers' attitudes and practices toward old people's nutrition. Aim: The study assesses healthcare workers' attitudes toward old people's nutrition using the validated Italian version of the SANN-G questionnaire, focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1,789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software. Results: Most respondents were female (68.59%) and aged 41–50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most displaying neutral or negative attitudes. Education on malnutrition significantly improved attitudes, particularly in assessment, intervention, and individualization. Younger respondents and nurses were more likely to have positive attitudes after educational interventions, while older respondents and physicians tended to show neutral or negative attitudes. Conclusion: Continuing education on malnutrition is crucial for fostering positive attitudes among healthcare workers. Specialized education leads to more proactive approaches, highlighting the need for targeted educational programs to improve old people's nutritional care.

Background and aims: The COVID-19 pandemic significantly impacted the mental health of healthcare professionals, especially those working in Psychosocial Care Centers (CAPS), which are crucial services in the Brazilian mental health system. This study aimed to analyze satisfaction and workload as predictive factors for psychological distress among CAPS professionals during the pandemic. Methods: A cross-sectional study was conducted with 53 professionals from seven CAPS. The Workload Impact Scale (IMPACTO-BR) and Job Satisfaction Scale (SATIS-BR), the General Health Questionnaire (GHQ-12), and a sociodemographic questionnaire were used. Descriptive and analytical statistical analyses were performed. Results: Professionals reported moderate satisfaction (3.67 ± 0.45) and mild workload (1.82 ± 0.63). One-third of the sample showed scores indicative of psychological distress. Logistic regression analysis revealed that workload (OR = 1.39, 95% CI = 0.0025) and low job satisfaction (OR = 1.23, 95% CI = 0.0495) were significant predictors of psychological distress. Conclusions: Low job satisfaction and high professional workload were predictive variables of psychological distress. These findings highlight the need for investments in promoting the quality of life at work for mental health professionals, especially during crises. The implications for human resource management and public policy development emphasize the importance of an integrated approach that considers the well-being of professionals for the effectiveness and sustainability of the psychosocial care model.

Background/Objectives: To understand the lived experiences of the informal caregivers of people with chronic noncommunicable diseases and their interpretations of the significance of that care. The perspectives of men and women interacting with people in a situation of chronicity are examined. Methods: This qualitative phenomenological-hermeneutic study was based on Van Manen’s comprehensive and interpretative vision. Criterion-oriented non-probability random sampling was used. In-depth interviews were used to collect the information. Twenty caregivers participated in the study. Results: The following five themes emerged: transformation of the caregiver’s world; uncertainty of care; tireless guardianship and unwavering devotion; isolation and emotional exhaustion; and imbalance between caring for others and the self. Conclusions: The experience of informal caregivers reveals that both men and women face significant challenges, albeit from gender-differentiated perspectives and experiences. Men and women elaborate different meanings of caregiving, reflecting their gender roles and expectations. Therefore, an inclusive and equitable approach that recognizes and addresses these gender differences is essential in order to improve the support and quality of life for all informal caregivers, respecting and valuing their unique voices and experiences. An inclusive and equitable approach that recognizes gender intersections is required to improve support and the quality of life for caregivers.

Background and Objective: Prostate cancer is the leading cancer affecting males. The treatment is radical prostatectomy, with its main complications being urinary incontinence and erectile dysfunction. Various studies demonstrate that exercises targeting the pelvic floor muscles help improve these complications, although sometimes, these exercises are not performed correctly, rendering the effort ineffective. To avoid this circumstance, a study comparing a group with biofeedback‐guided learning led by a nurse expert in the technique against another without this learning method is designed. Methods: Randomized clinical trial with two arms; the study group underwent two biofeedback sessions prior to surgery for the identification of the muscles to work on, compared to another group where no prior learning of the muscles was done. These fifteen‐minute sessions involved the placement of electromyography sensors for muscle contraction detection. Both groups followed the same care process where the protocol for reinforcing the perineal muscles after the removal of the urinary catheter was explained. Data were collected through validated questionnaires. Key Findings and Limitations: The results obtained show a clear improvement in the prevalence of urinary incontinence and erectile dysfunction in patients who underwent two biofeedback sessions prior to surgery, as well as a high rate of adherence and satisfaction with the care received in both the control group and the study group, regardless of whether they experienced urinary incontinence and/or erectile dysfunction. Conclusions and Clinical Implications: Biofeedback is a safe method that helps reduce complications after prostatectomy.

Background: Family and Community Nurse specialists are advocates of a holistic model of care in multidisciplinary primary care teams. The study aimed to describe and understand the experiences and perceptions of family and community nurse specialists with regard to their employment situation in primary care teams in Spain; Methods: A Qualitative descriptive study was conducted. Eighteen family and community specialist nurses from different autonomous communities in Spain participated. Individual interviews and a focus group were conducted; Results: The results showed two themes and four sub-themes: 1) Current work situation of the Family and Community Nursing specialist: a) The lack of social and work recognition, and b) The advantages of working with Family and Community Nursing specialists; and 2) Support network and system of rejection: a) Systematic ambivalence towards Family and Community Nursing and b) Need for institutional support. Conclusions: Their inclusion in primary care teams fosters the nurse-patient bond, increases and/or maintains patient quality of life and promotes patient health empowerment. However, there is a great lack of knowledge on the part of society and health administrations regarding the functions of these nurses.

Background/Objectives: Home and community care (HCC) nurses experienced increased occupational challenges during the COVID-19 pandemic including increased workloads, job stressors and occupational risks like virus exposure. The objective was to elucidate what factors influenced nurses’ decisions to stay in their role, take a temporary leave, or exit HCC during the COVID-19 pandemic. Methods: A secondary analysis of data collected using a cross-sectional online open survey distributed among HCC Registered Practical Nurses across Ontario between June and September 2022 was conducted. The factors contributing to nurses’ decision to remain in HCC, temporarily leave, or exit the sector were evaluated using multinomial logistic regression (p < 0.05). Results: Of the 664 participants, 54% (n=357) stayed in the HCC sector, 30% (n=199) temporarily left, and 16% (n=108) exited the sector. Nurses with greater years of experience working in HCC and those who avoided infection were more likely to stay in their role in HCC, which may reflect strong relationships with long-term clients, opportunity and accumulated experience to increase income, and maintained good health. Nurses with higher levels of emotional intelligence were more likely to take leaves and exit HCC, suggesting that stepping away may have been a strategy to safeguard themselves. Conclusions: HCC leadership should prioritize the development of solutions to support nurses in the HCC workforce, including those with fewer years’ experience. This may promote nurses’ participation in the sector, particularly during times of heightened occupational challenges and crises like COVID-19.

Background: Falls in older adults are prevalent and can result in an injury affecting their quality of life. Whether a fall is fatal or not, it has a high financial impact. Older adults with dementia are more likely to fall than their cognitively healthy counterparts, increasing their risk of serious injury or even death. This quality improvement project developed, implemented, and evaluated an evidence-based fall prevention bundle to reduce preventable falls in a long-term memory care unit.; Methods: The interventions that were implemented includes fall risk screening, physical exercise, vitamin D supplementation, purposeful hourly rounds, and post-fall huddles. Kurt Lewin’s force field analysis guided the project’s implementation. Nurses, healthcare providers, certified nursing assistants, restorative aides, and life enrichment staff from all shifts at a long-term memory care unit participated in the project. The participants implemented the evidence-based fall prevention bundle based on their scope of practice. They participated for 12 weeks. The frequency of falls was compared three months before, during, and after implementation. Paired t-test and independent samples t-test were used to analyze statistically significant differences between variables.; Results: Thirty staff members attended educational sessions, and 22 residents received interventions. Fall rates dropped 50% during the project's implementation but increased subsequently. The difference in the number of falls before, during, and after implementation was not statistically significant.; Conclusions: Staff working in a long-term care facility may help reduce fall rates using evidence-based interventions, but measures should be taken to sustain the initiative's implementation.

Objective: This study aims to construct an early risk warning model to predict the risk of treatment failure in patients undergoing sequential High-Flow Nasal Cannula (HFNC) oxygen therapy following mechanical ventilation weaning. Methods: A retrospective analysis was conducted on clinical data from 145 patients who received HFNC treatment in the Emergency Intensive Care Unit of the Third People's Hospital of Bengbu City from June 2018 to June 2023. A wide range of indicators including general information, comorbidities, laboratory test results, vital signs, disease-related scores, and oxygenation data were collected. Data analysis was performed using R software, starting with the Lasso regression to filter features related to treatment outcomes. Patients were divided into a training set (70%) and a validation set (30%) using random grouping software. The Random Forest algorithm was then employed to evaluate and rank the important features related to outcome indicators. The predictive efficiency and stability of the model were assessed through the Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis, culminating in the construction of an early risk warning nomogram. Results: The study found that the Random Forest model exhibited high predictive accuracy in the training set (AUC=0.98) and good stability in the validation set (AUC=0.84). Key feature variables identified by the model, such as APACHE II score, BNP, NLR, mROX, and SOFA, were found to significantly impact the prediction of HFNC treatment failure. Based on these variables, an early warning nomogram was further developed, providing clinicians with a convenient and effective risk assessment tool. Conclusion: This study has constructed an early risk warning model based on the Random Forest algorithm, capable of effectively predicting the risk of HFNC treatment failure. The model's high predictive efficiency and stability offer strong support for clinical decision-making, contributing to personalized treatment and improved patient outcomes. Future research should aim to expand the sample size, perform multicenter validation, and explore the integration of the model into Clinical Decision Support Systems for real-time risk assessment and intervention.

The aim of this study was to evaluate the psychometric properties of the Communication Skills Scale (CSS) among Peruvian nurses and its association with job insecurity during the COVID-19 pandemic. We explored five models of confirmatory factor analysis for the CSS and its four subscales and assessed the convergent validity and criterion validity of the scale by analyzing its connection with job insecurity through stepwise multiple regression. We used insights from a focus group for the cultural adaptation of the scale. In the psychometric phase, 225 nurses participated through a virtual survey. The psychometric analysis revealed that the CSS and its subscales have a robust internal structure—similar to the original questionnaire—and are optimally reliable in the Peruvian population. Furthermore, the results show that job insecurity was associated with contract type, communication skills, empathy, and job satisfaction. The CSS and its subscales are valid and reliable to be applied to Peruvian nurses. Initiatives should be undertaken to strengthen communication skills and increase job satisfaction among nursing professionals by improving their working conditions, especially in times of crisis, to reduce job insecurity and promote well-being.

Introduction: 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 analyze this relationship among family caregivers. Therefore, we aimed to systematically syn-thesize the relationships between perceived and received social support in informal caregivers. Methodology: We have carried out a quantitative systematic review with meta-analysis, regis-tered 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, 12 studies were obtained, two of which were eliminated due to a high risk of classification bias. 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 vari-ation of 7%. Subgroup analysis indicated no differences in the age group of the people cared for (adults or children), selection bias, and confounding bias. In conclusion, perceived social support is related to more social support received by family caregivers.

Complexity of care, adequate staffing levels, and workflow are key factors affecting nurses’ workloads. Clinical complexity classification and related staffing adjustment remain notable gaps in the current evidence limiting the capacity for optimal staffing practices. This study aimed to adapt and validate the WANNNT-SC to the Italian context to allow the assessment of newborns admitted to the NICUs. To evaluate the reliability of the tool among different profes-sionals, a correlation test was performed using Pearson’s correlation, which resulted in a strong correlation (r = 0.967, p = 0.01). In the test-retest phase, there was a significant correlation (r = 0.910 and p = 0.01). Using an analysis of variance, we found that the higher the I-WANNNT-SC score, the higher the predicted death rate (F = 13.05 and p < 0.001). The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool represents the first tool available for the Italian context that aims to measure the nursing workload in neonatal intensive care. It could allow adjustments in nursing staffing based on NICU activities and patient needs. This study was prospectively approved by the local Ethics Committee “Palermo 1” (Protocol CI-NICU-00).

Background and Objectives: The burdened symptomatology accompanying advanced non-small cell lung cancer (NSCLC) is associated with poor prognosis and lower quality of life (QoL). Although both chemotherapy and immunotherapy increase survival, they are still associated with reduced functionality due to their toxicity. This study aimed to estimate the QoL and symptom burden of NSCLC patients receiving second-line chemotherapy compared to patients receiving second-line immunotherapy. Materials and Methods: This comparative, prospective study, conducted from January 2020 to December 2021, included 111 NSCLC patients who were divided into two groups: 61 patients receiving second-line chemotherapy and 50 patients receiving second-line immunotherapy. Patients QoL and symptom burden were estimated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30) (value range 0 - 100) from treatment cycle 1 to 6. Results: The QoL (mean score > 50) and functionality dimensions (mean score > 50) were moderate to good in both treatment groups, while the symptoms burden did not appear to be a serious problem (mean score < 50). From cycle 3 to cycle 5, the QoL was significantly better in the immunotherapy group. From cycle 3, role and social functioning scores were higher in the immunotherapy group, while emotional and cognitive functioning were higher from cycle 2 (p < 0.05). The chemotherapy group experienced higher levels of nausea/vomiting, constipation and financial difficulties in all cycles (p < 0.05). Fatigue and appetite loss were significantly greater from cycle 2 and insomnia was significantly greater from cycle 3. On the contrary, the immunotherapy group experienced higher levels of diarrhea in cycles 5 and 6 (p < 0.05). Conclusions: Although both therapy groups did not report significantly impaired QoL and severe symptoms, it seems that QoL improved in the immunotherapy group, which reported less symptom burden compared to the chemotherapy group.

Objective: This study aimed to analyze the general characteristics, job stress, burnout, and turnover intentions of Clinical Research Associates (CRAs). Our objective was to provide a reference point for devising strategies to reduce CRA turnover and burnout rates. Methods: A descriptive, quantitative, and correlative research design was used. A total of 126 CRAs completed a questionnaire that consisted of 115 items, with 21 items on general characteristics, 60 items on occupation-al role, and 10 items on personal strain in job stress. The Burnout Inventory scale was used to investigate 22 items of burnout, and turnover intentions was measured using a 5-item scale. Results: Of the 126 participants, 63 (50%) answered that they intended to leave their job within 1 year & the most of participants were nurse (n = 56, 44.4%). Job stress related to the occupational role of CRA’s vocational stress (r = 0.518), burnout (r = 0.406), and turnover intention (r = 0.181) of personal strain were correlated with each other. Job stress due to personal strain had an explanatory power of 18.7% as a factor influencing turnover intention. Conclusions: To reduce the turnover intention of CRAs, who play an important role in clinical research, it is necessary to find ways to re-duce job stress and burnout.

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 a process of implementing it. 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 2020). Results: Out of 6970 initial articles extracted from 4 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. Conclusion: Electronic nursing records are indispensable and beneficial for enhancing care quality, improving patient safety, and affirming the autonomy of the nursing profession.

Adolescence is a critical period for the development of self-perception, emotional well-being, and health-related behaviors. During this stage, adolescents undergo significant physical, emotional, and social changes that influence their overall health and interactions with their environment. This study analyzes the prevalence of behaviors related to self-perceived health, mood, and substance use among adolescents, identifies risk factors, and draws comparisons between different groups. It also examines how these factors interact with family and community dynamics to inform strategies for improving mental health care. Method: A descriptive cross-sectional study using questionnaires was conducted. Participants were adolescents aged 14 to 18 years from a school in the Baix Llobregat province of Catalonia. Descriptive and bivariate statistical analyses were performed using the chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were employed to describe the health behaviors and emotional states of the participants. Results: The study reveals significant variations in adolescents' self-perceived health, emotional management, and substance use patterns. Adolescents with lower self-perceived health and negative mood states tend to exhibit higher rates of substance use, particularly alcohol and tobacco. Gender differences were observed, with girls generally reporting better health awareness and emotional regulation compared to boys. Conclusions: This study highlights the need for integrated approaches to family, community, and mental health care. Findings emphasize the importance of early intervention programs addressing emotional well-being and substance use in a holistic manner. Public health policies should prioritize comprehensive strategies involving schools, families, and communities to foster healthier behaviors and improve adolescent mental health outcomes.

Individualized nursing care allows a systematic assessment and intervention, considers the patient's preferences, values, and context, and contributes to a positive care trajectory. However, its operationalization has proven to be challenging. This research aims to determine which items of nursing care individualization are most integrated into nurses' clinical practice, and those that are less included. A cross-sectional study was conducted on 122 eligible and registered nurses at a Hospital Center, in Ophthalmology (operating room and inpatient ward), Cardiology Service, Internal Medicine, and Medical Emergency Unit, in Portugal. The Indi-vidualized Care Scale nursing version (ICS-Nurse) was used for the assessment, including three sub-dimensions: clinical situation, personal life situation, and decisional control over care-related decisions. Analyses were performed using Cronbach's Alpha and Principal Component Analysis to confirm the relationships between the variables, suggested by the literature and previous studies. In the results, no statistically significant differences were identified between the sociodemographic profile and the sub-dimensions of individualization. Nurses overall have a good perception of the importance of individualized care (4.06 ± 0.46 ICS-A-NURSE), but face difficulties in its implementation during the last shift worked (3.97 ± 0.49 ICS-B-NURSE). The sub-dimensions more integrated into the care environment were clinical situations and decisional control, and the less integrated were the personal lives of patients. This study identifies key aspects of the individualization of nursing care in acute and perioperative settings, as its omission represents a failure to address the multidimensional health needs of patients, families, and caregivers. We suggest the development of training programs that promote a holistic approach, as well as future studies that consider patient outcomes related to the individualization of nursing care.

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.

Background and Objectives: Pregnant women living with HIV (WLHIV) are likely to be traumatized and stigmatized, hindering their ARV treatment uptake and leading to the spread of the virus and low quality of life. Previous research has examined HIV stigma reduction interventions, yet syntheses of such evidence among pregnant WLHIV have not been presented. Our literature synthesis aims to identify effective HIV stigma reduction interventions and create an emergent pragmatic framework for future education, research, and clinical practice. Methods: Mixed Systematic-Realist Review (MSRR), an innovative approach developed by our team, was applied to synthesize studies on stigma reduction interventions among pregnant WLHIV. Combining the principles and processes of systematic review and realist review, MSRR is a 5-step evidence-based, context-bound strategy, starting from topic identification through pragmatic framework creation. Results: Using pre-determined inclusion criteria to search for relevant articles in five databases, we identified 238 articles and then reduced them to four after using pre-determined exclusion criteria. All four studies were conducted in Sub-Saharan countries with adult pregnant WLHIV (n = 824). Multicomponent stigma reduction interventions in the literature yielded positive outcomes (de-creased stigma and lessened depressive symptoms). The emergent framework, depicted in a diagram format, was based on the input-process-output framework. Conclusions: The novel MSRR adopts the strengths of both systematic and realist reviews and can be applied across diverse populations. Additionally, the results and emergent pragmatic framework can be used for HIV stigma reduction education and to advance research and clinical practice.

Background: Chronic diseases are major causes of morbidity, disability, and death worldwide. In many cases, they are potentially preventable and treatable. Glaucoma is one of the leading causes of morbidity and blindness, the early recognition of which can help reduce the adverse outcomes of the disease. Health illiteracy among these patients and the absence of self-management of these diseases are barriers to effective management worldwide. Therefore, the present study aimed to calculate the level of health literacy and activity level of patients’ activation in self-management and to explore the link between them among patients with glaucoma in outpatient clinics. Material and methods: Convenience sampling of patients with glaucoma attending the outpatient ophthalmology clinics of a university hospital in Heraklion-Greece was performed. Convenience sampling was used to recruit 312 participants. Data were collected between November 2023 and May 2024. The Patient Activation Measure-13 (PAM-13) questionnaire, in its Greek version, was used to evaluate patients’ activation level in self-management, whereas the Greek version of the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) was used to assess health literacy. Results: Participants were classified as level 1(disengaged & overwhelmed) level in self-management (= 40.7, SD: ±29.9) and a sufficient health literacy level (= 10.7, SD ±3.7). However, there was no statistically significant relationship between health literacy levels and patient activation in self-management (p=0.602). Conclusions: Glaucoma patients experience challenges with health literacy and self-management activation, though there is no significant relationship between these two parameters. Multifaceted interventions seem essential for enhancing patients’ activation. Further research involving larger sample sizes, multi-center studies, and interventional design is needed.

When experiencing a variety of family negative events, families recognized as having high family resilience maintain and improve family functioning. It is important, therefore, to be able to assess families lacking in family resilience in order to prevent, reduce, or ameliorate family symptoms. The purpose of this study was to clarify the state of exerted family resilience in order to create an assessment scale for insufficiencies in family resilience (IFR). Family resilience is defined as “when a family becomes aware of family symptoms, its power to autonomously and actively improve its own family functions.” The results of a literature review of 22 cases from 16 studies on family resilience and the results of 28 semi-structured interviews with 28 parenting-age families in Japan were qualitatively categorized, and directed content analysis was conducted based on the Concentric Sphere Family Environment Theory. A total of 157 labels, with a total of 23 categories and 47 subcategories, such as “Can utilize relatives,” “Family members can communicate with members of other families,” “Family members can share information,” “All family members can communicate with one another,” “All family members can cooperate with one another,” and “Can share time with family,” was revealed. Thus, a variety of diverse aspects contributing to a family’s resilience, including family member interactions, entire family interactions, use of social resources, and religious and spiritual support, were revealed. The results of this study should be linked to the creation of the IFR.

Background: Cancer-Related Fatigue (CRF) is a prevalent and debilitating symptom in breast cancer patients, significantly impacting their quality of life and potentially affecting postoperative outcomes. Despite advances in breast cancer treatment, the long-term implications of CRF on prognosis remain unclear. Methods: This retrospective cohort study included 310 postoperative breast cancer patients from two large comprehensive hospitals. We systematically collected demographic, medical history, lifestyle, psychological status, and CRF data. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors. Random forest survival analysis, propensity score matching, Kaplan-Meier survival analysis, and restricted cubic spline analysis were utilized to comprehensively evaluate the relationship between CRF and postoperative prognosis. Results: Higher CRF scores were associated with worse postoperative outcomes (HR = 1.07, 95% CI: 1.03-1.10, P < 0.001). Other independent prognostic factors included higher HADS scores (HR = 1.09, 95% CI: 1.01-1.17, P = 0.032), not undergoing breast-conserving surgery (HR = 0.43, 95% CI: 0.20-0.89, P = 0.024), and not receiving endocrine therapy (HR = 7.13, 95% CI: 2.64-19.22, P < 0.001). Random forest survival analysis highlighted CRF as the most critical variable impacting prognosis. Propensity score matching effectively balanced baseline characteristics, and Kaplan-Meier survival curves demonstrated significantly lower survival rates in high-CRF patients both before and after matching (P < 0.05). Restricted cubic spline analysis revealed a nonlinear relationship between CRF scores and disease progression risk, with significant risk increases beyond specific thresholds. Conclusions: CRF is a crucial predictor of disease progression in postoperative breast cancer patients. Higher CRF and HADS scores, non-breast-conserving surgery, and lack of endocrine therapy are associated with poorer prognosis. These findings underscore the importance of comprehensive postoperative care, including effective management of fatigue and psychological health, to improve patient outcomes. Future research should focus on prospective studies and targeted interventions for CRF to validate these findings and enhance clinical practices.

Work disparities experienced by nurses in long-term care (LTC) can impact the retention, well-being, and health of this workforce. Despite the significant impact disparities experienced by nurses have on the workforce and LTC sector, a review of the available literature on work disparities has not been conducted on work disparities experienced by nurses in LTC. Consequently, this scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and how such disparities are linked with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO host). Of the 5,652 articles retrieved, 16 studies published between 1997 and 2024 met the inclusion criteria. The average number of work disparities within each study was 3.06 (minimum = 1, maximum = 6, SD = 1.62). Types of work disparities across the 16 studies were work opportunities (n = 19), work treatment (n = 18), job security (n = 8), and work compensation (n = 8). Only four articles investigated the association of a work disparity with a variable of health and well-being. Future research on how macro-level disparities intersect with meso-level work disparities may inform a contextual understanding of how disparities transpire in the work of nurses in LTC. Studies are required to address the gaps in knowledge regarding how work disparities negatively influence the health of nurses to inform better retention, well-being, and health of nurses in LTC.

Background/Objectives: Resources to cope for maternity and women’s participation are essential modulators of maternal well-being. Therefore, it is relevant that the psychosocial factors of woman will be monitored during maternity to promote adequately healthcare. This study consisted in the design and the validation of two new tools that identify women's knowledge of obstetric healthcare rights (MatCODE) and perception of resource scarcity (MatER) during pregnancy, labor and early postpartum; Methods: The content validity was carried out using the Aiken's V coefficient and the content validity index (CVI-i) based on 5 experts. In addition, for the face validity of the pilot cohort was considered the INFLESZ scale. Finally, the questionnaires were applied to 185 women, which allowed to assess the construct validation by factorial and Rasch analysis. The divergent validity was also studied with validated psychological questionnaires; Results: MatCODE and MatER questionnaires received CVI-i and Aiken's V&gt;0.80 values, also the INFLESZ demonstrates acceptable semantic understanding. The analysis confirms the unidimensional of the questionnaires with fit values for MatCODE of RMSEA=0.113 [0.105; 0.122] and MatER of RMSEA=0.067 [0.063; 0.072]. The divergent validity showed significative and consistent correlations with the constructs assessed. In MatCODE was =0.95 and =0.94 and in MatER was =0.79 and =0.78; Conclusions: MatCODE and MatER are new useful tools monitoring maternal healthcare, with adequate psychometric characteristics in Spanish context.

This paper investigates the integration of artificial intelligence (AI) and robotics in healthcare, highlighting the potential of autonomous humanoid robots to replicate compassionate care while centering on ethical and safety concerns related to reliability, quality, and empathy. It reviews the benefits, challenges, and ethical considerations of deploying humanoid robots in care settings, including user acceptance and technological limitations, and questions their ability to genuinely simulate compassion. Through multisensory simulations of human-robot interactions (HRIs) using agent-based modeling, the study reveals complex dynamics among patients, robots, and healthcare systems, suggesting that advanced robot designs can enhance personalized sensing with quantum and neuromorphic information processing. Additionally, it analyzes the philosophical implications of robotic nursing care, advocating for a posthumanist perspective that recognizes nonhuman caring agencies, and concludes with recommendations for future research to improve communication and humanize the capabilities of robots in caregiving.

AI-driven tools can identify nursing students' strengths and weaknesses, thus enabling the development of customized learning plans that target specific areas for improvement. This targeted approach can enhance knowledge retention and skill development, resulting in better prepared healthcare professionals. Nursing students are required to overcome their own psychological stress during their internship in order to understand sick children’s emotional reactions, as well as to be able to interact and communicate with such children. The application of AI picture-based teaching e-books helps nursing students to understand how to use therapeutic games to improve communication with sick children. A comparison of the differences between nursing teachers’ self-efficacy scores and nursing students’ application of AI picture-based teaching e-books (experimental group) and narrative handouts (control group) was achieved via therapeutic games to deal with sick children’s fear of medical examinations and treatments. In addition, a comparison was also conducted on the differences between the impact of the self-efficacy of the experimental group and that of the control group in dealing with sick children’s behavioral responses with respect to fears of medical examinations and treatments. This study is a quasi-experimental study, in which the self-efficacy scores of 30 nursing students were collected and analyzed in both the experimental group and the control group before and after intervention in dealing with sick children’s behavioral responses to fears of medical examinations and treatments. It was found that the self-efficacy score of the experimental group was higher than that of the control group (β coefficient is 0.356) when assessing the self-efficacy scores and behavior of the experimental and control groups in dealing with sick children’s fears of medical examinations and treatments through one-way analysis of covariance (one-way ANCOVA), moreover, a statistically significant difference (p < 0.05) was observed. The experimental group’s score of behavioral responses to the fears of sick children to examinations and treatments was lower than that of the control group (β coefficient was -1.540), wherein a statistically significant difference (p < 0.05) was shown. The self-efficacy of the experimental group in dealing with sick children’s fears of medical examinations and treatments had a statistically significant impact on the sick children’s behavioral responses to the fear of medical examinations and treatments (p < 0.05). In addition, the higher the self-efficacy scores of the experimental group in dealing with sick children’s fear of medical examinations and treatments, the lower the sick children’s behavioral responses to fears of medical examinations and treatments (the β coefficient was -0.914), the control group’s self-efficacy scores in dealing with sick children’s fears of medical examinations and treatments did not have a statistically significant impact on the sick children’s behavioral responses to fears of medical examinations and treatments (p > 0.05). This study proves that the application of AI picture-based teaching e-books by nursing teachers is more effective than narrative handouts in improving nursing students’ self-efficacy when using therapeutic games to deal with, as well as reduce, sick children’s fears of medical examinations and treatments.

The comfort of the elderly in hospital settings requires a special attention from the involved health care professionals, particularly nurses, since hospitalization often generates suffering and discomfort. In such contexts, it is essential to take into account the specific characteristics of the elderly, considering their life experiences and their needs, to promote the health, well-being, and comfort of this population. Hence, the present work aimed to explore the nursing interventions that promote comfort among the elderly in hospital settings. A mixed descriptive exploratory study was conducted, through the application of a questionnaire, using intentional non-probabilistic sampling. The study encompassed 55 elderly individuals hospitalized in a medical service of a public hospital located in Lisbon. The results show that the participants perceived a reasonable level of comfort (5.65 ± 6.46). The following categories emerged from the content analysis: 1) Physical interventions; 2) Psycho-spiritual interventions; 3) Socio-cultural interventions; and 4) Environmental interventions. These findings help to understand comfort-promoting nursing interventions in the studied population. It was concluded that, to improve care quality, comforting interventions should focus on the elderly patient’s individuality, through support activities, empowerment, and the preservation/correction of the surrounding environment. Additionally, the provided care should be based on the real needs, expectations, preferences, and values of the elderly individual.

This cross-sectional survey assessed the resilient coping levels and their relationship with the socio-demographic characteristics of nursing professionals in Saudi Arabia. Adult (≥18 years) registered nurses and practicing for ≥1 year were included. Resilient coping levels (as assessed via a 4-item Brief Resilience Coping Scale; BRCS) and socio-demographic and other characteristics data were collected. Descriptive analysis and ordinal logistic regressions were used to analyze the data. Further, the psychometric properties of the BRCS were reported. A total of 216 nursing professionals were included. The mean BRCS score was 14.6 (standard deviation=3.6), with most nursing professionals (62.5%) reporting medium to high resilience coping levels. The ordinal logistic regression model demonstrated that increasing age (p=0.002), best overall health (p=0.001), and nurses posted in the outpatient department (p=0.049) and intensive care unit (p=0.032) had significantly high resilient coping levels. The internal consistency of the BRCS was good (Cronbach’s alpha=0.80). In summary, nursing professionals in Saudi Arabia showed medium resilient coping levels. Moreover, this study suggests that BRCS is a psychometrically reliable and adequate tool for assessing resilience coping levels and provides valuable insights into the relationship between resilient coping levels and socio-demographic characteristics of the nursing professionals in Saudi Arabia.

Effective leadership is reflected by evidence-based attributes, competencies, and behaviors. The Future of Nursing Report (2011) identified a gap in leadership knowledge, recommending development of creative and innovative strategies to strengthen nursing leadership curricula. These results provided an impetus and charge for nursing education to reexamine and revise leadership content. This mixed methods study analyzed baccalaureate and masters nursing students’ development of their leadership knowledge and skills. Through reflections, undergraduate (n=60) and master’s (n=52) students identified their perceived priorities and tips for success for nursing leaders across the healthcare continuum. Qualitative content analysis aligned students’ comments with the American Organization for Nursing Leadership (AONL) Nurse Executive Competencies (2015). Descriptive data provided the summaries of which leadership competencies were represented. Alignment to the competencies varied, commensurate with the level of educational program: BSN-level management skills vs. MS-level executive skills. Common responses across both programs prioritized communication, professionalism, and leadership behaviors. The results provide an opportunity for students’ synthesis of leadership skills and practices, may guide educators in the design of multi-level leadership curricula, and support development of clinical leaders in practice. This study was prospectively registered with the Campus Institutional Review Board on January 23, 2023, protocol code: 0086-001.

The survival rates of women with stage 0 or 1 breast cancer stands at almost 100% and around 93% for stage 2. As the disease advances with decreasing survival, the rate detoriates to 72% for stage 3 and about 22% for stage 4 (ACS, 2018). Undoubtedly, earlier presentation is synonymous with better prognosis and survival. In fact data indicates that early stage breast cancer diagnoses has 90% survival rate as compared to 27% for the advanced states (ACS, 2018). In this regard, governmental and non-governmental agencies are working tirelessly towards the realization of improved breast cancer care and survival through early presentation and detection. For instance, the Sustainable Development Goal (SDG) Target 3.4 seeks to reduce by one third, premature mortality from cancers and other non-communicable diseases through prevention and treatment. Clearly, early presentation, diagnoses and treatment will assist in the realization of the SDG target 3.4 goal. To achieve this, research must be focused on early presentation among women with breast cancer.. However, current studies have focused mainly on advanced breast cancer regarding treatment, symptoms experience (emotional and psychological), coping and support systems, and the reasons for delayed diagnoses and treatment. Objective In this review, it is argued that, rather than focusing on advanced breast cancer which has been adequately explored, the attention has to be on what measures or approaches promote early presentations among Ghanaian women. Methods The review included all primary studies that provided answers to the phenomenon of interest. It included both quantitative and qualitative studies. Search scope encompassed studies within the last ten years; thus from 2010 to 2020 irrespective of the country of study.Studies were included if: The paper is of a primary study; the study population included women with early BC or BC symptoms; the study outcome is the association between early stage breast cancer and earlier presentation; the study has a comprehensive data analysis protocol; the results of the studies are unique.A thorough literature search was conducted using the following electronic database: Google scholar and Pubmed. Google scholar alert on new studies was subscribed. This gave update on newly published papers for appraisal and possible inclusion.Manual identified of other potentially eligible publications by searching the reference lists of retrieved studies was also done. After a thorough search, this review included studies from several countries around the Globe such as Ireland, London, Turkey, Iran, Ghana, Kenya, Ethiopia etc Data Collection The title and or abstract of all retrieved papers were independently scanned through to establish which studies should be further evaluated. The full texts of these potential articles were then assessed. Extraction The Cochrane extraction form for data extraction was resorted to. From each eligible article, the following study identifiers/information were extracted: author(s), first author, year, title, objective, article type, location, setting, study design and method, sample size, instruments used, and results. Results Prompt help seekers mainly self-discovered their BC, and this occurred through accidental touch, after menstruation, through breastfeeding, during grooming, and while taking their bath.Notably, women who were termed prompt help seekers had higher seriousness perception of their symptoms. This was likened to their level of understanding and awareness, as well as periodic examination and comparison. Similarly, women who knew they were at risk for breast on account of family history, and increased incidence of BC in their localities, labeled their initial symptoms as requiring prompt attention.Following interpretation and labeling of symptoms, the participants generally resorted to symptom monitoring until the onset of additional and or intense symptoms. Though most women thought of benign growths, a few feared it could be malignant. These emotional reactions led the women to purposively seek clarification by selectively consulting others. Further, participants opened up to social acquaintances such as family relationships, people with prior experience of breast disease, and in some few instances health professionals. Some women also resorted to media items to better their understanding. Remarkably, prompt help seekers sort for help within one month. Last but not least, some women first communed with their creator after discovery and labeling based on their spiritual affiliations.Also, researchers should consider conducting surveys to assess the BC risks for specific smaller groups. This would help tailor specific educational interventions to promote earlier presentation and treatment among the vulnerable.

The exposure of employees to specific risks is usually due to increasing levels of work-related stress, which negatively affects their skills and effectiveness in their job duties, lead-ing to the onset of physical/mental illnesses, mistakes, or even accidents. The aim of this study is to investigate the psychosocial risks experienced by nurses in tertiary hospitals in Greece and their association with their attitudes towards safety and the occurrence of medication errors. The research was conducted in four tertiary hospitals in Greece, with the participation of 514 nurses of all educational levels. Questionnaires were used to collect data on work-related stress, professional burnout, and medication errors. The results highlighted that psychosocial risks, such as high work pressure and lack of support, are directly linked to professional burnout and an increased likelihood of medication errors. The necessity of social support, job autonomy, and work-life balance are underscored as critical factors for reducing stress and improving the quality of care. Specific strategies are proposed to enhance the mental health of nurses and improve working conditions.

Sleep is a crucial aspect of geriatric assessment for hospitalized older adults, and implementing AI-driven technology for sleep monitoring can significantly enhance the rehabilitation process. Sleepsense, an AI-driven sleep-tracking device, provides real-time data and insights, enabling healthcare professionals to tailor interventions and improve sleep quality. This study explores the perspectives of an interdisciplinary hospital team on implementing Sleepsense in geriatric hospital care. Using the Interpretive Descriptive approach, we conducted focus groups with physicians, nurses, care aides, and an activity worker. The Consolidated Framework for Implementation Research (CFIR) informed our thematic analysis to identify barriers and facilitators to implementation. Among 27 healthcare staff, predominantly female (88.89%) and Asian (74.1%) and mostly aged 30-50 years, themes emerged that Sleepsense is perceived as a timesaving and data-driven tool that enhances patient monitoring and assessment. However, barriers such as resistance to change and concerns about trusting the device for patient comfort and safety were noted, while facilitators included training and staff engagement. The CFIR framework proved useful for analyzing implementation barriers and facilitators, suggesting future research should prioritize effective strategies for interdisciplinary team support to enhance innovation adoption and patient outcomes in rehabilitation settings.

Background: School nursing plays a crucial role in promoting the health and well-being of students in educational settings. Previous research has highlighted its protective effect across various health domains, including substance use, mental health, violence, and sexual health. Despite its importance, the job satisfaction of school nurses and the factors influencing it have been insufficiently addressed in scientific research, underscoring the need to better understand their challenges and barriers. Therefore, the objective of this research is to evaluate the perceived job satisfaction and professional quality of life of school nurses at a national level in Spain. Methods: A descriptive cross-sectional study was conducted using the Font-Roja Job Satisfaction Questionnaire and the CPV-35 Professional Quality of Life Questionnaire. The sample included 553 school nurses from different geographical regions in Spain, selected through school nursing groups and associations. Data were collected from November 2023 to February 2024. Results: The majority of the nurses were women (68%), with a median age of around 40 years and predominantly less than 5 years of work experience (56%). Significant differences were observed in job satisfaction and professional quality of life depending on the employing entity (healthcare and educational settings). Factors such as workload, institutional support, and work experience influenced the perception of job satisfaction. Conclusions: We affirm that this study, being one of the first of its kind at a national level in Spain, highlights the need to develop effective strategies to improve the job satisfaction and professional quality of life of school nurses. School nurses in Spain present a moderately high level of job satisfaction, although there are significant differences in factors such as status and job monotony depending on the sector of employment (Healthcare, Education, Others). Nurses in educational contexts report lower levels of job satisfaction, influenced by the nature of the work, interpersonal relationships, opportunities for professional development, and institutional support. Additionally, work experience impacts satisfaction, being more positive for nurses with greater experience. We also affirm that the professional quality of life of school nurses is homogeneous, with an average score of 6.000 on the CPV-35. Although professional competence is uniformly perceived, work pressure is a common concern. Working more than 37.5 hours per week is associated with higher professional quality of life, although also with lower job satisfaction. Only half of the schools have a school nurse, highlighting the need for policies that ensure equity in service provision. There is also a recognized need for health training for teachers, which could improve support for nurses and student health. Active interaction with the educational community reinforces the integral role of school nurses and emphasizes the importance of the socioeconomic context in interventions and resource allocation. Keywords: School nursing, job satisfaction, professional quality of life, work factors, educational settings.

This study sheds light on personal characteristics of and the coping strategies that older Canadians self-identifying as severely anxious post-COVID-19 were more and less prone to gravitate to. Our studied sample consisted of 606 older people residing in 10 Canadian provinces. Participants completed the Geriatric Anxiety Scale – 10 and a personal checklist of everyday coping strategies for mitigating anxiety. Severely anxious older Canadians tended to be in their 60s, and in poor to fair health. They were not significantly more likely to be women or to be chronically ill, nor to self-identify as non-binary or as having a life partner. Older Canadians experiencing severe anxiety were, however, far more likely to normalize their fear and anxiety, challenge their worries, and to relax or meditate. They were less inclined to decrease other sources of stress in their lives, to stay active, and to get enough sleep. We offer anticipatory guidance for mental health program planners and practitioners, and researchers, fruitful avenues of inquiry.

Catheter-associated urinary tract infections (CAUTI) are a recurring problem for individuals with neurogenic bladder who rely on frequent intermittent catheterization. Dysbiosis of the urine microbiome, characterized by the presence of pathogenic organisms and insufficient levels of Lactobacilli, is common in this population. We propose that introducing beneficial Lactobacilli via a catheter lubricant could act as a prophylactic "live barrier" to enhance beneficial bacteria in the urethra. The IC TF1 Catheter Lubricant gel discussed in this study is a freshly prepared viscous gel composed of sterile gelling components and a dry Lactobacillus Rhamnosus spp. powder. The gel prepared on- site by simple mixing, is usable for 24 hours with predictable and precise viability counts. Our investigation focuses on the design, physical attributes, manufacturability with quality control criteria, stability of probiotic viability, antimicrobial properties, cellular toxicity, and tissue compatibility of the IC TF1 gel. The gel demonstrates promising physical properties and biocompatibility, leading to the need for further pre-clinical and human trials to assess its safety and effectiveness in reducing pathogenic urethral colonization.The localized delivery of probiotic supplementation through catheter lubrication has the potential to enhance the well-being of individuals with neurogenic bladder and aid in the management of CAUTI.

In diabetic foot injury prevention, no studies relate physical activity with the inflammatory response of the plantar tissues, evaluated by thermography and pressure distribution. These measurements are easy to be implemented in diabetic foot follow-up. The objective of this study was to analyze whether the plantar skin response, evaluated with thermography, after physical activity in healthy or diabetic patients, is a foot ulcer prognostic tool and to asses if there is a correlation between exercise intensity, plantar pressure and plantar thermographic response. A systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format in the PubMed, Scopus and Web of Science databases, with no year limit during the second quarter of 2024. A total of 14 studies have been included in this review. The use of infrared thermography for early inflammatory tissue detection, plantar pressures and the monitoring of controlled physical activity, make possible to monitor changes that allow the identification of patients at risk of developing foot ulcers.

Introduction: Adolescence is a critical period for the development of affectivity and sexual-ity. Adolescents begin to explore their sexual identity, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the 4th year of ESO, identifying risk factors, comparing behaviors and risks, monitoring these behaviors, analyzing pornography consumption, and evaluating the use of the in-ternet as a source of sexual information. Method: Descriptive cross-sectional study using questionnaires. Participants are 4th-year ESO students from a school in the Baix Llobregat province (Catalonia) aged between 14 and 18 years. Descriptive and bivariate statistical analyses were conducted using the Chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were also used to describe the health behav-iors of the participants. Results: The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use man-agement vary between genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in age of initia-tion and frequency between boys and girls. Conclusions: The study on adolescent affectiv-ity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors in municipal public health.

Emotional intelligence may help nurses to cope with demanding work environments. Although it is well known that emotional intelligence is positively related to work performance literature on nurses is limited. The aim of our study was to examine the impact of emotional intelligence on work performance in a sample of nurses in Greece. We conducted a cross-sectional study in Greece. We collected data from a convenience sample of nurses during January 2024. We measured emotional intelligence with the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), and work performance with the Individual Work Performance Questionnaire (IWPQ). We created multivariable linear regression models adjusted for sex, age, educational level, and work experience. We found that the four streams of emotional intelligence (i.e. well-being, self-control, emotionality, sociability) increases nurses’ work performance. In particular, we found a positive relationship between well-being and task performance and contextual performance. Similarly, there was a positive relationship between self-control and task performance. Additionally, sociability increased task performance and contextual performance. Moreover, emotionality and sociability reduced counterproductive work behavior. Our multivariable models identified a positive impact of emotional intelligence on nurses’ work performance. Nurses managers and healthcare organizations should adopt appropriate interventions to improve nurses’ emotional intelligence.

Several years now, the global scientific community has accepted and recognized the importance of Evidence-based practice (EBP) for Nursing science. The main factor for the implementation of EBP is the competence of undergraduate Nursing students towards EBP, so that they as active nurses be ready for its application in their clinical practice, in order to provide better care for their patients. The aim of the present study is to examine the level of evidence-based practice competency evaluated with the self-reported EBP-COQ questionnaire. A quantitative study based on cross-sectional design was conducted from February to June 2022 in a convenience sample of Greek undergraduate nursing students. The Evidence-Based Practice Competence Questionnaire (EBP-COQ) and a questionnaire on undergraduate students’ gender, age, academic year, and training in the field of research were used. The SPSS 26.0 program was used to perform descriptive, bivariate and multivariate analyses. A total of 175 undergraduate students participated at the Hellenic University Nursing (Greece), specifically from the 2nd and 3rd academic year. The mean score of EBP-COQ for nursing undergraduate students was 3.03 ± 0.26, indicating moderate EBP. Among the EBP-COQ dimensions, the mean scores were obtained 3.03 ± 0.32 for Attitude toward EBP, 3.01 ± 0.49 for Skills in EBP, and 3.03 ± 0.49 for Knowledge in EBP. They were not found significant differences among participants’ mean EBP-COQ scores regarding gender (p = 0.766), age (p = 0.400), academic year (p = 0.153), and training in the field of Research Methodology (p = 0.538). It appears that the level of readiness towards EBP is mediocre between undergraduate nursing students at a university in Greece. Therefore, it is necessary to carry out new studies in the future, so that there is a correct approach of all the elements that contribute to the readiness of Nursing undergraduate students regarding EBP.

There is a lack of studies on the level of stress and health of families of workers in road transport. This study aimed to evaluate the perceived stress level and Family Effectiveness of family members of road transport workers. A quantitative study was carried out with family members of road transport workers in the southern region of Brazil. For the data collection, a sociodemographic form, the Perceived Stress Scale (PSS), and the Evaluation of Family Effectiveness Strategies were used. The data were analyzed by simple frequency, Spearman correlation coefficient (ρ) (p &lt; 0.05), and descriptive analysis from the perspective of the Systemic Organization. 49 family members of road transport workers were participants. Perceived stress was higher in family members who had more than nine years of schooling, the targets of Control and Growth were higher in the evaluation of Family Effectiveness. The Control target was also higher in families with more than three people. The Coherence dimension had higher levels in families with health problems and whose income was less than $792.00 US dollars per month. In the Individuation dimension, income over $792.00 had better results. The Maintenance dimension of the system was higher in families whose drivers’ activity was as an intercity driver, as well as in the Stability target. In conclusion, the social factors such as schooling, income, diseases, type of worker activity in road transport, and number of people in the family influenced perceived stress and Family Effectiveness, which demonstrates the need to increase the promotion of health care of the families of road transport workers.

Age diversity in the workplace is a growing challenge. This study aimed to assess work ability among Family and Community Nurses (FCNs) in a large Local Health Authority (LHA) in Tuscany, Italy. The Work Ability Index (WAI) was administered to 178 FCNs, along with demographic and occupational data. Results showed a significant negative correlation between chronological age and WAI, indicating decreasing work ability with age. Moreover, work setting, educational attainment, and health conditions influenced work ability. Nurses working in home settings and those with higher educational levels reported better work ability. A high prevalence of health conditions, particularly musculoskeletal disorders, was observed. These findings highlight the need for targeted interventions to support FCNs' work ability and address age-related challenges. This study provides a foundation for developing strategies to optimize the nursing workforce and ensure high-quality care delivery.

(1) Background: With the global population aging, the demand for effective rehabilitation products for the elderly is increasing. Traditional products often fail to meet the comprehensive needs of elderly users, who require solutions addressing physical, psychological, and social aspects; (2) Methods: Using the Analytic Hierarchy Process, Quality Function Deployment, Axiomatic Design, and the System Usability Scale to identify and prioritize user needs, market research and user interviews were conducted to understand the preferences of the elderly and obtain design specifications. The focus was on multimodal sensory feedback, which was validated through the study; (3) Results: Elderly users have a strong preference for rehabilitation products that are durable, easy to use and have comprehensive sensory feedback. Intelligent rehabilitation bed as the carrier, strengthened structure, high strength material, ergonomic adjustment, integrated health monitoring system. Using digital technology for real-time health monitoring and personalized feedback to provide a comprehensive recovery experience, high user satisfaction was reported in the evaluation; (4) Conclusion: It is important to emphasize user-centered design and integrate multi-modal sensory feedback to meet the comprehensive rehabilitation needs of elderly users. Future studies should expand user samples and expert opinions to refine and validate the design and improve its effectiveness and usability.

The implementation and sustainability of evidence-based practice (EBP) is a complex process. Best practice guidelines (BPGs) can facilitate the translation of knowledge from theory into practice, but they require working groups to adapt recommendations and encourage adherence to them. The aim of this study was to identify facilitators and barriers of BPGs in the Registered Nurses’ Association of Ontario®, within the framework of Best Practice Spotlight Organisations® (BPSOs®), in a hospital setting. The study was conducted using the modified Delphi method (two rounds) with a cohort of BPSO® Best Practice Champions. The facilitators and barriers included in the first round were identified through a bibliographic search. The degree of concordance was determined in the second round using the highest mean resulting values. A total of 44 nurses responded, with a mean age of 42.57±8.563. Facilitators included: Work Environment; Working in a hospital that encourages research; and Dedicating time to EBP (p&lt;0.001). Barriers: Excessive workload; Professional mobility (p&lt;0.001); and Lack of time (p=0.002). As such, it is necessary to approach human resource management by implementing new policies that guarantee systemic sustainability. The BPSO® programme is an excellent framework for promoting the translation of theoretical knowledge into practice and effecting institutional change.

Substance abuse is a significant public health issue both globally and nationally. Substance abuse involves the detrimental or risky consumption of psychoactive substances, posing a significant global issue, particularly among the youth. In India, cannabis abuse is a major concern. Cannabis is consumed legally in many states as Bhang, also known as marijuana or weed, while Charas and Ganja are illegal under both international drug conventions and the Indian NDPS Act of 1985. The Cannabis users are at great risk of developing Cannabis use disorder which is a pattern of problematic cannabis use leading to clinically significant impairment or distress. It is the most widely used illegal substance worldwide, showing a high prevalence in India.

Background: The use of complementary therapies in the population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our objective was to investigate Spanish universities that offer subjects on complementary therapies in their Nursing degree programs. Methods: Observational descriptive cross-sectional study. For this purpose, we used the document published on the website of the Ministry of Universities as a working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. Results: Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, with most of them being elective courses. Conclusions: The training content on complementary care in Nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.

This study analyzed the risk of falls in the elderly and the safety of the environment in a teaching hospital in Brazil. The Morse Falls Scale was used to stratify the risk of falls in 45 hospitalized elderly individuals, and a checklist was used to analyze the hospital environment. The analysis was based on the chi-square test and multiple regression. The moderate risk of falls was predominant (51.1%). The variable age group (p-value = 0.024) showed statistical evidence of association with the risk of falls. However, the multiple regression analysis showed no difference between the age groups and the risk situation for falls. The hospital wards showed an adequate arrangement of furniture, but some aspects had inadequacies, such as objects in the corridors, non-functional bells in some beds, and inadequacy of the toilet bowls in terms of the recommended height, the absence of non-slip flooring and the support bar in some bathrooms. In conclusion, the moderate risk of falls among the elderly and the adequacy of the hospital environment to technical standards were evident, with the exception of failures in the emergency communication system and sanitary installation.

Detecting and evaluating pain in people with cognitive impairment, especially dementia, is a challenge. Their ability to accurately report pain and comprehend related questions decreases the reliability of their self-report. This has contributed to the fact that pain is underdiagnosed and undertreated in this population, which can lead to involuntary ageism. The design and assessment of this training capsule under the context of the European COST-Action TD1005 responds to the need for education and training in "Pain Assessment In Cognitive Impairment, especially dementia" and the development of the internationally agreed observational PAIC15 scale. The 3-hour capsule, intended for healthcare workers and caregivers, consists of theoretical-practical levels: 1) basic concepts and challenges in pain in aging, cognitive impairment/dementia, 2) available scales and PAIC15, 3) video presentation of clinical cases illustrating a 3×2 matrix of situations (rest, transfer and experimental pain) and stages of disease (mild and moderate). The objectives focused on training the ability to observe, detect, and assess the signs of pain using PAIC15 and its feasibility. The pre-post analysis in a Master educational setting showed agreement with the results obtained in the Spanish national survey on 1) scarce knowledge of observational tools and their use, and 2) uncertainty in the identification of signs of pain and feasibility in moderate/severe scenarios. The capsule improved the ability to identify and evaluate the pain items, especially facial expressions, and their confidence on observational tools. Debriefings highlighted the relevance of observational scales in dementia and the gain obtained using the new observational instrument.

: Background. Delivering bad news is a sensitive and challenging aspect of nursing healthcare, requiring a holistic approach that respects patients' preferences, cultural values, and religious beliefs to promote adaptation to the state's health. Aim: map the evidence of the dimensions present in the communication and management of bad news by nurses, with the person in a palliative situation, their caregivers, and family members. Methods: Based on Joanna Briggs Institute methodology, the search was conducted through MEDLINE Complete (EBSCOhost), CINAHL Complete (EBSCOhost), SciELO, and Open Access Scientific Repository in Portugal. From a total of 756 articles, 14 were included, published between 2018 and 2023. Results: Structure components in bad news are influenced by the characteristics of the palliative patients, their caregivers, family members; nurses; and the organizational environment. Promoting the quality of the communication process is desirable through continuous and advanced training in end-of-life; training in bad news; religiously and culturally sensitive nursing interventions centered on hope and maintaining faith; emotional management; and utilization of a checklist protocol. Conclusions: Honest communication allows people to actively participate in the decision-making process and in the trajectory of the care plan that is focused on themselves and their preferences, which has outcomes in functional capacity and readaptation.

Placing a nasogastric tube (NGT) is a frequent nursing technique in intensive care units. The gold standard for its correct positioning is the chest X-ray due to its high sensitivity but represents a radiation source for critically ill patients. Our study aims to analyze whether the ultrasound performed by an intensive care nurse is a valid method to verify the NGT’s correct positioning and to evaluate the degree of interobserver agreement between this nurse and an intensive care physician in the NGT visualization using ultrasound. Its correct positioning was verified by direct visualization of the tube in the stomach and indirect visualization by injecting fluid and air through the tube ("dynamic fogging" technique). 23 critically ill patients participated in the study. A sensitivity of 35% was achieved using direct visualization, increasing up to 85% using indirect visualization. The degree of interobserver agreement was 0.88. Therefore, the NGT indirect visualization by an intensive care nurse using ultrasound could be a valid method to check its positioning. However, the low sensitivity obtained by direct visualization suggests the need for further training of intensive care nurses in ultrasonography. According to the high degree of agreement obtained, ultrasound could be performed by both professionals.

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability worldwide. Patient treatment and management pose a challenge for healthcare systems. The prognosis of these patients may be influenced by factors such as sex. This study aims to describe the clinical parameters of patients hospitalized in the Intensive Care Unit (ICU) of a Spanish hospital due to Trauma Brain Injury and to establish differences based on sex. Methodology: An observational, cross-sectional, and analytical study was conducted from March 2015 to December 2019. All patients admitted to the ICU during this period who presented isolated significant Traumatic Brain Injury, defined as an abbreviated injury scale (AIS) ≥ 3, were included. Data on baseline characteristics, mechanism of injury, substance use, and acute management in the prehospital and hospital stages (including the need for hospitalization) were recorded. A descriptive and in-ferential analysis was conducted using the chi-square test. Results: A total of 950 patients were ultimately included. The majority of the patients were men (723) with a mean age of 45.16 (± 17.55). There were statistically significant differences in terms of the mechanism of injury (p

Introduction: Gestational diabetes mellitus (GDM) pregnant women are under more psychological stress than healthy pregnant women. The objectives of the current study were to examine: (1) The differences in anxiety, depression, stress, and somatization levels between women diagnosed with GDM and healthy pregnant women. (2) The differences in anxiety, depression, stress, and somatization levels among women with well-controlled blood sugar levels compared to those who are not well-controlled. Methods: A quantitative cross-sectional study was conducted, involving 103 women who had been pregnant at least once, including 40 women diagnosed with GDM and 63 healthy pregnant women. An online questionnaire was distributed and included three parts: a socio-demographic parameters, the DASS-21 questionnaire assessing anxiety, depression, and stress, and the BSI (Brief Symptom Inventory) questionnaire assessing somatization. Results: Differences in anxiety (t=14.470, <.001), depression (t=8.17, <.001), stress (t=16.354, <.001), and somatization (t=13.679, <.001) levels between women diagnosed with GDM and healthy pregnant women were found. Women diagnosed with GDM reported higher levels of anxiety, depression, stress, and somatization compared to those without GDM. Additionally, Women with better blood sugar control, indicated by lower glycated hemoglobin (HbA1c) levels, reported lower levels of anxiety. (t (38) = -2.04, p<0.05), depression (t(38)= -2.88, p<0.01), stress (t(38)= -1.88, p<0.05), and somatization (t(38)= -1.88, p<0.05) compared to women with poorer blood sugar control. Conclusion: Pregnant women diagnosed with GDM report higher levels of negative personality traits such as anxiety, depression, stress, and somatization compared to healthy pregnant women.

Background: Burns are a common and severe medical emergency requiring immediate specialized care to minimize damage and prevent complications. Burn severity depends on depth, extent, and location, with more complex care needed for burns on critical areas or extensive burns. Nursing is essential in burn management, providing immediate care, adapting treatments, managing pain, preventing infections, and offering emotional support for recovery. Methods: Retrospective, observational study that analyzed burn cases treated at the Hospital Complex of Cáceres (Spain) 2018-2022. Inclusion criteria were based on ICD-10 codes for burns, excluding severe cases not treated in this service. Data were analyzed using descriptive statistics, Student's t-tests, Chi-square tests, and ANOVA. Results: 220 patients, with a mean age of 47 years and 60.9% male. Most burns (95.5%) affected the external body surface, with a mean hospital stay of 7.86 days. Medical treatment was provided to 75.5% of patients, and 24.5% required surgical intervention. Significant differences in treatment procedures were observed according to age, skin thickness, and burn degree. Older patients had more procedures and longer hospital stays. Excision and transfer procedures were more common in full-thickness and severe burns. Conclusions: The findings align with previous research on burn demographics and treatment approaches. Treatment differences by age and burn severity highlight the need for tailored interventions. The study underscores the importance of comprehensive burn management, including psychological support for improved long-term outcomes. Further research could explore the impact of socio-economic factors on burn incidence and treatment.

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives with violent patients. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient's wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. Nurses' main concerns were the risk of falls and the use of the bags as a weapon. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least part of mechanical restraints. As with all ‘milder means‘, care should be taken to really replace restraint and not to introduce additional coercion.

(1) Background: Elite sport can increase vulnerability to developing mental health pathologies. The purpose of the study is to determine the frequency at which these behavioural disorders appear in elite footballers and evaluate their relationship with other addictions. (2) Methods: A cross-sectional study was conducted between November 2020 and January 2022 on 306 participants. The variables of gambling and gaming were studied. The different groups were compared using Chi-squared tests. Probabilities exceeding 95% (p-values &lt; 0.05) and residuals results greater than 2 or less than −2 were considered significant. (3) Results: There were significant differences between the two groups in terms of alcohol (p &lt; 0.001), tobacco (p &lt; 0.001), and cannabis (p &lt; 0.018) consumption. We also found differences between those who had a history of a nervous disease (p &lt; 0.015). 6.6% of the of football players had a probable diagnosis of gambling disorder compared to 1% in the general population (p &lt; 0.007). Among the pathological and non-pathological cases of gambling in the football population, significant differences were found between those with a salary of €900–1,500/month (p &lt; 0.033) or a history of a nervous pathology (p &lt; 0.001). (4) Conclusions: This study showed that professional football players were vulnerable to mental health pathologies related to gaming.

Innovation is a crucial issue in healthcare services since it can affect job-related variables such as productivity, satisfaction and burnout. The aim of our study was to examine the impact of innovation support on quiet quitting, innovative behavior and innovation outputs among nurses. We conducted a cross-sectional study in Greece during April 2024. We employed a convenience sample of nurses. We used the following instruments: (a) the Innovation Support Inventory (ISI) to measure innovation support, (b) the Quiet Quitting Scale (QQS) to measure quiet quitting, (c) the Innovative Behavior Inventory (IBI) to measure innovative behavior, and (d) the Innovation Outputs (IO) scale to measure innovation outputs. Our multivariable analysis identified a negative relationship between innovation support and quiet quitting. Moreover, we found that managerial support and cultural support improved several aspects of innovative behavior, such as idea generation, idea search, idea communication, implementation starting activities, involving others, and overcoming obstacles. Additionally, managerial support improved innovation outputs. Our findings suggested the positive impact of innovation support on quiet quitting, innovative behavior and innovation outputs among nurses. Organizations and nurses’ managers should establish an innovative working environment to improve nurses’ passion, motives and productivity.

This study aimed to translate and validate the Genomic Nursing Concept Inventory (GNCI) in Greek, analyze the genomic knowledge of nurses in Crete, Greece, and explore potential factors that could affect it. This cross-sectional study included 324 nurses from public hospitals and primary care units between July and December 2022. The GNCI is a 31-item questionnaire that evaluates genomic nursing concepts, but it has not been translated and validated in Greek. The translation process included independent forward translations, reconciliation, and back-translation. To evaluate internal consistency, Cronbach’s alpha was used, and Confirmatory Factor Analysis (CFA) was conducted to determine the fit of the model. Multiple linear regression analysis was performed to examine the associations between the demographic variables and GNCI scores. The internal consistency of the GNCI was acceptable (Cronbach’s alpha= 0.622). The CFA indicated that the one-factor model had an adequate fit (SRMR = 0.076, CD = 0.677, CFI = 0.744). The mean GNCI score was moderate (0.35±0.14). Regression analysis suggested that only gender could affect GNCI scores, with female nurses scoring higher than male nurses (p&gt;0.001). In conclusion, the Greek version of the GNCI is a reliable tool for assessing genomic knowledge among Greek nurses.

To identify the effect of frailty on loneliness of older adults receiving home care, considering their socioeconomic and homebound status. This cross-sectional study enrolled 218 individuals aged ≥65 years receiving home-based health services “Help at Home” in the Region of Evrytania, Greece, after an open invitation by Municipality authorities from March to June 2022. Tilburg Frailty Indicator (TFI) was used for the evaluation of frailty, UCLA Loneliness Scale version 3 for loneliness and social isolation was accessed through five questions (living alone, frequency of interaction with children, relatives, friends, and participation in social organizations). The mean age of the participants was 81.48 ± 9.06, 61.9% were female, 54.1% experienced high levels of loneliness (UCLA-3 mean 45.76 ±11.10 [range 20-68]), and 46.3% of the participants identified as socially isolated. Also, 58.3% of the individuals were classified as frail (TFI mean 5.95 ± 3.07, [TFI range 0-13], with 57.3% experiencing physical frailty, 43.6% psychological frailty, and 27.1% social frailty. An analysis of covariance (ANCOVA) placing UCLA-3 as the dependent variable revealed that loneliness and across all domains of TFI were significantly higher in participants with frailty (total frailty [yes] 49.27 vs. [no] 40,87 p &lt;0.001) particularly, (physical frailty [Yes]=48.99 vs. [No]=41.42, p &lt;0.001, psychological: 48.60 vs. 43.57 p &lt;0.001 and social: 53.38 vs. 42.94 p &lt;0.001) compared to non-frail individuals, even after adjusting for potential confounding effects (covariates: gender, age, marital status, family status, living status, educational level, annual income, chronic diseases, homebound status, and social isolation). Our data analysis confirmed that frailty is a significant risk factor for higher levels of loneliness among older adults who received home-based healthcare.

The complexity of the current social context leads healthcare professionals to deal daily with users who are increasingly varied in terms of culture, language and religion. Transcultural nursing is a practical discipline that aims to respond to the patient's need for assistance, but must not ignore the study and knowledge of the patient, with his history, his culture, but also with his expectations, in order to respond to his care needs with effectiveness, efficiency, adequacy and respect. This work originates from the desire to investigate the "state of health" of the relationship between nurses/health workers and migrant patients, researching the variables that improve or worsen it. It aims to investigate how diversity affects the care provided to migrant people, highlighting the difficulties felt by nurses and define the areas of possible care improvements. It seems possible to affirm that the nurses and health workers interviewed still respond to the problem of migrant patients with a strong spirit of participation and availability, without, however, this motivational charge being accompanied by a widespread "nursing" awareness of the problem.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

Background: The importance of knowing the workload of family nurses lies essentially in the possibility of improving health outcomes, care processes and the nurse’s professional life. There is a lack of studies that fully describe nursing workload in primary care, particularly, in the context of family health nursing, and the ideal metrics to be used remains unknown, making it impossible to characterize and therefor provide the necessary insight to acknowledge the different contributions of several aspects that embodies the global workload of family nurses. The objective of this scoping review was to map the known evidence and characterize the instruments used to assess the workload of family nurses. Methods: Scoping review, according the Joanna Briggs Institute proposed methodology for scoping reviews, consisting of 3 research stages: 1) initial research in Medline and CINHAL; 2) extended search, using keywords and search terms, in the following databases: JBI, CINAHL Complete, MEDLINE, Cochrane and Scopus; 3) Search the reference list of the selected articles. No time limit was defined. Results: Fourteen studies referring to ten as-sessment instruments were included. Nine of them analyze workload as a dimension of a broader instrument, and two studies refer to an instrument that focuses exclusively on workload. Con-clusions: The diversity of professional competencies and contexts, the conceptual complexity of workload and the absence of an theoretical framework, makes it difficult to identify consensual instruments to assess the workload of family nurses. This study was registered in Open Science Framework® with the following registration (https://osf.io/3k6vr).

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Introduction: Emotional intelligence plays a critical role in nursing leadership, influencing organizational dynamics and patient care. However, there is limited understanding of the impact of Emotional Intelligence on leadership in Primary Health Care in the Greek context. Methods: A longitudinal experimental design assessed the effects of an educational intervention on EI and leadership among Greek Primary Health Care nurses. Questionnaires, including the Wong and Law Emotional Intelligence Scale (WLEIS) and Multifactor Leadership Questionnaire - form 5x (MLQ), were administered pre- and post-intervention. Results: The intervention group exhibited significant improvements in Emotional Intelligence and adoption of transformational leadership styles compared to the control group. Tables highlighted nuanced changes in leadership dynamics post-intervention. Conclusions: Educational interventions effectively enhance nurses' Emotional Intelligence and influence leadership styles, emphasizing the need for tailored professional development programs in nursing education.

One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence negatively altered satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.

Introduction: The image of the nurse is a source of concern because of its impact on recruitment to the profession, policy decisions about the profession, funding of nursing services, consumer use of nursing services and how the image of the nurse affects nursing practice. Aim: This study aims to assess the psychometric properties of the Italian version of the Nursing Attitudes Questionnaire (NAQ-IV). Methods: 564 persons between the years 2022 and 2023 with heterogeneous ages and occupations from Northern, Central and Southern Italy participated in the study. Cronbach's alpha, item versus total correlations, skewness and kurtosis were calculated; factor analysis was performed using principal axis factoring and the viramax rotation method. Results: The results showed a Cronbach's alpha of 0.89 on the scale and between 0.88 and 0.89 between the factors; all items tested for correlation between the item and the total and the criteria for variance in the responses. Factor analysis showed a 4-factor model explaining more than 59.91% of the variance, with the largest variance being explained by the 'Role & professionalism' factor (25.96%). Conclusion: These results allow for a discussion regarding the theoretical framework of the NAQ-IV and provide a reliable and valid instrument for the comparison of welfare, organisation of health services, role, professionalism, stereotypes, values, advocacy, motivation and perceived satisfaction with the figure of the nurse and nursing care.

Micronutrient deficiencies remain a public health burden among non-pregnant women in developing countries, including Nepal. Hence, this study examined micronutrient deficiencies among non-pregnant Nepalese women aged 15-49 using the 2016 Nepal National Micronutrient Status Survey (NNMSS). Data on 2143 non-pregnant women was extracted from the 2016 NNMSS. The study analysed ferritin, soluble transferrin receptor (sTfR), red blood cell (RBC) folate and zinc. Multivariable logistic analysis was carried out to assess factors associated with micronutrient deficiencies. Prevalence of ferritin, sTfR, folate, and zinc were 19%, 13%, 16% and 21%, respectively. Non-pregnant women from the Janajati region were significantly less prone to ferritin [adjusted odds ratio (AOR): 0.45; 95% confidence interval (CI): 0.25, 0.80], and those who had body mass index (BMI) of 25 kg/m2 or higher had significantly higher odds of ferritin [AOR: 2.69; 95% CI: 1.01, 7.17]. Non-pregnant women aged 35-49 years were significantly less predisposed to folate deficiency [AOR: 0.58; 95% CI: 0.40, 0.83], and the likelihood of zinc deficiency was significantly lower among non-pregnant women from richer households [AOR: 0.48; 95% CI: 0.31, 0.76]. The study provides further insight into screening high-risk subgroups and instituting public health interventions to address the prevailing micronutrient deficiencies among non-pregnant Nepalese women.

The intelligent elderly care model places new demands on the skills of aging caregivers. The identification and development of forward-thinking, high-potential nursing talent is essential for advancing the intelligent elderly care sector. Multi-benchmarking selection and competitive analysis is used to evaluate and identify nursing personnel in the rehabilitation treatment center of a hospital in Hefei City. Using proxy evaluation and democratic evaluation model, three types of benchmarks such as single item benchmark, individual benchmark and group benchmark were identified and selected, and the professional nursing team was constructed based on the evaluation results. Different from the traditional other-directed evaluation, multi-benchmarking selection and competitive analysis is self-directed evaluation, this method is more conducive to the identification of high-potential and digital nursing talents by intelligent elderly service organizations, and facilitates the formation of professional nursing teams with complementary strengths and cross-fertilization, so as to satisfy the diversified and multi-level needs of the elderly for intelligent elderly services.

Background: Colorectal cancer (CRC) patients experienced multiple chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e., grading scales or diagnostic codes) predicts rehospitalization and cancer survival. However, a comprehensive synthesis of clinician-reported chemotoxicity is still lacking. Objectives: We conducted a systematic review and meta-analysis to determine the chemotoxicity's prevalence and risk factors in CRC. Methods: A systematic search from 2009 to 2024 yielded 30 studies for review, with 25 included in the meta-analysis. Results: Pooled prevalences of overall, non-hematological, and hematological moderate-to-severe toxicities were 45.7%, 39.2%, and 25.3%, respectively. The most common clinician-reported chemotoxicities were gastrointestinal (GI) toxicity (22.9%) and neuropathy or neutropenia (17.9%). Significant risk factors at baseline were malnutritional status, frailty, impaired immune or hepato-renal functions, short telomere lengths, low gut lactobacillus levels, age, female sex, aggressive chemotherapy, and low QOL. Age was associated with neutropenia (β: -1.44) and GI toxicity (β:1.85) (Ps 65 y.o.) had higher prevalences of overall (OR: 1.14) and GI (OR: 1.65) toxicities, but a lower prevalence of neutropenia (OR: 0.65) than younger adults (Ps

According to Young Minds [1] ‘everyone gets angry sometimes’. Their website offers a number of de-escalating strategies, including staying calm, managing responses and setting limits to help young people who most deem resistive. Yet, Young Minds are not alone because such logical advice is ubiquitous in the literature about challenging behaviour despite the fact that in our experience when faced with high states of arousal, most young people tend to act first and deal with the consequences later. It’s not that they are stupid or non-caring, but they are human capable of great feats as well as stupidity. The same is true for any claims that solution focused (SF) conversations can put right the several decades of psychological theory suggesting resistance requires logic and better cognition. By giving the correct thinking skills, young people will walk away from risk, avoid physical confrontation, handle challenging situations like logical thinkers, and generally discount that the process of growing up is part of the challenge. It is with this in mind that over recent years in our current SF practice (with staff group supervision) we have examined the concept of ‘resistance’ and how it can be put to use as a process of collaboration. To do this, we have revisited SF theory that preoccupied many of its pioneers during the 1980’s and 1990’s and attempted to make it useful for the early 2020’s for professionals having conversations with young people, who, in traditional models, are labelled challenging. We want to introduce key differences of solution focused practice and how Anita started to formulate a 6D-SF model (details, dynamics, dimensions, dispositions, dislocations, descriptions) for contemplating how groups of professionals relate to each other and are triggered by challenging behaviour. We do not claim to have proof, logic or exactness on our side, but we’re happy to suggest how our resistance mirrors what many of the staff teams feel and describe when working through their work.

1) Background: Several studies have shown the benefit of drawing when learning anatomy. Virtual Reality (VR) also appears to be useful to increase the understanding of the location of anatomical structures. This study aims to describe how students in an Operating Room Nursing (OR nursing) master study program perceive the benefit of active learning methods, including drawing and the use of VR. 2) Methods: We combined these two methods in a class of 29 students. 38 half-finished drawings of anatomical structures were made. The students were to complete these during lectures with guidance from the teacher. The students also attended a two-hour VR session where they were to find various anatomical structures. A paper questionnaire was applied to evaluate the teaching program. Data were analyzed statistically. 3) Results: The students highly appreciated these learning methods. They reported that drawing made them work more actively during lectures and increased their learning outcome. They also perceived that the use of VR technology increased their understanding of the location of anatomical structures. 4) Conclusion: The combination of drawing and VR technology may be of benefit to OR Nursing students when learning anatomy by both increasing student activity and learning outcomes.

Colonoscopy, essential for diagnosing and treating colorectal cancer, relies on effective bowel preparation to inspect the colonic mucosa fully. Traditional education methods include printed instructions and verbal explanations, but these may not ensure clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. Using the outpatient’s Android mobile device, the mobile health care model is provided as a nursing guide to assist in bowel preparation for colonoscopy. This single-blinded, randomized trial en-rolled patients for colonoscopy at a Northern Taiwan gastroenterology center. Eligible patients were physically and mentally healthy and could communicate in Chinese. The study tested the ColonClean app during bowel preparation. After the procedure, endoscopists rated the prepara-tion quality using the Aronchick Scale. Data analysis with SPSS software (version 25.0) evaluated if the app significantly improved bowel preparation compared to those who did not use it. Forty patients were recruited for both the control (conventional method) and experimental (conven-tional method plus ColonClean app) groups. In the experimental group, endoscopists assessed bowel preparation quality; all achieved at least "Fair," with 75% receiving "Excellent" or "Good" ratings. The ColonClean App enhanced bowel preparation quality more effectively than tradi-tional nursing guidance.

Healthcare personnel must face two problems of growing importance: violence in the workplace and the loss of work ability due to ageing of the workforce. Studying the relationship between these two phenomena can help to prepare effective prevention measures. In a public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analysed the relationship between this indicator and the violence experienced in the previous and following years. 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR=0.94 CI95%=0.90; 0.98 p&lt;0.01) and in the following year (OR=0.88 CI95%=0.84; 0.92 p&lt;0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR=3.65 CI95%=1.90; 7.03 in the previous year, OR=3.54 CI95%=1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental conditions can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

(1) Context: Cancer triggers significant changes in family dynamics. It is noteworthy that coping and problem-solving skills, particularly in situations involving cancer in children and adolescents, have not been adequately explored in the context of family adaptation. This study aims to analyze the effectiveness of family interventions in coping to improve problem-solving skills in parents and/or caregivers of children and adolescents during and after oncological treatment. (2) Methods: This is a scoping review following the recommendations of the Joanna Briggs Institute and the Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), from 2014 to 2024, in the databases LILACS, CINAHL, SCOPUS, Web of Science, and PUBMED. (3) Results: Forty-five studies were eligible. Coping strategies were categorized as follows: (1) positive attitudes (including a sense of courage and hope, family support to enhance resilience, and future planning), (2) caregiver empowerment (involving acceptance of diagnosis, emotional distancing, and coping through religiosity), and (3) communication skills (encompassing professional communication, horizontal dialogue with healthcare teams, and sincere communication with friends and family). (4) Conclusions: Over time, families develop coping and problem-solving strategies that influence changes in family functioning patterns, aiding them in accepting, reinterpreting, and reframing ideas and feelings associated with neoplasia.

Considering the multifaceted nature of neurodegenerative diseases like dementia and the neces-sity for interprofessional knowledge, this research extends its scope to encompass professionals with diverse levels of training and experience in dementia care. A need analysis for the project “My INdividual Digital EDucation.RUHR” (MINDED.RUHR) is conducted to develop an au-tomatized recommender system for individual learning content using AI. In this sub-study, the aim was to reveal didactic specialties, knowledge gaps and structural challenges of further edu-cation in dementia care of different health professions and to derive learning preference personae. Eight focus group interviews among nine health professions and up to six participants (n = 34) each took place to survey distinct didactic experiences and learning needs. The results reflect various learning preferences, with a propensity to multimedia, practical and interactive tasks. Health professions are used to digital education but show aversions against certain e-learning formats. The derived learning preference personae constitute profound blueprints for a us-er-centred digital education design process, aiming to establish personalized and representative further education in dementia care applicable to various individual preferences and structural workplace challenges of healthcare professions.

Aims: This study aims to evaluate the impact of family-centered empowerment on Jordanian adolescents with type 1 diabetes (T1DM), focusing on their HbA1c levels, self-efficacy, and quality of life (QOL). Background: Poor glycemic management in adolescents with type 1 diabetes increases complications. Improved control is linked to various variables, but few studies focus on Middle Eastern populations. Methods: An experimental study involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participants were created: control (n = 34) and intervention (n = 34). Data was collected through face-to-face interviews and medical records. Results: The study found significant differences in self-efficacy scores between the intervention and control groups, with the intervention group experiencing a significant decrease in HbA1c readings and a significant difference in QOL between pre-program and post-program phases. Discussion: Family empowerment can significantly improve the lives of Jordanian teenagers with type 1 diabetes. This strategy leads to improved glycemic management, increased self-efficacy, and improved quality of life. Future treatments and health policies should recognize and value the critical role families play in the care of this population. Conclusion: The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate these training into treatment plans and educational programs for adolescents to enhance their QOL.

Chronic conditions like type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are major global health issues, causing significant morbidity and mortality. In Latin America, these conditions contribute to millions of premature deaths annually, posing challenges exacerbated by limited healthcare access and poor primary care quality, particularly in Mexico. Complementary medicine presents a potential solution, offering minimally invasive techniques to improve physical, mental, and spiritual well-being. Effective treatment adherence, crucial for positive outcomes, is influenced by self-efficacy, the ability to manage one's behavior in response to medical conditions. However, treatment adherence rates remain low, indicating a pressing public health concern. This study aimed to explore how perception of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic conditions in Mexico. Analyzing data from 113 participants revealed significant correlations between variables, with treatment adherence positively associated with self-efficacy and perception of holistic medicine negatively correlated with self-efficacy. Regression analysis showed that incorporating perception of complementary medicine and treatment adherence significantly explained self-efficacy levels, suggesting the potential of complementary therapies in holistic healthcare approaches. However, collinearity between variables highlights the need for further research to better understand these relationships and their implications for improving healthcare outcomes in Mexico. Integrating complementary therapies with conventional treatments could enhance overall well-being and treatment adherence, offering promising avenues for addressing chronic conditions in the region. These findings underscore the importance of comprehensive healthcare approaches that integrate both conventional and complementary modalities to optimize health outcomes and quality of life for individuals with chronic conditions in Mexico and beyond.

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers: (1) Background: It is important to get a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will inform the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences, based on trustable information.; (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized findings; (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed the identification of current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.

Transition from basic to higher education is regarded as a ‘juggle of many balls’ because students ought to balance between theoretical and clinical requirements, including social life. As a result, a significant number of undergraduate first-year nursing students succumb to these challenges due to lack of coping mechanisms emanating from poor resilience. As a result, the aim of this study was to determine the factors that influence resilience among undergraduate first-year nursing students at a South African university. A quantitative cross-sectional descriptive research design was followed. Data was collected using an adapted self-administered online questionnaire. Principal component analysis extraction method and Varimax rotation were used to analyse data. A total of 123 participants completed the questionnaire. The eigenvalues showed that the first factor explained 23.9% of the variance, the second factor 11.2%, a third factor 7.5% while the fourth factor explained 5.9% of the variance. The fifth until the eight factor had eigenvalues greater than 1 but less than 2. This study showed that resilience can be dependent on various factors such as lecture support, parental support, academic achievement, peer and mentor support, optimism about the future and being self-determined.

The Philippines has the highest HIV incidence rate in the Asia-Pacific region. Previous studies identified multilevel factors contributing to this phenomenon. This scoping review describes the extent of the literature on HIV contributory factors and identifies gaps to guide directions for HIV prevention research. The keywords HIV incidence, individual, sociocultural, environmental factors, and Philippines, were used to search for evidence on Google Scholar, PubMed, Scopus, and Web of Science databases. A total of 1,017 peer-reviewed articles published in the English language from 2014 to 2024 were reviewed using the Joanna Briggs Institute Scoping Review protocol. Thirty articles were included in this review. The majority of the available evidence was quantitative studies published between 2020 and 2024. Individual, sociocultural, economic, educational, political, and environmental factors shaped the Philippines’ HIV epidemic. Low levels of HIV knowledge, low testing rates, high-risk sex behaviors, stigma, lifestyle, location, lack of HIV education in schools, conservative society, and restrictive policies are HIV contributing factors. The Philippine HIV epidemic is multifactorial. Identifying the contributory factors is crucial in developing targeted interventions for high-risk populations. A dedicated HIV research program is needed to provide evidence-based information to guide the development of HIV preventive programs and research.

This study aimed to investigate the relationship between sleep duration, dementia severity, age, and ANS regulation. This cross-sectional pilot study included 27 older patients with probable Alzheimer’s disease, hospitalized at a psychiatric center. We measured heart rate variability to assess ANS regulation at night, evaluated dementia severity using the Clinical Dementia Rating scale, and obtained sleep duration data from sleep diaries maintained by psychiatric nurses. The data were analyzed using repeated-measures generalized linear models with age, sex, dementia severity, and medication (antipsychotics) as covariates. A sleep duration of 7–8 h per night was associated with better ANS regulation than other sleep durations, as indicated by sympathovagal balance (p = 0.005). ANS dysregulation was characterized by a 20.7% increase in sympathetic nervous system activity and a 14.8% decrease in parasympathetic nervous system (PSNS) activity. We found a significant correlation between dementia severity and PSNS activity (p = 0.04) and observed an inverted U-shaped association between sleep duration and ANS regulation. This pilot study demonstrated that a sleep duration of 7–8 h per night may be critical in maintaining optimal ANS regulation. Bidirectional associations between sleep duration, inadequate sleep duration, aging, and ANS regulation warrant further investigation.

Workplace bullying is common among nurses affecting negatively several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data during February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale and the Brief COPE to measure workplace bullying, quiet quitting and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies was a negative predictor of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses’ managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Background: During the stay in the neonatal intensive care unit, parents play a crucial role in the care of their infants. Recent studies reported a decrease in parental participation due to Coronavirus Disease (COVID-19) pandemic that determined restricted access policies in hospitals. The aim of this study is to describe the barriers to a good parents’ participation during the stay in the neonatal intensive care unit in the COVID-19 era. Methods: A quantitative observational study was carried out. Results: 270 parents participated in this study. Mothers’ participation in care seems to be higher as compared to fathers (p = 0.017). Parents who lived the birth of their first child reported a better level of participation in care when compared to those who lived the birth of their second born (p = 0.005). Parents of extremely preterm neonates reported a lower interaction with their infant if compared to parents of term newborns (p &lt; 0.001). Conclusions: Some more disadvantaged categories have reported lower scores: cultural and linguistic minorities, parents of multiple children and fathers. COVID-19 pandemic made several Family Centred Care activities not possible with a higher impact on those who benefited the most of these facilities. This study was prospectively registered by the IRB-CRRM of the University “G. d’Annunzio” Chieti-Pescara on the 23/01/2024 with registration number CRRM;2023_12_07_01.

Background: Music evokes positive emotions and reduces stress and anxiety. Operating Room (OR) staff face various challenges which can lead to high levels of stress. The aim of the study is to assess whether listening to music during intraoperative phases improves the work environment by reducing anxiety and stress in the entire surgical team. Methods. A prospective observational study was conducted from February to September 2023, involving medical personnel, nursing staff, and nursing students. They were divided into two groups: Group 1 with music during surgical procedures, and Group 2 without music. Participants were administered two validated instruments: the Zung Anxiety Self-Assessment Scale (SAS) to measure anxiety, and the Positive and Negative Affect Schedule to assess emotions generating stress. Additional items were included for demographics, job satisfaction, and the organization method. Results. Music did not impact anxiety but increased positive emotions while reducing negative ones. Music had an ancillary effect, highlighting the need for significant organizational interventions aimed at increasing operator satisfaction, including voluntary rather than mandatory assignments for nursing staff. Conclusions. Music appears to reduce stress in the intraoperative team when supported by a positive work environment in which assigned operators have chosen to work in the OR.

Sexual Violence (SV) can deeply impact victims' physical and psychosocial well-being. Yet many healthcare providers, including registered nurses (RNs), hesitate to screen patients due to a lack of confidence and knowledge. The SATELLITE Sexual Violence Assessment and Care Guide was developed to address this gap; however, the guide’s educational effectiveness remained untested. This pilot study aimed to assess the feasibility, acceptability, and efficacy of an education program based on the SATELLITE guide among RNs in clinical settings, using a pre- and post-test design. Results indicated that the education was not only feasible and acceptable, but also demonstrated the effects as desired with significant increases in RNs' knowledge and confidence in SV screening and care. The program's assessment tool was valid and reliable, and participant recruitment was feasible. Based on these findings, it is recommended that the SATELLITE education program be further tested with a larger RN sample and extended to other healthcare providers. Additionally, exploring different regions, cultural contexts, and healthcare settings would enhance understanding of the program's broader applicability and effectiveness.

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: a) immediate care, b) intermediate care, psychosocial care and d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed and the reinforcement of these advanced practices through the systematization of nurses’ skills, in order to promote victims’ rehabilitation, minimize their suffering and improving their quality of life during and after an earthquake.

Keywords: mHealth; peritoneal dialysis; functionality; usability

The prevalence of HIV infections in the province of Papua is rising. The study aimed to examine the effect of a sexual reproductive health-based HIV prevention program on knowledge, subjective norms, and attitudes, as well as the behavior control of reproductive health and HIV prevention. A quasi-experimental study was applied in this study with an equivalent control group. The total of 289 students is divided into the experimental group (n = 134) and the control group (n = 155). The experimental group received the sexual reproductive health-based HIV prevention program. The control group received the routine program from the school. The results found a significant difference in knowledge, subjective norms and attitudes, and behavior control of reproductive health and HIV prevention among intervention groups before and after receiving the Sexual Reproductive Health School-Based HIV Prevention program (p-value

Health and well-being are a major concern for the elderly who experienced evacuation due to the 2011 Fukushima Daiichi Nuclear Power accident. This study examined the feasibility of a picture sound book with Ninja-essence to maintain or improve exercise habits and physical and mental conditions of the elderly affected by the Fukushima Daiichi Nuclear Power plant accident. We conducted a pre–post intervention study to evaluate a picture sound book with Ninja-essence for returnees and evacuees post lifting evacuation restrictions. In total, 29 people participated in this study. Residents in two groups, returnees and evacuees, were provided with the tool. Results of the pre–post changes were analyzed using descriptive statistics, i.e., Fisher’s exact test and t-test, and a significant difference was observed in both groups of participants between their left and right hand-grip strength, the maximum phonation time in the participants of the group that regularly engaged in exercise, and in the questions regarding swallowing exercises and singing songs or practicing words (p < 0.013 and 0.033); 16 of 29 participants reportedly enjoyed the program. The results demonstrated the future possibility of determining the improved outcome of this program in larger samples.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

Nurses have experienced several psychological and work-related issues during the COVID-19 pandemic including pandemic burnout and job burnout. The aim of the study was to examine the impact of social support and resilience on COVID-19 pandemic burnout and job burnout among nurses. We conducted a cross-sectional study in Greece. Study population included 963 nurses. We measured social support, resilience, COVID-19 pandemic burnout, and job burnout with the Multidimensional Scale of Perceived Social Support, Brief Resilience Scale, COVID-19 burnout scale, and single item burnout measure respectively. Nurses received high levels of social support, while their resilience was moderate. Additionally, nurses experienced moderate levels of COVID-19 burnout and job burnout. Increased social support (adjusted beta = -0.075, 95% CI = -0.125 to -0.024) and increased resilience (adjusted beta = -0.399, 95% CI = -0.491 to -0.308) were associated with reduced COVID-19 pandemic burnout. We found a negative relationship between social support and job burnout (adjusted beta = -0.263, 95% CI = -0.405 to -0.121). A similar negative relationship was found between resilience and job burnout (adjusted beta = -0.529, 95% CI = -0.785 to -0.272). Social support and resilience can act as protective factors against COVID-19 pandemic burnout and job burnout among nurses. Policy makers should develop and implement appropriate strategies to improve nurses’ social support and resilience since they are the backbone of healthcare systems worldwide.

Background: This study aimed to develop and evaluate a dietary self-care promotion program for hemodialysis patients based on Hurley's self-efficacy model. Methods: The needs of hemodialysis patients were identified, and an online community-based dietary self-care promotion program was developed with expert evaluations. 44 hemodialysis patients were randomly assigned to an experimental group (n=22) and a control group (n=22). The program was applied to the experimental group for four weeks. Before and after the intervention, as well as four weeks after the intervention, dietary self-efficacy, dietary self-care behavior, interdialytic weight gain, serum phosphorus, and serum potassium were assessed in both groups. Results: Significant differences over time and between groups were observed in dietary self-efficacy, interdialytic weight gain, serum phosphorus, and serum potassium. The interaction between time and group was also significant. While no significant differences were found over time in dietary self-care behavior, significant group differences and interaction effects between time and group were identified. Conclusions: The results indicate that the dietary self-care promotion program using an online community for hemodialysis patients is more effective in enhancing dietary self-efficacy and dietary self-care behavior compared to conventional treatment. This suggests the clinical applicability of the proposed dietary self-care promotion program.

Introduction and Purpose: Nurses are expected to be competent in practice based on the domain of standards and interpersonal soft skills (ISS). Nurses are faced with inadequate physical assessment 28%, formulating diagnoses 56%, plans 34%, implementation 31%, evaluation 37,5%, and communication skills 41%. Aims to develop an ISS learning model based on transformative learning theory and digitalization (TLTD) to improve nurses’ competencies. Method: Used Explanatory cross-sectional involved 190 practitioner nurses. Variables of individual characters (X1), facilities (X2), Social environment support/SES (X3), TLTD (X4), ISS (X5), and nursing competencies (Y) were measured. Data was collected using a checklist questionnaire, conducted on 6 June to 10 August 2022 at Dili, Baucau, and Maliana hospitals. Used descriptive and inferential analysis with SEM-PLS. Result: Five of the 11 hypotheses of statistical p-value < 0,05 and T-Test > 1,96, including X2>X4, X3>X5, X4>X5, and X5>y, to form ISS learning model. The characteristic of respondents were 81,8% young adults, 67,9% women, 57,8% undergraduates, judging the previous training 35% was unsuccessful, and 45,8% did not meet expectations. Learning facilities that are still lacking include policies 23,7%, curriculum 23,4%, guideline 22,7%, modules 27,9%, infrastructure 20,3%, social environment support 24,2% low, organizational support, 30,0% low peer support and 26,3% low family support. The average TLTD is 25,3% to 34,2%, ISS 22,1% to 30,5%, and nurse competence 25,3% to 30,5%.Suggestion: Result of the study become base to improve nurse’s competencies. Conclusion: Learning model was formed by facilities, SES, TLTD, ISS, and nurses’ competencies.

Keywords: Barriers; Facilitators; Sepsis; Sepsis Six Guidelines; Nurses.

Over the years there has been an increase in the development of assistive technologies (AT’s). The implementation and scaling of AT’s at care organizations remains challenging. Moreover, to date, it has been underexplored during which stages of dementia these technologies can be best implemented. Previous work has developed an infographic providing guidance on when best to introduce AT’s for people with dementia. Although this infographic is relevant, it was based solely on the experience of the authors during various national and international projects. However, over the years a wide spread of studies has been conducted in the field of dementia on the use and implementation of technology for PwD. Therefore, in this paper we will revise the current infographic based on the insight gained from existing literature and complement these by interviews with expert on the implementation of care technology

In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC) - a campaign to educate 50,000 health professionals about health impacts of climate change - launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty 1) integrated resources into didactic and clinical settings such as population or organ-system content, leadership, and policy and 2) used resources to support assignments. In four years, faculty reported educating over 37,700 students using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.