J Nurs Manag [JOURNAL]
Sun
200 papers
Association Between Shift Patterns and Occupational Stress and Perceived Professional Benefits Among Nurses: A Cross-Sectional Study.
Kong X, Cai L, Wang J
J Nurs Manag · 2026 · PMID 42316884 · Full text
OBJECTIVE: This cross-sectional study examined the associations between shift patterns, occupational stress, and perceived professional benefits among hospital nurses. METHODS: A convenience sample of 325 nurses from a s...
OBJECTIVE: This cross-sectional study examined the associations between shift patterns, occupational stress, and perceived professional benefits among hospital nurses. METHODS: A convenience sample of 325 nurses from a single tertiary hospital in Hubei Province, China, was enrolled. Data were collected using a general information questionnaire, a shift pattern scale, a perceived professional benefits scale, and an occupational stress scale. Statistical analyses included chi-square tests, t-tests, rank-sum tests, Pearson's correlation, and multivariable linear regression. RESULTS: Nonshift nurses had significantly higher occupational stress scores than shift nurses (67.23 vs. 58.55, p < 0.001). Among shift nurses, those with 2-6 years of experience and those working > 6 night shifts per month reported higher stress levels. Among different shift patterns, only the 21:00-8:00 group scored lower in nurse-patient relationship than the nonshift group, whereas the 18:00-01:30 and 01:30-08:00 groups reported higher perceived professional benefits from positive occupational perceptions than the nonshift group. The nonshift group experienced higher occupational stress levels compared to the shift group. Pearson's correlation analysis indicated that the overall score for occupational sense of gain was positively correlated with the total scores for work tasks and development, interpersonal support, patient care, and occupational stress. Positive but modest correlations were observed between several stress dimensions and professional benefit dimensions (r = 0.12-0.18, p < 0.05). CONCLUSIONS: In this single-site sample, certain shift patterns and a higher monthly frequency of night shifts were associated with increased occupational stress, whereas longer shift experience was correlated with better nurse-patient relationship scores. Nursing managers may use these findings to limit night shifts to ≤ 6 per month, provide targeted support for mid-career nurses, and monitor stress levels across shift types.
Collaborative Networks in Critical Care Nursing Teams: Based on Social Network Analysis and Multiple Regression Quadratic Assignment Procedure.
Shi J, Quan Q, Ye K … +4 more , Feng L, Chen F, Yang J, Fang Z
J Nurs Manag · 2026 · PMID 42313815 · Full text
BACKGROUND: Effective collaboration among intensive care unit (ICU) nurses is critical for patient safety, yet traditional analyses often overlook the relational dependencies inherent in teamwork. This study aimed to del...
BACKGROUND: Effective collaboration among intensive care unit (ICU) nurses is critical for patient safety, yet traditional analyses often overlook the relational dependencies inherent in teamwork. This study aimed to delineate task-specific collaboration structures and identify pair-level determinants using network-aware methodologies. METHODS: A cross-sectional study was conducted in a tertiary ICU involving 96 registered nurses during day shifts from January 1, 2025, to February 1, 2025. Collaboration was defined as coparticipation in clinical events and categorized into four task types: emergent response, procedural care, patient flow, and safety double-checks. RESULTS: Event-based networks revealed distinct topologies: Emergent care showed compact clustering, while procedural care displayed hub-and-spoke configurations centered on specialists. MRQAP analysis (R = 0.27) identified work assignment proximity as the strongest predictor of collaboration (β = 0.314, p < 0.001). Psychological safety similarity (β = 0.176, p = 0.004) and competency complementarity (β = 0.142, p = 0.021) were also significant, while tenure similarity showed a borderline association. CONCLUSIONS: ICU nurse collaboration is multidimensional and task-dependent. Managerial strategies should prioritize optimizing roster designs for spatial proximity, fostering a psychologically safe climate, and strategically developing complementary competencies to enhance team resilience and care quality.
Correction to "Association Between Psychological Empowerment and Work Engagement Among Rural Nurses: A Latent Profile and Moderation Analysis".
J Nurs Manag · 2026 · PMID 42313574 · Full text
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Network Architecture of Digital Leadership: Identifying Affective Commitment Bridges and Intervention Leverage Points Among Chinese Nursing Managers.
Yue W, Chen Y, Ma X
J Nurs Manag · 2026 · PMID 42310935 · Full text
BACKGROUND: Digital transformation in healthcare frequently underperforms because organizations treat it as technical installation rather than sociotechnical redesign, underinvesting in the human-centered psychological d...
BACKGROUND: Digital transformation in healthcare frequently underperforms because organizations treat it as technical installation rather than sociotechnical redesign, underinvesting in the human-centered psychological dimensions of change leadership among nursing managers. Prior research has predominantly employed linear, variable-centered models that obscure conditional interdependencies among leadership, commitment, and innovation constructs, leaving the network architecture through which these factors jointly configure transformation readiness largely unmapped. OBJECTIVE: To examine the network structure linking digital leadership, commitment to change, and creative self-efficacy among Chinese nursing managers and identify intervention leverage points for human-centered digital transformation. SETTINGS: Hospitals across multiple Chinese provinces. METHODS: Cross-sectional network analysis of 2764 nursing managers using validated instruments. Network analysis was selected over conventional regression-based approaches for its capacity to model simultaneous conditional dependencies without imposing a priori directional assumptions. Gaussian graphical models with regularized partial correlations identified conditional dependencies. Centrality metrics and bridge analysis determined node importance and cross-domain connections. Bootstrap procedures assessed stability and parameter accuracy. RESULTS: Affective commitment exhibited highest expected influence and was identified as the principal psychological bridge linking leadership to innovation. Continuance commitment showed negative expected influence, suggesting an association with inhibitory network patterns. Positive attitude and track record demonstrated strongest bridge connections from leadership to commitment domains, surpassing technical competencies. Network stability analyses confirmed robust interpretability. CONCLUSIONS: Human-centered digital transformation effectiveness appears associated with cultivating authentic affective commitment rather than compliance-driven engagement. Organizations should prioritize emotion-focused leadership development, eliminate coercive change strategies, and select champions based on optimistic orientation and credible success records as approaches that may support innovation capacity.
Working Well in a Dynamic Nursing Career: A Critical Incident Technique Study of Nurses' Actions for a Sustainable Working Life.
Gustafsson J, Fridlund B, Ericsson E
J Nurs Manag · 2026 · PMID 42299506 · Full text
BACKGROUND: A sustainable working life for nurses involves creating conditions that allow productivity and well-being to be maintained throughout a nursing career. To address nurses' health and well-being, as well as the...
BACKGROUND: A sustainable working life for nurses involves creating conditions that allow productivity and well-being to be maintained throughout a nursing career. To address nurses' health and well-being, as well as the ongoing shortage of nurses, it is essential to understand the key elements that contribute to a sustainable working life for nurses. OBJECTIVE: The aim was to explore and describe nurses' actions in situations that are important to sustainability in their working lives, as well as why these actions matter and how they contribute to sustainable working life across the career span. DESIGN: An exploratory descriptive design using a qualitative research approach based on Flanagan's critical incident technique (CIT). SETTING AND PARTICIPANTS: Forty-seven nurses (general and specialist) from diverse fields of care within three healthcare regions in Sweden were interviewed between April and October 2024. METHODS: A two-step sampling approach was used. Data were analyzed inductively, in line with the guidelines for CIT. RESULTS: Nurses employed various individual-, organizational-, and team-oriented strategies to maintain a sustainable working life. Organizational support played a vital role. Supportive leadership adopting a "person-first" approach and a positive organizational culture facilitated work-life balance, professional development, and effective teamwork. Negative organizational cultures, such as excessive workloads and ethical conflicts, reduced nurses' well-being and willingness to remain with the organization. CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: Sustainability in nursing emerged as a dynamic process shaped by the interaction between nurses' adaptive strategies and organizational conditions, particularly supportive leadership and a positive organizational culture. This underscores the importance of integrated, long-term management approaches that balance individual needs, professional development, and supportive work environments to sustain nurses' engagement across the career span.
Effects of Traditional and Innovative Safe Breastfeeding Pillows on Postpartum Maternal Breastfeeding Self-Efficacy, Awareness, and Comfort: A Randomized Controlled Trial.
Chou JF, Kuo CH, Tam KW … +4 more , Jen HJ, Chang WP, Chou YY, Chen KH
J Nurs Manag · 2026 · PMID 42299080 · Full text
OBJECTIVE: To evaluate the effectiveness of an innovative "Safe Breastfeeding Pillow" on postpartum maternal self-efficacy, awareness, and comfort during breastfeeding. METHODS: A participant- and outcome assessor-blinde...
OBJECTIVE: To evaluate the effectiveness of an innovative "Safe Breastfeeding Pillow" on postpartum maternal self-efficacy, awareness, and comfort during breastfeeding. METHODS: A participant- and outcome assessor-blinded, parallel randomized controlled trial was conducted. Postpartum mothers were randomized into intervention and control groups. The intervention group used the innovative Safe Breastfeeding Pillow, which includes a main pillow and an additional pillow that can be wrapped around the baby to maintain a stable feeding posture and reduce the risk of accidents due to maternal fatigue during breastfeeding. The control group used a U-shaped breastfeeding pillow as usual. Outcome measures included the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Breastfeeding Awareness Scale (BAS), Body Part Discomfort Scale (BPDS), and B-R-E-A-S-T-Feed Observation Form. Statistical analyses included Chi-squared tests, independent t-tests, and linear regression. RESULTS: In total, 128 mothers (64 each in the intervention and control groups) were enrolled. No differences were found between the two groups in demographic characteristics. The BSES-SF did not significantly differ between the groups. The intervention group reported significantly higher scores for the BAS (3.58 ± 0.04 vs. 1.60 ± 0.15, p < 0.0001). In the BPDS, the intervention group showed significantly higher comfort levels in all body parts during breastfeeding compared to the control group (3.52 ± 0.13 vs. 1.70 ± 0.33, p < 0.0001). Both groups exhibited increased emotional bonding at the initial assessment and at discharge according to the B-R-E-A-S-T-Feed Observation Form. CONCLUSIONS: The innovative Safe Breastfeeding Pillow effectively improved maternal comfort, safety, and breastfeeding awareness compared to a traditional pillow. It provides essential support and warmth, enhancing the overall breastfeeding experience and maternal well-being. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leaders should incorporate the "Safe Breastfeeding Pillow" into routine care as a key strategy to ensure feeding safety, enhance maternal comfort, and improve breastfeeding rates. TRIAL REGISTRATION: ClinicalTrials.gov_identifier: NCT05687383.
"When Rest Feels Wrong": A Qualitative Study of Rest Intolerance Among Nursing Interns and Implications for Workforce Resilience.
Cai J, Chen F, Xiong Y … +5 more , Zhang Q, Zhou L, Xiang J, Li J, Ye Z
J Nurs Manag · 2026 · PMID 42298955 · Full text
OBJECTIVE: To explore the psychological experience and underlying mechanisms of "rest intolerance" among nursing interns. BACKGROUND: Effective recovery is essential for preventing burnout and ensuring patient safety. Ho...
OBJECTIVE: To explore the psychological experience and underlying mechanisms of "rest intolerance" among nursing interns. BACKGROUND: Effective recovery is essential for preventing burnout and ensuring patient safety. However, nursing interns often experience "rest intolerance", a paradoxical psychological state where resting induces distress rather than recovery. As interns represent the future pipeline of the nursing workforce, understanding this phenomenon is critical for managers aiming to build resilient teams and reduce early-career attrition. DESIGN: A qualitative interpretive phenomenological study. METHODS: Twenty-one nursing interns were recruited via purposive sampling. Data collected through semi-structured interviews were analyzed using Colaizzi's method. RESULTS: Six themes and fourteen subthemes emerged. Participants described rest intolerance as involving four interrelated psychological experiences: (Theme 1) maladaptive cognitive ruminations (obsessive thinking and guilt regarding downtime); (Theme 2) toxic social comparison (viewing peers' activity as a benchmark for self-worth); (Theme 3) distorted professional identity (equating rest with laziness or lack of commitment); and (Theme 4) psychological inability to disengage (passive anxiety states). Participants attributed these states to two primary systemic stressors: (Theme 5) transitional shock and (Theme 6) task-time resource imbalance. CONCLUSIONS: Interns suffer a "recovery deficit" associated with a cultural and psychological inability to accept rest, which may contribute to burnout and turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Findings suggest that simply providing time off may be insufficient if organizational culture stigmatizes rest. Accordingly, nurse managers and educators could (1) move beyond resilience training to address "rest guilt" explicitly; (2) model healthy recovery behaviors to help dismantle "hustle culture" in clinical wards; and (3) structure internships to reduce the task-time imbalance that appears to trigger cognitive dissonance during downtime. NO PATIENT OR PUBLIC CONTRIBUTION: This research did not involve patient or public participation in its design, conduct, data collection, analysis, or manuscript preparation. No patients or members of the public were involved in the development of the research question, interpretation of results, or dissemination of findings.
Nurses' Roles in Supporting Mental Health Among Preoperative Cardiac Patients in Kazakhstan: A Qualitative Study.
Shaldarbek A, Almazan J, Balay-Odao EM
J Nurs Manag · 2026 · PMID 42287033 · Full text
INTRODUCTION: Patients with cardiovascular disease undergoing surgery commonly experience psychological distress, including anxiety, depression, and fear of mortality, which may negatively influence surgical outcomes and...
INTRODUCTION: Patients with cardiovascular disease undergoing surgery commonly experience psychological distress, including anxiety, depression, and fear of mortality, which may negatively influence surgical outcomes and recovery. However, mental health support for patients with cardiovascular disease remains unprioritized in many healthcare systems, particularly in middle-income countries such as Kazakhstan, where mental health services are still fragmented and underdeveloped. OBJECTIVE: This study aims to explore and describe the mental health promotion strategies employed by nurses when caring for preoperative patients with cardiovascular disease. DESIGN: This study employed an exploratory-descriptive qualitative design. Data were collected through semistructured interviews with 13 nurses working in cardiac surgery units in Kazakhstan from February 3 to April 10, 2025. The interview data were analyzed using thematic analysis. The study was conducted in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULT: Initially, 96 codes were generated from the data. These codes were subsequently organized into 19 subthemes and further synthesized into four major themes: "Patient Emotional Support Needs," "Mental Health Implementation Strategies," "Challenges to Mental Health Promotion," and "Influencing Factors in Mental Health Promotion." CONCLUSION: Nurses play a pivotal role in promoting the mental health and psychological well-being of patients with cardiovascular disease, with therapeutic communication and professional presence serving as fundamental components of holistic care. In Kazakhstan, this responsibility also requires adapting nursing management strategies to culturally grounded perspectives on mental health, thereby ensuring the delivery of compassionate, culturally sensitive, and comprehensive care that extends beyond physical recovery.
Relationship Between Emotional Labor and Job Performance in Emergency Nurses: Multiple Mediating Effects of Caring Ability and Communication Competency.
Feng D, Huang S, Xiong J … +4 more , Cheng J, Fu J, Xiao Y, Zheng D
J Nurs Manag · 2026 · PMID 42286968 · Full text
AIM: Emergency nurses face tough occupational challenges and substantial emotional burdens, which can impact their job performance. Caring behavior and communication are essential components of patient-centered care, but...
AIM: Emergency nurses face tough occupational challenges and substantial emotional burdens, which can impact their job performance. Caring behavior and communication are essential components of patient-centered care, but their role in the relationship between emotional labor and job performance is unclear. This study aimed to explore the mediating role of caring ability and communication competency on emotional labor and job performance. DESIGN: Cross-sectional study. METHODS: A cross-sectional study of 210 emergency nurses was conducted at eight city tertiary hospitals in central, eastern, and southwestern China from November 2023 to January 2024. Potential participants were selected using a convenience sampling method. The study variables, including emotional labor, caring ability, communication competency, and job performance, were assessed via self-report questionnaires. Path analysis using a multiple mediation model was performed using AMOS 28.0. RESULTS: The results of this study showed that the mean score of emergency nurses' job performance score was 4.53 ± 0.52. Caring ability and communication competence partially mediated the relationship between deep acting and job performance, with effect sizes of 0.022 and 0.100, respectively. The chain-mediating effect of caring ability and communication competence was 0.071. CONCLUSION: Emotional labor did not directly influence job performance. The emotional management strategy of deep acting was the sole approach that indirectly influenced job performance via the complete mediating role of caring ability and communication competence. Emergency nurses utilizing deep acting tactics can more easily identify and regulate their emotions, exhibit greater empathy, treat patients sincerely, communicate effectively, and improve job performance. IMPACT: Nursing managers and educators should attach importance to the emotional labor of emergency nurses, particularly cultivating and fostering deep acting, and take measures to strengthen communication skills and caring education to improve job performance and provide better nursing services for patients. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
The Legislative Trajectory of Korea's Nursing Act: Insights From the Multiple Streams Framework.
Lee D
J Nurs Manag · 2026 · PMID 42257539 · Full text
BACKGROUND: The enactment of the Korean Nursing Act emerged through a prolonged and conflict-laden policy process shaped by workforce instability, interprofessional conflict, and changing political conditions within the...
BACKGROUND: The enactment of the Korean Nursing Act emerged through a prolonged and conflict-laden policy process shaped by workforce instability, interprofessional conflict, and changing political conditions within the Korean healthcare system. Recent healthcare crises, including the COVID-19 pandemic and the 2024 healthcare service vacuum, further intensified policy attention toward nursing workforce governance and healthcare system sustainability. AIM: This study examines the legislative trajectory and postenactment policy developments of the Korean Nursing Act between 2005 and 2025 through the analytical lens of Kingdon's Multiple Streams Framework (MSF). METHOD: Using qualitative document analysis, this study analyzed legislative bills, National Assembly records, government documents, organizational statements, media reports, and academic literature related to the Nursing Act. The analysis focused on interactions among the problem, policy, and politics streams, as well as the role of policy windows and policy entrepreneurs throughout the legislative process. RESULTS: The findings indicate that longstanding issues-including poor working conditions, ambiguity in nursing roles, workforce instability, and concerns regarding healthcare sustainability-gradually evolved from profession-specific grievances into broader public policy concerns. Focusing events such as the COVID-19 pandemic and the 2024 healthcare service vacuum substantially strengthened the problem stream and altered the political environment surrounding the legislation. The policy stream evolved through repeated revision, negotiation, and conflict over issues including professional boundaries, the "community" clause, and physician assistant (PA) nurses. Within the politics stream, partisan realignment, organized interest-group conflict, and executive intervention significantly influenced the trajectory of policy change. Although convergence among the problem, policy, and legislative political streams enabled passage of the Nursing Act during the 21st National Assembly, presidential veto power ultimately disrupted policy adoption. Enactment during the 22nd National Assembly became possible only after crisis-driven political realignment weakened institutional resistance and enabled renewed stream coupling. CONCLUSION: This study demonstrates that stream convergence within healthcare policymaking processes may remain unstable under presidential systems characterized by strong executive authority. The findings extend existing applications of the MSF by illustrating how executive veto power may destabilize policy convergence even after substantial legislative agreement has emerged. IMPLICATIONS FOR NURSING MANAGEMENT: The study provides important implications for healthcare workforce governance, nursing leadership, and policy advocacy in aging societies facing healthcare workforce shortages. The findings suggest that effective nursing policy reform requires sustained interprofessional coordination, strategic policy entrepreneurship, and governance systems capable of responding flexibly to healthcare crises and workforce instability.
Perceived Crises and Preparedness Gaps in Operating Room Nursing: A Qualitative Study of Training Priorities With Nurses and Educators.
Redjem ID, Huaulme A, Jannin P … +1 more , Michinov E
J Nurs Manag · 2026 · PMID 42244096 · Full text
BACKGROUND: The operating room (OR) is a complex, high-stress environment in which crisis situations place considerable demands on staff and compromise patient care. Despite the availability of crisis management training...
BACKGROUND: The operating room (OR) is a complex, high-stress environment in which crisis situations place considerable demands on staff and compromise patient care. Despite the availability of crisis management training, existing research has predominantly relied on objective measures of effectiveness rather than examining nurses' perceived preparedness to manage crises. AIM: This study aims to explore nurses' perceptions of crisis management in the OR, specifically what they perceive as a crisis situation, and which crises they consider important but feel insufficiently prepared to manage. Examining these dimensions allows for the identification of crisis situations representing priority areas for OR nurses' training. METHODS: This exploratory qualitative study used focus group interviews with certified nurse anaesthetists, perioperative nurses, and nurse educators from anaesthesia and perioperative nursing programmes. Seven focus groups were analysed using qualitative content analysis, using an inductive approach with limited quantification. RESULTS: Five categories of crisis situations were identified: (1) interpersonal dynamics; (2) staffing and equipment constraints; (3) errors or incidents during the care process; (4) unexpected external events; and (5) deterioration in the patient's condition. Participants reported feeling least prepared to manage interpersonal conflicts, emotional demands, and unexpected external events. CONCLUSION: This study identifies two critical training gaps. First, while nurses receive substantial training in procedural and technical crisis management, they perceive a significant lack of nontechnical skills training, particularly regarding interpersonal dynamics. Second, training related to low-frequency, high-impact crises appears insufficient.
Barriers and Facilitators to Implementing Point-of-Care Ultrasound to Confirm Gastric Tube Placement in Preterm Infants: A Qualitative Study.
Wang Y, Zhou J, Zhang J … +7 more , Li Y, Jing Y, Xie Y, Chen Y, Zhou Y, Jiang J, Feng S
J Nurs Manag · 2026 · PMID 42237584 · Full text
AIM: To explore the barriers and facilitators influencing the use of point-of-care ultrasound (POCUS) for confirming the position of gastric tubes in preterm infants in the neonatal intensive care unit (NICU). BACKGROUND...
AIM: To explore the barriers and facilitators influencing the use of point-of-care ultrasound (POCUS) for confirming the position of gastric tubes in preterm infants in the neonatal intensive care unit (NICU). BACKGROUND: Many research studies indicated that POCUS is an effective and repeatable technique for monitoring the tip position of gastric tubes; however, the application rate of this technique among nurses in the NICU for confirming the position of gastric tubes in preterm infants remains low. METHODS: Using a qualitative descriptive research design, we conducted interviews with direct care nurses (n = 8), frontline doctors (n = 2), and nursing leaders (n = 2) at a tertiary-level hospital to explore the barriers and facilitators influencing nurses' use of POCUS for confirming the position of gastric tubes in preterm infants. RESULTS: The study identified two main themes: facilitators and barriers. The facilitators include the following six subthemes: adequate resource allocation and equipment; demonstrable safety and clinical efficacy; intrinsic motivation and professional development; supportive and innovative work environment; strong managerial and leadership support; and clear pathways for process optimization. The barriers also include six subthemes: deficiencies in competency development systems; complexity of neonatal clinical presentations; absence of institutional policies and standardized protocols; sociocultural and cognitive resistance; perceived legal and ethical risks; and unclear team collaboration dynamics. CONCLUSION: This study explored the main factors hindering and promoting the implementation of the POCUS for gastric tube position confirmation from the perspectives of direct care nurses, frontline doctors, and nursing leaders. Participants pointed out that there were issues with insufficient protection and support in areas such as training systems, institutional regulations, cognitive levels, and team collaboration. Therefore, it is necessary to formulate strategies and policies to address these obstacles.
Construction of a Three-Dimensional Preventive Intervention Model for Nurses' Job Burnout: Integration of Multiple Theories and Pilot Verification in Obstetrics and Gynecology Nurses.
Wang H, Meng Y, Mu Y … +4 more , Feng Y, Zhang Y, Yang Y, Zhang H
J Nurs Manag · 2026 · PMID 42231616 · Full text
Given the current severe global shortage of nursing staff, nurse burnout has become a hidden risk threatening patient safety. Alleviating nurse burnout and ensuring patient safety are therefore the core tasks of current...
Given the current severe global shortage of nursing staff, nurse burnout has become a hidden risk threatening patient safety. Alleviating nurse burnout and ensuring patient safety are therefore the core tasks of current clinical nursing management. To address the inadequacies of existing nursing interventions, which are mostly one-dimensional and lack an integrated framework, this study integrates the core logic of the Conservation of Resources Theory, Job Demands-Resources Model, Effort-Reward Imbalance Model, Role Stress Theory, and Social Cognitive Theory. Combined with the definition of burnout dimensions in the Maslach Burnout Inventory, a "Three-Dimensional Preventive Intervention Model" suitable for nurses is constructed from the perspective of intervention implementation. The model consists of a framework structure covering three levels: organizational management-individual nurse-career significance. Specifically, the organizational management focuses on dynamic adjustment of workload to control resource depletion; the individual nurse provides psychological resource support to enhance resource reserves; and career significance activates professional value to achieve resource appreciation. Additionally, the model fully considers key influencing factors related to each dimension, establishing an operable and flexible intervention system for practical clinical settings. To verify the model's feasibility, a preliminary effectiveness validation was conducted in the obstetrics and gynecology department, where nurse burnout is highly prevalent. The results show that this model can provide medical institutions with a standardized general framework for burnout prevention measures at the organizational level. It also allows for dynamic adjustment of intervention measures in a modular manner according to the characteristics of different clinical departments and enables targeted optimization of key priorities across different dimensions. Overall, the model offers replicable and promotable experiences for effective burnout prevention in clinical departments in the future.
Artificial Intelligence Anxiety Levels Among Healthcare Professionals: A Systematic Review and Meta-Analysis.
Kahraman H, Yüceler Kaçmaz H, Akutay S
J Nurs Manag · 2026 · PMID 42227769 · Full text
BACKGROUND: Artificial intelligence (AI) is increasingly being integrated into various aspects of healthcare delivery, from diagnostics to patient management. While these advancements offer significant benefits, they als...
BACKGROUND: Artificial intelligence (AI) is increasingly being integrated into various aspects of healthcare delivery, from diagnostics to patient management. While these advancements offer significant benefits, they also raise anxiety among healthcare professionals regarding job security, ethical implications, and changes in clinical decision-making. Despite the growing importance of this issue, there is limited consensus among healthcare professionals regarding the overall level of anxiety about AI. METHODS: This systematic review and meta-analysis was conducted to assess healthcare professionals' anxiety about AI. This study was conducted in accordance with PRISMA guidelines and registered in the PROSPERO database (CRD420251017693). A comprehensive literature search was conducted in the Web of Science, PubMed, Scopus, EBSCO, ScienceDirect, and Wiley Online Library databases up to April 2025. Studies focusing on healthcare professionals' levels of anxiety about AI were included. Risk of bias was assessed using the JBI critical appraisal tool. In the analyses, effect sizes were calculated using the random effects model, while heterogeneity, sensitivity, and publication bias were assessed via Cochrane's Q, I, τ, leave-one-out analysis, funnel plots, and Egger's and Begg's tests. RESULTS: Nine studies involving 1877 healthcare professionals were included in the systematic review, and five studies (n = 926) that met the criteria were included in the meta-analysis. The meta-analysis revealed that the mean score on the AI anxiety scale was 59.26 (95% CI = 40.54-77.97), indicating that healthcare professionals generally experience a moderate level of AI-related anxiety. A statistically significant heterogeneity was observed among the included studies (I = 99.1%, τ = 224.20, p < 0.0001). CONCLUSION: While it can be suggested that healthcare professionals experience moderate to high levels of anxiety towards AI technologies, the high heterogeneity observed across the included studies makes it difficult to draw a generalized conclusion. The study highlights the necessity of proactive measures, including education and organizational support, to build healthcare professionals' confidence and readiness for AI adoption.
Job and Employee Satisfaction Among Healthcare Staff in a Tertiary Hospital: A Cross-Sectional Study.
Jelic M, Ristic A, Djokovic F … +5 more , Jovanovic V, Soldatovic I, Salovic B, Mandic-Rajcevic S, Perovic M
J Nurs Manag · 2026 · PMID 42227575 · Full text
BACKGROUND: Job satisfaction significantly influences the quality of patient care. Healthcare staff working with vulnerable patients in tertiary obstetrics and gynaecology hospitals faces specific work challenges and hig...
BACKGROUND: Job satisfaction significantly influences the quality of patient care. Healthcare staff working with vulnerable patients in tertiary obstetrics and gynaecology hospitals faces specific work challenges and higher expectations from patients. The secondary data analysis from the National Survey of Employee Satisfaction aimed to evaluate job satisfaction and its association with intrinsic and extrinsic factors. METHODS: A cross-sectional study was conducted involving 385 employees (physicians, nurses, administrative and technical staff) at two tertiary obstetrics and gynaecology hospitals. Data were collected using a self-administered, anonymous questionnaire (National Survey of Employee Satisfaction). This single instrument assessed demographic characteristics and 14 factors of the work environment and working conditions. Participants rated their level of satisfaction on a 5-point Likert scale, with scores ranging from 1 ('very dissatisfied') to 5 ('very satisfied'). RESULTS: Participants were aged 35-54 years, with nurses comprising the largest proportion of the sample (60.3%). The greatest proportion reported dissatisfaction with their salary (61.8%), while the highest level of satisfaction was reported for work equipment (41.5%). Overall job satisfaction varied across professional categories of employees. Exploratory factor analysis among healthcare professionals identified two underlying dimensions of job satisfaction: extrinsic (hospital-related) and intrinsic (profession-related) factors, which together explained 59% of the total variance. Both factors were significantly associated with overall job satisfaction, with extrinsic factors showing a slightly stronger correlation. CONCLUSION: Improving non-financial incentives (recognition of work, organizational support and workload management) may enhance healthcare staff engagement, communication, staff morale, retention and service quality. Given the identified intrinsic and extrinsic dimensions of job satisfaction and their significant association with overall job satisfaction, this empirically derived framework may be used for comparative analyses across different healthcare contexts and may inform the development of more targeted measurement tools and intervention models.
Actual Scope of Nursing Practice and the Influencing Factors: A Single-Center Cross-Sectional Study in China.
Wang W, Yang R, Liu X … +8 more , Shi X, Shen Z, Li S, Zhu Z, Zhu M, Ji S, Shi X, Hou Y
J Nurs Manag · 2026 · PMID 42218897 · Full text
AIMS: The "Actual Scope of Nursing Practice" (ASCOP) reflects what nurses are authorized and competent to do and what they do in routine practice. This study examined ASCOP levels and determinants in a tertiary hospital...
AIMS: The "Actual Scope of Nursing Practice" (ASCOP) reflects what nurses are authorized and competent to do and what they do in routine practice. This study examined ASCOP levels and determinants in a tertiary hospital in Suzhou, China, to inform nursing management and hospital administration. DESIGN: This cross-sectional study followed the STROBE standards. METHODS: A random sample of 375 nurses was recruited from a Suzhou tertiary hospital between September and October 2025. We collected data using a demographic questionnaire, the ASCOP questionnaire, the growth need strength (GNS) subscale, the job content questionnaire, and the role stressors scale. Descriptive analyses were performed for each variable. Spearman's rank correlation analyses analyzed key variables, followed by univariate and regression analyses to identify factors associated with the ASCOP. RESULTS: The mean ASCOP score was 4.03. The final regression analysis explained 38.3% of ASCOP score variance (adjusted R = 38.3%). Professional title was the strongest positive predictor (β = 0.296). Role stressors (β = 0.294), psychological demands (β = 0.257), and GNS (β = 0.234) were also positively associated with ASCOP. Department was statistically associated with ASCOP; however, the effects were modest. CONCLUSION: Professional title was the strongest positive predictor of nurses' ASCOP, suggesting that organizational hierarchy may serve as a key structural influence. This study found a pattern of challenge-related activities in general nursing units. High psychological demands and moderate role ambiguity were not associated with limiting practice expansion in this single-center study. Together with the GNS, they were associated with a broader ASCOP. IMPLICATIONS FOR NURSING MANAGEMENT: This study advises nursing managers to (1) implement tiered authorization with a clear, graded ASCOP list aligning decision rights and roles to nurse competency; (2) introduce structured bounded autonomy by defining clinical safety thresholds while preserving limited discretion for highly competent nurses; and (3) provide development opportunities to motivated nurses and prioritize workflow support for high-demand roles.
Reflections of Nurse Leaders on Optimising Organisational Culture in Aged Care in Rural and Regional Australia: A Critical Discourse Analysis.
Magee D, Bramble M, Jakimowicz S … +2 more , Randell-Moon H, Francis K
J Nurs Manag · 2026 · PMID 42218594 · Full text
BACKGROUND: Research on organisational culture in aged care settings is formative. This study gives primacy to the voices of registered nurses (RNs) who are integral to clinical and managerial leadership in rural and reg...
BACKGROUND: Research on organisational culture in aged care settings is formative. This study gives primacy to the voices of registered nurses (RNs) who are integral to clinical and managerial leadership in rural and regional aged care contexts in Australia. OBJECTIVE: To describe and analyse the reflections and understandings of RNs who are or have been employed in residential and community aged care settings in rural and regional Australia on optimising organisational culture and cultures of care. METHODS: This manuscript reports on a component of a larger study with 14 participants. Five RNs at the board, executive and clinical nurse consultant level employed in residential or community aged care settings in rural or regional Australia during 2017-2024 participated in semistructured interviews. The interview questions were guided by appreciative inquiry, and this facilitated a strength-based approach to discussion on organisational culture. Data were analysed using critical discourse analysis informed by Michel Foucault, which is concerned with an examination of the nature and utilisation of power as a relational force in social systems. FINDINGS: The participants, reflecting on their experience in rural and regional contexts, viewed strong nursing leadership as integral to person-centred cultures in aged care settings. Nursing leadership incorporates nurses working to full scope of practice in settings that support postgraduate study and research and innovation. Interwoven through these perspectives is evidence of Foucault's concepts of governmentality and disciplinary structures informing nursing practice. Power is both a repressive and productive force that shapes professional relationships and the capacity for RNs to be agents of change. A clear separation of the operational and governance arms of aged care organisations was viewed by participants as necessary for effective management, while highlighting the need for more RNs to contribute in roles at the board and executive level. CONCLUSIONS: This study underscores the opportunity for professional nursing bodies, government agencies and the aged care sector to work together to require RN representation on boards of aged care providers; to develop policies that enable RNs to work to their full scope; and to strengthen mentoring, career pathways, and financial assistance for nurses pursuing further education. RNs working in aged care also emphasised the importance of building a research-focused culture that drives improvement and innovation, noting that staff education is essential for enabling meaningful involvement in research and project work.
Parents' Perspectives on Artificial Intelligence-Supported Pediatric Healthcare Services: A Descriptive and Correlational Study.
Akoglu B, Simsek A
J Nurs Manag · 2026 · PMID 42216846 · Full text
BACKGROUND: The increasing integration of artificial intelligence (AI) into healthcare systems highlights the need to examine parents' knowledge, attitudes, and concerns, as they play a significant role in decision-makin...
BACKGROUND: The increasing integration of artificial intelligence (AI) into healthcare systems highlights the need to examine parents' knowledge, attitudes, and concerns, as they play a significant role in decision-making regarding pediatric care. This study aimed to assess parents' knowledge levels, attitudes, and concerns regarding AI in pediatric healthcare services. METHODS: This descriptive and correlational study was conducted with 71 parents between November 2024 and January 2025. Data were collected online by using the Child and Parent Information Form, Information Form for Artificial Intelligence-Based Applications (For Parents), and Artificial Intelligence Anxiety Scale. Participants were recruited via web-based messaging applications using a convenience sampling method. Descriptive statistics and Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests were applied in the analyses; the significance level was set at p < 0.05. RESULTS: The mean age of parents was 34.6 years, and 63.4% were mothers. Most participants (80.3%) reported insufficient knowledge about AI. The mean score on the AI Anxiety Scale was 113.9 (±30.14), indicating high anxiety levels. Scale scores differed significantly by age, education, employment status, internet health research, attitude toward AI use in hospitals, and trust in AI (p < 0.05). While 60.6% did not support AI use in hospitals, 73.2% had positive attitudes toward AI-supported robots for their children. CONCLUSION: Parents generally have limited knowledge about AI but high concerns, especially regarding data security and privacy. While attitudes toward AI use in hospitals were cautious, parents showed conditional acceptance of AI-supported applications for children. The findings underscore the importance of educational initiatives to support the safe and ethical use of AI in pediatric healthcare; however, these results should be interpreted with caution due to the relatively small sample size and the use of convenience sampling, which may limit the generalizability of the findings.
Association Between Joint Commission International Patient-Centered Standards and Self-Reported Nursing Performance in Sana'a, Yemen Hospitals.
Qabban KA, Al-Wesabi MM, Jowah HM
J Nurs Manag · 2026 · PMID 42216826 · Full text
BACKGROUND: Yemen's prolonged conflict has severely strained the healthcare infrastructure, creating resource shortages and staffing deficits that compromise nursing practice and patient safety. The Joint Commission Inte...
BACKGROUND: Yemen's prolonged conflict has severely strained the healthcare infrastructure, creating resource shortages and staffing deficits that compromise nursing practice and patient safety. The Joint Commission International (JCI) provides globally recognized patient-centered standards for quality improvement; however, their implementation and association with self-reported nursing performance remain underexplored in fragile, resource-constrained settings such as Yemen. METHODS: This cross-sectional study was conducted between August and October 2024 at six hospitals in Sana'a, Yemen. A simple random sample of 526 nurses from emergency, inpatient, intensive care, and neonatal units completed a validated 66-item questionnaire assessing six JCI domains-international patient safety goals (IPSGs), access to care and continuity (ACC), patient-centered care (PCC), assessment of patients (AOP), care of patients (COP), and medication management and use (MMU)-and self-reported nursing performance. Analyses included confirmatory factor analysis (CFA) with multigroup measurement invariance testing across hospital types, multiple regression (variance inflation factor [VIF] = 3.07-5.69; Durbin-Watson = 1.84), relative weights analysis to address multicollinearity, the marker-variable technique to assess common method bias (CMB), and extensive sensitivity analyses. RESULTS: JCI implementation was moderately high, with the highest mean score for ACC (mean = 4.95 ± 1.38) and the lowest for IPSGs (mean = 4.46 ± 1.48). Self-reported nursing performance was moderate (mean = 4.64 ± 1.39). The standards explained 67.2% of the variance in self-reported performance (R = 0.672, p < 0.001), with MMU (β = 0.277), IPSGs (β = 0.208), and PCC (β = 0.137) emerging as the strongest correlates of self-reported nursing performance, although the cross-sectional same-source design precludes causal inference. ACC, AOP, and COP did not reach statistical significance. Measurement invariance testing achieved full scalar invariance (ΔCFI = 0.008), validating direct mean comparisons across hospital types. Nurses in private hospitals reported significantly higher levels of JCI standard implementation than nurses in public hospitals across all six domains (p < 0.001; Cohen's d = -0.60 to -0.89). The common method variance (CMV)-adjusted R was 0.59. CONCLUSION: JCI patient-centered standards showed significant positive associations with self-reported nursing performance in Yemen. Given the cross-sectional, same-source self-report design, these findings should be interpreted as correlational rather than causal, even after common-method-bias adjustment (CMV-adjusted R = 0.59). Targeted training in medication safety and patient safety protocols, coupled with equitable resource allocation and systemic investment in public hospitals, is recommended to close quality gaps and improve outcomes for vulnerable Yemeni populations. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should treat medication safety, IPSG-anchored supervision, and patient-centered communication as priority levers for quality improvement. They should also advocate for equitable resourcing and structural support of public-sector nursing to close the implementation gap with private hospitals.
Navigating Role Transition: A Qualitative Study of How New Nurse Managers Develop Resilient Leadership.
Song Z, Wang J, Gao P … +2 more , Xu X, Huang X
J Nurs Manag · 2026 · PMID 42216571 · Full text
AIM: To explore how new nurse managers develop resilient leadership during early managerial transition and to identify organizational and individual supports that facilitate this process in high-stress nursing contexts....
AIM: To explore how new nurse managers develop resilient leadership during early managerial transition and to identify organizational and individual supports that facilitate this process in high-stress nursing contexts. BACKGROUND: Resilient leadership is essential for addressing stress, uncertainty, and workforce instability in healthcare organizations. However, limited research has examined how new nurse managers develop this capability during the early stages of their managerial transition. METHODS: From May to July 2025, a qualitative descriptive study using in-depth semistructured interviews was conducted with new nurse managers at three Class A tertiary hospitals in Zhejiang Province, China. Data were analyzed using content analysis supported by NVivo 12.0. RESULTS: Thirteen subcategories were identified and grouped into three main categories: (1) multidimensional challenges in developing resilient leadership; (2) empowering support for developing resilient leadership; and (3) endogenous growth and leadership strategies. CONCLUSION: New nurse managers face multidimensional challenges in developing resilient leadership. This capability is shaped through the interaction between individual agency and organizational support and is facilitated by experiential learning, shifts in management philosophy, and team empowerment.
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