J Nurs Manag [JOURNAL]
Sun
200 papers
Comparing Job Stress and Well-Being Between Hospital and Long-Term Care Nurses: A Cross-Sectional Study in Taiwan.
Shy WJ, Liang KL, Hung YC
J Nurs Manag · 2026 · PMID 42157515 · Full text
BACKGROUND: As population aging intensifies, the nursing workforce faces increasing pressure across hospital and long-term care (LTC) sectors. Understanding how different work environments influence job stress and well-b...
BACKGROUND: As population aging intensifies, the nursing workforce faces increasing pressure across hospital and long-term care (LTC) sectors. Understanding how different work environments influence job stress and well-being is essential for improving workforce sustainability and care quality. OBJECTIVES: This study aimed to compare job stress and well-being between hospital and LTC nurses in Taiwan and to identify key demographic, occupational, and psychosocial factors associated with well-being. METHODS: Design and methods were guided by the Job Demands-Resources (JD-R) framework. A cross-sectional design was conducted with 275 registered nurses recruited from hospitals and LTC institutions. Data were collected using a structured questionnaire that included the Nursing Staff Stress Scale and the WHO-5 Well-Being Index. Descriptive statistics, independent t-tests, Pearson correlations, and multiple regression analyses were performed. RESULTS: Hospital nurses reported significantly higher job stress, particularly in the domains of personal response, work concern, and inability to complete private work, while LTC nurses demonstrated higher levels of well-being. Well-being was negatively correlated with job stress. Regression analysis revealed that shorter working hours, fewer delayed off-duty occurrences, higher income, being married, and higher education were significantly associated with better well-being. The final model explained 37% of the variance in well-being. CONCLUSIONS: Substantial differences in stress and well-being exist between hospital and LTC nurses. Addressing workload, improving organizational support, and promoting balanced work conditions are essential for sustaining the mental health and stability of the nursing workforce. These findings provide actionable insights for nursing managers and policymakers aiming to design evidence-based interventions that enhance workforce sustainability and psychological health. Practical strategies-such as reducing excessive working hours, minimizing delayed off-duty time, and strengthening leadership support and flexible scheduling systems-are essential to enhance nurses' well-being and workforce sustainability.
Factors Influencing Nurses' Work-Life Balance: A Systematic Review of Challenges, Opportunities and Strategic Solutions for Healthcare Practice and Policy.
Yang N, Ng YX, Yeoh Lui CX … +2 more , Woo BFY, Liaw SY
J Nurs Manag · 2026 · PMID 42157502 · Full text
AIM: To consolidate existing evidence on the factors affecting nurses' work-life balance. BACKGROUND: Work-life balance is an emerging concept among many professions, including nursing. Given the global nursing shortage...
AIM: To consolidate existing evidence on the factors affecting nurses' work-life balance. BACKGROUND: Work-life balance is an emerging concept among many professions, including nursing. Given the global nursing shortage and high demand for nurses, more attention should be placed on understanding the factors affecting nurses' work-life balance. Better measures can hence be created to improve nurses' work-life balance. METHODS: Six databases (PubMed, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Scopus and Web of Science) were searched from inception up to February 2024. A grey literature search and screening of reference lists of relevant papers were also conducted. Identified studies were screened against the eligibility criteria, including population, outcome and type of study. The screening, appraisal and data extraction of the eligible papers were done independently by two reviewers. Available evidence was then synthesised using a convergent integrated approach. RESULTS: Twenty-one quantitative studies and one qualitative study were included. Six themes on factors affecting nurses' work-life balance were derived: (1) sociodemographic characteristics, such as age, gender, income status and marital status, (2) personal life, including family support and social life, (3) job control, with emphasis on control over working hours, (4) job demand, encompassing both physical and psychological impacts, (5) work schedule, with highlight on frequent night shifts and shift changes and (6) working environment, including work culture and settings. DISCUSSION: As evident from this review, work-life balance is a multifactorial concept. Nurses, nurse leaders and healthcare organisations have the shared responsibility of ensuring that nurses have an improved work-life balance. Understanding the different factors affecting nurses' work-life balance can allow these stakeholders to take steps towards improving nurses' work-life balance, which in turn result in better clinical outcomes. However, it should be considered that the evidence gathered in this study might not provide a complete overview of the factors affecting nurses' work-life balance due to the complexities of the topic. CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: This review provides insight into the factors affecting the work-life balance of nurses and emphasises the need for the involved stakeholders to create strategies including safe-care interventions, flexible working hours and family-friendly policies to enhance nurses' work-life balance.
Intertemporal Decision-Making in Health Behaviours: A Conceptual Analysis.
Fan S, Lai X, Ma J … +4 more , Zhu Y, Xiao X, Zhou Y, Wang H
J Nurs Manag · 2026 · PMID 42153963 · Full text
AIM: To report a conceptual definition of intertemporal decision-making in health behaviours. BACKGROUND: Decisions regarding health behaviours-such as whether to smoke or exercise-occur daily. As these decisions involve...
AIM: To report a conceptual definition of intertemporal decision-making in health behaviours. BACKGROUND: Decisions regarding health behaviours-such as whether to smoke or exercise-occur daily. As these decisions involve trade-offs between short-term and long-term outcomes, conceptualising them within an intertemporal context is crucial for understanding the mechanisms underlying health behaviours and advancing related research. METHODS: This study employed Walker and Avant's (2019) concept analysis technique. A systematic search was conducted across databases including PubMed, EMBASE, MEDLINE, CINAHL, APA PsycINFO, EconLit with Full Text and Scopus from the date each database was available to March 2025. Additionally, dictionaries, grey literature and reference lists were reviewed to identify relevant literature. RESULTS: A total of 49 papers were included. Intertemporal decision-making in health behaviours refers to the process through which individuals make trade-offs and choices between the short-term and long-term outcomes of health-related behaviours, with the consequences encompassing both different aspects (health aspect and nonhealth aspect) and different signs (costs and benefits). Throughout this process, individuals' dynamic preferences in health-related decisions ultimately determine their behavioural choices. CONCLUSION: This study developed a universal definition and conceptual model for 'intertemporal decision-making in health behaviours', which aids in comprehensively interpreting individuals' health behaviours. This conceptual analysis lays the foundation for future research, education, practice and policy, which also contributes to improving healthcare practices and global health. IMPLICATIONS FOR THE NURSING MANAGEMENT: We recommend that nursing managers guide nursing teams to integrate patients' health-related decision preferences into care assessments, which promotes evidence-based precision care practices and optimises medical resource allocation.
Development and Evaluation of an Evidence-Based Management Indicator System for Transitional Care in Preterm Infants Using a Delphi and AHP Approach.
Meng Q, Wang F, Chen K … +3 more , Li Y, Li Y, Hu Y
J Nurs Manag · 2026 · PMID 42149135 · Full text
BACKGROUND: The transition from hospital to home represents a critical and often perilous period for preterm infants. Inadequate discharge preparation frequently leads to adverse outcomes and preventable readmissions. OB...
BACKGROUND: The transition from hospital to home represents a critical and often perilous period for preterm infants. Inadequate discharge preparation frequently leads to adverse outcomes and preventable readmissions. OBJECTIVE: This study aimed to develop and evaluate a robust management indicator system to standardize and enhance the quality of transitional care for this vulnerable population. METHODS: A sequential multiphase study was conducted, beginning with a systematic literature review to establish a preliminary indicator pool. A two-round Delphi survey involving 21 neonatal care experts was then used to refine the indicators and achieve consensus. Finally, the analytic hierarchy process (AHP) was employed to determine the relative weight of each indicator. RESULTS: The response rate for both Delphi rounds was 100%. The expert consensus reliability (Cr) was 0.967 and 0.964 for the two rounds, respectively, with consensus scores (Cs) of 0.971 for both. Kendall's W coefficients were 0.385 and 0.187 (both p < 0.05), indicating statistically significant agreement among experts across both rounds. The finalized management indicator system comprises 3 equally weighted primary indicators (0.333 each), 17 secondary indicators, and 42 tertiary indicators. Notably, at the secondary level, "Transitional care readiness" (0.234) received the highest weight. Among the tertiary indicators, the highest weight was assigned to "Emergency preparedness skills" (0.162), followed by "Medication administration guidance" (0.054). CONCLUSION: The management indicator system developed in this study demonstrates methodological rigor and expert consensus, offering a standardized, weighted framework for assessing transitional care readiness, guiding transitional care processes, and informing evidence-based management practices for preterm infants. The system's emphasis on emergency preparedness and family capability assessment highlights areas that may warrant greater attention in current discharge planning approaches, pending further empirical validation.
Effect of Career Shocks on Nurses' Job Performance: Psychological Resilience as a Key Moderator.
Zhang N, Sun X, Bu X … +1 more , Xu Z
J Nurs Manag · 2026 · PMID 42148474 · Full text
BACKGROUND: In the digital era, the nursing workplace has experienced profound changes, exposing nurses to complex career shocks. Existing professional studies often overemphasize individual agency in career development,...
BACKGROUND: In the digital era, the nursing workplace has experienced profound changes, exposing nurses to complex career shocks. Existing professional studies often overemphasize individual agency in career development, neglecting how environmental stressors such as career shocks influence job performance through psychological mechanisms. AIM: Grounded in the job demands-resources (JD-R) model, this research examines how positive and negative career shocks differently influence the job performance of nurses, paying particular attention to the moderating effect of psychological resilience. METHODS: This research employs a cross-sectional quantitative design. A total of 385 nurses were recruited through convenience sampling. Data were collected using questionnaires, and structural equation modeling (SEM) was utilized to analyze the relationships among the variables via Mplus. RESULTS: The findings show that both positive and negative career shocks have a positive relationship with nurses' job performance. Psychological resilience demonstrated a significant positive moderating effect on the relationship between positive career shocks and nurses' job performance, amplifying the beneficial effects of positive shocks; however, it showed no significant moderating effect on the link between negative career shocks and nurses' job performance. CONCLUSION: This study elucidates the influence pathways and mechanisms of positive and negative career shocks on nurses' job performance, thereby contributing to the advancement of nursing management research.
Assessing Evidence-Based Practice Competence in Nurse Leadership Roles in Spain.
Segura-López G, Cayuela-Fuentes PS, Leal-Costa C … +4 more , Fernández-Salazar S, Vera-Pérez JA, Ramos-Morcillo AJ, Ruzafa-Martínez M
J Nurs Manag · 2026 · PMID 42145075 · Full text
OBJECTIVE: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments. BACKGROUND:...
OBJECTIVE: This study evaluated the competency of nursing leaders and managers in Spain regarding evidence-based practice (EBP) and identified factors that affect its implementation in clinical environments. BACKGROUND: EBP is essential for enhancing healthcare quality; however, there are still gaps between theoretical knowledge and its practical application. Nursing leaders are crucial in promoting EBP, yet their competence levels and obstacles have not been thoroughly examined in Spain. MATERIAL AND METHODS: A cross-sectional study surveyed 159 nurse managers across 16 autonomous communities in Spain, utilizing the validated EBP-COQ Prof tool. The questionnaire assessed four competency domains-attitude, knowledge, skills, and utilization-using a 1 to 5 Likert scale. Predictors of EBP competency, including training, mentorship, and organizational affiliation, were analyzed using multivariate linear regression. RESULTS: Participants demonstrated a strong overall EBP competence, with an average total score of 143.77 out of 175. The highest scores were in the attitude domain (36.26/40) and knowledge (43.09/55), whereas utilization scores were relatively lower (37.57/50). This indicates that applying EBP in practice still lags behind positive attitudes and knowledge. Key factors predicting higher EBP competence included EBP training, consistent reading of scientific literature, mentoring nursing students, and working in a BPSO center. These results also imply that organizational constraints may continue to impede the integration of EBP competence into routine managerial practice. CONCLUSIONS: Spanish nurse managers possess strong EBP knowledge but continue to encounter difficulties in applying it clinically. The study highlights four adjustable factors of EBP competency that could guide focused interventions. IMPLICATIONS FOR NURSING MANAGEMENT: Healthcare institutions should implement (1) training programs for addressing knowledge-to-practice gaps, especially for nonspecialist managers; (2) mentorship systems pairing EBP-competent leaders with novices; (3) protected time for EBP activities; and (4) expanded BPSO accreditation to institutionalize evidence-based care. Future initiatives should include EBP metrics in performance evaluations, and research should explore factors such as leadership styles and the impact of resource allocation on patient outcomes through longitudinal designs.
Nursing Interns' Disgust Sensitivity, Ageism and Gerontological Nursing Career Motivation: A Network Analysis.
Tang Y, Zhu C, Xu L … +5 more , Wang L, Hu Y, Zhu L, Gu Y, Xu H
J Nurs Manag · 2026 · PMID 42145067 · Full text
BACKGROUND: Disgust sensitivity and ageism significantly affect nursing interns' motivation to work in gerontological nursing. However, the complex interactions between these factors remain underexplored. OBJECTIVE: This...
BACKGROUND: Disgust sensitivity and ageism significantly affect nursing interns' motivation to work in gerontological nursing. However, the complex interactions between these factors remain underexplored. OBJECTIVE: This study used network analysis to explore relationships among nursing interns' disgust sensitivity, ageism and motivation to pursue a career in gerontological nursing and to identify key nodes in this network. METHODS: This study recruited 698 nursing interns. The Disgust Scale-Revised (DS-R), the Fraboni Scale of Ageism and the Gerontological Nursing Career Motivation Questionnaire were used as measures. Centrality and bridge centrality indices were used to identify central and bridge symptoms. Network stability was assessed using a case-dropping bootstrap procedure. The network comparison test was used to analyse differences in networks by gender and residence. Bayesian networks were used to investigate possible probabilistic connections among variables. RESULTS: Network analysis identified 'antilocution' (D5) as the most central node in the overall network, whereas 'expectation' (D7) had the highest bridge strength. Bayesian network analysis further revealed that 'avoidance' (D4) had the greatest probabilistic influence and was strongly linked to other nodes associated with ageism and disgust sensitivity. 'Practicality' (D9) and 'importance' (D10) also showed significant probabilistic associations within the motivation domain. The network structure proved stable and reliable, with no significant differences attributable to gender or to residence. CONCLUSIONS: This study highlights the complex relationships among disgust sensitivity, ageism and motivation for a career in gerontological nursing. It identifies 'antilocution' (D5) in ageism and 'expectation' (D7) in career motivation as central nodes, associated with negative attitudes and lower career identity. Additionally, 'avoidance' (D4) behaviour shows a probabilistic association with higher levels of disgust sensitivity and with ageism. These findings suggest targeted interventions to improve the well-being and career motivation of nursing interns in gerontological nursing.
The Effect of a WhatsApp Chatbot-Based Training Program on Infection Control Knowledge and Practices Among Hemodialysis Nurses: A Cluster-Randomized Controlled Trial.
Alhawatmeh H, Issa SM, Alasqah I
J Nurs Manag · 2026 · PMID 42144875 · Full text
BACKGROUND: Patients undergoing hemodialysis are highly susceptible to infection; however, evidence suggests variability in nurses' infection control competencies. Although digital learning tools are increasingly used in...
BACKGROUND: Patients undergoing hemodialysis are highly susceptible to infection; however, evidence suggests variability in nurses' infection control competencies. Although digital learning tools are increasingly used in nursing, there have been few randomized controlled trials assessing WhatsApp chatbot-based infection control training for hemodialysis nurses. Thus, the purpose of this study was to assess the effect of a WhatsApp chatbot-based training program on nurses' knowledge and practices related to infection control in hemodialysis units. METHODS: A cluster-randomized controlled trial was conducted from July to September 2024, involving 50 hemodialysis nurses recruited via convenience sampling from five hospitals in Jordan. Ten clusters, defined by hospital site and work shift, were randomly assigned using a computer-generated sequence prepared by an independent researcher to either an intervention group, which received the WhatsApp chatbot-based training program, or a control group. Guided by constructivist learning theory, the intervention facilitated active knowledge construction through an interactive, automated chatbot dialogue delivered over 4 weeks. Outcome measures were collected using a self-reporting questionnaire at baseline and 4 weeks after completion of the 5-day intervention. RESULTS: Mixed-model repeated-measures ANOVA revealed that the intervention group showed statistically significant improvements in both knowledge (F (1, 48) = 19.34, p < 0.0001, η = 0.28) and practice (F (1, 48) = 14.52, p < 0.0001, η = 0.23), both indicating large effect sizes, compared with the control group. CONCLUSION: The study results indicate that the WhatsApp chatbot-based training program is an effective e-learning approach that helped hemodialysis nurses develop their infection control knowledge and practice. The results suggest that WhatsApp chatbot-based education provides nurse managers with a flexible and scalable method to enhance infection control competencies and improve patient safety in hemodialysis units.
Correction to "Psychometric Properties of the Mandarin Version of the Quality Improvement Self-Efficacy Inventory Among the Nurses: A Methodological Study".
J Nurs Manag · 2026 · PMID 42144699 · Full text
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Usability and Behavioral Intention in Quasimandatory National Digital Health Systems: The Mediating Role of E-Satisfaction.
Kılıç B, Durmaz Y
J Nurs Manag · 2026 · PMID 42142039 · Full text
The rapid expansion of national digital health infrastructures has transformed the way citizens interact with healthcare systems. However, the long-term success of these platforms depends not only on technological implem...
The rapid expansion of national digital health infrastructures has transformed the way citizens interact with healthcare systems. However, the long-term success of these platforms depends not only on technological implementation but also on users' perceptions and continued engagement. This study investigates how the usability of a national mobile health application influences users' behavioral intention through the mediating role of e-satisfaction. Drawing on usability and technology acceptance literature, the study proposes a research model in which the perceived usability of a mobile health application positively affects users' behavioral intention both directly and indirectly via e-satisfaction. Empirical data were collected from users of the Turkish national digital health platform e-Nabız through a structured survey. The proposed research model was tested using structural equation modeling techniques. The results indicate that mobile health application usability significantly enhances users' e-satisfaction, which in turn positively influences behavioral intention, including recommendation intention and continued preference intention. Interestingly, the analysis revealed that even negative usability perceptions were associated with increased e-satisfaction, likely reflecting the quasimandatory nature of the platform, where functional necessity and perceived value can outweigh usability difficulties. The findings also demonstrate the mediating role of e-satisfaction in the relationship between usability and behavioral intention. By focusing on a large-scale national digital health platform, this study contributes to the growing literature on digital health adoption by highlighting the importance of usability-driven user experience in quasimandatory digital health systems. The results provide practical insights for policymakers and digital health system designers seeking to improve citizen engagement and long-term utilization of national digital health infrastructures.
Exploring the Implementation of a New Nursing Role Using the CFIR-ERIC Approach: A Qualitative Study.
Saragosa M, Shing P, Hirji ZA … +2 more , Ronald K, Jeffs L
J Nurs Manag · 2026 · PMID 42141845 · Full text
AIM: This study aimed to retrospectively describe the implementation barriers and facilitators when introducing a new nursing role (RPN) using the Consolidated Framework for Implementation Research (CFIR) and to map impl...
AIM: This study aimed to retrospectively describe the implementation barriers and facilitators when introducing a new nursing role (RPN) using the Consolidated Framework for Implementation Research (CFIR) and to map implementation strategies onto the Expert Recommendations for Implementing Change (ERIC) factors to identify relevant strategies supporting new role implementation in the acute care setting. DESIGN: A qualitative descriptive study embedded in a multiphase implementation evaluation study. METHODS: Semistructured interviews with organizational leaders, implementation leaders, and nurses, combined with document analysis, were analyzed using the CFIR deductively to identify barriers and enablers mapped to the ERIC tool for strategies guiding implementation. RESULTS: Participants (N = 25) represented organizational leaders (n = 3), implementation leaders (n = 11), RNs (n = 4), and RPNs (n = 7) from October 2024 to January 2025. Seventeen CFIR constructs across five domains were identified. Common themes of enablers include factors in the inner setting, such as a tension for change, mission alignment, and innovation compatibility. Many enablers were also found in the implementation process, which involved teaming, assessing context and needs, engaging, tailoring strategies, and reflecting and evaluating. Barriers to implementation were found in the inner setting, including culture and limited access to knowledge and information about the role. Eleven implementation strategies were identified to address or amplify the barriers or enablers, including involving and preparing staff for the introduction, developing education material, and identifying champions. CONCLUSION: The introduction of the RPN role in acute care was shaped by organizational readiness, leadership support, and workforce needs, while challenges related to role clarity and team integration remained. Implementation science approaches may help guide strategies to support the successful integration of new nursing roles within hospital care delivery models. REPORTING METHOD: This study adhered to COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Effects of Immersive Virtual Reality Simulation on Nursing Students' Learning Outcomes: A Systematic Review and Meta-Analysis.
Li X, Hu Y, Peng H … +5 more , Luo S, Yang C, Luo B, Wan X, Li Y
J Nurs Manag · 2026 · PMID 42141728 · Full text
BACKGROUND: Traditional nursing education faces significant challenges in bridging theoretical knowledge and clinical practice, with clinical placements increasingly constrained by limited availability and patient safety...
BACKGROUND: Traditional nursing education faces significant challenges in bridging theoretical knowledge and clinical practice, with clinical placements increasingly constrained by limited availability and patient safety concerns. Immersive virtual reality (IVR) simulation offers unprecedented sensory immersion and spatial presence as a potential solution. However, existing evidence regarding IVR's effectiveness in nursing education remains fragmented and inconclusive. OBJECTIVE: To evaluate the effectiveness of IVR simulation on nursing students' learning outcomes using Bloom's taxonomy. METHODS: This systematic review and meta-analysis followed PRISMA guidelines and included randomized controlled trials comparing IVR simulation with conventional education in nursing students. MEDLINE, Embase, CINAHL, and CENTRAL were searched from inception to March 25, 2025. Outcomes were classified into cognitive, psychomotor, and affective domains according to Bloom's taxonomy. Random-effects models were applied, with subgroup and sensitivity analyses conducted to explore sources of heterogeneity and identify potential effect modifiers. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. RESULTS: Twenty RCTs involving 2063 nursing students were included. In the cognitive domain, IVR simulation significantly improved knowledge acquisition (SMD = 0.33, 95% CI: 0.04-0.61); numerical trends suggested stronger effects when debriefing was incorporated, and benefits diminished at follow-up. In the psychomotor domain, IVR simulation did not significantly enhance skill performance (SMD = 0.49, 95% CI: -0.24-1.22), despite a numerical trend favoring the intervention. In the affective domain, IVR simulation significantly improved self-efficacy (SMD = 0.38, 95% CI: 0.04-0.72) but showed no significant effects on satisfaction or confidence. Adverse effects were generally mild and consisted primarily of visual and vestibular symptoms. CONCLUSION: IVR simulation may enhance knowledge acquisition and self-efficacy among nursing students. The importance of debriefing and the need for reinforcement strategies to sustain knowledge gains were highlighted. IVR's effects on skills and other affective outcomes remain inconclusive. Further high-quality RCTs with standardized protocols are required to clarify IVR's role in nursing education.
Turnover Intention and Associated Factors Among Night-Shift Midwives in China: A Cross-Sectional Study.
He D, Zhang J, He J … +7 more , Zuo J, Meng Y, Li N, Huang Y, Zhu M, Wang G, Luo B
J Nurs Manag · 2026 · PMID 42138800 · Full text
OBJECTIVE: Midwives play a crucial role in maternal and neonatal health. However, there is a growing global shortage of midwives, and the high turnover rate is a key contributing factor. The research focusing on the turn...
OBJECTIVE: Midwives play a crucial role in maternal and neonatal health. However, there is a growing global shortage of midwives, and the high turnover rate is a key contributing factor. The research focusing on the turnover intention of night-shift midwives is limited in China. METHODS: This cross-sectional study was conducted from January to December 2023 across 493 public hospitals in mainland China, with 1588 night-shift midwives participating. A self-designed questionnaire collected sociodemographic information and night-shift work-related characteristics. Turnover intention was measured using the Turnover Intention Scale, and sleep quality was assessed using the Pittsburgh Sleep Quality Index. Multiple linear regression analysis was conducted to identify factors influencing turnover intention. RESULTS: A proportion of 49.7% (n = 789) of night-shift midwives reported turnover intentions. Lower turnover intention was associated with being married, having better health status, good sleep quality, and ≥ 15 years of work experience. Higher satisfaction with shift scheduling and overall work were also associated with lower turnover intention. Conversely, completing additional work during rest time after night shifts and experiencing job burnout were associated with higher turnover intentions. CONCLUSIONS: High turnover intention among night-shift midwives represents a significant challenge for maternal health services in China. Hospital administrators may consider prioritizing shift scheduling systems, regularly monitoring job burnout and satisfaction levels, and implementing targeted interventions to reduce turnover and ensure workforce sustainability.
Life Adjustment of Second- and Third-Year Nurses in Japan Engaged in Shift Work Under a Health Self-Management Program: Qualitative Analysis.
Nagata A
J Nurs Manag · 2026 · PMID 42136543 · Full text
AIM: This study aimed to interpretively explore the life adjustment processes of second- and third-year nurses engaged in shift work under a health self-management program, focusing on the integration of professional ada...
AIM: This study aimed to interpretively explore the life adjustment processes of second- and third-year nurses engaged in shift work under a health self-management program, focusing on the integration of professional adaptation and well-being. METHODS: Seven nurses in their second or third year of clinical practice participated in a program utilizing Ryodoraku biofeedback. Data from interviews were analyzed using the Steps for Coding and Theorization method. RESULTS: The adjustment process was conceptualized into three overarching themes: (1) navigating physiological limits and autonomous health regulation, where nurses utilized biofeedback to bridge the gap between subjective fatigue and physiological reality; (2) emotional dissonance and the struggle for agency, involving the negotiation of workplace demands; and (3) integrating professional growth and personal revitalization, where health management became a strategy for professional identity formation. CONCLUSION: The use of visual biofeedback served as a catalyst for participants to reflect on and transition toward proactive self-regulation, instead of passive endurance. The findings suggest that supporting early-career nurses requires not only rest but also tools to visualize physiological states and organizational support to foster professional agency, linking health management directly to career sustainability.
Perceptions of Factors Associated With Sustainability of Evidence-Based Nursing Practice: A Sequential Mixed Methods Study.
Lai J, Zhang Y, Chi J … +11 more , Miao J, Lin H, Luo W, Fu J, Deng S, Guo Z, Zhong C, Tang J, Guo B, Yang T, Wu Y
J Nurs Manag · 2026 · PMID 42136524 · Full text
BACKGROUND: To improve the quality of nursing services and patient outcomes, the implementation of evidence-based nursing practice (EBNP) becomes increasingly important. Little is known about determinants to sustainabili...
BACKGROUND: To improve the quality of nursing services and patient outcomes, the implementation of evidence-based nursing practice (EBNP) becomes increasingly important. Little is known about determinants to sustainability of EBNP. OBJECTIVE: To explore potential barriers and facilitators in the sustainability of EBNP from Chinese nurses' perspectives. METHODS: A cross-sectional survey and semistructured interviews were conducted among Chinese nurses participating in evidence-based practice (EBP) between May to June 2023 and June to July 2024. The interviews and answers to the open-ended questions were analyzed using content analysis. Based on the length of time that EBNP has been routinely applied in clinical settings, we divided the time into seven stages from not routinely used to greater than 5 years. Descriptive statistics evaluated barriers and facilitators influencing sustainability in different stages. RESULTS: Of 406 nurses surveyed, 319 provided valid responses. Fifteen nurses participated in interviews. Among 48 constructs in updated Consolidated Framework for Implementation Research, participants reported 3 as barriers, 7 as facilitators, and 21 as both barriers and facilitators. The remaining 17 constructs were not mentioned by participants or were mentioned with insufficient frequency to be categorized as either barriers or facilitators. Major facilitators included benefits to patients and professionals, access to information technology infrastructure, commitment, competent leadership, team and leadership support, incentives, training, assessment of patients' and professionals' needs, regular tailoring of strategies, and quality control measures/supervision. Barriers across the sustainment phases included heavy workload, staffing shortages, limited leadership support, low compliance, and low enthusiasm among nurses, even after EBP had been sustained for over 5 years. CONCLUSION: The findings enhance understanding of factors promoting the sustainability of EBP from nurses' perspectives. They highlight that dynamically identifying related barriers provides lessons for designing strategies and programs that promote the sustainability of EBNP in China.
Effects of Decision Aids on Decision Knowledge, Conflict, and Satisfaction Among Patients With Cancer: A Systematic Review and Meta-Analysis.
Chen Y, Zhu C, Li L … +3 more , Li J, Yan Q, Hu X
J Nurs Manag · 2026 · PMID 42136107 · Full text
AIM: To examine the effects of decision aids (DAs) on decision knowledge, conflict, and satisfaction among patients with cancer. BACKGROUND: DAs are frequently used to improve the quality of health decision-making across...
AIM: To examine the effects of decision aids (DAs) on decision knowledge, conflict, and satisfaction among patients with cancer. BACKGROUND: DAs are frequently used to improve the quality of health decision-making across various cancer types (e.g., breast, prostate, and colorectal cancer). However, the impact of DAs on decision knowledge, conflict, and satisfaction remains unclear, and the various delivery methods (e.g., telephone, brochure, mixed delivery methods, and web-based delivery methods) exhibit inconsistent effects. METHODS: We systematically searched eight databases and two search engines from inception to November 30, 2025, for randomized controlled trials (RCTs), evaluating DAs in adult cancer patients facing treatment decisions. A frequentist random-effects meta-analysis was conducted using Stata 16.0 to synthesize the primary outcomes of decision knowledge, conflict, and satisfaction. Pooled effects were estimated as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Heterogeneity was explored via subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and Egger's test, with the trim-and-fill method applied when indicated. The methodological quality of individual studies was assessed using the Cochrane Risk-of-Bias Tool 2.0 (ROB 2), and the overall certainty of the evidence for each outcome was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RESULTS: Thirty RCTs with 4303 cancer patients were included. The pooled analysis showed a positive effect on decision knowledge (SMD = 0.91, 95% CI: 0.49-1.33) and a reduction in decision conflict (SMD = -0.23, 95% CI: -0.39 to -0.07). No significant effect was observed on decision satisfaction (SMD = 0.03, 95% CI: -0.42-0.48). In subgroup analyses, all three delivery methods (brochure, web-based, and mixed) were associated with increased decision knowledge, while only web-based and mixed methods were associated with reduced decision conflict. DAs designed for both specific and various cancer types were associated with improved knowledge, whereas only those targeting a specific cancer type were associated with reduced conflict. CONCLUSION: DAs are effective in improving decision knowledge and reducing decision conflict, but they do not effectively increase decision satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses should integrate evidence-based DAs, particularly web-based and mixed delivery formats, into routine cancer care to enhance patients' decision knowledge and reduce conflict. To maximize effectiveness, DAs should be tailored based on targeted cancer types, educational levels, and health literacy to achieve unmet needs in decision satisfaction.
From Resilience Gap to Recovery: A Longitudinal Study of Nurse Job Satisfaction, Seniority, and Managerial Interventions in the Postpandemic Era.
Lee YW, Lai FC, Siao HJ … +4 more , Huang YC, Chen CL, Jhuang YC, Lin CH
J Nurs Manag · 2026 · PMID 42132342 · Full text
AIM: The COVID-19 pandemic has exerted a profound and enduring impact on nurse job satisfaction. Guided by the Job Demands-Resources (JD-R) model, this study aimed to examine (1) longitudinal differences in job satisfact...
AIM: The COVID-19 pandemic has exerted a profound and enduring impact on nurse job satisfaction. Guided by the Job Demands-Resources (JD-R) model, this study aimed to examine (1) longitudinal differences in job satisfaction trajectories across seniority levels, conceptualized as a "Resilience Gap" driven by dynamic resource depletion, and (2) the emergence of recovery following an adaptive institutional response. DESIGN AND METHODS: A 5-year longitudinal observational design was employed using nine waves of panel data (2020-2025) from 2162 nurses (8009 observations) at a large Taiwanese medical center. Linear mixed-effects modeling was applied to estimate within-person changes and between-group differences over time. In early 2024, nursing leadership implemented a set of generation-sensitive, hospital-wide managerial interventions, including structured mentorship, empowerment forums, and autonomous e-rostering. The 2025 outcomes were interpreted descriptively within a noncausal framework. RESULTS: From 2020 to 2024, a distinct "Resilience Gap" emerged, with job satisfaction among junior and midcareer nurses declining significantly faster than that of senior nurses. This disparity widened progressively during the prolonged "coexistence phase" of the pandemic. In the final observation period (2025), an observable rebound in job satisfaction was identified among less experienced nurses. This descriptive inflection, while temporally aligned with the implementation of managerial interventions, does not imply causal attribution. CONCLUSION: The findings conceptualize resilience as a dynamic regulatory capacity within the JD-R framework, reflecting the ongoing balance between job demands and available resources. The observed recovery suggests that proactive, generation-sensitive managerial strategies may be associated with mitigating prolonged occupational strain although causal inference cannot be established within the present design. IMPACT: This study introduces the "Resilience Gap" as a longitudinal diagnostic construct for workforce monitoring and provides a theoretically grounded, data-informed foundation for developing adaptive management strategies. The findings highlight the importance of continuous resource alignment, multisource monitoring, and empathetic leadership in sustaining a resilient, multigenerational nursing workforce.
Turkish Version of the Unfinished Nursing Care Survey: Validity and Reliability Data.
Özsaban A, Taskiran Eskici G, Palese A … +2 more , Grassetti L, Bassi E
J Nurs Manag · 2026 · PMID 42132010 · Full text
BACKGROUND: Measuring unfinished nursing care (UNC) with valid and reliable instruments is essential for identifying systemic issues and improving patient safety and outcomes. The Unfinished Nursing Care Survey (UNCS) wa...
BACKGROUND: Measuring unfinished nursing care (UNC) with valid and reliable instruments is essential for identifying systemic issues and improving patient safety and outcomes. The Unfinished Nursing Care Survey (UNCS) was developed as a comprehensive, valid, and reliable tool. This study aimed to examine the validity and reliability of the Turkish version of the UNCS (UNCS-TR). METHODS: This validation study established the linguistic equivalence of the UNCS-TR using the translation and back-translation method. Content validity was evaluated based on expert opinions. Construct validity, internal consistency, hypothesis testing, and criterion validity were examined among 422 nurses in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. RESULTS: The overall content validity index of the UNCS-TR was 0.98. Mokken Scale Analysis for Part A demonstrated strong scalability (H = 0.616) and excellent internal consistency (Molenaar-Sijtsma statistic = 0.966; Cronbach's alpha = 0.964; Guttman's lambda 2 = 0.965). All 21 items reflecting elements of unfinished care loaded onto a unidimensional structure in Part A. For Part B, which measures reasons for UNC, confirmatory factor analysis supported an 18-item, six-factor structure with acceptable to good fit indices and excellent internal consistency (Cronbach's α = 0.950). Nurses with greater professional experience reported significantly lower perceptions of UNC. No significant differences were found between bedside nurses and nurse managers. Nurses over 30 years of age perceived significantly fewer instances of UNC compared to younger nurses, and intensive care nurses reported significantly fewer instances than those working in medical-surgical units. CONCLUSION: The Turkish version of the UNCS (UNCS-TR) is a valid and reliable instrument for measuring UNC.
When Tech Meets Touch: Multistakeholder Perspectives and Implementation Strategies for eHealth in Chronic Kidney Disease: A Systematic Review Using Computational Linguistics.
Zheng X, Xie L, Liu Y … +4 more , Yu Q, Zhang H, Zhang X, Wang A
J Nurs Manag · 2026 · PMID 42130091 · Full text
BACKGROUND: Chronic kidney disease heavily burdens patients and health systems. Digital health interventions offer significant potential but face implementation challenges driven by stakeholders' emotional and practical...
BACKGROUND: Chronic kidney disease heavily burdens patients and health systems. Digital health interventions offer significant potential but face implementation challenges driven by stakeholders' emotional and practical experiences. This review synthesizes these affective dimensions to inform clinical practice. METHODS: A qualitative systematic review was conducted across six databases for studies published through April 2025. Methodological quality was rigorously appraised. We integrated Python-based computational sentiment analysis to quantify stakeholder emotional polarity (positive, negative, neutral) with thematic analysis. Identified barriers were mapped to established implementation frameworks to select expert-validated implementation strategies. RESULTS: Twenty-three qualitative studies were included, revealing five domains: accessibility, communication, workflow, empowerment, and clinical effectiveness. Patients praised digital empowerment but highlighted socioeconomic access barriers. Nurses valued workflow efficiencies but reported role ambiguity. Clinicians expressed deep skepticism toward remote clinical effectiveness due to diagnostic limitations. To resolve these tensions, prioritized implementation strategies include identifying clinical champions, promoting intervention adaptability, and systematically assessing organizational readiness before deployment. CONCLUSION: Stakeholder emotions critically dictate digital health adoption. For clinical practice, these findings emphasize moving beyond generic deployments. Healthcare systems must address clinician diagnostic concerns via hybrid care models, resolve nurse workflow ambiguities through targeted training, and provide low-cost devices to bridge patient equity gaps. Tailoring solutions to these psychosocial needs is essential for successful integration into routine kidney care.
The Influence Path Analysis of Clinical Nurses' Job Satisfaction Based on the Dual-Factor Theory.
Jia W, Wang H, Gao L … +3 more , Chen Z, Lu H, Dong W
J Nurs Manag · 2026 · PMID 42124382 · Full text
BACKGROUND: Clinical nurses significantly contribute to sustaining healthcare systems worldwide. However, they experience multiple adverse situations that affect their job satisfaction, which in turn influences the quali...
BACKGROUND: Clinical nurses significantly contribute to sustaining healthcare systems worldwide. However, they experience multiple adverse situations that affect their job satisfaction, which in turn influences the quality of nursing services. AIM: To analyze the pathways influencing clinical nurses' job satisfaction from the perspective of the dual-factor theory. METHODS: We recruited 202 clinical nurses from August to September 2024 using a convenience sampling method for this cross-sectional questionnaire survey assessing job burnout, job satisfaction, and fear of missing out. The fuzzy-set qualitative comparative analysis (fsQCA) method was used to examine the factors, their synergistic effects, and the configurational pathways through which different combinations of factors influence clinical nurses' job satisfaction. RESULTS: The average score for job satisfaction in this study was 60.28 ± 10.51 points. Single-factor analysis showed that age, fear of missing out, and job burnout were significantly associated with job satisfaction. However, fsQCA necessity analysis indicated that no single factor was a necessary condition for high job satisfaction (consistency < 0.9). The configuration analysis extracted six sufficient condition combinations, categorized into two types: hygiene-dominated and motivation-health configurations. Among these, age (as a moderating variable) emerged as a core condition in several configurations. CONCLUSION: The fsQCA method, grounded in the two-factor theory, illustrated the influence of multiple interacting and synergistic factors on clinical nurses' job satisfaction and identified the specific elements contributing to high job satisfaction within various configurations of their roles. This insight helps hospitals and nursing managers identify optimal combination of factors that enhance the stability of clinical nurses' careers and clarify potential improvement pathways from a configuration perspective. Overall, our findings provide novel evidence and a framework for the development of effective interventions to enhance job satisfaction.
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