J Nurs Scholarsh [JOURNAL]
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200 papers
Social Determinants of Health and Falls Among Community-Dwelling Older Adults: A Zero-Inflated Negative Binomial Regression Analysis.
Kim E, Wi D, Lee J … +2 more , Park C, Kim Y
J Nurs Scholarsh · 2026 Jan · PMID 41532404 · Publisher ↗
INTRODUCTION: Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors...
INTRODUCTION: Falls among older adults represent a major public health challenge, yet research examining the role of social determinants of health (SDOH) in fall risk remains limited. This study aimed to identify factors associated with fall occurrence and fall frequency among community-dwelling older adults in Korea, with particular emphasis on SDOH. DESIGN: A cross-sectional study design. METHODS: We used a large nationwide sample (n = 9746) from the 2023 National Survey of Older Koreans. The number of falls in the past year served as the dependent variable. Independent variables included a range of socioeconomic and environmental variables as SDOH, alongside biological and behavioral variables. A zero-inflated negative binomial (ZINB) regression analysis was employed to address excess zeros and overdispersion in fall count data. RESULTS: Among participants, 94.8% experienced no falls, 3.2% reported a single fall, and 1.9% reported recurrent falls. In the logit model for fall occurrence, higher household income level, absence of age-friendly housing, higher access to parks, and lower access to welfare centers were associated with higher risk of fall occurrence. In the count model for fall frequency, higher education level, presence of age-friendly housing, and outdoor mobility barriers were associated with higher fall frequency within the at-risk group. CONCLUSIONS: The findings provide empirical evidence on the critical roles of SDOH in falls among community-dwelling older adults. Specifically, a ZINB regression analysis identified distinct sets of SDOH associated with fall occurrence versus fall frequency, highlighting the complex and multifaceted nature of fall patterns among older adults. CLINICAL RELEVANCE: Healthcare providers and policymakers seeking to reduce falls should implement tailored, SDOH-integrated strategies by addressing the different mechanisms underlying fall occurrence and fall frequency.
Parents' Experiences of Having an Adolescent With a Mental Disorder Admitted to a Public Hospital's Psychiatric Unit.
Vorster-Mbontsi H, Ndlovu N, Poggenpoel M
J Nurs Scholarsh · 2026 Feb · PMID 41521530 · Full text
INTRODUCTION: Parents of adolescents with a mental disorder describe having overwhelming feelings regarding the psychiatric diagnosis, which they respond to with grief. Existing research indicates that these parents face...
INTRODUCTION: Parents of adolescents with a mental disorder describe having overwhelming feelings regarding the psychiatric diagnosis, which they respond to with grief. Existing research indicates that these parents face unique challenges, such as self-blame and stigma. Parents are crucial in adolescent care, and healthcare professionals should find interventions that educate parents about the disorder, treatment and symptom management. The aim of this study was to explore and describe parents' experiences in having an adolescent with a mental disorder admitted to the psychiatric unit of a public hospital in Gauteng, South Africa. DESIGN: The study used Heidegger's interpretive phenomenological design. METHODS: A qualitative, exploratory, descriptive and contextual method was used. Data were collected through semi-structured telephonic interviews with 10 parents who had an adolescent with a mental disorder admitted to a public hospital in Gauteng, South Africa. Tesch's thematic coding steps were used for data analysis. RESULTS: The themes arising from the findings reflected (1) parents experienced that their lives were stuck amid grief for the loss of what their adolescent child used to be, and anxiety about what the future holds, (2) parents experienced that when they reached out for professional help, the healthcare system failed them due to a lack of guidance, information and support, (3) parents experienced that they prayed for divine intervention as a coping strategy, and (4) parents experienced stigma from the community. CONCLUSION: The findings illustrate the need for psychiatric nurses to facilitate the mental health of parents of adolescents with a mental disorder. Furthermore, positive attitudes among parents are improved once they are empowered and receive the necessary support, and stigmatization will also be reduced. It is recommended that further research be conducted to explore the effectiveness of emotional and professional support in addressing the challenges parents experience with an adolescent who has a mental disorder. CLINICAL RELEVANCE: This paper contributes knowledge to nursing practice by exploring the experiences of parents who have an adolescent with a mental disorder in the South African context.
Examining Stroke Symptom Messages Implemented Globally: A Need for Contextually Relevant Stroke Symptom Messaging.
Singh H, Belson S, Beauchamp JES … +1 more , Nelson MLA
J Nurs Scholarsh · 2026 Jan · PMID 41404701 · Full text
BACKGROUND: Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messa...
BACKGROUND: Stroke is a global health concern. A timely response to a stroke can help reduce morbidity and mortality. However, barriers to timely response include poor recognition of stroke symptoms. Stroke symptom messages are designed to increase stroke recognition and encourage individuals to seek urgent medical assistance. The Face, Arm, Speech, Time (FAST) and Balance, Eyes, Face, Arm, Speech, Time (BE FAST) are commonly used stroke symptom messages shown to improve stroke symptom recognition and response. However, cultural factors and language differences may limit the effectiveness of stroke symptom messages and their acceptability in different countries and contexts. There has not been a comprehensive examination of the stroke symptom messages used worldwide and how these messages have been adapted in various settings. AIMS: We explored what stroke response messages are being used globally, and the contextual factors that influence the adoption of a stroke response mnemonic in different settings. METHODS: A 14-item survey was disseminated by the World Stroke Organization to its networks. The survey contained open- and closed-ended questions and allowed uploading relevant stroke symptom campaign materials. The survey was analyzed using descriptive statistics and a content analysis. RESULTS: All except one survey respondent used a stroke symptom message. Fifteen respondents (27%) reported they did not translate their stroke awareness messaging. Of these 15 respondents, they used the English versions of FAST (n = 8), BE FAST (n = 4), and both FAST and BE FAST (n = 3). Forty respondents (71%) reported that they/their organization used an acronym to raise public awareness of the signs/symptoms of stroke that was different from FAST or BE FAST (English), many of which were direct or indirect translations or influenced by FAST and BE FAST. Survey responses shared insights and recommendations related to the content, tailoring and dissemination of stroke symptom messages. CONCLUSIONS: Study findings highlight the global use of stroke symptom messages and their contextual adaptations to fit diverse settings and contexts. The challenges in applying universal or commonly used stroke symptom messages to different contexts were highlighted. CLINICAL RELEVANCE: Nurses could have a key role in raising awareness of stroke symptoms and the development of locally adapted stroke symptom messages.
Creating a Healthy Work Environment by Balancing Work-Family Conflict Through Ethical Leadership: A Structural Equation Modeling Approach.
Della Bella V, Moraca E, Basso RR … +8 more , Carosi N, Imoletti D, Palladino L, Pulcini F, Trebbi E, Tognaccini L, Fiorini J, Sili A
J Nurs Scholarsh · 2026 Jan · PMID 41398976 · Publisher ↗
INTRODUCTION: Creating a healthy work environment requires balancing organizational goals with ethical responsibilities, where head nurses' ethical leadership can shape staff outcomes by mitigating work-family conflicts...
INTRODUCTION: Creating a healthy work environment requires balancing organizational goals with ethical responsibilities, where head nurses' ethical leadership can shape staff outcomes by mitigating work-family conflicts and promoting nurses' well-being, retention, and patient safety. This study aims to analyze the mediating role of work-family between head nurses' ethical leadership and nurses' reported errors, turnover intention, and physical and mental health. DESIGN: Nationwide Multicenter cross-sectional study. METHODS: Validated self-report scales were used to assess nurses' perceptions of head nurses' ethical leadership, work-family conflict, error, turnover intention, physical and mental health. Descriptive and inferential analyses were conducted. Structural equation modeling examined the relationships among these variables based on Della Bella's and Fiorini's framework. RESULTS: Data from 409 nurses across seven Italian hospitals was analyzed. The structural equation model showed an excellent fit. Head nurses' Ethical leadership was negatively associated with work-family conflicts, turnover intention, and errors, and positively associated with nurses' health. Work-family conflicts were significantly linked to turnover intention, errors, and nurses' health. Work-family conflicts mediate the relation between ethical leadership and turnover intention, errors, and nurses' health. CONCLUSION: Promoting healthy work environments is crucial for nurses', patients', and organizations' well-being. Ethical leadership helps achieve this condition by reducing work-family conflicts, fostering nurses' well-being, decreasing turnover intention, and improving care quality. Disseminating ethical leadership programs and integrating with work-life balance policies can therefore strengthen both staff retention and organizational outcomes. CLINICAL RELEVANCE: Ethical leadership can foster patient care, reduce turnover intention and errors, and improve nurses' well-being. Therefore, maintaining employee performance and organizational results requires integrating work-life balance policies with ethical leadership development programs. REPORTING METHOD: The study adhered to The Strengthening the Reporting of Observational Studies in Epidemiology checklist. NO PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement. PROTOCOL REGISTRATION: The study was preregistered on the Open Science Framework https://osf.io/8jk37/overview. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.
Investigating the Personal and Professional Variables That Predict Discrimination Attitudes Among Nurses and Physicians.
Tekin S, Harmanci Seren AK
J Nurs Scholarsh · 2026 Feb · PMID 41320832 · Publisher ↗
INTRODUCTION: Healthcare professionals are expected to provide holistic care to their patients without discrimination based on factors such as religion, language, age, gender, and race. DESIGN: It is a cross-sectional de...
INTRODUCTION: Healthcare professionals are expected to provide holistic care to their patients without discrimination based on factors such as religion, language, age, gender, and race. DESIGN: It is a cross-sectional descriptive study. AIM: The study aimed to examine the discriminatory attitudes of nurses and physicians working in hospitals in Sanliurfa and to define whether the personal and professional variables predict discriminatory attitudes among them. METHODS: The STROBE reporting method, which is one of the EQUATOR guidelines, was followed. Data were collected from a total of 376 physicians and nurses through online platforms between March and June 2020 via the information form and the Discrimination Attitude Scale. RESULTS: The discriminatory attitudes of the nurses and physicians participating in the study were above average. The total discriminatory attitudes scores of the participants varied according to sex, income levels, profession, hospital experience, and unit (p < 0.05). In addition, sex, profession and unit variables predicted the total discriminatory attitudes of nurses and physicians (p < 0.05). CONCLUSION: Although nurses' and physicians' discriminatory attitudes scores were generally higher, the highest mean score was in the subscale "discrimination against other nationalities." Sex, profession, and unit variables predicted the total discriminatory attitudes of nurses and physicians. Further quantitative and qualitative research is needed to understand the reasons for the highest discriminatory attitudes towards other nationalities among healthcare professionals, to overcome this issue. CLINICAL RELEVANCE: Nursing or healthcare managers, as well as policymakers, may consider the predictive variables when staffing and training nurses and physicians working in similar regions and conditions.
Evaluation of the Integration of Genetics and Genomics Into Nursing Practice.
Calzone K, Stokes L, Peterson C … +3 more , Yee LM, Liewehr D, Badzek L
J Nurs Scholarsh · 2026 Jan · PMID 41276756 · Full text
PURPOSE: Assess US registered nurse genomic competency. DESIGN: Administered the Genetics and Genomics Nursing Practice Survey (GGNPS). METHODS: GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utiliz...
PURPOSE: Assess US registered nurse genomic competency. DESIGN: Administered the Genetics and Genomics Nursing Practice Survey (GGNPS). METHODS: GGNPS assesses genomic knowledge, skills, attitudes, confidence, and utilization in nursing practice. Distributed by the American Nurses Association via email and online to US registered nurses. Results are analyzed using descriptive statistics and compared to 2010 data. RESULTS: 1065 registered nurses responded. Most (41%) were Master's prepared, actively seeing patients (51%) and 66% considered it very important to learn more about genomics. Most (55%) reported their genomic knowledge was poor yet 51% reported a patient initiated a genetic discussion with them in the past 3 months. 66% completed all knowledge score items with a median score of 9/12, no change from 2010. Only 26% had heard of the Essential Competencies. Most reported no genomic curricular content (64%); had not attended a genomic course since licensure (64%); intended to learn more about genomics (70%); and would attend a course on their own time (79%). CONCLUSIONS: Nurses felt genomics was important but have capacity deficits. Despite genomic discoveries and evidence-based practice guidelines that impact healthcare quality and safety, 20 years after the Genomic Competencies were established (2005) nursing genomic practice capacity remains low. CLINICAL RELEVANCE: Genomics is critical to the safe, quality nursing practice regardless of the level of academic training, clinical role, or specialty.
Invisible Inequities: Gender in Nursing and the Leadership Paradox.
Ferrer L, Bernales M, Bradbury C
J Nurs Scholarsh · 2026 Jan · PMID 41276720 · Publisher ↗
PURPOSE: To examine the paradox of representation without power in nursing leadership and to highlight how gendered hierarchies persist in academic, clinical, and policy arenas despite nursing's predominantly female comp...
PURPOSE: To examine the paradox of representation without power in nursing leadership and to highlight how gendered hierarchies persist in academic, clinical, and policy arenas despite nursing's predominantly female composition. ORGANIZING CONSTRUCT OR ARGUMENT: Existing systems of evaluation and promotion often reproduce inequities by undervaluing relational and collaborative leadership styles-forms of leadership intrinsic to nursing practice. This commentary draws on global and contextual perspectives to advocate for accreditation and institutional metrics that integrate equity indicators and recognize inclusive leadership as a marker of excellence. CONCLUSIONS: Advancing gender equity in leadership is both an ethical and strategic imperative. Embedding equity education and inclusive leadership development within nursing curricula from the earliest stages of professional formation is essential to reshape the future of nursing leadership. CLINICAL RELEVANCE: Promoting gender equity in leadership will strengthen nursing's contribution to health systems, enhance organizational resilience, and advance equitable patient care.
Moral Resilience Is Distinct From General Resilience When Predicting Burnout Among Interprofessional Health Care Workers: Secondary Analysis.
Nelson KE, Hanson GC, Giordano SS … +1 more , Rushton CH
J Nurs Scholarsh · 2026 Jan · PMID 41267446 · Publisher ↗
INTRODUCTION: Burnout, a form of moral suffering, has become more commonplace among health care workers in recent years. Measures of general resilience have been widely used to capture improvement in burnout but lack the...
INTRODUCTION: Burnout, a form of moral suffering, has become more commonplace among health care workers in recent years. Measures of general resilience have been widely used to capture improvement in burnout but lack the ability to capture the anguish that comes with burnout from a moral standpoint. The purpose of this analysis was to understand whether moral resilience is uniquely related to burnout beyond a measure of general resilience in a sample of interprofessional health care workers. DESIGN: Secondary analysis of cross-sectional survey data. METHODS: In total, 702 interprofessional health care workers participated in a cross-sectional survey. Key measures included the Rushton Moral Resilience Scale (RMRS), the Connor-Davidson Resilience Scale (CD-RISC-10), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Hierarchical multiple regression modeling was used to examine the effect of moral resilience (RMRS) in predicting the three dimensions of burnout (MBI-HSS) over and above general resilience (CD-RISC-10). RESULTS: Moral resilience explained five, six, and 4% of variance for personal accomplishment, depersonalization, and emotional exhaustion, respectively, after accounting for general resilience (CD-RISC-10) and all covariates. CONCLUSIONS: Findings highlight the clear conceptual differences between general and moral resilience and their unique relationship to burnout. Accounting for moral resilience will facilitate an improved multi-level response to moral suffering among health care workers. CLINICAL RELEVANCE: Measuring and understanding the differences between general resilience and moral resilience is vital for us to better facilitate the necessary support(s) for health care workers experiencing moral suffering. This will contribute to more sustainable clinical environments, reduced burnout and suffering, and improved patient outcomes.
Global, Regional, and National Incidence Trends of Pressure Injury From 1990 to 2021.
Xu X, Shi G, Yang W … +2 more , Liu P, Jiang L
J Nurs Scholarsh · 2026 Feb · PMID 41243730 · Publisher ↗
BACKGROUND AND OBJECTIVE: With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age gro...
BACKGROUND AND OBJECTIVE: With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age groups from 1990 to 2021. METHODS: This study utilized data from the Global Burden of Diseases (GBD) 2021 to determine the age-standardized incidence rate (ASR) of PI stratified by age groups from 1990 to 2021. Estimated annual percentage changes (EAPCs) were calculated to measure corresponding temporal trends. RESULTS: Over three decades, the incident cases of PI have doubled from 1.1 million to 2.5 million worldwide. The incidence of PI showed an exponential rise with increasing age groups in 2021. The significant increasing trends were observed in the population aged 20-54 years (EAPC = 0.11) and 55+ years (EAPC = 0.55) from 1990 to 2021. The ASR among males has increased from 32.53 to 33.34 per 100,000 population, with an EAPC of 0.27, while the ASR among females decreased. The ASR was increased with higher income levels and the highest ASR was observed in the high-income region (49.95 per 100,000 population). Among six regions, the Americas had the highest ASR in 2021 (90.20 per 100,000 population), while South-East Asia showed the fastest increase (EAPC = 1.22). CONCLUSIONS: The global burden of PI is a growing global health problem among the elderly population, particularly in the Americas. A greater incidence burden in males and high-income level regions was found. This study advocates for urgent attention to coping strategies for aging populations and older people with PI. CLINICAL RELEVANCE: This study advocates for urgent attention to coping strategies for aging populations.
Reframing Competence and Moral Clarity in Nursing Practice.
Babate FJ, Sa'at SF
J Nurs Scholarsh · 2026 Feb · PMID 41204687 · Publisher ↗
This article challenges the tendency to frame diminished confidence and ethical uncertainty among nurses as individual shortcomings. While the need for up-to-date knowledge and moral clarity is undeniable, this piece arg...
This article challenges the tendency to frame diminished confidence and ethical uncertainty among nurses as individual shortcomings. While the need for up-to-date knowledge and moral clarity is undeniable, this piece argues that systemic factors-such as inadequate institutional support, unsafe staffing, and lack of access to continuing education-play a significant role in undermining nurses' ability to act ethically and confidently. Drawing from global case examples, including the Ebola crisis and the COVID-19 pandemic, this article highlights how moral distress often stems not from ignorance or weakness, but from structural barriers and ethical overload.
Response.
Hirschfeld MJ
J Nurs Scholarsh · 2026 Feb · PMID 41204683 · Publisher ↗
Abstract loading — click title to view on PubMed.
Examining the Construction of Sensory Balance and Well-Being in Psychiatric Nurses Caring for Trauma Victims: A Qualitative Study.
Günday EA, Güler KG
J Nurs Scholarsh · 2026 Feb · PMID 41199426 · Publisher ↗
BACKGROUND: Sensory balance is the individual's ability to regulate internal and external sensory stimuli to remain in a functional and balanced state. OBJECTIVE: This study aims to explore in depth the experiences of ps...
BACKGROUND: Sensory balance is the individual's ability to regulate internal and external sensory stimuli to remain in a functional and balanced state. OBJECTIVE: This study aims to explore in depth the experiences of psychiatric nurses caring for trauma victims in building sensory balance and well-being. INTRODUCTION: Psychiatric nurses caring for trauma victims may be constantly exposed to intense sensory stimuli such as yelling and agitation. It is known that post-traumatic stress disorder and burnout are seen in nurses caring for these individuals; however, it is noteworthy that studies on how this process is reflected sensoryly in individuals are limited. METHOD: Snowball sampling method was used in this qualitative phenomenological study. In-depth interviews were conducted with 14 volunteer psychiatric nurses caring for trauma victims. Data were collected using a semi-structured interview form and analyzed using Colaizzi's method. COREQ guidelines were adhered to throughout the research process. FINDINGS: Four categories and a total of eight themes were obtained from the in-depth interviews. "Traces of Traumatic Contact, Emotional Armor and Inner Distance, Transformation through Exhaustion, Institutional Silence and Seeking Solidarity". CONCLUSION: This study shows that psychiatric nurses caring for trauma victims are both professionally and individually traumatized and face the risk of losing their identity. It has also been found that nurses withdraw both sensorially and emotionally and experience burnout. But in some cases this process transforms into the development of awareness and maturity. It was also found that despite adverse working conditions, contact with nature, silence and collegial solidarity played a protective role in rebuilding well-being. CLINICAL RELEVANCE: This study addresses in depth the sensory, emotional and identity impacts experienced by psychiatric nurses caring for trauma victims and draws attention to the effects of these conditions on the process of well-being construction. The results of the study provide important points for the development of education, self-care and institutional support mechanisms to support nurses' well-being.
What Do You Need to Know and What Knowledge Does the Discipline of Nursing Need to Discover?
Gennaro S
J Nurs Scholarsh · 2025 Nov · PMID 41131790 · Publisher ↗
Abstract loading — click title to view on PubMed.
Quality and Bias in Randomized Controlled Trials Published in Latin American Nursing Journals: A Meta-Epidemiological Study.
Buitrago-García D, Medina-Aedo M, Montesinos-Guevara C … +5 more , Rodriguez Vargas W, Lozano Hernández M, Castro CA, Pardo-Hernandez H, Bonfill X
J Nurs Scholarsh · 2025 Nov · PMID 40993964 · Publisher ↗
INTRODUCTION: Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains uncl...
INTRODUCTION: Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals. OBJECTIVE: To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals. DESIGN: Meta-research study. METHODS: A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed. RESULTS: A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16-22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having "some concerns", largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were "Delivery of care" and "Physical functioning". CONCLUSIONS: Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.
Lived Experiences of Transgender Inmates in Barcelona Prisons: An Interpretative Phenomenological Study.
Sererols-Serra J, Leyva-Moral JM
J Nurs Scholarsh · 2025 Nov · PMID 40968470 · Full text
INTRODUCTION: Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender...
INTRODUCTION: Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender prisoners' health management experiences. METHODOLOGY: An interpretative phenomenological approach was used. Data were collected through in-depth interviews with eight transgender inmates in Barcelona, Spain, and analyzed using the seven-step Colaizzi method. RESULTS: Three primary themes emerged: (1) Navigating Vulnerability in Healthcare Dynamics, which highlighted experiences of stigma and inadequate care; (2) The Quest for Wellbeing Amidst Uncertainty, underscoring concerns regarding treatment continuity; and (3) Negotiating a Landscape of Violence, revealing experiences of harassment and discrimination. DISCUSSION: This study highlights the need for culturally competent, person-centered healthcare policies in prisons, particularly for transgender individuals. Addressing the specific health needs of transgender inmates is crucial for enhancing their overall well-being. This emphasizes the importance of systemic reforms to improve care provision for transgender prisoners. CLINICAL RELEVANCE: Prison nurses must prioritize person-centered approaches, ensure continuity of gender-affirming treatments, and provide empathetic mental health support to enhance trust and improve the overall well-being of transgender inmates.
ChatGPT-4 in Nursing Research: A Methodological Evaluation of Bias Risk in Randomized Controlled Trials.
Tuncer M, Tuncer GZ
J Nurs Scholarsh · 2025 Nov · PMID 40958374 · Publisher ↗
BACKGROUND: Conducting bias assessments in systematic reviews is a time-consuming process that involves subjective judgments. The use of artificial intelligence (AI) technologies to perform these assessments can potentia...
BACKGROUND: Conducting bias assessments in systematic reviews is a time-consuming process that involves subjective judgments. The use of artificial intelligence (AI) technologies to perform these assessments can potentially save time and enhance consistency. Nevertheless, the efficacy of AI technologies in conducting bias assessments remains inadequately explored. AIM: This study aims to evaluate the efficacy of ChatGPT-4o in assessing bias using the revised Cochrane RoB2 tool, focusing on randomized controlled trials in nursing. METHODS: ChatGPT-4o was provided with the RoB2 assessment guide in the form of a PDF document and instructed to perform bias assessments for the 80 open-access RCTs included in the study. The results of the bias assessments conducted by ChatGPT-4o for each domain were then compared with those of the meta-analysis authors using Cohen's weighted kappa analysis. RESULTS: Weighted Cohen's kappa values showed better agreement in bias in the measurement of the outcome (D4, 0.22) and bias arising from the randomization process (D1, 0.20), while negative values in bias due to missing outcome data (D3, -0.12) and bias in the selection of the reported result (D5, -0.09) indicated poor agreement. The highest accuracy was observed in D5 (0.81), and the lowest in D1 (0.60). F1 scores were highest in bias due to deviations from intended interventions (D2, 0.74) and lowest in D3 (0.00) and D5 (0.00). Specificity was higher in D5 (0.93) and D3 (0.82), while sensitivity and precision were low in these domains. CONCLUSIONS: The agreement between ChatGPT-4o and the meta-analysis studies in the same RCT assessments is generally low. This indicates that ChatGPT-4o requires substantial enhancements before it can be used as a reliable tool for bias risk assessments. CLINICAL RELEVANCE: The AI-based tools have the potential to expedite bias assessment in systematic reviews. However, this study demonstrates that ChatGPT-4o, in its current form, lacks sufficient consistency, indicating that such tools should be integrated cautiously and used under continuous human oversight, particularly in evidence-based evaluations that inform clinical decision-making.
The Experience of Self-Care in People With Osteoporosis: A Qualitative Descriptive Study.
Tedesco C, Bernalte-MartÍ V, Tormen M … +11 more , Cuoco A, Pucciarelli G, Vellone E, De Maria M, Basilici Zannetti E, Cittadini N, Pennini A, Tecce SM, Smakaj A, Tarantino U, Alvaro R
J Nurs Scholarsh · 2025 Nov · PMID 40940711 · Publisher ↗
INTRODUCTION: Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailo...
INTRODUCTION: Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailored nursing interventions. The objective of the study was to explore and describe the experience of self-care maintenance, monitoring, and management in people with osteoporosis. DESIGN: A qualitative descriptive study. METHODS: We conducted semi-structured interviews. Data were analyzed using Mayring's qualitative content analysis with a deductive approach based on Riegel's theory of self-care. We reported data in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. RESULTS: Participants (1 Male, 19 Females; Aged 55-80) Identified Four Themes of self-care: maintenance (e.g., Medication Adherence, Physical Activity), monitoring (e.g., Symptom Recognition, Test Interpretation), management (e.g., Lifestyle Reflections, Prevention), and general self-care. Key factors included motivation, trust in healthcare professionals, and integration of health behaviors into daily life. Barriers were low self-efficacy, poor symptom recognition, and inconsistent adherence. CONCLUSION: Self-care in osteoporosis is a multidimensional and dynamic process influenced by individual beliefs, contextual factors, and support from healthcare professionals. Recognizing the variability in patients' self-care behaviors is essential to develop personalized education and support. Strengthening general health behaviors may enhance disease-specific self-care. This understanding can guide healthcare professionals in designing more effective, tailored care strategies.
Barriers to and Facilitators of Shared Decision-Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study.
Han J, Son YJ, Jang M … +2 more , Cho E, Ahn J
J Nurs Scholarsh · 2025 Nov · PMID 40936297 · Full text
INTRODUCTION: To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care. DESIGN: Qualitative descriptive study. METHODS: Qualitative inte...
INTRODUCTION: To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care. DESIGN: Qualitative descriptive study. METHODS: Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework. RESULTS: We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM. CONCLUSION: Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation. CLINICAL RELEVANCE: This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.
Effectiveness of an Online Training Program on Brief Tobacco Intervention (BTI) for Nurses: A Quasi-Experimental Study. The E-Learning BTI Project.
Ramos-Morcillo AJ, Ruzafa-Martinez M, Granero-Moya N … +3 more , Leal-Costa C, Fernández-Salazar S, García-Moral AT
J Nurs Scholarsh · 2025 Nov · PMID 40922133 · Full text
INTRODUCTION: Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions (BTIs) increases the effectiveness of these interventions. OBJECTIVE: To assess the effective...
INTRODUCTION: Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions (BTIs) increases the effectiveness of these interventions. OBJECTIVE: To assess the effectiveness of an online training program on BTI based on the 5As and 5Rs model in acquiring anti-tobacco brief advice competencies among nurses. METHOD: Quasi-experimental study with a pre-test and post-test design, with a control group and without random assignment. In the experimental group (EG), online training was provided in three sections: BTI theoretical content and methodology, clinical scenario videos, and feedback. Each scenario assessed the 5As and 5Rs as a validated instrument (BTI-Prof). The control group (CG) only assessed the three videos of clinical scenarios. In both groups, competence was measured at the following points in time: T0 (before the training), T1 (at the end of the training), and T2 (after 90 days). The efficacy of the intervention was measured through a two-way ANOVA, and the variation rate was calculated from T0 to T1 and from T0 to T2. RESULTS: 236 nurses participated (157 EG; 79 CG). The mean age was 42.9 years, and 76.7% were women. There was a significant group*time interaction in the three cases, indicating that the online BTI training increases the competence of these professionals in clinical scenario 1 (F = 10.210; p ≤ 0.001; η = 0.081), clinical scenario 2 (F = 6.235; p = 0.002; η = 0.051), and clinical scenario 3 (F = 11.271; p ≤ 0.001; η = 0.090). CONCLUSION: A brief, asynchronous, and online intervention using standardized video-based cases is effective in improving nurses' BTI competence. This type of training can be a useful option for the National Health System as part of a global and continuous strategy for nurses to perform BTI. CLINICAL RELEVANCE: An asynchronous online training program provides nurses with standardized, evidence-based tools to implement brief tobacco interventions in routine care, offering a scalable and practical solution to strengthen preventive strategies in health systems.
The Relevance of Sustainability and the Climate Crisis to the Nursing Profession and Nursing Education: A Literature Review.
Hendry M, Helfer T, Eissler C … +1 more , Burr C
J Nurs Scholarsh · 2025 Nov · PMID 40916075 · Full text
INTRODUCTION: The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems...
INTRODUCTION: The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations. DESIGN: A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded. METHODS: A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed. RESULTS: The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience. CONCLUSION: This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges. CLINICAL RELEVANCE: Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically, taking a leadership role includes both acting as a knowledge multiplier and increasing the health literacy of the general population.
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