J Nurs Scholarsh [JOURNAL]
Sun
200 papers
Artificial Intelligence Applications in Healthcare: A Systematic Review of Their Impact on Nursing Practice and Patient Outcomes.
Abdelmohsen SA, Al-Jabri MM
J Nurs Scholarsh · 2025 Nov · PMID 40836587 · Publisher ↗
BACKGROUND: Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analyt...
BACKGROUND: Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes. AIMS: This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research. METHODS: This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes. RESULTS: A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability. CONCLUSION: AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field. CLINICAL RELEVANCE: Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical considerations, and data privacy to guarantee its effective implementation and positive impact on the quality and safety of healthcare.
Writing So That Your Work Will Be Read.
Gennaro S
J Nurs Scholarsh · 2025 Sep · PMID 40831010 · Publisher ↗
Abstract loading — click title to view on PubMed.
From Task Shifting to Advanced Practice Nursing in Primary Care: A Contextualized Framework for LMICs Informed by Evidence From The Philippines.
Tamayo RLJ, Moncatar TJR
J Nurs Scholarsh · 2025 Nov · PMID 40785144 · Publisher ↗
INTRODUCTION: As healthcare systems confront rising demands and workforce shortages, advanced practice nursing (APN) has emerged globally as a vital strategy to improve care delivery and address systemic gaps, particular...
INTRODUCTION: As healthcare systems confront rising demands and workforce shortages, advanced practice nursing (APN) has emerged globally as a vital strategy to improve care delivery and address systemic gaps, particularly in primary care facilities in low- and middle-income countries like the Philippines. DESIGN: Qualitative case study. METHODS: This study was conducted in a rural setting in the Philippines and draws on a preceding mixed-methods case study that explored task shifting and advanced nursing practice in primary care facilities. Using purposeful sampling, 41 nurses, physicians, academics, policymakers, and recipients of care participated in interviews and focus group discussions. Qualitative data were thematically analyzed in ATLAS.ti, and quantitative data were descriptively analyzed in JASP. Findings were integrated into the APN framework tailored to primary care in low- and middle-income countries (LMICs). RESULTS: Although the Philippines lacks a formal APN policy, nurses informally fulfill many advanced practice roles aligned with Hamric's model, particularly in direct patient care, leadership, collaboration, and evidence-based practice. Key enabling competencies include health promotion, systems thinking, and policy implementation-environmental barriers such as a lack of regulatory frameworks, educational pathways, and financing limit APN institutionalization. CONCLUSION: This study proposes a contextualized advanced practice nursing (APN) model, which is relevant for LMICs, particularly in primary care facilities facing workforce shortages and rising NCD burdens. To institutionalize APN roles, key reforms should include investments in education, certification, financing, and regulation. Settings implementing initiatives to attain universal health coverage can serve as entry points for recognizing APN functions through competency-based systems. CLINICAL RELEVANCE: The study proposes a contextualized APN framework for low-resource settings, showing that formalizing expanded nursing roles through education and certification can enhance access to quality care and advance UHC in underserved areas.
From Conversation to Standardized Terminology: An LLM-RAG Approach for Automated Health Problem Identification in Home Healthcare.
Zhang Z, Gupta P, Song J … +2 more , Zolnoori M, Topaz M
J Nurs Scholarsh · 2025 Nov · PMID 40785044 · Full text
BACKGROUND: With ambient listening systems increasingly adopted in healthcare, analyzing clinician-patient conversations has become essential. The Omaha System is a standardized terminology for documenting patient care,...
BACKGROUND: With ambient listening systems increasingly adopted in healthcare, analyzing clinician-patient conversations has become essential. The Omaha System is a standardized terminology for documenting patient care, classifying health problems into four domains across 42 problems and 377 signs/symptoms. Manually identifying and mapping these problems is time-consuming and labor-intensive. This study aims to automate health problem identification from clinician-patient conversations using large language models (LLMs) with retrieval-augmented generation (RAG). METHODS: Using the Omaha System framework, we analyzed 5118 utterances from 22 clinician-patient encounters in home healthcare. RAG-enhanced LLMs detected health problems and mapped them to Omaha System terminology. We evaluated different model configurations, including embedding models, context window sizes, parameter settings (top k, top p), and prompting strategies (zero-shot, few-shot, and chain-of-thought). Three LLMs-Llama 3.1-8B-Instruct, GPT-4o-mini, and GPT-o3-mini-were compared using precision, recall, and F1-score against expert annotations. RESULTS: The optimal configuration used a 1-utterance context window, top k = 15, top p = 0.6, and few-shot learning with chain-of-thought prompting. GPT-4o-mini achieved the highest F1-score (0.90) for both problem and sign/symptom identification, followed by GPT-o3-mini (0.83/0.82), while Llama 3.1-8B-Instruct performed worst (0.73/0.72). CONCLUSIONS: Using the Omaha System, LLMs with RAG effectively automate health problem identification in clinical conversations. This approach can enhance documentation completeness, reduce documentation burden, and potentially improve patient outcomes through more comprehensive problem identification, translating into tangible improvements in clinical efficiency and care delivery. CLINICAL RELEVANCE: Automating health problem identification from clinical conversations can improve documentation accuracy, reduce burden, and ensure alignment with standardized frameworks like the Omaha System, enhancing care quality and continuity in home healthcare.
AI Nurses Network: The Importance of Clinical Research Networks in Nursing.
O'Connor S, Grosan C, Oakey RJ … +6 more , Zhang M, Li X, Stanmore E, Woodcock D, Armes J, Cull J
J Nurs Scholarsh · 2025 Nov · PMID 40751173 · Full text
Abstract loading — click title to view on PubMed.
The Effectiveness of Death Education on Death Anxiety, Depression, and Quality of Life in Patients With Advanced Cancer: A Meta-Analysis of Randomised Controlled Trials.
Su Y, Zhang S, Duan L … +1 more , Hu X
J Nurs Scholarsh · 2025 Nov · PMID 40751159 · Publisher ↗
BACKGROUND: Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve thes...
BACKGROUND: Patients with advanced cancer can suffer from serious distress like death anxiety and depression, in addition to facing a reduced quality of life. Death education interventions have been shown to improve these outcomes, but their effectiveness remains unclear, especially in the advanced stages. OBJECTIVE: This meta-analysis aimed to examine the efficacy of death education interventions on death anxiety, depression, and quality of life in advanced cancer sufferers, and to explore the influence of the intervention site, duration, the age of participants, and dyadic relationships with caregivers on the effectiveness of these interventions. DESIGN: A meta-analysis of randomized controlled trials was performed. METHODS: A systematic search of 10 electronic databases identified 19 eligible RCTs with 1531 participants. Data were extracted and analyzed via Review Manager 5.4. Subgroup analyses were performed on the basis of the intervention site, duration, age of participants, and presence of caregivers. RESULTS: In comparison to the control intervention, the death education intervention notably alleviated death anxiety (SMD = -2.11, 95% CI: -5.91 to -0.89, p = 0.008) and depression (SMD = -0.45, 95% CI: -0.72 to -0.18, p = 0.001). Quality of life (SMD = 0.86, 95% CI: 0.39-1.33, p = 0.0003) was also significantly improved. Subgroup analyses revealed that interventions with longer durations, conducted in professional settings, and targeting younger patients were more likely to be effective in reducing depression and enhancing the quality of life. Interventions without family companionship were more effective in improving depression, while interventions with family companionship were more effective in improving quality of life. CONCLUSION: Death education interventions are effective at improving death anxiety, depression, and quality of life in patients with advanced cancer. Tailoring interventions to individual features and cultural backgrounds is crucial to achieving the best effect. CLINICAL RELEVANCE: Death education is an effective and important intervention measure that can help patients with advanced cancer better cope with death anxiety and depressive emotions and improve their quality of life. Clinical medical workers should select appropriate death education programs based on the specific conditions of patients and provide necessary support and guidance. TRIAL REGISTRATION: CRD42024565376.
Factors Related to Dementia Preventive Self-Management Behaviors Among Community-Dwelling Older Adults With Type 2 Diabetes: A Cross-Sectional Study.
Pipatpiboon N, Sripetchwandee J, Bressington D
J Nurs Scholarsh · 2025 Nov · PMID 40717017 · Publisher ↗
INTRODUCTION: Dementia resulting from type 2 diabetes mellitus (T2DM) complications significantly impacts older adults' quality of life, increasing suffering for both patients and their families. Numerous studies have id...
INTRODUCTION: Dementia resulting from type 2 diabetes mellitus (T2DM) complications significantly impacts older adults' quality of life, increasing suffering for both patients and their families. Numerous studies have identified self-management as a key factor in adopting appropriate health behaviors to prevent diabetes-related complications. However, internationally, there is insufficient empirical evidence for individual and family process factors predicting dementia prevention behaviors in older adults with T2DM. Therefore, we aimed to explore how dementia-preventive self-management behaviors (outcome dimension) are related to contextual and process dimensions based on the Individual and Family Self-Management Theory (IFSMT). DESIGN: A cross-sectional observational study. METHODS: The 444 older adults with T2DM from six community hospitals in Chiang Mai completed valid and reliable self-reported measures, including a Socio-demographic Questionnaire, the Dementia Prevention of Individual and Family Self-Management Process Questionnaire (DP-IFSM-PQ), and the Dementia Preventive Self-Management Behavior Questionnaire (DPSMBQ). Data were analyzed using bivariate correlations, partial correlations, and multivariate linear regression with the stepwise method. RESULTS: Most participants exhibited high levels of individual and family self-management processes and dementia-preventive self-management behaviors. Bivariate and partial correlation analyses revealed a significant association between DP-IFSM-PQ and DPSMBQ scores. Stepwise multiple linear regression identified self-efficacy, a subdomain of DP-IFSM-PQ, as the strongest predictor of DPSMBQ scores. Other significant predictors included awareness of dementia prevention among family members, neighbors, and the community; family income sufficiency; history of comorbidities; distance to the hospital; and knowledge and beliefs (a subdomain of the DP-IFSM-PQ). The regression model was statistically significant (F [1, 437] = 46.662, p = 0.000, Adjusted R = 0.382). CONCLUSIONS: Self-efficacy and knowledge and beliefs, based on IFSMT, are key predictors of dementia-preventive behaviors among older adults with T2DM. These predictors could be used as potential intervention components in a subsequent co-design study for promoting dementia preventive self-management behaviors in older adults with T2DM. The results also reinforce the importance of family members and healthcare providers in supporting older adults with T2DM to enhance their dementia prevention behaviors.
The Wish to Die in Older Adults and Its Relationship to Burden and Depressive Symptoms in Home Care Workers: A Quasi-Experimental Longitudinal Study.
Malumbres-Talavera J, Gallart A, Monforte-Royo C
J Nurs Scholarsh · 2025 Sep · PMID 40673432 · Publisher ↗
INTRODUCTION: Older adults may experience a wish to die in the context of deteriorating health, a loss of autonomy, loneliness, or depression. Home care workers may likewise experience burden or symptoms of depression as...
INTRODUCTION: Older adults may experience a wish to die in the context of deteriorating health, a loss of autonomy, loneliness, or depression. Home care workers may likewise experience burden or symptoms of depression as a result of prolonged contact with this physical and emotional suffering. Training initiatives that can support the well-being of home care workers are therefore important. AIM: To describe the typical profile of older adults who express a wish to die to their home care worker, and to examine whether a psycho-educational intervention for care workers exploring the end-of-life process and self-care strategies had an impact on the older adult's wish to die and on the care worker's perceived burden and depressive symptoms. DESIGN: Quasi-experimental, longitudinal study involving non-randomized experimental and control groups and follow-up at 3-6 months post-intervention. METHODS: At the start of the study, all care workers (n = 126) provided sociodemographic information (age, gender) for themselves and the care recipient, and completed the Karnofsky Performance Status scale and the Assessment of the Frequency and Extent of the Desire to Die (AFEDD) interview to provide a baseline measure of the care recipient's functional status and wish to die. They also completed the Beck Depression Inventory (BDI) and Zarit Burden Interview (ZBI) as a measure of their own perceived burden and depressive symptoms. The AFEDD, BDI, and ZBI were completed again by care workers at 3 and 6 months post-intervention. RESULTS: The typical profile of care recipients was a woman aged 85.5 years who required considerable support and assistance and who had at least occasionally experienced a wish to die, although these thoughts were not always verbalized. Scores on the AFEDD remained relatively stable over the follow-up period in both the control and experimental groups. There was no significant association between the older adult's wish to die and depressive symptoms in the care worker across the study period. However, a positive and significant correlation between a wish to die in the older adult and perceived burden in the care worker was observed at 6 months post-intervention in both the total sample (p = 0.032) and among controls (p = 0.028). By contrast, this significant association was not found for care workers in the experimental group (p = 0.376), suggesting that the psycho-educational intervention may have had a protective effect. CONCLUSION: Although further studies are needed to corroborate and extend these findings, the results suggest that psycho-educational interventions aimed at increasing home care workers' understanding of the end-of-life process and which introduce them to self-care strategies may help to reduce their perceived burden when the older person for whom they are caring expresses a wish to die. CLINICAL RELEVANCE: Home care workers may find it challenging to care for an older adult who expresses a wish to die. Psycho-educational interventions that enhance care workers' understanding of the end-of-life process and teach them self-care strategies could help to support their well-being and their ability to provide adequate care.
Effectiveness of Group Interventions With Socially-Assistive Robots for Older Adults: A Systematic Review.
Ruan YX, Cheung MC
J Nurs Scholarsh · 2025 Nov · PMID 40673426 · Full text
INTRODUCTION: Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of...
INTRODUCTION: Socially assistive robots (SARs) have been used in group interventions for older adults; however, their effectiveness remains unclear. This systematic review aimed to synthesize evidence on the efficacy of group interventions with SARs on various outcomes (physical, cognitive, psychological, quality of life, therapeutic engagement, and sociality) for older adults, and the factors that influence their effectiveness. DESIGN AND METHOD: A literature search was conducted using five databases (Web of Science, PubMed, Scopus, PsycINFO, and MEDLINE) in October 2024. The research team selected and analyzed the studies applying a narrative synthesis. RESULTS: In all, 25 articles were identified, 15 of which were deemed of good quality. We found that companion robots are commonly used in group interventions for older adults that consist of physical, cognitive, and combined physical and cognitive activities. Insufficient evidence was identified on the effectiveness of physical interventions and groups with physical and cognitive activities on health outcomes (i.e., physical, cognitive, psychological, and quality of life). Regarding the cognitive group interventions, positive physical outcomes (i.e., improved sleep quality, decreased pulse rate, and increased pulse oximetry), improved cognitive function, positive psychological outcomes (i.e., decreased agitation, depression, anxiety, and loneliness, and increased positive emotions) were found; however, the positive effects in terms of cognitive level and certain psychological outcomes were comparable to the control groups. Mixed results were reported for quality of life in older adults. Across the three types of interventions, robots facilitated engagement and increased the sociality of most older adults. The effectiveness depended on the cognitive function of the older adults, the presence of staff, the type of robot, and the schedule of the interventions. CONCLUSION: Research gaps have been identified, and more rigorous studies investigating the effectiveness of different types of group interventions in older adults are needed before applying SARs in group interventions on a large scale. CLINICAL RELEVANCE: Given the importance of group interventions in nursing care of older adults, healthcare professionals can use socially assistive robots in such interventions to assist in caring for older adults.
Antepartum Anxiety, Dyadic Coping, and Stress Among Chinese Pregnant Couples: The Actor-Partner Interdependence Mediation Model.
Ding Y, Han RR, Deng YF … +2 more , Lam Nogueira BOC, Gao LL
J Nurs Scholarsh · 2025 Sep · PMID 40662458 · Publisher ↗
INTRODUCTION: Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission bet...
INTRODUCTION: Pregnancy can cause stress for couples, potentially leading to anxiety. However, most studies on antepartum anxiety focus on expectant mothers, ignoring the expectant fathers and the stress transmission between couples. We aim to examine the mediation of dyadic coping between antepartum anxiety and stress in expectant mothers and fathers. DESIGN: We implemented a cross-sectional study in Guangzhou, China, from October 2023 to January 2024. METHODS: Three-hundred and twenty-nine Chinese pregnant couples completed the Perceived Stress Scale, the Dyadic Coping Inventory, and the State-Trait Anxiety Inventory. The actor-partner interdependence mediation model was used for data analysis. RESULTS: Expectant mothers experienced antepartum anxiety symptoms at a rate of 42.6%, while the rate for expectant fathers was 32.5%. Regarding the actor effects, stress was positively associated with antepartum anxiety in expectant mothers (β = 0.66, 95% confidence interval CI [0.56, 0.74]) and fathers (β = 0.58, 95% CI [0.42, 0.70]), with dyadic coping acting as a mediator (expectant mothers: β = 0.08, 95% CI [0.03, 0.14]; fathers: β = 0.11, 95% CI [0.04, 0.19]). Regarding the partner effects, maternal dyadic coping was positively associated with paternal stress (β = 0.10, 95% CI [0.01, 0.19]). CONCLUSION: The study highlights the interplay of stress, dyadic coping, and antepartum anxiety in expectant mothers and fathers, emphasizing the need to assess their antepartum anxiety and implement couple-centered interventions to enhance their psychological well-being during the first trimester of pregnancy. CLINICAL RELEVANCE: This study highlights the importance of assessing antepartum anxiety in both expectant mothers and fathers, emphasizing the mediation of dyadic coping in reducing stress and anxiety. The findings support the integration of couple-centered mental health interventions into routine antepartum care to enhance psychological well-being during pregnancy.
Hope-Promoting Communication With Pediatric Patients With Chronic Diseases and Their Families: A Scoping Review.
Alvarenga WA, Leite ACAB, de Carvalho TM … +5 more , da Silva Gonzaga BV, de Morais MFS, da Silva LP, Charepe Z, Nascimento LC
J Nurs Scholarsh · 2025 Sep · PMID 40629541 · Publisher ↗
INTRODUCTION: The way communication is conducted directly influences the professional-patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the...
INTRODUCTION: The way communication is conducted directly influences the professional-patient relationship, how patients cope with their diagnosis, and their sense of hope throughout treatment. This study aims to map the literature on strategies that healthcare professionals can use to promote hope in communication with pediatric patients and their families in the context of chronic illness. Based on this objective, the study highlights an algorithm to assist healthcare professionals in instilling hope in this population through communication. DESIGN: Scoping review. METHODS: This systematized review was conducted using the databases PubMed, LILACS, PsycInfo, Embase, CINAHL, and Scopus, employing the PCC framework and the Boolean operators AND and OR. The time frame was limited to the last 20 years (2004-2024). A total of 734 studies were identified across the databases, with an additional four retrieved through manual citation searches, resulting in 19 articles included in the final sample. RESULTS: The findings highlight three key pillars for promoting hope in communication: (1) careful preparation for information delivery, which involves identifying the diverse needs of families and creating a physically comfortable and emotionally supportive environment; (2) providing information and emphasizing how it is presented-considering content, clarity, honesty, empathy, and adaptation to the recipient's specific needs; and (3) follow-up after information delivery, ensuring emotional support and active, skilled listening. CONCLUSIONS: Interpersonal communication between the healthcare professional, the patient, and the family was mainly focused on the transmission of information about the disease and treatment in a clear and empathetic manner, considering who is receiving the information and how the information is interpreted. CLINICAL RELEVANCE: This review provides guidance for healthcare professionals in implementing communication strategies that foster hope in the context of pediatric chronic illness. Additionally, this guide may serve as a model for training students and healthcare professionals. Further research is needed to implement and explore additional effective communication strategies for this population across diverse cultural settings.
Factors Influencing Mistriage Based on the Korean Triage and Acuity Scale: A Retrospective Cross-Sectional Study.
Yi N, Baik D
J Nurs Scholarsh · 2025 Sep · PMID 40619607 · Full text
INTRODUCTION: Mistriage is important because of its potential for serious consequences, notwithstanding the beneficial effects of the emergency patient classification system employed to alleviate overcrowding in emergenc...
INTRODUCTION: Mistriage is important because of its potential for serious consequences, notwithstanding the beneficial effects of the emergency patient classification system employed to alleviate overcrowding in emergency departments (EDs). This study aimed to assess mistriage using the Korean Triage and Acuity Scale (KTAS) and identify factors influencing it. DESIGN: Retrospective cross-sectional study. METHODS: We examined the factors influencing mistriage in the KTAS and rates of under- and over-triage. Participants were obtained by combining electronic health records with registry data from the National Emergency Department Information System. We assessed the eligibility of patients aged ≥ 15 years who visited the ED between July 1, 2022, and June 30, 2023. Using the KTAS classification criterion, two experienced experts determined the final acuity level. We employed multivariate logistic regression analysis to evaluate the factors that predict under- and over-triage. RESULTS: Of 53,947 ED encounters, 1110 participants were enrolled in this study. Mistriage occurred in 207 (18.6%) patients: 88 (7.9%) had under-triage, and 119 (10.7%) had over-triage. In adjusted analyses, under-triage was associated with lower mean arterial pressure (odds ratio [OR], 5.42; 95% confidence interval [CI], 1.45-20.32) and presenting complaints of immunity or fever (OR, 3.41; 95% CI, 1.38-8.45), while over-triage was associated with advanced age (OR, 0.52; 95% CI, 0.28-0.98), pain (OR, 1.96; 95% CI, 1.18-3.25), lower KTAS experience (OR, 1.95; 95% CI, 1.08-3.51), and several specific present complaints. CONCLUSIONS: By improving mistriage, the quality of emergency medical services may be enhanced through reduced costs, increased operational efficiency, and improved patient safety and satisfaction. Implementation of standardized criteria, validated triage tools, and enhanced provider training is crucial for achieving more accurate emergency triage. Additionally, establishing regulatory and financial incentives and developing realistic standards for mistriage management will optimize triage processes and ensure prompt, prioritized care.
Association Among Psychological Capital, Relationship Satisfaction and Psychological Distress in Stroke Patient-Spouse Dyads: An Actor-Partner Interdependence Mediation Model.
Sun Q, Wang S, Song W … +5 more , Ge S, Li X, Ma L, Zhang Z, Mei Y
J Nurs Scholarsh · 2025 Sep · PMID 40605184 · Publisher ↗
PURPOSE: To explore the association between psychological capital and psychological distress in stroke patient-spouse dyads and examine the mediating effect of relationship satisfaction in this association. METHODS: A po...
PURPOSE: To explore the association between psychological capital and psychological distress in stroke patient-spouse dyads and examine the mediating effect of relationship satisfaction in this association. METHODS: A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model. RESULTS: In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = -5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = -0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = -0.020, p < 0.05; β = -0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = -0.011, p < 0.05; β = -0.020, p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
Effectiveness of a Tailored Psychoeducational Intervention for Patients With Advanced Cancer in Indonesia: A Randomized Controlled Trial.
Huda N, Gautama MSN, Dewi WN … +3 more , Waluyo A, Chang HJ, Shaw MK
J Nurs Scholarsh · 2025 Sep · PMID 40604337 · Publisher ↗
BACKGROUND: Patients with advanced cancer often face numerous physical, psychological, and practical challenges from their disease and treatments, yet interventions addressing their specific unmet needs remain limited. P...
BACKGROUND: Patients with advanced cancer often face numerous physical, psychological, and practical challenges from their disease and treatments, yet interventions addressing their specific unmet needs remain limited. PURPOSE: This study aimed to evaluate the effectiveness of a tailored psychoeducational intervention (PEI) on stress, anxiety, depression, coping, and fatigue among advanced cancer patients in Indonesia. DESIGN: A randomized controlled trial was conducted from August 2022 to March 2023 in Indonesia. METHODS: A total of 151 advanced cancer patients from a referral hospital in Indonesia were randomized into intervention and control (conventional management) groups. Participants were assessed using validated questionnaires including the Depression, Anxiety, and Stress Scale (DASS-21), Fatigue Severity Scale (FSS), and Brief COPE at three time points: baseline (T0, before intervention), after first intervention (T1), and after second intervention (T2). The PEI was delivered face-to-face with telephone follow-up calls. Generalized Estimating Equations (GEE) analysis was used to evaluate the intervention's effectiveness. RESULTS: The intervention was significantly associated with improved coping and reduced fatigue scores. Significant time effects were observed for depression, stress, coping, and fatigue scores. For anxiety, a significant impact was found at the second time point but not at the third, compared to the baseline. The difference-in-difference (DID) analysis revealed significant effects on coping and fatigue scores, while anxiety only showed significance at the second time point. CONCLUSIONS: This study provides evidence for the potential effectiveness of PEI in improving coping strategies, relieving stress, anxiety, and depression, and reducing fatigue among advanced cancer patients in Indonesia. CLINICAL RELEVANCE: The tailored PEI, including follow-up phone calls, can be independently implemented by nurses. Focusing on patients' unmet needs and spirituality, this intervention can help manage mental health issues and strengthen coping mechanisms, potentially leading to positive effects on physical conditions such as fatigue.
The Effect of Compulsory Citizenship Behaviors on Subjective Vitality Among Nurses.
Elibol E, Yildiz B, Seren AKH
J Nurs Scholarsh · 2025 Nov · PMID 40604334 · Publisher ↗
AIM: The study aims to assess the extent of compulsory citizenship behaviors (CCBs) and their impact on the nurses' subjective vitality based on self-determination theory. BACKGROUND: CCBs are harmful to both nurses and...
AIM: The study aims to assess the extent of compulsory citizenship behaviors (CCBs) and their impact on the nurses' subjective vitality based on self-determination theory. BACKGROUND: CCBs are harmful to both nurses and organizations. These behaviors mean employees are expected to perform additional tasks outside their job descriptions. Although CCBs are highlighted within the recent nursing literature, empirical evidence of their effects is lacking. METHODS: This is descriptive cross-sectional research. The study included 244 staff nurses using a convenience sampling method who worked in two hospitals in Istanbul. Data were collected via a survey consisting of a personal information form, the compulsory citizenship scale, and the subjective vitality scale. STROBE guidelines were followed when reporting the study. Descriptive statistical analyses, independent samples t-test, one-way ANOVA test, Pearson's correlation, and hierarchical simple linear regression analyses were used. RESULTS: The participants' mean scores for compulsory citizenship and subjective vitality were 3.34 out of 5 (SD = 1.05) and 4.15 out of 7 (SD = 1.36), respectively. Nurses' compulsory citizenship scores significantly differed according to their education level, income, and sector. Their subjective vitality scores statistically differed according to their income levels. Regression analysis revealed that CCBs were significant negative predictors of subjective vitality (β = -0.22, p < 0.01). CONCLUSION: By examining the CCBs and subjective vitality relationship, the current study extended the existing knowledge by drawing attention to the destructive and harmful effects of CCBs on positive psychological sources of nurses' subjective vitality. CCBs negatively predicted subjective vitality. CLINICAL RELEVANCE: Organizational factors such as CCBs, which leads to a lack of autonomy, affect nurses' well-being, thus affecting care quality and patient safety. As the International Council of Nurses mentioned, "Nurses cope with many physical, mental, emotional, and ethical challenges. It is essential that we address these challenges in a way that supports their overall health". In this regard, managers and policymakers in hospitals should develop preventive cautions for CCBs. However, in-service training activities should be carried out to increase awareness about the harmful effects of CCBs on nurses' psychological well-being.
Perceptions of Gender Equity and Workplace Bias Among Nurses: Implications for Job Satisfaction and Career Progression.
Ibrahim AM
J Nurs Scholarsh · 2025 Sep · PMID 40542472 · Publisher ↗
BACKGROUND: Gender equity and workplace bias are critical factors influencing job satisfaction and career progression in healthcare. Despite global initiatives promoting equity, disparities persist within nursing, impact...
BACKGROUND: Gender equity and workplace bias are critical factors influencing job satisfaction and career progression in healthcare. Despite global initiatives promoting equity, disparities persist within nursing, impacting organizational commitment and workforce retention. AIM: This study investigates registered nurses' perceptions of gender equity and workplace bias and their impact on job satisfaction at King Khaled Hospital, Saudi Arabia. METHODS: A cross-sectional quantitative study design was employed, involving 246 randomly selected registered nurses. Data were collected using the gender equity in the Workplace Scale (GEWS), Workplace Gender Bias Scale (WGBS), and Job Satisfaction Survey (JSS). Descriptive statistics and Pearson correlation analyses were conducted using SPSS to assess gender differences and relationships between perceptions of equity, bias, and job satisfaction. RESULTS: The study revealed moderate agreement regarding gender equity in promotions (48.8%) and compensation (52%), indicating room for improvement in implementing equality policies. Workplace bias was perceived notably in stereotyping (50.8%) and differential treatment (60%), with female nurses reporting higher levels of bias. Job satisfaction was moderate, with 60% of participants expressing overall satisfaction and only 42% satisfied with promotional opportunities. Perceptions of gender equity positively correlated with job satisfaction (r = 0.65, p < 0.001), while workplace bias was inversely correlated (r = -0.54, p < 0.001). CLINICAL RELEVANCE: Persistent gender inequities and workplace biases negatively affect job satisfaction and career progression in nursing. Addressing these disparities through equitable organizational policies, diversity training, and inclusive leadership can enhance job satisfaction, improve retention, and foster a supportive work environment. These findings highlight the need for systemic reforms to promote workplace equity and well-being in healthcare organizations.
Virtual Reality Intervention for Fall Prevention in Older Adults: A Meta-Analysis.
Saragih ID, Chen YM, Suarilah I … +2 more , Susanto H, Lee BO
J Nurs Scholarsh · 2025 Sep · PMID 40533914 · Publisher ↗
PURPOSE: Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promisi...
PURPOSE: Falls among older adults are a major public health concern, often leading to serious outcomes such as fractures, head trauma, and increased mortality. Virtual reality (VR) interventions have emerged as a promising strategy for fall prevention by improving balance, reducing fear of falling, and enhancing confidence. However, the impact of VR interventions on specific outcomes such as fear of falling, balance, and postural control in older adults remains insufficiently synthesized. DESIGN: Systematic review and meta-analysis. METHODS: A comprehensive systematic search of six databases was conducted from inception to January 20, 2025. Randomized controlled trials (RCTs) evaluating VR interventions targeting fear of falling, balance, and postural control in older adults were included. Methodological quality was assessed using the Cochrane risk-of-bias tool (RoB-2). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using random-effects models for each outcome. FINDINGS: Seventeen RCTs involving 988 older adults, published between 2016 and 2025, met the inclusion criteria. VR interventions demonstrated significant effects in reducing fear of falling (SMD = -0.40; 95% CI: -0.72 to -0.08; I = 45.10%; p = 0.02), improving balance (SMD = 0.45; 95% CI: 0.07-0.83; I = 73.54%; p = 0.02), and enhancing postural control (SMD = 0.50; 95% CI: 0.13-0.86; I = 46.89%; p = 0.01). CONCLUSION: This meta-analysis highlights the effectiveness of VR interventions in reducing fear of falling and improving balance and postural control among older adults. CLINICAL RELEVANCE: VR represents a valuable tool in fall prevention strategies, addressing key outcomes essential for maintaining independence and mobility in this population.
Long-Term Effectiveness of Tobacco Smoking Cessation Interventions in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Saadulloh D, Rohman, Rayasari F … +3 more , Ganefianty A, Yunitri N, Chou KR
J Nurs Scholarsh · 2025 Sep · PMID 40533909 · Publisher ↗
BACKGROUND: Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation h...
BACKGROUND: Smoking is a major global health problem. It kills more than half of the users. At least 1.18 billion people smoked cigarettes every day as of 2020. Although many interventions for tobacco smoking cessation have been implemented, their effectiveness remains unclear. This study aimed to assess the long-term effectiveness of various smoking cessation interventions in adults. DESIGN: We conducted a systematic review and meta-analysis of randomized controlled trials reporting long-term outcomes. METHODS: Evidence searches were conducted in the Cochrane Library, Embase, Medline-OVID, PubMed, Web of Science, and Clinicaltrials.gov. Two researchers searched until August 2023 without restrictions on country, language, or year of publication. The risk ratio (RR) for continuous abstinence was obtained through biochemical verification at measurements ≥ 6 months post-intervention. Data were extracted and assessed for quality using Risk of Bias 2. Meta-analysis was carried out using a random effects model. Subgroup analyses and meta-regression were performed to explore moderator variables. Sensitivity and publication bias analyses were also performed. RESULTS: Twenty-two effect sizes from 13 studies showed that tobacco smoking cessation interventions increased continuous abstinence by 2.5 times (RR 3.52; 95% CI; 2.19-5.65). The highest ratio was in the behavioral intervention (RR 7.83) with more than 6 months of therapy (RR 10.57). The tobacco smoking cessation intervention worked better in 55-64 years (RR 7.29), especially in Asia (RR 10.08). The intervention was more effective for female respondents (RR 4.21) and combination therapy format (RR 3.82). However, meta-regression showed that differences in gender and therapy format did not significantly influence the effectiveness of tobacco smoking cessation interventions in adults (p values 0.2748 and 0.8769). Sensitivity analysis (p-value 0.0025) further strengthens the evidence of the conclusions and credibility of the findings. CONCLUSION: Behavioral therapy lasting more than 6 months was the most successful tobacco smoking cessation intervention in respondents aged 55-64 years, especially when implemented in Asia. Although not significant, therapies delivered in combination formats, especially in women, have the potential to increase continuous abstinence for adults. These findings provide important evidence for developing effective prevention and treatment strategies for long-term smoking cessation concerning the type, format, and total of therapy.
Career Cartography to Envision Careers That Advance Health and Health Policy.
Doering JJ, Feetham S, Schiffman RF
J Nurs Scholarsh · 2025 Sep · PMID 40528535 · Publisher ↗
INTRODUCTION: Today in academia and health care, creating a vision and crafting a career path that progresses toward that vision is essential. Career cartography is the comprehensive and iterative process of applying the...
INTRODUCTION: Today in academia and health care, creating a vision and crafting a career path that progresses toward that vision is essential. Career cartography is the comprehensive and iterative process of applying the science of cartography within the context of policy toward achieving a career with impact. PURPOSE: The purpose of this article is to advance the knowledge and application of the original publication as described by Feetham and Doering in 2015. Career cartography supports scientific thinking, communicates science, and addresses the uncertainty of a career. METHODS: We conducted a critical analysis of differences between the original publication and our current practical experience of career cartography. Workshops conducted the past 10 years have advanced our understanding of the career cartography components and their utility to one's career. This analysis is informed by a review of the 25 publications citing the 2015 publication to evaluate how scholars report applying the process across health professions and organizations. RESULTS: All components of career cartography are expanded beyond the 2015 publication to include application of the process with exemplars. CONCLUSION: Career cartography is an effective guide across disciplines and at all stages of a career for determining, directing, evaluating, and communicating one's career and its impact. CLINICAL RELEVANCE: The intentional and ongoing use of career cartography maximizes the impact one's chosen career can have on improvements to health and health policy.
Perceived Organizational Support for Strengths Use and Work-Related Flow: The Mediating Role of Self-Efficacy and Optimism.
Bai C, Bai B, Zhong N
J Nurs Scholarsh · 2025 Sep · PMID 40495455 · Publisher ↗
BACKGROUND: Work flow is critical for nurses due to the demanding nature of their profession, as it enhances stress resilience, engagement, and quality of care. AIMS: This study sought to examine the relationship between...
BACKGROUND: Work flow is critical for nurses due to the demanding nature of their profession, as it enhances stress resilience, engagement, and quality of care. AIMS: This study sought to examine the relationship between perceived organizational support for strengths use and work-related flow among nurses, and to explore the mediating roles of psychological capital components: self-efficacy, resilience, hope, and optimism. METHODS: This cross-sectional study, involving 607 nurses, was conducted in March 2024. Validated scales were employed to measure perceived organizational support for strengths use, psychological capital, and work-related flow. Data analysis was performed using SPSS version 25.0, along with the PROCESS macro for mediation analysis. RESULTS: The study revealed a significant positive relationship between perceived organizational support for strengths use, psychological capital, and work-related flow. Among the four psychological capital dimensions, only self-efficacy and optimism significantly mediated the relationship between perceived organizational support for strengths use and work-related flow. CONCLUSION: These findings underscore the importance of fostering a strengths-based organizational climate and enhancing key psychological resources-particularly self-efficacy and optimism-to improve nurses' flow experiences at work. CLINICAL RELEVANCE: Enhancing perceived organizational support for strengths use can foster self-efficacy and optimism among nurses, thereby promoting work-related flow. By cultivating a strengths-based work environment and reinforcing key psychological resources, healthcare institutions can improve nurses' well-being, engagement, and ultimately the quality of patient care.
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