SAGE Open Nursing最新文献

{"title":"Nurse Anesthetist-Performed PICC Insertion: A Prospective Longitudinal Study in a Norwegian Hospital.","authors":"Ann-Chatrin Linqvist Leonardsen, Ellen Marie Lunde, Mona Sand Andersen","doi":"10.1177/23779608251367258","DOIUrl":"https://doi.org/10.1177/23779608251367258","url":null,"abstract":"<p><strong>Introduction: </strong>The majority of hospitalized patients require vascular access for intravenous medical treatment. A peripherally inserted central catheter (PICC) may be indicated for long-term treatment. In many Norwegian hospitals, this is a nurse anesthetist-led initiative.</p><p><strong>Objective: </strong>The aim of this study was to examine the use of PICCs from insertion to completed treatment and to assess potential risk factors for the development of catheter-related complications.</p><p><strong>Methods: </strong>A quantitative prospective, longitudinal design was used. Data were collected via electronic patient records, as well as through telephone surveys with patients every fourth week until the catheter was discontinued. The Statistical Package for the Social Sciences version 28 was used for analysis.</p><p><strong>Results: </strong>In total, 401 PICCs were included. The primary indications were antibiotic treatment (<i>n</i> = 272), nutrition (<i>n</i> = 46), or chemotherapy (<i>n</i> = 42). A total of 163 PICCs were used for a period of over 30 days. Overall, 41 catheter-related complications were identified through patient records. Erythema at the insertion site (<i>n</i> = 12) was the most common complication, and the most severe complications were deep venous thrombosis (<i>n</i> = 5) and confirmed catheter-related infection (<i>n</i> = 4). After 4 weeks, 12 patients reported complications, with pain/numbness (<i>n</i> = 4) being the most frequent. The study demonstrated no statistically significant covariation between the occurrence of complications and age, length of time the catheter was in use, primary indication, venous diameter, or the number of insertion attempts.</p><p><strong>Conclusion: </strong>The study showed a low incidence of severe PICC-related complications. Peripherally inserted central catheters were inserted and used according to local guidelines. The study indicates that nurse anesthetists' knowledge and experience can be utilized in the future selection and insertion of vascular access for patients, as well as in training and education on PICCs.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251367258"},"PeriodicalIF":2.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy Outcomes Among Young, Middle-Aged, and Older Adolescents in Gadarif, Eastern Sudan: A Case-Control Study.","authors":"Omer Munder, Gamal K Adam, Khalid Nasralla, Nadiah AlHabardi, Ahmed A Hassan, Ishag Adam","doi":"10.1177/23779608251364596","DOIUrl":"https://doi.org/10.1177/23779608251364596","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent pregnancy is considered a global public health problem that affects both developed and developing countries. While the obstetric and perinatal outcomes of adolescent pregnancies have been extensively studied, there is not much available data comparing the obstetric and perinatal outcomes of younger and older adolescents.</p><p><strong>Objective: </strong>The objective of this study is to compare the obstetric and perinatal outcomes between two groups of adolescent pregnancy.</p><p><strong>Methods: </strong>This unmatched case-control study was conducted at Gadarif Maternity Hospital in eastern Sudan. The cases (<i>n</i> = 141) were young/middle-aged adolescents (13-17 years), who were compared with older adolescents (18-19 years) as the controls (<i>n</i> = 159).</p><p><strong>Results: </strong>Compared with controls, cases had a lower level of education (78.0% vs. 62.3%; <i>P</i> = .003). There was no significant difference between the cases and controls in terms of antenatal follow-up (56.0% vs. 57.9%; odds ratio [OR] = 0.92; 95% confidence interval [CI]: 0.58-1.46), maternal anemia (46.8% vs. 39.0%; OR = 0.72; 95% CI: 0.45-1.15), preterm delivery (11.3% vs. 10.7%; OR = 0.93; 95% CI: 0.45-1.92), a cesarean delivery (13.5% vs. 15.1%; OR = 1.14; 95% CI: 0.59-2.18), low birth weight (10.6% vs. 13.8%; OR = 0.74; 95% CI: 0.36-1.49), neonatal intensive care unit admission (10.6% vs. 7.5%; OR = 1.45; 95% CI: 0.65-3.23), or neonatal deaths (5.0% vs. 5.0%; OR = 0.98; 95% CI: 0.34-2.79).</p><p><strong>Conclusion: </strong>Young/middle-aged pregnant Sudanese adolescents are not at increased risk of obstetric and perinatal complications compared to older pregnant adolescents.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251364596"},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life Among School-Age Children With Type 1 Diabetes Mellitus: A Cross-Sectional Study.","authors":"Amira Adel Mohammed, Roqia Saleem Awad Maabreh, Mahmoud H Alrabab'a, Anwar M Eyadat, Salam Bani Hani","doi":"10.1177/23779608251369588","DOIUrl":"https://doi.org/10.1177/23779608251369588","url":null,"abstract":"<p><strong>Background: </strong>Ensuring good health and well-being for children requires a high quality of life (QOL). Sustainable development has led to the elimination of many chronic and epidemic diseases. QOL is a multifaceted system encompassing several dimensions, including social, physical, and psychological functioning, which has emerged as a necessary outcome for children with chronic disorders.</p><p><strong>Objectives: </strong>This study aimed to understand QOL in Egyptian school-age children with type 1 diabetes mellitus (T1DM). It examined sociocultural, economic, and healthcare issues faced by these children, revealing unique determinants such as family dynamics and community perceptions in Egypt, which differ from global data.</p><p><strong>Methods: </strong>A cross-sectional study was used at the Hospital of Health Insurance outpatient clinics in Banha, Egypt. A group of healthy peers was compared with another group from the outpatient clinic. 412 school children, ages 6 to 12 years, had T1DM, and 412 healthy peer groups with the same child age and gender, the researchers interviewed. Three tools were used: a demographic data sheet, a socioeconomic scale, and the Pediatric Quality of Life Inventory 4.0 Generic Core Scale.</p><p><strong>Results: </strong>The mean age of children was 12.9 ± 3.2. More than 60% of diabetic children had uncontrolled blood glucose levels, and 60% had poor socioeconomic levels. Children with diabetes had a significantly lower QOL than healthy peers in all dimensions. For the duration of the disease, where emotional function from the QOL was only affected, males revealed significantly higher scores related to school functioning. Children with middle and high socioeconomic status showed a highly significant relationship to school, social, and total QOL.</p><p><strong>Conclusion: </strong>T1DM had a negative effect on all QOL domains of the school children. The researchers recommended establishing protocols integrated between children's homes, schools, and health insurance hospitals and clinics for providing comprehensive health education.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251369588"},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registered Nurses' Characteristics and Their Levels of Compassion Competence and Satisfaction: A Cross-Sectional Survey.","authors":"Jacqueline Galica, Stephanie Saunders, Chiamaka Madu, Ziwei Pan, Hok Kan Ling, Jennifer Waite, Denise Neumann-Fuhr, Erna Snelgrove-Clarke","doi":"10.1177/23779608251367257","DOIUrl":"https://doi.org/10.1177/23779608251367257","url":null,"abstract":"<p><strong>Introduction: </strong>Although registered nurses are expected to treat patients with care and compassion, a variety of characteristics may influence their ability to express compassion.</p><p><strong>Objectives: </strong>(1) To assess registered nurses' level of compassion competence and compassion satisfaction, and; (2) to explore how individual-level, employment-related, and organization-level characteristics are associated with their level of compassion competence and compassion satisfaction.</p><p><strong>Methods: </strong>Registered nurses working in any practice setting in Ontario, Canada, completed a cross-sectional electronic survey of valid and reliable measures. Descriptive statistics and multiple linear regression analyses were used to address study objectives.</p><p><strong>Results: </strong>One hundred eighty-one registered nurses participated. Most identified as female (<i>n</i> = 157; 96.3%), Caucasian (<i>n</i> = 144; 88.3%), and completed baccalaureate training as their highest level of education (<i>n</i> = 80; 50.6%). Participants' average compassion competence score was higher than average (4.18 on a 5-point scale), and most participants (<i>n</i> = 171, 98.3%) reported moderate to high levels of compassion satisfaction. Compassion satisfaction was the only significant predictor of compassion competence, which indicated a positive relationship (<i>β</i> = 0.344, <i>p</i> < .001). Compassion competence was among a variety of significantly positive predictors of compassion satisfaction (<i>β</i> = 0.652, <i>p</i> < .001). The other positive significant predictors of compassion satisfaction were higher than baccalaureate education (<i>β</i> = 0.363, <i>p</i> < .001), full-time work status (<i>β</i> = 0.253, <i>p</i> = .012), working in organizations with greater compassion practices (<i>β</i> = 0.114, <i>p</i> = .005), and organizations with higher climate for change (<i>β</i> = 0.292, <i>p</i> < .001).</p><p><strong>Conclusions: </strong>Study findings illuminate varying degrees of significance for individual-level, employment-related, and organization-level characteristics and how these predict registered nurses' levels of compassion. These distinctions have important implications for intervention development and future research in understanding compassionate care among nurses.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251367257"},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Home Care on Glycosylated Hemoglobin and Quality of Life in Type 2 Diabetes Patients Discharged After Surgery.","authors":"Maryam Heidarpour, Lila Faridani, Mojtaba Akbari, Amir Shahzeydi, Hamid Melali, Parvaneh Abazari","doi":"10.1177/23779608251365336","DOIUrl":"10.1177/23779608251365336","url":null,"abstract":"<p><strong>Introduction: </strong>More than a third of diabetes patients undergo surgery at least once in their lifetime. However, there is limited research on managing the needs of these patients after hospital discharge.</p><p><strong>Objective: </strong>This study aimed to determine the effect of home care on glycosylated hemoglobin (HbA1C) and quality of life in type 2 diabetes patients discharged from hospitals.</p><p><strong>Methods: </strong>This study was a randomized clinical trial. About 69 type 2 diabetes patients undergoing surgery were assigned to intervention and control groups after discharge orders. Home care was provided for three months with an interprofessional approach. Data collection tools included diabetes-related quality of life questionnaire and laboratory tests. Data were analyzed using SPSS version 23 with parametric and non-parametric tests.</p><p><strong>Results: </strong>HbA1C levels decreased significantly in the intervention group over the three-month period (P < 0.05), whereas this decrease was not significant in the control group (P > 0.05). The mean quality of life scores improved in satisfaction and future concern domains in the intervention group and in the social concern domain in the control group (P < 0.05). The mean changes in total quality of life scores over three months post-discharge were not significant in both groups (P > 0.05).</p><p><strong>Conclusions: </strong>The findings of this study indicate that structured home care delivered through a team-based approach contributes not only to improved glycemic control but also to enhancing specific dimensions of quality of life-particularly satisfaction with life despite diabetes and reduced concerns about the future-in post-surgical diabetic patients. These results emphasize the importance of incorporating such services into post-discharge care plans to support patient well-being and recovery.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251365336"},"PeriodicalIF":2.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitudes, and Practices of Intensive Care Unit Nurses Regarding Oral Care for Intubated Patients in Hebron Hospitals, Palestine.","authors":"Nesreen Alqaissi, Mohammed Qtait","doi":"10.1177/23779608251368041","DOIUrl":"10.1177/23779608251368041","url":null,"abstract":"<p><strong>Introduction: </strong>Oral care in intubated patients is essential to prevent ventilator-associated pneumonia and other complications. Intensive care unit (ICU) nurses play a vital role in implementing oral care protocols effectively for intubated patients.</p><p><strong>Objective: </strong>This study aimed to assess the knowledge, attitudes, and practices (KAP) of ICU nurses in Hebron hospitals, Palestine, regarding oral care for intubated patients.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 108 ICU nurses using a structured questionnaire that covered demographic data, KAP.</p><p><strong>Results: </strong>Of the participants, 43.45% demonstrated good knowledge, while 56.55% had poor knowledge. Positive attitudes were reported by 77.5% of the nurses, and good practices were observed in 46.5% of them. No significant correlation was found between demographic variables and KAP (<i>p</i> > 0.05). However, a statistically significant positive correlation was found between knowledge and practice (<i>r</i> = 0.474, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Although most ICU nurses exhibited positive attitudes toward oral care, substantial gaps were identified in their knowledge and clinical practice. These findings highlight the need for continuous education and the implementation of standardized oral care protocols to enhance the quality of care in ICUs.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251368041"},"PeriodicalIF":2.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Artificial Intelligence Attitudes and Acceptance on Critical Thinking Motivation among Nursing Students in Saudi Arabia.","authors":"Ayman Mohamed El-Ashry, Nagla Saleh Al Saleh, Nora Ghalib AlOtaibi, Turki Zuhaymil Almutairi, Lujain Adel Sallam, Muhanna M Alnassar, Khloud Abdulhadi Alshehri, Sahar Abdulkarim Al-Ghareeb, Raiza Abdullah Al-Otaibi, Wejdan Munahi Almutairi, Sameer A Alkubati, Mona Metwally El-Sayed","doi":"10.1177/23779608251369564","DOIUrl":"10.1177/23779608251369564","url":null,"abstract":"<p><strong>Introduction: </strong>As Saudi Arabia advances its Vision 2030 agenda, which emphasizes artificial intelligence (AI) integration in healthcare and education, understanding students' acceptance of AI in academic settings is increasingly important.</p><p><strong>Objective: </strong>To examine the relationship between nursing students' attitudes toward AI, perceived usefulness, perceived usability, and their critical thinking motivation.</p><p><strong>Methods: </strong>A multicenter cross-sectional correlational study was conducted across three Saudi universities. Data were collected from 390 undergraduate nursing students using the General Attitudes towards AI Scale, the technology acceptance model questionnaire, and the critical thinking motivation scale. Analysis included Pearson correlations and multiple linear regression.</p><p><strong>Results: </strong>Students reported positive attitudes toward AI, with strong correlations among AI attitude, usefulness, and usability (<i>r</i> = .63-.78, <i>p</i> < .001). Weak but significant positive correlations were found between AI-related factors and critical thinking motivation (<i>r</i> = .20-.40, <i>p</i> < .001). Higher academic level, the belief that AI will not replace nursing roles, and greater AI usability significantly predicted critical thinking motivation (adjusted <i>R</i>² = .245, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>Acceptance and perceived usability of AI tools are positively associated with critical thinking motivation in nursing students. These findings underscore the potential of AI to support cognitive skill development in nursing education. Educators should integrate AI early in nursing curricula, provide structured training, and frame AI as a support tool in clinical decision-making. Doing so can foster both critical thinking and digital competence among future nurses.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251369564"},"PeriodicalIF":2.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Economic Power of Nursing: A Policy Imperative.","authors":"Mona Gamal Mohamed","doi":"10.1177/23779608251365823","DOIUrl":"10.1177/23779608251365823","url":null,"abstract":"","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251365823"},"PeriodicalIF":2.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Massages Administered by Spouses on Labor Pain and Delivery Duration among Primiparous Women.","authors":"Pi-Hui Chen, Chien-Huei Kao, Su-Chen Gou, Chieh-Yu Liu, Panchalli Wang, Chia-Lung Shih","doi":"10.1177/23779608251366751","DOIUrl":"10.1177/23779608251366751","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effects of massages administered by spouses on labor pain and delivery duration among primiparous women.</p><p><strong>Methods: </strong>This quasi-experimental study included women who were selected to give birth at the researchers' hospital and were assigned to either to an experimental or control group based on their willingness to participate. The experimental group received the massage during the latent and active phases of labor. Pain levels during labor were measured using the Visual Analog Scale.</p><p><strong>Results: </strong>A total of 100 women, with 50 in each group, were included in the analysis. During both the latent and active phases of labor, the experimental group experienced greater reductions in pain levels compared with the control group (<i>p</i> < .001). Compared with the control group, fewer participants in the experimental group needed pain relief medication, although this difference was not statistically significant (36% in the experimental group vs. 56% in the control group, <i>p</i> = .07). The first stage of labor was significantly shorter for the experimental group (11.21 ± 5.25 h) than for the control group (16.06 ± 7.35 h, <i>p</i> < .001). However, no significant differences in the duration of the second and third stages were observed between the two groups.</p><p><strong>Conclusion: </strong>The massage administered by spouses during labor significantly reduced labor pain and shorten the duration of the first stage of labor.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251366751"},"PeriodicalIF":2.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic Performance and Satisfaction of Student-Directed Learning in Online Education Among Multidisciplinary Undergraduate Students: A Retrospective Comparative Study.","authors":"Basma Al Yazeedi, Zeinab Al Azri, Lina Shakman, Safiya Al Shidhani, Maryam Al Kharusi","doi":"10.1177/23779608251365990","DOIUrl":"10.1177/23779608251365990","url":null,"abstract":"<p><strong>Introduction: </strong>The outcomes of student-directed learning (SDL) compared to teacher-directed learning (TDL) in online education is yet to be established.</p><p><strong>Objectives: </strong>This study compared the academic performance outcomes between students enrolled in SDL online course with those enrolled in TDL online course. Additionally, the researchers assessed student satisfaction with the educational design, communication and interaction, and assessment and evaluation of the SDL online course.</p><p><strong>Method: </strong>A retrospective comparative design study was conducted. The researchers studied two groups of multidisciplinary students enrolled in two different classes (classes A and B) of the Physical and Psychological Child Health course. A complete enumeration sampling method was followed, where students in class A received the SDL, while students in class B had the TDL. The study outcome measured was students' grades in the first (Week 3), second (Week 6), and final (Week 8) exams, reflecting the students' academic performance in the taught course. Additionally, students' satisfaction with the SDL course was assessed using a 17-item self-reported questionnaire. Descriptive and Mann-Whitney U nonparametric test were used. Significance was set at less than .05.</p><p><strong>Results: </strong>Data from 118 students, 63 in the SDL group and 55 in the TDL group, were analyzed. Students in the SDL class demonstrated notably higher final exam scores than students in the TDL class (<i>p</i> = .02). Yet after removal of outliers, the difference was not significant (<i>p</i> = .08). Widespread satisfaction was evident with the SDL course, with an overall satisfaction rate of 85%. The satisfaction rate for educational design, communication and interaction, and assessment and evaluation was 88.4%, 78.8%, and 86.4%, respectively.</p><p><strong>Conclusion: </strong>Applying SDL in online education has strong potentials to improve learning outcomes, while at the same time satisfy students' learning needs. Future research may focus on investigating the integration of practical components in student-directed online education.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"11 ","pages":"23779608251365990"},"PeriodicalIF":2.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}