SAGE Open Nursing最新文献

{"title":"Psychometric Properties of the Arabic Version of the Heart Failure Somatic Perception Scale (HFSPS) in an Omani Sample.","authors":"Amira Mohammed Ali, Saeed A Al-Dossary, Maha Atout, Carlos Laranjeira, Maryam Alharrasi, Ahmed Ayed, Heba Emad El-Gazar, Mona Metwally El-Sayed, Haitham Khatatbeh, Mohamed Ali Zoromba, Amal Diab Ghanem Atalla, Rasmieh Alamer, Maha Subih, Annamaria Pakai","doi":"10.1177/23779608261426824","DOIUrl":"10.1177/23779608261426824","url":null,"abstract":"<p><strong>Background: </strong>The Heart Failure Somatic Perception Scale (HFSPS) is a brief instrument designed to assess the perceived burden of common symptoms of heart failure (HF).</p><p><strong>Aim: </strong>To investigate the psychometrics of the Arabic HFSPS.</p><p><strong>Methods: </strong>This methodological study investigated the construct validity of the HFSPS among 180 Omani patients with HF through exploratory factor analysis (EFA) and confirmatory factor analysis. Criterion validity was evaluated through correlations with the symptom frequency dimension of Kansas City Cardiomyopathy Questionnaire 12-item (KCCQ-12), Control Attitudes Scale-Revised Five-Items (CAS-R 5), and Patient Health Questionnaire-2 (PHQ-2).</p><p><strong>Results: </strong>EFA revealed three factors with eigenvalues >1, which explained 56.1% of the variance. Out of seven competing models, a five-factor structure comprising a new factor \"weight gain,\" which comprised correlated items \"11 and 14\" in other models, expressed the best fit. It was invariant across gender and marital status with adequate convergent and discriminant validity as indicated by average variance extracted >0.50, strong subscale-total correlations, and acceptable heterotrait-monotrait ratios. Criterion validity was evidenced by significant associations with KCCQ-12 symptom frequency, PHQ-2, and CAS-R 5, and HFSPS reliability was excellent (ω = .93).</p><p><strong>Conclusion: </strong>Weight gain seems a distinct dimension that deciphers error correlations previously found in the HFSPS. It may relate to patients' physical activity, nutritional habits, and metabolic dysregulations, necessitating integrating weight control measures in the routine care of patients with HF.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261426824"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425137","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":"Student-Centered Pedagogical Strategies in Nursing Education: A Systematic Review and Meta-Synthesis of Experiences, Perceived Impacts, Facilitators, and Barriers.","authors":"Solmaz Saeidi, Moluk Pouralizadeh, Zahra Taheri-Ezbarami, Hamid Sharif-Nia, Ehsan Kazemnejad Leili","doi":"10.1177/23779608261466384","DOIUrl":"10.1177/23779608261466384","url":null,"abstract":"<p><strong>Introduction: </strong>To promote active learning, critical thinking, and professionalism among nursing students, pedagogical practices are increasingly shifting to student-centered approaches. This systematic review and meta-synthesis of qualitative studies and mixed-methods studies was undertaken to examine the perspectives of both nursing students and educators of their experiences of student-centered pedagogies.</p><p><strong>Methods: </strong>This review was reported in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement, with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement's flow diagram followed to ensure transparency of the review study selection process. A systematic search was undertaken in five major electronic databases of peer-reviewed, qualitative studies and mixed-methods studies with a qualitative component published between 2015 and 2025. SPIDER tool was used for inclusion criteria. A data extraction form was developed for this synthesis, and thematic synthesis was carried out according to Thomas and Harden (2008) using NVivo 12. The risk of bias was assessed using the Critical Appraisal Skills Programme (CASP) Checklist.</p><p><strong>Results: </strong>The database search yielded 366 citations from which 31 studies were ultimately included in this review. Synthesis identified four main themes: 1) facilitating students' active cognitive engagement; 2) fostering of clinical competence and metacognitive competence; 3) fostering positive, supportive learning environments; 4) addressing facilitators and barriers, namely, cognitive overload and resistance to change and lack of resources and institutional support.</p><p><strong>Conclusion: </strong>Student-centered pedagogies may improve students' learning, engagement, and clinical and metacognitive competence within nursing education. However, for student-centered pedagogies to be implemented effectively, identified barriers to student engagement need to be addressed. Further, it is necessary to facilitate the implementation of this pedagogical shift by providing faculty development and curricula, and support infrastructure.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261466384"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425105","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":"Self-Management, Self-Efficacy, and Glycemic Control Among Adults With T2DM in the West Bank: A Descriptive Study.","authors":"Khalid Yaseen, Abeer Shaheen","doi":"10.1177/23779608261463496","DOIUrl":"10.1177/23779608261463496","url":null,"abstract":"<p><strong>Background: </strong>T2DM Mellitus is a complex chronic disease that affects adults of any age. Diabetes self-management and self-efficacy are associated with glycemic control.</p><p><strong>Objective: </strong>To assess self-management, self-efficacy, and glycemic control and their relationship in adults with T2DM in the West Bank.</p><p><strong>Methods: </strong>A cross-sectional descriptive design was used. A convenience sample of 154 patients was obtained from the primary health directorate's diabetes clinics in Ramallah and Al-Bireh governorate, West Bank.</p><p><strong>Results: </strong>The mean diabetes self-management score was 5.75 (SD = 1.49), with most participants demonstrating low self-management ability (n = 110, 71%). Participants also reported low perceived diabetes self-efficacy, with a mean score of 44.56 (SD = 9.45). Glycemic indicators reflected suboptimal control, with a mean Hemoglobin A1c (HbA1c) level of 8.7% (SD = 1.62) and a mean fasting blood glucose of 175.43 mg/dL (SD = 73.43). Self-management was significantly negatively correlated with body mass index (BMI) (r = -0.165, p = 0.041) and HbA1c (r = -0.209, p < 0.01), while showing a significant positive correlation with diabetes management self-efficacy (r = 0.576, p < 0.01).</p><p><strong>Conclusion: </strong>Diabetes self-efficacy and self-management were significantly linked to better glycemic control and improved diabetes outcomes. The use of tablets as the only treatment regimen was associated with significant improvement in glycemic control. Fasting blood sugar may serve as a predictor of long-term glycemic changes and support early diagnosis and screening. In addition, body mass index significantly influences diabetes self-management, self-efficacy, and glycemic control.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261463496"},"PeriodicalIF":2.9,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406227","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":"Patient-Engaged AI: The Nursing Path to Health Equity.","authors":"Razel B Milo, Caroline Etland, Nicole Martinez, Sheree Scott, Catherine De Leon, Patricia Calero, Christine Nibbelink, Jane Georges, Cynthia D Connelly","doi":"10.1177/23779608261466379","DOIUrl":"10.1177/23779608261466379","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) technology in healthcare has emerged as a highly effective tool for enhancing health data analysis and patient engagement. Recent research examining patients' use of AI applications for self-managing health demonstrates notable benefits but also raises multiple concerns, including exacerbation of health disparities. Furthermore, limited information is available regarding nurses' interactions with patient-engaged AI (PEAI) and its impact on the nurse-patient relationship.</p><p><strong>Objective: </strong>Developing new theoretical frameworks is essential to strengthening the evidence base for AI in nursing practice. The proposed middle-range theory constitutes a significant advancement toward delineating domains of nursing research to define AI utilization within the nurse-patient relationship and addressing health disparities.</p><p><strong>Methods: </strong>Walker and Avant's steps were used to construct the theory, define concepts, and synthesize the literature and models.</p><p><strong>Results: </strong>An integrated theory-building synthesis identified 28 articles, from which five key themes emerged as crucial for mitigating health equity gaps: communication, end-user trust and perceptions, technology and design, self-management, and ethics and privacy. These impact patient engagement and, in turn, are influenced by health literacy.</p><p><strong>Conclusion: </strong>Nursing research and practice are positioned to contribute critical evidence to close health disparities and redefine the nurse-patient relationship within the transformative context of the AI revolution.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261466379"},"PeriodicalIF":2.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13338546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406276","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":"Digital Competence and Perceived Pedagogical Optimization in Online Nursing Education: A Cross-Sectional Study in Peru.","authors":"Maryori Loconi-Samillan, Mireya Leandro-Matta, Eliane A Goicochea-Palomino, Jeel Moya-Salazar","doi":"10.1177/23779608261450723","DOIUrl":"10.1177/23779608261450723","url":null,"abstract":"<p><strong>Introduction: </strong>Online education has experienced significant growth, particularly accelerated by the pandemic and the expansion of Information and Communication Technologies (ICT). In Peru, a country that endured one of the world's longest COVID-19 lockdowns, the transition has faced challenges such as a lack of devices and connectivity.</p><p><strong>Objective: </strong>To determine the perception of the optimization of pedagogical approaches for online learning and its relationship to the level of digital competence among nursing students at a private university in Lima, Peru, in 2024.</p><p><strong>Methods: </strong>A cross-sectional study assessed the perception of 278 nursing students at a private university via simple random sampling. An online, Likert-scale, 58-item questionnaire was used for data gathering. Both instruments demonstrated high reliability (Cronbach's α: 0.914-0.922) and validity (Aiken's V: 0.894-0.995). We used Mann Whitney U and one-way ANOVA with Eta-square (η2) values for comparing the variables Spearman's Rho for association.</p><p><strong>Results: </strong>Most participants were women aged 18-27 (73.9%). A moderate perception of pedagogical optimization prevailed (56.8%), while 81.4% exhibited high digital competence. Age significantly influenced pedagogical perception (p< 0.001) and digital competence (p= 0.006), with younger students outperforming older peers. Academic semester showed no significant impact. A strong association emerged between pedagogical perception and digital competence (Rho=0.336, p<0.001), with high-competence students exclusively reporting high pedagogical satisfaction. Also, students with high digital competence differed significantly from those with moderate/low competence (U = 6061, p < 0.001).</p><p><strong>Conclusion: </strong>These findings highlight the interdependence of digital proficiency and effective pedagogical design in nursing education. While high digital competence is prevalent, gaps in pedagogical optimization suggest that technological integration alone is insufficient without structured teaching strategies. Addressing age-related disparities and enhancing interactive virtual learning are critical to preparing nurses for technology-driven healthcare environments.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261450723"},"PeriodicalIF":2.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438301","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":"Verbal Workplace Violence and Burnout Among Italian Nurses: The Role of Self-Efficacy and Coping.","authors":"Gennaro Laus, Sipontina Rita Zerulo, Antonella Varetto, Maria Michela Gianino, Daniela Acquadro Maran","doi":"10.1177/23779608261459535","DOIUrl":"10.1177/23779608261459535","url":null,"abstract":"<p><strong>Introduction: </strong>Verbal workplace violence (WPV) is the most frequent form of aggression experienced by nurses and represents a significant psychosocial risk for professional well-being and workforce sustainability. Although individual resources such as self-efficacy and coping strategies may influence nurses' responses to verbal WPV, their role should be interpreted within the context of chronic occupational stress.</p><p><strong>Objective: </strong>This study aimed to examine the prevalence and characteristics of verbal WPV among Italian nurses and to investigate its associations with burnout, psychological distress, perceived self-efficacy, and coping strategies, comparing nurses exposed and not exposed to verbal WPV.</p><p><strong>Methods: </strong>A cross-sectional quantitative study was conducted using an online self-administered questionnaire. A convenience sample of 384 Italian nurses completed validated measures assessing exposure to verbal WPV, burnout (Oldenburg Burnout Inventory), psychological distress (GHQ-12), perceived self-efficacy at work, and coping strategies (Brief COPE). Descriptive analyses, group comparisons, correlation analyses, and multiple linear regression models were performed, stratified by exposure to verbal WPV.</p><p><strong>Results: </strong>Overall, 34.4% of participants reported experiencing verbal WPV, most frequently in high-pressure clinical settings. Nurses exposed to verbal WPV reported lower levels of emotional exhaustion but slightly higher psychological distress compared with non-exposed nurses. They also reported higher perceived self-efficacy and greater use of problem-focused and cognitive coping strategies. Among exposed nurses, self-efficacy and coping strategies explained a substantial proportion of variance in exhaustion and disengagement, indicating complex and non-linear psychological adaptation processes. More linear occupational stress patterns emerged among non-exposed nurses.</p><p><strong>Conclusion: </strong>Verbal WPV is a pervasive occupational hazard in nursing and is associated with differentiated psychological adaptation processes rather than uniformly protective or detrimental outcomes. These findings indicate that organisations cannot rely solely on individual interventions and must take responsibility for preventing violence.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261459535"},"PeriodicalIF":2.9,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438399","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":"Corrigendum to \"Personality Traits, Fear of Missing Out, and Social Media Addiction Among Nursing Students: A Structural Equation Modeling Approach\".","authors":"","doi":"10.1177/23779608261463871","DOIUrl":"https://doi.org/10.1177/23779608261463871","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/23779608251345959.].</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261463871"},"PeriodicalIF":2.9,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392127","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":"Iranian Clinical Nurses' Experiences of Workplace Social Capital: A Qualitative Content Analysis.","authors":"Mehrangiz Ghabimi, Seyyed Abolfazl Vagharseyyedin","doi":"10.1177/23779608261451334","DOIUrl":"10.1177/23779608261451334","url":null,"abstract":"<p><strong>Introduction: </strong>Workplace social capital (WSC) represents an essential resource for improving nurses' efficiency and well-being; however, limited attention has been paid to this concept within Iranian healthcare setting.</p><p><strong>Objectives: </strong>This study explored Iranian clinical nurses' experiences and perceptions of WSC.</p><p><strong>Methods: </strong>A qualitative design was used based on conventional content analysis. Data were collected through in-depth, semi-structured interviews with hospital-based nurses selected via purposive sampling. Data analysis was conducted concurrently with data collection following Graneheim and Lundman's content analysis approach.</p><p><strong>Results: </strong>The analysis yielded three main categories: (1) an egocentric atmosphere, (2) lack of a flourishing workplace, and (3) an unsafe work environment, each with its respective subcategories.</p><p><strong>Conclusion: </strong>The findings provide valuable insights for nursing policymakers and managers aiming to strengthen nurses' workplace social capital. Key recommendations include promoting teamwork, fair performance appraisals, equitable career advancement, and a stronger ethical climate.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261451334"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377435","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":"Community-Based Palliative Care: A Bibliometric and Visual Analysis of Scientific Publications (2015-2025).","authors":"Qin Yu, XiaoJin Wei, XiaoJing Xue","doi":"10.1177/23779608261465166","DOIUrl":"10.1177/23779608261465166","url":null,"abstract":"<p><strong>Introduction: </strong>Community-based palliative care has been widely studied worldwide, yet the developmental trajectory of this field remains unclear. In this study, we aimed to elucidate current research focuses, emerging hotspots, and trends in community-based palliative care through bibliometric and visual analyses.</p><p><strong>Methods: </strong>This study involved bibliometric analysis, combined with visual knowledge mapping of the retrieved literature. Data were retrieved from the Web of Science Core Collection for publica1tions from 2015 to 2025. Bibliometric networks were visualized using CiteSpace and VOSviewer. The reporting framework for this study complies with the Preferred Reporting Items for Bibliometric Analysis guidelines.</p><p><strong>Results: </strong>Overall, 1,180 publications on community-based palliative care were examined. Annual publication output showed a continuous upward trend, with the United States contributing the largest number of publications (330 articles). The institution with the highest research output was the University of Edinburgh. <i>BMC Palliative Care</i> was the most productive journal. Four core research topics were identified: (a) community-based palliative care services and practice; (b) palliative care and health outcomes among older adults with chronic diseases in the community; (c) advance care planning and decision-making; and (d) barriers to and training in palliative care among community health workers.</p><p><strong>Conclusion: </strong>Publications on community-based palliative care have increased steadily since 2015, indicating growing academic interest in the field. The United States and Western Europe lead this domain, supported by strong presence of prominent researchers and leading research institutions. Several cohesive, high-output author groups have emerged, reflecting the development of well-connected research collaborations. Although existing research primarily centers on four core topics, \"interviews,\" \"framework,\" \"family physicians,\" \"lung,\" and \"dementia\" may represent emerging research frontiers.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261465166"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377353","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":"Moral Distress and Ethical Climate Among Japanese Intensive Care Unit Nurses.","authors":"Hideki Yamauchi, Kyoko Ueno","doi":"10.1177/23779608261457808","DOIUrl":"10.1177/23779608261457808","url":null,"abstract":"<p><strong>Introduction: </strong>Moral distress among intensive care unit (ICU) nurses is a global concern that affects the quality of care and well-being. In Japan, how hierarchy and consensus culture shape nurses' experiences and ethical perceptions remain underexplored.</p><p><strong>Objectives: </strong>This mixed-methods study explored moral distress, how Japanese ICU nurses perceive the ethical climate, and the interrelationship between the two.</p><p><strong>Methods: </strong>An explanatory sequential design was used. Phase one involved a web-based survey of 168 ICU nurses from 54 facilities, employing the revised Japanese versions of the Moral Distress Scale and the Hospital Ethical Climate Survey. Phase two comprised semi-structured interviews with 11 purposively selected nurses based on quantitative findings, followed by content analysis.</p><p><strong>Results: </strong>Quantitative analysis showed moderate moral distress, with the highest score for \"lack of respect for patient dignity\" and significant correlations with longer ICU experience. \"Organizational support through clear hospital philosophy\" received low ratings and was negatively correlated with distress arising from collaboration difficulties. Qualitative findings expanded on these results by identifying themes of powerlessness over futile treatment, communication challenges in multidisciplinary teams, and dissatisfaction with physician-centered decision-making.</p><p><strong>Conclusion: </strong>Japanese ICU nurses experienced moderate moral distress, with end-of-life care emerging as a salient context. The distress was associated with the ethical climate, particularly the lack of perceived organizational support. These findings emphasize the need to enhance organizational structures, clarify ethical principles, and foster open interprofessional communication. Future research should use longitudinal designs to examine the effects of structured interventions-such as ethical decision-making support systems-on reducing moral distress and improving the ethical climate in ICUs.</p>","PeriodicalId":43312,"journal":{"name":"SAGE Open Nursing","volume":"12 ","pages":"23779608261457808"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377437","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}