Nursing Open最新文献

{"title":"Mediating Effect of Career Adaptability Between Transition Shock and Retention Intention Among Intern Nursing Students in the Initial Stage of Internship: A Cross-Sectional Study.","authors":"Yu Zhu, Jiliu Li, Xiu Ying Hu, Yingxue Chen","doi":"10.1002/nop2.70858","DOIUrl":"10.1002/nop2.70858","url":null,"abstract":"<p><strong>Aim: </strong>To examine whether career adaptability mediated the relationship between transition shock and retention intention among intern nursing students.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>From September 1st to October 1st 2024, an online questionnaire survey was conducted among 336 nursing interns from one hospital in northern Fujian Province, China using convenience sampling. Demographic questionnaire, Transition shock of newly graduated nurse scale, Nurses' workplace adaptability scale, and Nurses' retention intention scale were used to collect data. The SPSS 26.0 software was used for statistical analysis. Spearman correlation analysis was used to explore the interaction among transition shock, career adaptability, and retention intention, and PROCESS Macro Model 4 for the mediating effect.</p><p><strong>Results: </strong>It showed that transition shock was negatively related to retention intention and career adaptability. Conversely, career adaptability was positively with retention intention. Career adaptability mediated the role of 32.95% the association between transition shock and retention intention.</p><p><strong>Conclusion: </strong>Associations consistent with partial mediation were revealed among transition shock, career adaptability, and retention intention.</p><p><strong>Impact: </strong>This study examined how career adaptability was related to retention intention among nursing interns experiencing transition shock. Career adaptability partially mediated the transition shock-retention intention association, suggesting its potential as a focus to support novice nurses' retention.</p><p><strong>Implications for the profession and/or patient care: </strong>For nursing education, enhancing career adaptability could be incorporated into internship training; for nursing practice, preceptors can support interns during the clinical transition. Such efforts may help stabilize the novice nursing workforce and sustain quality of patient care, warranting further empirical testing.</p><p><strong>Reporting method: </strong>In accordance with the STROBE checklist for cross-sectional studies: NO PATIENT OR PUBLIC CONTRIBUTION: This is a cross-sectional study in which participants only provided data as respondents and are not engaged as collaborators in the research process.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70858"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A BOPPPS-PBL Nursing Innovation Course for Newly Recruited Nurses: A Single-Group Quantitative Pilot Evaluation of Creativity, Self-Efficacy and 1-Year Project Outputs.","authors":"Hao Yang, Xiaosha Jing, Yujia Guan, Min Yang, Ting Bai, Lingling Xing, Dan Mu, Xihong Wang, Hongqian Liu","doi":"10.1002/nop2.70734","DOIUrl":"10.1002/nop2.70734","url":null,"abstract":"<p><strong>Background: </strong>Creativity and problem-solving are essential to contemporary nursing, but newly recruited nurses have limited opportunities to develop these competencies through traditional lecture-based education. This pilot study developed and evaluated a nursing innovation course that used the Bridge-in, Objectives, Preassessment, Participatory Learning, Postassessment and Summary (BOPPPS) model, with Problem-Based Learning (PBL) embedded in the participatory phase.</p><p><strong>Methods: </strong>An uncontrolled single-group pretest-posttest pilot design was used. Sixty newly recruited nurses in one tertiary hospital attended the course as a required component of standardised training, while participation in the research evaluation was voluntary. The course combined short lectures, clinical cases, small-group PBL and innovation project design. Creativity and general self-efficacy were assessed before and after the course; self-efficacy was measured using a locally modified five-response-category GSES. Course evaluations and documented project outputs were also collected.</p><p><strong>Results: </strong>Complete data from all 60 participants were analysed. Creativity increased from 20.50 ± 4.15 to 23.63 ± 3.32 (mean difference 3.13, 95% CI 1.69-4.58; p < 0.001; Cohen's dz = 0.56), and self-efficacy increased from 38.78 ± 8.64 to 42.48 ± 6.10 (mean difference 3.70, 95% CI 0.84-6.56; p = 0.012; Cohen's dz = 0.33).</p><p><strong>Conclusions: </strong>Participation was associated with higher post-course creativity and self-efficacy, and the course appeared feasible and acceptable. The uncontrolled design and mentor-supported setting preclude attributing score changes or outputs to the course alone; controlled multicentre studies are needed.</p><p><strong>Implications for nursing practice: </strong>The BOPPPS-PBL structure may inform innovation-focused content in nurse orientation, nurse continuing education and newly recruited nurse training when educators also provide facilitator preparation, protected learning time and context-appropriate mentoring.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70734"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable Machine Learning Models for Classifying Preoperative Anxiety in Patients With Femoral Neck Fractures: A Retrospective Cohort Study.","authors":"Xue Zhang, Shuzhi Zheng, Zanhua Zhang, Peiyi Yang, Qiao Wei, Mimi Jin, Fang He","doi":"10.1002/nop2.70919","DOIUrl":"10.1002/nop2.70919","url":null,"abstract":"<p><strong>Aim: </strong>To develop and internally validate explainable machine learning models for concurrent classification of preoperative anxiety in patients with femoral neck fractures.</p><p><strong>Design: </strong>Single-centre retrospective observational cohort study.</p><p><strong>Methods: </strong>Clinical, perioperative and psychosocial data from 271 surgical admissions (270 patients) during 2024 were analysed. Preoperative anxiety was classified during the preoperative bedside assessment phase using a prespecified score greater than 8 on the anxiety subscale of the Hospital Anxiety and Depression Scale. Three tree-based ensemble models were compared using fivefold, patient-grouped nested cross-validation with fold-specific preprocessing, feature selection, resampling, tuning and separate probability calibration.</p><p><strong>Results: </strong>Preoperative anxiety according to this prespecified definition was identified in 79 admissions. The anxiety group was older, had lower psychological resilience and perceived social support, and had greater surgical fear and frailty. The three algorithms showed similar internal discrimination, and paired comparisons did not support superiority of one model. Psychological resilience, perceived social support and surgical fear were selected in every validation fold for all models. Frailty index was selected in three of five folds for each model.</p><p><strong>Conclusion: </strong>The models identified a stable psychosocial feature profile for concurrent classification but require external and prospective validation before clinical use.</p><p><strong>Implications for nursing practice: </strong>These findings may inform future research on structured nursing assessment of preoperative anxiety. The models should not replace validated screening or clinical judgement and require prospective evaluation before routine use.</p><p><strong>Impact: </strong>Psychological resilience, perceived social support and surgical fear were the most stable selected features.</p><p><strong>Reporting method: </strong>The Strengthening the Reporting of Observational Studies in Epidemiology and TRIPOD+AI reporting guidelines were followed.</p><p><strong>No patient or public contribution: </strong>None, because this study retrospectively analysed existing de-identified records.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70919"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Cdyn-Guided PEEP and Nursing Activities During PACU Recovery in Infants Undergoing One-Lung Ventilation: A Retrospective Observational Cohort Study.","authors":"Mingran Hao, Bin Zhang, Yuejiao Han, Changbin Zhao, Zhaoyuan Dong, Benqin Song","doi":"10.1002/nop2.70935","DOIUrl":"https://doi.org/10.1002/nop2.70935","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the association between Cdyn-guided PEEP during one-lung ventilation (OLV) and nursing activities in the post-anaesthesia care unit (PACU) among infants undergoing thoracoscopic surgery under general anaesthesia: DESIGN: Retrospective observational cohort study.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data from infants with congenital pulmonary airway malformation (CPAM) who underwent thoracoscopic lobectomy at a Children's Hospital Affiliated to Shandong University between January 2022 and February 2025. Patients were classified according to the recorded intraoperative PEEP strategy actually delivered during OLV: Group P was managed with Cdyn-guided individualized PEEP; Group C was managed with fixed PEEP of 5 cmH₂O. The primary outcome was PACU Nursing Activities Score (NAS). Baseline clinical characteristics, postoperative outcomes (incidence of delirium, pain scores), PACU observation time, and adverse events were compared between the two groups.</p><p><strong>Results: </strong>A total of 93 patients were included. Baseline characteristics were generally balanced, with most standardized mean differences < 0.2. After adjustment for prespecified covariates, Cdyn-guided PEEP was associated with a lower NAS score (adjusted mean difference = -3.75; 95% CI: -6.44 to -1.07; p = 0.007). Compared with Group C, Group P was also associated with a shorter PACU stay and a lower composite adverse event rate.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70935"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a 'Baby-Midwife-Family' Micro-Video Intervention on Fear of Childbirth Among Primiparous Women.","authors":"Qianqian Zhao, Liangzhentian Yu, Jianlan Lu, Feiyan Guo, Yu Chen","doi":"10.1002/nop2.70803","DOIUrl":"10.1002/nop2.70803","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effectiveness of a multi-perspective 'Baby-Midwife-Family' micro-video intervention in reducing fear of childbirth among primiparous women, while also examining its effects on childbirth self-efficacy and depressive symptoms.</p><p><strong>Design: </strong>A non-concurrent controlled trial.</p><p><strong>Methods: </strong>This study was conducted at a tertiary hospital in Guangzhou, China. A total of 140 eligible primiparous women were enrolled. Women admitted during Dec 2024-Jan 2025 were allocated to the historical control group (n = 70) and received usual care, whereas those admitted during Feb-Mar 2025 were allocated to the intervention group (n = 70) and received usual care plus the micro-video intervention. Fear of childbirth (primary outcome), childbirth self-efficacy, and depressive symptoms (secondary outcomes) were assessed at hospital admission, before participants entered the delivery room, and on the day after delivery. Data were analysed using repeated-measures analysis of variance with intention-to-treat and per-protocol analyses.</p><p><strong>Results: </strong>Women receiving the micro-video intervention showed significantly greater reductions in fear of childbirth and greater improvements in childbirth self-efficacy over time than those receiving usual care alone. Depressive symptoms decreased over time in both groups, with no significant group effect.</p><p><strong>Conclusion: </strong>The findings support the 'Baby-Midwife-Family' micro-video intervention as a useful addition to childbirth preparation for primiparous women admitted for delivery.</p><p><strong>Impact: </strong>This brief intervention adds to routine maternity nursing care by providing timely childbirth education during the short pre-delivery period.</p><p><strong>Reporting method: </strong>TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) Statement.</p><p><strong>Patient or public contribution: </strong>No patients or public contribution.</p><p><strong>Trial registration: </strong>This study was registered with the Chinese Clinical Trial Registry (Registration No. ChiCTR2500109537, https://www.chictr.org.cn/showproj.html?proj=278878).</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70803"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational and Work-Related Factors Associated With Job Esteem Among Nurses in Beijing: A Cross-Sectional Study.","authors":"Zixuan Yan, Xianzong Ma, Cunduo Jin, Huaguo Zhang, Qingqing Su, Meihua Ji, Wenyu Zhang","doi":"10.1002/nop2.70842","DOIUrl":"10.1002/nop2.70842","url":null,"abstract":"<p><strong>Aim: </strong>To examine occupational and work-related factors associated with job esteem among nurses in Beijing, with particular attention to workload, working-time arrangements, job satisfaction, and intention to leave.</p><p><strong>Design: </strong>A multicenter cross-sectional study.</p><p><strong>Methods: </strong>An anonymous online survey was completed by 1381 registered nurses from seven hospitals in Beijing between January 2023 and September 2024. Data were collected on demographic and occupational characteristics, working time, perceived workload, job satisfaction, intention to leave, and job esteem. A multivariable linear mixed-effects model with a random intercept for hospital was used to examine factors associated with the total job esteem score.</p><p><strong>Results: </strong>Among the participants, 61.0% of the nurses worked 41 h or more per week, and 35.3% worked for at least 9 consecutive hours per day. The mean job esteem score was 81.8 ± 12.1, with professional authority and future value receiving the lowest dimension scores. Higher total job esteem scores were associated with a monthly income of ≥ RMB 10,001, contract or other employment relationships, and 6-20 years of working experience. Nurses working 41-45 h per week had lower scores than those working ≤ 40 h. Job satisfaction and intention to leave the current hospital showed the strongest associations with job esteem, although the estimates across job-satisfaction categories did not follow a consistent stepwise pattern. Other working-time and workload indicators were not independently associated with job esteem. Hospital tier was not independently associated with job esteem, and between-hospital variation was negligible.</p><p><strong>Conclusions: </strong>Job esteem among nurses was associated with remuneration, employment relationships, work experience, weekly working hours, job satisfaction, and intention to leave. The findings support continued organizational attention to fair remuneration, early-career support, professional recognition, transparent career-development pathways, and reasonable working hours. Job satisfaction and intention to leave may also help organizations identify aspects of the work environment that require attention.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70842"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lived Experiences of Early Career Nurses During a One-Year Enhancement Training Program in Oman: A Descriptive Phenomenological Study.","authors":"Issa J Al Balushi, Mahmood Salim Almaawali, Farhan Sadique, Aisha A Al Shibli, Sulaiman Al Balushi","doi":"10.1002/nop2.70905","DOIUrl":"10.1002/nop2.70905","url":null,"abstract":"<p><strong>Background: </strong>The transition from nursing education to professional practice is marked by rapid professional development, increasing responsibility, psychological strain, and uncertainty. In Oman, the one-year Enhancement Training Program (ETP) was introduced to support early career nurses (ECNs) in bridging the gap between academic preparation and clinical practice.</p><p><strong>Objective: </strong>To explore and describe the lived experiences of early career nurses during the one-year Enhancement Training Program at Sohar Hospital, Oman, and to understand how these experiences shaped their transition into professional nursing practice.</p><p><strong>Methods: </strong>Colaizzi's descriptive phenomenological method guided data collection and analysis. Semi-structured interviews were conducted with 17 ECNs. Analysis involved repeated reading, extraction of significant statements, formulation of meanings, organization into theme clusters, development of an exhaustive description, derivation of the fundamental structure, and participant validation. Reflexivity, peer debriefing, member checking, and an audit trail supported trustworthiness.</p><p><strong>Results: </strong>Seven themes captured the essence of ECNs' experiences: (1) Transition-Related Anxiety and Uncertainty, (2) Confidence Development Through Clinical Exposure, (3) Supervisory Mentorship and Team Dynamics, (4) Learning Through Critical Clinical Encounters, (5) Navigating Patient and Family Communication, (6) Workplace Structures and Resource Pressures, and (7) Professional Identity Formation and Belonging. The experience reflected a gradual movement from uncertainty and dependence toward growing confidence, competence, and professional belonging.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70905"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflective Practice and Related Factors Among Specialty Nurses in Tertiary General Hospitals Across China: A Latent Profile Analysis.","authors":"Songyao Li, Wenqiong Lin, Panpan Zhang, Yaru Li, Ziru Fang, Yuning Wang, Hongmei Zhang","doi":"10.1002/nop2.70874","DOIUrl":"https://doi.org/10.1002/nop2.70874","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To identify distinct subgroups of reflective practice among specialty nurses in tertiary general hospitals using latent profile analysis (LPA), and to explore the influencing factors associated with subgroup classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Study participants were recruited via convenience sampling. An online questionnaire survey was conducted using the basic information questionnaire, the reflective practice questionnaire, and the workplace spirituality scale. Latent profile analysis (LPA) was used to identify subgroups of specialty nurses' reflective practice. Additionally, univariate analysis and logistic regression were conducted to find the predictive factors of different categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Data were collected from 817 eligible specialty nurses across 13 tertiary general hospitals in China from April to June 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 817 specialty nurses were included, identifying three categories of reflective practice: low reflective practice group (23.38%), moderate reflective practice group (37.58%) and high reflective practice group (39.04%). Specialty nurses who were married, held positions, had higher monthly incomes, and exhibited stronger workplace spirituality were more likely to have higher levels of reflective practice than the other profiles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The majority of specialty nurses fell into the moderate and high reflective practice groups. The marital status, job position, monthly income and workplace spirituality of specialty nurses were associated with reflective practice. Targeted interventions may help enhance the reflective practice of specialty nurses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Implications for the profession and/or patient care: &lt;/strong&gt;The findings of this study offer an evidence base for nursing administrators to design tailored intervention programmes. Particular emphasis should be placed on specialty nurses in the low reflective practice group, whose reflective practice may be improved through the enhancement of workplace spirituality via structured mentorship, foundational reflective training and supportive organizational strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Impact: &lt;/strong&gt;The heterogeneity and predictive factors related to specialty nurses' reflective practice in tertiary general hospitals provide valuable evidence for the formulation of individualized interventions. Nursing administrators should understand the importance of reflective practice, offer performance rewards and educational opportunities for specialty nurses, implement magnetic management strategies to enhance workplace spirituality, thereby effectively improving the level of reflective practice among specialty nurses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting method: &lt;/strong&gt;This study was reported in accordance with the EQUATOR guidelines and followed the STROBE statement for cross-sectional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70874"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Providing End-of-Life Nursing Care: A Qualitative Content Analysis.","authors":"Zahra Taheri-Ezbarami, Fateme Jafaraghaee, Ali Karimian Sighlani, Seyed Kazem Mousavi","doi":"10.1002/nop2.70866","DOIUrl":"https://doi.org/10.1002/nop2.70866","url":null,"abstract":"<p><strong>Aim: </strong>To explore the challenges of providing end-of-life nursing care in Iran.</p><p><strong>Design: </strong>Qualitative content analysis.</p><p><strong>Methods: </strong>Fifteen participants, including seven nurses, two head nurses, two educational supervisors, two academic staff, one nursing service manager and one critical care physician, were purposively selected from across Iran from October to December 2023. Data were collected through in-depth semi-structured interviews in person and by telephone and analyzed using MAXQDA 2020 software using the inductive content analysis approach of Elo and Kingas. We also examined trustworthiness using Elo et al.'s checklist and Lincoln and Guba's criteria.</p><p><strong>Results: </strong>Four main themes emerged: (1) Emotional burden of caring for dying patients (fear and anxiety, compassion fatigue, moral distress and grief responses); (2) Systemic neglect of end-of-life care (educational gaps, lack of national standards and absence of a palliative care organization); (3) Fragmented interdisciplinary care and communication gaps (poor teamwork, physician-centred system, unclear role definitions and cultural and religious barriers); and (4) Absence of supportive infrastructure (economic, social and technological constraints). Participants believed that these themes were related and mutually reinforcing.</p><p><strong>Conclusion: </strong>End-of-life nursing care in Iran faces serious, interconnected challenges. Therefore, it requires comprehensive institutionalization, planning and educational and clinical interventions.</p><p><strong>Implications for nursing practice: </strong>To improve care quality, nurses need appropriate policies and specific clinical protocols for end-of-life care.</p><p><strong>Impact: </strong>This study examines an important gap in understanding the challenges of end-of-life care in Iran and provides evidence for policymaking, education and health system management.</p><p><strong>Reporting method: </strong>The study report was guided by the COREQ checklist.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70866"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Self-Efficacy Mediates the Relationship Between Patient Empowerment and Medication Adherence: A Path Analysis in Patients With Coronary Artery Disease - Empirical Research Quantitative.","authors":"Atefeh Allahbakhshian, Fatemeh Hashempour, Samin Saiyadani, Parvin Sarbakhsh, Masood Mohammadnezhad, Fatemeh Radimaher","doi":"10.1002/nop2.70837","DOIUrl":"https://doi.org/10.1002/nop2.70837","url":null,"abstract":"<p><strong>Aim: </strong>To examine the mediating role of cardiac self-efficacy in the relationship between patient empowerment and medication adherence among patients with coronary artery disease (CAD) and to identify which empowerment sub-dimensions are most prominent.</p><p><strong>Design: </strong>A cross-sectional correlational study.</p><p><strong>Methods: </strong>A convenience sample of adults attending a cardiology clinic completed validated versions of the Coronary Artery Disease Empowerment Scale (CADES), Cardiac Self-Efficacy Scale and Morisky Medication Adherence Scale. Data were analysed using Spearman's correlations, ordinal logistic regression and path analysis with bootstrap mediation testing.</p><p><strong>Results: </strong>Positive correlations were found among empowerment, self-efficacy and adherence. Regression analysis showed that cardiac self-efficacy predicted adherence, while empowerment did not directly predict adherence. Path analysis confirmed that self-efficacy mediates the empowerment-adherence relationship. The self-determination subscale of empowerment was the strongest predictor of self-efficacy, whereas personal competence was not significant.</p><p><strong>Conclusion: </strong>Patient empowerment enhances medication adherence indirectly by building cardiac self-efficacy, primarily through fostering patient autonomy rather than merely providing knowledge.</p><p><strong>Implications for the profession and/or patient care: </strong>Nurse-led strategies should target cardiac self-efficacy. Motivational interviewing and autonomy-supportive interventions may be more effective than traditional education.</p><p><strong>Impact: </strong>What problem did the study address? The study addressed the gap in understanding the nurse-led interventions that translate patient empowerment into actual medication adherence behaviours. What were the main findings? Self-efficacy acts as the essential bridge between empowerment and adherence and this bridge is built most effectively through self-determination rather than personal competence. Where and on whom will the research have an impact? These results will impact clinical nurses, nurse educators and healthcare professionals involved in cardiac care by highlighting that nurse-led counselling strategies and autonomy-supportive interventions may be more effective for improving medication.</p><p><strong>Reporting method: </strong>We adhered to the STROBE guidelines.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70837"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}