Nursing Open最新文献

{"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}

{"title":"ENGENDER NANDA Guideline: Ensuring Gender inclusion in NANDA-I. A Delphi Study.","authors":"Mª Rosa Rifà-Ros, Miriam Rodriguez-Monforte, Elena Carrillo-Alvarez, Angel Gasch-Gallen","doi":"10.1002/nop2.70740","DOIUrl":"https://doi.org/10.1002/nop2.70740","url":null,"abstract":"<p><strong>Aim: </strong>To develop a guideline for the integration of the gender perspective in the use of NANDA-I nursing diagnoses.</p><p><strong>Design: </strong>The Delphi technique was used in order to reach consensus between two groups of experts: (a) in nursing diagnoses and (b) in gender, thus allowing us to draw up the guidelines to include the gender perspective in the three levels of the NANDA- taxonomy (domains, classes and diagnoses).</p><p><strong>Methods: </strong>The Delphi study included four rounds. The first was carried out considering a qualitative approach to define the items of the guidelines followed by three Delphi rounds to reach consensus combining quantitative thresholds and qualitative feedback. Thirty experts were invited to participate in order to assess and reach consensus on two main criteria: relevance and feasibility of the items. Consensus was evaluated by calculating the mean and standard deviation of each item according to the scores obtained by the participating experts. The study followed the CREDES Guidelines.</p><p><strong>Results: </strong>The participants included 20 experts in gender and NANDA-I nursing diagnoses. The Delphi process yielded 14 indicators, organized into three domains. This process integrates the consideration of differentiating characteristics in terms of sex, the use of non-sexist language in the diagnosis, the consideration of the gender perspective in the process of clinical reasoning and the need for including gender experts in the process of translating NANDA-I language into languages that use binary gender nouns.</p><p><strong>Patient or public contribution: </strong>No patient or public involvement occurred in the design or conduct of this study.</p><p><strong>Reporting method: </strong>In order to allow critical appraisal of the methodology and resulting guidance, the study followed the CREDES Guidelines, a reporting standard for Conducting and REporting DElphi Studies.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70740"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116949","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":"Factors Associated With Family Caregivers' Attitudes Toward Withholding Life-Sustaining Treatment in Older Adults With Dementia: A Cross-Sectional Study.","authors":"Kukjin Kim, Yoonah Noh, Jia Lee","doi":"10.1002/nop2.70922","DOIUrl":"10.1002/nop2.70922","url":null,"abstract":"<p><strong>Aim: </strong>To examine factors associated with family caregivers' attitudes toward withholding life-sustaining treatments (LSTs) for older adults with dementia.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A questionnaire survey assessed advance care planning (ACP) knowledge, perceptions of a good death, caregiver burden, and attitudes toward withholding LSTs using previously developed instruments. Hierarchical regression was supplemented by bootstrap confidence intervals, robust inference, and a reduced clinical sensitivity model.</p><p><strong>Data sources: </strong>Data were collected from 113 family caregivers of older adults with dementia in South Korea from August 28 to September 12, 2022.</p><p><strong>Results: </strong>Spouse and child caregivers reported more favourable attitudes than other relatives across the main and sensitivity analyses. The association with ACP knowledge was sensitive to model specification and inference method. Associations with religious affiliation, prior family discussion, and perceptions of a good death were not consistently supported in robustness analyses.</p><p><strong>Conclusion: </strong>The findings suggest areas for further study in caregiver education and early ACP discussions. They do not establish causal effects or demonstrate that changing caregivers' attitudes improves care outcomes.</p><p><strong>Implications for nursing practice: </strong>Nurses can support accessible ACP education and timely, values-based discussions with older adults and their families, adapting communication to each person's decision-specific capacity and preferences.</p><p><strong>Reporting method: </strong>The study was reported according to the STROBE guidelines.</p><p><strong>No patient or public contribution: </strong>The study was designed as a researcher-led questionnaire survey, without patient or public involvement in its design, conduct, analysis, interpretation, or reporting. Family caregivers participated only as survey respondents.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70922"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148161","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":"Sarcopenia, Depression, Fatigue, and Fear of Falling in Middle-Aged and Older Adults With Visual Impairment: Empirical Research Quantitative.","authors":"Eunjin Yang, Young-Shin Joo, Jee-Hye Yoo","doi":"10.1002/nop2.70900","DOIUrl":"10.1002/nop2.70900","url":null,"abstract":"<p><strong>Aim: </strong>To examine whether depression and fatigue mediate the association between sarcopenia and fear of falling in middle-aged and older adults with visual impairment, based on the biopsychosocial model.</p><p><strong>Design: </strong>Cross-sectional secondary data analysis.</p><p><strong>Methods: </strong>Data from 211 community-dwelling adults aged 50 years and older with visual impairment in South Korea, collected between September 2024 and March 2025, were analysed. The risks of sarcopenia, depression, fatigue, and fear of falling were measured. Serial mediation was tested using Hayes' PROCESS macro (Model 6).</p><p><strong>Results: </strong>Sarcopenia was positively associated with depression, fatigue, and fear of falling, and its direct effect on fear of falling was significant. Depression alone did not mediate the association, whereas fatigue showed a significant indirect effect, including a serial pathway through depression and fatigue.</p><p><strong>Conclusions: </strong>Fatigue was a key pathway linking sarcopenia to fear of falling, whereas depression alone was not. Screening for sarcopenia risk, fatigue, and depression, along with tailored interventions, is warranted.</p><p><strong>Implications for the profession and/or patient care: </strong>When assessing fall risk in middle-aged and older adults with visual impairment, nurses should screen not only for physical function but also for sarcopenia risk, fatigue, and depression. Nurse-led interventions combining strength and balance training with fatigue and mood management may help reduce fear of falling in this population.</p><p><strong>Impact: </strong>This study addressed how, and why, sarcopenia relates to fear of falling in adults with visual impairment. Fatigue emerged as the key pathway. The findings can help nurses and other providers develop integrated fall-prevention care for this population.</p><p><strong>Reporting method: </strong>To strengthen the validity of the research, it was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution, as this study involved a secondary analysis of de-identified data.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70900"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116860","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":"Development and Internal Validation of a Nomogram for Identifying Postpartum Fatigue in Postpartum Women: A Cross-Sectional Study.","authors":"Zhidong Guo, Min Xu, Shouzhen Cheng","doi":"10.1002/nop2.70907","DOIUrl":"10.1002/nop2.70907","url":null,"abstract":"<p><strong>Aim: </strong>To identify factors associated with postpartum fatigue in postpartum women and to develop and internally validate a clinical nomogram.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>This cross-sectional study recruited 780 postpartum women via convenience sampling at a tertiary hospital in Guangdong, China (January-May 2025). After excluding invalid questionnaires, 744 participants were randomly allocated (7:3) to derivation and internal validation sets. Data were collected using a general information questionnaire and validated scales for postpartum fatigue, depression and social support. Candidate factors were pre-specified based on clinical relevance and previous evidence. LASSO regression was used for variable selection. Model performance was assessed using the AUC, calibration plots, the Hosmer-Lemeshow test and decision curve analysis (DCA), with internal validation by randomly splitting the sample into derivation and internal validation sets.</p><p><strong>Results: </strong>Among the 744 postpartum women, the prevalence of postpartum fatigue was 69.0% (n = 513). Four independent factors were associated with postpartum fatigue: postpartum depression, maternal sleep quality, breastfeeding ability and intrapartum blood loss. The nomogram showed good discrimination in both the derivation (AUC = 0.821) and internal validation (AUC = 0.801) sets. At the optimal cut-off of 0.682, sensitivity and specificity were 75.2% and 76.8%, respectively. The Hosmer-Lemeshow test confirmed good calibration in both sets (derivation: χ² = 8.949, p = 0.3466; internal validation: χ² = 4.422, p = 0.8172). DCA indicated favourable clinical net benefit across a relevant range of thresholds.</p><p><strong>Conclusions: </strong>We developed and internally validated a practical nomogram for identifying postpartum fatigue using readily available clinical and psychosocial factors. The model showed good performance.</p><p><strong>Implications for nursing practice: </strong>This nomogram may assist nurses and midwives in early identification of postpartum women at increased likelihood of fatigue and facilitate individualized nursing interventions to improve postpartum recovery.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution was made to the design, conduct, analysis, interpretation or writing of this study.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70907"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149847","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":"Self-Perceived Competence and General Happiness Scores Among Acute-Care Nurses in the United Arab Emirates: A Cross-Sectional Study.","authors":"Ibrahim Al Faouri, Rahma Nemer, Fatma Magdi Ibrahim","doi":"10.1002/nop2.70928","DOIUrl":"10.1002/nop2.70928","url":null,"abstract":"<p><strong>Aim: </strong>To examine the association between scores on an investigator-adapted self-perceived nursing competence questionnaire and a five-point modification of the Oxford Happiness Questionnaire among registered nurses in one acute-care hospital in the United Arab Emirates.</p><p><strong>Design: </strong>Cross-sectional correlational survey.</p><p><strong>Methods: </strong>Between 15 September and 15 November 2025, 200 direct-care registered nurses completed an online survey. Self-perceived competence was scored with a 21-item investigator-adapted questionnaire informed by Nurse Competence Scale domains; general happiness was scored with a 29-item Oxford Happiness Questionnaire modified to use five response categories. Neither modified score is established as psychometrically equivalent to its source instrument. Exploratory factor analysis, correlation and covariate-adjusted linear regression with HC3 robust inference were used.</p><p><strong>Results: </strong>The adapted scores correlated modestly (r = 0.293, 95% CI 0.160-0.414); the adjusted competence-score coefficient was B = 0.440 (95% CI 0.248-0.633). Removing a competence item about feeling valued and supported within the team yielded r = 0.290 and adjusted B = 0.447 (95% CI 0.248-0.645). Exploratory factor analyses indicated factorability but did not validate either adaptation: the competence items did not reproduce seven intended domains, and happiness items primarily separated by wording polarity.</p><p><strong>Conclusion: </strong>Higher scores on the locally adapted self-perceived competence questionnaire were associated with higher scores on the modified general happiness questionnaire. The modest, cross-sectional, concurrent self-report association does not establish construct equivalence, direction of effect or benefits from competence training.</p><p><strong>Implications for the profession and/or patient care: </strong>Support for professional capability may be considered as one component of a broader workforce strategy that addresses staffing, workload, leadership, recognition and psychological safety.</p><p><strong>Impact: </strong>Earlier research examined competence and happiness among nurses in Iran; this study extends the question to a contemporary multicultural UAE acute-care sample. Its modest association between adapted questionnaire scores is useful for hypothesis generation, subject to measurement and sampling limitations.</p><p><strong>Reporting method: </strong>The study is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist for cross-sectional studies.</p><p><strong>Patient or public contribution: </strong>No patients or members of the public contributed because this study examined registered nurses as professional participants; nurses contributed only as survey respondents.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70928"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196998","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":"Factors Associated With Entrepreneurial Intention Among Nursing Students: A Cross-Sectional Study Using a Socio-Ecological Model.","authors":"Ji Young Lim, Wonjung Noh, Mohiniso Vohidova, Anna Lee","doi":"10.1002/nop2.70870","DOIUrl":"10.1002/nop2.70870","url":null,"abstract":"<p><strong>Aim: </strong>To examine the factors associated with entrepreneurial intention among Korean nursing students using a socio-ecological model.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>This study, conducted in August 2024, involved 205 undergraduate nursing students who completed an online questionnaire assessing their entrepreneurial intention and individual, interpersonal, organizational, and policy-level factors. Descriptive statistics and Pearson's correlation analyses were performed, followed by multiple linear regression analysis with entrepreneurial intention as the outcome variable and factors across the four socio-ecological levels entered simultaneously as explanatory variables.</p><p><strong>Results: </strong>Peer influence and family influence were significantly associated with entrepreneurial intention, with family involvement being especially significant in Korea's collectivist culture. National economic conditions and government entrepreneurial support were also associated with students' entrepreneurial intention. Individual-level characteristics were not significantly associated with entrepreneurial intention in the adjusted model.</p><p><strong>Conclusion: </strong>Nursing students' entrepreneurial intention was mainly associated with interpersonal and policy level factors. Nursing entrepreneurship education should strengthen peer and family support and increase awareness of government programs to prepare future nurses for innovation in evolving healthcare environments.</p><p><strong>Implications for the profession and/or patient care: </strong>Nursing entrepreneurship education should extend beyond individual competency development by incorporating peer-supported learning, culturally appropriate family engagement and practical information on government entrepreneurship support. These approaches may broaden professional career pathways and strengthen nurses' capacity to develop innovative healthcare services, technologies and care models.</p><p><strong>Impact: </strong>This study addressed the limited understanding of multilevel factors associated with entrepreneurial intention among nursing students. Interpersonal and policy-level factors were more strongly associated with entrepreneurial intention than individual- or organizational-level factors. The findings may inform nursing educators, educational institutions and policymakers seeking to strengthen entrepreneurship and innovation within the nursing profession.</p><p><strong>Reporting method: </strong>This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology Statement for cross-sectional studies.</p><p><strong>No patient or public contribution: </strong>There was no involvement from patients or the public; the investigation exclusively examined nursing students' entrepreneurial intention and related determinants.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70870"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117005","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":"Intensive Care Nurses' Self-Reported Adherence to Evidence-Informed Microaspiration-Prevention Practices and Potential Implementation Determinants: A Multicenter Cross-Sectional Study.","authors":"Yongju Pei, Shuyu Fan, Xinping Shi","doi":"10.1002/nop2.70914","DOIUrl":"https://doi.org/10.1002/nop2.70914","url":null,"abstract":"<p><strong>Aim: </strong>To assess intensive care nurses' self-reported adherence to recommended microaspiration-prevention practices and explore potential implementation determinants.</p><p><strong>Design: </strong>Multicentre, cross-sectional.</p><p><strong>Methods: </strong>From December 2024 to February 2025, nurses in 31 intensive care units at 17 hospitals in Henan Province, China, completed a questionnaire on 22 preventive practices and 43 implementation-related items informed by the Theoretical Domains Framework. Bivariate analyses, a fully adjusted three-level mixed-effects model accounting for unit and hospital clustering, and generalised estimating equation sensitivity analyses examined associations.</p><p><strong>Results: </strong>Of 510 respondents, 476 were analysed. Mean adherence was 77.17/110 (70.15% of maximum), with basic care scoring highest (73.6%) and risk management lowest (67.2%). After adjustment, adherence was lower in units with 10-14, 15-19 and ≥ 20 beds than in those with < 5 beds; the 5-9-bed group did not differ. Both training exposures were associated with higher adherence in the primary analysis; only evidence-based practice training remained significant in the 14-item analysis. The lowest-scoring items concerned near-term implementation intention (3.10), competing priorities (3.21), and professional responsibility (3.29); the highest concerned time efficiency (4.19), workflow compatibility (4.15) and interest (3.94).</p><p><strong>Conclusion: </strong>Self-reported adherence varied across practices and domains. Intensive care unit bed capacity and training exposure were associated with adherence, and implementation-related findings identified potential areas for further investigation.</p><p><strong>Implications for nursing practice: </strong>Findings may guide intensive care unit nurses, nurse managers, and educators in strengthening targeted microaspiration-prevention training, clarifying responsibilities, integrating preventive practices into routine workflows, and reinforcing bedside supervision, particularly in units with 10-14, 15-19, or ≥ 20 beds.</p><p><strong>Reporting method: </strong>The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed. Patient or Public Contribution: None.</p>","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149239934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unseen Side of Nursing Leadership: Conceptualizing Leadership Blind Spots in Healthcare Settings.","authors":"Ebtsam Aly Abou Hashish","doi":"10.1002/nop2.70841","DOIUrl":"10.1002/nop2.70841","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nursing leadership effectiveness depends not only on clinical expertise and formal authority but on the capacity to perceive how one's own conduct is experienced by staff. Leadership blind spots-unrecognized gaps between a nurse leader's self-perception and the actual impact of their behaviour on staff voice, trust, and psychological safety-represent a consequential and theoretically underdeveloped phenomenon in nursing management. Left unrecognized, these gaps may silently undermine staff well-being, patient safety, and organizational culture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To clarify and conceptually define leadership blind spots in nursing using Walker and Avant's concept analysis framework, identify their defining attributes, antecedents, consequences, and empirical referents, and propose a Leadership Blind Spot Pathway Model and recommendations for measurement, practice, and policy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Walker and Avant's eight-step concept analysis framework was applied. A structured literature search was conducted across six electronic sources-PubMed, CINAHL, Scopus, PsycINFO, Web of Science, and Google Scholar-covering publications from 2020 to 2025 and supplemented by foundational theoretical works. From an initial pool of 58 records, 30 sources were retained for analysis following duplicate removal and two-stage screening.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A nursing leadership blind spot is proposed as a recurring and insufficiently recognized discrepancy between a nurse leader's self-perceived behaviour and how that behaviour is experienced by staff. Four core defining attributes were identified: self-other perceptual discrepancy, limited recognition and integration of corrective feedback, miscalibrated confidence in leadership judgement, and relational-contextual unawareness of leadership impact. These attributes are clinically expressed through six manifestations-communication, fairness, emotional, power, performance, and change-related blind spots. Antecedents operate at individual, contextual, and organizational levels; consequences extend to nurse leaders, nursing staff, patients, and healthcare organizations. A Leadership Blind Spot Pathway Model incorporating a self-reinforcing feedback loop is proposed, in which staff silence both reflects and perpetuates leader unawareness. The concept is distinguished from destructive leadership, incompetence, burnout, and related constructs by the combination of a self-other perceptual discrepancy and limited recognition of that discrepancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Leadership blind spots represent a potentially distinct and operationalizable construct in nursing that warrants empirical validation. Embedding multisource feedback, reflective practice, and psychological safety into leadership development represents a promising, though not yet empirically tested, pathway to their detection and reduction. Development and psychometric validation of ","PeriodicalId":48570,"journal":{"name":"Nursing Open","volume":"13 10","pages":"e70841"},"PeriodicalIF":3.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082443","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}