BMC Nursing最新文献

{"title":"Moral distress and moral injury among nurses in German acute inpatient care - a cross-sectional study.","authors":"Tobias Mai, Anna-Henrikje Seidlein, Michael Schilder, Iulia Dahmer","doi":"10.1186/s12912-026-05526-7","DOIUrl":"10.1186/s12912-026-05526-7","url":null,"abstract":"<p><strong>Background: </strong>Moral suffering in health care is increasingly a focus of research. The extent of and relationship between two distinct forms of moral suffering, namely, moral injury (MI) and moral distress (MD), has not yet been studied in nurses in acute inpatient care in Germany.</p><p><strong>Objectives: </strong>This study aims to examine the severity of MI and MD in the context of organizational support, the correlation between the two constructs, and the variables associated with the extent of MD and MI.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including 1323 nurses employed in German hospitals. The data were collected in March and April 2023 in an online survey using the German version of the Moral Distress Scale (MDS), the German Moral Injury Symptom Scale for Health Professionals (G-MISS-HP), the Perceived Organizational Support Scale (POS-s) and an additional questionnaire on the individual perception of ethical and structural conditions in the institution. The data were analyzed descriptively. Partial credit Rasch models were fitted to the item-level responses of the G-MISS-HP and the MDS to obtain interval-level measures of moral injury and moral distress for subsequent analyses. Median regressions with backward variable selection were performed for MD- and MI-Rasch scores to identify variables associated with the level of moral distress/injury. The associations between the MD and MI-Rasch scores were tested using Spearman's correlation test.</p><p><strong>Results: </strong>A total of 68.6% (n = 907; 95% CI: 66.1%-71.1%) of the respondents scored above the validated G-MISS-HP screening threshold (≥ 29), which has previously been associated with impairment in family, social, and occupational functioning. Spearman's correlation analysis revealed statistically significant positive associations between the MD-Rasch score and the MI-Rasch subscores (guilt/shame subscore: r = 0.57, 95% CI [0.53; 0.61]; spiritual troubles subscore: r = 0.22, 95% CI [0.16; 0.27]; condemnation subscore: r = 0.39, 95% CI [0.34; 0.43], all p < 0.001). Median regression analyses revealed significant associations of both MD and MI with perceived organizational support (POS-s), satisfaction with the treatment team's consideration of own perspective, responsibility for staff, and participation in interprofessional case discussions.</p><p><strong>Conclusions: </strong>Manifestations of moral suffering are common. Our findings highlight the importance of measures to promote an ethical climate and to address the negative consequences of moral suffering, particularly at the management level.</p><p><strong>Registration: </strong>German Clinical Trials Register ( https://www.drks.de/ ): DRKS00030785 (date: 06 February 2023).</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerability in nursing science: a principle-based concept analysis.","authors":"Miriam Läpple, Martina Hasseler","doi":"10.1186/s12912-026-05523-w","DOIUrl":"10.1186/s12912-026-05523-w","url":null,"abstract":"<p><strong>Background: </strong>The term \"vulnerability\" is widely used across disciplines and variably defined within nursing, reflecting differing theoretical and methodological assumptions. This ambiguity hinders coherent application in research and practice. A broad understanding of vulnerability in healthcare is susceptibility to risks and/or illnesses, implying the need for special protection or treatment.</p><p><strong>Methods: </strong>To clarify the concept of vulnerability in nursing, its disciplinary meanings were synthesized and its maturity was evaluated by using a principle-based concept analysis according to Penrod and Hupcey (2005), which was conducted on nursing literature. Databases MEDLINE via PubMed, CINAHL and LIVIVO were systematically searched with defined keywords, and citation searching. Of 1,169 records identified, 49 studies (1983-2024) were included. The evidence was evaluated using the principles of principle-based concept analysis: epistemological adequacy, pragmatic utility, linguistic clarity, and logical coherence.</p><p><strong>Results: </strong>Three diverging perspectives were identified: (1) vulnerability as a universal human condition; (2) vulnerability as an individual, risk-oriented notion; and (3) vulnerability as a multifactorial state influenced by social determinants of health. Each perspective shapes nursing's approach to individuals in its own way, focusing on different methodologies. The three perspectives have been combined into an integrative concept for nursing. It addresses the individual, community, and healthcare policy levels. The multidimensionality of vulnerability is suitable to support the notion of nursing care for the individual with a view to the social determinants of health. An assessment of the concept across the principles indicates that it is partially mature and requires further theoretical and empirical development.</p><p><strong>Conclusions: </strong>The analysis provides an integrative concept of vulnerability for nursing science which can serve as a foundation for its disciplinary use and thematic relevance. Further work should develop discriminant definitions vis-à-vis related constructs, advance valid operational measures, and test the concept empirically across settings to support assessment, intervention design, and system-level health policy, health-promotion, and disease prevention strategies.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in pediatric oncology nurses' knowledge and observed mucormycosis-prevention practices following an educational programme: a one-group pretest-posttest study.","authors":"Amira El-Sayed, Sabah Alsharkawy, Eman Abdelfattah Hassan, Hoda Wahid, Nema Ragab, Hagar Abd El-Hamid","doi":"10.1186/s12912-026-05382-5","DOIUrl":"10.1186/s12912-026-05382-5","url":null,"abstract":"<p><strong>Background: </strong>Mucormycosis is a life-threatening fungal infection increasingly affecting immunocompromised individuals, including children receiving chemotherapy. Its rising prevalence and severe outcomes highlight the importance of prevention. Nurses play a pivotal role, requiring improved knowledge and strict adherence to infection control practices.</p><p><strong>Aim: </strong>This study aimed to evaluate the changes in pediatric oncology nurses' knowledge and observed mucormycosis-prevention practices following an educational programme.</p><p><strong>Methods: </strong>A quasi-experimental design with pre- and posttest assessments were used. The study was conducted at the Children's Cancer Hospital Egypt (CCHE) 57,357 and included 81 nurses. Data were collected using a structured questionnaire to assess characteristics and knowledge, along with an observational checklist designed to evaluate nurses' practices. The educational intervention consisted of three sessions covering mucormycosis risk factors, pathophysiology, and infection control measures.</p><p><strong>Results: </strong>The mean knowledge score increased from 5.82 ± 0.91 to 12.1 ± 0.76 (p < 0.001), and the mean practice score increased from 3.86 ± 1.13 to 7.58 ± 1.02 (p < 0.001). A positive correlation was found between knowledge and practice scores in both preintervention (r = 0.348, p = 0.001) and postintervention (r = 0.382, p < 0.001). Knowledge and observed practice scores increased significantly following the educational sessions.</p><p><strong>Conclusion: </strong>Structured educational sessions were associated with significant short-term improvements in nurses' knowledge and observed mucormycosis-prevention practices. As patient outcomes and mucormycosis incidence were not measured, these findings should not be interpreted as evidence of reduced infection rates. Continuous professional development and targeted training are important for strengthening infection prevention knowledge and practices among pediatric oncology nurses.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Nursing home staff's reasoning about providing palliative care following an educational intervention - a qualitative interview study\".","authors":"Camilla Ekeblom, Carina Lundh Hagelin, Jane Österlind","doi":"10.1186/s12912-026-05480-4","DOIUrl":"https://doi.org/10.1186/s12912-026-05480-4","url":null,"abstract":"<p><strong>Background: </strong>Palliative care (PC) is increasingly recognised as an essential component of healthcare, yet access remains unequal, particularly for older people. Nursing homes accommodate older people with complex needs and account for a large proportion of deaths, making PC a central component of care in these settings and underscoring the importance of integrating a PC approach into everyday care. However, staff often lack sufficient training and may perceive PC as limited to end-of-life care rather than as an ongoing approach. Education has been proposed to strengthen PC competence, but little is known about how staff reason about PC following such initiatives. This study aimed to explore nursing home staff's reasoning about providing PC after participating in an interprofessional educational intervention (IPEI).</p><p><strong>Methods: </strong>A descriptive qualitative design was used. Eighteen staff members from five nursing homes in Sweden, including registered nurses, assistant nurses, a physician, first-line managers, and PC champions, participated. Data were collected through semi-structured individual interviews conducted between March and April 2024 and analysed using inductive qualitative content analysis.</p><p><strong>Results: </strong>Three main categories were identified: (1) managing one's own emotions, thoughts, and attitudes; (2) the significance of relationships, communication, and interactions in care; and (3) navigating norms, assumptions, and organisational structures in everyday PC. These categories reflect how staff reasoned about providing PC at individual, relational, and organisational dimensions.</p><p><strong>Conclusions: </strong>The findings suggest that staff perceived the IPEI as providing opportunities for personal and professional development. Staff's reasoning further suggested that alignment across individual, relational, and organisational dimensions is important in supporting the provision of PC. Providing PC was not solely a matter of enhancing staff knowledge; rather, staff's reasoning suggested that knowledge and conditions for care are shaped through the interplay between staff attitudes, their reasoning about care, relational dynamics, and organisational conditions. When these dimensions align and mutually reinforce one another, favourable conditions for providing PC may be supported. Such conditions may also be supported through interprofessional educational initiatives that combine theoretical knowledge with opportunities for reflection and practical application.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring nursing students' communication experiences with artificial intelligence-supported virtual patients: a qualitative study.","authors":"Ayşegül Korkmaz Doğdu, Ayşe Dağistan Akgöz","doi":"10.1186/s12912-026-05448-4","DOIUrl":"10.1186/s12912-026-05448-4","url":null,"abstract":"<p><strong>Background: </strong>Effective communication is essential in nursing, and artificial intelligence (AI) tools such as ChatGPT are increasingly integrated into nursing education.</p><p><strong>Methods: </strong>This phenomenological study explores how ChatGPT-supported virtual patient scenarios influence nursing students' empathy and communication skills. Third-year nursing students enrolled in a Family Health Nursing elective interacted with a virtual patient through predefined ChatGPT prompts simulating a counseling session. Data were collected through focus group interviews and online reflective diaries.</p><p><strong>Results: </strong>Thematic analysis revealed three themes: \"Unrealistic empathy and communication experience\", \"Solution-oriented and effective communication experience\", \"Communication and empathy awareness: Future communication strategies and professional preparation\" CONCLUSIONS: Although participants perceived ChatGPT-supported virtual patient communication as providing a less realistic communication and empathy experience than real patient interactions, they also reported that ChatGPT's interaction style offered a structured and solution-oriented communication experience. Furthermore, the ChatGPT-supported virtual patient communication experience was perceived as helping students make reflection and self-assessment about communication and empathy, and identify areas for improvement before interacting with real patients. These findings suggest that ChatGPT-supported virtual patient communication cannot replace real patient encounters, but it can serve as a complementary educational tool that encourages reflective learning and prepares nursing students for subsequent clinical communication experiences.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why specialize? An exploration of how clinical experience influences students' motivation for specialist nursing education.","authors":"Helena Kullenberg, Lena Skoglund, Maria Christidis","doi":"10.1186/s12912-026-05482-2","DOIUrl":"10.1186/s12912-026-05482-2","url":null,"abstract":"<p><strong>Background: </strong>Existing research has examined motivation among specialist nursing students and identified factors influencing their pursuit of postgraduate education, including the role of clinical experience. However, it remains unclear whether and how motivation varies with years of clinical experience, and how such differences can be understood from a pedagogical perspective in postgraduate nursing education.</p><p><strong>Aim: </strong>To explore how nurses with different lengths of clinical experience articulate their motivations for pursuing specialist nursing education.</p><p><strong>Methods: </strong>This study was part of a larger survey examining the effects of clinical experience on self-efficacy, nursing competence, academic performance, and study outcomes among specialist nursing students. This paper presents a qualitative analysis of students' reported motivation to pursue further education, based on qualitative free-text responses. The study used inductive descriptive thematic analysis, supplemented by cross-group comparisons and descriptive quantification of codes to identify patterns across clinical experience length. When interpreting the analysis, the study used Situated Learning theory and the Novice to Expert framework.</p><p><strong>Results: </strong>A total of 94 students participated. The analysis identified four overarching motivational themes: Professional Role Advancement, Expanded Participation, Contributing to the Improvement of Clinical Practice, and Personal Advantages. Overall, participants described a broad range of motivations for undertaking specialist nursing education, with emphasis across themes varying by group according to length of clinical experience.</p><p><strong>Conclusion: </strong>The findings suggest that length of prior clinical experience may shape not only what students know but also what they seek from formal education and how they engage with new knowledge. Consistent with perspectives on situated learning and the development of nursing expertise, the findings suggest that students' prior experiences and positions in clinical practice may influence how they approach and make sense of further education. For educators, this underscores the importance of not assuming that all students have the same personal goals. Rather, education may serve different purposes for different students, and recognizing these varied orientations may help shape educational environments that respond to students' different starting points and expectations while maintaining shared academic and professional goals.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative behavior among clinical nurses: empirical level stratification and associated factors in a cross-sectional study in Zhejiang Province, China.","authors":"Kai Cao, Lijun Lin, Ran Yu, Huan Zheng, Fang Chen","doi":"10.1186/s12912-026-05474-2","DOIUrl":"10.1186/s12912-026-05474-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Innovation in nursing practice is closely related to quality of care, yet nurses working in high-demand clinical environments may show relatively low levels of innovative behavior. Previous studies have primarily described nurses' innovative behavior using total scores, with less attention to individual heterogeneity. This study used latent profile analysis (LPA) to identify empirically derived levels of innovative behavior among clinical nurses and to examine their statistical associations with organizational justice, job embeddedness, and other resource-related factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A convenience sample of 422 clinical nurses was recruited from 27 tertiary hospitals in 10 cities in Zhejiang Province, China, between December 2025 and March 2026. Data were collected using a demographic questionnaire, the Nurse Innovative Behavior Scale, the Organizational Justice Scale, and the Job Embeddedness Scale. LPA was conducted using the mean scores of the three dimensions of innovative behavior as observed indicators. Univariate analyses and exploratory multinomial logistic regression were used to examine factors associated with profile membership.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The three-profile solution was retained for descriptive stratification: 61.85% (n = 261) were classified as the relative low-innovation level (C1), 31.99% (n = 135) as the relative moderate-innovation level (C2), and 6.16% (n = 26) as the relative high-innovation level (C3). These labels are sample-relative descriptors and do not represent validated clinical or managerial cutoffs. The three profiles differed significantly in total and dimensional scores of organizational justice and job embeddedness (all P &lt; 0.001). These between-profile comparisons are descriptive and do not establish temporal or causal relationships. In exploratory multinomial logistic regression, organizational justice remained associated with profile membership after adjustment: for each one-point increase in organizational justice, the odds of C2 versus C1 were 1.081 (95% CI 1.044-1.120, P &lt; 0.001), and the odds of C3 versus C1 were 1.285 (95% CI 1.162-1.422, P &lt; 0.001). Nurses without an administrative position had lower odds of C2 versus C1 than nurses at head nurse or above (OR = 0.497, 95% CI 0.259-0.952, P = 0.035). Job embeddedness, research training, and monthly income were not statistically associated with profile membership after adjustment. The continuous one-factor model had a lower BIC than the three-profile model, while the four-profile solution showed better information-criterion fit than the three-profile solution. Accordingly, the three-profile solution should be interpreted as empirical stratification along a continuous innovative-behavior dimension rather than as mutually exclusive discrete types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this sample, nurses' innovative behavior was predominantly at a relatively low level and could be empiric","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Happy and helpful: relationship of authentic leadership with employees helping behaviors: the mediating role of hedonic and eudaimonic wellbeing among nursing staff.","authors":"Tahir Farid, Sadaf Iqbal, Mohammad A Algarni, Mohammad Raheem, Zahid Ullah, Syed Rashid Ali","doi":"10.1186/s12912-026-05441-x","DOIUrl":"10.1186/s12912-026-05441-x","url":null,"abstract":"<p><strong>Purpose: </strong>Authentic leadership plays a pivotal role in fostering helping behaviours among nursing staff within healthcare settings. Drawing on social learning theory, this study examines the impact of authentic leadership on nurses' helping behaviours and investigates the mediating roles of hedonic and eudaimonic well-being in this relationship, contributing to the growing body of nursing leadership and workforce well-being research.</p><p><strong>Design/methodology/approach: </strong>Utilising a three-wave time-lagged design, data were collected from 230 nursing staff in large hospitals, to empirically test the proposed hypotheses.</p><p><strong>Findings: </strong>The results indicate that authentic leadership positively influences employees' helping behaviors as well as both hedonic and eudaimonic well-being. Furthermore, the study found that both hedonic and eudaimonic well-being positively mediated the relationship between authentic leadership and employees' helping behaviors.</p><p><strong>Originality/value: </strong>These findings contribute to the literature by highlighting the importance of authentic leadership in fostering positive employee behaviors and well-being, and by identifying the underlying mechanisms through which this influence occurs.</p><p><strong>Practical implications: </strong>The study further offers practical implications for nursing staff, healthcare administrators, and nursing workforce policymakers, emphasising the need to cultivate authentic leadership practices and prioritise nurses' psychological well-being as foundational strategies for enhancing helping behaviours, strengthening team cohesion, and improving overall clinical and organisational effectiveness.</p>","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a structured nurse-led empowerment protocol on knowledge, practical skills, and self-care behaviours among patients with permanent pacemakers: a quasi-experimental study.","authors":"Walaa Nady Sayed Kamel, Aml Ramadan Abdelgalil Assaf, Ahmed Mostafa Shehata, Nahla Mohamed Mahmoud Afify","doi":"10.1186/s12912-026-05368-3","DOIUrl":"https://doi.org/10.1186/s12912-026-05368-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with permanent pacemakers frequently demonstrate insufficient knowledge and inadequate self-care behaviours, which increase the risk of avoidable post-implantation complications. Structured, theory-informed empowerment protocols may improve these outcomes, yet robust evidence from low- and middle-income countries remains limited. Grounded in Bandura's self-efficacy theory and a patient-empowerment model, this study evaluated the effect of a nurse-led empowerment protocol on knowledge, practical skills, and self-care behaviours among patients with permanent pacemakers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A non-equivalent control-group, pretest-posttest quasi-experimental design was used and reported in accordance with the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement. Seventy adults with newly implanted permanent pacemakers were recruited from Tanta University Hospitals, Egypt, between December 2025 and April 2026. Because the two arms were recruited in consecutive calendar periods to prevent educational contamination, allocation was non-random and group membership is confounded with time period. The control group (n = 35) received routine hospital care; the study group (n = 35) additionally received a structured empowerment protocol (four individual sessions of 30-45 min each, using illustrated Arabic booklets, demonstration and return demonstration, followed by weekly telephone reinforcement during the first month). Three co-primary outcomes were assessed at baseline, immediately post-intervention, and at one-month follow-up: knowledge (Pacemaker-Related Knowledge Questionnaire, 0-20), practice competence (Observational Checklist, 0-50), and self-care behaviour (Self-Care Behaviours Scale, 0-20). Data were analysed using repeated-measures ANOVA (group × time) with Greenhouse-Geisser correction and independent and paired t-tests; a family-wise threshold of α = 0.017 (0.05/3) was applied across the three co-primary group × time tests. Between-group effect sizes and 95% confidence intervals (CIs) were computed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study group improved significantly more than the control group on all three co-primary outcomes. Mean knowledge scores rose from 6.51 ± 2.45 to 15.31 ± 3.46 post-intervention (control: 5.57 ± 2.47 to 7.46 ± 5.60; group × time F(1.43, 97.38) = 148.09, p &lt; 0.001, η²p = 0.685; between-group post-intervention difference 7.85 points, 95% CI 5.67-10.03, Cohen's d = 1.69). Practice competence improved from 16.29 ± 2.87 to 41.17 ± 10.00 in the study group (control: 14.91 ± 3.33 to 18.54 ± 12.21; F(1.59, 108.12) = 120.34, p &lt; 0.001, η²p = 0.639; difference 22.63, 95% CI 17.40-27.86, d = 2.03). Self-care behaviour scores increased from 13.63 ± 3.11 to 19.00 ± 3.23 in the study group (control: 12.86 ± 2.30 to 15.00 ± 3.10; F(2, 136) = 49.85, p &lt; 0.001, η²p = 0.423; difference 4.00, 95% CI 2.52-5.48, d = 1.26). All three interactions remained sig","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Emotional intelligence and its relationship with moral distress in nurses: a cross-sectional study.","authors":"Leila Ghanbari-Afra, Ali Alizadeh, Abed Asgari, Somayeh Namdari, Seyed Kazem Mousavi, Mohammad Amin Houshangi Shayan, Zahra Akbari","doi":"10.1186/s12912-026-05440-y","DOIUrl":"https://doi.org/10.1186/s12912-026-05440-y","url":null,"abstract":"","PeriodicalId":48580,"journal":{"name":"BMC Nursing","volume":"25 1","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}