Journal of Nursing Scholarship最新文献

{"title":"Quality and Bias in Randomized Controlled Trials Published in Latin American Nursing Journals: A Meta-Epidemiological Study.","authors":"Diana Buitrago-García, Melixa Medina-Aedo, Camila Montesinos-Guevara, Wendy Rodriguez Vargas, Mónica Lozano Hernández, Carlos Alberto Castro, Hector Pardo-Hernandez, Xavier Bonfill","doi":"10.1111/jnu.70049","DOIUrl":"https://doi.org/10.1111/jnu.70049","url":null,"abstract":"<p><strong>Introduction: </strong>Randomized controlled trials (RCTs) are essential for evidence-based nursing care. However, the quality of reporting and adherence to methodological standards in Latin American nursing journals remains unclear. This study evaluates the characteristics, reporting quality, and potential risk of bias of RCTs published in Latin American nursing journals.</p><p><strong>Objective: </strong>To assess the reporting compliance and risk of bias of RCTs published in Latin American nursing journals.</p><p><strong>Design: </strong>Meta-research study.</p><p><strong>Methods: </strong>A comprehensive handsearch of 29 Latin American nursing journals was performed covering publications from 2000 to 2024. Identified RCTs were assessed for adherence to CONSORT reporting guidelines and evaluated for risk of bias. Outcomes were classified using the COMET taxonomy. A descriptive analysis was performed.</p><p><strong>Results: </strong>A total of 6377 references were screened, identifying 34 eligible RCTs, most published after 2018. The median CONSORT compliance was 19 reported items (IQR 16-22). High compliance (> 90%) was observed in abstract reporting items, study objectives, and participant selection criteria. However, critical methodological features such as randomization procedures, blinding, and protocol registration showed low adherence (< 40%). Risk of bias was mostly rated as having \"some concerns\", largely due to insufficient reporting. According to the COMET taxonomy, the most frequently reported outcome domains were \"Delivery of care\" and \"Physical functioning\".</p><p><strong>Conclusions: </strong>Reporting compliance and risk of bias of RCTs published in Latin American nursing journals presents significant gaps, particularly in key methodological domains. These shortcomings hinder transparency, reproducibility, and integration into evidence synthesis. Strengthening editorial policies and enforcing reporting standards could enhance the quality and reliability of published research in Latin American nursing journals.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived Experiences of Transgender Inmates in Barcelona Prisons: An Interpretative Phenomenological Study.","authors":"Jordi Sererols-Serra, Juan M Leyva-Moral","doi":"10.1111/jnu.70047","DOIUrl":"https://doi.org/10.1111/jnu.70047","url":null,"abstract":"<p><strong>Introduction: </strong>Incarceration significantly impacts inmates health, particularly marginalized groups like transgender persons, due to systemic oppression and inadequate healthcare. This study aims to understand transgender prisoners' health management experiences.</p><p><strong>Methodology: </strong>An interpretative phenomenological approach was used. Data were collected through in-depth interviews with eight transgender inmates in Barcelona, Spain, and analyzed using the seven-step Colaizzi method.</p><p><strong>Results: </strong>Three primary themes emerged: (1) Navigating Vulnerability in Healthcare Dynamics, which highlighted experiences of stigma and inadequate care; (2) The Quest for Wellbeing Amidst Uncertainty, underscoring concerns regarding treatment continuity; and (3) Negotiating a Landscape of Violence, revealing experiences of harassment and discrimination.</p><p><strong>Discussion: </strong>This study highlights the need for culturally competent, person-centered healthcare policies in prisons, particularly for transgender individuals. Addressing the specific health needs of transgender inmates is crucial for enhancing their overall well-being. This emphasizes the importance of systemic reforms to improve care provision for transgender prisoners.</p><p><strong>Clinical relevance: </strong>Prison nurses must prioritize person-centered approaches, ensure continuity of gender-affirming treatments, and provide empathetic mental health support to enhance trust and improve the overall well-being of transgender inmates.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT-4 in Nursing Research: A Methodological Evaluation of Bias Risk in Randomized Controlled Trials.","authors":"Metin Tuncer, Gülsüm Zekiye Tuncer","doi":"10.1111/jnu.70048","DOIUrl":"https://doi.org/10.1111/jnu.70048","url":null,"abstract":"<p><strong>Background: </strong>Conducting bias assessments in systematic reviews is a time-consuming process that involves subjective judgments. The use of artificial intelligence (AI) technologies to perform these assessments can potentially save time and enhance consistency. Nevertheless, the efficacy of AI technologies in conducting bias assessments remains inadequately explored.</p><p><strong>Aim: </strong>This study aims to evaluate the efficacy of ChatGPT-4o in assessing bias using the revised Cochrane RoB2 tool, focusing on randomized controlled trials in nursing.</p><p><strong>Methods: </strong>ChatGPT-4o was provided with the RoB2 assessment guide in the form of a PDF document and instructed to perform bias assessments for the 80 open-access RCTs included in the study. The results of the bias assessments conducted by ChatGPT-4o for each domain were then compared with those of the meta-analysis authors using Cohen's weighted kappa analysis.</p><p><strong>Results: </strong>Weighted Cohen's kappa values showed better agreement in bias in the measurement of the outcome (D4, 0.22) and bias arising from the randomization process (D1, 0.20), while negative values in bias due to missing outcome data (D3, -0.12) and bias in the selection of the reported result (D5, -0.09) indicated poor agreement. The highest accuracy was observed in D5 (0.81), and the lowest in D1 (0.60). F1 scores were highest in bias due to deviations from intended interventions (D2, 0.74) and lowest in D3 (0.00) and D5 (0.00). Specificity was higher in D5 (0.93) and D3 (0.82), while sensitivity and precision were low in these domains.</p><p><strong>Conclusions: </strong>The agreement between ChatGPT-4o and the meta-analysis studies in the same RCT assessments is generally low. This indicates that ChatGPT-4o requires substantial enhancements before it can be used as a reliable tool for bias risk assessments.</p><p><strong>Clinical relevance: </strong>The AI-based tools have the potential to expedite bias assessment in systematic reviews. However, this study demonstrates that ChatGPT-4o, in its current form, lacks sufficient consistency, indicating that such tools should be integrated cautiously and used under continuous human oversight, particularly in evidence-based evaluations that inform clinical decision-making.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Experience of Self-Care in People With Osteoporosis: A Qualitative Descriptive Study.","authors":"Chiara Tedesco, Vicente Bernalte-MartÍ, Mara Tormen, Angela Cuoco, Gianluca Pucciarelli, Ercole Vellone, Maddalena De Maria, Emanuela Basilici Zannetti, Noemi Cittadini, Annalisa Pennini, Salvatore Maria Tecce, Amarildo Smakaj, Umberto Tarantino, Rosaria Alvaro","doi":"10.1111/jnu.70044","DOIUrl":"https://doi.org/10.1111/jnu.70044","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailored nursing interventions. The objective of the study was to explore and describe the experience of self-care maintenance, monitoring, and management in people with osteoporosis.</p><p><strong>Design: </strong>A qualitative descriptive study.</p><p><strong>Methods: </strong>We conducted semi-structured interviews. Data were analyzed using Mayring's qualitative content analysis with a deductive approach based on Riegel's theory of self-care. We reported data in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.</p><p><strong>Results: </strong>Participants (1 Male, 19 Females; Aged 55-80) Identified Four Themes of self-care: maintenance (e.g., Medication Adherence, Physical Activity), monitoring (e.g., Symptom Recognition, Test Interpretation), management (e.g., Lifestyle Reflections, Prevention), and general self-care. Key factors included motivation, trust in healthcare professionals, and integration of health behaviors into daily life. Barriers were low self-efficacy, poor symptom recognition, and inconsistent adherence.</p><p><strong>Conclusion: </strong>Self-care in osteoporosis is a multidimensional and dynamic process influenced by individual beliefs, contextual factors, and support from healthcare professionals. Recognizing the variability in patients' self-care behaviors is essential to develop personalized education and support. Strengthening general health behaviors may enhance disease-specific self-care. This understanding can guide healthcare professionals in designing more effective, tailored care strategies.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145055396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to and Facilitators of Shared Decision-Making Implementation in Fertility Preservation for Patients With Cancer: A Qualitative Study.","authors":"Jeehee Han, Youn-Jung Son, Mina Jang, Eunji Cho, Jeonghee Ahn","doi":"10.1111/jnu.70014","DOIUrl":"https://doi.org/10.1111/jnu.70014","url":null,"abstract":"<p><strong>Introduction: </strong>To identify the barriers and facilitators in the implementation of fertility preservation (FP) shared decision-making (SDM) in oncology care.</p><p><strong>Design: </strong>Qualitative descriptive study.</p><p><strong>Methods: </strong>Qualitative interviews with 16 female patients with cancer and seven healthcare providers were conducted between July 2022 and April 2024. Data were analyzed using directed content analysis, guided by the implementation science framework.</p><p><strong>Results: </strong>We identified 22 categories comprising 38 codes as barriers to SDM implementation and 17 categories comprising 26 codes as facilitators. Findings revealed that, at the innovation level, accessibility, feasibility, interdisciplinary collaboration, and quality improvement efforts were decisive in the implementation of FP SDM. At the individual level, healthcare providers' awareness and attitudes towards FP and SDM, as well as patients' knowledge, attitudes, and capabilities in FP SDM, were crucial factors in the implementation of FP SDM. In social, economic, and organizational contexts, support from significant others, social awareness about FP, multidisciplinary care, financial assistance, and educational resources were determinants in implementing FP SDM.</p><p><strong>Conclusion: </strong>Implementing FP SDM among female patients with cancer necessitates a strategic approach that considers barriers and facilitators. Educating and promoting FP SDM among the public and healthcare providers, combined with incentivizing policies, can enhance individual knowledge and awareness while achieving systemic improvements, facilitating its successful implementation.</p><p><strong>Clinical relevance: </strong>This study provides insights into barriers and facilitators and proposes strategic approaches to enhancing FP SDM implementation, contributing to improved quality of life for cancer survivors and advancements in clinical practice.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Online Training Program on Brief Tobacco Intervention (BTI) for Nurses: A Quasi-Experimental Study. The E-Learning BTI Project.","authors":"Antonio Jesús Ramos-Morcillo, Maria Ruzafa-Martinez, Nani Granero-Moya, César Leal-Costa, Serafín Fernández-Salazar, Ana Teresa García-Moral","doi":"10.1111/jnu.70046","DOIUrl":"10.1111/jnu.70046","url":null,"abstract":"<p><strong>Introduction: </strong>Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions (BTIs) increases the effectiveness of these interventions.</p><p><strong>Objective: </strong>To assess the effectiveness of an online training program on BTI based on the 5As and 5Rs model in acquiring anti-tobacco brief advice competencies among nurses.</p><p><strong>Method: </strong>Quasi-experimental study with a pre-test and post-test design, with a control group and without random assignment. In the experimental group (EG), online training was provided in three sections: BTI theoretical content and methodology, clinical scenario videos, and feedback. Each scenario assessed the 5As and 5Rs as a validated instrument (BTI-Prof^(C)). The control group (CG) only assessed the three videos of clinical scenarios. In both groups, competence was measured at the following points in time: T0 (before the training), T1 (at the end of the training), and T2 (after 90 days). The efficacy of the intervention was measured through a two-way ANOVA, and the variation rate was calculated from T0 to T1 and from T0 to T2.</p><p><strong>Results: </strong>236 nurses participated (157 EG; 79 CG). The mean age was 42.9 years, and 76.7% were women. There was a significant group*time interaction in the three cases, indicating that the online BTI training increases the competence of these professionals in clinical scenario 1 (F = 10.210; p ≤ 0.001; η² = 0.081), clinical scenario 2 (F = 6.235; p = 0.002; η² = 0.051), and clinical scenario 3 (F = 11.271; p ≤ 0.001; η² = 0.090).</p><p><strong>Conclusion: </strong>A brief, asynchronous, and online intervention using standardized video-based cases is effective in improving nurses' BTI competence. This type of training can be a useful option for the National Health System as part of a global and continuous strategy for nurses to perform BTI.</p><p><strong>Clinical relevance: </strong>An asynchronous online training program provides nurses with standardized, evidence-based tools to implement brief tobacco interventions in routine care, offering a scalable and practical solution to strengthen preventive strategies in health systems.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relevance of Sustainability and the Climate Crisis to the Nursing Profession and Nursing Education: A Literature Review.","authors":"Mara Hendry, Tannys Helfer, Christian Eissler, Christian Burr","doi":"10.1111/jnu.70045","DOIUrl":"https://doi.org/10.1111/jnu.70045","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The climate crisis impacts global health and is exacerbated by the healthcare sector's emissions. Nurses, as the largest professional group, are key to promoting climate-resilient, low-carbon health systems. Integrating climate change and sustainable development into nursing education is crucial, yet gaps remain in understanding their representation in curricula and practice. This review examines the role of nursing in addressing climate change and sustainable development, focusing on their integration into education and related recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A narrative literature review was conducted to synthesize existing recent research on nursing, climate change, and sustainable development. No restrictions were applied to study design; however, studies published before 2017 were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A search was conducted in PubMed, CINAHL, and Google Scholar (January 2023, and updated in August 2024). Relevant studies were screened and duplicates removed. Data extraction followed inductive content analysis, with coding and categorization being undertaken collaboratively. MAXQDA PLUS 2022 was used for analysis, and new findings from the follow-up search were incorporated into existing categories or new ones were developed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The review analyzed 33 articles on nursing's role in addressing climate change. Findings highlight gaps in knowledge, delayed responses, and the need for nurses to take on leadership roles. Education is crucial, yet curricula integration remains limited. Nurses must engage in advocacy, interdisciplinary collaboration, and policy development. Barriers include a lack of faculty awareness and overloaded curricula. A collective call for action urges nurses to embrace sustainability, strengthen research, and lead in achieving climate resilience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This review highlights the need to integrate climate change and sustainable development into nursing education and practice. Nurses are vital to public health and to addressing climate change, but education gaps hinder their potential. Future research should focus on improving curricula, exploring Advanced Practice Nursing leadership roles, and addressing healthcare system challenges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Integrating Sustainable Development and the Climate Crisis into nursing education and practice is crucial to preparing nurses for the health challenges posed by environmental changes, as well as for ensuring effective patient care, disaster response, and policy advocacy. Their integration is a process and should be viewed as being a consequence of the delayed responses, as identified in this review. This process should specifically address the identified gaps, such as the lack of basic knowledge concerning climate change and sustainable development, as well as learning to take on leadership roles in practice. More specifically","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Applications in Healthcare: A Systematic Review of Their Impact on Nursing Practice and Patient Outcomes.","authors":"Sahar A Abdelmohsen, Mohammed Musaed Al-Jabri","doi":"10.1111/jnu.70040","DOIUrl":"https://doi.org/10.1111/jnu.70040","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical consider","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Writing So That Your Work Will Be Read","authors":"Susan Gennaro","doi":"10.1111/jnu.70043","DOIUrl":"10.1111/jnu.70043","url":null,"abstract":"","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"57 5","pages":"711-712"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Task Shifting to Advanced Practice Nursing in Primary Care: A Contextualized Framework for LMICs Informed by Evidence From The Philippines.","authors":"Reiner Lorenzo J Tamayo, T J Robinson Moncatar","doi":"10.1111/jnu.70041","DOIUrl":"https://doi.org/10.1111/jnu.70041","url":null,"abstract":"<p><strong>Introduction: </strong>As healthcare systems confront rising demands and workforce shortages, advanced practice nursing (APN) has emerged globally as a vital strategy to improve care delivery and address systemic gaps, particularly in primary care facilities in low- and middle-income countries like the Philippines.</p><p><strong>Design: </strong>Qualitative case study.</p><p><strong>Methods: </strong>This study was conducted in a rural setting in the Philippines and draws on a preceding mixed-methods case study that explored task shifting and advanced nursing practice in primary care facilities. Using purposeful sampling, 41 nurses, physicians, academics, policymakers, and recipients of care participated in interviews and focus group discussions. Qualitative data were thematically analyzed in ATLAS.ti, and quantitative data were descriptively analyzed in JASP. Findings were integrated into the APN framework tailored to primary care in low- and middle-income countries (LMICs).</p><p><strong>Results: </strong>Although the Philippines lacks a formal APN policy, nurses informally fulfill many advanced practice roles aligned with Hamric's model, particularly in direct patient care, leadership, collaboration, and evidence-based practice. Key enabling competencies include health promotion, systems thinking, and policy implementation-environmental barriers such as a lack of regulatory frameworks, educational pathways, and financing limit APN institutionalization.</p><p><strong>Conclusion: </strong>This study proposes a contextualized advanced practice nursing (APN) model, which is relevant for LMICs, particularly in primary care facilities facing workforce shortages and rising NCD burdens. To institutionalize APN roles, key reforms should include investments in education, certification, financing, and regulation. Settings implementing initiatives to attain universal health coverage can serve as entry points for recognizing APN functions through competency-based systems.</p><p><strong>Clinical relevance: </strong>The study proposes a contextualized APN framework for low-resource settings, showing that formalizing expanded nursing roles through education and certification can enhance access to quality care and advance UHC in underserved areas.</p>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}