Elisabet Badiella-Jarque, Carme Planas-Campmany, Edurne Zabaleta-del-Olmo, Sonia Sevilla-Guerra
{"title":"Unequal Leadership: Gender Disparities in Nursing and Healthcare Leadership in a Public Health System","authors":"Elisabet Badiella-Jarque, Carme Planas-Campmany, Edurne Zabaleta-del-Olmo, Sonia Sevilla-Guerra","doi":"10.1111/jnu.70079","DOIUrl":"10.1111/jnu.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Women constitute the majority of the global healthcare workforce—especially in nursing—yet remain under-represented in formal leadership roles. Understanding how gender disparities intersect with profession, age, and governance models is critical to advancing equity and strengthening nursing leadership within health systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional ecological study across publicly funded healthcare entities in Catalonia, Spain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 124 entities were collected as of 31 December 2023 and analyzed by gender, profession (physician, nurse, or other), age group (≤ 55, > 55), and governance model (direct vs. indirect management) across five hierarchical leadership levels. Descriptive and inferential analyses were conducted to examine gender disparities in leadership distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8015 leadership positions were identified, of which 62.2% were held by women, despite women representing 75% of the workforce. A clear gender gradient emerged across leadership levels, with women's representation decreasing systematically at each step upward in the hierarchy. Women's representation declined significantly with increasing seniority, whereas men's representation increased at higher organizational levels. Among professions, male physicians were markedly represented at senior levels, while nurses—both women and men—were concentrated in lower and mid-level positions. Gender disparities were also shaped by age and governance model: younger women were clustered in frontline roles, and female leaders in indirectly managed entities were more evenly distributed across leadership levels than those in directly managed organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Persistent gender disparities—particularly affecting nurses and younger professionals—highlight the need for inclusive leadership development, transparent promotion pathways, and robust gender-disaggregated data for workforce planning. Strengthening nursing leadership is not only a matter of equity but a strategic priority for building inclusive and responsive health systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437306","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}
Wai San Wilson Tam, Neo Tung, Shi Xuan Lee, Gregor Štiglic, Tom Huynh, Arthur Tang
{"title":"Development and Evaluation of a Generative AI Chatbot for Database Searching in Systematic Review","authors":"Wai San Wilson Tam, Neo Tung, Shi Xuan Lee, Gregor Štiglic, Tom Huynh, Arthur Tang","doi":"10.1111/jnu.70076","DOIUrl":"10.1111/jnu.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Systematic reviews (SRs) require comprehensive, reproducible searches, yet developing search strategies is resource-intensive and demands specialized expertise. Generative AI offers potential to streamline this process, but empirical evaluations for GAI-assisted SR searching remain scarce. The objectives of this study are to: demonstrate a step-by-step process for developing a custom ChatGPT-based chatbot to support SR search strategy development, and evaluate its performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional evaluation study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used ChatGPT-4.0 to create a chatbot designed to mimic a medical librarian, generating PICO-informed searches. Its knowledge base was augmented with two methodological references. After piloting testing, we refined its instructions. For evaluation, we randomly sampled 50 Cochrane SRs published in 2024. Standardized P–I–O prompts produced database-ready queries for PUBMED and EMBASE. The primary outcome was per-review success rate, summarized by median and inter-quartile range. A sensitivity analysis was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pilot testing achieved a retrieval rate of 41/49 (83.7%). In the main sample (1169 studies; median 13.5 studies per SR), the chatbot identified a median of 67.4% of included studies (IQR: 43.1%–88.4%). When limited to indexed studies (<i>n</i> = 1114), retrieval rose to 72.0% (IQR: 46.0%–92.5%). Lower performance was observed when outcomes were absent from the abstracts or interventions had many lexical variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A GAI-based chatbot can rapidly generate SR searches (~67%–72% identification), serving as a useful starting point but not a replacement for expert-led approaches. Integration of librarian expertise, structured prompts, and controlled vocabularies may improve performance. Further benchmarking and transparent reporting are needed to guide adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel Akyirem, Gail Melkus, Soohyun Nam, Katie Wang, Frank Micah, Emmanuel Ekpor, LaRon E. Nelson
{"title":"Diabetes-Related Stigma, Hemoglobin A1c, and Psychological and Behavioral Outcomes Among Adults With Type 2 Diabetes in Ghana: A Structural Equation Modeling Approach","authors":"Samuel Akyirem, Gail Melkus, Soohyun Nam, Katie Wang, Frank Micah, Emmanuel Ekpor, LaRon E. Nelson","doi":"10.1111/jnu.70073","DOIUrl":"10.1111/jnu.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Whereas diabetes-related stigma is increasingly recognized as a barrier to diabetes management, little is known about this social phenomenon in collectivist African settings. The purpose of this study was to examine diabetes-related stigma among adults with type 2 diabetes (T2D) in Ghana, highlighting behavioral and psychological mechanisms underpinning the impact of stigma on hemoglobin A1C.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional analytical design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults with T2D (<i>n</i> = 190), seeking care at a tertiary hospital in Ghana, were recruited. A battery of questionnaires assessing psychological (diabetes-related stigma, depression, anxiety, diabetes distress) and behavioral constructs (diabetes concealment and diabetes self-management) were administered. Venous blood samples were obtained for A1C assessment. A latent variable, “adverse psychological outcomes” comprising anxiety, depression, and diabetes distress, was derived and validated using confirmatory factor analysis. Structural equation modeling was used to test multiple psychological and behavioral pathways through which stigma was associated with A1C.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants had an average age of 59.44 (SD = 10.7) years, were mostly female (70.5%, <i>n</i> = 134), and had T2D diagnosis for a median of 14.5 years. We found significant indirect effects of T2D stigma on HbA1c through adverse psychological outcomes alone (<i>β</i> = 0.16; 95% CI: 0.01, 0.32, <i>p</i> = 0.038), as well as the combination of adverse psychological outcomes and self-management behaviors (<i>β</i> = 0.16; 95% CI: 0.001 to 0.32, <i>p</i> = 0.048). We also found that the association between T2D stigma and diabetes self-management was fully mediated by adverse psychological outcomes, and participants who conceal their diabetes tend to report greater adverse psychological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We note that adverse psychological outcomes play a central role in how T2D stigma is associated with HbA1c. Our findings provide preliminary insight into potential aspects of diabetes that may be targeted in future stigma-reduction interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Our results do provide some indication that addressing mental health issues in individuals with T2D may be an effective intervention strategy in curtailing the adverse clinica","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379660","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 Transformational Power of Person-Centered Fundamental Care Delivered by Nurses","authors":"Alison Kitson","doi":"10.1111/jnu.70062","DOIUrl":"10.1111/jnu.70062","url":null,"abstract":"","PeriodicalId":51091,"journal":{"name":"Journal of Nursing Scholarship","volume":"58 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221894","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}
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