Nursing Outlook最新文献

{"title":"Intersecting vulnerabilities in emergency care: A scoping review","authors":"Aline Chenou,&nbsp;Valérie Wilmé,&nbsp;Nadia Tiberti,&nbsp;Erik-André Sauleau,&nbsp;Sabrina Garnier-Kepka","doi":"10.1016/j.outlook.2026.102919","DOIUrl":"10.1016/j.outlook.2026.102919","url":null,"abstract":"<div><h3>Background</h3><div>Vulnerability in emergency care is increasingly recognized as multifactorial, yet it is often conceptualized through fragmented or individual-level approaches. Intersectionality offers a framework to understand how multiple social and structural factors interact to shape health outcomes, but its application in emergency care research remains unclear.</div></div><div><h3>Purpose</h3><div>This scoping review aimed to map how vulnerability is conceptualized in emergency departments, identify patterns of intersecting vulnerabilities, and examine their implications for care pathways, with a focus on nursing-relevant processes.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following JBI methodology. Four databases (MEDLINE, CINAHL, Embase, ScienceDirect) were searched for studies published between 2020 and 2025. Eligible studies included adult populations in ED settings and addressed social, structural, or individual vulnerability. Data were extracted using a theoretically informed framework grounded in intersectionality and Intersectionality-Based Policy Analysis.</div></div><div><h3>Discussion</h3><div>A total of 137 studies were included. Vulnerability was predominantly conceptualized through single-axis or additive approaches, with limited use of explicit intersectional frameworks. Six patterns of vulnerability interaction were identified, ranging from formal intersectionality to single-dimension analyses. Emergency departments emerged as sites where structural and social vulnerabilities are both concentrated and amplified, contributing to disparities in access, clinical decision-making, and outcomes. Nursing perspectives were underrepresented across the literature.</div></div><div><h3>Conclusions</h3><div>Current research inadequately captures the complexity of vulnerability in emergency care. Integrating intersectionality into nursing research and practice is essential to address inequities. Emergency nurses play a critical role in identifying and responding to intersecting vulnerabilities and in advancing structurally competent, equity-oriented care.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102919"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149276841","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 contributions to the prevention of female genital mutilation in multicultural contexts: A scoping review","authors":"Vânia Teixeira MSc, RN,&nbsp;Clara Roquette-Viana PhD, RN,&nbsp;Amélia Simões Figueiredo PhD, RN","doi":"10.1016/j.outlook.2026.102948","DOIUrl":"10.1016/j.outlook.2026.102948","url":null,"abstract":"<div><h3>Background</h3><div>Female genital mutilation (FGM) remains a global public health and human rights concern that increasingly affects multicultural societies due to migration and population mobility. Despite expanding prevention efforts, limited synthesis exists on the specific nursing contributions to FGM prevention across high-prevalence and migrant-receiving settings.</div></div><div><h3>Purpose</h3><div>To map and critically examine nursing contributions to FGM prevention in multicultural contexts, identifying nursing contribution domains, evidence gaps, implications for nursing education, practice, research and health policy.</div></div><div><h3>Methods</h3><div>A scoping review was conducted following Joanna Briggs Institute methodology and reported according to PRISMA-ScR guidelines.</div></div><div><h3>Discussion</h3><div>Across 16 included sources, nursing contributions were mapped across individual, family, community, and health-system levels encompassing health education, preventive counseling, culturally responsive communication, risk identification, safeguarding conversations, referral, community engagement, professional training, and protocol-informed practice. However, the predominantly descriptive evidence highlights limited clarity regarding nursing roles, competencies, and intervention components, as well as their inconsistently integration into health systems, referral pathways, and professional training. These findings suggest a need for clearer nursing roles and stronger organizational support for FGM prevention.</div></div><div><h3>Conclusion</h3><div>Nursing contributions to FGM prevention are multifaceted and extend beyond direct clinical care. Greater conceptual clarity, the integration of culturally responsive and trauma-informed principles, stronger integration into health systems and evaluation research are needed to strengthen prevention-oriented nursing practice in multicultural contexts.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102948"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149290092","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":"The illusion of inclusion: Perceived diversity and the limits of marginalization reduction in nursing faculty","authors":"Heather M. Englund PhD, DNP, APNP, FNP-BC, CNE","doi":"10.1016/j.outlook.2026.102943","DOIUrl":"10.1016/j.outlook.2026.102943","url":null,"abstract":"<div><h3>Background</h3><div>Diversity is increasingly emphasized in nursing education; however, representation does not necessarily translate into inclusion. The relationship between perceived diversity and faculty experiences of marginalization remains insufficiently understood.</div></div><div><h3>Purpose</h3><div>To examine associations between perceived student and faculty diversity and multidimensional marginalization among nursing faculty.</div></div><div><h3>Methods</h3><div>A cross-sectional secondary analysis was conducted using a national sample of 1,430 full-time nursing faculty. Marginalization was assessed using the Englund Marginality Index (EMI), examining differentiation, voice, intermediacy, and total marginalization. Hierarchical multiple regression analyses evaluated the incremental contribution of perceived student and faculty diversity after controlling for demographic and academic-position characteristics.</div></div><div><h3>Discussion</h3><div>Greater perceived diversity was associated with lower marginalization in bivariate analyses, although adjusted associations varied across domains. Perceived student diversity was associated with lower differentiation, voice-related marginalization, intermediacy, and total marginalization. Perceived faculty diversity was associated with lower intermediacy and total marginalization but not differentiation or voice. Diversity variables explained an additional 3.4%–10.3% of variance across outcomes, suggesting that perceived student and faculty representation have distinct relationships with faculty experiences of marginalization.</div></div><div><h3>Conclusion</h3><div>Perceived diversity was associated with lower faculty marginalization, but these relationships differed by domain and source of diversity. Findings underscore the importance of distinguishing demographic representation from meaningful inclusion and suggest that institutional diversity initiatives should address faculty voice, influence, and participation rather than representation alone.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102943"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149327556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A matter of policy: The disregarding of the fraud and harm of self-indigenization in academic nursing","authors":"Margaret P. Moss PhD, JD, RN, FAAN, FADLN,&nbsp;Cynthia Greywolf PhD, DNP-PMHNP, APRN,&nbsp;Rydell Todicheeney PhD, MBA/HCM, APRN, PHN, GERO-BC, PCCN, ACNS-BC,&nbsp;Jeneile Luebke PhD, RN,&nbsp;Misty Wilkie PhD, RN, FAAN","doi":"10.1016/j.outlook.2026.102921","DOIUrl":"10.1016/j.outlook.2026.102921","url":null,"abstract":"<div><h3>Background</h3><div>A growing number of non-Indigenous individuals most often White are adopting false or unverifiable American Indian identities within academia. This phenomenon (“Pretendianism,” and increasingly “self-Indigenization”) is not a harmless identity error. It produces concrete harms: it displaces Indigenous scholars, redirects resources intended for tribal Nations, compromises research validity when “Indigenous” samples are not verifiable, and accelerates epistemic and cultural harms through the circulation of fabricated stories and appropriated practices. Left unchecked, these dynamics further cultural genocide, understood as the systematic destruction of a people’s traditions, language, values, and distinctive knowledge systems.</div></div><div><h3>Purpose</h3><div>We are five Indigenous nurse scholars from five federally recognized tribal Nations and distinct academic contexts who collectively issue a call to action for nursing, higher education, funders, journals, and professional organizations to stop normalizing and rewarding identity fraud.</div></div><div><h3>Method</h3><div>Using a critical Indigenous analysis grounded in sovereignty and verification norms, we (1) clarify what constitutes legitimate Indigenous political identity in the United States (2) describe common patterns of Pretendian narratives and institutional “cover” strategies, and (3) present brief, grounded author narratives that illuminate authentic Indigenous lived realities.</div></div><div><h3>Discussion</h3><div>Historical trauma rooted in forced assimilation through adoption/boarding school disruption, land dispossession, and contemporary inequities all form experience and accountability that cannot be fabricated without cost. Each authentic American Indian/Alaska Native living today continue to be touched by the attempts of the Genocide of a people. This generational burden cannot and should never be ‘pretended’.</div></div><div><h3>Conclusion</h3><div>Pretendianism undermines Indigenous knowledge integrity, harms students and communities who treat false claims as authoritative and reproduces colonial hierarchies by privileging palatable “Indigeneity” detached from sovereignty, land, and relational accountability. We offer actionable institutional steps.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102921"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurses’ perceptions following deployment during a seismo-volcanic crisis: A qualitative study","authors":"Eunice Pires,&nbsp;Adriana Henriques,&nbsp;Cristina Baixinho,&nbsp;Andreia Costa","doi":"10.1016/j.outlook.2026.102947","DOIUrl":"10.1016/j.outlook.2026.102947","url":null,"abstract":"<div><h3>Background</h3><div>Disaster risk is increasing globally, placing growing pressure on health systems. In geographically isolated territories, seismovolcanic crises rapidly disrupt healthcare delivery. Despite the central role of nurses in disaster response, qualitative evidence describing their experiences in isolated contexts remains limited.</div></div><div><h3>Purpose</h3><div>To analyze the perceptions and experiences of nurses deployed to respond to a seismovolcanic crisis on an island without a hospital.</div></div><div><h3>Methods</h3><div>A descriptive qualitative study was conducted between March 2024 and November 2025. Twelve nurses involved in the response participated in semi-structured interviews. Data were analyzed using interpretive qualitative content analysis supported by WebQDA software.</div></div><div><h3>Discussion</h3><div>Nurses operated under sustained uncertainty, limited situational awareness, and reliance on evacuation pathways. Their roles extended beyond clinical care to coordination, community mediation, and integration into emergency command structures.</div></div><div><h3>Conclusion</h3><div>The findings suggest that clearer deployment governance, disaster-specific competency development, and recognition of nursing leadership may support preparedness and health system resilience in geographically vulnerable island settings.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102947"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149302436","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":"Journal impact factors and the structure of the nursing journal ecosystem","authors":"Leslie H. Nicoll PhD, MBA, RN, FAAN,&nbsp;Mohammed Quazi PhD, PStat®,&nbsp;Heather Carter-Templeton PhD, RN, FAAN, NI-BC,&nbsp;Melissa Mastorovich DNP, RN, PMH-BC, FAADN,&nbsp;Marilyn H. Oermann PhD, RN, FAAN, ANEF","doi":"10.1016/j.outlook.2026.102904","DOIUrl":"10.1016/j.outlook.2026.102904","url":null,"abstract":"<div><h3>Background</h3><div>Journal Impact Factors (JIFs) are widely used to evaluate nursing journals, yet they reflect only a subset of the broader nursing journal ecosystem. Although the number of journals assigned JIFs has increased, the implications of this expansion remain unclear.</div></div><div><h3>Purpose</h3><div>To examine the structure of the nursing journal ecosystem by comparing journals listed in the Nursing Journals Directory with those indexed in Journal Citation Reports (JCR), and to analyze patterns of change across periods of expansion.</div></div><div><h3>Methods</h3><div>A cross-sectional comparison was conducted using the Nursing Journals Directory and the 2024 JCR nursing category. Longitudinal JIF data were analyzed across three periods: approximately 49 journals (1997–2004), 130 journals (2005–2018), and 199 journals (2019–2024).</div></div><div><h3>Discussion</h3><div>The number of nursing journals with JIFs increased substantially from 49 nursing journals between 1997 and 2004 to 194 journals in the 2024 JCR nursing category (199 journals when counting all journals with at least one JIF observation during 2019–2024). Citation patterns were not evenly distributed across journals. Citations were concentrated among a relatively small subset of journals: the top 10% of journals accounted for 29% of total citations. Analysis of publisher distribution indicated substantial concentration among a small number of large commercial publishers. Journals published by Wolters Kluwer, Wiley (including Wiley-Blackwell), Elsevier, and Sage accounted for a disproportionate share of both indexed journals and total citations.</div></div><div><h3>Conclusions</h3><div>The nursing journal ecosystem has expanded substantially, with JIF-indexed journals representing only part of a broader landscape. Changes in JIFs are uneven and occur within a context of structural shifts in indexing and citation systems rather than consistent gains in quality. These findings support a systems-based perspective in which journal quality is shaped by governance, editorial capacity, and mission in addition to citation metrics.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102904"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond conceptual adoption: Advancing complexity science in nursing through measurement, simulation, and intervention","authors":"Ippolito Notarnicola PhD, MscN, RN, FFNMRCSI, FESNO, FSCSNE","doi":"10.1016/j.outlook.2026.102945","DOIUrl":"10.1016/j.outlook.2026.102945","url":null,"abstract":"<div><div>This conceptual paper examines the growing integration of Complex Adaptive Systems (CAS) theory within nursing research and highlights a critical gap between conceptual adoption and methodological implementation. While complexity science has gained increasing recognition as a framework for understanding healthcare systems, characterized by nonlinearity, emergence, and dynamic interactions, its empirical application remains limited. Current CAS-informed nursing studies are predominantly qualitative and descriptive, providing valuable theoretical insights but lacking the methodological capacity to model system dynamics, test nonlinear relationships, or generate predictive knowledge. To address this gap, the paper proposes a structured progression toward operationalizing complexity science in nursing through three interconnected methodological shifts: measurement, simulation, and intervention. First, it emphasizes the need for robust, multilevel measurement frameworks capable of capturing adaptive competence not as a set of discrete skills, but as a higher-order construct emerging from interconnected domains and contextual interactions. Second, it advocates for the integration of computational approaches, including agent-based modeling and system dynamics, to simulate healthcare processes and explore emergent system behaviors. Third, it highlights the importance of developing longitudinal and intervention-based research designs to evaluate the impact of complexity-informed strategies on outcomes such as workforce resilience, patient safety, and system performance. The Nursing Theory of CAS (NTCAS) is presented as a conceptual scaffold supporting this transition from theoretical recognition to empirical execution. The paper concludes that advancing methodological alignment with system complexity is essential for transforming complexity science in nursing from a descriptive paradigm into a predictive and actionable framework.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102945"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the tools used to measure the patient experience of patients followed by an advanced practice nurse: A scoping review","authors":"Jocelyn Schwingrouber,&nbsp;Sandra Chartier,&nbsp;Kenza Mecheri,&nbsp;Sébastien Colson","doi":"10.1016/j.outlook.2026.102940","DOIUrl":"10.1016/j.outlook.2026.102940","url":null,"abstract":"<div><h3>Background</h3><div>With the rise of the Advanced Practice Nurse (APN) role, the assessment of patient experience has become a major issue in the quality of care. Existing measurement tools (PREMs) are often considered inadequate to capture the specificity of APN practice.</div></div><div><h3>Purpose</h3><div>This review therefore aims to map the instruments used in the literature to measure the experience of patients followed by an APN.</div></div><div><h3>Method</h3><div>A scoping review was conducted across several databases, following JBI and PRISMA-ScR standards. Quantitative or mixed-methods studies from the last 10 years measuring the experience of patients followed by an APN were included. Study selection and data extraction were performed by two independent researchers.</div></div><div><h3>Discussion</h3><div>Forty studies were included, identifying 30 validated tools and 11 non-validated ones. The main findings show heterogeneous tools: generic surveys, specific scales, or custom-made questionnaires. The measured dimensions of the patient experience primarily assess general perception, accessibility and continuity, shared decision-making, and patient empowerment. Although some tools are relevant, the review highlights the absence of a standardized and universal tool to assess the patient experience of patients followed by an APN.</div></div><div><h3>Conclusion</h3><div>Currently, there is no single tool that encompasses all the key dimensions of advanced practice and all the dimensions of the patient experience. The development of multiple case studies integrating one or more existing tools appears to be of interest. This type of project would make it possible to objectify the impact of APNs, improve care, and support the evolution of the profession.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102940"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149344685","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":"Following the rainbow brick road: Lessons for nursing leadership from the 2nd LGBTQ+ National Nursing Summit (2025) amid policy disruption","authors":"Alicia K. Matthews PhD,&nbsp;Billy Caceres PhD,&nbsp;Caroline Dorsen PhD, FNP-BC, FAAN,&nbsp;Tyler Gaedecke PhD, RN,&nbsp;Sophia Kalomeris BSN, RN,&nbsp;Susan Maloney MPhil, BSN, RN,&nbsp;Julie Zerwic PhD, RN,&nbsp;Tonda L. Hughes PhD, RN, FAAN","doi":"10.1016/j.outlook.2026.102936","DOIUrl":"10.1016/j.outlook.2026.102936","url":null,"abstract":"<div><h3>Background</h3><div>Recent federal policy changes under the Trump administration led to the abrupt termination of hundreds of National Institutes of Health (NIH)–funded projects, disproportionately affecting research on sexual and gender minority (SGM) health.</div></div><div><h3>Purpose</h3><div>This manuscript presents a structured reflective synthesis of contemporaneous field notes and facilitated summit discussions from the 2025 SGM National Nursing Summit, a national convening of nursing students, researchers, administrators, and clinicians held during a period of significant political disruption.</div></div><div><h3>Methods</h3><div>We synthesize the concerns, tensions, and priorities that surfaced as participants grappled with the implications of these changes for SGM research, education, and practice.</div></div><div><h3>Discussion</h3><div>Five interrelated areas emerged across discussions: generational differences in how the current moment is understood; experiences of institutional withdrawal and betrayal; uncertainty around whether to persist or redirect SGM-focused work; calls for greater intersectional solidarity; and growing career precarity, particularly among early-career scholars.</div></div><div><h3>Conclusion</h3><div>Conversations reflected a shift from long-term planning toward collective meaning-making and immediate problem-solving. The paper concludes with practical recommendations intended to support researchers, strengthen professional networks, and sustain SGM nursing scholarship, offering insights for nursing leaders navigating rapidly evolving policy and workforce challenges.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 6","pages":"Article 102936"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149290008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An ecological model of turnover intentions among nurses in Ireland","authors":"Elaine Berkery,&nbsp;Nuala F. Ryan,&nbsp;Helen Purtill","doi":"10.1016/j.outlook.2026.102893","DOIUrl":"10.1016/j.outlook.2026.102893","url":null,"abstract":"<div><h3>Background</h3><div>High turnover among Irish nurses remains a persistent workforce challenge, creating the need to better understand the factors that shape nurses’ intentions to leave. Against this backdrop, this paper examines the predictors of turnover intentions within the Irish nursing workforce.</div></div><div><h3>Puropse</h3><div>Using an ecosystem organizing model, we analyze how individual nurse characteristics, job-related variables, and organizational factors interact to shape a nurse’s turnover intentions.</div></div><div><h3>Design</h3><div>A cross-sectional questionnaire-based study across a large public hospital group in Ireland.</div></div><div><h3>Method</h3><div>Data collection took place between September and October 2022 across five different hospital sites, with 263 qualified nurses completing the survey. Turnover intentions were measured using Roodt’s Turnover Intention Scale. Linear regression models were constructed controlling for individual characteristics (age, level of employment, length of service, and domestically vs. internationally trained nurses), job-related variables (job satisfaction and employee engagement), and organizational factors (organizational commitment, organizational citizenship, shared leadership, and hospital size).</div></div><div><h3>Discussion</h3><div>Bivariate analysis showed significant correlations between turnover intentions and job satisfaction, organizational commitment, employee engagement, shared leadership, and organizational citizenship behavior. In the fully adjusted model job satisfaction (<span><math><mrow><mi>β</mi><mo>=</mo><mo>−</mo><mn>1.65</mn><mo>,</mo><mi>p</mi><mo>&lt;</mo><mn>.001</mn><mo>)</mo></mrow></math></span>, organizational commitment (<span><math><mrow><mi>β</mi><mo>=</mo><mo>−</mo><mn>1.33</mn><mo>,</mo><mi>p</mi><mo>&lt;</mo><mn>.001</mn></mrow></math></span>), shared leadership (<span><math><mrow><mi>β</mi><mo>=</mo><mo>−</mo><mn>0.98</mn><mo>,</mo><mi>p</mi><mo>&lt;</mo><mn>.01</mn></mrow></math></span>) and hospital size (<span><math><mrow><mi>β</mi><mo>=</mo><mn>1.35</mn><mo>,</mo><mi>p</mi><mo>&lt;</mo><mn>.01</mn></mrow></math></span>) demonstrated the strongest associations with turnover intentions.</div></div><div><h3>Conclusion</h3><div>The use of an ecosystem organizing model sheds light on individual, job, and organizational factors that jointly shape turnover intentions, highlighting key predictors that should inform targeted retention strategies to support a more sustainable nursing workforce.</div></div>","PeriodicalId":54705,"journal":{"name":"Nursing Outlook","volume":"74 5","pages":"Article 102893"},"PeriodicalIF":3.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892866","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}