Nurs. Rep., Volume 15, Issue 4 (April 2025) – 20 articles

Background/Objectives: Although nursing complexity and health literacy (HL) are critical determinants of patient outcomes, their combined impact on mortality, hospital re-admissions, and emergency department (ED) visits remains poorly understood. This study aims to measure nursing complexity and HL in hospitalized patients, examine their interaction, and analyze their impacts on mortality, hospital re-admissions, and ED visits over a one-year follow-up period. Methods: Adult patients from two hospital centers were enrolled, excluding those with stays under two days or cognitive impairments. Data were collected at baseline to assess nursing complexity (measured according to the number of nursing diagnoses assigned to patients within 24 h from hospital admission) and HL (assessed using the Single-Item Literacy Screener, SILS). Patients were followed during a 12-month follow-up period to track mortality, hospital re-admissions, and ED visits. Latent class analysis classified patients into distinct nursing complexity and HL profiles. Survival analyses and Cox proportional hazard models were used to evaluate the relationships between variables. Results: At baseline, among the 2667 enrolled patients, 55.9% were classified as having high nursing complexity, and 32% had inadequate HL. High nursing complexity was associated with lower HL (r = 0.384; p < 0.001). During follow-up, 387 patients (14.5%) were lost. Of the remaining sample, mortality occurred in 8.3% of the patients, hospital re-admissions in 27.2%, and ED visits in 16.8%. Nursing complexity was significantly associated with higher mortality (HR: 1.84, adjusted HR: 1.81), but not with hospital re-admissions or ED visits. The patients with inadequate HL (32%) had increased risks of mortality (HR: 11.21, adjusted HR: 7.75), hospital re-admissions (HR: 3.61, adjusted HR: 3.58), and ED visits (HR: 20.78, adjusted HR: 14.45). The patients with both high nursing complexity and inadequate HL had the highest mortality risk and the lowest 12-month survival rate (75%; 95% CI: 71.1–79.1%; p < 0.001). Conclusions: This study demonstrates that both high nursing complexity and inadequate HL independently and jointly contribute to adverse patient outcomes. Interventions targeting HL and supporting patients with high nursing complexity could reduce risks, enhance care, and improve patient survival. While these findings underscore the critical role of both factors in patient outcomes, the limitations include this study’s single-country setting and reliance on a single-item HL measure. Future research should validate these findings in broader healthcare contexts and integrate multidimensional HL assessments for a more comprehensive evaluation. Full article

Background: Care plans are a critical tool in nursing education because they enhance clinical competence; however, undergraduate students often face challenges in writing them effectively, which can impact their readiness for clinical practice. While existing research predominantly focuses on care plans within specific clinical contexts, little is known about how students experience the learning process and how these experiences shape their professional development. Objectives: This study aimed to explore the experiences of undergraduate nursing students in writing care plans to understand the impact on their clinical competence and identify strategies for improvement. Design: A qualitative phenomenological study utilizing focus group interviews was conducted. Methods: Semi-structured interviews with open-ended questions were conducted with 15 undergraduate nursing students in six focus groups. Data were analyzed using Colaizzi’s method to identify key themes. Results: Four main themes emerged: (1) enhancement and integration of knowledge and skills, (2) initiative learning and motivation, (3) adequate support and feedback from tutors, and (4) difficulties in transitioning from classroom learning to clinical practice. The findings highlight that care plan writing enhances students’ competence in patient care, with positive learning attitudes and tutor feedback playing crucial roles. However, students encounter difficulties in applying theoretical knowledge to complex clinical scenarios, particularly in prioritizing interventions and managing time effectively. Conclusions: Writing care plans not only fosters personal and professional development but also enhances students’ clinical competence, preparing them for real-world practice. Nurse tutors are encouraged to promote consistent practice in care plan writing, provide timely feedback, and share clinical experiences to support students’ learning. These findings underscore the need to reframe care plans as developmental tools rather than mere tasks for clinical transition, ultimately enhancing the quality of patient care. Full article

Background: Breast cancer is one of the main causes of mortality among women, and mastectomy has a significant effect on the body image, sexuality and psychology of women. The aim of postmastectomy rehabilitation is to improve functionality, minimize complications and promote well-being and quality of life. Objectives: This study aimed to understand the role of nurses specializing in rehabilitation nursing in the rehabilitation of women who have had a mastectomy. Methods: This was a qualitative, exploratory and descriptive study. The participants included seven nurses specializing in rehabilitation nursing who provided structured narratives about their experiences and care strategies in the rehabilitation of women who have had a mastectomy. The interviews were analyzed by thematic categorization via content analysis. Results: Three main categories emerged: the meaning of care, professional intervention strategies and health gains. Care is seen as a developmental and person-centered experience, with a focus on preventing complications. The interventions prioritize personalized projects, emotional support and self-care training. Conclusions: The rehabilitation of women postmastectomy depends on a holistic and individualized approach centered on the person through emotional and functional support. Rehabilitation interventions improve the functionality, quality of life and autonomy of women and are essential for preventing complications and promoting the acceptance of new health conditions. Full article

Background: Recent trends in public psychiatry have resulted in increasingly shorter hospital stays. In parallel, a number of patients seem to require frequent rehospitalization. Several studies have examined the subject of rehospitalization in psychiatry from a quantitative point of view, but little qualitative literature exists on patients’ experiences. Objectives: This qualitative study, conducted in a Swiss university hospital, explores the lived experiences of patients who are hospitalized multiple times within a year. Methods: Using criterion-based purposive sampling, we conducted 20 semi-structured interviews. Results: Our findings show that patients explain their return to the hospital either by external factors, such as social and housing difficulties, or by their state of suffering and the sense of security that the hospital can offer them. From their perspective, hospitalizations are not always failures but can also meet a specific need for safety and stabilization. Conclusions: This study highlights the importance of better understanding the needs of frequently hospitalized patients to optimize their care, while also emphasizing the value of exploring their lived experiences through qualitative research. Full article

Objective: Psychological safety (PS) is essential for health and social care professionals (HSCPs) working in high-stress environments. While much of the existing research focuses on PS within teams, less is known about HSCPs’ lived experiences across diverse health and social care settings. This scoping review aims to synthesise the qualitative literature on PS, identifying key barriers and enablers to its development in health and social care workplaces. Methods: A systematic search was conducted across MEDLINE, PsycINFO, Embase, CINAHL, Scopus, Web of Science, and the Cochrane Library, covering a 20-year period (2004–2024). Eligible studies included primary qualitative research exploring HSCPs’ experiences of PS. Screening and data extraction were managed using Rayyan. An inductive thematic synthesis approach was applied to identify key patterns in the data. Results: The review identified several enablers and barriers to PS. The main enablers included (1) feeling safe within the team and (2) personal factors, which encompassed professional skills, experience, social support, and self-care. Conversely, key barriers were identified: (1) the normalisation of traumatic incidents, (2) unsupportive team and management structures, (3) organisational constraints, and (4) a lack of knowledge and training on PS. Conclusions: Understanding the enablers and barriers of PS is critical for improving workplace culture, resilience, and wellbeing among HSCPs. These findings provide a foundation for future research and interventions aimed at strengthening PS at individual, team, and organisational levels across diverse health and social care settings. The results also offer valuable insights for informing policies and practice to ultimately enhance both staff wellbeing and patient care quality. Full article

Background/Objectives: The advent of large language models (LLMs), like platforms such as ChatGPT, capable of generating quick and interactive answers to complex questions, opens the way for new approaches to training healthcare professionals, enabling them to acquire up-to-date and specialised information easily. In nursing, they have proven to support clinical decision making, continuing education, the development of care plans and the management of complex clinical cases, as well as the writing of academic reports and scientific articles. Furthermore, the ability to provide rapid access to up-to-date scientific information can improve the quality of care and promote evidence-based practice. However, their applicability in clinical practice requires thorough evaluation. This study evaluated the accuracy, completeness and safety of the responses generated by ChatGPT-4 on pressure injuries (PIs) in infants. Methods: In January 2025, we analysed the responses generated by ChatGPT-4 to 60 queries, subdivided into 12 main topics, on PIs in infants. The questions were developed, through consultation of authoritative documents, based on their relevance to nursing care and clinical potential. A panel of five experts, using a 5-point Likert scale, assessed the accuracy, completeness and safety of the answers generated by ChatGPT. Results: Overall, over 90% of the responses generated by ChatGPT-4o received relatively high ratings for the three criteria assessed with the most frequent value of 4. However, when analysing the 12 topics individually, we observed that Medical Device Management and Technological Innovation were the topics with the lowest accuracy scores. At the same time, Scientific Evidence and Technological Innovation had the lowest completeness scores. No answers for the three criteria analysed were rated as completely incorrect. Conclusions: ChatGPT-4 has shown a good level of accuracy, completeness and safety in addressing questions about pressure injuries in infants. However, ongoing updates and integration of high-quality scientific sources are essential for ensuring its reliability as a clinical decision-support tool. Full article

Background: The Caregiver Contribution to Self-Care of Diabetes Inventory (CC-SCODI) is an instrument grounded in the middle-range theory of self-care of chronic illness. It is designed to measure how caregivers support individuals with diabetes mellitus in carrying out self-care activities. Effective tools are essential for clinicians and researchers to evaluate factors influencing self-care, including caregivers’ contributions. This study aimed to assess the reliability and validity of the Spanish translation of the CC-SCODI. Methods: A total of 201 caregivers of individuals with Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) were recruited for participation in this cross-sectional study. Participants were selected through convenience sampling at a university hospital. Before administration, the survey questions were translated and culturally adapted to ensure appropriateness for both patients and caregivers. Confirmatory factor analysis (CFA) was performed on each of the CC-SCODI subscales using models fitted to the relevant indices. Results: The initial construction of the four-dimensional tool was verified. The internal consistency of the four subscales was assessed using Cronbach’s α to measure the caregiver contribution to patients’ self-care maintenance (α = 0.725), self-care monitoring (α = 0.728), self-care management (α = 0.729), and caregiver self-efficacy in contributing to patient self-care (α = 0.921). Model fit indices demonstrated a chi-square value of 1.028 with 773 degrees of freedom. CFA indicated an excellent model fit, confirming the reliability and validity of the proposed structure. Conclusions: The internal consistency and reliability of the Spanish version of the CC-SCODI were deemed adequate. Due to its strong psychometric properties, this instrument is considered appropriate for evaluating the contribution of caregivers to the self-care behaviors of Spanish-speaking individuals with diabetes. Full article

Background: The prevention of pressure injuries depends on the early and correct assessment of at-risk patients. Since risk assessment involves more than using a risk factor instrument, we intend to map the existing recommendations and statements of good practice for pressure injury risk assessment in adults admitted to intensive care units, as well as identify the strengths of the evidence and recommendations in the literature. Methods: This study is a scoping review, guided by the Joanna Briggs Institute framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews was adopted as a guide for writing this study. Results: Searches were carried out in six databases, resulting in 794 studies, of which 15 were included. The recommendations and statements of good practice were grouped into five categories: risk assessment instruments, skin assessment, medical device surveillance, other alternatives to risk assessment, and implementing best practices in clinical settings. The strengths of the evidence and recommendations were identified when available in the literature. Conclusions: The mapping showed that the evidence is sufficient to indicate recommendations and statements of good practice for the risk assessment of pressure injuries in adults admitted to intensive care units. The protocol was retrospectively registered in the Open Science Framework on the 4th of August of 2023. Full article

Background/Objectives: Human dignity is an inalienable value central to human rights and ethics. Professional dignity is pivotal to fostering self-esteem, job satisfaction, and high-quality care in nursing. Despite its importance, no validated tool currently exists to measure nurses’ professional dignity in English-speaking contexts. This study aimed to develop and psychometrically test the Nurses’ Professional Dignity Scale (NPDS). Methods: The tool’s development was guided by a theoretical model from a meta-synthesis. A consensus meeting with five nurse researchers identified three core dimensions for the NPDS: Respect, Professional Value, and Appreciation. Nineteen items were initially generated and refined through face and content validity assessments (all item-level content validity indices [I-CVIs] ≥ 0.80; scale-level content validity index/Ave [S-CVI/Ave] = 0.92). Psychometric testing was conducted with 227 nurses across clinical settings in the United States using confirmatory factor analysis (CFA) to validate a three-factor model. Results: The CFA confirmed the three-factor model with acceptable fit indices (CFI = 0.938, TLI = 0.923, RMSEA = 0.069), resulting in the retention of 15 items. The scale demonstrated excellent reliability, with composite reliability coefficients of 0.92 for Respect, 0.82 for Professional Value, 0.93 for Appreciation, and 0.91 for the overall scale. Conclusions: The NPDS is a valid and reliable measure of nurses’ professional dignity, aligning with theoretical frameworks. It captures both status-dignity and condition-dignity aspects, encompassing respect, professional competence, and societal appreciation, offering a multidimensional structure for assessing individual domains and overall scores. The NPDS contributes to advancing nursing research and practice by addressing workplace dignity, enhancing job satisfaction, and fostering supportive organizational environments that recognize nurses’ professional worth. Future studies are recommended to validate the scale in diverse populations and explore its stability over time through longitudinal research. This study highlights the importance of preserving nurses’ dignity in improving professional identity, workplace environments, and patient care outcomes. Full article

Background/Objetives: Pressure injuries pose a significant challenge in healthcare, adversely impacting individuals’ quality of life and healthcare systems, particularly in intensive care units. The effective identification of at-risk individuals is crucial, but traditional scales have limitations, prompting the development of new tools. Artificial intelligence offers a promising approach to identifying and preventing pressure injuries in critical care settings. This review aimed to assess the extent of the literature regarding the use of artificial intelligence technologies in the prediction of pressure injuries in critically ill patients in intensive care units to identify gaps in current knowledge and direct future research. Methods: The review followed the Joanna Briggs Institute’s methodology for scoping reviews, and the study protocol was prospectively registered on the Open Science Framework platform. Results: This review included 14 studies, primarily highlighting the use of machine learning models trained on electronic health records data for predicting pressure injuries. Between 6 and 86 variables were used to train these models. Only two studies reported the clinical deployment of these models, reporting results such as reduced nursing workload, decreased prevalence of hospital-acquired pressure injuries, and decreased intensive care unit length of stay. Conclusions: Artificial intelligence technologies present themselves as a dynamic and innovative approach, with the ability to identify risk factors and predict pressure injuries effectively and promptly. This review synthesizes information about the use of these technologies and guides future directions and motivations. Full article

Background/Objectives: Ageing is a continuous process of physiological changes that occur over time and affect both ability and function, including vision. A major health issue for older people is visual impairment, which affects both daily activities and quality of life. Undetected visual impairment is a significant problem. Therefore, early detection is crucial to enable older people to optimise their vision and/or receive eye care. This study protocol aims to explore the prevalence of undetected visual impairment among the ageing population and its impact on their quality of life. Methods: This study has an exploratory design. We include participants attending a healthcare centre and participants attending an optician, aged 75 years and older, in Sweden. At baseline eye examinations, fundus photography, the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25) and health economic data are collected. Individual semi-structured interviews (n = 25–30) will then be conducted about older people’s experiences of visual impairment, both consequences and strategies for coping with visual impairment in daily life. The NEI VFQ-25 and health economic data will be collected at 6- and 12-month follow-ups. Conclusions: This study will provide important knowledge to facilitate early detection of visual impairment in older people, thereby providing a deeper understanding of methods to preserve visual function and quality of life despite the presence of visual impairment. Full article

Background: Emerging evidence suggests that emotions significantly influence clinical decision-making among healthcare professionals. Given that evidence-based nursing (EBN) relies heavily on clinical reasoning, and emotions play a critical role in shaping its quality, exploring the relationship between emotional competence and EBN is essential. Objective: This scoping review aims to map and synthesize existing knowledge on the relationship between nurses’ emotional competence and EBN, while identifying research methodologies and integration challenges. Methods: Following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a scoping review was conducted. The search strategy included studies from databases such as Scopus and CINAHL, as well as grey literature. Eligibility criteria included primary and secondary research articles in Portuguese, English, Spanish, and French, published since 1990, focusing on the relationship between emotional competence and EBN in nurses. Data were synthesized thematically. Results: Of 751 publications identified, 11 met the inclusion criteria. Three themes emerged: (1) the relationship between emotional competence and EBN in different healthcare contexts; (2) research methodologies used; and (3) integration challenges and suggestions. Findings suggest that nurses with higher emotional competence are more likely to adopt safer, evidence-based practices, facilitating EBN implementation and improving care quality and safety. Conclusions: The evidence highlights the importance of integrating emotional intelligence and EBN in nursing education and practice. Combined educational programs are recommended to enhance professional safety, performance, and well-being. Future research should further explore this relationship to develop practice models that reconcile emotional competencies with evidence-based nursing. Full article

Background/Objectives: The prevalence of mental health issues, such as depression, loneliness, and a decreased quality of life among older adults in long-term care (LTC) facilities in Thailand, calls for further study. In Thailand, where Buddhism is the predominant religion, many positive psychological strengths are fostered among older adults. One notable strength is equanimity, which is characterized by a balanced and accepting response to both positive and negative events. This practice is commonly associated with enhancing the well-being of older individuals. However, the study between equanimity and well-being is scarce. The purpose of the study is to assess equanimity in LTC residents and to determine if it is a significant predictor of the mental well-being of the residents. Methods: The cross-sectional data was obtained from 236 LTC residents in Thailand. Equanimity was measured using the Inner Strength-Based Inventory (iSBI) and mental well-being from the Thai Geriatric Depression Scale (TGDS-6). Demographic factors, depression, loneliness, and other inner strengths were also explored as covariates in a logistic-regression analysis. Results: The mean scores for equanimity (Mean = 3.78 ± 1.00) and mental well-being (Mean = 0.720 ± 0.449) were determined. The multiple regression analysis found equanimity significantly predicted well-being (B = 0.593, p = 0.002) along with depression (B = −0.395, p < 0.001) and mindfulness (B = 0.355, p = 0.046). Conclusions: This study identifies equanimity as a key predictor of mental well-being among Thai long-term care residents, alongside depression and mindfulness. While the study’s cross-sectional design limits causal conclusions, the results suggest that incorporating equanimity-based practices into geriatric care could be beneficial. Future longitudinal research is needed to validate these findings and improve resilience and well-being in aging populations. Full article

Aim: The aim of this study was to identify the effectiveness of Family Group Conferencing (FGC), a decision-making model that is not only family-centered but also takes the form of a family-driven or social network, and to consider the challenges to FGC implementation. Methods: A scoping review was conducted using the Arksey and O’Malley framework. A systematic search was conducted of such electronic databases as PsycInfo, CINAHL, Google Scholar, and Web of Science. Criteria were set utilizing the search terms “family group conferencing” or “family group conference”, with the search refined to studies published between January 2015 and July 2020. The data extracted by the review team were inductively analyzed, and the findings were classified into categories. Results: This review included a total of 26 studies. The categories underscoring the effectiveness of FGC included “sense of ownership”, “restoring belongingness”, “reduction of coercion”, and “learning platform”. Categories presenting challenges to FGC implementation included “severe situations of main actor”, “severe situations of the family”, “the complex role of the FGC coordinator”, and “the cost-ineffectiveness of FGC”. Conclusions: The effectiveness in the capacity of decision-makers was determined by the interaction between the main actor and social network of the FGC, with the challenges to FGC reducing the likelihood of completing the FGC process. It will be necessary therefore to identify the skills and qualifications of FGC coordinators, who must take into account group dynamics, so as to enable the main actor and their social network to develop a positive reciprocal interaction. Full article

Background/Objectives: Genomics plays a crucial role in healthcare, enhancing diagnostics, risk assessments, and therapeutic interventions. However, many healthcare professionals, including nurses, face challenges when it comes to integrating genomics into their practice. This study aims to evaluate the genomic knowledge of nurse practitioners in Greece by translating and validating the Genomic Nursing Concept Inventory (GNCI). Methods: A cross-sectional study involving 324 nurses was conducted in Crete, Greece. The GNCI, a 31-item questionnaire, was translated and validated for the Greek context to assess nurses’ genomics competence. Results: The Greek version of the GNCI demonstrated acceptable reliability (Cronbach’s alpha = 0.622). The confirmatory factor analysis indicated a satisfactory fit for the one-factor model. However, the mean GNCI score revealed significant knowledge gaps, with nurses answering only 30.1% of questions correctly. Notably, nurses showed a better understanding of genomic basics and mutations compared to inheritance and genomic healthcare applications. Conclusions: The present study successfully translated and validated the GNCI in Greek and highlighted important genomic-related knowledge gaps among Greek nurses, emphasizing the urgent need for more targeted educational interventions. By enhancing genomic literacy through curriculum integration and professional development, nurses could be better prepared, leading to improved patient care and healthcare outcomes in Greece. Full article

Background: Although screening for early signs of autism spectrum disorder (ASD) using the Modified Checklist for Autism in Toddlers (M-CHAT) has been recommended by the Brazilian Ministry of Health since 2014, the feasibility of this intervention and its effects in primary care have not been sufficiently investigated. Objectives: (1) to verify the feasibility of implementing the M-CHAT in the Brazilian Unified Health System, through routine childcare vaccination; (2) to evaluate the level of knowledge and practices of nursing professionals in Brazilian primary health care in relation to ASD to check the expertise to apply M-CHAT to verify early signs of this condition; (3) to verify, after implementation, the frequency of children with possible early signs of ASD using the M-CHAT. Methods: This is an observational, cross-sectional study conducted in a medium-sized city in southeastern Brazil. A total of 97 nursing professionals from 21 health facilities participated. The professionals answered a questionnaire on knowledge and practices regarding ASD, attended training on early signs of ASD and for the use of M-CHAT. Finally, they administered the M-CHAT to 267 parents of children aged 16 to 57 months in primary care settings. Results: Insufficient knowledge of ASD was identified among the nursing professionals evaluated. Approximately 80% agreed that the training was satisfactory, and 88% agreed that they felt competent to use the M-CHAT; 74% agreed with the benefits of using the M-CHAT to detect early signs of ASD in public health settings. However, 91% of the professionals reported that incorporating the M-CHAT into the day care routine overloaded their work, and less than 50% agreed that the instrument should continue to be used in the day care routine. Sixty-seven (25.09%) children screened positive for possible early signs of ASD by M-CHAT. Conclusions: The insufficient level of knowledge on ASD found among nursing professionals suggests gaps in Brazilian academic and professional training in this area. Although most participants recognized the importance of early detection of signs of ASD in primary care settings, the implementation of the M-CHAT in the routine primary care settings was not well accepted for most participants due to work overload, which indicates the need for public health policies to offer working conditions that minimize the overload of professionals, maintaining early screening interventions for ASD in Brazilian primary care institutions. Full article

Background: Women diagnosed with serious mental illness (SMI) face increased vulnerability and significant risks to their sexual and reproductive health, an issue that is often overlooked in healthcare systems. Aim: This study aimed to explore the sexual and reproductive healthcare provided to women with SMI, based on the perspectives of professionals specialising in mental health and sexual and reproductive health. Methods: A descriptive qualitative design was used. Semi-structured interviews were conducted with a purposive sample of professionals from community mental health and sexual and reproductive health in Catalonia (Spain). Data were analysed using thematic analysis. Results: Two themes were identified: clinical practice and professional context. The clinical practice theme had three sub-themes: lack of a preventive framework, attention to sexual and reproductive needs, and supporting women in their desire for motherhood and in pregnancy. The professional context theme had four sub-themes: cross-disciplinary coordination, lack of protocols, lack of human resources and time, and lack of training in mental health. Conclusions: Mental health professionals and sexual and reproductive health professionals expressed different perspectives about sexual and reproductive healthcare for women with SMI, pointing to a need for greater training and coordination. Full article

Background: Caring for children in palliative care especially impacts healthcare professionals’ personal and professional lives. Their emotional experience and needs are frequently forgotten. Healthcare professionals face emotional demands when caring for children with palliative needs and their parents. Objective: This scoping review aims to identify and map the scientific production about the emotional labor of healthcare professionals in pediatric palliative care. Methods: This scoping review was conducted according to the JBI recommendations and the PRISMA Extension for Scoping Reviews. We searched 16 electronic databases in August 2023 and updated the search on 17 February 2025. Articles were screened according to eligibility criteria, and a content analysis allowed for a summary of key findings. Results: Eleven publications were selected. Most studies were conducted in the United States of America and with nurses as the professionals involved. Many publications were qualitative studies and developed in a neonatal intensive care context. Using content analysis, five themes were identified: (1) emotional experience of healthcare professionals, (2) relational context involved, (3) managing professional and personal boundaries, (4) intrapersonal strategies of emotional labor, and (5) social and organizational strategies of emotional labor. Conclusions: The importance of implementing emotional labor strategies is highlighted, especially intrapersonal, social, and organizational strategies. Education, training, and reflection are needed within a workplace culture that recognizes emotional experiences and supports the emotional management of healthcare professionals. Emotional labor in pediatric palliative care should be recognized. Further research in this area is needed. Full article

Background: Evidence-Based Nursing Practice (EBNP) plays a crucial role in ensuring high-quality patient care. This study evaluates master’s degree nursing students’ knowledge, attitudes, and skills related to EBNP, identifying strengths and key gaps that require curriculum improvements to enhance their competencies in evidence-based practice. Methods: A cross-sectional study was conducted among 103 master’s degree nursing students at Wrocław Medical University. Data were collected using a demographic questionnaire and the standardized Polish version of the Evidence-Based Practice Profile Questionnaire (EBP2Q). Results: The findings indicate that students demonstrated generally positive attitudes toward EBNP (mean score: 53.43 ± 10.05 out of 70). However, knowledge of research terminology was moderate (44.66 ± 18.01 out of 85), and the frequency of EBNP utilization in practice was relatively low (22.15 ± 8.74 out of 45). Significant differences were observed based on study mode and academic progression, with part-time students scoring higher in attitudes toward competency development (p = 0.02). A weak but positive correlation was found between professional experience and the frequency of EBNP utilization (r = 0.182, p = 0.068), while knowledge of research terminology showed a non-significant association with age (r = 0.167, p = 0.092). Conclusions: These findings highlight the need for targeted curriculum enhancements, particularly in research literacy, practical application opportunities, and the integration of mentorship and educational resources. Strengthening EBNP education will better equip nursing students to implement evidence-based practices in clinical settings, ultimately improving patient care quality. Full article

Introduction: Nurses and midwives caring for newborns with lethal defects experience significant emotional stress. Understanding coping strategies and the factors influencing stress is crucial for improving their well-being and ensuring high-quality care. Objectives: The aim of this study was to identify the coping strategies used by nurses and midwives in stressful situations and to analyse the relationship between stress levels and selected sociodemographic and professional factors. Methods: A cross-sectional study was conducted in the second quarter of 2023 among 307 nurses and midwives working in neonatal and obstetric wards in the Silesian metropolitan area, Poland. A diagnostic survey method was applied using a standardised questionnaire. The Perceived Stress Scale (PSS-10) and the MINI-COPE Inventory were used to assess stress levels and coping mechanisms. A stratified random sampling method was employed to ensure representation from various professional backgrounds. Data analysis was conducted using descriptive statistics, chi-square tests, Spearman’s correlation, and Cohen’s d coefficient, with statistical significance set at p < 0.05. Results: High stress levels were associated with shorter professional experience, frequent exposure to lethal defects, and emotional discomfort in interactions with grieving families. The most commonly used coping strategies were active coping (M = 2.06, SD = 0.635) and planning (M = 1.95, SD = 0.590), whereas self-blame (M = 1.20, SD = 0.714, p < 0.001) and denial (M = 0.88, SD = 0.751, p < 0.001) were linked to higher stress levels. Positive reinterpretation (r = −0.211, p < 0.001) and seeking emotional support (r = −0.129, p = 0.024) correlated with lower stress levels. Nurses and midwives with secondary education reported higher stress levels compared to those with higher education (χ²(10) = 30.651, p = 0.001). Work experience played a role, with moderate stress levels most frequently observed among those with 2–5 years of professional experience (χ²(14) = 24.023, p = 0.046). Emotional involvement, particularly supporting parents during their farewell to the child (69.1%), was identified as the most stressful aspect of their work. Conclusions: Promoting adaptive coping strategies, such as positive reinterpretation and emotional support, can help reduce stress and improve the well-being of nurses and midwives. Implementing psychological support programmes and stress management training is essential for maintaining high-quality neonatal care. Full article