Search Results (341)

Background/Objectives: Primary Care Physicians (PCPs) are widely regarded as trusted sources of health information and can play a pivotal role in increasing seasonal influenza vaccination (SIV) within their communities. We aimed to explore PCPs’ attitudes toward SIV and their views regarding proposed strategies to enhance SIV uptake in the evolving post-pandemic landscape. Methods: A qualitative study utilizing semi-structured individual interviews with a nationwide sample of 25 PCPs was conducted. Results: Physicians’ attitudes toward SIV were overwhelmingly positive; they recognized its protective value for individuals and the community alike, its efficacy in averting serious illness, and its proven safety profile. Regarding strengthening SIV uptake, PCPs positively appraised the following strategies: (a) viewing all clinical encounters as opportunities for vaccination; (b) outsourcing vaccination to nursing, allied health staff and community pharmacists, provided that specific prerequisites are met; (c) forwarding personalized notifications to health providers and (d) the public; and (e) establishing at-home vaccinations. Financial incentives would reportedly act as tangible acknowledgement and motivate PCPs to work toward primary prevention. However, others have argued that SIV is inherently embedded in their duty as PCPs, and potential remunerations would dwindle the public’s confidence in PCPs. Establishing incentives for the general population reportedly minimizes confidence and the perceived value of SIVs and was assessed to be ineffective in the Greek context. Promoting SIVs through video games was considered to be less effective for the adult population. Conclusions: Mapping PCPs’ insights is key in designing effective SIV strategies that are concurrent with communities’ values, needs, and learnt experience from the COVID-19 pandemic. Full article

Background: The flipped classroom is an innovative student-centered teaching approach frequently applied in nursing education. The success of the approach relies on students coming prepared to class. Faculties play a critical role in facilitating students’ pre-class preparation. Objective: The objective of this study was to elicit nursing students’ preferred designs for pre-class preparation in large-group, flipped-classroom teaching in evidence-based practice, and to use these insights to inform practical, faculty-driven changes to course design and delivery. Methods: An action research study was conducted among bachelor’s students in nursing at a Norwegian university college. Data were collected through questionnaires with closed and open-ended questions, focus group interviews, and class meetings. Descriptive statistics and thematic analysis were applied to analyze data. Data were analyzed sequentially, and findings provided guidance for further actions. Results: The action was carried out and evaluated in two cohorts. The thematic analysis revealed one main theme—students need motivation for pre-class preparation—and three associated sub-themes: (1) Information: Communicate relevance and provide timely reminders, (2) Organization: Learning platform and workload, and (3) Engage learners: Diverse, interactive and aligned learning activities. Conclusions: Faculties can support motivation through clear communication of relevance, a well-organized learning platform, activating pre-class activities, and timely reminders. Successfully accommodating pre-class preparation for large-group teaching also appears to require coordinated faculty engagement and a shared commitment to student-centered approaches. Further evaluation is needed to determine which specific configurations work best in different contexts. Full article

Background: Nurses’ job satisfaction is an important factor associated with motivation, retention, and performance, potentially influencing the quality and safety of healthcare delivery. Identifying organizational and professional determinants of job satisfaction is essential for the sustainability of healthcare systems. Objective: This study aims to describe nurses’ job satisfaction across its multiple dimensions and examine differences in job satisfaction dimensions across sociodemographic and professional groups. Methods: A quantitative, cross-sectional, descriptive–correlational study was conducted with 153 nurses. Data were collected between October and December 2024 using an online questionnaire, with a response rate of 28.9%, which included the Escala de Satisfação dos Enfermeiros com o Trabalho (ESET). Descriptive and inferential statistical analyses were performed, with the significance level set at 0.05. Results: Moderate levels of job satisfaction predominated among participants (75.8%), with 5.2% of participants reporting low satisfaction. The highest mean scores were observed in satisfaction with co-workers and professional recognition, while the lowest scores were found in the recognition and remuneration dimension. Statistically significant differences in mean job satisfaction scores were observed across groups defined by variables such as work setting, work schedule, weekly workload, and employment across multiple workplaces. Conclusions: Nurses’ job satisfaction is multidimensional and varies across different professional and organizational groups. These findings highlight areas of lower job satisfaction that may represent priorities for future organizational assessment and management attention. Full article

Background/Objectives: Therapeutic communication is a core competency in mental health nursing, yet clinical placements often offer limited opportunities for undergraduate students to practise relational skills in a safe and structured way. Simulation, particularly when aligned with the Healthcare Simulation Standards of Best Practice™ (INACSL), may provide a useful context for fostering empathy, emotional presence, and professional communication. This study aimed to evaluate undergraduate nursing students’ satisfaction and self-confidence following participation in a standardised-patient simulation designed to address therapeutic relationship competencies. Methods: A descriptive cross-sectional study was conducted with 142 third-year nursing students at a public university. Participants completed two INACSL-aligned simulation encounters involving psychiatric scenarios that required therapeutic engagement. After the sessions, students completed a questionnaire based on the Student Satisfaction and Self-Confidence in Learning Scale, adapted to the context of the simulation. Data were analysed using descriptive statistics. Results: Students reported high levels of satisfaction and self-confidence following the simulation experience. Between 88.0% and 92.9% of participants agreed or strongly agreed with items related to realism, relevance, and motivation. High levels of agreement were also observed for items related to therapeutic communication, critical thinking (98.6%), clinical competence (95.8%), and teamwork (93.6%). Lower levels of agreement were found for the usefulness of video-based debriefing (61.9%) and the adequacy of material resources (57.1%), suggesting areas for improvement in future implementation. Conclusions: Standardised-patient simulation was positively evaluated by nursing students and was associated with high levels of satisfaction and self-confidence in learning. The findings suggest that this type of educational strategy may support students’ perceived development of therapeutic communication and relational skills in mental health nursing education. However, these results are based on self-reported data collected using an adapted measurement approach and should be interpreted with caution. Further research using validated instruments and performance-based measures is needed to assess competence development more directly. Full article

The current study aimed to investigate complex links among a large set of anxiety-related variables and identify targets for well-being interventions in a large sample of male and female vocational education training students. In total, 28 psychological constructs, such as self-esteem, parental pressure and dissatisfaction and motivation, were assessed in four groups of VET students (mode age: 16). The sample included 3069 females in ASSP schools (nursing and caring); 2108 females and 1772 males in Commerce schools (sales and management); and 2262 males in MELEC schools (electricity and maintenance). We used Gaussian Graphical models (GGMs) that allow for building sparse models of links among multiple variables and detecting targets for interventions via the identification of the most central nodes. We showed gender differences in absolute means for some variables (higher self-esteem and math grades in males; higher anxiety and error sensitivity, but stronger endorsement of mastery approach achievement goals in females), as well as in network structure. GGMs suggested that the key nodes were self-reported math competence for females in the ASSP group, self-regulation for females in Commerce, and mastery approach goals for males in both MELEC and Commerce groups, and that these should be differentially targeted by educational interventions in these populations. Full article

Background/Aim: Cardiovascular disease (CVD) represents a relevant global public health challenge with dyslipidemia as a major modifiable cardiovascular risk factor (CVRF). Recent advances have introduced injectable lipid-lowering therapies (LLT). Their clinical effectiveness in real-world practice seems to depend not only on pharmacological efficacy but also on patients’ acceptance, adherence, and persistence, influenced directly by perceived barriers and facilitators. The main objective of this scoping review is to map the barriers and facilitators related to the use of novel injectable LLTs among adult patients with dyslipidemia or CVD. Methods: This review was conducted in accordance with JBI methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for scoping reviews (PRISMA-ScR); pre-registration on Open Science Framework (OSF) was performed. A search was conducted in MEDLINE from PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) from EBSCOhost, and Google Scholar up to June 2025. Eligible studies included qualitative, quantitative, mixed-methods, and review papers involving adult patients with dyslipidemia who reported experiences, perceptions or challenges related to the use of injectable LLT in any healthcare or community setting worldwide. Two reviewers independently screened studies, selected and extracted data. Results: Out of 665 records identified, 7 studies met the inclusion criteria. Patients’ adherence to injectable LLTs is shaped by psychological fears, prior negative experiences, and perceived efficacy. Satisfaction increases when patients feel supported and informed. Convenience, self-administration, and motivational meaning facilitate persistence. Organizational support and economic accessibility further influence uptake, highlighting that adherence depends on both patient experience and structural factors. Conclusions: Patient acceptance and persistence with injectable LLT depends on a complex interplay of emotional, clinical, organizational and economic factors, beyond pharmacological efficacy alone. Fear of injections, previous statin-related experiences, administrative complexity, and high costs remain major barriers, while shared decision-making, trust in healthcare providers, perceived efficacy, regimen convenience, and supportive structures act as strong facilitators. Addressing these challenges requires multidimensional and multidisciplinary strategies for policy makers and clinical managers. Full article

Background/Objectives: Culturally responsive care requires both intercultural communication competence (ICC) and empathy; however, these constructs are often examined separately in nursing research. This study aimed to (i) describe nurses’ ICC and empathy levels, (ii) test the association between ICC and empathy, and (iii) examine group differences by selected demographic and professional variables. Methods: A quantitative, cross-sectional correlational design was conducted with 300 nurses recruited from state and private hospitals. ICC was measured using the Arasaratnam Intercultural Communication Competence Scale (cognitive, affective, and total), and empathy was assessed using the 18-item Jefferson Scale of Empathy (compassionate care, perspective taking, standing in the patient’s shoes, and total). Data were analyzed with descriptive statistics, Pearson correlations, independent-samples t-tests, and one-way ANOVAs with Scheffé post hoc tests (α = 0.05). Results: Both ICC and empathy were above the scale midpoint. Cognitive ICC (M = 4.71, SD = 1.42) exceeded affective ICC (M = 4.35, SD = 1.34), and total empathy was high (M = 4.50, SD = 0.90), with compassionate care as the highest subscale (M = 4.60, SD = 1.10). ICC total was moderately correlated with total empathy (r = 0.607, p < 0.05); affective ICC correlated with compassionate care (r = 0.455) and perspective taking (r = 0.493). Male nurses reported higher ICC than female nurses (p < 0.05), while empathy did not differ by gender. Younger nurses (20–29) scored higher in ICC and empathy than older groups, and nurses with ≥28 years of experience also showed elevated levels. Nurses who willingly chose nursing had higher ICC and empathy across dimensions (all p < 0.001). Hospital type showed minimal differences except for “standing in the patient’s shoes” (private > state, p = 0.04). Conclusions: ICC and empathy were generally high and interrelated among nurses, with meaningful variation across workforce characteristics. Training should emphasize experiential and reflective approaches to strengthen affective ICC and perspective taking, while organizational strategies should foster intrinsic motivation and support professional development across career stages. Full article

Background: In 2021, an Australian Hospital Nursing Research Hub sponsored 13 healthcare staff to complete the Graduate Certificate (Clinical Redesign), to build capability in health service improvement though work-integrated learning (WIL). Healthcare professionals undertaking workplace-based WIL likely experience significant challenges including balancing professional and student roles and aligning work with academic requirement. These pressures were likely intensified during the Coronavirus disease 2019 (COVID-19) pandemic. This study aimed to explore and understand the experiences of hospital healthcare staff completing WIL redesign projects, including the impacts of COVID-19. Methods: A qualitative descriptive inquiry approach was used to explore individual student experiences. Thirteen staff, mostly nurses, who enrolled in the 2021 course were invited to participate. Online semi-structured interviews were conducted. Data were analyzed using a general inductive thematic analysis approach. Results: Four participants (36%) took part; all were female and working full-time. Five main themes were identified that centered around: COVID-19, Support, Motivation, Alignment and Relevance, and Success. Conclusions: Novel insights include the need to reconceptualize “success” to improve student experience, the critical role of organizational–university–student alignment in enabling WIL studies, and the unique pressures of completing WIL during crisis conditions that direct impact the health sector, such as COVID-19. Although not generalizable, these findings are likely to be important considerations more broadly to strengthen WIL design, support and student experiences, ultimately enhancing health service staff capability to lead quality improvement in the workplace. Full article

Social media environments and meme-based communication are increasingly incorporated into nursing education, yet it remains unclear whether students respond uniformly to digitally embedded instructional strategies. This study examined whether alignment between meme-based instruction and perceived social media learning utility differentiates motivation, perceived academic impact, and demand for educator presence among undergraduate nursing students. A cross-sectional study was conducted with 458 nursing students from Spanish universities who completed a structured questionnaire assessing perceptions of meme-based instruction, social media learning utility, motivation, perceived academic impact, and expectations of educator presence. Hierarchical regression models examined interaction effects, quadrant comparisons were analysed using Kruskal–Wallis tests, and a sequential mediation model evaluated indirect pathways. Students reported high endorsement of meme-based instruction (M = 4.44, SD = 0.80) and social media learning utility (M = 4.15, SD = 0.80). However, substantial divergence emerged across alignment profiles. Students showing high alignment between meme endorsement and perceived social media utility tended to report higher motivation and different expectations of educator presence, whereas perceived academic impact was primarily explained by additive effects. These findings suggest that digital instructional innovations may not generate entirely homogeneous responses across students and that alignment between instructional format and perceived learning utility is associated with differences in motivational activation and instructional expectations in undergraduate nursing education. Full article

Objectives: This study aimed to evaluate the relationship between quiet quitting and burnout among nurses, considering the influence of sociodemographic and occupational factors in healthcare settings. Methods: This cross-sectional, observational, and quantitative study was conducted from April to July 2025 in health services in northern Portugal, involving 1097 nurses who completed a questionnaire, the Silent Employment Abandonment Scale, and the Shirom–Melamed Burnout Scale. Descriptive and inferential analyses examined associations between sociodemographic variables, work context, and outcomes. Results: The 1097 participating nurses showed a positive correlation between overall quiet quitting and total burnout across all domains. Burnout remained significantly associated with overall quiet quitting after adjustment, and physical and cognitive fatigue showed the most consistent independent associations across models. The strongest coefficients were observed for the ‘lack of motivation’ dimension. Conclusions: Quiet quitting was consistently associated with burnout among nurses after adjustment for sociodemographic and occupational factors. The pattern of results was stronger for physical and cognitive fatigue and for lack of motivation, supporting the interpretation of quiet quitting as an important correlation of occupational strain in nursing and reinforcing the need for organizational and leadership strategies that reduce fatigue and sustain professional engagement. Full article

Background/Objectives: Japan’s mental healthcare system is characterized by the world’s highest number of psychiatric beds, widespread “social hospitalization,” and a structurally entrenched managerial support model that frequently undermines patient autonomy. Joint Crisis Plans (JCPs)—collaboratively developed crisis management documents—have been increasingly adopted as a care coordination tool; however, their role in transforming professional practice towards recovery-oriented support remains underexplored. This study aimed to elucidate the experiences of professionals utilizing JCPs across diverse facility types and to develop a theoretical understanding of the process by which they redefine their role from ‘manager’ to ‘recovery companion’. Methods: A qualitative design using the Modified Grounded Theory Approach (M-GTA), grounded in symbolic interactionism, was employed. Semi-structured interviews were conducted with 13 professionals (7 nurses, 6 mental health and welfare workers) across nine facilities (psychiatric hospitals, 24-h residential facilities, outpatient facilities) in the Kanto region of Japan. Theoretical sampling continued until saturation. Data were analyzed using the constant comparative method, with validity ensured through team checking. Results: Nine categories and 23 subcategories were extracted. A three-stage support transformation process emerged: (1) Initial Stage and Motivation, in which professionals confronted the limitations of managerial practice; (2) Role Redefinition and Practice through Collaboration, involving joint crisis management, strength-based support, and network building; and (3) Stage of Integration of Perspectives and Implementation of Recovery-Oriented Practice, in which professionals witnessed individual recovery and integrated new support values into their practice. Negative cases revealed that JCP effectiveness is contingent on the co-construction of shared meaning rather than procedural compliance. Conclusions: JCP was suggested to function as a potential tool to facilitate navigating and reframing structural managerial barriers in Japanese mental healthcare. The creation of a shared language through JCP was associated with supporting conditions for individual self-determination, alleviating professional conflicts, and contributing to shifts in organizational culture. Full article

Background: Living with type 2 diabetes can be demanding from multiple perspectives. Many individuals with type 2 diabetes experience limited self-care ability and poor adherence to self-care recommendations. Objective: To describe factors that influence self-care adherence among adults with type 2 diabetes. Methods: A systematic review based on 19 studies using quantitative, qualitative, and mixed-method designs. The study design is a systematic literature review in accordance with the guidelines of the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) and PRISMA guidelines. The articles were retrieved from the research databases CINAHL, PubMed, and PsycInfo. Quality appraisal was conducted using the MMAT, and the studies were analyzed through meta-aggregation and subsequently compiled into a unified set of findings. Results: The findings showed that numerous factors influence adherence to self-care. These were presented in categories: sociodemographic factors; disease- and treatment-related factors; healthcare-related factors; and psychological factors. Psychological factors played a decisive role in adherence, particularly regarding motivation. Conclusions: Living with Type 2 diabetes demands considerable engagement and supporting them as a district nurse is a multidimensional task consisting of several components. Self-care adherence in type 2 diabetes cannot be understood as the result of isolated factors but rather as a complex interplay of psychological, social, economic circumstances. Understanding effective patient education enhances knowledge and understanding of the importance of adhering to treatment is the key to improving compliance in patients with type 2 diabetes. Full article

Background: Nurses’ motivation is essential for ensuring the quality of care and workforce retention. Understanding the underlying psychological mechanisms is essential, particularly through Self-Determination Theory (SDT). This approach clarifies how work environments influence work engagement and performance. Existing research has explored SDT in various contexts. However, little is known about how contextual and organizational factors specifically impact nurses’ motivation in low- and middle-income countries such as Morocco. This study contributes to addressing this gap. Objectives: This study explores how organizational factors within a Moroccan university hospital influence the BPNs’ satisfaction in a Moroccan teaching university hospital. Methods: An exploratory qualitative case study was used. Purposive sampling was used to select 26 participants, including nurse managers (n = 7), rehabilitation therapists (n = 5), pharmacy technicians (n = 4), nurses at the Hematology Department (n = 4), nurses at the Emergency Department (n = 4), and nurses in the outpatient consultation unit of the Otorhinolaryngology Department (n = 2). Data collection was conducted from March to June 2023, following ethical approval. Data analysis followed Yin’s five-step process, incorporating deductive and inductive coding, within- and cross-case thematic analysis, and iterative explanation-building. Results: Identified motivation emerged as the most frequently reported type, although BPNs’ satisfaction varied. Rehabilitation therapists consistently reported high levels of autonomy, competence, and relatedness, which were attributed to transformational leadership, task specialization, and a supportive organizational culture. In contrast, nurses experienced role ambiguity, transactional leadership, excessive workloads, and limited autonomy in decision-making, all of which contributed to unmet BPNs. Performance evaluations and financial incentives were widely perceived as unjust. Conclusions: This study shows that in LMIC hospital settings, nurses’ motivation depends on organizational support for their BPNs, especially in resource-constrained environments. The significant disparities between professions within hospitals indicate that supportive environments with autonomy-supportive leadership, clear roles, fair evaluation, and adequate staffing are both achievable and essential for motivating and retaining nurses. Full article

Objective: This study aimed to examine the effects of personality features and attitudes toward the nursing profession on job motivation and intention to quit among male nurses within the framework of the Job Demands–Resources (JD-R) model. In this framework, personality traits and perceptions of the profession were conceptualized as personal resources, while job motivation represents a motivational process that may influence turnover intention. Methods: A cross-sectional design was employed with 303 male nurses actively working in different regions of Turkey. Data were collected via an online survey using non-probability sampling methods. The measurement tools included the Attitude Scale Toward the Nursing Profession, Job Motivation Scale, Personality Features Scale, and the Nurse Turnover Intention Scale. Data were analyzed using descriptive statistics, confirmatory factor analysis, and structural equation modeling. Results: Structural equation modeling revealed that attitudes toward the nursing profession (β = −0.90, p < 0.001), personality features (β = −0.10, p < 0.001), and job motivation (β = −0.14, p < 0.001) had significant and negative effects on intention to quit. Attitudes toward the profession emerged as the strongest predictor, explaining 49% of the variance in intention to quit. Attitudes toward the nursing profession, personality features, and job motivation were found to have significant and negative effects on intention to quit among male nurses. Consistent with the JD-R model, the findings suggest that personal resources (personality and professional perception) and motivational processes (job motivation) may play an important role in shaping turnover intentions among male nurses. Accordingly, professional identity-strengthening initiatives, role model-based mentoring, and motivation-enhancing training programs may help support the retention of male nurses in the profession. Full article

Background: Chronic heart failure (CHF) in older adults requires sustained self-management and close follow-up, yet day-to-day care is often carried out by families with support from primary healthcare nurses. In Saudi Arabia, where family caregiving is culturally normative, collaboration between nurses and patients’ families may be pivotal to effective CHF management, but remains insufficiently understood in primary healthcare contexts. Methods: A qualitative study informed by an interpretive phenomenological approach was conducted. Participants (n = 24; 12 nurses and 12 family caregivers) were recruited using purposive sampling from primary healthcare centers in Riyadh, Saudi Arabia. In-depth, semi-structured interviews were conducted in Arabic or English, audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis following Braun and Clarke’s six-phase framework. Strategies to enhance trustworthiness included member checking, peer debriefing, maintenance of an audit trail, and reflexive journaling. Results: Twenty-four participants (12 nurses and 12 family caregivers) were interviewed. Four interrelated themes were generated from both nurses’ and family caregivers’ accounts. (1) “We Are Caring Together”: Collaboration was experienced as shared responsibility for daily CHF management, grounded in trust; (2) Navigating Roles and Boundaries: Participants described unclear expectations, role overlap, and tension between professional authority and family knowledge; (3) Communication as the Engine of Collaboration: Effective partnerships depended on clear information exchange, caregiver-tailored education, and continuity of contact, while communication gaps created uncertainty and delayed support-seeking; and (4) Cultural and System Constraints Shaping Collaboration: Strong family obligation motivated caregiving but also intensified moral pressure and limited help-seeking, while time pressure and fragmented services constrained meaningful engagement and continuity across settings. Conclusions: Nurse–family collaboration in CHF management is relational, shaped by trust, role negotiation, and communication, and constrained by cultural norms and system pressures. This study contributes to the literature by demonstrating how moral obligation, hierarchical professional norms, and system fragmentation distinctively shape collaboration in the Saudi primary care context, extending existing conceptualizations derived primarily from Western individualist settings. Strengthening collaboration requires explicit role clarification, health literacy–informed caregiver education, continuity of contact, and organizational supports. Findings are limited by purposive sampling, single-city context, and exclusion of patient perspectives. Full article