Pub Date : 2026-01-11DOI: 10.1016/j.ijnsa.2026.100489
Halperin Ofra, Eldar – Regev Orit
Introduction
The cultural diversity of Israel's population presents significant challenges for nursing and healthcare professionals. Understanding the cultural impact on health is crucial for ensuring quality care and meeting diverse population needs.
Objective
To investigate the relationships among socio-demographic parameters, multicultural coursework, cross-cultural patient interactions, and cultural and self-awareness among nursing students.
Method
In this cross-sectional study we collected data from 900 nursing students across three Israeli colleges, using a questionnaire combining the Clinical Cultural Competency Questionnaire and a Demographic and Social Characteristics Questionnaire. We used descriptive statistics, parametric and non-parametric correlations, multivariate analysis of variance, and hierarchical multiple regression analyses.
Results
We revealed high levels of cultural awareness, self-awareness, and comfort among participants. However, practical skills scored lower, and multicultural knowledge demonstrated the lowest scores. We found no correlation between cultural awareness and exposure to patients from different cultures. Demographic factors exhibited significant associations with cultural competence components. Age positively correlated with self-awareness, comfort level, and skills, but not with cultural awareness. Third- and fourth-year participants displayed higher cultural competence compared to first- and second-year participants. Ethnic background emerged as a crucial factor in cultural competence development, while sex differences, though significant, showed minimal effect across all measures.
Conclusions
We have revealed the complex interrelation of factors associated with Israeli nursing students’ cultural competence, including ethnicity, sex, age, and educational exposure. Structured cultural competence training may be necessary within this country's nursing education programs, particularly in contexts of societal conflict.
Practice Implications
Cultural competence should be considered as a comprehensive component of mandatory nursing curricula in Israel to enhance students’ practical multicultural skills. Clinical experiences might emphasize multicultural therapeutic encounters, and nursing education could provide ongoing opportunities for cross-cultural interaction throughout academic training.
{"title":"Perceived cultural competence among nursing students: A cross-sectional study","authors":"Halperin Ofra, Eldar – Regev Orit","doi":"10.1016/j.ijnsa.2026.100489","DOIUrl":"10.1016/j.ijnsa.2026.100489","url":null,"abstract":"<div><h3>Introduction</h3><div>The cultural diversity of Israel's population presents significant challenges for nursing and healthcare professionals. Understanding the cultural impact on health is crucial for ensuring quality care and meeting diverse population needs.</div></div><div><h3>Objective</h3><div>To investigate the relationships among socio-demographic parameters, multicultural coursework, cross-cultural patient interactions, and cultural and self-awareness among nursing students.</div></div><div><h3>Method</h3><div>In this cross-sectional study we collected data from 900 nursing students across three Israeli colleges, using a questionnaire combining the Clinical Cultural Competency Questionnaire and a Demographic and Social Characteristics Questionnaire. We used descriptive statistics, parametric and non-parametric correlations, multivariate analysis of variance, and hierarchical multiple regression analyses.</div></div><div><h3>Results</h3><div>We revealed high levels of cultural awareness, self-awareness, and comfort among participants. However, practical skills scored lower, and multicultural knowledge demonstrated the lowest scores. We found no correlation between cultural awareness and exposure to patients from different cultures. Demographic factors exhibited significant associations with cultural competence components. Age positively correlated with self-awareness, comfort level, and skills, but not with cultural awareness. Third- and fourth-year participants displayed higher cultural competence compared to first- and second-year participants. Ethnic background emerged as a crucial factor in cultural competence development, while sex differences, though significant, showed minimal effect across all measures.</div></div><div><h3>Conclusions</h3><div>We have revealed the complex interrelation of factors associated with Israeli nursing students’ cultural competence, including ethnicity, sex, age, and educational exposure. Structured cultural competence training may be necessary within this country's nursing education programs, particularly in contexts of societal conflict.</div></div><div><h3>Practice Implications</h3><div>Cultural competence should be considered as a comprehensive component of mandatory nursing curricula in Israel to enhance students’ practical multicultural skills. Clinical experiences might emphasize multicultural therapeutic encounters, and nursing education could provide ongoing opportunities for cross-cultural interaction throughout academic training.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100489"},"PeriodicalIF":3.1,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-10DOI: 10.1016/j.ijnsa.2026.100488
Hanghang Jin , Mengjuan Jing , Yuhao Zhao , Xiaoyu Nie , Xiaojing Wei , Liming Li
Background
Effective communication with mechanically ventilated awake patients in the intensive care unit (ICU) is a major challenge. Invasive mechanical ventilation deprives patients of their ability to communicate and hinders nurse-patient communication. Effective communication is an important step in building the nurse-patient relationship. Communication tools such as eye-tracking devices have the potential to improve communication between ICU nurses and patients.
Objective
The aim of this paper was to explore the use of eye-tracking technology for nurse-patient communication with mechanically ventilated patients in the ICU, and to inform its improved implementation in this setting.
Methods
Using a descriptive qualitative design and following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Semi-structured interviews were conducted from February to May 2025 with 16 mechanically ventilated patients who communicated using eye-tracking devices at least three times during their hospitalization at a hospital in Henan Province. Thematic analysis was employed, guided by the framework developed by Braun and Clarke.
Results
Three themes were identified: Technical interaction experience, Psychological experience, and the Barriers to using the device. This paper found that eye-tracking devices were feasible in communicating basic needs and provided psycho-emotional benefits. Patients were able to regain a sense of engagement, engage in emotionally supportive interactions, and feel psychologically safe. However, factors such as physiologic fatigue and environmental conditions created barriers to optimal use of the devices.
Conclusion
Eye-tracking technology can serve as a valuable supportive tool for nurse-patient communication in the ICU. It empowers patients to participate in their daily care and facilitates emotionally supportive interactions. However, barriers to implementation must be addressed to optimize its effectiveness. Future efforts should focus on refining these communication tools based on these findings to ensure that critically ill patients can fully benefit from them.
Implications for clinical practice
Eye-tracking devices are used as communication aids to help intubated or tracheostomy patients express basic needs and participate in their own care. To ensure communication effectiveness, clinical practice needs to be optimized in various ways, such as optimizing device performance and providing systematic training and support for caregivers to deal with barriers to device use.
{"title":"Mechanically ventilated patients' Experiences of communication using eye-tracking technology: A qualitative descriptive study","authors":"Hanghang Jin , Mengjuan Jing , Yuhao Zhao , Xiaoyu Nie , Xiaojing Wei , Liming Li","doi":"10.1016/j.ijnsa.2026.100488","DOIUrl":"10.1016/j.ijnsa.2026.100488","url":null,"abstract":"<div><h3>Background</h3><div>Effective communication with mechanically ventilated awake patients in the intensive care unit (ICU) is a major challenge. Invasive mechanical ventilation deprives patients of their ability to communicate and hinders nurse-patient communication. Effective communication is an important step in building the nurse-patient relationship. Communication tools such as eye-tracking devices have the potential to improve communication between ICU nurses and patients.</div></div><div><h3>Objective</h3><div>The aim of this paper was to explore the use of eye-tracking technology for nurse-patient communication with mechanically ventilated patients in the ICU, and to inform its improved implementation in this setting.</div></div><div><h3>Methods</h3><div>Using a descriptive qualitative design and following the Consolidated Criteria for Reporting Qualitative Research (COREQ). Semi-structured interviews were conducted from February to May 2025 with 16 mechanically ventilated patients who communicated using eye-tracking devices at least three times during their hospitalization at a hospital in Henan Province. Thematic analysis was employed, guided by the framework developed by Braun and Clarke.</div></div><div><h3>Results</h3><div>Three themes were identified: Technical interaction experience, Psychological experience, and the Barriers to using the device. This paper found that eye-tracking devices were feasible in communicating basic needs and provided psycho-emotional benefits. Patients were able to regain a sense of engagement, engage in emotionally supportive interactions, and feel psychologically safe. However, factors such as physiologic fatigue and environmental conditions created barriers to optimal use of the devices.</div></div><div><h3>Conclusion</h3><div>Eye-tracking technology can serve as a valuable supportive tool for nurse-patient communication in the ICU. It empowers patients to participate in their daily care and facilitates emotionally supportive interactions. However, barriers to implementation must be addressed to optimize its effectiveness. Future efforts should focus on refining these communication tools based on these findings to ensure that critically ill patients can fully benefit from them.</div></div><div><h3>Implications for clinical practice</h3><div>Eye-tracking devices are used as communication aids to help intubated or tracheostomy patients express basic needs and participate in their own care. To ensure communication effectiveness, clinical practice needs to be optimized in various ways, such as optimizing device performance and providing systematic training and support for caregivers to deal with barriers to device use.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100488"},"PeriodicalIF":3.1,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-09DOI: 10.1016/j.ijnsa.2026.100484
Elisabete Alves , Ana Ramos , Paula Pereira , Mauro Lopes , César Fonseca
Introduction
Ageing is a multifactorial and progressive process that leads to a gradual decline in mental and physical function, directly impacting the ability to perform daily living activities and health-related quality of life. Thus, it is essential to develop strategies that prioritize the maintenance of the functional capacity and the enhancement of the quality of life and well-being of older adults.
Objective
This scoping review intends to map the rehabilitation programs, used by rehabilitation nurses, for promoting mobility and self-care, among older adults, to identify the main health gains resulting from the rehabilitation programs implemented.
Methods
This scoping review follows the JBI methodology and the results obtained are described according to the PRISMA-ScR guidelines, and was registered in the OSF (osf.io/zqkp3/). The electronic databases CINAHL Complete; Complete MEDLINE; Cochrane Central Register of Controlled Trials; Web of Science, Scopus, and Google Scholar, were searched in March 2025, for papers published in the last 10 years. Two researchers independently analyzed the papers for eligibility and extracted the data. Data on health gains whose association with the intervention was described were collected and synthetized, through narrative synthesis.
Results
The initial search yielded a total of 15,347 records, and after screening, 12 papers were included. The evaluation of the methodological quality and levels of evidence of the studies, according to the JBI Critical Appraisal Tool, concluded that the average quality score of the studies ranged from 67% to 100%. The results revealed a variety of interventions implemented, targeting different aspects of rehabilitation, with a wide range in the duration (15 to 60 min) and frequency of sessions (three to 56), as well as the use of diverse instruments to assess the effectiveness of the interventions. The health gains associated with the musculoskeletal system were reported most frequently, followed by those related to neurocognitive enhancements. Respiratory and renal gains were only reported by one study each.
Conclusions
This scoping review reinforces the evolving vision of nursing rehabilitation as a cornerstone of comprehensive healthcare, demonstrating its significant impact on enhancing health gains at several physiologic systems among older adults. Adopting a multiple physiological system-based framework for the analysis and implementation of these interventions may enhance the precision, accountability, and efficacy of care. Such poses nursing rehabilitation as an essential strategy in the continuum of care, advocating for its integration into healthcare systems and policies to support the health and sustainable recovery of the older population.
老龄化是一个多因素的渐进过程，导致精神和身体功能逐渐下降，直接影响日常生活活动的能力和与健康相关的生活质量。因此，必须制定战略，优先考虑维持老年人的功能能力和提高老年人的生活质量和福祉。目的本综述旨在绘制康复护士用于促进老年人活动能力和自我护理的康复方案，以确定实施康复方案所带来的主要健康收益。方法本综述采用JBI方法学，所得结果按照PRISMA-ScR指南进行描述，并在OSF （OSF .io/zqkp3/）中注册。电子数据库CINAHL Complete；完整的MEDLINE;Cochrane中央对照试验登记册；Web of Science， Scopus和b谷歌Scholar在2025年3月检索了过去10年发表的论文。两名研究人员独立分析了论文的合格性并提取了数据。通过叙述综合，收集并综合了与所述干预措施相关的健康收益数据。结果初步检索到15347篇文献，经筛选，最终纳入12篇文献。根据JBI关键评估工具对研究的方法学质量和证据水平进行评估，得出的结论是研究的平均质量得分在67%至100%之间。结果显示，针对康复的不同方面实施了各种干预措施，持续时间（15至60分钟）和频率（3至56次）的范围很广，以及使用各种工具来评估干预措施的有效性。与肌肉骨骼系统相关的健康收益被报道得最多，其次是与神经认知增强相关的健康收益。呼吸系统和肾脏方面的益处各只有一项研究报告。结论：这一范围综述强化了护理康复作为综合医疗保健基石的不断发展的愿景，证明了其对提高老年人几个生理系统的健康收益的重大影响。采用基于多个生理系统的框架来分析和实施这些干预措施，可以提高护理的准确性、问责性和有效性。这使得护理康复成为持续护理的一项基本战略，倡导将其纳入卫生保健系统和政策，以支持老年人口的健康和可持续康复。
{"title":"Health gains from rehabilitation programs implemented by nurses for older people with impaired mobility and self-care deficit: A scoping review","authors":"Elisabete Alves , Ana Ramos , Paula Pereira , Mauro Lopes , César Fonseca","doi":"10.1016/j.ijnsa.2026.100484","DOIUrl":"10.1016/j.ijnsa.2026.100484","url":null,"abstract":"<div><h3>Introduction</h3><div>Ageing is a multifactorial and progressive process that leads to a gradual decline in mental and physical function, directly impacting the ability to perform daily living activities and health-related quality of life. Thus, it is essential to develop strategies that prioritize the maintenance of the functional capacity and the enhancement of the quality of life and well-being of older adults.</div></div><div><h3>Objective</h3><div>This scoping review intends to map the rehabilitation programs, used by rehabilitation nurses, for promoting mobility and self-care, among older adults, to identify the main health gains resulting from the rehabilitation programs implemented.</div></div><div><h3>Methods</h3><div>This scoping review follows the JBI methodology and the results obtained are described according to the PRISMA-ScR guidelines, and was registered in the OSF (osf.io/zqkp3/). The electronic databases CINAHL Complete; Complete MEDLINE; Cochrane Central Register of Controlled Trials; Web of Science, Scopus, and Google Scholar, were searched in March 2025, for papers published in the last 10 years. Two researchers independently analyzed the papers for eligibility and extracted the data. Data on health gains whose association with the intervention was described were collected and synthetized, through narrative synthesis.</div></div><div><h3>Results</h3><div>The initial search yielded a total of 15,347 records, and after screening, 12 papers were included. The evaluation of the methodological quality and levels of evidence of the studies, according to the JBI Critical Appraisal Tool, concluded that the average quality score of the studies ranged from 67% to 100%. The results revealed a variety of interventions implemented, targeting different aspects of rehabilitation, with a wide range in the duration (15 to 60 min) and frequency of sessions (three to 56), as well as the use of diverse instruments to assess the effectiveness of the interventions. The health gains associated with the musculoskeletal system were reported most frequently, followed by those related to neurocognitive enhancements. Respiratory and renal gains were only reported by one study each.</div></div><div><h3>Conclusions</h3><div>This scoping review reinforces the evolving vision of nursing rehabilitation as a cornerstone of comprehensive healthcare, demonstrating its significant impact on enhancing health gains at several physiologic systems among older adults. Adopting a multiple physiological system-based framework for the analysis and implementation of these interventions may enhance the precision, accountability, and efficacy of care. Such poses nursing rehabilitation as an essential strategy in the continuum of care, advocating for its integration into healthcare systems and policies to support the health and sustainable recovery of the older population.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100484"},"PeriodicalIF":3.1,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100486
Lu-Yen A Chen , Tonks N Fawcett , Colin Chandler , Tzu-Wen Weng
Background
Fever is a common symptom among hospitalized patients and often triggers nursing interventions. Although clinical guidelines recommend the use of antipyretics primarily to alleviate patient discomfort rather than to normalize temperature, both pharmacological and non-pharmacological treatments remain routinely employed. However, the rationale behind these interventions in adult care settings remains poorly understood.
Aim
This study aims to explore how nurses manage fever in adult patients and examine the rationale underpinning their clinical decisions in fever management.
Methods
A sequential explanatory mixed-methods design was employed. Quantitative data on nurses’ fever management and decision-making for patients with fever were collected via an online survey of 177 registered nurses in Scotland. Qualitative data on nurses’ rationale and experience in managing fever were obtained through open-text responses in the online survey and five follow-up interviews. Thematic analysis and descriptive statistics were integrated to interpret findings.
Results
Independent nursing judgement was the most frequently cited rationale for fever intervention (49.2 %). However, according to the qualitative finding, clinical decisions were predominantly influenced by habitual routines, institutional norms, and risk-averse thinking. Participants frequently initiated interventions as part of the Sepsis Six protocol, even in the absence of confirmed infection. Fever phobia, defined as exaggerated perceptions of fever-related harm, was evident in both interview and questionnaire data. Comfort was commonly cited as a justification for treatment, yet few participants reassessed patient comfort after administering interventions.
Conclusion
Nurses’ fever management is influenced more by embedded routines and clinical culture than by formal knowledge or guideline adherence. Fever phobia and Sepsis Six pressures can contribute to unnecessary intervention, highlighting the need for reflective education and systems-level support for evidence-based practice.
The result of this study illustrated the potential for overtreatment in fever care and provides actionable insights to support evidence-informed decision-making in nursing practice. Future initiatives should focus on challenging fever phobia, supporting critical reflection, and aligning practice with current evidence through targeted educational strategies.
{"title":"Nursing management decisions in fever: a mixed-methods approach to understanding","authors":"Lu-Yen A Chen , Tonks N Fawcett , Colin Chandler , Tzu-Wen Weng","doi":"10.1016/j.ijnsa.2026.100486","DOIUrl":"10.1016/j.ijnsa.2026.100486","url":null,"abstract":"<div><h3>Background</h3><div>Fever is a common symptom among hospitalized patients and often triggers nursing interventions. Although clinical guidelines recommend the use of antipyretics primarily to alleviate patient discomfort rather than to normalize temperature, both pharmacological and non-pharmacological treatments remain routinely employed. However, the rationale behind these interventions in adult care settings remains poorly understood.</div></div><div><h3>Aim</h3><div>This study aims to explore how nurses manage fever in adult patients and examine the rationale underpinning their clinical decisions in fever management.</div></div><div><h3>Methods</h3><div>A sequential explanatory mixed-methods design was employed. Quantitative data on nurses’ fever management and decision-making for patients with fever were collected via an online survey of 177 registered nurses in Scotland. Qualitative data on nurses’ rationale and experience in managing fever were obtained through open-text responses in the online survey and five follow-up interviews. Thematic analysis and descriptive statistics were integrated to interpret findings.</div></div><div><h3>Results</h3><div>Independent nursing judgement was the most frequently cited rationale for fever intervention (49.2 %). However, according to the qualitative finding, clinical decisions were predominantly influenced by habitual routines, institutional norms, and risk-averse thinking. Participants frequently initiated interventions as part of the Sepsis Six protocol, even in the absence of confirmed infection. Fever phobia, defined as exaggerated perceptions of fever-related harm, was evident in both interview and questionnaire data. Comfort was commonly cited as a justification for treatment, yet few participants reassessed patient comfort after administering interventions.</div></div><div><h3>Conclusion</h3><div>Nurses’ fever management is influenced more by embedded routines and clinical culture than by formal knowledge or guideline adherence. Fever phobia and Sepsis Six pressures can contribute to unnecessary intervention, highlighting the need for reflective education and systems-level support for evidence-based practice.</div><div>The result of this study illustrated the potential for overtreatment in fever care and provides actionable insights to support evidence-informed decision-making in nursing practice. Future initiatives should focus on challenging fever phobia, supporting critical reflection, and aligning practice with current evidence through targeted educational strategies.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100486"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100482
Xuefen Lan , Min Li , Yu Wang , Miaoqin Chen , Heyun Jiang , Shunfei Lu , Ying Zhou
<div><h3>Background</h3><div>Artificial intelligence literacy is essential for nursing students to become competent in navigating contemporary healthcare complexities and to ensure safe patient care. This literacy is needed urgently due to the rapid integration of artificial intelligence into the clinical, educational, and research domains. This integration requires immediate adaptation in order to mitigate ethical risks in tech-driven healthcare.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine both the level and determinants of artificial intelligence literacy among nursing students.</div></div><div><h3>Design</h3><div>A cross-sectional study was conducted from April 1 to April 20, 2025.</div></div><div><h3>Setting(s)</h3><div>This study was conducted at a public higher education institution that offered a Master of Science in Nursing program.</div></div><div><h3>Participants</h3><div>Four hundred and twenty-three nursing students were enrolled in the study using convenience sampling.</div></div><div><h3>Methods</h3><div>Anonymous, self-administered online questionnaires were completed by the participants. Descriptive statistics including means, standard deviations, frequencies, and percentages were computed to characterize the sample. Multivariable linear regression analysis with adjustment for relevant covariates was then performed to examine potential associations between the variables.</div></div><div><h3>Results</h3><div>Moderate but uneven artificial intelligence literacy was observed among the nursing students, with a mean artificial intelligence literacy scale score of 59.67 (SD = 8.52). The ethics dimension was the least developed, in contrast to better performance in operational usage. Significant predictors of artificial intelligence literacy included frequency of artificial intelligence use, attitudes toward artificial intelligence, and digital literacy. Dimension-specific associations were identified and included correlation of awareness with gender, attitudes toward artificial intelligence, interest in artificial intelligence and digital literacy; usage with age, frequency of artificial intelligence use, and attitudes toward artificial intelligence; evaluation with attitudes toward artificial intelligence; and ethics with gender.</div></div><div><h3>Conclusions</h3><div>This study identified key determinants that influenced the artificial intelligence literacy of nursing students and showed that artificial intelligence ethics was the most deficient domain among Chinese nursing cohorts. Notably, the frequency of artificial intelligence use, attitudes toward artificial intelligence, interest in artificial intelligence, and digital literacy collectively shaped the artificial intelligence literacy profiles of nursing students. Practical implications including developing and implementing targeted interventions such as artificial intelligence ethics workshops and digital literacy curricula are necessary to enh
{"title":"Characteristics and determinants of artificial intelligence (AI) literacy in Chinese nursing students: A cross-sectional study","authors":"Xuefen Lan , Min Li , Yu Wang , Miaoqin Chen , Heyun Jiang , Shunfei Lu , Ying Zhou","doi":"10.1016/j.ijnsa.2026.100482","DOIUrl":"10.1016/j.ijnsa.2026.100482","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence literacy is essential for nursing students to become competent in navigating contemporary healthcare complexities and to ensure safe patient care. This literacy is needed urgently due to the rapid integration of artificial intelligence into the clinical, educational, and research domains. This integration requires immediate adaptation in order to mitigate ethical risks in tech-driven healthcare.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine both the level and determinants of artificial intelligence literacy among nursing students.</div></div><div><h3>Design</h3><div>A cross-sectional study was conducted from April 1 to April 20, 2025.</div></div><div><h3>Setting(s)</h3><div>This study was conducted at a public higher education institution that offered a Master of Science in Nursing program.</div></div><div><h3>Participants</h3><div>Four hundred and twenty-three nursing students were enrolled in the study using convenience sampling.</div></div><div><h3>Methods</h3><div>Anonymous, self-administered online questionnaires were completed by the participants. Descriptive statistics including means, standard deviations, frequencies, and percentages were computed to characterize the sample. Multivariable linear regression analysis with adjustment for relevant covariates was then performed to examine potential associations between the variables.</div></div><div><h3>Results</h3><div>Moderate but uneven artificial intelligence literacy was observed among the nursing students, with a mean artificial intelligence literacy scale score of 59.67 (SD = 8.52). The ethics dimension was the least developed, in contrast to better performance in operational usage. Significant predictors of artificial intelligence literacy included frequency of artificial intelligence use, attitudes toward artificial intelligence, and digital literacy. Dimension-specific associations were identified and included correlation of awareness with gender, attitudes toward artificial intelligence, interest in artificial intelligence and digital literacy; usage with age, frequency of artificial intelligence use, and attitudes toward artificial intelligence; evaluation with attitudes toward artificial intelligence; and ethics with gender.</div></div><div><h3>Conclusions</h3><div>This study identified key determinants that influenced the artificial intelligence literacy of nursing students and showed that artificial intelligence ethics was the most deficient domain among Chinese nursing cohorts. Notably, the frequency of artificial intelligence use, attitudes toward artificial intelligence, interest in artificial intelligence, and digital literacy collectively shaped the artificial intelligence literacy profiles of nursing students. Practical implications including developing and implementing targeted interventions such as artificial intelligence ethics workshops and digital literacy curricula are necessary to enh","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100482"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100479
Hannah Pinnekamp , Vanessa Priester , Johanna Steidle , Khalid Majjouti , Alexander Brehmer , Michaela Tapp-Herrenbrück , Michael Aleithe , Jens Kleesiek , Bernadette Hosters , Uli Fischer
<div><h3>Background</h3><div>Artificial intelligence (AI) is playing an increasingly important role in nursing care, including wound management. Differentiating pressure injuries from incontinence-associated dermatitis is clinically challenging, often leading to misclassification. Although AI-based wound assessment is advancing, few models specifically address incontinence-associated dermatitis, and clinical evidence remains limited. The KIADEKU project developed and piloted a transformer-based AI app to support care for these wounds.</div></div><div><h3>Objective</h3><div>The aim of this pilot intervention study was to assess the impact of the AI-based app on duration of wound assessment, dressing changes, documentation, nursing staff task load, and guideline adherence. Secondary aims included evaluating the AI’s accuracy and app usability compared to standard systems.</div></div><div><h3>Design</h3><div>This monocentric, non-randomized controlled study was conducted in two sequential phases: a control phase with conventional wound management, followed by an intervention phase utilizing the AI-based app.</div></div><div><h3>Setting and Participants</h3><div>The study included 88 voluntary nurses caring for pressure injuries and incontinence-associated dermatitis in adult patients on seven participating wards of LMU Hospital.</div></div><div><h3>Methods</h3><div>Wound care was systematically observed, and nurses completed questionnaires on task load, usability, and covariates. Outcomes were measured using standardized protocols, validated tools (NASA Task Load Index (NASA-TLX), Usability Metric for User Experience (UMUX-LITE)) and expert-defined indicators. Statistical analyses included descriptive statistics, group comparisons (t-test, Mann-Whitney U test), and multivariate linear regression adjusting for covariates. An independent wound assessment validated AI-generated predictions, with accuracy evaluated using F1-scores.</div></div><div><h3>Results</h3><div>A total of 88 wound care sessions were analysed. The intervention group had a statistically significantly longer mean duration of care and documentation (12.84 vs. 9.20 min; p = 0.002; 95 % CI: –5.59; –1.41 min) and higher guideline adherence (mean rank = 50.91 vs. 38.38; p = 0.017). Nurse task load showed no statistically significant group differences. Regression analysis identified AI app use, nurse qualification, and wound severity as statistically significant predictors of care duration, while AI use did not predict task load or guideline adherence. Usability ratings were similar to standard systems. Model performance showed high accuracy in identifying wound types, but lower accuracy in classifying their categories.</div></div><div><h3>Conclusions</h3><div>This pilot study is the first to evaluate an AI-based app supporting nursing wound management for pressure injuries and incontinence-associated dermatitis. While the app did not reduce care duration or nurse workload, it may have po
人工智能（AI）在护理中发挥着越来越重要的作用，包括伤口管理。鉴别压力损伤与失禁相关性皮炎在临床上具有挑战性，经常导致错误分类。尽管基于人工智能的伤口评估正在取得进展，但很少有模型专门针对失禁相关的皮炎，临床证据仍然有限。KIADEKU项目开发并试用了一款基于变压器的人工智能应用程序，以支持对这些伤口的护理。本初步干预研究的目的是评估基于人工智能的应用程序对伤口评估时间、换药时间、记录、护理人员任务负荷和指南依从性的影响。次要目标包括与标准系统相比评估人工智能的准确性和应用程序的可用性。设计：这项单中心、非随机对照研究分为两个连续阶段：常规伤口管理的控制阶段，以及使用基于人工智能的应用程序的干预阶段。环境和参与者研究包括88名自愿护士，他们在LMU医院的7个参与病房照顾成人患者的压力损伤和失禁相关皮炎。方法系统观察护理情况，护士填写任务负荷、可用性和协变量问卷。使用标准化协议、经过验证的工具（NASA任务负载指数（NASA- tlx）、用户体验可用性度量（UMUX-LITE））和专家定义的指标来测量结果。统计分析包括描述性统计、分组比较（t检验、Mann-Whitney U检验）和协变量调整的多变量线性回归。独立的伤口评估验证了人工智能生成的预测，并使用f1评分评估准确性。结果共分析了88次伤口护理。干预组的平均护理和记录时间较长（12.84 vs. 9.20 min; p = 0.002; 95% CI: -5.59; -1.41 min），指南依从性较高（平均rank = 50.91 vs. 38.38; p = 0.017）。护士任务负荷组间差异无统计学意义。回归分析发现，人工智能应用程序的使用、护士资格和伤口严重程度是护理持续时间的统计显著预测因素，而人工智能的使用并不能预测任务负荷或指南遵守情况。可用性评级与标准系统相似。模型对伤口类型的识别准确率较高，但对伤口类别的分类准确率较低。本初步研究首次评估了一款基于人工智能的应用程序，该应用程序支持压力性损伤和失禁相关性皮炎的护理伤口管理。虽然该应用程序没有减少护理时间或护士工作量，但它可能有潜力提高指南的依从性。限制包括有限的用户体验和样本偏差。未来需要更大样本的多中心研究和随机试验来验证研究结果并支持临床整合。注册www.drks.de DRKS00031355。2023年4月5日注册，2023年5月31日首次招聘。
{"title":"Effects of a transformer-based AI-based application to support incontinence-associated dermatitis and pressure injury assessment, nursing care and documentation: Controlled pilot intervention study","authors":"Hannah Pinnekamp , Vanessa Priester , Johanna Steidle , Khalid Majjouti , Alexander Brehmer , Michaela Tapp-Herrenbrück , Michael Aleithe , Jens Kleesiek , Bernadette Hosters , Uli Fischer","doi":"10.1016/j.ijnsa.2026.100479","DOIUrl":"10.1016/j.ijnsa.2026.100479","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) is playing an increasingly important role in nursing care, including wound management. Differentiating pressure injuries from incontinence-associated dermatitis is clinically challenging, often leading to misclassification. Although AI-based wound assessment is advancing, few models specifically address incontinence-associated dermatitis, and clinical evidence remains limited. The KIADEKU project developed and piloted a transformer-based AI app to support care for these wounds.</div></div><div><h3>Objective</h3><div>The aim of this pilot intervention study was to assess the impact of the AI-based app on duration of wound assessment, dressing changes, documentation, nursing staff task load, and guideline adherence. Secondary aims included evaluating the AI’s accuracy and app usability compared to standard systems.</div></div><div><h3>Design</h3><div>This monocentric, non-randomized controlled study was conducted in two sequential phases: a control phase with conventional wound management, followed by an intervention phase utilizing the AI-based app.</div></div><div><h3>Setting and Participants</h3><div>The study included 88 voluntary nurses caring for pressure injuries and incontinence-associated dermatitis in adult patients on seven participating wards of LMU Hospital.</div></div><div><h3>Methods</h3><div>Wound care was systematically observed, and nurses completed questionnaires on task load, usability, and covariates. Outcomes were measured using standardized protocols, validated tools (NASA Task Load Index (NASA-TLX), Usability Metric for User Experience (UMUX-LITE)) and expert-defined indicators. Statistical analyses included descriptive statistics, group comparisons (t-test, Mann-Whitney U test), and multivariate linear regression adjusting for covariates. An independent wound assessment validated AI-generated predictions, with accuracy evaluated using F1-scores.</div></div><div><h3>Results</h3><div>A total of 88 wound care sessions were analysed. The intervention group had a statistically significantly longer mean duration of care and documentation (12.84 vs. 9.20 min; p = 0.002; 95 % CI: –5.59; –1.41 min) and higher guideline adherence (mean rank = 50.91 vs. 38.38; p = 0.017). Nurse task load showed no statistically significant group differences. Regression analysis identified AI app use, nurse qualification, and wound severity as statistically significant predictors of care duration, while AI use did not predict task load or guideline adherence. Usability ratings were similar to standard systems. Model performance showed high accuracy in identifying wound types, but lower accuracy in classifying their categories.</div></div><div><h3>Conclusions</h3><div>This pilot study is the first to evaluate an AI-based app supporting nursing wound management for pressure injuries and incontinence-associated dermatitis. While the app did not reduce care duration or nurse workload, it may have po","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100479"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100480
Neeltje de Vries , Peter de Winter , Sanne Drost-Goossens , Hester Vermeulen , Catharina van Oostveen
<div><h3>Background</h3><div>The global nursing shortage poses a critical challenge to healthcare systems. The World Health Organization projects a shortage of 4.5 million nurses by 2030. Contributing factors include an aging workforce and an increasing rate of nurse turnover, driven by high workloads, limited development opportunities, and a lack of managerial support. Intentions to leave predict actual departure and threaten the quality of care, increase patient mortality, and impose high replacement costs. While retention strategies exist, many are not tailored to nurses because nurses’ subjective experiences and perspectives are lacking, potentially limiting their effectiveness. Engaging nurses in designing these interventions may enhance their relevance and impact.</div></div><div><h3>Objectives</h3><div>(i) Identify the key factors associated with nurses’ retention in hospitals, and (ii) provide an in-depth understanding of why nurses perceive these factors as critical in shaping their retention.</div></div><div><h3>Design</h3><div>A mixed-methods approach, utilizing Q-methodology and semi-structured interviews, was employed.</div></div><div><h3>Setting</h3><div>Dutch hospitals.</div></div><div><h3>Participants</h3><div>A diverse group of 26 practicing and three former nurses.</div></div><div><h3>Methods</h3><div>Participants ranked 58 statements in response to the prompt: “<em>I am willing to continue working as a nurse within the organization if…</em>” Consecutively, individual interviews were conducted to provide further insight into the reasoning behind nurses’ choices. Quantitative data were analyzed using centroid factor analysis with varimax rotation to identify shared viewpoints. Qualitative interview data were analyzed using the rigorous and accelerated data reduction method to deepen the understanding of the factors shaping nurses’ retention.</div></div><div><h3>Results</h3><div>A total of 29 Q-sorts and interviews were analyzed. This resulted in three factors: (A) ‘Challenging work and inclusive positioning for high-quality care’, (B) ’Room to excel in nursing roles’, and (C) ‘Being seen, heard, and valued’. Together, these perceptions shaped participants’ intention to stay. Additionally, a common pattern across all factors was participants’ perception of being structurally unheard.</div></div><div><h3>Conclusions</h3><div>A multifaceted interplay of factors influenced nurse retention. While meaningful and challenging tasks were essential, professional recognition, support systems, and growth opportunities were equally important. A systemic approach that addresses these various dimensions may be crucial for enhancing retention rates, maintaining a high-quality of patient care, and ultimately mitigating the impact of the nursing shortage in healthcare organizations. Nurses may play a crucial role in designing and implementing retention strategies. Their input is not just valuable but most likely necessary for the relevance and eff
{"title":"Key factors associated with nurse retention and how they work: A mixed-methods study","authors":"Neeltje de Vries , Peter de Winter , Sanne Drost-Goossens , Hester Vermeulen , Catharina van Oostveen","doi":"10.1016/j.ijnsa.2026.100480","DOIUrl":"10.1016/j.ijnsa.2026.100480","url":null,"abstract":"<div><h3>Background</h3><div>The global nursing shortage poses a critical challenge to healthcare systems. The World Health Organization projects a shortage of 4.5 million nurses by 2030. Contributing factors include an aging workforce and an increasing rate of nurse turnover, driven by high workloads, limited development opportunities, and a lack of managerial support. Intentions to leave predict actual departure and threaten the quality of care, increase patient mortality, and impose high replacement costs. While retention strategies exist, many are not tailored to nurses because nurses’ subjective experiences and perspectives are lacking, potentially limiting their effectiveness. Engaging nurses in designing these interventions may enhance their relevance and impact.</div></div><div><h3>Objectives</h3><div>(i) Identify the key factors associated with nurses’ retention in hospitals, and (ii) provide an in-depth understanding of why nurses perceive these factors as critical in shaping their retention.</div></div><div><h3>Design</h3><div>A mixed-methods approach, utilizing Q-methodology and semi-structured interviews, was employed.</div></div><div><h3>Setting</h3><div>Dutch hospitals.</div></div><div><h3>Participants</h3><div>A diverse group of 26 practicing and three former nurses.</div></div><div><h3>Methods</h3><div>Participants ranked 58 statements in response to the prompt: “<em>I am willing to continue working as a nurse within the organization if…</em>” Consecutively, individual interviews were conducted to provide further insight into the reasoning behind nurses’ choices. Quantitative data were analyzed using centroid factor analysis with varimax rotation to identify shared viewpoints. Qualitative interview data were analyzed using the rigorous and accelerated data reduction method to deepen the understanding of the factors shaping nurses’ retention.</div></div><div><h3>Results</h3><div>A total of 29 Q-sorts and interviews were analyzed. This resulted in three factors: (A) ‘Challenging work and inclusive positioning for high-quality care’, (B) ’Room to excel in nursing roles’, and (C) ‘Being seen, heard, and valued’. Together, these perceptions shaped participants’ intention to stay. Additionally, a common pattern across all factors was participants’ perception of being structurally unheard.</div></div><div><h3>Conclusions</h3><div>A multifaceted interplay of factors influenced nurse retention. While meaningful and challenging tasks were essential, professional recognition, support systems, and growth opportunities were equally important. A systemic approach that addresses these various dimensions may be crucial for enhancing retention rates, maintaining a high-quality of patient care, and ultimately mitigating the impact of the nursing shortage in healthcare organizations. Nurses may play a crucial role in designing and implementing retention strategies. Their input is not just valuable but most likely necessary for the relevance and eff","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100480"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100485
Majken Epstein , Marie Söderström , Ann Rudman , Philip Tucker , Anna Dahlgren
<div><h3>Background</h3><div>Newly graduated nurses often face demanding working conditions including high workload, stress, and irregular working hours. During the first years of practice, burnout symptoms are common. Recovery, including sleep, can be seen as a key protective factor in the associations between stress, shift work and negative health outcomes. Previously, a proactive, group-based intervention (recovery programme) for new nurses, promoting individual strategies for recovery, decreased burnout and fatigue symptoms post-intervention and showed preventive effects on somatic symptoms over time. To optimise the implementation and outcomes of an intervention, it is important to understand its mechanisms of impact (i.e., <em>how</em> it produces change) as well as to identify contextual factors influencing its implementation.</div></div><div><h3>Objective</h3><div>To deepen the understanding of the recovery programme’s mechanisms of impact and to explore how its implementation, including participants’ opportunities for recovery and the feasibility of recovery strategies, was influenced by the context.</div></div><div><h3>Design</h3><div>Qualitative descriptive design.</div></div><div><h3>Participants and setting</h3><div>Twelve nurses (nine women) who had participated in the intervention at four Swedish hospitals, between 12 and 25 months (<em>M</em> = 19) after participation.</div></div><div><h3>Methods</h3><div>Semi-structured individual telephone interviews were conducted and analysed using thematic analysis.</div></div><div><h3>Results</h3><div>The programme’s proposed mechanisms of impact, including increased knowledge about sleep, enhanced motivation for behavioural change, and the use of recovery strategies, were confirmed. Motivation to apply recovery strategies was supported by a shift in mind-set regarding the importance of self-care; to improve readability; and follow-up on the behavioural change process during sessions. Contextual factors influencing recovery opportunities and the feasibility of strategies were related to both the work context and the individual. These factors included demanding schedules, extended and disrupted working hours, workload, opportunities for recovery at work, social norms, the organisation of work procedures, private life circumstances, and the deprioritisation of personal recovery needs. Booster sessions and reminders were suggested to facilitate the continued use of recovery strategies after the programme.</div></div><div><h3>Conclusions</h3><div>When supporting nurses in developing individual recovery strategies, it is important to provide opportunities to share experiences with other new nurses and to follow-up on their behavioural change process. Importantly, several organisational factors should also be considered. Organisations should work systematically with the planning and management of working hours that promote recovery, create opportunities for recovery during work shifts, organise wo
{"title":"The importance of self-care and contextual factors: A process evaluation of a recovery intervention for new nurses","authors":"Majken Epstein , Marie Söderström , Ann Rudman , Philip Tucker , Anna Dahlgren","doi":"10.1016/j.ijnsa.2026.100485","DOIUrl":"10.1016/j.ijnsa.2026.100485","url":null,"abstract":"<div><h3>Background</h3><div>Newly graduated nurses often face demanding working conditions including high workload, stress, and irregular working hours. During the first years of practice, burnout symptoms are common. Recovery, including sleep, can be seen as a key protective factor in the associations between stress, shift work and negative health outcomes. Previously, a proactive, group-based intervention (recovery programme) for new nurses, promoting individual strategies for recovery, decreased burnout and fatigue symptoms post-intervention and showed preventive effects on somatic symptoms over time. To optimise the implementation and outcomes of an intervention, it is important to understand its mechanisms of impact (i.e., <em>how</em> it produces change) as well as to identify contextual factors influencing its implementation.</div></div><div><h3>Objective</h3><div>To deepen the understanding of the recovery programme’s mechanisms of impact and to explore how its implementation, including participants’ opportunities for recovery and the feasibility of recovery strategies, was influenced by the context.</div></div><div><h3>Design</h3><div>Qualitative descriptive design.</div></div><div><h3>Participants and setting</h3><div>Twelve nurses (nine women) who had participated in the intervention at four Swedish hospitals, between 12 and 25 months (<em>M</em> = 19) after participation.</div></div><div><h3>Methods</h3><div>Semi-structured individual telephone interviews were conducted and analysed using thematic analysis.</div></div><div><h3>Results</h3><div>The programme’s proposed mechanisms of impact, including increased knowledge about sleep, enhanced motivation for behavioural change, and the use of recovery strategies, were confirmed. Motivation to apply recovery strategies was supported by a shift in mind-set regarding the importance of self-care; to improve readability; and follow-up on the behavioural change process during sessions. Contextual factors influencing recovery opportunities and the feasibility of strategies were related to both the work context and the individual. These factors included demanding schedules, extended and disrupted working hours, workload, opportunities for recovery at work, social norms, the organisation of work procedures, private life circumstances, and the deprioritisation of personal recovery needs. Booster sessions and reminders were suggested to facilitate the continued use of recovery strategies after the programme.</div></div><div><h3>Conclusions</h3><div>When supporting nurses in developing individual recovery strategies, it is important to provide opportunities to share experiences with other new nurses and to follow-up on their behavioural change process. Importantly, several organisational factors should also be considered. Organisations should work systematically with the planning and management of working hours that promote recovery, create opportunities for recovery during work shifts, organise wo","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100485"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100483
Carley Moore, Olga Kozlowska, Marion Waite
<div><h3>Background</h3><div>Although clinical practice has been prioritised and operationalised globally, research activities remain underdeveloped and inconsistently supported in advanced practice roles. A focus on clinical tasks limits the growth of advanced practitioners as research leaders, negatively impacting job satisfaction, retention, and progression into consultant-level practice. Stakeholder attitudes and actions are central to shaping advanced practitioners’ engagement with research and their professional development. However, the interpretation and response to research as a core component remain poorly understood. This knowledge gap risks ineffective efforts to strengthen the research pillar of advanced practice, highlighting the need to better understand stakeholder perspectives to integrate research more effectively into advanced practice.</div></div><div><h3>Objective</h3><div>This scoping review aims to map how stakeholders interpret and respond to research within advanced practice and identify gaps in the conceptual, methodological, and theoretical aspects of the literature.</div></div><div><h3>Information Sources</h3><div>A systematic search was conducted in CINAHL, MEDLINE, and the British Nursing Database, focusing on English-language literature published between 2013 and 2025.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute method for scoping reviews and informed by the Patterns, Advances, Gaps, Evidence for Practice, and Research Recommendations framework, data were extracted, analysed, and synthesised. Data were presented in tabular form and supplemented with a narrative synthesis.</div></div><div><h3>Results</h3><div>The findings were mapped into four categories: 1) Research as a Role Expectation, 2) Contextual Factors Shaping Research, 3) Educational Preparation for Research, and 4) Interventions Supporting Research. While research is an expected feature of advanced practice, its engagement is often hindered by time constraints, heavy clinical workloads, lack of leadership, insufficient education, and limited clinical-academic collaboration. Research activities are commonly assessed using traditional metrics, such as publications, while neglecting ‘soft’ outcomes, including increased confidence, skill development, and influence on team culture. Furthermore, many studies lacked theoretical frameworks, limiting their explanatory power.</div></div><div><h3>Conclusions</h3><div>Research appears underdeveloped but is narrowly defined in advanced practice, often measured by traditional outputs rather than processes and impacts on learning and development. This review highlights the need for a comprehensive, theory-informed approach to understanding research in advanced practice. Such insights are crucial for shaping educational curricula, professional development, and organisational strategies to better support advanced practitioners as leaders and contributors to healthcare innovation.</div><div>Th
{"title":"Stakeholders' interpretations and responses to research as a feature of advanced practice: A scoping review","authors":"Carley Moore, Olga Kozlowska, Marion Waite","doi":"10.1016/j.ijnsa.2026.100483","DOIUrl":"10.1016/j.ijnsa.2026.100483","url":null,"abstract":"<div><h3>Background</h3><div>Although clinical practice has been prioritised and operationalised globally, research activities remain underdeveloped and inconsistently supported in advanced practice roles. A focus on clinical tasks limits the growth of advanced practitioners as research leaders, negatively impacting job satisfaction, retention, and progression into consultant-level practice. Stakeholder attitudes and actions are central to shaping advanced practitioners’ engagement with research and their professional development. However, the interpretation and response to research as a core component remain poorly understood. This knowledge gap risks ineffective efforts to strengthen the research pillar of advanced practice, highlighting the need to better understand stakeholder perspectives to integrate research more effectively into advanced practice.</div></div><div><h3>Objective</h3><div>This scoping review aims to map how stakeholders interpret and respond to research within advanced practice and identify gaps in the conceptual, methodological, and theoretical aspects of the literature.</div></div><div><h3>Information Sources</h3><div>A systematic search was conducted in CINAHL, MEDLINE, and the British Nursing Database, focusing on English-language literature published between 2013 and 2025.</div></div><div><h3>Methods</h3><div>Following the Joanna Briggs Institute method for scoping reviews and informed by the Patterns, Advances, Gaps, Evidence for Practice, and Research Recommendations framework, data were extracted, analysed, and synthesised. Data were presented in tabular form and supplemented with a narrative synthesis.</div></div><div><h3>Results</h3><div>The findings were mapped into four categories: 1) Research as a Role Expectation, 2) Contextual Factors Shaping Research, 3) Educational Preparation for Research, and 4) Interventions Supporting Research. While research is an expected feature of advanced practice, its engagement is often hindered by time constraints, heavy clinical workloads, lack of leadership, insufficient education, and limited clinical-academic collaboration. Research activities are commonly assessed using traditional metrics, such as publications, while neglecting ‘soft’ outcomes, including increased confidence, skill development, and influence on team culture. Furthermore, many studies lacked theoretical frameworks, limiting their explanatory power.</div></div><div><h3>Conclusions</h3><div>Research appears underdeveloped but is narrowly defined in advanced practice, often measured by traditional outputs rather than processes and impacts on learning and development. This review highlights the need for a comprehensive, theory-informed approach to understanding research in advanced practice. Such insights are crucial for shaping educational curricula, professional development, and organisational strategies to better support advanced practitioners as leaders and contributors to healthcare innovation.</div><div>Th","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100483"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.ijnsa.2026.100481
Lia G. Pinkus, Jodi L. Ford
Background
Adolescent psychiatric rehospitalization is a growing public health concern, with estimated readmission rates ranging from 12–38% worldwide. Despite its significant impact on youth development and long-term outcomes, limited research addresses the multifactorial determinants underlying readmission risk. The multilevel framework draws from ecological models to contextualize risk across the lifespan.
Objectives
This paper aims to provide (1) an overview of the scope of psychiatric rehospitalization during adolescence and into adulthood (2) a multilevel theoretical foundation of predictors for psychiatric rehospitalization and (3) potential avenues for future research and clinical practice.
Methods
Guided by a multilevel theoretical perspective, a descriptive analysis was conducted to identify potential individual, interpersonal, institutional and societal factors that may influence adolescent and future adult rehospitalization to inpatient psychiatric units.
Results
Key predictors of rehospitalization include severe psychiatric diagnoses, prior hospitalizations, family dysfunction, placement in out-of-home care, and inadequate aftercare services. Biological influences such as intergenerational trauma and epigenetic changes may further predispose adolescents to poor outcomes. Life transitions during sensitive developmental periods, socioeconomic disadvantage and minority status, although understudied, also contribute to disparities in mental health outcomes and rehospitalization.
Conclusions
Applying a multilevel theoretical perspective reveals that adolescent psychiatric rehospitalization is shaped by the intersection of biological, psychological, social, and structural factors. A comprehensive multilevel framework can inform future research, policy, and clinical interventions to promote long-term recovery and reduce psychiatric rehospitalization.
{"title":"Predictors of adolescent psychiatric rehospitalization: A multi-level framework","authors":"Lia G. Pinkus, Jodi L. Ford","doi":"10.1016/j.ijnsa.2026.100481","DOIUrl":"10.1016/j.ijnsa.2026.100481","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent psychiatric rehospitalization is a growing public health concern, with estimated readmission rates ranging from 12–38% worldwide. Despite its significant impact on youth development and long-term outcomes, limited research addresses the multifactorial determinants underlying readmission risk. The multilevel framework draws from ecological models to contextualize risk across the lifespan.</div></div><div><h3>Objectives</h3><div>This paper aims to provide (1) an overview of the scope of psychiatric rehospitalization during adolescence and into adulthood (2) a multilevel theoretical foundation of predictors for psychiatric rehospitalization and (3) potential avenues for future research and clinical practice.</div></div><div><h3>Methods</h3><div>Guided by a multilevel theoretical perspective, a descriptive analysis was conducted to identify potential individual, interpersonal, institutional and societal factors that may influence adolescent and future adult rehospitalization to inpatient psychiatric units.</div></div><div><h3>Results</h3><div>Key predictors of rehospitalization include severe psychiatric diagnoses, prior hospitalizations, family dysfunction, placement in out-of-home care, and inadequate aftercare services. Biological influences such as intergenerational trauma and epigenetic changes may further predispose adolescents to poor outcomes. Life transitions during sensitive developmental periods, socioeconomic disadvantage and minority status, although understudied, also contribute to disparities in mental health outcomes and rehospitalization.</div></div><div><h3>Conclusions</h3><div>Applying a multilevel theoretical perspective reveals that adolescent psychiatric rehospitalization is shaped by the intersection of biological, psychological, social, and structural factors. A comprehensive multilevel framework can inform future research, policy, and clinical interventions to promote long-term recovery and reduce psychiatric rehospitalization.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"10 ","pages":"Article 100481"},"PeriodicalIF":3.1,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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