SAGE Open Nursing最新文献

Introduction: Children with Type 1 diabetes face complex medical and psychosocial challenges in school settings, often requiring support from educators, yet Jordanian teachers often lack sufficient training to support these students effectively.

Objectives: To evaluate the effectiveness of a structured, theory-based educational intervention in enhancing primary school teachers' knowledge, attitudes, and self-efficacy for managing Type 1 diabetes.

Methods: Quasi-experimental, non-equivalent control group, pre-test/post-test design. Eight public primary schools in Amman, Jordan, were purposively selected. A total of 139 teachers (intervention n = 78; control n = 61) completed validated Arabic questionnaires assessing Type 1 diabetes knowledge, attitudes, and self-efficacy before and after a single 3-h session grounded in Bandura's social cognitive theory. The session included presentations, group discussions, videos, and printed materials-repeated measures analysis of variance was used to evaluate the outcomes.

Results: The main effects of time, group, and their interaction were statistically significant (p < .001). In the intervention group, significant improvements from pre- to post-test in all outcome domains: knowledge (M = 56.11 to M = 77.15), attitudes (M = 94.23 to M = 102.87), and self-efficacy (M = 25.54 to M = 33.78) (p < .001). No significant changes were observed in the control group. Prior experience with students with Type 1 diabetes did not moderate any outcome.

Conclusions: A brief, structured, theory-driven educational session significantly enhanced teachers' preparedness to manage Type 1 diabetes in the classroom, supporting the integration of standardized diabetes education programs to foster safer, more inclusive school environments.

Introduction: Experiencing birth trauma can result in various mental health issues, such as posttraumatic stress disorder, postpartum depression, anxiety, and challenges with bonding. Typical signs of traumatic childbirth include flashbacks, nightmares, avoidance of reminders, physical distress when triggered, loss of sexual intimacy, neglect of gynecological care, mood swings, anger, and social withdrawal. This study is novel and significant providing in-depth insights that are often absent from existing literature.

Objectives: To investigate the traumatic birth experiences of Saudi mothers, as well as their perceptions of and reactions to traumatic childbirth.

Methods: An interpretative phenomenological qualitative study was conducted in one government hospital in the eastern province of Saudi Arabia. This study employed a purposive sampling method to recruit participants. The data collection involved conducting semistructured interviews with 15 participants whose first childbirth occurred within the previous 18 months and who perceived their birth experience or their baby's arrival as traumatic.

Results: An interpretative phenomenological analysis was used to analyze the data. From the analysis, one core category was identified when birth turns from a happy event into trauma, along with three themes: (a) birth trauma, (b) experiences of obstetric mistreatment, and (c) unable to experience positive emotions.

Conclusion: This study explored mothers' traumatic birth experiences and their emotional reactions, highlighting the need for better support and communication. The findings suggest that women should have the chance to share their childbirth experiences and should be assessed postpartum for signs of psychological distress. Implementing continuous, compassionate, and woman-centered care, involving partners, and understanding birth experiences can improve postnatal well-being. The findings suggest that midwives should focus on psychological health, with antenatal screening for birth-related fears, to identify at-risk women and tailor care to prevent trauma. Healthcare providers should prioritize continuous, woman-centered care as a vital part of organizational improvements to better address women's needs.

Introduction: Traditional clinical examination (TCE) and objective structured clinical examination (OSCE) are assessment methods that evaluate the ability of healthcare students to integrate their knowledge, skills, attitude, and clinical judgment in providing effective and safe care to patients.

Objectives: The study sought to assess the views and satisfaction of nursing students toward OSCE and TCE in Saudi Arabia.

Methods: This study was conducted in a college of nursing in Riyadh, Saudi Arabia.

Results: OSCE covered a wide range of knowledge areas, highlighted areas of weakness, and presented logical and appropriate clinical situations. The OSCE scores provided a true and standardized measure of essential clinical skills. The examination was well-designed and structured, was considered a fair assessment method, and was identified as the preferred form of assessment.

Conclusion: Both OSCE and TCE are widely used to assess the clinical competence of nursing students. They differ significantly in structure, scope, and objectivity.

Background: Ethical decision-making was a major challenge for healthcare professionals during the COVID-19 pandemic, particularly in contexts where religion and law strongly influence clinical practice. Both deontological and consequentialist ethical frameworks guide medical decisions; however, balancing these approaches is especially difficult during crises.

Objective: This study aimed to explore the ethical decision-making experiences of intensive care nurses during the COVID-19 pandemic within a Muslim community in Iran.

Materials and methods: A qualitative content analysis was conducted based on in-depth, semi-structured interviews with 14 intensive care nurses.

Results: Three main themes emerged: (a) Humanitarian commitment involving actions beyond formal duties; (b) Nursing practice influenced by legal and organizational frameworks; and (c) Application of a consequentialist perspective in decision-making. Nurses described acting ethically under legal constraints, sometimes prioritizing patients' welfare when physicians were unavailable, and balancing religious, ethical, and legal considerations in their practice.

Conclusion: Nurses' ethical decision-making was shaped by both professional and contextual factors, including law, religion, and cultural values. Their actions reflected a balance between deontological and consequentialist ethics rather than strict adherence to rigid legal or institutional rules. The findings highlight the need for context-sensitive ethical guidelines and support systems for nurses working under crisis conditions.

The Sickle Cell Data Collection program reported maternal death rates in California (2004-2014) of 629 per 100,000 for Black women with SCD, 12 per 100,000 for Black women without SCD, and 6 per 100,000 in the general population. Yet little is known about the lived experiences of pregnant Black women with SCD, or their perceptions of nurses as advocates. To explore how social structures shape maternal health, the complexities of pregnancy while living with SCD, and nursing's role in care and advocacy, a qualitative study using semi-structured interviews was conducted. An interpretive framework centered participants' voices and revealed key themes: (1) Trauma During Childbirth; (2) Dismissal, Disbelief, and Inadequate Pain Management; (3) Self-advocacy; and (4) Emotional and Psychological Impact. Together, these themes highlight the intersecting challenges of pregnancy faced by Black women with SCD and the transformative potential of compassionate, informed, and equitable care.

Introduction: Psychological first aid is an essential framework for delivering immediate emotional and psychological support to individuals affected by crises and traumatic events. Emergency nurses must possess adequate knowledge and preparedness to provide effective psychological first aid during emergencies.

Objective: This study aimed to assess the levels of knowledge and preparedness to provide Psychological First Aid (PFA) among emergency nurses working in hospitals across the West Bank, Palestine between February and April 2024.

Methods: A descriptive cross-sectional study was conducted between February and April 2024 among 164 emergency nurses working in 19 governmental and nongovernmental hospitals across nine cities in the West Bank, Palestine. Data were collected using an online structured questionnaire assessing nurses' knowledge of and preparedness for psychological first aid. Statistical analyses were performed using descriptive and inferential statistics to describe study variables.

Results: Most nurses had moderate knowledge of psychological first aid (71.3%), 14.6% had low knowledge, and 14.0% had high knowledge. In terms of preparedness, 51.2% reported being prepared, 31.7% were unprepared, and 17.1% were uncertain. Preparedness was significantly influenced by sex, workplace setting, and professional roles (p < .05).

Conclusion: Despite moderate knowledge levels, over half of the emergency nurses reported adequate preparedness to deliver psychological first aid, suggesting a readiness to respond but with insufficient theoretical grounding. The findings highlight the urgent need to integrate psychological first aid modules into emergency nursing curricula, conduct periodic simulation-based training, and develop standardized institutional protocols to ensure consistent and evidence-based PFA delivery across Palestinian hospitals.

Background: Virtual reality (VR) is increasingly recognized as a valuable adjunct in cancer supportive care, but evidence for its efficacy in reducing psychological distress during chemotherapy in Middle Eastern settings remains limited.

Objectives: To evaluate the effectiveness of immersive virtual reality as an engaging distraction on stress and anxiety among cancer patients during chemotherapy in Palestine.

Methods: Between June and September 2023, 150 cancer patients were randomly assigned to an intervention group (n = 75) receiving VR during chemotherapy or a control group (n = 75) receiving standard care. Outcomes were measured using the Generalized Anxiety Disorder scale (GAD-7) and Perceived Stress Scale (PSS-10) before and after intervention.

Results: Postintervention analysis revealed potential benefits with significantly lower stress levels in the experimental group (M = 17.7 ± 2.8) compared to controls (M = 19.2 ± 2.5; mean difference: 1.5 points, 95% CI 0.6, 2.4, p < .05, Cohen's d = 0.58, 95% CI 0.25, 0.91). Mean GAD-7 scores were significantly lower in the VR group (M = 6.2 ± 3.1) versus controls (M = 10.8 ± 4.2; mean difference: 4.6 points, 95% CI 3.3, 5.9, p < .001). 54.7% of VR participants (n = 41) achieved minimal anxiety compared to 26.7% of controls (n = 20) (Risk Ratio=2.05, 95% CI 1.35, 3.12). Effect sizes were moderate to large for both outcomes. The observed stress reduction of 1.5 points exceeds the established minimal clinically important difference (MCID) of approximately 1.0-1.5 points for the PSS-10, while the anxiety reduction of 4.6 points meets the MCID threshold of 4 points for the GAD-7.

Conclusion: Engaging distraction via virtual reality demonstrates potential benefit in reducing stress and anxiety among cancer patients during chemotherapy. However, this study design cannot isolate VR-specific immersive effects from general distraction. Future research with active control conditions is needed to establish VR's unique value proposition.

Introduction: Critical thinking, defined as the purposeful, self-regulatory judgment involving interpretation, analysis, evaluation, and inference, is a fundamental requirement for education in the healthcare field. Reflection, a metacognitive process that promotes self-awareness and deeper understanding of experiences, is regarded as one of the key strategies that enhances critical thinking disposition by fostering motivation and habitual application of these skills.

Objective: This study aimed to evaluate the effects of daily versus weekly reflection on the critical thinking disposition of nursing students, including its dimensions of engagement, innovativeness, and cognitive maturity.

Methods: This quasi-experimental study with a pretest-posttest design was undertaken at Birjand University of Medical Sciences, Birjand, Iran in 2023. Participants (n = 48; 24 per group) were recruited via census sampling method and randomly assigned into two daily and weekly reflection groups. The intervention was conducted during four weeks of clinical training. Data were collected through a demographic information questionnaire and Ricketts' critical thinking disposition questionnaire.

Results: No statistically significant differences were observed between the two groups concerning the mean scores for overall disposition towards critical thinking (p = 0.673, Cohen's d = 0.12) and for each of its dimensions: engagement (p = 0.740, Cohen's d = 0.08), innovativeness (p = 0.281, Cohen's d = 0.22), and maturity (p = 0.652, Cohen's d = 0.10) both before and after the intervention. Mean scores slightly increased in both groups post-intervention (daily: +3.2, 95% CI [1.5, 4.9] ; weekly: +2.8, 95% CI [1.0, 4.6]), though not significantly.

Conclusion: Considering that the mean score of critical thinking disposition and each of its dimensions after the 4-week intervention in the two groups had no statistically significant difference, therefore, it is suggested to investigate the long-term effect of daily and weekly reflection in future studies.

Background: Electronic Medical Records (EMRs) have become essential tools in modern healthcare, enhancing efficiency, safety, and quality of care. However, multiple factors influence nurses' satisfaction with EMR use.

Aim: To assess nurses' work satisfaction with EMR use and identify associated facilitators and barriers among nurses in Palestinian governmental hospitals.

Methods: A cross-sectional quantitative design was employed. A convenience sample of 190 nurses from medical and surgical wards was recruited. Data were collected using a self-administered questionnaire covering demographics, work environment variables, and an adapted version of the Nursing Work Satisfaction Questionnaire (NWSQ). Sample size was determined using G*Power software. Data were analyzed using SPSS.

Results: Among 190 nurses, 51.1% were aged 20-30 years, with nearly equal gender distribution. Most (63.1%) had received EMR training, and 53.2% perceived the system as user-friendly. 52.1% were satisfied with their work using EMRs. Regression analysis demonstrated that ease of system use (β = 0.274, p < .001), EMR training (β = 0.230, p = .020), technical support satisfaction (β = 0.148, p = .012), and age (β = 0.194, p = .045) remained significant predictors of nurses' work satisfaction after adjustment. The regression model explained 23.4% of the variance in work satisfaction (R ² = .234).

Conclusion: Nurses in Palestinian governmental hospitals reported moderate satisfaction with EMR use. Factors such as training, system usability, technical support, and age significantly contributed to satisfaction. Strengthening these areas may enhance the integration and effectiveness of EMRs in nursing practice.

Background: Objective structured clinical examinations (OSCEs) are widely used to assess nursing students' clinical skills. However, ensuring consistent scoring between examiners remains difficult, particularly for subjective areas such as communication.

Purpose: This study aimed to evaluate inter-rater agreement between two faculty examiners in a pre-graduation OSCE recommended for final-year pre-registration nursing students in Japan, comparing technical skill stations with communication-focused stations.

Methods: A total of 90 final-year nursing students completed two OSCE stations: one assessing technical procedures, the other assessing communication and patient education. Two examiners independently scored each aspect of performance using binary checklists. Inter-rater agreement was calculated using Cohen's kappa and prevalence- and bias-adjusted kappa.

Results: Higher inter-rater agreement was found for psychomotor items (e.g., auscultation) than for verbal or empathy-based items. In the technical station, agreement improved across successive circuits, suggesting examiner calibration. In contrast, in the communication station, agreement remained consistently low. Empathy-related items showed the greatest discrepancy between kappa and prevalence- and bias-adjusted kappa, highlighting challenges in evaluating subjective skills.

Conclusions: OSCE inter-rater reliability was higher for objective technical skills than for subjective communication skills and empathy-related behaviors, among pre-registration nursing students.

Implications for practice: Improving checklist clarity and providing targeted examiner training for communication and empathy-related items may enhance the reliability of OSCE scoring in nursing education.