SAGE Open Nursing最新文献

Introduction: Artificial intelligence (AI) is increasingly embedded in healthcare, reshaping clinical decision-making, care delivery, and professional nursing roles. Although nursing curricula now include digital health and informatics, they remain largely focused on technical skills and insufficiently prepare nurses for ethical, relational, and collaborative engagement with intelligent systems. As AI becomes an active participant in care processes, nursing education requires a human-centered framework that supports meaningful human-AI collaboration. This article aims to develop a theoretically grounded Fifth Industrial Revolution (5IR) framework to guide nursing curriculum redesign for ethical and effective collaboration with AI.

Method: A discursive conceptual approach was employed, integrating conceptual analysis with a structured but nonsystematic review of interdisciplinary peer-reviewed literature published between 2019 and 2025. The analysis was guided by 5IR theory, post digital theory, and sociotechnical systems thinking. Through iterative thematic synthesis, the literature was examined to identify core competencies, pedagogical strategies, and institutional conditions necessary for AI-integrated nursing education.

Results: Seven interrelated competency domains were identified through conceptual synthesis: technological fluency and algorithmic literacy, ethical and legal acumen, digital empathy and relational intelligence, critical thinking in AI-supported decision-making, interdisciplinary collaboration and systems thinking, adaptive learning and postdigital literacy, and cultural competence in global AI contexts. These findings informed the development of the 5IR Human-AI Collaborative Nursing Education Model, which comprises five interdependent components: sociotechnical foundations, a human-AI collaborative competency core, transformative curriculum pedagogies, a multistakeholder codesign ecosystem, and adaptive evaluation with continuous feedback.

Conclusion: The findings highlight a persistent gap between current nursing curricula and the ethical, relational, and sociotechnical demands of AI-enabled healthcare. The proposed model offers an adaptable, human-centered framework that positions nurses as ethical collaborators and codesigners of intelligent care systems, providing a foundation for future curriculum innovation, empirical research, and policy development.

Objectives: To explore the experiences of patients, carers, nursing students, and health care workers of the BOOST 2.0 implementation trial in the subacute geriatric rehabilitation ward and understand the factors influencing uptake and sustainability.

Methods: This research is a qualitative study using a thematic analysis approach. Semistructured individual and focus group interviews were conducted with various stakeholders who were involved in the implementation trial. A total of 11 focus groups and 31 individual interviews were included in the present study, which were recorded, transcribed verbatim, and coded using reflexive thematic analysis. After themes were constructed using open coding, they were presented using the Consolidated Framework for Implementation Research. Participant validation was conducted with members of the research team who were not involved with coding to ensure accuracy of the research findings.

Results: Three key themes were developed: (1) perceptions about the BOOST 2.0 intervention, (2) perceptions of the implementation strategy of BOOST 2.0, (3) BOOST 2.0 within the inner (ward) and outer (hospital) setting. Patients, carers, nursing students, and health care workers perceived that the BOOST 2.0 intervention would increase patient physical activity on the ward and facilitate quicker discharges. The use of nursing students to deliver exercise therapy was hindered by a perceived lack of confidence and clinical experience, conflicting clinical priorities, and placement policies. The use of allied health assistants was more acceptable to staff and patients due to their exposure to the ward.

Conclusion: This study provides insights into how the alternative health workforce can deliver health interventions in hospitals. Further research is needed to explore the effectiveness of using a diverse clinical workforce to deliver interventions that can improve outcomes for patients.

Introduction: Health habits like type 2 diabetes self-care may be influenced by masculinity. Nevertheless, there is limited evidence from research that quantitatively assesses the relationship between masculinity and self-care among Mexican adult men with type 2 diabetes.

Objective: The purpose of this study was to investigate the association between masculinity and self-care behaviors in Mexican adult men with type 2 diabetes.

Methods: A cross-sectional, correlational study was conducted with adult men previously diagnosed with type 2 diabetes at five primary healthcare centers. Data was gathered between February and June of 2019. The Conformity to Masculine Norms Inventory and Summary of Diabetes Self-Care Activities questionnaire were employed. SPSS v.26 was used to conduct correlations and multiple linear regression analysis.

Results: A total of 221 adult males participated (mean age = 52.4 years, SD = 9.8; time of diabetes evolution = 8.9 years, SD = 5.8). Alcohol consumption was reported by 42.5%, 25.3% reported smoking, and 17.6% stated having previously been diagnosed with hypertension. Masculinity was negatively correlated with self-care behaviors, including diet (r = -.200, p = .003), self-monitoring of blood glucose (r = -.133, p = .038), foot care (r = -.268, p = .001), and oral hygiene (r = -.283, p = .001). Homophobia, self-reliance, risk-taking, violence, and control over women were aspects of masculinity that were negatively associated with self-care. In regression analyses, total masculinity predicted lower diabetes self-care, with homophobia and violence emerging as significant negative predictors.

Conclusions: Masculinity was negatively associated with self-care in Mexican adult men with type 2 diabetes, particularly in the dimensions of diet, self-monitoring of blood glucose, foot care, and oral hygiene. In order to increase self-care adherence, improve glycemic control, avoid complications, and lower premature mortality, future interventions should address these features of masculinity.

Introduction: Vulnerability is a fundamental human condition shaped by existential interdependence and social structures. In nursing, it is experienced by both patients and nurses, influenced by care relationships, institutional norms, and ethical responsibilities. This review explores how the phenomenon of vulnerability is reflected in the research literature on nursing clinical practice, from both patient and nurse perspectives.

Methods: A qualitative literature search of eight bibliographic databases (inception to 13 May 2025) identified 29 papers, assessed using the Critical Appraisal Skills Programme Qualitative Checklist (CASP-QC). Data were analysed through qualitative content analysis inspired by Graneheim, Lundman and Lindgren.

Results: Socioeconomic and sociopolitical conditions shape vulnerability by influencing care needs and perceptions of healthcare and nursing. Physical changes that compromise bodily autonomy expose patients to undignified care, as loss of control over one's body can lead to embarrassment, shame, and diminished dignity. A lack of holistic care increases patient vulnerability when professionals fail to recognise patients as unique individuals. Nurses' vulnerability is portrayed as a significant burden, shaped by personal suffering, grief, and contextual work factors. This suffering may result in emotional distancing from patients when nurses lack the courage to engage.

Conclusion: Vulnerability is multifaceted, shaped by personal, relational, and sociopolitical conditions. Patients often experience vulnerability through lack of recognition of individuality and dignity, while nurses face emotional strain, knowledge gaps, ethical tensions and limited support. Vulnerability can also be viewed as a strength, fostering ethical sensitivity, moral courage and deeper nurse-patient relationships.

Background: Chronic obstructive pulmonary disease (COPD) remains a pressing global health challenge, characterized by progressive respiratory impairment and substantial impacts on quality of life.

Objectives: This study aimed to examine the level of medication adherence among patients with COPD in Jordan and explore the relationship between medication adherence and illness perception (IP) among patients with COPD in Jordan.

Materials and methods: A cross-sectional, correlational design was used to recruit a convenience sample utilizing the Medication Adherence Report Scale Questionnaire (MARS-5), and the Brief Illness Perception Questionnaire (Brief IPQ) was utilized. The study was conducted in the outpatient pulmonary clinics of four major referral hospitals in Jordan.

Results: The study involved 169 COPD patients, with a majority being married and male. Most had bachelor's degrees, making between 300 and 500 Jordanian Dinar. 39.1% had 1-3 family members, with 66 reporting family members. The study used a medication adherence reporting scale to evaluate patients' medication adherence. The mean score was 23.17, with 91.1% of COPD patients adhering to their treatment regimen, while 8.9% were non-adherent. The majority were unlikely to forget, alter dosage, discontinue, skip doses, or use less than prescribed. The study found that timeline acute/chronic, consequences, personal control, treatment control, coherence, and timeline cyclical positively correlated with the MARS-5 mean score, indicating high scores correlate with high medication adherence, while emotional representation had no significant correlation.

Conclusion: The study found that COPD patients in Jordan demonstrated high medication adherence and generally positive IPs, particularly regarding treatment effectiveness, illness coherence, and personal control. These findings underscore the importance of patient-centered education and supportive interventions to enhance adherence and self-management.

Introduction: Stroke affects patients' physical, psychological, and social well-being, with many survivors suffering anxiety, depression, and a decline in quality of life (QOL). These problems remain underexplored among Middle Eastern populations.

Objectives: This study aimed to assess levels of stroke-related anxiety, depression, and QOL, as well as to determine their associated factors and predictors among Iraqi patients with stroke.

Methods: A cross-sectional descriptive correlational design was used, employing the Stroke-Specific Quality of Life (SS-QOL) scale and Hospital Anxiety and Depression Scale on 200 Iraqi stroke survivors.

Results: The sample consisted of middle-aged and older adults, with a mean age of 58.3 years and 42% of participants aged 65 or above; 52.5% were male. Clinically significant levels of anxiety and depression were reported, with a mean score of 12.2 (SD = 3.4) for anxiety, and 11.46 (SD = 3.45) for depression. Higher risk was observed in older, unmarried, unemployed patients and those in early or intermediate stages since stroke onset. Levels of QOL poorly declined poststroke and were below the theoretical mid-range levels of SS-QOL, with mean SS-QOL = 82.6 (SD = 30.2; range = 49-129). Predictor variables of poor QOL included advanced age (B = -0.647, p < .001), unmarried status (B = -5.85, p < .01), hypertension (B = -4.73, p < .05), early post-stroke stage vs chronic (B = -19.8, p < .001), intermediate vs chronic stage (B = -11.3, p < .001), and clinically significant levels of anxiety (B = -6.61, p < .01) and depression (B = -23.6, p < .001). Together, these predictors explained 87% of the variance in QOL (adjusted R ² = .874, F(18,181) = 77.5, p < .001). Severe depression emerged as the strongest predictor, accounting for 31% of variance (t(181) = -23.6, p < .001; sr² = .310).

Conclusions: Iraqi stroke survivors experience severe levels of anxiety and depression, consistent with poor QOL, and are influenced by socio-demographic and clinical factors. Early assessment and targeted management of high-risk groups by healthcare providers should be considered with the objective of optimizing recovery and rehabilitation. Depression is of great clinical importance due to its significant impact on QOL.

Introduction: Practical skills supervision is essential in nursing placement education, allowing students to bridge theoretical knowledge with hands-on experience. Registered nurse mentors, with their professional experience and expertise, are key in this process. However, there is limited knowledge about registered nurse mentors' experiences of practical skills supervision in clinical placements.

Objective: To explore registered nurse mentors' experiences of practical skills supervision. This study therefore aimed to explore factors influencing registered nurse mentors when supervising student nurses during their practical skills learning.

Methods: An exploratory qualitative design was employed. The study was conducted at two hospitals affiliated with one bachelor nursing education program. The study employed a purposive sampling method, intentionally selecting registered nurse mentors based on their experience in relation to the study's objective. Data were collected during the Covid-19 pandemic through individual interviews including ten registered nurse mentors. The pandemic itself did not, however, influence the data. A thematic analysis approach was used for data analysis.

Results: Two main categories and four sub-categories related to registered nurse mentors' experience with practical skills supervision were identified: (1) external factors at the clinical placement venue influencing registered nurse mentors' supervision and (2) factors inherent in the registered nurse mentor role influencing supervision.

Conclusion: Educational institutions and clinical placements should work together to strengthen the supervision competencies of registered nurse mentors, as their collaboration is essential for optimizing students' learning experiences and fostering the development of practical skills during hospital placements. Results from the present study can inform the design of registered nurse mentoring programs.

Background: During the COVID-19 pandemic, nurses faced increased psychological burdens due to prolonged exposure to patients, resulting in diminished quality of life (QOL). Sense of coherence (SOC) has been recognized as a crucial psychological resource that enhances coping capacity and promotes QOL.

Objectives: This study aimed to examine the factors associated with QOL among nurses, particularly focusing on the role of SOC in mitigating job stress during the COVID-19 pandemic.

Methods: A cross-sectional survey was conducted among 798 staff nurses at a university hospital in Japan in December 2021 using four validated self-administered measures to assess SOC, job stress, social support, and QOL. Of the distributed questionnaires, 144 were returned (response rate: 18%). Multiple regression analyses were performed to explore factors predicting mental health-related QOL.

Results: Among nurses who cared for COVID-19 patients, job stress (β = 0.311, p = .018) and the manageability subscale of SOC (β = 0.282, p = .047) significantly predicted higher QOL scores. These associations were not observed among nurses who did not care for COVID-19 patients.

Conclusions: Enhancing the manageability aspect of SOC may be a protective factor against psychological stress in nurses caring for COVID-19 patients. These findings highlight the importance of localized psychological support strategies－such as structured peer support, resilience training, and organizational transparency－to help nurses maintain mental well-being and QOL during and beyond pandemic conditions.

Background: Anemia is characterized by reduced hemoglobin, hematocrit, or red blood cell counts below normal levels for age, sex, and race. In 2019, globally, the prevalence of anemia in children aged 6 to 59 months was 39.8%, with the highest rate in the African Region at 60.2%. In Ethiopia, this rate reached 52.1%. This study aimed to assess the prevalence and associated factors of anemia in children under five in Ethiopia.

Method: A quantitative cross-sectional study was conducted at Wolkite Health Center and Hospital in March 2024. Participants were selected through systematic sampling, and data were collected via structured interviews and venous blood samples. Data analysis was performed using SPSS version 25, focusing on descriptive statistics and multivariable analysis to identify significant associations, with a significance level set at P ≤ .05.

Results: The overall prevalence of anemia among 164 participants was 39.0%, with 22.6% classified as mild, 13.8% as moderate, and 2.6% as severe. Anemia was significantly associated with inadequate dietary diversity (adjusted odds ratio [AOR] = 2.218, 95% confidence interval [CI] = 1.253-3.925) and underweight status (AOR = 2.835, 95% CI = 1.151-6.982).

Conclusion: Childhood anemia is a moderate public health issue in the study area, with significant links to recent malaria infections, inadequate dietary diversity, and underweight status. Addressing these factors is essential for improving child health outcomes.

Introduction: Index case human immunodeficiency virus (HIV) testing is a key strategy to identify those most at risk of acquiring HIV, with a high yield of positive cases.

Objective: To assess the acceptance rate of index case HIV testing and its associated factors among patients receiving anti-retroviral therapy in a public health facility in Arba Minch town, Southern Ethiopia, 2024.

Methods: A facility-based, retrospective study was conducted from July 1 to 15, 2024. The total sample size was 379, and a simple random sampling technique was used to select clients' cards. Data were entered into Epi Data version 3.1 and then exported to statistical package for social science version 25 statistical software for analysis. Binary logistic regression analysis was used to check the association. Finally, significant independent associations were identified with a p-value less than 0.05 and a 95% confidence interval (CI).

Result: The acceptance of index case HIV testing among patients on anti-retroviral therapy follow-up was 72.8% with a 95% CI (68.6-77.4). Gender [adjusted odds ratio (AOR): 2.69, 95%CI: 1.46-5.37], place of residence [AOR: 2.35, 95%CI: 1.26-4.39], WHO clinical stage I [AOR: 0.07, 95%CI: 0.01-0.59], WHO clinical stage II [AOR: 0.09, 95%CI: 0.01-0.89], duration on ART [AOR: 2.61, 95%CI: 1.23-5.55], disclosure status [AOR: 5.53, 95%CI: 2.87-10.65], and educational status of the partner [AOR: 0.12, 95%CI: 0.04-0.44] were associated.

Conclusion: Seven in 10 patients on anti-retroviral therapy follow-up accept index case HIV testing. Gender, place of residence, WHO clinical stage, duration of anti-retroviral therapy, exposure status, and spouse education were associated with HIV testing acceptance. Thus, gender identity, urbanization of the index case location, description of the index case at the WHO clinic level, reporting of cases to household members, and improving spouse education would increase acceptance.