SAGE Open Nursing最新文献

Introduction: Although leaders can foster psychological safety by encouraging moral behaviors, the link between the two remains unclear. Despite its importance in clinical education and patient safety, empirical research has not adequately explored the unique impact of nursing leaders' moral character and actions.

Objectives: This study not only examined the relationships between nursing leaders' moral leadership, nurses' psychological safety, team learning behaviors, and teams' psychological safety but also assessed whether moral leadership and sample characteristics predict nurses' and teams' psychological safety.

Methods: A quantitative cross-sectional design was employed. After a pilot study, an online survey using Google Forms was conducted over 1 month in 2024. To assess the concepts studied, 365 nurses were recruited from different hospitals using convenience snowball sampling, yielding a response rate of 73%.

Results: Responses were rated on a 5-point Likert scale. Nurses rated their leaders as moral. Individualized means varied across variables. Most leaders showed high integrity and temperament, but moderate courage and prudence. Nurses' respect was the highest moral subscale, followed by team learning. Teams' psychological safety was high, especially in risk-taking and expectations, but moderate in learning from failure and support. Moral leadership correlated with nurses' psychological safety and teams' safety. Moral leadership and work area predicted nurses' and teams' psychological safety.

Conclusions: These findings suggest that although moral leadership is perceived positively, its impact on psychological safety may vary depending on contextual factors such as organizational culture and leadership style. Nursing leaders' moral leadership and area of work were the shared determinants of nurses' and teams' psychological safety. Moral nursing leaders make a difference in the work environment. When nurses and nursing teams admire the qualities of their moral leaders, their psychological safety, including team learning behaviors, improves, resulting in several positive outcomes. Moral leadership contributes to psychologically safe environments by promoting openness, respect, and learning from failure. Future research should explore cross-cultural applications of moral leadership and its impact on team dynamics.

Introduction: Nurses' ability to understand and manage emotions may offer insight into why certain aspects of care are missed, alongside operational aspects, including staffing and workload. The current body of nursing literature has examined the structural and procedural dimensions of missed nursing care (MISSNCARE), frequently neglecting the significant influence of emotional factors in the provision of healthcare. Specifically, emotional intelligence (EI) may influence clinical decision-making by enhancing prioritization, stress management, and interpersonal communication, thereby reducing care omissions.

Objectives: This study aimed to examine the relationships and differences between the perceived types and reasons for MISSNCARE and registered nurses' (RNs) levels of EI. In addition, predictors of MISSNCARE were identified.

Methods: A quantitative cross-sectional design was used in the current study. A convenience sample of 285 RNs was recruited from different hospitals. Descriptive and inferential statistics were applied to analyze the data.

Results: The most frequent type of MISSNCARE activities was patient ambulation, and the most common reason for MISSNCARE was related to labor resources. Nurses perceived that they had higher-than-average levels of EI. A statistically significant, strong negative correlation was found between the perceived EI levels and types of MISSNCARE. The results also indicated that 42.90% of the variance in MISSNCARE was explained jointly by the role of EI, hospital type, gender, and marital status. Single and female nurses with higher EI levels and who worked in private hospitals reported lower incidences of MISSNCARE compared to their counterparts.

Conclusions: Nurses with higher levels of EI reported a lower incidence of MISSNCARE. Future research should consider more robust methods to enhance a more comprehensive understanding of the relationship between MISSNCARE and nurses' EI. The findings underscored the potential for strategic improvement in EI as a means to reduce instances of MISSNCARE and enhance the overall quality of patient care.

Background: Burnout is a growing occupational health issue among nurses, particularly those working in emotionally demanding units such as oncology and hematology. In Palestine, limited resources, high workloads, and political instability further exacerbate this challenge. Shift work, a necessity in hospital settings, has been linked to disrupted sleep patterns, emotional exhaustion, and burnout. However, limited evidence exists on its specific impact among Palestinian oncology nurses.

Objective: To examine the association between shift work and burnout among oncology/hematology nurses in Palestinian hospitals, and to explore gender-specific differences.

Methods: This cross-sectional study included 214 registered nurses working in oncology/hematology units across public, private, and nongovernmental hospitals in the West Bank and Gaza. Data were collected using a validated Arabic version of the Maslach Burnout Inventory-Health Services Survey (MBI-HSS). Burnout was assessed across three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Statistical analysis included t-tests, ANOVA, and multivariate linear regression.

Results: More than half of participants (57.2%) reported moderate levels of burnout. Emotional exhaustion was the most prevalent subscale (69.4%), followed by reduced personal accomplishment (53.3%) and depersonalization (45%). Shift workers demonstrated higher burnout scores, particularly among males. Younger age and fewer years of oncology experience were associated with greater burnout. Gender differences in subscale patterns were observed but not statistically significant.

Conclusion: Shift work contributes to increased burnout among Palestinian oncology nurses. Age and experience play moderating roles. Policy reforms are needed to address scheduling practices and improve mental health support for nursing staff.

Introduction: In nursing homes, registered nurses, associate nurses along with physiotherapists and occupational therapists represent different levels and length of education which may induce a struggle for power, status, and control affecting the clinical learning environment.

Objective: This study scrutinizes how closure strategies of power, status, and control among health professions may affect the clinical learning environment in nursing homes.

Design and methods: In a qualitative, explorative design a strategic sample was used to explore the experience of power, status, and control in three Norwegian nursing homes aimed at improving the clinical learning environment for healthcare students and apprentices. An interprofessional preceptor team and interprofessional learning teams were established in each of the three nursing homes, facilitating collaboration, competency development, and confidence among the preceptors. Data were collected by focus group discussions and field observations.

Results: The findings revealed a formal and informal hierarchy based on status and power among the health professions which influenced the clinical learning environment. Controlling routines became a strategy for the associate nurses to gain control over one's own work, and interprofessional collaboration was replaced by parallel practices. The apprentices followed their preceptors in daily routines and care, while the nursing students followed theirs, mainly conducting professional planning and development. The clinical learning environment was affected by perceived status differences between the professions, particularly evident when the learners participated in the interprofessional learning teams.

Conclusion: The findings disclosed challenges concerning interprofessional collaboration, communication, and quality in clinical practice, possibly due to a struggle for power, status, and control among health professions. This seemed to be mirrored in the clinical learning environment representing a negative impact on students' and apprentices' opportunities to experience interprofessional collaboration. Interprofessional preceptor teams and learning teams represent possibilities to improve learning conditions and facilitate basic nursing learning.

Background: Academic tripping, the phenomenon of students underperforming relative to their capabilities, presents a significant challenge in nursing education. Psychological factors such as self-control, fear of failure (atychiphobia), and learned helplessness are theorized to play a critical, yet underexplored, role in this process.

Aim: This study aimed to investigate the interrelationships between self-control, fear of failure, and learned helplessness among first-year nursing students who have experienced academic tripping.

Methods: A cross-sectional, exploratory design was employed with 370 first-year nursing students from two Egyptian universities, selected via convenience sampling. Participants completed validated Arabic versions of the Performance Failure Appraisal Inventory (PFAI), Learned Helplessness Scale (LHS), and Brief Self-Control Scale (BSCS). Pearson's correlation coefficient (r), ANOVA, and t-tests were used to analyze bivariate relationships and group differences. A path analysis was conducted to model the direct and indirect effects between the core variables.

Results: Participants reported moderate levels of learned helplessness (M = 44.12, SD = 5.32), self-control (M = 34.84, SD = 7.13), and fear of failure (M = 69.64, SD = 20.10). A significant negative correlation was found between self-control and learned helplessness (r = -0.235, p < .001). Path analysis revealed that self-control exerts a significant direct effect on reducing learned helplessness (β = -0.097, p = .005) and a stronger indirect effect by mitigating negative failure appraisal (β = -0.533, p < .001), which in turn predicts helplessness (β = 0.085, p < .001). Study hours and the presence of an academic tripping plan were also significantly associated with better psychological outcomes.

Conclusion: The findings demonstrate that self-control is a pivotal protective factor against learned helplessness, operating both directly and indirectly through its reduction of catastrophic failure appraisal. This suggests that interventions designed to enhance self-regulatory capacities and reframe cognitive appraisals of failure may be effective in breaking the cycle of academic tripping and fostering resilience among novice nursing students.

Introduction: Newly employed nurses often experience professional, psychological, and organizational challenges that may compromise their well-being, job satisfaction, and performance. Understanding these challenges in the Palestinian context is vital to inform supportive interventions.

Objectives: To assess the types and levels of workplace challenges faced by newly employed nurses in public and private hospitals in Hebron, Palestine.

Methods: A cross-sectional study was conducted among 167 nurses with one year or less of experience, recruited purposively from six hospitals. Data were collected using a validated self-administered questionnaire covering four domains: personal adjustment, patient and family interactions, workplace violence, and healthcare system challenges. Descriptive and inferential statistics were analyzed using SPSS version 20.

Results: Participants reported a moderate overall level of challenges (mean = 3.01). The most common issues were stress affecting performance, high workload, and sleep deprivation. Patient and family interactions (mean = 3.05) and healthcare system challenges (mean = 3.05) were rated highest, while workplace violence (mean = 2.99) and new nurse adjustment issues (mean = 2.96) also reflected moderate burdens. No significant differences were found by gender, education level, or hospital type; however, departmental differences were significant, with pediatric nurses reporting the greatest challenges (p < .001).

Conclusion: Newly employed nurses in Hebron face moderate, department-specific challenges shaped by systemic inefficiencies and cultural dynamics. Targeted interventions such as structured orientation, mentorship, workforce development, and stronger protections against workplace violence are essential to improve retention, job satisfaction, and the quality of healthcare delivery in Palestine.

Background: Nausea and vomiting negatively impact patients' quality of life and may influence systemic antitumour therapy (CHT). While delayed CHT-associated nausea (dCIN) is most commonly linked to moderate or highly emetogenic regimens, evidence suggests that it may also occur with low (LEC) and minimally emetogenic CHT (MinEC). This study aims to assess the occurrence and characteristics of dCIN in real-world clinical settings, with an emphasis on patients receiving LEC and MinEC.

Methods: In a prospective multicentre international cross-sectional study, adult oncology outpatients receiving systemic antitumour therapy rated the intensity of dCIN daily on a 0-100 visual analogue scale (VAS) for five consecutive days. The primary endpoint was dCIN occurrence in LEC and MinEC. Secondary endpoints included known risk factors and the relationship between dCIN and patient characteristics.

Results: Among 172 patients, 65 (38%) received LEC and 31 (18%) MinEC. Most patients received antiemetic therapy in accordance with MASCC/ESMO and ASCO guidelines. dCIN occurred in 18.5% (n = 12; 95% CI [10.5, 29.1]) of LEC and 3% (n = 1; 95% CI [0.04, 14.1]) of MinEC patients. Only 3 patients (1.7%) reported vomiting. Younger age and gastrointestinal tumours were independent risk factors for dCIN. Emetogenicity of therapy, fear, and prior CHT-associated vomiting did not remain significant in the model.

Conclusions: A considerable proportion of patients receiving LEC still experience dCIN in real-world clinical settings. These findings highlight the need for improved symptom management and tailored interventions beyond traditional emetogenic risk classification.The trial was registered at clinicaltrials.gov NCT04342780 (Date of registration: 03/25/2020).

Introduction: Newborn danger signs can lead to a high risk of morbidity and mortality without immediate medical interventions. Postnatal mothers are expected to identify these signs and seek appropriate medical care for their newborns where necessary. Cultural beliefs significantly impact how postnatal mothers seek healthcare for their newborns. These beliefs, rooted in traditions and often associated with evil spirits or reliance on traditional healing practices, have been observed across various cultures worldwide. The study explored cultural beliefs and health-seeking practices among postnatal mothers in the Bono East region of Ghana regarding newborn danger signs.

Methods: The study adopted the qualitative approach using a descriptive exploratory design. The study's theoretical framework was guided by the socioecological model by McLeroy et al.. Fifteen participants were selected using the purposive sampling technique. Data was collected by face-to-face interviews using a semistructured interview guide. With consent from participants, interviews were recorded and transcribed verbatim. The thematic analysis approach was employed to analyze the data.

Findings: The study revealed that, while participants were identified to have generally fair knowledge of newborn danger signs, beliefs in spiritual causes of newborn danger signs and use of readily available local remedies like fresh tomatoes and local gin for treating newborn conditions hindered proper health-seeking practice among postnatal mothers.

Conclusion: Findings of the study suggests recommendations for intensive, culturally sensitive health education campaigns at the community level and in the hospitals during antenatal and postnatal services to reduce the influence of cultural practices on newborn care.

Introduction: Home blood pressure monitoring is often considered less reliable than conventional blood pressure monitoring due to different factors.

Aim: To investigate variations in home blood pressure monitoring and associated factors, differences in measured blood pressure under varying conditions such as postural changes from sitting to standing, among adults with hypertension.

Methods: A systematic review of studies was conducted on adults (≥18 years) with hypertension. Peer-reviewed studies published between 1992 and 2025 were searched in the Web of Science, PubMed, MEDLINE, and CINAHL databases in August 2023 and September 2025. The review included studies on home blood pressure monitoring, the associated factors, and reported in systolic and/or diastolic values. The main outcome was variations in home blood pressure monitoring categorized as small (<5 mmHg), moderate (5-15 mmHg), or large (>15 mmHg). Associated factors were also identified and the findings were analyzed using narrative synthesis.

Results: A total of 2,843 peer-reviewed articles were identified across four databases, of which 33 met the inclusion criteria. Generally, variations in home blood pressure monitoring ranged from -21.8 to +9.5 mmHg for systolic blood pressure and from -5.0 to +5.5 mmHg for diastolic blood pressure, where the + and - signs indicate the direction of changes. Fifteen factors associated with variations in home blood pressure monitoring were identified and broadly categorized into patient, device, procedural, protocol, and observer factors with related subcategories.

Conclusions: There were variations in home blood pressure monitoring and were associated with the factors, ranging from large decreases to large increases in both systolic and diastolic blood pressures, among adults with hypertension. Therefore, when measuring and interpreting blood pressure at home, it is essential to consider the factors associated with the variations. Furthermore, this study serves as a baseline for future research. This review is registered in PROSPERO.

Introduction: Coronary artery disease is the leading cause of death, and one of the major health burdens worldwide. The prevalence of coronary artery disease in Ethiopia is increasing steadily irrespective of age and gender. Some of the risk factors are preventable and modifiable.

Objective: The aim was to examine the levels of knowledge, attitude, and practice of cardiac patients toward preventive measures of coronary artery disease.

Methods: An institution based cross sectional study was conducted in Tikur Anbessa Specialized Hospital between March and April 2022. A total of 402 patients were randomly selected. Interviewer guided standardized questioners were used to gather information from participants. Descriptive statistics was utilized to describe participant's characteristics and logistics regression analysis was employed to examine the relationship between independent and outcome variables. Level of significance was determined at p < .05 and 95% CI.

Result: A total of 320 participants with response rate of 83.3% were included. The mean age was 46.74 ± 14.15SD. Most (67.2%) of the respondents demonstrated good knowledge with mean knowledge score of 58 ± 15.96 SD. More than half of the respondents (54.4%) had good attitude, with mean attitude score of 60.4 ± 25.33SD. Half (50%) of respondents mean showed good practice with mean practice score of 55.13 ± 17.365. Upon logistic regression, variables namely, sex (AOR = 0.578, 95%CI: 0.332-0.879), and presence of comorbidity (AOR = 2.818, 95%CI: 1.029-7.713), were significantly associated with knowledge. Similarly, occupation (AOR = 0.66, 95%CI: 0.330-0.968), marital status (AOR = 0.545, 95%CI: 0.333-0.893), and sex (AOR = 0.506, 95%CI: 0.313-0.819), were significantly associated with practice of coronary artery disease prevention.

Conclusion: The study found that 67.2% of cardiac patients had good knowledge, 54.3% had a positive attitude, but only 50% practiced effective coronary artery disease prevention. Male gender, single marital status, unemployment, and presence of comorbidities were significantly associated with lower knowledge and poor preventive practices.