SAGE Open Nursing最新文献

Introduction: Progressive muscle relaxation (PMR) is a structured technique that induces relaxation by alternately tensing and relaxing muscle groups, supporting both physical and psychological well-being. Slow stroke back massage (SSBM) is also recognized as a therapeutic method that enhances comfort and reduces stress. Given the susceptibility of older adults to hypertension, psychological stress, and sleep disturbances, evaluating the effects of these non-pharmacological interventions remains highly relevant. This review aimed to examine the effects of PMR and SSBM on blood pressure reduction, stress alleviation, and sleep quality improvement among older adults.

Methods: A scoping review was conducted following the Arksey and O'Malley (2005) framework, refined by Levac et al. (2010), and reported according to PRISMA-ScR guidelines. Literature searches were performed in Scopus, ProQuest, PubMed, and Google Scholar for studies published between January 2019 and March 2024. The Boolean strategy combined search terms related to PMR, SSBM, blood pressure, stress, and sleep quality. Eligible studies included empirical research among with older adults that assessed PMR or SSBM with outcomes on blood pressure, stress, or sleep. Non-empirical articles, studies involving children, non-English publications, and studies with poor methodological quality were excluded. After duplicate removal and screening, 10 studies were included in the synthesis. Data were extracted using a standardized form and were analyzed thematically.

Results: Ten studies met the inclusion criteria and contributed to two major themes. First, PMR significantly reduced systolic and diastolic blood pressure, lowered heart rate, decreased stress and anxiety scores, and improved sleep quality. Second, SSBM helped stabilize blood pressure, reduce stress and depressive symptoms, and enhance sleep comfort in older adults.

Conclusion: PMR and SSBM are effective, evidence-based, non-pharmacological interventions for improving cardiovascular and psychological outcomes in older adults. Both techniques may be recommended as complementary therapies in geriatric nursing practice.

Introduction: Patient safety issues have become a priority in health policy and health systems governance. This priority has drawn attention to health professionals' licensing and effectiveness of the nursing curriculum in preparing students with the appropriate patient safety competencies. Despite their crucial role, there is a notable gap in the literature regarding the comprehension and competency of nursing students in patient safety within Iran.

Objective: This multicenter cross-sectional correlational study aimed to investigate the relationship between cultural competence, patient safety culture, and safe nursing care (SNC) among nursing students in southern Iran.

Methods: A total of 238 nursing students enrolled in clinical internship courses between November 2024 and February 2025 at three medical universities in Fars Province, Iran, were recruited using a census sampling approach. Data were collected through four instruments: (a) a demographic questionnaire; (b) the Hospital Survey on Patient Safety Culture, which measures perceptions of safety culture; (c) the Inventory for Assessing the Process of Cultural Competence, which evaluates cultural competence across five domains; and (d) the SNC tool, which assesses nursing performance in clinical skills, teamwork, and patient safety.

Results: The students reported moderate to high levels of cultural competence (75.73 ± 17.2), moderate perceptions of patient safety culture (116.02 ± 21.25), and moderate to good performance in SNC (245.29 ± 59.16). Correlational analysis revealed statistically significant and positive associations among the three constructs, with patient safety culture strongly correlated with SNC (r = 0.68, p < .001) and moderately correlated with cultural competence (r = 0.50, p < .001). In the SNC model (Adjusted R ² = 0.46), academic year remained the strongest predictor (B = 44.536, 95% CI [33.201, 55.870], p < .001), highlighting the critical role of academic progression in enhancing safe care performance.

Conclusion: These findings underscore the need to integrate structured cultural competence and patient safety education into nursing curricula while expanding clinical learning opportunities in diverse healthcare environments. Furthermore, experiential training in multicultural settings may foster a deeper understanding of cultural and safety principles, thereby improving the quality of care at both individual and organizational levels.

Introduction: This systematic review provides the first comprehensive synthesis of empirical studies on Artificial Intelligence (AI) integration in nursing education, offering actionable insights for nurse educators and clinical leaders. It highlights how AI transforms learning environments by enhancing personalization, feedback, and instructional efficiency.

Aims: To examine how AI is applied across nursing education settings and its impact on learning outcomes.

Methods: A systematic search of PubMed, CINAHL, IEEE Xplore, and Scopus identified peer-reviewed studies published from January 2010 to April 2025. Eligible studies focused on empirical AI applications in academic, clinical, or hybrid nursing education contexts. Studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist, and findings were synthesized thematically.

Results: Twenty-eight studies met the inclusion criteria. AI-enhanced nursing education in four main areas: (a) personalized learning systems tailored content to individual needs, (b) simulation-based training improved decision-making in high-acuity scenarios,(c) automated assessment tools provided immediate, unbiased feedback, and (d) at the institutional level, AI supported curriculum management and predictive analytics. Common risks included technological inequities, faculty preparedness gaps, and ethical concerns around privacy and bias.

Conclusion: To support implementation, this study recommends: (a) integrating AI-powered simulation into emergency care training, (b) deploying adaptive platforms to support at-risk learners, and (c) using automated tools for real-time formative feedback. Diagnostic accuracy is proposed as a measurable outcome to assess impact. The next step for educators is to initiate multi-site pilot programs over 6-12 months, evaluating improvements in learning outcomes, trust, and system integration.

Background: In healthcare settings, staff and their leaders frequently struggle to support colleagues who are affected by adverse events, often referred to as second victims. Existing support systems have proven inadequate, leaving a gap in addressing both emotional and professional needs.

Aims: This work aims to explore the effect of educating and training charge nurses through targeted programs, while strengthening the hospital's support infrastructure.

Methods: The initiative was developed by the Patient Safety and Risk Management unit of an acute care hospital, which includes ambulatory clinics, with support from the hospital's Human Resources unit. A structured educational and training program, led by a psychologist, was designed to equip charge nurses with skills to effectively support second victims. The program included three 8-h sessions with theoretical instruction, simulations, role-playing, and reflective discussions on charge nurses' roles. The Theory of Change approach was used to define the causal pathway from training to improved peer support, clarify key assumptions, and guide evaluation. The work adheres to SQUIRE 2.0 guidelines for nonrandomized evaluations.

Findings: The intervention received positive feedback, with charge nurses reporting increased confidence in supporting second victims. Early indicators suggest improved peer support and staff awareness. Ongoing monitoring and adaptation will ensure program effectiveness.

Conclusions: Integrating charge nurses as second victim supporters strengthens resilience and psychological safety. Future steps include continuous assessment, content refinement, and evaluation of long-term outcomes to ensure sustained impact.

Background: The code of ethics identifies the moral and ethical obligations inherent in the midwife's professional role. The practice of a code of ethics for midwives is important for the quality of care.

Objective: To assess the level of practice of the professional code of ethics, identify associated factors, and explore barriers to its practice among midwives in referral hospitals of the Amhara regional state, Ethiopia.

Method: An institutional-based cross-sectional study with concurrent triangulation of a qualitative component was conducted from December 1, 2023 to January 30, 2024. A simple random sampling technique was used to select 423 study participants. Qualitative participants were selected purposively until saturated information was obtained. The P-value <.05 was used to assert statistical significance in multivariable analysis. For the qualitative component, participants were selected purposively, and data were collected through in-depth interviews using semistructured questions. The data were analyzed using thematic analysis.

Results: This study revealed that 222 (53.5%) (95% confidence interval [CI]; 48.6%, 58.4%) midwives had good practice of the code of ethics. Training on the code of ethics (adjusted odds ratio [AOR] = 2.12, 95% CI: 1.10, 4.09), good knowledge about the code of ethics (AOR = 4.97, 95% CI: 2.89, 8.56), favorable attitude toward the code of ethics (AOR = 2.63, 95% CI: 1.58, 4.39) and job satisfaction (AOR = 1.83, 95% CI: 1.12, 2.98) were significantly associated with the practice of the code of ethics. Individual factors, institutional factors, patient-related factors, and current political instability emerged as themes representing barriers to the practice of the code of ethics.

Conclusions: According to the findings of this study, the practice of the code of ethics was lower than national expectations, as every healthcare provider had a responsibility to work in line with the professional code of ethics. Strengthening training programs, enhancing knowledge development, and fostering job satisfaction are also crucial for improving the practice of a code of ethics.

Introduction: Climate change poses a major threat to the health and well-being of people around the world, especially vulnerable groups such as pregnant women. Nurses need to be actively involved in addressing the health impacts of a changing climate. It is very important to help and take care of people who are pregnant. Knowing about and dealing with how climate change affects towns and pregnant women is extremely important.

Objective: To assess how nurse education modules about climate change affect pregnant women's reported practice and quality of life (QoL).

Method: A quasi-experimental (one-group pre-posttest) design was utilized. The obstetrics and gynecological outpatient clinic at Benha University Hospitals served as the study's site, a purposive sample of 128 pregnant women. Four instruments were employed to gather data: tool (a) Structured interviewing questionnaire, tool (b) Maternal knowledge questionnaire, tool (c) Maternal reported practices, and tool (d) World Health Organization QoL. Nurses received structured training prior to implementing the educational modules, the training included orientation on the module content, demonstration of teaching steps and supervised practice to ensure standardization. Nurses' competency was evaluated using a checklist before applying the modules with participants.

Results: Comparing the postintervention phase to the preintervention phase revealed a highly statistically significant difference in knowledge, QoL, and practices regarding heat stress and climate change (p ≤ .000). The results clarified that, about one third of the studied sample had adequate knowledge regarding climate change and heat stress in the preintervention compared to two-thirds at postintervention phase. The mean score of the overall QoL was increased from 61.91 ± 7.46 prior intervention to 96.42 ± 11.39 postintervention, as well as, the total mean score of reported practices was improved from 41.28 ± 7.27 prior intervention to 63.15 ± 5.24 postintervention. The results confirming the impact of the educational module in improving the studied sample's knowledge, reported practices and QoL regarding climate change and heat stress.

Conclusion: The study showed that the nursing educational module on climate change had a positive effect on pregnant women' QoL and their reported practices. To maintain these improvements over time, it's recommended to integrate the module into routine nursing training and maternal and maternal care programs. Incorporating this approach in to daily practice could help ensure sustainable benefits and promote healthier outcomes for mother and their babies in the context of environmental changes.

Background: Diabetes health literacy (DHL) and self-care behavior play an important role in avoiding and controlling complications of diabetes mellitus and are positively associated with good glycemic control and quality of life improvement. However, we lack evidence describing their magnitude in the East Arsi zone of the Oromia regional state of Ethiopia.

Objectives: This study was aimed to assess the magnitude of DHL, self-care behavior, and associated factors among adult diabetes patients attending follow-up care at selected public hospitals in the East Arsi zone, Oromia, Ethiopia, 2025.

Methods: An institutional based cross-sectional study was employed in five public hospitals found in the East Arsi zone. A total of 468 participants were included using a simple random sampling technique. Data were collected using a structured questionnaire and analyzed using binary logistic regression to assess associations between dependent and independent variables.

Result: More than half of the study participants (57.7%) exhibited low DHL, while 55.6% demonstrated poor self-care behavior. Significant factors associated with low DHL included being male, low education level, residing in rural areas, lack of diabetes education attendance, poor self-care behavior, and receiving diabetes information from only one source. Additionally, younger individuals, those living in rural areas, lack of exposure to diabetes education, and lower monthly incomes were significantly linked to poor diabetes self-care behavior.

Conclusion: These findings highlight the urgent need for targeted educational and behavioral interventions, particularly among rural residents, males, individuals with low income, low education, and those lacking exposure to diabetes education, to enhance DHL and improve self-care practices.

Introduction: Blood pressure control is critical in acute ischemic stroke patients undergoing thrombectomy. Fluctuations in blood pressure can compromise cerebral reperfusion and influence 90-day functional prognosis. However, the relationship between blood pressure and prognosis remains unclear.

Objective: To examine the impact of blood pressure control strategies on 90-day functional prognosis, intracranial hemorrhage, mortality, and neurological deterioration in patients with acute ischemic stroke following thrombectomy.

Method: We systematically searched major Chinese/English databases up to April 2025 for interventional studies on post-thrombectomy blood pressure management in acute ischemic stroke. Dual-reviewer screening with predefined criteria identified eligible studies. Cochrane Risk of Bias Tool assessed methodological quality. Data extraction and random-effects meta-analysis (RevMan 5.1) evaluated pooled risk ratios (95% confidence intervals), with heterogeneity quantified via I ² statistics.

Results: This meta-analysis of 12 studies (n = 4,794) found no significant benefit of intensive over standard blood pressure lowering in functional recovery, hemorrhagic risk, mortality, or early neurological outcomes post-thrombectomy. However, subgroup analyses revealed critical associations: lower systolic blood pressure correlated with functional independence (-4.46 mmHg), while elevated levels were linked to intracranial hemorrhage (+6.55 mmHg) and mortality (+3.12 mmHg).

Conclusion: The meta-analysis findings suggest that individualized blood pressure thresholds, rather than uniform intensive control, may optimize postintervention outcomes, warranting further prospective validation.

Introduction: Peripheral artery disease (PAD) is a chronic condition caused by atherosclerosis, leading to limb ischemia and reduced quality of life. While surgical interventions like angioplasty improve vascular patency, postoperative exercise rehabilitation is critical but often sees low adherence, with dropout rates over 60%. Research often overlooks patients' subjective experiences and barriers to rehabilitation.

Aim: This study explores postoperative exercise rehabilitation behaviors in PAD patients, aiming to identify influencing factors and inform targeted intervention strategies to enhance recovery and quality of life.

Methods: A qualitative study involved 18 PAD patients (mean age 63.1 ± 13.1 years, 77.8% male) from Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, engaged in exercise rehabilitation for ≥2 months. Semi-structured interviews (40-60 min) were conducted from December 2024 to February 2025 until data saturation. Data were analyzed using NVivo 12, with themes identified through peer debriefing and an audit trail to ensure credibility.

Results: Patients reported partial walking improvements, though recovery varied by age and compliance. Low-intensity exercises like walking were preferred. Facilitators included medical guidance, perceived functional gains, social/familial support, and digital tools. Barriers were physiological (pain, weakness, ulcers) and psychological/social (lack of support, isolation, limited knowledge).

Conclusion: Exercise rehabilitation in PAD patients is shaped by diverse facilitators and barriers. Personalized interventions leveraging medical guidance, social support, and digital tools can boost adherence and outcomes. Addressing physiological and psychological barriers is essential for patient-centered rehabilitation. Future efforts should explore scalable, technology-driven solutions to optimize recovery.

Introduction: The delay in children going to the dentist is a significant factor contributing to the deterioration of their dental problems. Additionally, the soothing scent of vanilla, reminiscent of ice cream, and the pleasant aroma of orange can enhance relaxation during dental procedures.

Objective: The present study aimed to determine and compare the effects of aromatherapy with orange and vanilla essential oils on pain and dental anxiety in children undergoing dental procedures.

Methods: The present study was a randomized controlled trial with three parallel groups, two interventions, and a control group. One hundred and twenty-six children undergoing dental procedures were invited to study. Each group received either vanilla, orange, or placebo essence during their dental procedures. Pain, anxiety levels were assessed.

Results: Both vanilla and orange aromatherapy effectively reduced dental pain and dental anxiety in children undergoing dental procedures. Vanilla aromatherapy reduced dental pain (P < .01, ES = 4.67) and dental anxiety (P < .001, ES = 7.05), while orange aromatherapy also significantly reduced dental pain (P < .01, ES = 3.23) and dental anxiety (P < .001, ES = 4.36). Comparisons between the two aromatherapies showed that vanilla was more effective than orange in reducing dental pain (P < .01, ES = 1.70) and dental anxiety (P < .001, ES = 2.74).

Conclusion: Vanilla and orange aromatherapy effectively reduced dental pain and anxiety in children undergoing dental procedures. Therefore, further studies are recommended to investigate the effects of these aromatherapy interventions on children with other oral or dental conditions, aiming to provide more effective supportive care. Caregivers, especially dental clinic nurses, can consider recommending vanilla and orange aromatherapy as supportive measures to help reduce pain and distress during dental treatments.